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

It is as important for the man as it is for the woman to undergo certain tests before the IVF cycle is started. Fertility is not only an issue for a woman, but it also might be for the man in question. There are certain tests that need to be conducted on men before they can gear up for IVF:

1. Semen Analysis: One of the most important tests for male infertility is semen analysis. Sometimes, a man may be completely healthy, but his sperm production could be of poor quality. Semen analysis is done to provide an accurate evaluation of sperm number, the ability to move (motility), size and shape (morphology), as well as the consistency and volume of the sample collected.

2. Binding Test: Sometimes agglutination occurs where the sperms might stick to each other by their heads or tails. Sperm antibodies might cause this problem. The IVF treatment's success might be compromised if this happens. A simple binding test is done to determine this.

3. Trial Wash: This is also known as sperm wash. It is mostly done to remove chemicals from the sperm. Not doing a sperm wash might end up affecting the later stages of the IVF treatment. In this process, the misshapen and immotile sperm is separated so a clean sample of motile and healthy sperm can be collected.

4. TUNEL Assay: Since sperms build up about half of a child's genetic makeup, a TUNEL Assay or 'sperm DNA test' is required. This test is done to measure the sperm population that have fragmented DNA. Negative impacts on genetics can hamper the success of the fertility treatment.

TUNEL Assay is usually recommended to men with:
a) Leukocytes detected by the sperm analysis
b) Age approaching 50
c) A history of diabetes II type or prostatitis
d) Exposure to chemicals or prolonged heat at workplaces

5. Screening for Infectious Diseases: This test is done for both the partners to check for diseases like AIDS, Hepatitis C, and so on.

Tests Suggested for Men Before IVF

Egg Freezing, which is also known as mature oocyte cryopreservation, refers to the method through which reproductive potential is restored among women. Eggs get harvested from the ovaries, frozen and in an unfertilized manner and are stored for purpose of using them later on. The egg freezing procedure is recommended for those women, who would like to delay conceiving baby due to various kinds of reasons.

Before the freezing of eggs, it is important to first retrieve the eggs. Let us look at how the eggs are retrieved, followed by the procedure of egg freezing through two different ways.

Retrieval of Egg

Egg Retrieval takes place just like it is done in case of in vitro fertilization (IVF). Women would need to be put under medication for hormones or through injections, which shall lead to the stimulation of ovaries, leading to more eggs getting matured. After this women would receive the necessary medication to stimulate ovulation and then the extraction of eggs takes place through the use of a needle. Specialists perform this whole procedure by putting women under the effect of anesthesia and are also guided by ultrasounds. Once the extraction is completed, the freezing takes place.

There are two different techniques involved in the egg freezing process. They include:

Slow Egg Freezing Method

A substance called cryoprotectant is used in order to protect the biological tissues from getting damaged out of freezing. This slow freezing method of getting eggs freezed relies on low initial concentrations of crytoprotectant. The cryoprotectant in low concentration is introduced when the egg is at a relatively warm temperature and still continues to experience the usual functions of a living cell. Then the cryptoprotectant would spread all throughtout thus fill the egg, hence replacing most of the water inside the egg. The egg is then inserted into a small container made of plastic and ultimately get placed inside a cooling chamber. The lowering of temperature, to around -6 degree centigrade, takes place through injecting very tiny amounts of liquid nitrogen into the cooling chamber. The cooling process is controlled by a computer.

The main purpose of these techniques is to avoid ice crystals from getting formed in the egg. During the spreading of the cryoprotectant, if the ice crystals are still present, they can cause damage to the egg and hence the egg may not survive the process of thawing. Then the temperature is lowered further to around -32 degree centigrade. By this time, the egg s metabolic rate become slow. The container where the egg was placed, is then dipped inside the liquid nitrogen, forming a solid.

Rapid Egg Freezing Method or Vitrification

At the time of rapid freezing method, there is high concentration of initial cryoprotectant whereas the cell remains at room temperature. The egg is unable to stay for long in this temperature and thus gets poured immediately onto the liquid nitrogen. Cryoprotectant spreads at a rapid rate so as to avoid ice-crystal from getting damaged. Vitrification is a very new method for freeing eggs. Recent research has shown that vitrification of eggs largely improves the possibility for survival after thawing and the rates of pregnancy.

Different Techniques That Can Be Used For Egg Freezing!

Intracytoplasmic Sperm Injection i.e. ICSI is different from conventional IVF i.e. In Vitro Fertilization because a single sperm is selected by the embryologist to be injected by a needle into the egg rather than a dish with many sperms placed near the egg so that the fastest swimming sperm enters it. Once the sperm is injected directly into the egg, it fertilizes, after which the embryo is transferred into the womb or uterus. 

Your doctor might recommend ICSI treatment for you if you have an extremely low sperm count resulting in infertility or other medical sperm conditions such as poor motility or poor morphology. It may also be suggested if prior attempts at IVF procedures have failed in fertilizing the egg or the fertilization rate is extremely low. You must also consider ICSI treatment if you resort to embryo testing or if the sperm needs to be collected from the epididymis or testicles surgically. 

However, you must keep in mind that if your partner has a genetic problem resulting in low sperm count, it could be passed on to your child, if you decide to use your husband's sperm for this process.

