For Infertility Specialist and Consulting
Couples considering any kind of infertility treatments may often
have many questions regarding the treatment and the whole procedure. Here we
present some basic FAQs that we commonly receive about the treatment:
Q. What is
the first stage of Infertility treatment?
A. The first consultation involves the overall
assessment of cause of infertility and next is to get the present fertility
status of the couple. A transvaginal sonography scan gives a great information
regarding follicles, lining of uterus, presence of any fibroids, etc. Detailed semen
analysis is done and at the same time it is stored. Hysteroscopy is needed
where there is any abnormal finding in sonography.
Q. We have a
fear that other person’s sperms are used in IVF or sperms are mixed to increase
the success. Is it true?
A. When husband is able to provide sperms (even in the
least quantity), his sperms are used in IVF or in ICSI. Husband’s sperms can
even be retrieved from his testicles in cases of Azoospermia. Donor sperms are
used only when there is a written consent by the couple.
Q. Do we
need hospital admission or there is any sort of surgery during the treatment of
IVF or ICSI?
A. IVF or ICSI does not need hospital stay or any sort
of surgery. During egg retrieval we give general anesthesia (Inj Propofol) for
10 – 15 minutes and it is given by qualified anesthesiologist. Eggs are
retrieved by simple needle under ultrasound guide.
Q. If
pregnancy is achieved by IVF or ICSI, than do we need bed rest for further
period of pregnancy?
A. Absolute bed rest is not needed but we instruct the
female partner to abstain from heavy exhaustive work and avoid intercourse for
few weeks.
Q. Is there
any complication during the IVF or ICSI treatment?
A. Complication called Ovarian Hyper Stimulation
Syndrome is always feared during this treatment. It is more in younger females
and esp. females with Polycystic Ovaries. To avoid this physician always keeps
a check on growing follicles and titrates the doses of Gonadotropins. If it is
still imminent, then we do not transfer the embryos in that particular cycle
and Freeze them to transfer later on. Chances of this complication are very low
and usually treated in a conservative manner.
Q. Why IVF
fails?
A. IVF fails mainly because of two reasons .One is due
to quality of eggs and second is failure of implantation. These things may
happen in natural pregnancies also, but as there is cost involvement in IVF, so
it pinches. Quality of stimulation and quality of embryology matters a lot, but
these can be corrected by taking stringent measures but quality of eggs and
implantation is still beyond anybody’s approach.
Q. How many
days are required for IVF or ICSI treatment?
A. Treatment requires 30 days, from start of injection
of down regulation to embryo transfer.
Q. When egg
donation is advised?
A. It is advised when the female partner’s age is
around 40 or she is having premature menopause.
Q. What is
infertility?
A. Infertility can be defined as the inability of
couple to achieve conception a year or more of regular, unprotected coital
exposure.
Q. How long
a couple should wait to go for fertility treatment?
A. For normal couples the chance of achieving a
successful pregnancy is
• 20 % for any given month
• 57% within three months of trying
• 75 % within six months
• 90 % within one year
• 95 % within two years of attempting pregnancy
Hence a general rule is if couple does not achieve a
pregnancy within one year, they should go for finding out the reasons of infertility.
Q. What is
the frequency of couples suffering from infertility?
A. One in six couples attempting pregnancy will have
difficulty in achieving.
Q. How much
the men or women are responsible for infertility?
A. That is almost equal as in 30 % both are
responsible for infertility.
Q. Is there
chance of getting sick during IVF treatment?
A. Normal upper respiratory infections will not be
issue. Some antibiotics and medications can be taken with fertility drugs but
it is good to consult us first before taking any other medication.
Q. How the
age of partners affects achieving a pregnancy?
A. Achieving a successful pregnancy declines with age.
• Fertility declines in men after age 50
• Fertility declines in women after age 30
• 4 % of women before age 25 have difficulty achieving
a successful pregnancy.
• 13 % of women age 26-34 have difficulty having a
baby.
• 25 % of women have difficulty conceiving between the
ages of 35-39
• By the age 40, 34 % of women attempting pregnancy
will have difficulty achieving pregnancy.
Q. How a couple
can get an idea that their fertility treatment will have better chance of
achieving pregnancy?
A. Success in Fertility treatment is largely depends
on ovarian reserve of the female partner. Ovarian reserve is best assessed by
Day2 vaginal sonography. It is the number of small resting follicles gives the
idea about how many eggs are going to be retrieved during IVF. Other tests are
Day2 /3 FSH, AMH and inhibin assays. Day2/Day3 FSH are more frequently used.
Q. What are the
main factors causing infertility?
A. In Females: Causes could be
• Irregular ovulation or egg production, hormonal
imbalance 30 %
• Tubal Block 30 %
• Problems in uterus like fibroids ,adhesions , defect
in uterine lining called synechae, endometriosis and congenital anomalies 30 %
• Unexplained 30 %
In Males: Causes might be
• Low sperm count with or without low motility.
• Absence of vas deference (tube carrying the sperms),
testicular abnormality, and hormonal imbalance.
• Absence of sperms (azoospermia) Obstructive or
Nonobstructive
Q. Does the
blood group of the couple affect the fertility?
A. Blood group is not the cause of infertility.
Q. Semen leaks
out after intercourse, does it affect in achieving the pregnancy?
A. Volume of the semen is more than the capacity of
vagina. Hence part of the semen comes out. Semen is ejaculated in sperts. The
first spert is usually during deep penetration and is richest in sperms (least
seminal water). It gets sprayed over the mouth of uterus (external os). Hence
nature made an arrangement that sperm should enter the cervical canal and
plasma is thrown out.
Q. Does
masturbation in young age affects the male fertility status or sexual potential?
A. Masturbation is rather a good indicator that the
male is normal. You can never run out of sperms only because you masturbated.
Excessive masturbation may affect the timed intercourse because of flaccidity
of penis.
Q. Is Impotency
and Infertility same, referring to a male?
A. Impotent usually means a male who cannot perform
sex, but he may have good number of sperm to create a baby if injected
artificially. In the same way a person may be very good at sex, but may be
azoospermic. Hence virility and sperm productions are two departments. If
testis are very small or damaged in any way may cause infertility and impotency
both.
Q. Ovulation
inducing drugs may cause ovarian cancer in women?
A. Excessive ovulation may be a factor but it is not
yet clearly established that these drugs may cause cancer.
Q. Is it safe
to take herbal supplements?
A. During IVF treatment, herbal supplements may cause
unknown effects and it is advisable to consult your doctor before taking any
kind of herbal medications.
Q. IVF or ICSI
babies are having more danger of affected by genetic disorders?
A. Definitely there is concern, as these methods are
not natural. But till date there is no clear cut correlation between these
method and genetic diseases compared to population. It is a protective
phenomenon of nature to go for the best selection of the pregnancies either
achieved naturally or by artificial means. Abnormal fetuses are usually aborted
whether they are created by natural intercourse or by ART (assisted
Reproductive techniques).
Q. What are ART
(Assisted Reproductive Techniques)?
A. It is wide range of fertility treatments. Most
widely known is IVF (in-vitro fertilization) and ICSI (Intra-cytoplasmic sperm
injection). Others are IUI (Intrauterine Insemination), GIFT (Gamete
Intra-fallopian Transfer), TET (Tubal Embryo Transfer), DEP (Donor Egg
Program).
Q. What is the
legal aspect of IVF India?
A. At present in India, (2006) Laws regarding ART
procedures are under framing.
• There is no restriction on the no of embryos
transferred.
• Use of donor Eggs or embryos/Sperms.
• Surrogacy
• Embryo reduction
• Freezing
