When we talk about infertility attention usually falls on treatment for women. However, infertility can affect men as well. The condition of infertility, can be described as the inability to become pregnant for a period of 1 year despite having unprotected, well-timed sexual intercourse. A low sperm count is one of the primary reasons for infertility in men.

Typically there should be fifteen million sperm per milliliter of semen. Low sperm count refers to the ejaculation of less than a normal amount of sperm in semen. This can also be termed as oligospermia. A complete absence of sperm in semen is known as azoospermia. Low sperm count does not mean that you cannot impregnate your partner but it reduces the chance of a successful conception. Thus, one of the most common ways to treat infertility caused by low sperm count is IVF.

IVF involves harvesting eggs from the woman s uterus and sperm from the male partner and combining them in a laboratory to form a zygote. When IVF is used to treat male infertility, a semen analysis is the first step. This helps determine the patient s sperm count, sperm motility, volume, pH levels, white blood cell levels etc.
The ejaculated semen is then processed so as to separate the sperm cells from the plasma. In this process sperm cells with higher motility are identified and segregated. These cells have a higher chance of fertilizing the egg.
Sperm cells are then injected into the harvested egg. Some techniques may require the injection of 50,000 or more sperm cells while others such as intracytoplasmic sperm injection (ICSI) can be effective with a single sperm cell. Once the egg is fertilized, it is allowed to develop for a few days in the laboratory. 
Two or three embryos are then selected to be reintroduced into the woman s uterus with the help of a catheter. The remaining fertilized embryos are preserved in an embryo bank in case the pregnancy is not successful. If these need to be used later, the woman does not have to go through the initial stages of IVF treatment to stimulate the follicles and harvest eggs from the ovaries.
When it comes to IVF, the success rates are very high. However, one of the most common side effects is the birth of twins or triplets. This is because multiple embryos are inserted into the uterus. The number of babies born then depends on the number of embryos that are implanted successfully.

Declining Sperm Count - How IVF Can Help Deal With It?

When a childless couple is not able to conceive, there are myriad paths that the couple may follow to obtain a solution. If IVF does not help the couple, then they can go in for surrogacy. In this method, another lady conceives, carries and gives birth to the baby created by the sperm and eggs of the intended parents. Let us find out more about surrogacy today.

Who can use it?
Surrogacy can be availed by couples who are not able to conceive due to many conclusive reasons including the absence of a womb or the malfunctioning of the same. Also, recurrent miscarriages can be one of the reasons. Further, a couple who has been through IVF or In Vitro Fertilisation implantation failure a number of times can opt for surrogacy.

How does it Work?
Full surrogacy, as it is known, is a process of implanting an embryo in a host body. This embryo is usually created using the egg and the sperm of the parents, or even a fertilised egg that has been donated by a donor, which is then fertilised using the sperm from the intended father. Also, this embryo may be created by using donor eggs and donor sperms. Partial surrogacy is also a method that may be used. When artificial insemination or intrauterine insemination (IUI) is used to create an embryo with the sperm from the intended father and the egg from the surrogate mother, then the process is known as partial surrogacy.

Chance of having a baby with surrogacy
The chance of having a baby with surrogacy depend on various factors. It depends on the ability of the surrogate to get pregnant, as well as her overall health. Before choosing a surrogate, it is important to put her through all the necessary tests to ascertain a good state of health. Further, the age of the egg donor is also a factor in such cases. The success of related procedures like IVF or IUI will also determine the chances of conception through this method. Furthermore, the quality of the elements used by the couple or the intended parents will also make a difference to the process and its efficacy. Yet, the most important factor includes the age of the woman whose egg is being used.

Difference between IVF and Surrogacy
In IVF, the eggs are gathered from the woman and the sperm is taken from her partner before an embryo is created and affixed in the uterus of the intended mother. In surrogacy, it is actually another woman who carries this lab-created embryo through methods like artificial insemination. The sperm may come from the father and the egg may be donated by someone else, in many cases involving full or partial surrogacy.

What is Surrogacy and how it is different from IVF

The fallopian tubes are not mere passages for the egg to travel from the ovaries to the uterus. It is here that conception occurs and hence healthy fallopian tubes are essential for the fertilization of an egg. 

Damaged fallopian tubes are the most common cause of infertility. This damage can fall under three categories. 

 Blocked fallopian tubes
 One blocked and one open fallopian tube
 Tubal scarring

The third is usually an effect of pelvic infections or natural healing after a pelvic surgery. Sadly, in most cases, this condition is discovered only after infertility has been diagnosed. Other causes of fallopian tubal scarring include:

 Stds such as chlamydia trachomatis and neisseria gonorrhea
 Adhesions caused by ruptured ovarian cysts
 Appendicitis
 Peritonitis
 A history of ectopic pregnancies

Fallopian tubal scarring has no recognizable symptoms. Chronic pelvic pain is the only known symptom of this damage and that too can be seen only in severe cases of tubal scarring. On diagnosing infertility, your doctor will perform one of these tests to determine the condition of your fallopian tubes.

