Failed IVF Cycles What Next: Should You Try Again?

Couples unable to conceive naturally have a ray of hope thanks to in-vitro fertilisation. Despite its high success rates, IVF can not always guarantee that you will conceive a child. Couples are devastated when IVF fails because it feels like something unexpected has happened. You don’t have to lose sight of your expectations if IVF fails.

Related: 6 Things Not to Say to Someone Going Through IVF and Infertility

What might have caused an IVF cycle to fail?

The following are the reasons behind failed IVF:

Embryo quality

At some point, you must have wondered why IVF with good-grade embryos failed. One of the  factors contributing to IVF failure is the poor genetic material of the embryos which can not be detected with morphological grading. Embryos with genetic abnormalities either do not implant or result in abortion if pregnancy occurs.

 Age of the Female Partner

 A woman’s ovarian reserve continues to decrease as she matures, and getting pregnant becomes more difficult. Age affects both the quantity as well as the quality of the eggs. The genetic material alters with advanced age. A woman’s self-confidence may suffer after a succession of unsuccessful IVF treatments, so it’s important to try to conceive at the correct time. Her subsequent IVF attempts ought to have a lower success percentage.

Chromosomal problems

Miscarriages and unsuccessful IVF procedures may result from chromosomal abnormalities. Chromosomal abnormalities in women begin to develop in their 30s, in addition to chromosomal errors in sperm, which occur much less frequently than in women’s eggs.

Unhealthy lifestyle

Before beginning any treatment or trying conception, patients should stop smoking and drink for at least three months, as these habits may increase the likelihood that an IVF procedure will not be successful. These habits affect the genetic material of sperm and egg, eventually affecting the genetic material of the embryo. Additionally, women who smoke could require more IVF cycles than non-smokers to conceive. Being overweight or underweight may also reduce the success rate of an IVF cycle.

Related: Fertility And Diet: How Does Your Diet Affect Your Fertility Health?

How Can You Proceed Further After Multiple Failed IVF Cycles?

Do not panic if you have experienced many IVF failures; instead, try to identify the causes. To determine how to move forward, talk to your family and doctor. You should try to comprehend what additional tests need to be done, what choices you have, and whether you may try IVF again. Discussing the following steps with your doctor is a wonderful way to proceed. After several unsuccessful IVF attempts, you have the following choices:

Attempt IVF one more time

Ask your doctor if there are any changes that might be made to the IVF cycle to increase its success. Few people have IVF treatments that are successful on their very first try. However, it is not true for everyone. After understanding and correcting the probable reason for failure, you may attempt another cycle of IVF. This may require lifestyle modifications or additional advanced tests.

Gestational surrogacy

Gestational surrogacy is anoption if you’ve had several implantation failures, the embryos are of good quality but the endometrium is not receptive. It is also advised if the woman’s pregnancy appears to be difficult due to some chronic illness. In this procedure, the embryo is implanted into a surrogate’s uterus after it has developed in the IVF lab.

Use donor eggs

Using donor eggs can be your next step to have a successful IVF cycle if the poor-quality egg was the cause of your IVF failure.

Frozen embryo transfer

Embryos produced in excess during IVF can be saved for later use. You can use the frozen embryo if your prior IVF cycle was unsuccessful.

Related: Things to Consider Before Freezing Your Eggs

What is the right time to attempt the next time after a failed cycle?

Logically, they should start making the necessary corrections as soon as the reason for the IVF failure is identified, and only then should they try again. But what if there isn’t a problem that requires treatment, such as when IVF fails due to poor clinical judgement?

The success rate of repeat cycles that have been performed back-to-back and those that have been separated by a few months do not differ significantly from one another. Studies have shown that the interval between unsuccessful and succeeding IVF treatments has little bearing on the success rate. 

