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Overview

Infertility: Treatment, Procedure, Cost and Side Effects

What is the treatment?

Infertility refers to a condition when a woman cannot conceive even after having carefully timed and unprotected sex for over a year. It is difficult to pinpoint the exact cause of infertility. However, it may occur due to inadequate levels of some hormones in both men and women and also due to trouble with ovulation in women. A man suffers from infertility if the semen that he ejaculates contains less number of sperms and if the sperm is of low quality. In such a scenario, a man will not be able to reproduce.

There are different factors which can contribute to a man getting infertile. A man can suffer from infertility if he suffers from a condition called varicoceles, or from diseases or conditions like diabetes, cystic fibrosis, trauma, infection, testicular failure or has been exposed to chemotherapy or radiation. Other causes may include alcohol addiction, smoking, use of anabolic steroids and exposure to environmental toxins. A woman can suffer from infertility if any of the organs such as the ovaries, fallopian tubes or the uterus gets damaged.

Treating infertility in men involves treatment for premature ejaculation, varicoceles, blockage of the ejaculation duct, retrograde ejaculation and also surgery for epididymal blockage. A woman may have to take some medications if she is suffering from ovulation disorders. Other treatments for women include intrauterine insemination and even surgery to restore fertility.

How is the treatment done?

A doctor may advise a couple to have more sex per week so as to enable the woman to conceive. However, infertility in men can be due to a number of different reasons and their treatments differ too. Medication and behavioral therapy can help a man to overcome general sexual problems like premature ejaculation and erectile dysfunction. A varicose vein in the scrotum, which can cause infertility, can be surgically removed. In case of blockage of the ejaculatory duct, sperm can be injected into an egg in the laboratory after it has been extracted directly from the testicles. Retrograde ejaculation is treated by taking sperm directly from the bladder and later injected into eggs. The epididymis is a coil-like structure in the testicles that help to store and transport sperm. Surgery can help to remove the blockage if it gets blocked.

A woman suffering from ovulation disorders will be prescribed fertility drugs like clomifene, metformin, human menopausal gonadotrophin, human chorionic gonadotrophin, bromocriptine and follicle stimulating hormone. In addition to these, there are surgical procedures for women. Fallopian tube surgery helps to repair damaged or scarred fallopian tubes and makes it easier for eggs to pass through them. Laparoscopic surgery also helps to increase fertility.

There are some methods which help in assisted conception like intrauterine insemination, in vitro fertilization, intracytoplasmic sperm injection, donating sperm or egg, assisted hatching and surgical sperm aspiration.

Who is eligible for the treatment? (When is the treatment done?)

A man should becomes eligible for treatment after he has been diagnosed as suffering from such by a doctor. This is because there are no apparent signs or symptoms of infertility in men. The quantity and quality of the semen also appear normal to the naked eye. Therefore the tests that can identify infertility in men are semen analysis, hormone testing, genetic testing, testicular biopsy, imaging and other specialty testing. In case of women, some of the conditions that may make them infertile are irregular or no menstrual periods, endometriosis, pelvic inflammatory disease, very painful periods or multiple miscarriages. Some of the specific fertility tests that help to understand whether a woman is infertile are ovulation testing, hysterosalpingography, ovarian reserve testing, hormone testing and imaging tests.

Who is not eligible for the treatment?

A person is known to be infertile if he/she has not being able to have a baby even after having frequent and unprotected sex for a year. A man or woman is not eligible for treatment if he/she has been able to make the partner conceive/ conceive herself after having unprotected sex. A person is also not eligible if none of the tests have been able to diagnose him/her as suffering from the condition.

Are there any side effects?

Oral fertility drugs produce milder effects than injectable fertility drugs. The most common side-effects of fertility drugs are bloating, breast tenderness, upset stomach, hot flashes, mood swings and headache. The side effects of gonadotrophins are headache, upset stomach, mood swings, acne, weight gain, abnormal menstrual bleeding, dizziness and even upper respiratory tract infection. Some of the serious side effects of fertility drugs are changes in vision, ectopic pregnancy, ovarian torsion, ovarian hyperstimulation syndrome and allergic reactions. However, the most common side-effect of infertility treatment is a multiple pregnancy.

