What is infertility?

Infertility is defined as the inability to conceive a child despite trying for one year.

Is infertility a woman's problem?

It is a myth that infertility is always a "woman's problem." In 50% of all infertility case male is directly or indirectly responsible (referred to as male factors).

What causes infertility in men?

Lifestyle can influence the number and quality of a man's sperm. Alcohol and drugs--including marijuana, nicotine, and certain medications--can temporarily reduce sperm quality. Also, environmental toxins, including pesticides and lead, may be to blame for some cases of infertility.

The causes of sperm production problems can exist from birth or develop later as a result of severe medical illnesses, including mumps and some sexually transmitted diseases, or from a severe testicle injury, tumor, or other problem. Inability to ejaculate normally can prevent conception, too, and can be caused by many factors, including diabetes, surgery of the prostate gland or urethra, blood pressure medication, or impotence.

What causes infertility in women?

The other half of explained infertility cases are linked to female problems (called female factors), most commonly ovulation disorders. Without ovulation, eggs are not available for fertilization. Problems with ovulation are signaled by irregular menstrual periods or a lack of periods altogether (called amenorrhea).

Simple lifestyle factors--including stress, diet, or athletic training--can affect a woman's hormonal balance.

Other problems can also lead to female infertility. If the fallopian tubes are blocked at one or both ends, the egg can't travel through the tubes into the uterus, and abnormalities in the genital tract.

What is endometriosis?

Endometriosis is a condition in which tissue similar to that normally lining the uterus is found outside of the uterus, usually in the ovaries, fallopian tubes, and other pelvic structures. Endometriosis has no single symptom that is diagnostic. Patients with endometriosis may have painful periods, pelvic pain and backache during menses, painful intercourse and infertility.

What are uterine fibroids?

Uterine fibroids are growth that develop from the cells that make up the muscle of the uterus. Thay are also called leiomyomas or myomas. Uterine fibroids are common, benign growths that occur quite often in women. About one in every four or five women has them. Fibroids are most common in women aged 30 - 40, but can occur at any age. Many women who have fibroids are not aware of them because the growth can remain small and not cause a problem. Some symptoms that may occur include bleeding, irregular periods, menstrual pain, abdominal pain, painful intercourse, constipation, miscarriage and infertility.

What is artificial insemination or IUI?

IUI or intra uterine insemination is an in-office procedure that is used to treat a variety of fertility conditions that may include cervical mucus problems, diminished sperm motility and ovulation dysfunction. The procedure involves ovulation monitoring by ultrasound examination, sperm washing and insemination. Sperm washing is done by using protein enhanced mediums and centrifuging - procedures to obtain the best possible motile sperms. The washed sperms are then placed in the uterine cavity for fertilization to occur within the body.

What is in vitro fertilization (IVF) or Test Tube baby?

It is one of the many treatment options available to infertile couples. In Vitro means "in glass" and refers to the fact that fertilization takes place outside of the woman's body. IVF makes it possible to combine sperm and eggs in a laboratory for a baby that is genetically related to one or both partners. The fertilization of eggs and sperms are done in the laboratory resulting in an embryo.

In simple way steps involved are:

First, medication/injections are given to stimulate the ovaries to produce multiple eggs. Once mature, the eggs are suctioned from the ovaries. Procedure called Ovum Pick Up (OPU).

Aspirated eggs are placed in a laboratory culture dish with the man's sperm for fertilization. The dish is then placed in an incubator. Fertilized eggs are called embryos.

About two days later, one to three embryos are transferred back to the woman's uterus, procedure called Embryo Transfer (ET).

If the woman does not become pregnant, tested 14 days after ET, she may have to try again in the next cycle.

Can the IVF cycle be cancelled during a treatment cycle?

The aim of incentive monitoring program is to obtain a good number of healthy mature eggs. Thus if the cycle is unsatisfactory, it may be cancelled at any stage.

Few reasons for this are:

•Too few follicles are developing which would decrease the chance of obtaining at least one mature egg. •There are no follicles developing at all. This is rare but may occur. •Sometimes ovarian cysts develop in response to the drugs. These are not serious or harmful. They usually resolve within one month or may require to be aspirated before starting the stimulation. •Sometimes the patient gets hyperstimulated and it is dangerous to continue the stimulation. •Or if Growth of the endometrium (lining of the uterus) is not satisfactory on the day of ET for implantation. We may in such cases go in for ovum pick up, freeze the resulting embryos and attempt transfer in the next cycle.

Is hospitalization required during the treatment procedure?

No hospitalization is required either for IUI or IVF procedure. You need to come to our centre a few times as outdoor patients but admission is not advised nor required.

What is the time required for IUI/IVF treatment?

IUI treatment is short and requires 2-5 visits during the follicular monitoring prior to IUI, after IUI patient can go home and take a 14 days general rest before a pregnancy test is done.

For IVF, you need to come to the unit as an outdoor patient regularly for 21 days, and take daily injections and undergo monitoring during that time. After the procedure (ET) you may go home and take 14 days general rest, before a pregnancy test is done.