As a result, it is entirely up to the patient to decide how long to wait after the last IVF attempt has failed before attempting again, however, they should wait long enough to have recovered physically and psychologically from the shock. They would be encouraged to wait for a little before making a second try because of this, however, they can attempt another cycle once they are ready. To get ready for the happy voyage that lies ahead of them, they should embrace a stress-free and healthy lifestyle in the interim.

Takeaway

If you are considering IVF and searching for the top fertility clinic in New Delhi, Pristyn Care Ferticity Fertility Clinics may be the ideal option for you. Our team of highly skilled fertility doctors has successfully treated a number of patients. We collaborate closely with you to create a unique fertility treatment strategy. You can reach us at any time by calling, and we are pleased to help.

Ways Smoking Kills Your Fertility

Smoking is one of the most harmful habits which affects general health, and the effects on fertility are no different. Since smoking has a detrimental effect on the future child’s general health, the majority of fertility specialists advise their patients to stop smoking while they are trying to conceive. Here are the top 10 ways smoking can impair your ability to get pregnant:

Related: Smoking And Fertility: Effects Of Smoking On Male & Female Fertility

ECTOPIC PREGNANCY

Ectopic pregnancy is a term used to describe pregnancies that have developed outside of the uterus, most frequently in the fallopian tube. In addition to facilitating the union of the sperm and egg, the tubal cilia are also in charge of delivering the freshly fertilized egg, which is now a developing embryo, to the uterus for implantation. The embryo is more likely to not be carried to the uterus for implantation when the cilia are destroyed. Smokers have a higher risk of developing an ectopic pregnancy because their tubes are not working properly. Ectopic pregnancies can result in the loss of an ovary or a fallopian tube and pose a serious health risk.

MISCARRIAGE

When a woman becomes pregnant, smoking increases her risk of miscarriage. There could be a number of causes for this. One of the most likely explanations is that the chemicals in tobacco smoke cause DNA damage and harm to the “machinery” in the egg that controls how chromosomes separate normally. The use of smokeless tobacco products, such as vaping, is also linked to an increased risk of miscarriage, therefore the increased risk of miscarriage is not simply attributed to the chemicals in tobacco smoke. The risk of miscarriage may rise as a result of inadequate blood supply to a growing pregnancy caused by the narrowing of blood vessels seen in smokers.

Related: How To Get Ready For A Healthy Pregnancy After Miscarriage?

TUBAL DAMAGE

The cilia that line our fallopian tubes softly beat to pick up and move the ovulated egg and the sperm. Think of them as the tiny bristles on a brush. The egg and sperm can interact because of these delicate cilia. Smoking affects how well the cilia work, which can stop fertilization.

EARLIER MENOPAUSE

Women are born with all the eggs they are ever going to have. One egg “wins” and ovulates each month, and the remaining eggs in that small group start to disappear. We get close to menopause when our egg supply starts to diminish. It has been discovered that smoking women experience menopause 1-4 years earlier than their non-smoking counterparts. It is believed that the chemicals in tobacco smoke are to blame for our eggs dying off more quickly. As a result, smokers frequently exhaust their egg supply earlier than nonsmokers.

Related: Can You Get Pregnant With IVF After Menopause?

BAD IN VITRO FERTILIZATION (IVF) OUTCOMES

Most women today are aware of in vitro fertilization. The American Society for Reproductive Medicine (ASRM) committee opinion on smoking and infertility states that lower live birth rates were observed even when women who smoked used donor eggs (eggs from a younger, non-smoking woman) to create embryos, indicating that smoking may also have an impact on the uterus. According to some research, it takes twice as many IVF treatments for smokers as it does for nonsmokers to sustain a healthy pregnancy.

SPERM ABNORMALITIES

It has been demonstrated that smoking and using smokeless tobacco causes aberrant sperm parameters such as decreased concentration, decreased sperm motility, and improperly shaped sperm. There is data that suggests smokers’ sperm (and their partners’ sperm) have a tougher time fertilising the egg. The above-mentioned worse IVF results are a result of this. 