 Hysterosalpingogram: this is a type of x-ray. Your doctor will open the vagina with a speculum and inject a liquid into the uterus with the help of a catheter. If the liquid does not pass through the fallopian tubes, it is said to be blocked. This however, does not say much about tubal scarring.
 Laparoscopy: a small incision is made below the belly button and a slim, flexible tube with a camera is passed through the incision. This gives your doctor a clear view of the condition of your fallopian tubes. A laparoscopy can also be used to rule out other causes of infertility such as endometriosis or blocked fallopian tubes. 

Treatment for infertility caused by tubal scarring is of two types:

 Surgery: this is suggested in cases where tubal scarring is minimal. Depending on the intensity and placement of scar tissue, your doctor may decide to perform one of many types of surgeries. He may choose to remove the scarred section of the fallopian tube, create a new opening (in case of blockages) or rebuild the damaged edges of the fallopian tubes.
 In vitro fertilization (ivf): women with badly scarred fallopian tubes usually have poor chances of conceiving naturally. Hence, ivf is the preferred treatment route. However, your doctor may still advise you to undergo surgery and remove the damaged tubes prior to ivf to prevent the tubes from filling with fluid.

Tubal Scarring and Infertility

In vitro fertilization (IVF) is a process of fertilization in which eggs (ova) from a woman's ovary are removed. They are combined with sperm outside the body in a laboratory procedure, and then the fertilized egg (zygote) is transferred to the same or another woman s uterus for a successful pregnancy.

IVF is one of the several assisted reproductive techniques (ART) used to help infertile couples to conceive a child.

Causes of Infertility

Blocked fallopian tubes
Hormonal imbalance
Endometriosis
Women with ovulation disorder
Uterine fibroids
In the man, low sperm count or poor quality sperm
Genetic disorder
Procedures
Two procedures are done to gain access to ovaries

It involves inserting the needle through the vagina (transvaginally). With the help of an ultrasound machine, the physician guides the needle to the location of the ovaries
In the other procedure, called laparoscopy, a small thin tube with a viewing lens is inserted through an incision in the navel. This lets physician to see inside the patient, and locate the ovaries.
Method
Without additional techniques, the chances of pregnancy would be extremely small. The additional techniques used in IVF include-

Ovarian hyperstimulation- Stimulation to induce development of multiple follicles of the ovaries.
Final maturation induction- Induction of final oocyte maturation is performed, generally by an injection of human chorionic gonadotropin (HCG), when the ovarian follicles have reached a certain degree of development. This is known as the "trigger shot  
Egg and sperm preparation- Semen is prepared for fertilization by removing inactive cells and seminal fluid in a process called sperm washing. An oocyte selection may be performed prior to fertilization to select eggs with optimal chances of successful pregnancy. 
Co-incubation- Eggs are removed from the woman and placed in one of the fallopian tubes, along with the man's sperm. This allows fertilization to take place inside the woman's body. Therefore, this variation is actually an in vivo fertilization, not in vitro.
Embryo culture- The main durations of embryo culture are until cleavage stage (day two to four after co-incubation) or the blastocyst stage (day five or six after co-incubation)
Embryo transfer- The number to be transferred depends on the number available, the age of the woman and other health and diagnostic factors. Embryos are transferred to the patient's uterus through a thin, plastic catheter, which goes through her vagina and cervix.
Aftercare
After the IVF procedure is performed the woman can resume normal activities. A pregnancy test can be done approximately 12-14 days later to determine if the procedure was successful.

Risks

Multiple pregnancies
Ectopic pregnancy
Ovarian rupture, bleeding
Infections
Complications of anesthesia

In Vitro Fertilization - Quick Facts!

There is nothing more stressful to a patient and a caring gynaecologist than to face repeated IVF failure or recurrent pregnancy loss following IVF. So to advice couples who have failed one or more attempts, to keep on trying over and over and over; is not an easy job. Here, one can find solution in Ayurvedic treatment. Ayurveda, through its medicines, diet & lifestyle modifications and panchakarma raises a new hope after IVF failure. Ayurvedic treatment enhances success rate of Artificial Reproductive Techniques (IUI, IVF, ICSI-ET) or increases chance of natural conception as per cause of infertility.

What is Infertility?

Infertility is Inability to conceive even after one year of unprotected coitus or inability to carry pregnancy till full term. There are many causes of infertility; such as tubal block, PID, Endometriosis, PCOD in women and low sperm count, low sperm motility in men. When there is severe tubal disease, severe egg factors, failed IUI treatments, severe male factors, unexplained infertility, grade III & IV endometriosis; Test tube baby is suggested.

What is test tube baby? IVF (In-Vitro-Fertilization)?

It is a laboratory procedure in which processed sperm are either placed with oocyte (IVF) or injected into oocyte (ICSI) in a petridish to achieve fertilization. The resultant embryos are transferred into woman's uterus for implantation.

What are causes of IVF failure?

