What are the factors that make a woman fertile? + The most effective way to address infertility

Infertility is the inability to get pregnant after a year of unprotected intercourse. Both men and women can be infertile.

In about one-third of cases, the cause of infertility involves only the male.

In about one-third of cases, the cause of infertility involves only the female.

In the remaining cases, the cause of infertility involves both the male and female or no cause can be identified.

Women are born with a finite number of eggs. Thus, as the reproductive years progress, the number and quality of the eggs diminish. The chances of having a baby decrease by 3% to 5% per year after the age of 30 and this reduction is noted to a much greater extent after age 40.

Female infertility can also be caused by a number of factors including:

1. Damage to fallopian tubes

Damage to the fallopian tubes can prevent contact between the egg and sperm. Pelvic infections, endometriosis, and pelvic surgeries can lead to fallopian tube damage.

2. Hormonal causes

This can lead to ovulation disorders which prevent the ovaries from releasing eggs such as in polycystic ovary syndrome ,  hyperprolactinemia or disorders of the thyroid gland - hyperthyroidism / hypothyroidism, can interrupt the menstrual cycle and cause infertility.

3. Cervical causes

A small group of women may have a problem in which the sperm cannot pass through the cervical canal. Whatever the reason is , this problem may be treated with intrauterine inseminations.

4. Uterine causes

Abnormal anatomy and distortion of the uterine cavity due to the presence of polyps and fibroids or problem with the endometrial lining can lead to failed implantation of the embryo.

Endometriosis occurs when endometrial tissue grows outside the uterus - often affecting the function of the ovaries, uterus, and fallopian tubes.

5. Primary Ovarian Insufficiency:

Also called as Premature Menopause, when the ovaries stop working prematurely before the age of 40. Certain conditions are associated with early menopause like immune system diseases, radiation or chemotherapy and smoking.

Causes of male infertility may include:

1. Abnormal sperm production or function due to various problems, such as undescended testicles, genetic defects, health problems including diabetes, prior infections such as mumps, trauma or prior surgeries on the testicles or inguinal region.

2. Problems with the delivery of sperm, due to sexual problems, such as premature or retrograde ejaculation, certain genetic diseases, such as cystic fibrosis, structural problems, such as blockage of the epididymis, or damage to the reproductive organs.

3. Overexposure to certain chemicals and toxins, such as pesticides, radiation, tobacco smoke, alcohol, frequent exposure to heat can elevate the testicular temperature, impairing sperm production.

4. Damage related to cancer and its treatment, including radiation or chemotherapy for which timely cryopreservation can be done for future use.

5. Unexplained infertility, In approximately 20% of couples the cause cannot be determined using the currently available methods of investigation.

Why is IVF the best way to treat infertility in women?

Conception is a complicated process that depends on upon many factors:

On the production of healthy sperm by the man and healthy eggs by the woman

The sperm's ability to fertilize the egg when they meet.

The ability of the fertilized egg (embryo) to become implanted in the woman's uterus

IVF (or in-vitro fertilization) is a lab procedure where the sperm and the egg are combined in a dish (where fertilization takes place) and is followed by transferring the embryo (the fertilized egg) into the uterus. It is increasingly being used as a method to conceive as it has been established as a safe procedure that helps bypass a number of complications women may face while conceiving such as ovulation problems and issues with the fallopian tube.

Even women who face issues such as PCOS, endometriosis, and premature ovarian failure can conceive through this process. Moreover, IVF has been in practice since 1978 and has a safe track record. The success rates of IVF are high as well, making it a preferred procedure for couples who suffer from fertility problems. Unexplained infertility can also be treated with the help of this procedure.



What factors that  make a woman fertile? + The most effective way to address 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!

IVF is a useful process for people who want to become parents but have exhausted all other means of being so. However, the in-vitro fertilization method is definitely not suitable for everyone. Here are some facts you need to know about the procedure and they will help you determine whether you are suited for the program or not.