PRETERM DELIVERY

Preterm birth is believed to increase your chance of smoking. Preterm birth is the delivery of a child before 37 weeks. Depending on how early they were born, premature babies frequently spend days to months in the neonatal intensive care unit (NICU) and are considerably more likely to experience serious issues, such as underdeveloped brains and lungs, and even as mortality.

BIRTH DEFECTS

Children born to smokers are more likely to have birth abnormalities and disorders like Down’s syndrome due to DNA damage and damage to the machinery that normally separates chromosomes.

SMALL BABIES

Even if they are born at full term, babies are still in danger of being less in weight in addition to being born early. Compared to their contemporaries born at the same gestational age who were of normal weight, babies who were born small for gestational age (SGA) have a higher chance of dying and developing learning difficulties, autism, and behavioural issues.

CERVICAL AND OVARIAN CANCER

Most people know that smoking increases the chance of lung cancer, but did you realise that smoking also increases the risk of nearly all types of cancers? The human papillomavirus (HPV) is the virus that causes cervical cancer in the majority of instances. Most sexually active adults will have had HPV at some point in their lives because it is so widespread. The abnormal alterations found on pap smears frequently disappear on their own since the body is often able to fight off this virus. Smoking, however, weakens our body’s defences against this infection. As a result, smokers are much more likely to get cervical cancer than nonsmokers. Patients suffering from cancer may require extensive surgery, chemotherapy and/or radiotherapy. All these treatments have adverse effects on fertility. The best thing you can do to aid your body in eradicating the virus if your pap smear results are abnormal is to stop smoking. 

What Are The Surgery Options Related to Infertility in Women?

The inability of a woman to conceive or effectively bring her pregnancy to term is known as infertility. For a variety of reasons, including endometriosis, fibroids, cervical stenosis, ovarian cysts, and others, women experience infertility issues. Although there are surgical methods for addressing female infertility issues, the majority of infertile women choose assisted reproductive technologies like in vitro fertilization (IVF) over surgery.

What Are Some Common Situations When Surgery is Required?

There are a few typical circumstances when women with fertility issues might need surgery, and they are as follows:

• Ovarian cysts
• Uterine septum
• Endometriosis
• Uterine polyps
• Pelvic adhesions
• Tubal disease
• Tube ligation
• Uterine fibroids 

Why Do Doctors Recommend Surgery for Infertility?

Depending on the severity of the problem, different surgeries are recommended. Laparoscopy and hysteroscopy are typically used by clinicians to treat various problems that cause infertility. 

Here are several surgical options:

Laparoscopy: It is a procedure where the fertility specialist uses a narrow fibre optic telescope to introduce into your body through a small incision near the navel. There are many laparoscopic procedures performed for distinct diagnoses and treatments. These are:

• • Tuboplasty: This procedure restores function to a woman’s fallopian tubes to enable conception.
  • Endometriosis treatment: Endometriosis frequently results in infertility by causing adhesions between uterus,tubes,ovaries and surrounding structure or by formation of ovarian cysts. A laparoscopic operation can be used to treat the condition.
  • Adhesiolysis: Laparoscopy can be used to treat pelvic adhesions when they are diagnosed.
  • Myomectomy: The fibroids which are present in the body of uterus can be removed through laparoscopy 
  • Microsurgical tubal reanastomosis: This microsurgery reconnects the two ends of the fallopian tubes to reverse a tubal ligation.

• Ovarian cystectomy: This surgery is used to remove ovarian cysts that have developed.

• Salpingectomy or Tubal clipping : Salpingectomy is a procedure to remove the fallopian tube and Tubal clipping is done to clip the proximal part of the fallopian tube. These procedures are done in patients with fluid buildup (known as hydrosalpinx) in any one of the fallopian tubes.
• Salpingostomy: The goal of this surgery is to make a fresh opening in the portion of the fallopian tube closest to the ovary.
• Fimbrioplasty: When the portion of the fallopian tube closest to the ovary either develops scar tissues or becomes partially obstructed, this surgery is used to repair the fringed ends of the tube.

