In natural conception fertilization of egg and sperm occurs and fertilized embryo continues to grow inside the uterus of a woman resulting in pregnancy and birth of the child.
Infertility refers to the inability to conceive after a year of having regular unprotected sex. If you and your partner have been trying unsuccessfully to get pregnant for 12 months or longer, testing for fertility is essential.
Male fertility testing generally includes Semen analysis to evaluate the quality and quantity of semen. Hormone testing to check for levels of testosterone and other male hormones.
Female fertility tests help to screen the cause of female infertility. Blocked Fallopian tube is a common cause of offemale infertility. Fallopian tubes are thin tubes one on either side of the uterus which helps the egg to reach the uterus from the ovaries. When obstruction develops in these tubes it is known as blocked fallopian tubes or tubal occlusion.
Imaging tests
- Ultrasound and x-ray medical imaging by a fertility specialist to rule out any health concerns with reproductive organs, the uterus, cervix and fallopian tubes that could interfere with conception or pregnancy.
- Laparoscopy- a minimally invasive procedure which is minor surgery to examine reproductive organs, biopsies of tissues taken from the uterus and/or fallopian tubes, and genetic testing.
Lab tests – to evaluate whether or not women are ovulating regularly and check levels of vital reproductive hormones. The sample was taken: Blood and Urine
- Level of Follicle-stimulating Hormone (FSH) a hormone that affects reproduction
- Level of Luteinizing Hormone (LH) to help assess fertility
- Thyroid-Stimulating Hormone (TSH)level in the blood to evaluate thyroid function
- Level of Estradiol—to help assess fertility
- Level of Testosterone
- Level of Progesterone
- Prolactin— Measures prolactin, a hormone important during pregnancy and while breastfeeding
- HIV— Detects antibodies and antigens to help diagnose.
- Chlamydia &Gonorrhoea— Detects chlamydia and gonorrhea in a urine sample
When diagnosed with female infertility IVF is mostly the choice of treatment.IVF also was known as Invitro fertilization is a type of Assisted Reproductive Technology (ART) procedure wherein special medical techniques are used to help a woman in getting pregnant. It is a process of fertilization wherein an egg is extracted and combined with sperm outside the body in the laboratory and then the embryo is transferred to the uterus.
Reasons for performing IVF
Unexplained infertility that is the inability to conceive after a year of having regular unprotected sex,
Damaged or blocked Fallopian tubes
Male infertility Decreased sperm count and blockage causing male infertility
Endometriosis, Ovulation disorders, uterine fibroids
In Cases of egg freezing when women want to delay pregnancy
IVF with Donor Eggs By the age of 40 and above women have reduced fertility potential, most IVF clinics have an upper age limit for allowing IVF treatment when using own eggs, This is between 42 and 45 years of age. Donor eggs are commonly used until about age 49.
Procedure of IVF
I: Stimulation of ovaries
Medicines, called fertility drugs, are given to the woman to boost egg production. Blood tests for hormone levels and ultrasounds to examine ovaries are performed regularly.
II: Egg retrieval/ follicular aspiration is performed to remove the eggs. If a woman does not or cannot produce any eggs, donor eggs may be used.
III: Insemination
- Sperm is placed together with the best quality eggs. The mixing of the sperm and egg is called insemination.
- Eggs and sperm are then stored in an environmentally controlled chamber. The sperm most often fertilizes an egg a few hours after insemination. In a few cases, the sperm may be directly injected into the egg. This is called intracytoplasmic sperm injection (ICSI).
IV : Transfer of embryo to the uterus
- When the fertilized egg divides, it becomes an embryo. Embryos are placed into the uterus 3 to 5 days after fertilization through a catheter. If an embryo implants in the lining of the womb and grows, pregnancy results.
- More than one embryo may be placed into the uterus at the same time, which can lead to twins, triplets, or more. The number of embryos transferred varies depending on the individual diagnosis and clinical circumstances. Under 34 years, 1-2 embryos, 35 years and above 2-3 embryos.
Complications of IVF
- Chances of multiple pregnancies as more than one embryo is placed in uterus, leading to the risk of premature and low birth weight baby.
- Egg retrieval can result in bleeding, infection, and damage to ovaries or surrounding structures.
- Many couples suffer psychological stress and depression especially if IVF not successful.
- Rarelyfertility medications may cause ovarian hyperstimulation syndrome (OHSS).
The cost for IVF in India is approximately USD 3500 – USD 6000, Cost varies depending upon the complexity of the case, the hospital patient chooses, the experience of the doctor, the health of the partners, count and quality of sperm and egg. Total stay in India would be at least 3-5 weeks, and for that accommodation, charges would be extra.
The IVF cycle cost in India is much lower, not only is the price lower but the quality of facilities and expertise of doctor is at par with international standards. Internationally the cost of IVF ranges around USD 15000- 25000 which is around 3 times more than the price charged by Indian doctors and hospitals.
Recommended: Top doctors for IVF in India
Success Rate for IVF may differ from one clinic to another, IVF success depends on a number of factors the age of the patient, general health status of the patient, medical reasons for infertility, competency of the performing doctor, etc.
