Treatment procedures for infertility problem - IVF, in vitro fertilization(Part 3)

IVF Process

Step One - Ovarian Downregulation

This is a preparation procedure that uses medications, such as Gonadotropin-releasing hormone (GnRH) agonist or GnRH antagonist to temporarily ‘switch off’ the messages going from the brain (pituitary gland) to the ovaries telling them to produce an egg on a monthly basis.

 

Pituitary gland, which is close to the front of your brain, is responsible for the normal functioning of your ovaries.

 

Suppressing the pituitary gland not only helps in achieving optimum ovarian stimulation, but most importantly it stops your ovaries from releasing premature eggs.

 

Ovarian downregulation is particularly helpful for women who respond poorly, or not at all, to the ovarian stimulating medications and therefore cannot take the full advantage of the IVF treatment. 

 

 

 

Step Two - Ovarian stimulation

This involves stimulating the development and the release of eggs using various infertility medications.

 Infertility medications like gonadotropins will be used to stimulate the growth of the follicles and eggs which will be retrieved for IVF procedure.

Your doctor will monitor you frequently during this time to make sure your follicles are developing properly and to identify the right time for egg retrieval. Once your follicles are developed, your doctor will retrieve the mature eggs.

 

What does it involve?

Your treatment will depend on your specify needs but it generally include following pathway:

 

Are there any restrictions of using hCG injection?
Sometimes hCG injection may be stopped because:

·           A lack of mature eggs for the IVF procedure such that the follicles may not have developed properly

·           Woman ovulates prematurely and the eggs cannot be retrieved

·           Woman develops too many follicles and doctor feels that it would be unsafe to give the hCG injection.

 

How long is ovarian stimulation?

It can be a lengthy process with a lot of your time devoting to attending appointments with your doctor and taking your medications at the right time. The length of ovarian stimulation will depend on your ovarian response during the treatment.

 

Reference: fertility.com.hk

The information aims to provide educational purpose only. Anyone reading it should consult obstetricians and gynecologists before considering treatment and should not rely on the information above.

 

Treatment procedures for infertility problem - IVF, in vitro fertilization(Part 2)

Who is recommended for IVF?

This technique is used mainly where a woman has no fallopian tubes or if they are blocked. It has also been used in dealing with some types of male infertility and where the cause of infertility is unknown. Eggs are taken from the woman's ovaries when judged to be ripe and before they are released naturally. It is then mixed with sperms in a dish (in vitro) so that fertilization can occur. Once the fertilized egg has started to develop, it is transferred back to the woman's womb. The embryo must implant in the womb for a pregnancy to be established.

Tips! Preparation before IVF

Before commencing IVF therapy, you will be examined by gynecologists and embryologists to work out possible treatment options. Here are several preparations to be made before IVF.

 

-          Lifestyle modification:
It is always important to maintain healthy weight in women, avoid alcohol and tobacco and increase folic acid intake may increase the chance of conception;

-          Rubella vaccination (if applicable);

-          Treatment of chronic illness: consult your doctor before IVF treatment if you have any chronic illness;

-          Screening tests: certain test for ovarian reserve; and

-          Sperm wash: if sperm count is low.

 

 

 

Reference: fertility.com.hk

The information aims to provide educational purpose only. Anyone reading it should consult obstetricians and gynecologists before considering treatment and should not rely on the information above.

Treatment procedures for infertility problem - IVF, in vitro fertilization(Part 1)

According to the Hong Kong Council on Human Reproductive Technology, a couple may be classified as "infertile" or "sub-infertile" if pregnancy has not occurred after one year of regular unprotected sexual life. In Hong Kong, an estimated one in six couples has difficulty conceiving due to different reasons.

 

There are many reasons for infertility. Problems affecting male fertility include tubal obstruction or damage, semen abnormality or unexplained infertility while those affecting women include ovulation disorders, endometriosis and unexplained infertility. Age may also be one of the other factors affecting fertility.