What are the post-treatment guidelines?

A person should adopt a healthy lifestyle to make sure that he/she does not get affected by this condition. Smoking and consumption of alcohol increases the risks of infertility and should be avoided. It is of utmost importance for an overweight man to lose some weight. Both men and women should exercise as a sedentary lifestyle increases the risks of infertility. Furthermore, a healthy diet containing adequate quantities of folic acid, iron, zinc and vitamin B-12 should be adopted. A person should also reduce stress as it reduces the chances of conception.

How long does it take to recover?

A woman who has undergone laparoscopic surgery can probably go home on the day of the surgery itself. However, a woman will take about 2-3 weeks to recover from the surgery. Research has shown a person can again reproduce within a time span of 2 months- 2 years after successful treatment. A lot of factors determine how soon a person will recover after taking infertility drugs. Some of the factors are the person’s age, health, medical issues and others. A person taking clomiphene will normally see positive results after 5-12 days of taking the last clomiphene pill.

What is the price of the treatment in India?

The cost of laparoscopic surgery in India generally ranges between Rs 1 lakh to Rs 2 lakhs. The surgery to remove the varicose vein in the scrotum of a man may cost something between Rs 90,000 and Rs 1,50,000. Clomephene, used to treat infertility in women, costs around Rs 650 per cycle. The prices may vary with other variations of this drug. An ICSI treatment costs between Rs 1,50,000 to RS 2,50,000 while Frozen Embryo Transfer procedure will cost a patient an additional Rs 1,20,000.

Are the results of the treatment permanent?

A person who has undergone successful treatment for infertility is generally able to reproduce within 2 years. However, this is not a permanent result. A person may again have infertility problems due to leading an unhealthy lifestyle like smoking, drinking or by not being active. Some health issues also may have an effect on the fertility of men and women.

What are the alternatives to the treatment?

When infertility issues come up due to hormonal problems, using a natural progesterone cream can help a person to address it. Consumption of herbs like red raspberry leaf, nettle leaf, dandelion, alfalfa, red clover, maca and chaste tree berry also help to cure infertility. Getting enough sleep has also proved to play an important part in treating infertility problems.

Safety: Medium Effectiveness: High Timeliness: Medium Relative Risk: Medium Side Effects: Medium Time For Recovery: Medium Price Range:

1 lakhs to 3.7 lakhs

Popular Health Tips

Different Techniques That Can Be Used For Egg Freezing!

MD - Obstetrtics & Gynaecology, DGO
IVF Specialist, Mumbai
Different Techniques That Can Be Used For Egg Freezing!

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.

2947 people found this helpful

Laparoscopy In Infertility

MBBS, Md - Obs & Gynae
Gynaecologist, Faridabad
Laparoscopy In Infertility

In this article we will be talking about Laparoscopy during Infertility and different other information about it which will be helpful for those who want to undergo a Laparoscopy.

What is Laparoscopy?

Laparoscopy is the method with the help of which doctors can diagnose infertility or treat different other problems related to fertility. Laparoscopy is a kind of surgery which is conducted with the help of two or three small cuts around the abdomen area. Through these small cuts the doctor inserts a laparoscope (thin, fiber optic tube) which allows the doctor to see inside the abdominal organs or they also insert any other important
surgical equipment.

Laparoscope is usually fitted with a light and camera which allows to monitor the inside of the women abdominal or genital system. Women are suffering from infertility and also if they experience pelvic pain, then it is highly possible that they will need to undergo a Laparoscopy. It can also be done once other infertility tests have been conducted.

Reasons For Laparoscopy Diagnosis

Your doctor may recommend you to undergo Laparoscopy because of many reasons.

