Faqs : Infertility Treatment

Learning Infertility

What is Infertility?

It is a disease of the reproductive system that impairs the body ability to perform the basic function of reproduction.

2. What are various causes of infertility?

In one third cases it is female factor, in other one third it is male factor and in rest one third it is combined male and female factor and in nearly 20-25% of cases there is no cause responsible for infertility what is known as Unexplained subfertility(Infertility).

3. What are various male problems responsible for infertility?

Anejaculation, retrograde ejaculation, poor sperm number, poor sperm movement, poor sperm morphology.

4. How to decide if one should go for IUI or IVF/ICSI?

Trying to find the cause of infertility will help to decide the better course of action. Hence it is important to get fertility Check up done to find the exact nature of the problem.

5. Is IVF a painful procedure?

Infertility is an emotioanl journey. Treatment for infertility in the form of IVF brings in a component of commitment, time management and above all hope. It often creates one of the most distressing life crises a couple has faced. It can evoke significant feelings of loss. Many couples experience anxiety, depression, and feelings of being out of control or isolated. Hence it is important to discuss it fully before proceeding with this treatment option.

6. What if my eggs do not respond to injections of ovarian stimulation?

A response to ovarian stimulation depends on a number of different factors, the most important include available eggs, appropriate hormone levels, proper administration of any medications and lifestyle/environmental factors.

7. What if our eggs and sperms don’t fertilize well?

This could be due to either problem in the eggs or in the sperm. Please speak to your doctor or embryologist as to what can be done for optimization.

8. Should we undergo genetic testing?

Genetic testing is generally recommended if you have a family history or a child affected with genetic disorder. Genetic screening is also done if it is advanced age for the female partner, as it is known that risk of genetic problems increase with increasing maternal age.

9. How is infertility diagnosed?

Basic test for female is to assess Ovarian Reserve and in males is analysis of Semen.

10. What is Ovarian Reserve testing?

Ovarian reserve refers to the reproductive potential left within a woman's ovaries based on number and quality of eggs. In order to respond to ovarian stimulation, a woman must have eggs available to respond. A diminished ovarian reserve is assessed by

  1. High blood levels of follicle stimulation hormone (FSH)

  2. Low blood levels of anti Müllerian hormone (AMH)

  3. Low antral follicle count (AFC) in an ultrasound

For these patients, an alternate stimulation protocol may be tried or donated eggs may be used to achieve pregnancy.

Advanced Queries- about IVF

1. What is the maximum age for IVF?

Most US IVF clinics have an upper age limit for allowing IVF treatment using "own eggs"of somewhere between 42 and 45 years of age.

2. Is IVF more successful second time?

One IVF pregnancy raises chance of second time success. Women who miscarry during their first IVF cycle still have a higher chance of a live birth with subsequent treatment, compared with women who do not get pregnant after their first round.

3. How many eggs does a woman have at 50?

Over the course of a lifetime your ovaries will release about 500 eggs in their mature form. When the supply of eggs runs out, your ovaries cease to make estrogen, and you will go through the menopause. For most women this happens around the age of 50: the average age in the developed world is 51.4 years.

4. What tests are done before IVF?

Before beginning IVF, women will first undergo ovarian reserve testing. This involves taking a blood sample and testing it for the level of follicle stimulating hormone (FSH). The results of this test will give your doctor information about the size and quality of your eggs.

5. How many eggs does a woman have at 37?

Women are born with approximately two million eggs in their ovaries, but about eleven thousand of them die every month prior to puberty. As a teenager, a woman has only three hundred thousand to four hundred thousand remaining eggs, and from that point on, approximately one thousand eggs are destined to die each month.

6. Are IVF babies normal?

About 5 million kids worldwide have been born from IVF, says Dr Puneet Rana Arora, and most are healthy. ... Based on the available data, “in general we tell parents that IVF is safe and to a large degree, babies born from IVF are healthy and grow into healthy adults,”.

7. What can be possible reasons for IVF/ICSI failure?

No treatment related to assisted reproduction gives guarantee of conception. IVF/ICSI among all available procedure gets the highest probability of achieving pregnancy in one month. Possible reasons for failure of treatment could be –

  1. Low egg number – Not enough eggs are formed in response to the hormone injections. Most common reason is due to low ovarian reserve but can also be due to some faults in the receptors of gonadotophins.

