Infertility is defined as not being able to conceive a child despite trying for at least a year. According to the American Society for Reproductive Medicine, infertility affects 6.1 million American women and their partners, about 10 percent of the reproductive age population. This infertility percentage is almost the same for Cleveland.
Though this issue concerns most women, it is a myth that infertility is always a woman’s problem. Experts say that 80 percent of cases which was diagnosed with infertility are due to male problems. Infertility may be due to a single cause in either a woman or her partner, or a combination of factors that may prevent a pregnancy from occurring or continuing. According to the NWHRC (National Women’s Health Resource Center), most women in their late 30s are 30 percent less fertile than they were in their early 20s. About 20 percent of infertility cases are the result of fallopian tube disease. It also added that between 30 and 40 percent of women with endometriosis are infertile. In 85 to 90 percent of all cases, infertility is treated with either medication or surgery. However, recent improvements and innovations in medications such as microsurgery, and Assisted Reproductive Technologies (ART) such as In Vitro Fertilization (IVF), make pregnancy possible. There are now more than 45, 000 babies that were born using IVF.
In Vitro Fertilization is a fertility procedure which was first done successfully in 1978 in England by Dr. Robery Edwards, an embryologist and Dr. Patrick Steptoe, a gynecologist. Since then, the technology has been further advanced and developed by physicians and embryologists, with over 20,000 babies born worldwide. The possibility of a continuing pregnancy being achieved through IVF has improved from practically nothing to a one-time chance in 4 to 6 trials.
In Vitro Fertilization: New Hope for Overcoming Infertility
Here's a step by step description of what usually happens during an IVF treatment cycle.1. Fertility assessmentAt your first meeting, the doctor will discuss your medical and fertility history. This will be followed by a fertility assessment of both the partners to determine which treatment process will work best for you and increase your chances of conception. The fertility assessment will include ultrasound, blood tests, determination of sperm count and quality of eggs. IVF treatment is not a painful procedure at all and you needn't worry or be stressed about it, especially in the hands of a good doctor. Also, arrangements will be made for special psychological counselling sessions to help you cope with stress and anxieties regarding your infertility and IVF treatment.2. Ovulation stimulationThis is a standard procedure in IVF treatment or other assisted reproductive methods. Medication and injections are used to induce ovarian follicle development and oocyte maturation. It also prepares a woman's uterus for embryo implantation by supporting the endometrial tissues onto which the embryo will be implanted in case of fertilization. The growth of the follicle and the development of the uterine tissues are monitored by serial ultrasound scanning till the follicle is ready for collection. This process takes about two weeks.After egg collection you will be given medication to support the uterine lining. The medication is given in the form of pessaries, injection or gel.5. Embryo transferEmbryo transfer is normally carried out 48 hours after the egg collection. For this procedure a fine tube (catheter) is passed through the cervix and the embryos are injected high into the uterus in a minute amount of culture medium. This technique does not normally require sedation. Medical support is given for upto 15 days to support implantation.A urine pregnancy test (BhCG) is carried out 15 days after the embryo transfer. If the test is positive, the monitoring continues till the detection of foetal heart beat. If conception does not occur, the cycle is repeated.
- What Happens During IVF Treatment?
In Vitro Fertilization (IVF): What Is It? In Vitro Fertilization is an assisted reproductive technology (ART) commonly referred to as IVF. IVF is the process of fertilization by extracting eggs, retrieving a sperm sample, and then manually combining an egg and sperm in a laboratory dish. The embryo(s) is then transferred to the uterus. Other forms of ART include gamete intrafallopian transfer (GIFT) and zygote intrafallopian transfer (ZIFT). Why is IVF used? IVF can be used to treat infertility in the following patients: Blocked or damaged fallopian tubes Male factor infertility including decreased sperm count or sperm motility Women with ovulation disorders, premature ovarian failure, uterine fibroids Women who have had their fallopian tubes removed Individuals with a genetic disorder Unexplained infertility Find a Infertility Specialist in your area What is involved with in vitro fertilization? There are five basic steps in the IVF and embryo transfer process: Step 1: Fertility medications are prescribed to stimulate egg production. Multiple eggs are desired because some eggs will not develop or fertilize after retrieval. A transvaginal ultrasound is used to examine the ovaries, and blood test samples are taken to check hormone levels. Step 2: Eggs are retrieved through a minor surgical procedure that uses ultrasound imaging to guide a hollow needle through the pelvic cavity to remove the eggs. Medication is provided to reduce and remove potential discomfort. Step 3: The male is asked to produce a sample of sperm, which is prepared for combining with the eggs. Step 4: In a process called