Infertility is defined as not being able to conceive even after trying for over a year of having unprotected intercourse. Nearly 15% of the couples fail to have children naturally, and the cause could be either in you or your partner, or a combination of reasons. Infertility also includes the cases where the female is unable to sustain pregnancy.
We at Aashakiran Fertility Center give our best to couples for treating infertility so that they enjoy parenthood. The advanced techniques of Assisted Reproduction have given hopes to several couples who have succeeded in completing their family through us.
According to the World Health Organization (WHO) data, nearly 8-10% of couples all over the world are affected by one or other kind of infertility, with numbers ranging between 50 and 80 million. However, the incidence of such a condition may vary from one region to another.
No, infertility is not exclusively the problem with females. Nearly 30-40% of couples who cannot conceive due to infertility are due to the female partner, while an equal proportion, i.e. in 30-40% of cases, male partner is infertile. In 10-15% of the couples who are unable to conceive, both the partners are diagnosed with infertility. Whereas, 5-10% of the cases are of unexplained infertility i.e. the cause of the problem remains unexplained.
FACT: Over more than 3 million babies have been born after IVF treatment worldwide and the risk of any abnormality in such babies has not been found to be any more than other babies. The incidence of malformations in such babies is around 2%, which is comparable to that of babies born naturally.
FACT: Numerous studies have now confirmed that medications for IVF are not associated with risk of ovarian cancer.
The most common underlying causes of female infertility are explained below.
This could be attributed to endometriosis, infections, or adhesions. Such conditions lead to fallopian tubes getting blocked, thereby preventing the egg produced from the ovaries to reach uterus and unite with sperms.
The cervix produces a substance (mucous) that becomes thin at the time of ovulation, so that the sperm can easily pass through to meet the egg. Abnormality in the cervix results in poor quality of the mucous, usually a poor viscous mass that prevents the sperm journey through the cervix.
It is a condition, the cause of which is not exactly known. It leads to the formation of cysts in the ovary, along with adhesions which distort the anatomy of the pelvis. It is also associated with poor egg quality.
These occur when the FSH (follicle stimulating hormone), LH (luteinizing hormone) and estrogen hormones are not produced at the right time, in the right order and in the right amount. An imbalance in any of these hormones prevents the matured egg from being released from the ovary, thereby causing infertility. The three types of ovulation disorders are:
The root cause of infertility in males could be traced to the problems or defects in the reproductive system during fertilization stages. Lower sperm count, defects in sperm production, problem with the movement of sperms, and issues with the quality of sperm are often the main reasons contributing to male infertility. ach of these issues has an underlying cause, and understanding these causes is the first step in the direction of infertility treatment.
Sperms are being produced in the testicles, under the influence of various hormones. There are various factors that are involved in the production of a healthy sperm which maybe hampered or disturbed due to the various causes listed below:
Testosterone, FSH and LH rule the sperm production in your reproductive system. Over production or deficiency in the FSH or the LH retards the stimulation of the testicles and the testosterone respectively. As a result, your system is unable to produce adequate amount of sperms for conception.
55% of males are diagnosed as infertile due to damaged testicles. Unable to respond to hormones, the testes lose their ability to produce healthy and viable sperms.
Fertility is inhibited in case of undescended testicles. The testes loses its function, thus inhibiting the production of sperms.
The sperm production is very sensitive to any changes in temperature. Therefore, high temperatures like steaming hot water baths, Jacuzzis etc. which can overheat the testicles and can stop sperm production completely. Similarly, obesity and long hours of sedentary work can heat up the testicles causing low sperm production.
This is a condition where the semen is released into the bladder during ejaculation. This can be congenital, i.e. present since birth or may develop later in life due to diseases like diabetes, multiple sclerosis, prostrate surgery or some medications.
This condition accounts for 6% of the male fertility problems. There may be some obstruction in the passage of the sperm en route from the testis to the penis. This may be in the vas deference or the epididymis duct. If the blockage is on both sides, there will be no sperm in the ejaculate and results in azoospermia.
One is born with this condition. The opening of the urethra is on the underside of the penis instead and thus the semen does not reach the penis.
Infertility can be attributed to various factors in males and females, but there is no single underlying reason for it.
