Pregnancy is the result of a process that has many steps.
Women need functioning ovaries, fallopian tubes and a uterus to get pregnant. Infertility may result from a problem with any or several of the following steps. To get pregnant:
IVF - in vitro fertilization is the most common form of ART - Assisted Reproductive Technology. IVF is a type of assisted reproductive technology used for infertility treatment, a process of fertilization where an egg is combined with sperm outside the body, in vitro "in glass". IVF may be used to overcome female infertility where it is due to problems with the fallopian tubes, making in vivo fertilization difficult.
The process involves monitoring and stimulating a woman's ovulatory process, removing an ovum or ova (egg or eggs) from the woman's ovaries and letting sperm fertilize them in a liquid in a laboratory. The fertilized egg called zygote undergoes embryo culture for 2–6 days, and is then transferred to the same or another woman's uterus, with the intention of establishing a successful pregnancy.
Intracytoplasmic Sperm Injection (ICSI) is a specialised form of In Vitro Fertilization (IVF) which can assist in male infertility, where either the sperm numbers are very low or there is a defect in sperm quality and sperm has difficulty penetrating the egg cell. The sperm is injected directly into the egg cell. The use of ICSI has been found to increase the success rates of IVF.
Infertility refers to an inability to conceive after having regular unprotected sex. Infertility can also refer to the biological inability of an individual to contribute to conception or to a female who cannot carry a pregnancy to full term. In other words infertility refers to a couple that has failed to conceive after 12 months of regular sexual intercourse without the use of contraception.
Studies indicate that slightly over half of all cases of infertility are a result of female conditions, while the rest are caused by either sperm disorders or unidentified factors. Many cases of apparent infertility are treatable. Infertility may have a single cause in one of the partners, or it could be the result of a combination of factors.
In order to retrieve these multiple eggs for IVF, the woman must undergo injections with hormones and careful monitoring of her ovaries by ultrasound and her hormone levels by blood tests every day or every other day until she is ready for the egg retrieval. There are several methods of hormonal stimulation for IVF that basically can be divided into what we call “conventional stimulation” and “minimal stimulation,” or “mini-IVF.”
Eggs are retrieved by ultrasound guided needle aspiration under light sedation (in the operating room). This involves no surgical incision, and virtually no pain afterward. You just leave the hospital directly from the operating room, with no pain, and come back three days later to have the embryo (or embryos) placed very simply into the uterus through the cervix with a tiny catheter. No incision and no anesthetic are needed. An hour later you are able to go home.
Some health problems also increase the risk of infertility.
The fertilized eggs (embryos) continue to grow in the laboratory for up to six days before being transferred into the womb. The best one or two embryos will be chosen for transfer. After egg collection, you will be given hormone medicines to help prepare the lining of the womb to receive the embryo.
Additional Risk factors for women's infertility:
The egg donation process lasts from three to six weeks each times eggs are extracted. Both the donor and the recipient who will carry the fertilized egg to term are given hormone therapy for the first few weeks to get them onto the same reproductive cycle.
The egg retrieval itself is a minimally invasive surgical procedure lasting 20–30 minutes, performed under sedation (but sometimes without any). A small ultrasound-guided needle is inserted through the vagina to aspirate the follicles in both ovaries, which extracts the eggs.
Most experts suggest at least one year for women younger than age 35. However, women aged 35 years or older should consult a doctor after 6 months of trying unsuccessfully.
IVF is never the first step in the treatment of infertility except in cases of complete tubal blockage. Instead, it's reserved for cases in which other methods such as fertility drugs, surgery, and artificial insemination haven't worked. IVF can be used to treat infertility in the following patients:
Female Infertility tests:
There are five basic steps in the IVF and embryo transfer process:
Some side effects of IVF / fertility medications may include:
Some minor discomfort and side effects are expected. Please convey the treating team about the discomfort or symptom you may be facing
There are several ways uterine fibroids can reduce fertility. Changes in the shape of the cervix and uterus can affect the number of sperm that can enter the uterus.
Intrauterine insemination (IUI) is an infertility treatment that is often called Artificial Insemination. In this procedure, specially prepared sperm are inserted into the woman's uterus. The woman may be given a low dose of ovary stimulating hormones.
IUI is more commonly done when the man has a low sperm count, decreased sperm motility, or when infertility does not have an identifiable cause. The procedure is also helpful for males suffering from severe erectile dysfunction. When ovulation occurs, a fine catheter is inserted through the cervix into the uterus to place a sperm sample directly into the uterus. The sperm is washed in a fluid and the best specimens are selected.
Assisted reproductive technology (ART) involves a significant physical, financial and emotional commitment on the part of a couple. Psychological stress and emotional problems are common, especially if in vitro fertilization (IVF) is unsuccessful. As with most medical procedures, there are potential risks like:
Assisted Reproductive Technology (ART) includes all fertility treatments in which both eggs and sperm are handled outside of the body. ART procedures involve surgically removing eggs from a woman's ovaries, combining them with sperm in the laboratory and returning them to the woman's body.
ART procedures sometimes involve the use of donor eggs for the woman who cannot produce eggs (eggs from another woman), donor sperm or previously frozen embryos. Also, donor eggs or donor sperm is sometimes used when the woman or man has a genetic disease that can be passed on to the baby. An infertile woman or couple may also use donor embryos. These are embryos that were either created by couples in infertility treatment or were created from donor sperm and donor eggs. The donated embryo is transferred to the uterus.
You may choose to use donor eggs, sperm, or embryos.
Success rates vary and depend on many factors:
The number of embryos transferred typically depends on the number of eggs collected and maternal age. As the rate of implantation decreases as women age, more eggs may be implanted depending on age to increase the likelihood of implantation. However, a greater number of eggs transferred increases the chances of having a multiples pregnancy. The doctor will discuss the procedure so you both agree on how many embryos to implant.
IVF was traditionally used to help both men and women address infertility issues. Women with missing, damaged, or blocked fallopian tubes were some of the first patients to carry successful IVFs. The egg is fertilized outside the female body and then placed inside the uterus for a more likely implantation.
Based on the couple’s test results and other factors, infertility may be treated with: