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

Women undergo menopause in their 40s and this is primarily known as the age after which they can't bear children in their wombs any more. The ability to develop and maintain a healthy pregnancy wanes as a woman crosses the age of 30, which according to research is the optimal time for a woman to become a mother.

The body undergoes changes as it gets older and women slowly start losing the perfect conditions for pregnancy. However, with the rise of the IVF treatment for infertility, a great number of people are choosing to embrace parenthood at a relatively advanced age. However, the question is, can the same IVF treatment prove effective for a woman after her menopause?

The answer is yes. There have been several instances where a woman past menopause has been implanted with a fertilized egg and has been able to conceive a healthy offspring from the same. However, such an IVF treatment is much more complex and can require a lot of external hormonal treatments on the side as well.

How can IVF help menopausal women?
Women, who have gone into menopause more than 6 months ago, require additional care to achieve pregnancy through IVF. The uterus is usually shrunken in such people and the endometrial lining also develops a resistance to estrogen. Several cycles of estrogen treatment are needed for such women to achieve a healthy pregnancy.

Most doctors suggest at least a couple of months of estrogen and progesterone treatment prior to taking the actual IVF treatment. However, there is no guarantee that the same will be effective in every case.

By any chance, if the menopausal woman chose to store her eggs prior to her menopause, she can get those eggs fertilized and implanted after menopause, using the IVF method, in order to achieve a healthy pregnancy. Through, this procedure, the woman can not only become pregnant after menopause but can also ensure that she is the biological mother of the child who would be born.

At any rate, it is best to undergo the IVF treatment before menopause, as this improves the chances of conceiving. The hormonal treatments are often easier and most women can completely forego the progesterone and estrogen supplementation in such a case. This will not only reduce the time required to complete the treatment but will also significantly reduce the cost that the parents have to bear.

Can IVF Help Menopausal Women Get Pregnant?

In vitro fertilisation, commonly known as IVF, is the process of fertilising single or multiple eggs outside the body. This treatment can be performed by either using your own egg and sperm or using donated egg or sperm or sometimes both. The resulting sperms and eggs are evaluated for quality and then one or more of them are positioned properly in the uterus through the cervix. IVF is regarded as one of the most commonly opted treatment plans, and it accounts for more than 99% of assisted reproductive technology processes.

Who are suitable for IVF?
IVF can be helpful for you in case you have some issues with the egg quality or ovulation, fallopian tubes that are blocked in some way or endometriosis. It can also help you to get pregnant if your partner has problems with mortality and sperm count and when you have opted for donor eggs. About 1.5% of babies in the United States are conceived through the IVF process.

How does IVF work?
There are several steps through which IVF process works and the timeline follows the following steps:

    Stimulation for ovary: You will have to take a special kind of fertility drug for 8 to 14 days near the start of your menstruation cycle. This drug aids in the stimulation of your ovaries for developing multiple mature eggs to fertilise instead of a single one. You may also need to take an artificial hormone-like cetrofelix and leuprolide for keeping your body from releasing eggs very early.
    Development of follicle: When you are under all these medications, you will have to visit your doctor s office often for checking the hormone levels as well as ultrasound measurements for the ovaries.
    Getting the trigger shot: Once the follicles are ready, you are likely to receive a trigger shot, which is an injection causing the eggs for maturing fully and becoming capable of being fertilised. Your eggs are ready for being retrieved after about 36 hours of receiving this shot.
    Gathering the eggs: At this stage, you are likely to receive an aesthetic or ultrasound probe that is inserted through the vagina for checking the ovaries and identifying the follicles. Normally, about 8 to 15 eggs are retrieved through the insertion of a thin needle.
    Fertlisation: This is the most vital step, where an embryologist is going to examine the eggs before they are combined with the sperm and incubated overnight. Fertilisation happens at this particular time, but abnormal eggs are not fertilised.

Then the embryos slowly develop and are planted on the basis of your age and clinical condition. When the treatment is working, an embryo is implanted in the uterine walls and starts developing. 

IVF - How Does it Work?

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!

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

Intrauterine insemination (IUI) and in vitro fertilization (IVF) are two commonly used methods of fertility treatment, which increase a couple s chance of becoming pregnant.

The Procedure

IUI- IUI is a procedure during which processed and concentrated motile sperm are inserted directly into a woman s uterus. This procedure is timed according to a woman s ovulation, and may be performed one to two times in the days immediately following the detection of ovulation. After ovulation a woman s egg is picked up by the fallopian tube and waits there for the sperm. Since the IUI procedure deposits higher concentrations of good quality sperm close to where the egg is waiting, the chances that the egg and sperm will find one another are increased.

IVF- IVF is the most successful method of fertility treatment utilized today to help couples to conceive. The basic components of the IVF process include stimulation of the ovaries to produce multiple eggs at a time, removal of the eggs from the ovary (egg retrieval), fertilization of the eggs in the laboratory, and subsequent placement of the resulting embryos into the uterus (embryo transfer). The chance of pregnancy from IVF depends primarily on the age of the woman, the cause of infertility, and factors related to the quality of the IVF laboratory.

Success Rates

IUI Treatment: There is a marked difference between IVF and IUI pregnancy rates. IUI has a success rate between 5% and 20%, but it can even be as low as 1-2 %, depending on the woman s age and fertility levels. The chances of conceiving through IUI is higher if fertility drugs are administered along with the treatment.

IVF Treatment: IVF has a high success rate   between 20% and 35% and it can even go as high as 40%. This may not seem like a lot, but it is very high, considering that an average young and fertile couple has only a 15-20% chance to conceive in a month. It is important to understand what IVF and IUI success rates mean and the factors that affect it before deciding on a fertility treatment. You can also use any reliable online IUI vs IVF comparison tool to determine your approximate success rates with each of these treatments, depending on your age, lifestyle, and medical history.

You should use online sources of information to understand more about fertility problems, how age affects fertility levels, and whether freezing your eggs is a good option for you. However, discuss all these issues with your doctor to ensure that you have the right information and that you have understood it correctly. Fertility specialists provide you with personalized fertility plans based on your health which is why you should always talk to them before you make any decision.

IVF or IUI - Which One Should You Opt for?

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