insemination, the sperm and eggs are mixed together and stored in a laboratory dish to encourage fertilization. In some cases where there is a lower probability of fertilization, intracytoplasmic sperm injection (ICSI) may be used. Through this procedure, a single sperm is injected directly into the egg in an attempt to achieve fertilization. The eggs are monitored to confirm that fertilization and cell division are taking place. Once this occurs, the fertilized eggs are considered embryos. Step 5: The embryos are usually transferred into the woman’s uterus three to five days following egg retrieval and fertilization. A catheter or small tube is inserted into the uterus to transfer the embryos. This procedure is painless for most women, although some may experience mild cramping. If the procedure is successful, implantation typically occurs around six to ten days following egg retrieval. Side effects of in vitro fertilization Although you may need to take it easy after the procedure, most women can resume normal activities the following day. Some side effects after IVF may include: Passing a small amount of fluid (may be clear or blood-tinged) after the procedure Mild cramping Mild bloating Constipation Breast tenderness If you experience any of the following symptoms, call your doctor immediately: Heavy vaginal bleeding Pelvic pain Blood in the urine A fever over 100.5 °F (38 °C) Some side effects of fertility medications may include: Headaches Mood swings Abdominal pain Hot flashes Abdominal bloating RARE: Ovarian hyper-stimulation syndrome (OHSS) What are the risks associated with in vitro fertilization? As with most medical procedures, there are potential risks. More severe symptoms, typically from OHSS, include the following: Nausea or vomiting Decreased urinary frequency Shortness of breath Faintness Severe stomach pains and bloating Ten-pound weight gain within three to five days If you experience any of these symptoms above, contact your doctor right away. Additional risks of IVF include the following: Egg retrieval carries risks of bleeding, infection, and damage to the bowel or bladder. The chance of a multiples pregnancy is increased with the use of fertility treatment. There are additional risks and concerns related to multiples during pregnancy including the increased risk of premature delivery and low birth weight. Though the rates of miscarriage are similar to unassisted conception, the risk does increase with maternal age. The Mayo Clinic reports that the risk of ectopic pregnancy with IVF are 2-5%. An ectopic pregnancy is when a fertilized egg implants anywhere outside the uterus and is not viable. 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. IVF is expensive, and many insurance plans do not provide coverage for fertility treatment. The cost for a single IVF cycle can range from at least $12,000-$17,000. How successful is in vitro fertilization? The success rate of IVF clinics depends on a number of factors including reproductive history, maternal age, the cause of infertility, and lifestyle factors. It is also important to understand that pregnancy rates are not the same as live birth rates. In the United States, the live birth rate for each IVF cycle started is approximately: 41-43% for women under age 35 33-36% for women ages 35 to 37 23-27% for women ages 38 to 40 13-18% for women ages over 40 What if I don’t produce healthy eggs or my husband is sterile? You may choose to use donor eggs, sperm, or embryos. However, make sure to talk with a counselor experienced with donor issues. You will want to be informed about various legal issues related to gamete donation including the legal rights of the donor. How many embryos should be created or transferred? 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. Make sure to talk with your doctor before the procedure so you both agree on how many embryos to implant. How do I choose an infertility clinic? There are a number of questions to ask regarding the cost and details of specific centers and fertility programs. Some suggested questions are available online in Selecting Your ART Program. Some couples want to explore more traditional or over the counter efforts before exploring infertility procedures. If you are trying to get pregnant and looking for resources to support your efforts, we invite you to check out the fertility product and resource guide provided by our corporate sponsor. Review resource guide here. However, if you are looking for testing or options to increase your fertility chances of conception, you can find a fertility specialist with the search tool below: Find a Infertility Specialist in your area Last updated: March 12, 2017 at 23:21 pm Compiled using information from the following sources: 1. American Society for Reproductive Medicine. (2014). Gamete and embryo donation: Deciding whether to tell. https://www.asrm.org/FACTSHEET_Gamete_Donation_Deciding_Whether_To_Tell/ 2. Human Fertilisation & Embryology Authority. (2014). IVF – What is in vitro fertilisation (IVF) and how does it work? http://www.hfea.gov.uk/IVF.html 3. Human Fertilisation & Embryology Authority. (2014). Risks of fertility treatment. http://www.hfea.gov.uk/fertility-treatment-risks.html 4. MedlinePlus. (2014). In vitro fertilization (IVF). http://www.nlm.nih.gov/medlineplus/ency/article/007279.htm 5. Mayo Clinic. (2013, June 27). In vitro fertilization (IVF). http://www.mayoclinic.org/tests-procedures/in-vitro-fertilization/basics/definition/prc-20018905 6. RESOLVE: The National Infertility Association. (n.d.) IVF/ART. http://www.resolve.org/family-building-options/ivf-art/