A woman should be evaluated for any suspected infertility if she is unable to get pregnant after having 12 months of regular and unprotected sexual intercourse. A health care provider will ask basic questions about women health history for exploring root causes of infertility during evaluating of a woman’s fertility health. These questions may include:
- History of past pregnancies
- History of irregular menstrual cycles
- History of abnormal vaginal bleeding or discharge
- Known or suspected problems with the tubes, uterus or other problems in the abdominal cavity
- Prior miscarriage cases
- If she has abnormal vaginal bleeding or discharge
- If she has a history of previous pelvic surgery or pelvic infection
- Known or suspected male infertility problems
The evaluation should include the male as well as female partners and should be performed in a focused way to find all relevant factors for infertility. The least invasive methods should be tried first. The following tests may be performed as part of the infertility evaluation:
Hysterosalpingogram (HSG): A hysterosalpingogram (HSG) is a procedure that uses an X-ray to see if the fallopian tubes are open and to if the shape of the uterine cavity is normal. This procedure usually takes less than 5 minutes and you can go home the same day. This procedure usually has been performed after period but before the ovulation, since it’s less likely that pregnancy occurred during this time.
Transvaginal Ultrasonography: An ultrasound probe is inserted into the vagina that causes sound waves to bounce off organs inside the pelvis to check the uterus and ovaries for abnormalities such as fibroids and ovarian cysts. These sound waves form echoes that are sent to a computer which produces a picture called a sonogram. This test is also called transvaginal sonography and TVS.
Male Partner Semen Analysis: Semen analysis is an important part of the infertility evaluation, although it is obtained from the male partner. A semen analysis provides information about the shape, movement and number of the sperm. A semen analysis is still important even if the male partner has fathered a child before.
Other Blood Tests: Other blood tests can be useful to check prolactin and thyroid-stimulating hormone (TSH) and to identify thyroid disorders and hyperprolactinemia which may cause problems with fertility, repeated miscarriages and menstrual irregularities. A blood test done around day 23 of the woman’s menstrual cycle can identify the amount of a hormone known as progesterone. This test detects whether ovulation has occurred and whether the ovaries are producing normal amount progesterone.
Laparoscopy: Laparoscopy is a surgical diagnostic procedure in which a lighted telescope-like instrument (called laparoscope) is inserted through the wall of the abdomen into the pelvic cavity used to examine the organs inside the abdomen. Laparoscopy allows your doctor to view and analyze inside your body in real time, without open surgery. Your doctor also can receive biopsy samples during this procedure. Laparoscopy should not be the first option in the evaluation of a female patient, as it involved high potential surgical risk and cost. It may be recommended depending on the woman’s health conditions and the results of other tests. How IVF can be a big life changer?
Age is the major risk factor for health problems like the likelihood of chromosomal abnormalities in women. The risk of birth defects or disorders and the risk of miscarriage makes the things difficult for conceiving. Egg freezing is an alternate way to stop the natural biological clock of the body, expand reproductive chances and preserve the younger and possibly healthier eggs. Eggs freezing have become an increasingly attractive option for many women looking to extend their childbearing years. But few things need to know before going for eggs freezing:
Exact meaning of egg freezing: The process of egg-freezing or oocyte cryopreservation in medical language, involved stimulation of the ovaries with hormones to produce multiple eggs, the retrieved eggs are then sent to the lab where they are frozen unfertilized and stored to be thawed at a later date and combined with sperm in a lab and implanted in the uterus for further in vitro fertilization process.
Procedure of egg freezing: The process of retrieving eggs for further eggs freezing is similar to the first phase of in-vitro fertilization (IVF). The doctor will apply anesthesia and vaginal wall be a punctured from a needle. There is a possible risk for infection but the will reduce as far as surgical procedures move forward. To stimulate the ovaries to produce multiple eggs, round of hormone injections given to the woman. For regular monitoring of ovaries by vaginal ultrasound, the stage involves multiple visits to the doctor, about five times in the interval of 10 days. The eggs are retrieved after a week of hormone treatments.The complete egg retrieval process takes about 10 minutes and is done under mild sedation or anesthesia. The doctor guides a needle through the vagina to the ovarian follicle which contains the eggs using an ultrasound. A suction device installed at the end of the needle removes the eggs from the follicles. Retrieving the eggs from ovary is technically similar to that of from getting blood drawn from the body where a needle goes into the ovary the eggs taken out gently.
Associate Risk of Egg Freezing : The complete surgical procedure is almost safe, but risk of ovarian hyperstimulation syndrome or OHSS which create some heath related issues in some women may develop by the hormone shots. That mostly happens when a woman responds too aggressively to the hormones and the ovaries become painful and swollen. But in rare, OHSS increases the risk of blood clots and kidney failure that can be fatal.
Chances of having a baby with my freezing eggs: According to a survey conducted by the American Society for Reproductive Medicine, the chance that a single frozen egg will successfully lead to a pregnancy is about 12 percent. For this reason, it is often recommended to have coupled dozen eggs frozen to maximize the success rate for having baby in later life. Although the success will directly depend on a number of factors like age of woman and the quality of the sperm of her partner.
