Fertility With Vitro Fertilization IVF Treatment For Women IVF Fertility In Vitro Fertilization IVF
November 3, 2019
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Treatments of infertility for Men This will depend on many factors, including
the age of the patient(s), how long they have been infertile, personal preferences, and
their general state of health. Even if the woman has causes that cannot be corrected,
she may still become pregnant. Frequency of intercourse
The couple may be advised to have sexual intercourse more often. Sex two to three times per week
may improve fertility if the frequency was less than this. Some fertility experts warn
that too-frequent sex can lower the quality and concentration of sperm. Male sperm can
survive inside the female for up to 72 hours, while an egg can be fertilized for up to 24
hours after ovulation. Fertility treatments for men
• Erectile dysfunction or premature ejaculation – medication and/or behavioral approaches can
help men with general sexual problems, resulting in possibly improved fertility.
• Varicocele – if there is a varicose vein in the scrotum, it can be surgically removed.
• Blockage of the ejaculatory duct – sperm can be extracted directly from the testicles
and injected into an egg in the laboratory. • Retrograde ejaculation – sperm can be
taken directly from the bladder and injected into an egg in the laboratory.
• Surgery for epididymal blockage – if the epididymis is blocked it can be surgically
repaired. The epididymis is a coil-like structure in the testicles which helps store and transport
sperm. If the epididymis is blocked sperm may not be ejaculated properly.
7 Fertility treatments for women Ovulation disorders – if the woman has an
ovulation disorder she will probably be prescribed fertility drugs which regulate or induce ovulation.
These include: • Clomifene (Clomid, Serophene) – this
medication helps encourage ovulation in females who do not ovulate regularly, or who do not
ovulate at all, because of polycystic ovary syndrome (PCOS) or some other disorder. It
makes the pituitary gland release more FSH (follicle-stimulating hormone) and LH (luteinizing
hormone). • Metformin (Glucophage) – women who have
not responded to Clomifene may have to take this medication. It is especially effective
for women with PCOS, especially when linked to insulin resistance.
• Human menopausal gonadotropin, or hMG, (Repronex) – this medication contains both
FSH and LH. It is an injection and is used for patients who don’t ovulate on their own
because of a fault in their pituitary gland. • Follicle-stimulating hormone (Gonal-F,
Bravelle) – this is a hormone produced by the pituitary gland that controls estrogen production
by the ovaries. It stimulates the ovaries to mature egg follicles.
• Human chorionic gonadotropin (Ovidrel, Pregnyl) – this medication is used together
with clomiphene, hMG and FSH. It stimulates the follicle to ovulate.
• Gn-RH (gonadotropin-releasing hormone) analogs – for women who ovulate prematurely,
before the lead follicle is mature enough during hmG treatment. This medication delivers
a constant supply of Gn-RH to the pituitary gland, which alters the production of hormone,
allowing the doctor to induce follicle growth with FSH.
• Bromocriptine (Parlodel) – this drug inhibits prolactin production. Prolactin stimulates
milk production in breast feeding mothers. If non-pregnant, non-breast feeding women
have high levels of prolactin they may have irregular ovulation cycles and have fertility
problems. Risk of multiple pregnancies Fertility treatments
Injectable fertility drugs can sometimes be the victims of their own success and cause
multiple births – when the woman gets pregnant she has twins, triplets, or perhaps more babies
in one go. Oral fertility drugs also raise the risk of multiple pregnancies, but much
less so than injectable ones. It is important to monitor the patient carefully during treatment
and pregnancy. The more babies the mother carries inside her the higher is her risk
of premature labor. If a woman needs an HCG injection to activate
ovulation and ultrasound scans show that too many follicles have developed, it is possible
to withhold the HCG injection. Couples may decide to go ahead regardless if the desire
to become pregnant is very strong. Multifetal pregnancy reduction is possible
if too many babies are conceived – one or more of the fetuses is removed. Couples will
have to consider the ethical and emotional aspects of this procedure.
Surgical procedures for women • Fallopian tube surgery – if the fallopian
tubes are blocked or scarred surgery may repair them, making it easier for eggs to pass through
them. • Laparoscopic surgery – a small incision
is made in the woman’s abdomen. A thin, flexible microscope with a light at the end (laparoscope)
is inserted through the incision. The doctor can then look at internal organs, take samples
and perform small operations. For women with endometriosis, laparoscopy removes implants
and scar tissue, reducing pain and often aiding fertility.
Assisted conception IUI and IVF The following methods are currently available
for assisted conception. IUI (intrauterine insemination)
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.
This procedure must be done when ovulation occurs. 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.
IVF (in vitro fertilization) IVF in action
Sperm are placed with unfertilized eggs in a Petri dish; the aim is fertilization of
the eggs. The embryo is then placed in the uterus to begin a pregnancy. Sometimes the
embryo is frozen for future use (cryopreserved). Louise Joy Brown, born in England in 1978,
was the world’s first IVF baby. Before IVF is done the female takes fertility drugs to
encourage the ovaries to produce more eggs than normal.
Time-lapse imaging triples the chances of having a baby for couples undergoing IVF treatment,
researchers reported in Reproductive BioMedicine Online (May 2013 issue). Described as a “major
breakthrough”, time-lapse imaging became available in 2013 in the UK for monitoring the development
of IVF embryos before they are implanted in the womb.
In an Abstract in the journal, the authors wrote “Time-lapse imaging of human preimplantation
IVF embryos has enabled objective algorithms based on novel observations of development
(morphokinetics) to be used for clinical selection of embryos.”
With this new technique, the scientists could develop a way of accurately identifying which
embryos are more likely to have aneuploidy (abnormal chromosomes). Embryos with aneuploidy
are much less likely to be successfully implanted. The researchers, from CARE Fertility, said
further large-scale studies are needed to confirm their findings.
Researchers from Mount Sinai Hospital in Toronto, Canada, reported in CMAJ that IVF is more
successful if the woman has sufficient levels of vitamin D.
A study published in the Journal of Clinical Endocrinology & Metabolism (JCEM) found that
women who are deficient in vitamin D are half as likely to conceive using IVF compared with
women without vitamin D deficiency. ICSI (Intracytoplasmic sperm injection)
A single sperm is injected into an egg to achieve fertilization during an IVF procedure.
The likelihood of fertilization improves significantly for men with low sperm concentrations.
Donation of sperm or egg If there is either no sperm or egg in one
of the partners it is possible to receive sperm or eggs from a donor. Fertility treatment
with donor eggs is usually done using IVF. In the UK and a growing number of countries
the egg donor can no longer remain anonymous – the offspring can legally trace his/her
biological parent when reaching the age of 18.