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What is IVF?

IVF is the process of fertilisation by extracting eggs, retrieving a sperm sample, and then manually combining an egg and sperm in a laboratory. The embryos are then transferred to the uterus.

What impacts IVF success rates?

Some of the main factors for IVF success are the age of the woman and the sperm quality. While younger women have higher chances of success, the chances reduce with age-related decline in the quality as well as the quantity of eggs.

What is Fertility?

In cases where the male and female reproductive systems are functioning well, the female ovum is fertilized by the male sperm which forms an embryo. This embryo in 40 weeks’ time in a mother’s womb, is delivered as a baby.

However, if either the male or the female reproductive system is not functioning well, the embryo does not form. So, the couple cannot have a baby without the help of fertility treatments.

Some of the problems and treatments related to fertility are listed below.

Female Infertility

A woman is considered to have fertility problems if she is not able to conceive naturally even after trying for a year or has frequent miscarriage. The most common reasons for female infertility are:

  • not ovulating (releasing eggs)

  • blocked fallopian tubes so sperm can’t meet the egg

  • eggs are of poor quality

  • shape of the uterus makes it hard for a fertilized egg to implant

  • endometriosis

Symptoms / when to call your doctor

A couple can seek the help of a doctor if they are not able to conceive even after trying for a year.

Why you should see a doctor?

If the woman has fertility problems, she may not be able to conceive without seeking a doctor’s advice.

How is it diagnosed?

There are various tests that the doctor does to find the exact reason as to why the woman is not able to conceive. Some of them are:

  • Pelvic examination

  • Ultrasound

  • Ovulation tests

  • Testing the cervical mucus

Treatment for Female Infertility

Depending on the cause of infertility, the doctor will suggest an appropriate treatment. If there is a hormonal problem, it can be resolved using medication.

Types of treatments

There are two treatments which are most popular. They are:

Intrauterine Insemination

This is a simple procedure which allows the sperm to reach the egg more easily.

Flow of the procedure

  • Semen is collected from the man

  • ‘Sperm washing’ is done to separate healthy sperm

  • The sperm is directly put into the uterus

  • The sperm then, fertilizes the egg to form an embryo

Recovery Time

It’s an outpatient procedure taking just over an hour

Risks involved in the treatment:

Some of the risks of this treatment may be:

  • Infection

  • Spotting or light bleeding

  • Multiple pregnancies

In vitro Fertilization

In this procedure, the eggs and sperm are placed together and the embryo formation happens in a lab.

Flow of the procedure

  • Eggs are retrieved from the woman and sperms from the man

  • They are placed together in a dish and in a favourable atmosphere

  • Usually, multiple embryos form

  • These embryos are planted back into the uterus of the woman

  • When, one of the embryos sticks to the wall of the uterus, the process is successful

Recovery Time

The entire process takes about 3 weeks’ time. Both egg retrieval and placing embryos into the uterus are outpatient procedures taking about 20 minutes each.

Risks involved in the treatment:

Some of the risks of this treatment may be:

  • Miscarriage

  • Birth defects in the baby

  • Premature delivery

  • Low birth weight of the baby

  • Multiple births

Laparoscopic Surgery

This surgery is performed to resolve abnormalities like scar tissue, fibroids or endometriosis in the female reproductive system. It is performed using a laparoscope with minimal incisions and hence, you can expect a quick recovery.

Flow of the procedure

  • Patient is given general or local anaesthesia

  • Few small incisions are made in the abdomen

  • A laparoscope is inserted through one of the incisions

  • Observing the images appearing on the screen from the laparoscope camera, the doctor removes the scar tissue, fibroids or endometriosis.

  • The incisions are sutured or taped

Recovery Time and Dietary Advice:

  • Outpatient procedure or overnight stay at the hospital

  • Complete recovery takes about a couple of weeks

  • No dietary restrictions as such for this procedure

Risks involved in the treatment:

The procedure may lead to few risks like:

  • Allergic reactions

  • Blood clots

  • Infection

  • Nerve damage

  • Swelling due to blood outside a blood vessel

Hysteroscopic Surgery

This surgery is also done to correct any abnormalities in the female reproductive system like removing polyps, scar tissue or fibroids. In this procedure, a thin long instrument called hysteroscope is inserted through the vagina to perform the procedure.

Flow of the procedure

  • Patient is given general or local anaesthesia

  • A hysteroscope is inserted through the vagina

  • The abnormalities are removed using small instruments

Recovery Time and Dietary Advice:

  • Outpatient procedure or overnight stay at the hospital

  • Complete recovery takes about a couple of weeks

  • No dietary restrictions as such for this procedure

Risks involved in the treatment:

The procedure may lead to few risks like:

  • Damage to the cervix

  • Damage to other nearby organs like ovaries, bladder or bowel

  • Infection

  • Allergic reaction to anaesthesiae

Tubal Surgery

This procedure is done when there is a problem in the fallopian tubes. Based on the problem, different surgeries are performed. They are:

  • Fallopian Tube Recanalization: This is done when there is a blockage in the fallopian tube. Using a catheter, a dye is inserted into the tubes to remove the blockage.

  • Tubal Ligation Reversal Surgery: If the fallopian tubes had been tied previously to avoid pregnancy, this procedure reconnects the tubes to allow the egg to pass thereby, making it possible for the woman to get pregnant again.

  • Salpingostomy: This procedure is done when one or both the fallopian tubes are blocked and swollen with fluid. The doctor operates on the tubes and removes the fluid and thereby, the blockage and swelling.

  • Salpingectomy: This procedure is done to improve the efficiency of the in vitro fertilization process. In this, the fallopian tubes are removed by putting a loop around them and tightening it so as to cut them off.

  • Fimbrioplasty: If the blockage in the fallopian tube is close to the ovary, this procedure is used. Fimbriae are finger like projections in the tube. These pick up the egg once it is released. The doctor will clear the blockage and rebuild the fimbriae during this procedure.

Flow of the procedure

  • Patient is given local anaesthesia for this procedure

  • All these surgeries can be performed by opening up the abdomen or using a laparoscope

  • The doctor reaches the fallopian tubes through the incision

  • The required correction in done

  • The incision is closed

Recovery Time and Dietary Advice:

  • An open surgery takes time to heal requiring a hospital stay of 2-3 days whereas for a laparoscopic surgery, 1-2 days of hospital stay is required

  • Resuming normal routine takes a couple of weeks

Risks involved in the treatment:

There are some risks associated with this procedure. They may be:

  • Pelvic infection

  • Ectopic pregnancy

  • Scarring

  • Infection

Male Infertility

Male infertility is another reason why some couples can’t conceive naturally. Hormonal imbalances, lifestyle choices like smoking and infections can be causes of infertility.

Diagnosis:

Male fertility can be diagnosed by tests like:

  • Semen analysis

  • Scrotal ultrasound

  • Genetic tests

  • Biopsy

  • Urinalysis

Treatment:

For infections and hormonal imbalances, medication is given to resolve the infertility issue. Lifestyle changes are also recommended to improve fertility of the sperm.

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