Here are some of the most common and important reasons for Laparoscopy :

● If the woman experiences significant and frequent pain when she is engaged in
sexual intercourse.
● If the woman has severe and chronic menstrual cramps or pelvic pain at other
times of the cycle.
● If there has been a serious Pelvic inflammatory disease or severe pelvic
adhesions.
● If the doctor suspects that there is a chance of ectopic pregnancy and which can
be life threatening if left untreated.

So you can see that there are so many reasons because of which doctors can recommend you to choose Laparoscopy.

Why Is Laparoscopy in Infertility Important?

Infertility can be diagnosed with Laparoscopy and in many cases there have been instance that infertility was diagnosed only with this process. Laparoscope method not only helpa to identify the problem of infertility but also allows the doctor to check for much serious issues like cysts or tumors inside the abdominal system.

Laparoscopy is also very much beneficial for those who are suffering from significant pelvic pain. This process will help to remive the various scar tissues or endometrial residues which might be the reason for the pain.

Is Laparoscopy Safe?

Laparoscopy is a minimally evasive surgery which involves two or three very small incisions to be made around the abdomen. They will not hurt you much neither they will leave a mark of surgery for a long time. The Laparoscope is absolutely safe but there are some things to keep in mind that it is done in a medically induced environment which should not posses any threats of infection or pollutant. Laparoscopy is also recommended because there is not much postoperative problems which the patient face.

2467 people found this helpful

Who Are The Ideal Candidates For Egg Freezing?

MD - Obstetrtics & Gynaecology, DGO
IVF Specialist, Mumbai
Who Are The Ideal Candidates For Egg Freezing?

The freezing of sperm and embryos has been recognized for long as way to pursue treatments for fertility later on in life. Nowadays, the new techniques for freezing of eggs have lead to greater success. Due to this reason, the American Society for Reproductive Medicine no longer takes egg freezing as a procedure for experimental purposes.

 

Ideal Candidates for Egg Freezing

Now, we look into the candidates, who are ideal for going through the process of egg freezing. They include:

Women Who Intend To Put Off Childbearing: Generally fertility tends to decline with the advancement of age in women. Along with that, women who are in their twenties or thirties have less risk of miscarriage taking place and giving birth to babies with defects, in comparison to aged women. This happens mainly because of the increase in the percentage of embryos with abnormalities in chromosome, which occurs with advancement of age. Due to the problems that are associated with reproductive aging, a lot of women have preferred to use donor eggs, in order to increase their possibilities of bearing a child. Though this is an extremely effective method, yet the choice becomes hard to make as it involves the greatest amount of sacrifice.

Egg Freezing for Cancer Patients: Egg Freezing can be an extremely useful proposition for those who are diagnosed with cancer. The health data from 2001 onwards in the United States shows that around 8% of women who have been diagnosed with cancer, were aged below 40 years. The year 2007, saw an estimated 180,000 women getting diagnosed with invasive breast cancer. Around 5% of all those women who were aged below 40 years during the time of diagnosis, have never had the chance of becoming pregnant. Most of these women have stayed single. Women who have been diagnosed with breast cancer, 81% of those young women, who would go through treatments in the form of chemotherapy and radiation will remain alive and be free of ailments after a period of 5 years.

An unfortunate thing for all these women, who are in the childbearing age, chemotherapy and radiation would cause serious damage to the follicles which are in the process of getting matured in the ovaries.

Now, if a woman who has been diagnosed with cancer, looks to get involved with a male partner to conceive but still not ready to go for pregnancy, the ideal option would to create embryos through In Vitro Fertilization or IVF and go on to freeze the embryos. Embryo Cryptopreservation has gone on for year in a successful manner and is now known as the gold standard in preserving fertility.

Egg Freezing for Soldiers: Soldiers are also possible candidates, who could be ideal for egg freezing but unfortunately they tend to get overlooked. These people are often vulnerable towards getting pelvic injuries, which cause damage to their reproductive systems. Military records have shown that since the year 2003, well in excess of 1800 members, most of whom were Army troops, in Afghanistan and Iraq have gone on to suffer such injuries. There are cases when these injuries might well make a soldier incapable of bearing children.

Tubal Infection - Why Should You Get It Fixed Before IVF Planning?

