Medications are used to stimulate egg production and often used with timed sexual intercourse or insemination. Use of fertility medication ranges from non-invasive oral medicines to injections.
IUI, IVF, ICSI, Assisted hatching, Blastocyst culture, Surgical sperm retrieval, Egg freezing and Embryo freezing are terminologies that couples are well versed with these days. Only an expert would be able to select the process suitable for you, after necessary investigations.
At GynaeGalaxy, we offer each patient personalized, informative care with unique, effective treatment options. Our broad scope of services encompasses all stages of infertility - both male and female. We're here to discuss your condition, consider your lifestyle and needs; and formulate a best, balanced approach for your treatment.
Scheduling a consultation does not commit you to treatment - it simply allows you to make an informed decision by meeting face-to-face with one of our Fertility Expert. You'll have an examination and ultrasound, review of your records, and be able to ask all the questions you've been wondering about.
Ten or more follicles may be encouraged to ripen during stimulation, but this happens during a normal cycle too. The only difference is that most of the follicles die during a normal cycle, leaving only one or two survivors. With ovarian stimulation, they all ripen.In other words, ovarian stimulation saves many of the eggs which would otherwise be lost.
While there may be a specific diagnosis, the combination of fertility drugs and IUI is often suggested to couples with minor sperm abnormalities and also in couples with Unexplained Infertility. Couples are sometimes advised to try a few cycles of this less expensive treatment before undergoing IVF.
IUI (Intrauterine Insemination) is a procedure that places a sperm into the uterus, using a small flexible tube attached to a syringe after washing the sperm to remove bacteria and other debris.
The concept behind IUI is to isolate the motile sperm out of the ejaculate and place many of these sperm high in the reproductive tract. By placing the sperm past the cervix and into the uterus, more sperms will be present in the fallopian tube to fertilize the ovulated egg.
During a normal conception process, the fertilization of egg with the sperm happens in the fallopian tube. If your tubes are blocked, the fertilization of the egg and the sperm will be done in a laboratory (IVF) and the embryo that is formed is transferred into the uterus.
The prospect of daily injections can be overwhelming. While injections are a necessary part of IVF treatment, we've designed our medication schedules and injection type to minimize discomfort and stress; and our nurses carefully instruct and support every patient throughout this process. Injections normally need to be taken over a 10-12 day period.
Egg retrieval process lasts approximately 20 to 30 minutes and sedation is administered. There are no cuts or scars involved in the process. It is done under ultrasound guidance vaginally.
The number of eggs retrieved is related to your age and FSH values. Generally, younger the female partner and lower the day 3 FSH value; greater is the likelihood of retrieving more eggs.
The average number of eggs retrieved in a good prognosis patient is 12. Older patients and/or women with increased FSH levels can expect a lower number of eggs.
Over response (called Ovarian Hyper Stimulation) can be potentially serious and more often than not, it is medically manageable.
The clinic recommends having a minimum of four mature follicles on ultrasound prior to proceeding with egg retrieval. Depending on individual circumstances, several options exist including -
- Continuing with egg retrieval and embryo transfer despite the low number
- Converting to superovulation and intrauterine insemination (IUI), if the fallopian tubes are open and adequate sperm count exists
- Canceling the cycle and restarting another cycle with an alternate protocol.
If no alternate protocol exists, egg donation may be considered.
Many Experts advise bed rest following embryo transfer. But scientific evidence doesn’t subscribe to it. You may need to continue with proper medications after the embryo transfer, as advised by your Doctor.
A woman’s ovaries house hundreds of potential eggs. Each month, during the natural ovulation cycle, the ovary selects just one egg from a pool of 100 - 1,000. Those eggs which are not selected undergo a natural cell death process called atresia. When a woman uses fertility medication, the body’s natural selection process is overridden, and a number of these otherwise unused eggs are allowed to grow. As many as 20 eggs may be stimulated in a given cycle. Thus when using fertility medication in the IVF process, not only is the woman not using up all of her eggs, but she is ‘rescuing’ eggs that otherwise would have undergone atresia.
The ability to use a donor egg has enabled thousands of women to become pregnant when they otherwise might not have had this opportunity. While a woman’s eggs may not be viable, very often the uterus is completely healthy and capable of supporting a pregnancy. In these cases, egg donation with IVF has high success rates.
If it is impossible or unsafe for the woman to carry a pregnancy, some couples enlist the help of another woman to fulfill this function. This 'Surrogate Mother' becomes pregnant with the explicit intention of giving the child to the couple after birth.
Not all embryos survive Freezing and De-Freezing (thawing). The proportion of embryos that will be usable after freezing can be difficult to predict. The healthier the embryos, the better their chance of survival.
In general, the success of frozen thawed embryo transfer procedures depends on three factors -
- Quality and survival of the frozen-thawed embryos. In general, we only freeze good quality embryos so the current rate of survival is greater than 90%.
- Age of the woman who produced the eggs. In patients under the age of 35, the chances of pregnancy with frozen-thawed embryos are similar to a pregnancy with fresh embryos.
- Status of the uterus in the woman receiving the embryos. A healthy endometrial lining free of any interfering fibroids or polyps provides a sound environment for embryo implantation.
Intracytoplasmic sperm injection (ICSI) may be offered, if a woman desires to conceive with her partner's sperm. The other option is using a sperm from a donor to inseminate.
- In about 1% of the IVF cases, 'overstimulization' causes OHSS. This develops when the ovaries become extremely enlarged and extra fluid accumulates in the abdomen. This may require bed rest, intravenous fluids or drainage of the abdominal fluid.
- Multiple pregnancies that might occur in about 5 - 10% of the IVF cases.
In IVF, the sperm is allowed to select the egg for fertilization. ICSI is similar to IVF with the difference being that a single sperm is manually injected into the center of each egg using micro-injection needle.
Sometimes a tubal ligation or vasectomy can be surgically reversed. The chance of success depends on what type of procedure you had, how long ago, and other factors related to fertility in both of you (such as age). Considering the lesser changes of success with surgical reversal vis-a-vis a very high success rate with IVF in such couples, IVF is the treatment of choice.