Success Rates of ICSI:
The success rate of ICSI treatment depends on your age and your fertility problem. Your eggs are healthier when you are young and as you age, chances are that they will become less healthy.
1. 35 per cent if you are under 35 years of age
2. 29 per cent if you are between 35 to 37 years of age
3. 21 per cent if you are between 38 to 39 years of age
4. 14 per cent if you are between 40 to 42 years of age
5. 6 per cent if you are between 43 to 44 years of age
6. 5 per cent if you are above 44 years of age

Advantages of ICSI Treatment:
Intracytoplasmic Sperm Injection gives you a chance to conceive a child genetically when most other options are exhausted. Males may be unable to ejaculate on the day the eggs are collected due to anxiety. ICSI proves to be advantageous because sperm may also be surgically extracted for this process. It is extremely helpful for those couples who suffer from unexplained infertility. However, one of the most important factors is that ICSI treatment does not affect your child's physical or mental health.

Intracytoplasmic Sperm Injection (ICSI)

Daljindar Kaur's inspiring story of motherhood: How IVF became her savior

The success of In vitro fertilization continues in India as a septuagenarian woman gives birth to a baby boy. Even after 46 years of marriage, the couple from Amritsar was childless. Daljinder Kaur, along with her 79-year-old husband, Mohinder Singh Gill, had been visiting National fertility and the Test Tube Baby Centre in Hisar since 2013 and did not give up even after two failed IVF cycles. They had faced ridicule for their inability to have a baby and yet they kept their hopes up.
On the 19th of April, the couple was blessed with a baby boy who is nothing less than a miracle. The groundbreaking achievement of the embryologists from Hisar has been an inspiration and a beacon of hope for couples all across the country. Once again, IVF has proved to be one of the most successful procedures to have babies for couples with fertility issues. Following are some of the advantages of In vitro fertilization, which you should know about-
1. It can be used by anybody
In-vitro fertilization is not necessarily used by the going to be a mother. It can be used by gestational carriers or by a surrogate as well. So it depends on whether the parents want to take the help of a surrogate or themselves want to be involved in the pregnancy. IVF gives an opportunity to single women and same-sex couples to become parents.
2. Use of donated eggs and sperms
There might be circumstances when the doctor can recommend using donated sperms or eggs. In that case, the eggs can be fertilized manually in the lab and the fetus developed can be used for in vitro fertilization. This increases the chance of pregnancy by a fair amount.
3. Control over timing
In vitro fertilization is a solution for couples who have a very engaging professional life, and can be an option for people who want to have babies after a certain point of time. Eggs and embryos can be preserved for future use. It is also helpful for couples who already have a child and plan to have another later.
4. Decreases chances of miscarriage
Genetic abnormality is one of the primary causes of miscarriage. The technique of preimplantation genetic diagnosis (PGD) is used to ensure the viability of the embryo much ahead of time so that the mother can have an uncomplicated pregnancy and carry her baby full term.



Daljindar Kaur's inspiring story of motherhood: How IVF became her savior

As we all know that IVF stands for In vitro fertilisation. It is a method of stimulating the ovaries in a female body, to release an ovum (egg), which is taken out of the body and fertilised artificially in the laboratory with the help of a sperm. After this, the embryo is transferred back to the uterus where it grows and develops naturally.

Understanding the Procedure

The doctor attempts to have complete control over your menstrual and ovulation cycles, so as to know the correct time of the month when you ovulate. This includes, charting basal body temperatures, hormonal therapy drugs etc.
Frequent blood tests, ultrasound will be required to map the progress of ovulation.
Injections, drugs will be prescribed in required dosage to stimulate the ovaries.
During this time, the doctors will monitor the growth of oocytes (eggs).
After a suitable growth of the oocytes follicles, the eggs are retrieved for artificial insemination. (Fertilisation with the use of sperm cells in the laboratory).
After the successful fertilisation, the embryo is transferred back to the uterus.
Can IVF have side effects?

As a side effect it has a major chance of multiple pregnancies. People intending to have just one child, may not be mentally or economically prepared to take the responsibility of more than one child.
The drugs and medicines used throughout the IVF procedure may create hormonal complications in the long run. It bears a risk of ovarian hyperstimulation syndrome, if the mother has to go through the cycle multiple times.
But it offers a number of benefits too...

IVF increases the chance of pregnancy by a large percentage. It is one of the most successful methods of boosting fertility and pregnancy.
Couples, who have repeatedly failed to bear children naturally, can opt for this treatment to produce their own offspring.
In case the couples are completely infertile, donor eggs or sperms may be used in the process. However, in that case, the offspring will not bear the DNA of both parents.
IVF can greatly reduce the chance of surgery on the fallopian tubes.
IVF also provides an opportunity to choose the healthiest embryos before implanting it back in the uterus. A procedure, known as the pre-implantation genetic diagnosis, determines the presence of any abnormal genes or other chromosomal absurdity.
The procedure of IVF has a very high success rate and with technological advancements in the field of medicine, it has also become much safer.
IVF allows women, who go into premature menopause, to be able to bear a child. This treatment is mostly for women who decide to experience motherhood at a slightly older age.
IVF allows same sex partners and single women to bear an offspring.
It is extremely helpful for women who have their fallopian tubes damaged, blocked or surgically removed.

IVF - 9 Benefits You Must Know!

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