To work out on IVF failures, we should focus on causes of failure.
One of the most common causes of IVF failure is Abnormal Embryo. Abnormal embryo can be formed due to abnormal egg (oocyte) or abnormal sperm or if both are abnormal.
Another common cause is Implantation failure. Endometrium preparation and its receptivity are more important for implantation of an embryo. Endometrium should be 6 mm or more in thickness preferably 8-10 mm. To know details about endometrium preparation, Color Doppler should be done. It has also been observed that when pregnancy is achieved in absence of endometrial and sub-endometrial flow on the day of embryo transfer (ET), more than half of pregnancy will finish as spontaneous miscarriage. 
IVF cycle can be cancelled even before Ovum Pick Up due to Poor Ovarian Response, in which very few or no follicle growth is seen even after fertility injections.
Most neglected but important cause is Pre-treatment STRESS.
HOPE IN AYURVEDA:

According to Ayurveda, four factors are essential for conception; namely seed (oocyte and sperm), soil (reproductive track), season (fertile period) and water (nutrition).
Ayurvedic fertility treatments regularize metabolism of body, purify reproductive organs, maintain hormonal equilibrium, improve endometrium lining & receptivity, increase egg and sperm quality and relieve stress.
Womb preparation treatment of Ayurveda enhances success rate of IUI, IVF, ICSI-ET.

Womb Preparation Treatments:

Ayurvedic medicines
Ayurvedic herbs and medicinal preparations act as natural tonic to male and female reproductive organs. They maintain biological clock of menstruation; hence hormonal imbalance is corrected. They also help in making most potent and healthy sperm & ovum and eventually a healthy pregnancy.

Panchakarma (Detoxification)
Ayurveda can treat infertility by Panchakarma procedures like Basti, Uttarbasti, Vaman, Virechan, Nasya using different Ayurvedic formulations as per cause of infertility & failure of IVF and according to body constitution of patient.

Basti acts on vata predominantly. It increases strength of reproductive organs 
Uttarbasti is an intrauterine instillation of sterile medicated oil or ghee. It acts on endometrial receptors
Vamana and Virechana detox the whole body and improves digestive fire for proper nourishment of reproductive hormones and organs
Yoniprakshalana (Irrigation of vulva and vagina with warm decoction) and Pichudharan (Insertion of a sterile tampoon soaked in medicated ghee or oil in posterior fornix of vagina) are also helpful in infertility
According to Ayurveda; A Cheerful mind forms the basis of pregnancy; so relaxing panchakarma procedures like massage, steam, head massage, Shirodhara are done to reduce stress and its impact on infertility treatments.

Diet:
Like other fertility treatments, Ayurvedic treatment does not depend only on medicines. In fact, it ensures that patient follows a strict diet rules as per Ayurveda and avoids spicy and salty food. The proper food can help to provide proper nutrition to reproductive organs.

Lifestyle modification:
Nowadays infertility has become a part of lifestyle diseases. Ayurvedic Doctor can guide you to modify lifestyle according to your body constitution (Dinacharya) and seasonal variations (Rutucharya). It is always better to avoid cigarette smoking, tobacco and alcohol as they reduce fertility. Exercise is an inevitable part of lifestyle. One should learn exercise, yogasana (e.g. Surya Namaskara, Gomukhasan, Sarvangasan, Pavanmuktasan, Ardhamatsyandrasan, Naukasan, Dhanurasan, Shalabhasan etc.) and Pranayam from an experienced teacher.  

IVF Failure: Hope In Ayurveda!

Factors that determine the success of your IVF procedure

IVF or In Vitro Fertilization is a process wherein an egg is fertilized by a sperm in a laboratory dish to form the embryo (baby's first cell) which after growth in artificial medium in the lab is transferred into the uterus of women, In general, a blood sample is collected to determine whether you're pregnant or not about 10-14 days after the eggs are retrieved.

Coming to the success of the procedure, a number of factors are at play and these are:

The age at which you get pregnant

A factor that plays a role in influencing your chances of experiencing success in your IVF procedure is the age at which you opt for this procedure. The lower your age, the chances that you may get pregnant and deliver a healthy child using your own eggs witness an increase. On the other hand, if you're aged 41 and above, or your egg reserve is very low donor eggs are the most preferred option as they help to increase your prospects of meeting a success.

Lifestyle habits

Certain lifestyle factors can significantly affect your prospects of getting pregnant through this route. Smoking can reduce your prospect of success using this procedure by about 50%. It can cause you to have lesser number of eggs retrieved during the procedure while increasing instances of miscarriages. Likewise, obesity, alcohol use, consumption of excessive caffeine and drugs can adversely affect your chances of getting pregnant using IVF.

Cause of Infertility

If your supply of eggs is normal, success rate using IVF is high. Women who suffer from the problem of endometriosis experience lesser chances of getting pregnant than women who have unexplained fertility.

Reproductive history

IVF success rate chances are higher if you've delivered a baby previously using IVF.

Embryo status

Embryos that are better developed with good grade stand a higher chance of experiencing success than less developed embryos. More importantly, not every embryo is able to survive the development process.



What are the factors that determine the success of your IVF procedure?

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