In-Vitro Fertilization or IVF is an assisted reproductive technology (ART). IVF process required the fertilization by extracting eggs retrieving a sperm sample and then manually combining the egg and sperm in a laboratory dish. The embryo or embryos are then transferred to the uterus after the combination. Gamete intrafallopian transfer (GIFT) and zygote intrafallopian transfer (ZIFT) are other forms of ART.IVF is one of the effective way for treating infertility caused by ovarian disorders, premature ovarian failures or fibroids or blocked fallopian tubes in women and male factor fertility caused by low sperm count.It is also an effective treatment for women who have had their fallopian tubes removes or any other unexplained infertility and male with any genetic disorder.The successful rate for treating infertility with IVF mainly depends on number of factors like causes of infertility and of course, reproductive history, maternal age and lifestyle factors. But in reality, IVF is considered to be an effective treatment for infertility in childless couples.
Process of IVF and embryo transfer
- For stimulating egg production fertility medications are recommended. Multiple eggs may be desired because some eggs will fail to develop or fertilize after retrieval. A trans-vaginal ultrasound has been adopted to examine the ovaries, and blood test samples are collected to check hormone levels.
- With the help of a minor surgical procedure eggs are retrieved through ultrasound imaging to guide a hollow needle through the pelvic cavity to successfully remove the eggs. Medication is advised to reduce and remove further potential discomfort.
- A sample of sperm collected from male, which will be used for combining with the eggs.
- The sperm and eggs are mixed together and collected in a laboratory dish to encourage fertilization and this process is known as insemination. The process of intracytoplasmic sperm injection (ICSI) may be used in some situation where there is a lower probability of fertilization. During this procedure, a single sperm from male is injected directly into the egg in an attempt to achieve successful fertilization.
- Three to five days after the egg retrieval and fertilization the embryos are usually transferred into the woman’s uterus. A small tube or catheter is inserted into the uterus to transfer the embryos. This procedure is free from any sort of pain for most women, although women may experience mild cramping. If the procedure is successful, the implantation normally occurs around six to ten days after egg retrieval.
Side effect of IVF
After the process of IVF most women can start doing normal activities in the following day itself. Some side effects after IVF process include passage of small amounts of fluid in women after the procedure.
The produced fluid can be clear or slightly colored with blood. Bloating and mild cramping can also considered as side effect. Some women also experienced tender at breasts and constipation after the procedure as side effects. Some potential problems like blood in the urine, pelvic pain and fever over 100.5°F and heavy vaginal bleeding should be thoroughly checked by doctor immediately. The side effects of fertility medications may include headaches, abdominal pain, hot flashes and abdominal bloating mood swings or hyper-stimulation syndrome (OHSS).
IVF and IUI are two different ways through which a woman gets pregnant. It entirely depends on the health of the couple as which treatment will be best suited for them. But the guidance of the doctor is very necessary in this concern as they will be able to guide you in a better way. They can tell you about both the options in detail, the results of the treatment and how useful can it be in your case. So all this really helps as couples find the right solution to their problem and are able to benefit from the same.
If you too are struggling between IVF and IUI, here is a little more information about both of them. So let us get started.
IUI – This is the process wherein the male sperms are extracted and then inserted into the woman’s uterus for fertilization. Now this timing is very crucial. That is why the sperms are transferred during the ovulation only as the chances of getting pregnant are very high in this condition. The best thing about this process is that quality sperms are transferred into the body and therefore fertilization takes place properly. In case the male partner is not healthy enough, donors can be used for the sperms. In total you can say that it is a beneficial process and works well if the eggs are in good condition and quality sperms are inserted into the body.
IVF – On the other hand, IVF is quite different from IUI. This is the process in which both eggs and sperms are allowed to fuse outside the body. The woman is given fertility drugs to boost the production of the eggs and the same is extracted and then fused in the Petri dish. The adequate atmosphere is created in the lab so that cell division takes place. When fertilization is done, the same is transferred into the uterus where it grows like a normal pregnancy. In this case both the male and female donors can be used in case the couple eggs and sperms are not healthy.
This is definitely a very good process and does wonders for infertile couples. Sometimes IVF and IUI can be alternate treatments for the couples depending on their physical health. Only correct diagnosis can help in this condition as which of the two treatments will be beneficial. It is your doctor or expert who can best tell you about the benefits of IVF and IUI. Based on their advice you can decide which one you feel makes a better option.
The ultimate motive of any couple is to have a baby and both these treatments are really good. IVF and IUI are really effective in treating infertility and that is why couples wish to give it a try at least once. So what are you waiting for, if you are unable to conceive due to one or more reasons it is high time to consult a good specialist who can tell you which option is a better one. Hope the decision proves helpful to you.
After The IVF: Success Tips By Dr. Shivani Sachdev Gour
Follow us Facebook and Twitter