1. IVF Takes Time
Even though most clinics may not tell you this, but the IVF procedure takes a bit of time to deliver the desired results. On an average, the treatment can take anywhere between four weeks to a couple of months to produce results, depending on the patient s ability to respond to the medicines used. The procedure involves artificially stopping the menstrual cycle of the woman. Next, the ovulation process is stimulated so that the healthy egg can be extracted from the womb. The eggs chosen are then fertilized and left to undergo embryo culture for another six days. After this, the eggs are implanted back into the mother s body.

2. The process Can Be Stressful
IVF treatment and pregnancy can be quite a stressful period of time for the parents in question. The mother needs to be constantly monitored to check for any abnormal response to the pregnancy. Regular checkups by the doctor along with blood tests may also be suggested. However, this stress has very little chance of affecting the quality of the pregnancy. So, do not worry that overstressing yourself will lead to complications for the embryo.

3. More Than One Cycle Needed For Pregnancy
IVF treatment occurs in cycles. Each cycle involves transplanting a fertilized egg into the womb. However, pregnancy, right after completion of the first cycle, is quite rare. In fact, almost all patients need to undergo several similar cycles in order to get pregnant. So, do not be disheartened if you do not get pregnant after undergoing the very first cycle of IVF treatment.

4. IVF Is Costly
Not everyone is able to afford the high cost of IVF. Others may be able to afford the cost of undergoing a couple of cycles of the same, after which the high costs can become a burden. Only a select few can bear to carry on with the treatment until the pregnancy arises. So, consider your financial condition prior to signing on for such a treatment option.

At any rate, consult with an expert to get an even better idea about the IVF procedure and the consequent pregnancy. 

All You Need To Know About The IVF Procedure!

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

In vitro fertilisation (IVF) is a medical procedure followed for those women or couples suffering from infertility or for certain specific genetic problem. In the normal course, women or couples experience positive results within a few IVF cycles. However, in spite of reasonable pregnancy rates, some women may require few more cycles to achieve pregnancy. In such cases, in order to ensure a healthy pregnancy, the gynecologist may suggest the women undergo Endometrial Scratching before IVF. 

Endometrium explained in brief: 

The uterus is located in the pelvic region and it is in the size and shape of a pear. The inner cavity of the womb or uterus is protected by the tissue lining called endometrium, also called endometrial. The endometrium plays a significant role in supporting the pregnancy. 

The enhanced success of achieving pregnancy: 

The endometrial scratching procedure is a very simple one, which is resorted, so as to improve the results of IVF procedure. In this procedure, the gynecologist uses a very fine catheter and makes a small scratch on the endometrial lining. In fact, the scratch causes a kind of inflammatory reaction in the uterus. This inflammatory reaction induces the endometrium to be highly receptive to embryos during the successive menstrual cycle. This added receptivity enhances the success of pregnancy during the next menstrual cycle. 

Considering the higher level of success in achieving pregnancy, the endometrial scratching procedure has gained popularity in the IVF procedure. However, some of the other issues related to endometrial scratching may be as follows: 

Endometrial scratching optimises the uterine lining and thereby, makes it easier to continue the embryo implanting procedure. Normally, before the endometrial scratching procedure, the gynecologist may suggest endometrial biopsy. 
The endometrial procedure is usually suggested for those women who had two or more unsuccessful IVF procedures, despite having good quality embryos. However, in some cases, depending on the health of the patient and various other factors, the gynecologist may suggest this endometrial scratching at the very first IVF procedure. This procedure can be availed either for fresh embryos of the couple or frozen embryos or for the donor egg. 
Although this is a part of a surgical procedure; endometrial scratching is very simple and painless and it is done without administering anesthesia. The procedure does not require any hospitalisation. In fact, the patient can go home soon after the procedure. Except for a few pain killers, this procedure does not require any extensive medication. 
This is a safe and easy procedure. Neither does it lead to any side effects, nor is the procedure burdensome for your wallet. Many couples have been benefited by this endometrial scratching procedure.

Endometrial Scratching and IVF - Can it Help You Get Pregnant?

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

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