All these procedures can be done by laparoscopy or open surgery depending on surgeon expertise and availability of facilities.

Hysteroscopy: Hysteroscopy is done by  the fertility specialist using  a thin fibre optic telescope to enter into the uterus through the cervix of a woman to look for any abnormality like polyps, fibroid, or adhesions inside the uterus and remove them surgically. The various hysteroscopic procedures include:

• Adhesiolysis: The process of removing adhesions in the uterine cavity.
• Myomectomy: The removal of uterine fibroids present in cavity 
• Removing endometrial polyps or uterine septum (septal resection) 

These procedures are recommended only after detailed history and examination. With advancement in medical science the option for any invasive procedure is chosen after considering pros and cons of surgery and ART treatment.       

Related: How can ICSI help in infertility?                                                                    

Female Fertility: Everything You Need To Know

The ability of a woman to conceive and deliver a child is known as female fertility. If you’ve been trying to get pregnant with frequent, unprotected sex for at least a year (or at least six months if you’re older than 35) without success, you and your partner may start to question your fertility. You might be curious about your fertility and whether you can increase your fertility if you’re trying to get pregnant. Some factors, such as health conditions that affect your ability to conceive, may be outside of your control. However, your lifestyle decisions might also impact your fertility.

Related: Are you trying to Conceive? Here are the best tips to increase your chances 

What causes female fertility problems?

Female fertility issues can be caused by a number of reasons, such as:

• Ovulation disorders that impair the ovaries ability to release eggs. These include thyroid issues (hyperthyroidism or hypothyroidism), hyperprolactinemia, and hormonal conditions such as polycystic ovarian syndrome.
• When the ovaries stop functioning and menstruation stops before the age of 40, this condition is known as primary ovarian insufficiency (early menopause).
• Medical disorders include poorly managed diabetes, celiac disease, and several autoimmune diseases like lupus that are linked to the absence of menstruation.
• Pelvic adhesions, which are bands of scar tissue that bind organs together following surgery for the abdomen or pelvis, an appendicitis, or a pelvic infection. Adhesions limit the function of the fallopian tube hindering the egg to travel and fertilize.
• Endometriosis is a condition in which tissue that ordinarily lines the interior of the uterus begins to implant outside  the uterus into pelvic organs and abdominal cavity.
• Damage to or blockage of the fallopian tube, which is frequently brought on by the pelvic inflammatory illness.
• Abnormalities of the uterus or the cervical region, such as fibroids or polyps.

Age also has an impact. Delaying pregnancy may make it more difficult for you to conceive. Age-related changes in your eggs quantity and quality make it more challenging to get pregnant.

What can I do to promote female fertility?

Making healthy lifestyle decisions can support fertility. Such as:

• Being significantly overweight or underweight can interfere with proper ovulation and impair hormone production. The likelihood of pregnancy and the frequency of ovulation can both rise with appropriate weight maintenance.
• Chlamydia and gonorrhoea are two sexually transmitted diseases that are a major contributor to infertility in women. Engage in safe sex to prevent the spread of STIs.
• Fertility may be harmed by untreated celiac disease. Otherwise, the research is insufficient to recommend a specific diet to increase fertility. Of course, whether you’re trying to get pregnant or not, eating a mix of fruits, vegetables, whole grains, healthy fats, and proteins can benefit you.
• You can protect your fertility by keeping regular appointments with your doctor to monitor and address any health issues.
• Regularly working the night shift could increase your chances of infertility through changing hormone production, among other things. Try to get adequate sleep when you’re not working if you do the night shift.

Although stress won’t prevent you from becoming pregnant, you should think about reducing stress and using good coping mechanisms, like relaxation techniques, when you’re trying to get pregnant.