Female infertility could be due to ovulatory and anatomical disorders. These could be either due to inability of the egg to reach uterus or inability of the ovaries to release egg. It could also be due to damaged fallopian tubes. Sometimes a fertilized egg fails to attach to the uterus lining; and at times, an attached embryo fails to survive. Female infertility could also be due to certain other conditions such as autoimmune disorders, diabetes, tumors, and cancers, and certain hormonal problems such as thyroid or hyperprolactinemia. In certain other cases, infections such as Chlamydia, tuberculosis, gonorrhea in the womb can also contribute to infertility in women.
Whereas, male infertility could be due to blockage of sperm production or decreased sperm count. Apart from these, there are other risk factors, which could contribute to infertility in many, if not all the cases. These risk factors could be lack of sufficient nutrition, excessive smoking, sexually transmitted infections, or exposure to certain chemicals such as pesticides, herbicide, lead metal etc.
ART is a treatment option for couples with various types of infertility. It has been successfully used to overcome infertility due to blocked or damaged tubes, endometriosis, repeated IUI failure, unexplained infertility, poor ovarian reserve, poor or even nil sperm count (through sperm retrieval techniques like TESA/PESA) . IVF can be normally performed for counts which are more than 5 million per ml. For counts less than 5 million per ml., ICSI is a better option. At Fortis Bloom IVF Centre, the success rate of IVF are in the region of 40-50% for women less than 35 years, which are comparable to the leading units in the world.
IVF is an Assisted Reproduction Technique (ART), in which union of the eggs and sperms is done in a laboratory dish, and after fertilization, the resulting embryo is then transferred to the woman’s uterus. It involves Five Basic Step which are super ovulation (stimulating the development of more than one egg in a cycle), egg retrieval, fertilization, embryo culture, and embryo transfer.
IVF has emerged as the most successful treatment modality for couples who have failed to conceive naturally. In fact women who have ovarian failure or premature menopause can now conceive using egg donation program which has a success rate of 50-60% at Aashakiran Ferility World. Women with damaged or absent uterus can opt for surrogacy to have a baby.
Similarly men with nil or very low sperm count can father a child using the technique of ICSI. Such couples could have never achieved success without IVF. Even women with blocked/damaged tube who had dismal pregnancy rates even after tubal surgery, can now successfully conceive with IVF, and avoid the trauma and pain of surgery.
Yes, during the IVF procedure the egg of the genetic mother and sperm of the genetic father are used to create the embryos in the laboratory. These embryos are then transferred into the womb of the genetic mother or surrogate – where in both cases the child is of the genetic parents.
In case, the couple decides to go for a donor egg or sperm program, the child still remains of one genetic parent.
IVF treatment is generally very patient friendly nowadays and patients can carry on with their routine activities as usual. Certain precautions that should be observed during treatment include:
Avoid excessive caffeine, smoking, alcohol and drugs
Avoid heavy lifting, strenuous exercising and bouncing activities
Avoid sexual intercourse and orgasms
The cost of an IVF cycle has two components – One is the procedure cost, which is fixed for any ART unit and is usually around Rs. 80-90,000, whereas the other component is the drugs/medications cost which are essentially the hormone injections that the female has to take for ovarian stimulation. This cost is variable and depends on the total dose of hormones the patients need for ovarian stimulation. The dose need is lower for younger women with good “Ovarian Reserve” and higher for older women, which increases the treatment cost. On an average one IVF cycle costs around Rs. 1,40,000.
There is no restriction to the number of attempts for IVF, and women have even conceived in their 11th cycle, but generally a couple should try a maximum of 4 attempts of IVF/ICSI. If one fails to conceive, it is advisable to opt for either egg donation/embryo donation/semen donation/adoption.
There is no age limit for taking an IVF treatment, as long as the couple is healthy. With options of egg donation and embryo donation, women can now conceive even after menopause.
Most of the procedures nowadays are simple, of short duration and patient friendly, needing a maximum hospital stay being restricted to 4-6 hours. Sometimes the ovaries swell up excessively, leading to fluid collection in abdomen and lungs. This is called ovarian hyperstimulation syndrome (OHSS) and may need hospitalization and sometimes removal of the fluid from the abdomen by a procedure called ‘Paracentesis’.
Occasionally the pregnancy may lodge in the fallopian tubes (ectopic pregnancy) and may need medical treatment or surgery for its removal. Complications may occur during the egg retrieval procedure as the removal of eggs through an aspirating needle entails a slight risk of bleeding, infection, and damage to the bowel, bladder, or a blood vessel.