MCH - Reproductive Medicine & Surgery, MS - Obstetrics & Gynaecology
IVF Specialist, Chennai
Tubal Infection - Why Should You Get It Fixed Before IVF Planning?

There are two tubes on either side which connect the ovaries to the uterus. These are the fallopian tubes, and in the majority of the cases, this is where the fusion between the egg and the sperm happens. If there is any problem in either of the fallopian tubes, then the egg cannot travel down into the uterus and there cannot be fusion. Tubal infection or salpingitis and blocked fallopian tubes are some of the most common causes of infertility. In some cases, the sperm may travel up the fallopian tube halfway till the area of blockage and fuse with the egg. This is known as ectopic pregnancy, which is out of place.

Tubal infection is often a result of sexually transmitted diseases including trichomonas, gonococci, and chlamydia. Other general bacteria like strep and staph also produce salpingitis. In most cases, tubal ligation per se is not an issue. However, it can cause problems like blocked tubes or hydrosalpinx. In these cases, the complications arise. In some women, treating these could be the cure for their infertility itself. Blocked fallopian tubes can stop the eggs from traveling down the ovaries and fuse with the sperm. If the block is removed, then infertility is solved. Similarly, if the tubes are filled with pus as a result of the infection, then it does not produce a conducive environment for fertilization.

With IVF being used as a treatment for infertility, the tubes need to be cleared for infection or blockages. These might continue to pose problems and reduce the overall success rate of IVF. These are easy to diagnose so that the infection can be completely cleared and pus drained if required. Surgical debridement can also be done if required so that the tubes are cleared. In some cases, a part of the tube may be removed so that the issue is addressed completely. A course of antibiotics is often required to completely clear the infection. After that, once ovulation is stimulated, then the eggs can travel down so that they can be retrieved and frozen for further use.

Undetected blocked fallopian tubes of silent infection (chronic salpingitis, which does not present with any symptoms) can be one of the causes of failure to conceive with IVF. This can be quite demotivating for both the couple and the medical team. With IVF, there is no clear role for the fallopian tubes, as the eggs can be retrieved from the ovaries and placed directly in the uterus. So, in severe cases of infection, the tube(s) may be even completely removed to improve chances of fertility.

9 people found this helpful

Thinning Of Endometrium - Can It Cause Problems In IVF?

MCH - Reproductive Medicine & Surgery, MS - Obstetrics & Gynaecology
IVF Specialist, Chennai
Thinning Of Endometrium - Can It Cause Problems In IVF?

With infertility on the rise, more and more couples are turning to IVF as a definitive solution. Though there are some inherent risks with IVF, the success rates have gone up significantly over the last couple of decades. This has made it extremely popular for a couple facing infertility. IVF is no longer just a physical issue but also a hugely emotional one.

There are various factors which determine the success rate of IVF, and a thin endometrium is one of them. This is the inner lining of the uterus which should facilitate transfer and growth of the embryo throughout the course of pregnancy.

Ideally, the endometrium should be about 7 to 8 mm thick and have a 3-layered structure on ultrasound. If it is too thin, it may not be able to support the implantation of the fertilized egg. Further, even if it supports initially, as the embryo continues to grow, it may not be able to support the weight, leading to possible miscarriages.

Causes of the thin endometrium:

  1. Reduced blood supply to the uterus
  2. Reduced levels of estrogen
  3. History of endometriosis
  4. Scar tissue from prior uterine infections or surgery
  5. Fibroids

While blood tests can help identify reduced estrogen levels, ultrasound can be used to measure blood flow to the uterus. The cause of thin endometrium needs to be addressed before going ahead with IVF so that the chances of success are increased.