Related: Effects Of Diabetes On Infertility: Does Diabetes Affects Male And Female Fertility?

What not to do?

• Smoking prematurely ages your ovaries and depletes your egg supply. Ask your doctor to help you stop smoking if you do and try to quit smoking as soon as possible.
• Ovulation abnormalities are linked to an increased risk of heavy drinking. If you want to get pregnant, you have to fully cut out alcohol.
• The majority of research does not conclusively link excessive caffeine use to infertility. However, if you’re trying to conceive, the majority of reproductive health professionals advise limiting your daily caffeine intake to less than 200 to 300 mg.
• Too much intense exercise can prevent ovulation and lower progesterone levels in the body. If you are healthy weight and planning a pregnancy soon, think about keeping your weekly amount of rigorous exercise to less than five hours. Ask your healthcare professional how much physical activity is appropriate if you are overweight.
• Menstrual abnormalities may be more common in particular populations, including hairdressers, agricultural laborers, and others. Industrial employees exposed to medications or chemicals during the manufacturing process, dental assistants exposed to high quantities of nitrous oxide, and anyone exposed to high levels of organic solvents, such as dry cleaning chemicals, may also be at risk of diminished fertility.

Takeaway

If you’re thinking about getting pregnant and worried that your lifestyle choices might influence your fertility, you can consult an IVF specialist. They might be able to help you improve your fertility and chances of getting pregnant. 

How can ICSI help in infertility?

Intracytoplasmic sperm injection (ICSI) is an advanced in vitro fertilization (IVF) procedure in which a single sperm is injected directly into the cytoplasm of a human egg. This treatment assists couples who are struggling with severe male infertility or have had past fertilization failure with conventional insemination. ICSI is frequently done by some fertility clinics for every IVF cycle, while others typically save the procedure for couples who have severe infertility issues.

Why do we need ICSI?

ICSI is the best method for couples struggling with infertility to overcome these challenges if they are experiencing any of the issues listed below:

• Oligospermia or a very low sperm count
• Asthenozoospermia, commonly known as low sperm motility
• Teratozoospermia, the term for sperm that are improperly formed
• Sperm retrieved through TESE or testicular sperm extraction
• Retrograde ejaculation
• Sperm that has been frozen is being used, but it doesn’t appear to be active
• Preimplantation genetic diagnosis, or PGD, is being used
• Unexplained infertility
• Fertilization of cryopreserved oocytes
• Advanced age of female partner
• Low oocyte yield

Related: How can male infertility be treated?

What are the procedures for ICSI treatment for infertility?

• The transvaginal oocyte retrieval process is used to remove oocytes from female donors.
• On the same day that the eggs are taken, the partner’s sperm is also obtained.
• A holding pipette stabilizes the oocyte or egg by gently sucking through a microinjector.
• A single sperm is carefully picked up after being immobilized by the tail being cut off with a sharp, sensitive, and hollow needle.
• The needle is used to inject the sperm directly into the cytoplasm, and it is then carefully removed.
• To stabilize the oocyte, the polar body is placed at the 12 or 6 o’clock position.
• The egg is put into cell culture, the next day it is examined for evidence of fertilization and then in following days the embryo is observed for the growth.

After the embryo is grown for 3 to 5 days, it is inserted into the woman’s uterus. Following that, a blood test is done for the confirmation of pregnancy after 14 days.

What is the success rate of ICSI in infertility?

The fertilization rate attained in the UCSF IVF laboratory, which is currently 80 to 85 percent, provides insight into the ICSI success rate.

Through ICSI, male factor infertility couples have achieved fertilization rates of 70 to 80% for all injected eggs, which is similar to fertilization with regular sperm. In couples without a male factor infertility, the pregnancy rates obtained by ICSI are comparable to those obtained through IVF.

