The key to a successful treatment is the correct diagnosis of the cause of infertility. There are many infertility treatments depending on the cause. In 25% of the cases, the infertility cause might be unknown as there is no apparent reason why the couple cannot conceive. Initial treatments refer to treatments by medication and surgery. In some cases, it would be ideal to go through an initial treatment. When these initial treatments fail, assisted reproductive technologies (ART) are the next step to take. However, if the couple, especially the woman is over 35, it can be advised to skip the initial treatment and directly start with ART. Fertility decreases sharply after the age of 35 and infertility treatments will take some time and will get harder with each passing year. Thus, it is logical to skip the initial steps and go for ART right away.
• It takes two to have a baby. Infertility can affect both men and women equally. A decent diagnosis is the key to a successful treatment.
• Infertility is described as the inability to conceive after one year of trying with unprotected intercourse for couples in which the female is under 35 and six months of trying for couples in which the female is over 35.
• Having a baby gets harder as the couple ages, so if you are above 35, do not lose any time.
• About 25% of couples have infertility without an apparent cause.
• Almost 90% of infertility cases can be treated with the aid of medication, surgery or assisted reproductive Technologies.
Initial Infertility Treatments
• Ovulating Problems: Treatment may include taking medicine, such as:
Clomiphene (medication that stimulates ovaries to release eggs)
Metformin (medication used to treat polycystic ovary syndrome)
• Unexplained infertility: If there is no apparent cause for infertility, the following maight be tried before starting with assisted reproductive technologies.
Clomiphene (hormone taken as medication)
• Blocked tubes: If the cause of infertility blocked of one or both of the tubes, a surgery might be the answer.
• Endometriosis: If mild to modera is te endometriosis seems to be the main reason for your infertility, treatment may include laparoscopic surgery to remove endometrial tissue growth. This treatment may not be an option if you have severe endometriosis.
The problems in men is caused by the low number and/or low mobility of sperms. Insemination might be tried after sperm is collected and concentrated to increase the number, and washed to choose the sperms with highest motility and to decrease the risk of infection.
IVF – a modern & high-tech miracle
In vitro fertilisation (IVF) has a quite simple definition; it is a process by which an egg is fertilised by sperm outside the body: in vitro. However, for a couple who has been yearning for a baby, sometimes for years, it is a miracle, that turns a dream into reality. However, in this case, the miracle does not happen by itself, it needs a carefully devised protocol, an experienced team of doctors and a high tech clinic and laboratory.
Success Rate of IVF
Generally, the live birth rate for each IVF cycle is 30 to 35% for women under age 35, 25% for women between the ages of 35 and 37, 15 to 20% for women between the ages of 38 and 40 and 6 to 10% for women after age 40.
The success rates of infertility clinics vary tremendously. Medical technology used in the process as well as the experience of the doctor and clinic play a vital role in the success of the treatment. However, the success rates can be confusing, many factors come into the play. A clinic treating more couples over 40 might be lower than one that treats mostly younger couples. When evaluating a clinic, the age group of couples treated should definitely be taken into consideration.
• Before starting with your treatment, ultrasound and test will be done to determine your protocol (treatment plan)
• Your doctor will give an ultrasound to check if the size of your ovaries are normal.
• If everything looks fine, you are given fertility drugs, that you self-inject, to stimulate egg production. You may be given between 1-4 injections daily for 7-10 days, depending on your protocol. Many women worry about injections before starting with the treatment, however, they are painless and easy to self-apply. Your clinic will give you detailed instructions about how to do these injections. The needles are small and mostly done in the abdomen or in the outer part of the thigh.
• Egg production is monitored regularly with a vaginal ultrasound scan.
• The eggs are then retrieved while the eggs are in the follicles and just before ovulation takes place. You might be under mild sedation (twilight anesthesia) or general anesthetics.
• A sperm sample is taken from the man or sperm from a donor is used around the same time as egg retrieval.
• The sperm and eggs are mixed together in a laboratory; any eggs that become fertilized are called embryos.
• The woman is given progesterone, which helps thicken the lining of the uterus and prepares it for pregnancy.
• One or two embryos are collected and placed, through the vagina, into the uterus with a tiny catheter. This happens around two to five days after the eggs have been collected and fertilised.
• If there are extra embryos, you can freeze them to use in a future date if the cycle does not result in pregnancy or if your are planning a second pregnancy.
• Ten days later, a blood test will be made to find out whether there is a pregnancy.
What to Expect
During IVF treatment, it is understandable to feel stressful have mood swings. The time until embryo transfer, the doctor appointments and injections will keep you busy up to a point, for most women, it is the waiting period after the transfer that is the most stressful. The best way to deal with this is to keep yourself busy. In most cases, there will be no bed rest or severe limitation to your life. Go on with your life, keep doing things you normally would do (except for hard partying or extreme physical activities) that will divert your thoughts from getting pregnant.