Management:

  1. Estrogen supplements can be given if there is estrogen deficiency. This is essential to promote overall uterine health, which can sustain a healthy pregnancy.
  2. Surgically, uterine scraping where the top layers of the uterus are stimulated to produce a thicker lining. This is an outpatient procedure and produces excellent results in most women.
  3. Increased intake of L-arginine is another way to improve uterine health. It promotes blood flow, thickens the uterine lining, and improves the success rate. About 500 mg per day for about a month is considered beneficial.
  4. Uterine cleansing with for instance castor oil is another way to improve uterine lining.
  5. Uterine massage where herbal oils are used to massage the pelvis has also shown great results. It helps improve circulation to the uterus and surrounding reproductive organs and improves their overall health. This should be done about 2 to 3 months before IVF and stopped after IVF (can result in dislodgement!!)
  6. Acupuncture: Another well-established method to improve uterine lining and health is the use of acupuncture, as it improves circulation.
  7. Eating healthy, vitamin supplements if required, getting adequate rest, moderate workout, and quitting smoking all go a long way in improving uterine health.
4 people found this helpful

Popular Questions & Answers

I have a doubt that my husband has done vasectomy operation for child birth control. But he has not told me, how can I check it? Is there any mark on his body? Or some other method of testing.

MD-Ayurveda, Bachelor of Ayurveda, Medicine & Surgery (BAMS)
Sexologist, Dehradun
Hello- Vasectomy can't be performed without external incision. You can check for any cut marks in his scrotum. You can also go for his semen analysis, which can show no sperms if he has performed vasectomy.

I am taking ova Shield DS from 2nd day of my period. My doctor suggested to start taking susten 200 from day 17th onwards. Can susten 200 and ova shield ds be taken together? Or I should stop ova shield from day 17th? It will really very helpful if doctor can provide good guidance.

BASM, MD, MS (Counseling & Psychotherapy), MSc - Psychology, Certificate in Clinical psychology of children and Young People, Certificate in Psychological First Aid, Certificate in Positive Psychology, Positive Psychiatry and Mental Health
Psychologist, Palakkad
Dear user. I can understand. Please don't be panic. I suggest you to consult a gynecologist in person. We are here to help you in every aspect of your mental and physical health. Any sexual or psychological problems can be cured with the help of various methods and therapies. I suggest you to post your query with every detail here. We will help you in overcoming your problems certainly. Take care.

Today I have taken hsg injection to rupture the follicle on 11th day. Before that I was prescribe to have fer pill kit tablet. Shall I continue to have those tablets?

MD - Obstetrtics & Gynaecology, FCPS, DGO, Diploma of the Faculty of Family Planning (DFFP)
Gynaecologist, Mumbai
Most of medical problems need personally taking detailed medical history and examination with need of new + old reports (more so in such treatment) so meet concerned doctor-treating Gynecologist or infertility specialist.
1 person found this helpful

Table of Content

What is the treatment?
How is the treatment done?
Who is eligible for the treatment? (When is the treatment done?)
Who is not eligible for the treatment?
Are there any side effects?
What are the post-treatment guidelines?
How long does it take to recover?
What is the price of the treatment in India?
Are the results of the treatment permanent?
What are the alternatives to the treatment?
Play video
Infertility
There are many causes of infertility, including some that medical intervention can treat.The main symptom is an inability to get pregnant. In many cases, there are no additional symptoms.
Play video
Infertility
Infertility happens when a couple cannot conceive after having regular unprotected sex.While there may be many causes for the same , stress is the major cause.
Play video
Role Of Stress In Infertility
stress boosts levels of stress hormones, such as adrenaline, catecholamines, and cortisol, which can inhibit the release of the body s main hormone, gonadotropin releasing hormone, which is responsible for the release of sex hormones. Subsequently, this may suppress ovulation in women, reduce sperm count in men and lower libido in both women and men.
Play video
Male Infertility
Techniques of TESA, Micro-TESA, ICSI can be used to give a child to couples with their own sperms even if there is no sperm in the semen.
Play video
Infertility Treatment Prior To IVF
In vitro fertilization (IVF) is a remarkable and complex process in which sperm and egg are united outside the body and implanted into a woman s reproductive tract. Many treatments significantly improve the chances of getting pregnant. They include hormone treatments, fertility drugs and surgery.
Having issues? Consult a doctor for medical advice