Related : The Ultimate IVF Guide

Takeaway

Despite the fact that some medical professionals think ICSI causes birth malformations, it’s also possible that it does so because parents who undergo the treatment run the risk of developing abnormalities. If a person wants to undergo ICSI treatment, they should speak with their doctor, who can inform them about the procedure’s dangers and side effects.

Things to Consider Before Freezing Your Eggs

Egg freezing is a technique used to preserve women’s future fertility. Unfertilized eggs taken from your ovaries are frozen and kept to be used later in the future. It is possible to thaw a frozen egg, combine it with sperm in a lab, and transfer the embryo in your uterus (in vitro fertilization). 

How does egg freezing work?

Egg freezing is the act of extracting your eggs and freezing them so you can attempt pregnancy in the future through in vitro fertilization (IVF). If you’ve decided on egg freezing, you go through some of the same preliminary stages as those who undergo an IVF treatment:

• Step one: To increase egg production, fertility medications will be given to you. Your ovaries produce multiple eggs at once rather than just one when the hormones are injected. It’s known as ovarian stimulation.
• Step two: Your eggs will be removed from the ovaries after they are sufficiently matured. The treatment is typically conducted painlessly while you are sedated. This is a day-care procedure and requires hospitalization for  a short time.
• Step three: When the eggs are retrieved, they are frozen until you are ready to try to conceive in the future.
• Step four: The eggs are thawed and combined with sperm when you’re ready to try for pregnancy. Any developing embryos are then transferred to the uterus for implantation.

Why is it done?

Egg freezing can be done if you’re not ready to get pregnant right now but want to make sure you can get pregnant in the future. You can consider freezing your eggs if:

• You have a disease or situation that can impair your fertility.
• You require medical attention for cancer or another condition that might impair your ability to conceive.
• You want to preserve your younger eggs now for future use.

How many eggs are frozen?

The total number of eggs that are frozen will vary depending on the individual and the quantity of viable eggs produced during ovarian stimulation.

What should you consider before egg freezing?

Here are a few key points to consider before freezing your eggs: 

• It’s better to freeze your eggs when you’re young: Your ovarian reserve of eggs will be higher and healthier when you are young. As a result, you’ll have a better probability of getting pregnant. You can learn about your ovarian reserve and whether or not you should choose egg freezing from your doctor by taking a fertility hormone test. It is advised against egg freezing for women over the age of 38.

• There may be some side effects: Although the surgical method for freezing eggs is generally painless, it could result in slight discomfort. Due to the ovaries growing to make room for numerous increasing follicles with a maturing egg in each, the hormone injections may result in bloating and moodiness. Occasionally, in very few cases the hormone levels may get too high and it can result in ovarian hyper-stimulation syndrome (OHSS). The signs and symptoms include vomiting, nausea, and weight gain.

• There’s no guarantee of successful pregnancy: According to some research, there is only a 2–12% probability that a single frozen egg would result in a live birth. There haven’t been many studies done on this, though. The quality of the male partner’s sperm, the thawing process, and the viability of the eggs all have a role in whether or not a pregnancy using frozen eggs will be successful.
• You may need more than one procedure: According to study, you need to freeze several eggs, say about 15, to have a decent chance of becoming pregnant in the future. But whether a woman produces enough eggs in a single cycle depends on her ovarian reserve, her age at the time, and how her body reacts to stimulation. 

Takeaway

Making decisions concerning your fertility can easily leave you feeling stressed. We can assist you in taking immediate action so that you can determine whether or not egg freezing is something you would want to think about. If you choose to store your eggs and use them later, for instance, knowing your current AMH levels, which represent your ovarian reserve, can help you predict the effectiveness of IVF as well as ovarian stimulation, the process by which you take hormone therapy to produce eggs.

What Are The Various Tests Performed Before Undergoing IVF?

IVF is one of the most popular infertility treatments used for helping couples who are trying to conceive. The decision to undergo in vitro fertilization procedure depends on a variety of factors. A woman’s suitability for IVF is determined by a series of tests that are done before the procedure. 