  2. Failure of retrieval of eggs during egg collection.

  3. Failure of eggs to fertilise with sperm. This can happen either because of weak eggs or abnormal sperms.

  4. Very poor sperm count and abnormal shape of sperms on the day of egg collection /fertilisation.

  5. Failure of fertilised egg(embryos) to reach to good quality embryos or failure of these embryos to devide or cleave.

  6. Some cases may have no explanation for failure of pregnancy despite transfer of morphologically good looking blastocysts and good and adequate uterine texture and thickness. Please discuss with Dr Puneet as to options available in such cases as to further managing such cases and optimising pregnancy outcomes. Dr Puneet conducts a specialized implantation failure clinics . Please get in touch with us to know further about this specialized clinic.

General Queries- About IVF Procedure in India

1. How long do you have to wait between IVF transfers?

The answer is again a very firm no! Implantation usually takes place within 48 hours from transfer. Our recommendation, therefore, is to take it easy for 2-3 days after the embryo transfer, but after that time period, it is perfectly fine to resume working.

2. What should I avoid during IVF?

Add in legumes, including beans, chickpeas, and lentils. Eat healthy fats, such as avocado, extra-virgin olive oil, nuts, and seeds. Avoid red meat, sugar, refined grains, and other highly processed foods.

3. What is the success rate of IVF on the first try?

The good news is that IVF is generally successful, especially for women under age 35 and those using donor eggs. For women of all ages, the odds of a live birth are between 34 and 42 percent over three cycles.

4. How can I improve my IVF success?

To Increase Your Chances of IVF Success:

  1. Maintain a healthy weight
  2. Optimize sperm health
  3. Partner with an excellent doctor and embryology laboratory
  4. Reduce your stress
  5. Quit smoking
  6. Look into taking supplements
  7. Ensure you have adequate levels of vitamin D
  8. Focus on persistence and patience

5. Can i fly / travel by car after embryo transfer?

Air travel doesn't impact pregnancy rates following an IVF cycle. However, if possible, we do recommend staying close to one of our fertility centers, particularly in the nine to 11 days between your embryo transfer and pregnancy test.

6. Do you gain weight during IVF?

It's important to keep in mind that this weight gain is usually minimal -- five to ten pounds at most. ... Most IVF weight gain is related to water retention, so you may notice that your weight fluctuates more during an IVF cycle. Once you're no longer using IVF drugs, the weight should come off fairly easily.

7. Can you drink coffee during IVF?

Drinking large amounts of coffee may hurt a woman's chances of becoming pregnant through in vitro fertilization (IVF), a new study from Denmark suggests. ... Drinking between one and five cups of coffee a day did not affect women's chance of pregnancy with IVF.

8. Does Pineapple help IVF implantation?

There is the one that everyone knows, that if you eat pineapple core after an IVF embryo transfer, it can help with implantation. The theory is that pineapple (especially the core) contains something called bromelain. ... It's everywhere on infertility chat boards, fertility memes and IVF Instagram accounts.

9. What is pooling of Embryos?

Pooling of embryos is a treatment option where embryos are collected from few cycles of stimulation. This would mean a woman undergoes multiple cycles of stimulation with one Embryo transfer procedure. The aim of this procedure is to generate enough number of embryos either suitable for a blastocyst transfer or for a genetic analysis. 
This is normally recommended to women either with low ovarian reserve where number of embryos in one month is less or in cases where couples are contemplating genetic analysis where a certain number of embryos are needed to get some normal embryos for transfer.
Please speak to your doctor whether you will be suitable for this kind of treatment.

10. Why egg number and quality decrease with age?

A women is born with a fixed number of eggs at birth which undergo a process of auto destruction called as apoptosis. Every month a certain number of eggs come out of the pool for growth and ovulation once puberty is achieved. This number is known as antral follicular count (AFC). So, over women's reproductive lifespan there is decline in this pool of egg number. When ovarian reserve starts declining, antral follicle also starts declining. IVF/ICSI also does not increase the egg reserve and hence, has no effect on antral follicular count.