A Reproductive Technology (RT) procedure means a medical, surgical, obstetric or other procedures assisting or bringing about human reproduction by artificial means. RT treatment may be considered as one of the options to increase the chance of conception. Apart from RT treatment, other methods such as timed intercourse, drug therapy and surgery may be recommended by medical practitioners. You are strongly advised to consult your doctor for the most appropriate and suitable procedures if you intend to go through infertility treatment. (reference: http://www.chrt.org.hk/english/patients/patients_abo.html)

 

IVF - Introduction

IVF is commonly known as “test tube baby”. IVF is indicated for couples suffering from subfertility. IVF is probably the commonly used assisted reproductive technology and it has helped infertile couples conceive and bear children for over two decades. It starts with ovulation induction, followed by egg retrieval, fertilization and embryo transfer.

 

 

 

 

Reference: fertility.com.hk

The information aims to provide educational purpose only. Anyone reading it should consult obstetricians and gynecologists before considering treatment and should not rely on the information above.

 

Treatment procedures for infertility problem - IUI, Intrauterine insemination(Part2)

IUI Process
Woman has to take clomiphene or gonadotropins to increase the number of egg development. Your doctor will monitor you closely in order to prevent too many eggs being stimulated. A semen sample will be collected from your partner about an hour or two before you are scheduled for insemination. 

 

The semen is “washed” to separate the sperm from the seminal fluid, which contains substances that can irritate your uterus. Sperm “washing” sperm may also improve the ability of the sperm to fertilize the egg by reducing the distance for the sperm in reaching the egg and increasing the number of sperm entering the uterus.

Your doctor will inject the “washed” sperm directly into your uterus near the uterine entrance of fallopian tube at the time of ovulation. A speculum will be placed inside your vagina and a small catheter will be inserted through your cervix into your uterine cavity when the sperms are injected through the catheter into your uterus.  This procedure will not cause any discomfort and does not require any anesthetics.

 

Success rate
Success rates vary among international studies, ranging from 5-70%, with a mean success rate of about 9%. This can be explained by different protocols adopted in clinics as well as the patients’ condition (age, chronic illnesses, etc.).

 Most pregnancies in reported IUI studies occurred within 3-6 months. It is suggested that couples should opt for IVF after 6 months of IUI treatment failure.

 

Risks / Possible Complications

Bleeding/ spotting

Bleeding or spotting is often reported in IUI treatment, particularly those with a cervical tenaculum used.

Pain

The procedure is a bit uncomfortable. If needed, local anesthesia may be used to eliminate discomfort.

Multiple pregnancy

Multiple pregnancy is a common and major complication of assisted reproductive therapies. It poses both economic and sociological burden to the family.

Congenital defects of fetus

All ART have reported risks of fetal congenital defects

 

Can I go through this procedure more than once?
Yes, if you do not become pregnant after the first treatment, you can repeat the procedure again in your next few cycles. Obviously, further evaluation may be required if the treatment fails to show an effect after several attempts.

 

NOTE:

Fallopian tube of female should be normal in order to commence IUI.

Avoid sexual intercourse for 2-3 days before IUI therapy.

 

 

 

 

Reference: fertility.com.hk

The information aims to provide educational purpose only. Anyone reading it should consult obstetricians and gynecologists before considering treatment and should not rely on the information above.

 

Treatment procedures for infertility problem - IUI, Intrauterine insemination(Part 1)

According to the Hong Kong Council on Human Reproductive Technology, a

couple may be classified as "infertile" or "sub-infertile" if pregnancy has not occurred after one year of regular unprotected sexual life. In Hong Kong, an estimated one in six couples has difficulty conceiving due to different reasons.

 

There are many reasons for infertility. Problems affecting male fertility include tubal obstruction or damage, semen abnormality or unexplained infertility while those affecting women include ovulation disorders, endometriosis and unexplained infertility. Age may also be one of the other factors affecting fertility.

 A Reproductive Technology (RT) procedure means a medical, surgical, obstetric or other procedures assisting or bringing about human reproduction by artificial means. RT treatment may be considered as one of the options to increase the chance of conception. Apart from RT treatment, other methods such as timed intercourse, drug therapy and surgery may be recommended by medical practitioners. You are strongly advised to consult your doctor for the most appropriate and suitable procedures if you intend to go through infertility treatment. (reference: http://www.chrt.org.hk/english/patients/patients_abo.html)

 

Intrauterine insemination (IUI)
IUI involves the placement of sperm (usually after processing) into the uterine cavity.

IUI is one of the assisted reproductive therapies (ART) that help couples with subfertility issues, particularly those with mild male subfertility and unexplained infertility.