These IVF tests are done so as to find out the reason for infertility so that, proper course of treatment can be decided and any additional treatment if required planned. These tests also ensure that the couple do not have any type of disease or infection which may impair the result.  

Different tests performed before IVF are as follows:

Semen Analysis

A sample of sperm will be taken and submitted to a facility for testing in order to perform a semen analysis. The morphology, motility, count, and concentration of the sperm can all be determined with a semen test. If the semen parameters are altered like low count, motility and/or the normal morphology is poor then, ICSI may be recommended by the doctor. ICSI is a cutting-edge technique that includes injecting sperm into the egg.

Ovarian Reserve Testing

It is a blood hormone test that enables the IVF specialist to determine the total number of eggs in ovaries that is her ovarian reserve. The hormones which are mostly tested are  FSH, AMH, and estradiol. The doctor usually performs these tests on the day 2 or 3 of the menstrual cycle. Out of these blood tests AMH or Anti mullerian hormone is the most reliable test used for estimation of ovarian reserve.

Infectious Diseases Screening

An IVF specialist frequently requests that couples or donors undergo viral markers screening when getting ready for pregnancy through assisted conception treatment. The specialist will perform tests to check for infectious disorders like HIV, Hepatitis B, Hepatitis C, Chlamydia, Rubella, etc. before moving on with IVF. This is due to the fact that the disorders can impact the fetus’ growth and cause complications in the future.

Uterine Cavity Examination

Abnormalities of the uterine cavity could contribute to subfertility or continuing implantation failure, among other things. Your fertility specialist would advise the uterine cavity assessment before the IVF procedure. The endometrial lining, ovaries and uterine cavity  are scanned using transvaginal ultrasound. Hysteroscopy may be required in cases of recurrent implantation failure, recurrent miscarriages or in patients where abnormality is detected by ultrasound. 

Prolactin and Thyroid Hormones

The primary hormone for generating breast milk is prolactin, and high levels of this hormone can have an impact on pregnancy. Thyroid hormones are helpful for various metabolic activities. Pregnancy might also be impacted by thyroid hormone levels that are higher or lower. This test helps the IVF specialist in selecting the appropriate medications to balance hormone levels.

Mock Embryo Transfer

The procedure of embryo transfer has to be smooth with minimal handling of cervix, as manipulations may lead to uterine contractions which have adverse effect on outcome of the procedure. Mock embryo transfer is done with the embryo transfer cannula to determine the direction of cervical canal and uterus. As a result, the specialist will take the necessary precautions if required to customize the actual procedure.

The tests listed above are important tests carried out to determine whether IVF is the best course of treatment for you. All these tests help to make sure that there is a higher chance of conceiving with IVF treatment.

How are test tube baby produced? Step by step process

A test-tube baby is a child who is conceived outside the female body. A more complete definition specifies test tube babies as being made in a laboratory through the scientific process of In Vitro Fertilisation (IVF) and grown in the mother’s womb. In a petri dish, the sperm and eggs are combined to start the procedure. However, despite being a well-known term, “test-tube baby” continues to confuse couples seeking medical help for infertility issues.

When is a Test tube baby essential?

Test tube baby is required when the couple is unable to conceive naturally in spite of regular unprotected intercourse for a year. Few indications of  test tube baby are:

• When there is no ovulation
• When there is some problem with the egg.
• When there is damage to both or one of the fallopian tubes.
• When a premature ovarian failure takes place.
• When the woman has severe endometriosis.
• When the male partner has insufficient sperm.
• When either one or both partners have any kind of sexual dysfunction.
• When intrauterine insemination fails.

What is the step by step process of a test tube baby?

