There are several options to assisted reproductive technologies ranging from simple ovulatory enhancing drugs such as clomiphene (oral tablet, commonly taken for 5 days from day 3-5 of the cycle) to very high tech methods such as intracytoplasmic sperm injection (ICSI) and IVF.
Step 3: Looking at the assisted reproduction options
Depending on a couple's medical history and the status of the male's fertility, a couple having difficulty conceiving may be recommended clomiphene as a first resort to stimulate the ovaries to produce more eggs and increase the chances of conception. If this does not work after a few cycles, intra-uterine insemination (i.e. IUI) with clomiphene or another (more potent) fertility drug may be recommended. If this too is unsuccessful, after a few cycles using this approach the next resort is in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI).
The basic premise of IVF or ICSI is that the fertilization process (union of the sperm and egg) and embryo transfer process (placement of the embryo into the uterus) is aided by a fertility clinic laboratory. The IVF technique was initially designed for treatment of women with tubal infertility since the fallopian tubes are bypassed entirely with IVF. Eggs are retrieved from the body and inseminated in a lab with semen from a partner or a donor. In cases where egg and/or sperm donors are necessary, your fertility specialist will be able to guide you through and further explain the process prior to the beginning of a treatment cycle.
The exact process used depends on the type of infertility problem and clinic preferences. However, once the appropriate sperm and egg have been collected, they are placed in growth media containing special nutrients that allow them to live outside the body. In standard IVF, the sperm is placed into the dish containing the egg. Some fertility clinics perform ICSI routinely for reasons other than male infertility. Using this technique one sperm is drawn up in a needle and then injected into the egg. Irrespective of which procedure is used, within 18 hours, doctors can determine if fertilization has occurred and in 24 to 72 hours, it is possible to know if the embryo is growing. If so, the embryo is allowed to continue grow and divide in the laboratory in the special culture media. The resulting embryos are transferred to the uterus in a separate procedure.
Today's embryo culture systems allow the embryos to develop to the blastocyst stage (days 5-7). This allows embryos to further divide for an extra 2-3 days thus enabling a process of natural selection to determine the best embryo(s) to use for the transfer. This is particularly useful because on average only 40-50% of embryos will reach the blastocyst stage.
The number of embryos to be transferred after fertilization depends on the number and quality of the embryos and the clinic policy. The current trend is to transfer one good embryo to reduce the risk of multiple pregnancy. Any surplus embryos can be preserved for later cycles. Two weeks after transfer a pregnancy test will be done to confirm the success of the procedure.
There a few options and variations through the process of using assisted reproductive technologies and the best for you and your partner's circumstances will be dependent on your current situation and previous medical history. Your fertility specialist will be able to guide you through these important decisions.
Fertility problems can leave some couples feeling hopeless and powerless regarding their situation and many dislike the "out of control" feeling they describe as being an overwhelming companion in their journey. Hopefully you will not reach this point, or if you have, it is important to know you can take control by educating yourself on the options you have available. In addition, remember that by taking a comprehensive, step-by-step approach towards optimising you and your partner's general health prior to a conception attempt will help boost your natural fertility and dramatically increase your odds of creating a healthy conception, pregnancy and baby naturally or via assisted methods.
Copyright (c) 2009 Gabriela Rosa and Natural Fertility & Health Solutions P/L.
Leading Sydney-based natural fertility specialist, researcher and author Gabriela Rosa is devoted to helping bring healthy babies into the world and empower individuals through better health. Boost your natural fertility, get pregnant fast, increase the odds of IVF, prevent miscarriages and take home a healthier baby - click here for FREE fertility advice and your FREE Natural Fertility Booster ezine subscription.