 

Advantages of using IUI
By placing sperm artificially close to the site of fertilization, IUI bypasses many problems that can occur in the vagina or cervix.  It also improves delivery of the sperm to the egg, especially when there is a low sperm count or inactive sperm.  Other benefits include:

• Minimally invasive

• Less emotional commitment

• Quick procedures

 

Disadvantages of using IUI when compared to other assisted reproductive technologies

• Fertilisation cannot be confirmed

• Risk of multiple pregnancy

• Fallopian tubes must be unobstructed

 

 

Reference: fertility.com.hk

The information aims to provide educational purpose only. Anyone reading it should consult obstetricians and gynecologists before considering treatment and should not rely on the information above.

Treatment procedures for infertility problem - Intracytoplasmic Sperm Injection (ICSI) (Part 2)

What does it involve?

To start, you will have to take fertility medications to induce ovulation during your cycle before the ICSI because this procedure requires multiple eggs to ensure the success of the treatment.

 

Similar to standard IVF procedures, the mature eggs are collected from your ovaries and you may receive general anaesthesia during the procedure. Meanwhile, your partner will be asked to provide a semen sample. The sperms are then evaluated and the healthiest sperm are selected for the ICSI procedure.

 

After the eggs and sperms are collected, the ICSI process will take place in the laboratory in which the “healthiest” sperm is injected directly into the centre of the egg by an embryologist.

 

Eggs are observed for the following day or so and those that are fertilised and developed properly will then be transferred into your uterine cavity.

 

If the procedure has been successful, your doctor will discuss with you and your partner about the number of embryos to be transferred to your uterine cavity. Your doctor will place a speculum inside your vagina, insert a small catheter through your cervix into your uterine cavity, and transfer the embryos through the catheter. The transfer causes minimal discomfort.

 

You will be asked to do a pregnancy blood test at the clinic about 2 weeks after the embryo transfer. It is not recommended to do a home pregnancy test before that time because some of the fertility medications may lead to false results if the test is performed too early.

 

 

 

Advantages of ICSI

ICSI is the most commonly used method to overcome male infertility problems. By selecting one single “healthiest” sperm and directly injecting into the egg, it bypasses the problem of penetration, which may not be easily done by less healthy sperm in a natural environment, thus enhancing the chance of pregnancy. Other benefits include:

l   Most effective procedure for male infertility

l   Overcoming sperm quality problems

 

Disadvantages of ICSI

l   Possibility of transmitting infertility to offspring;

l   Technically demanding; and

l   More expensive than IVF.

 

 

 

 

Reference: fertility.com.hk

 The information aims to provide educational purpose only. Anyone reading it should consult obstetricians and gynecologists before considering treatment and should not rely on the information above.

Treatment procedures for infertility problem - Intracytoplasmic Sperm Injection (ICSI) (Part 1)

According to the Hong Kong Council on Human Reproductive Technology, a couple may be classified as "infertile" or "sub-infertile" if pregnancy has not occurred after one year of regular unprotected sexual life. In Hong Kong, an estimated one in six couples has difficulty conceiving due to different reasons.

 

There are many reasons for infertility. Problems affecting male fertility include tubal obstruction or damage, semen abnormality or unexplained infertility while those affecting women include ovulation disorders, endometriosis and unexplained infertility. Age may also be one of the other factors affecting fertility.

A Reproductive Technology (RT) procedure means a medical, surgical, obstetric or other procedures assisting or bringing about human reproduction by artificial means. RT treatment may be considered as one of the options to increase the chance of conception. Apart from RT treatment, other methods such as timed intercourse, drug therapy and surgery may be recommended by medical practitioners. You are strongly advised to consult your doctor for the most appropriate and suitable procedures if you intend to go through infertility treatment. (reference: http://www.chrt.org.hk/english/patients/patients_abo.html)

 

 

Intracytoplasmic Sperm Injection (ICSI)

ICSI is a method of gamete micromanipulation where a single sperm is injected into the inner cellular structure of an egg. The resulting embryo will be transferred into woman's womb as in a normal IVF cycle.

The information aims to provide educational purpose only. Anyone reading it should consult obstetricians and gynecologists before considering treatment and should not rely on the information above.