Step 1: Hormone Therapy And Egg Production

The first step in the test tube baby process is to encourage the growth of eggs inside the female’s body. Mainly, Gonadotropins and GnRHa, two injectable, medically prescribed hormones, are used to do this. The female receives these injectable hormones in a titrated dose, which cause the follicles already existing in her ovaries to develop and mature. hCG injection is used to complete the final stage of egg maturation. Egg collection is done  36 hours after receiving injection hCG.

Step 2: Eggs Retrieval

After hormone therapy, the next step is to collect  the eggs from the body using a minor surgical procedure. To minimize any potential discomfort, the procedure is done under general or local anesthesia. The eggs are retrieved  using a vaginal ultrasonography probe with an attached needle. The needle is inserted in each ovary and fluid from all formed follicles are aspirated. The fluid is seen under the microscope to identify the eggs, which are then kept in a petri dish in a specialized media in the incubator.

Step 3: Sperm Collection

The day the eggs are retrieved from the female’s body, the male also has to submit a fresh sample of semen. This is needed because the following, and most important, stage in the creation of a test-tube baby requires the collection of both sperm and eggs.

Step 4: Petri Dish

The mixing of the collected sperm and eggs in a petri dish is one of the most crucial procedures in the entire test tube baby procedure. The petri dish is stored in an incubator after the sperm and eggs have been combined. The specialist examines the mixture to look for any evidence of fertilization the next day and also keeps track of the development of the embryo in following days. This is necessary to make sure the embryo is growing well and to ascertain that embryo is ready for the transfer to the uterus.

Step 5: Final Transfer to Uterus

Transferring the prepared embryos into the uterus completes the process of creating a test tube baby. A very fine catheter is used to transfer one to three distinct embryos to the woman’s uterus. Hormonal support is given after the embryo transfer to support the possible pregnancy.

However, 14 days following the embryo transfer procedure, blood beta HCG levels are checked to see if you’re pregnant. For a single embryo transfer cycle during a test tube pregnancy, the success rate is up to 50 %, and for three embryo transfer cycles, the success rate is a cumulative 85–90%. However, the success rate depends on numerous factors and varies from couple to couple. 

Who Should Consider IVF Treatment?

Any couple who has tried to get pregnant for a year and been unsuccessful should think about getting fertility treatments. It is crucial that they speak with a fertility specialist in order to accurately diagnose the cause of their infertility and receive the appropriate care. 

Blocked Fallopian Tubes Treatment

The fallopian tubes are two tubes, one on each side of the uterus, that picks up the released egg from ovaries, allows sperm to enter in the fallopian tube, fertilization and early development of embryo occurs here. The embryo then moves towards the uterus with the help of hair-like structure in the fallopian tubes. If fertilization doesn’t occur the egg gets degenerated. When a blockage, such as scarring, an adhesion, or an infection, prevents the movement of sperm/egg/embryo in the tube, it is said to have a blocked fallopian tube, which is also referred to as tubal factor infertility. A blocked fallopian tube may affect fertility.

What are the symptoms of blocked fallopian tubes?

People who have blocked fallopian tubes rarely show any symptoms. Many people with this issue believe their fertility is normal. It’s not always the case. The first “symptom” of blocked fallopian tubes is often infertility.

Blocked fallopian tubes can occasionally cause a mild, ongoing abdominal ache on one side. This may occur in a hydrosalpinx, a form of blockage. When a blockage causes the tube to expand or grow, and fill with fluid, the condition is known as hydrosalpinx. 

Blocked fallopian tubes can have a variety of causes, some of which may also have unique symptoms. For instance, painful menstruation and painful sexual activity may be brought on by endometriosis and pelvic inflammatory disease, both of these diseases may affect the tubes.

How does a blocked fallopian tube affect fertility?

One common reason for infertility is blocked fallopian tubes. In the fallopian tube, sperm and an egg come together to fertilize. And when there is a blockage in the fallopian, it prevents the sperm and egg from meeting.

You might be able to conceive with one or both partially blocked fallopian tubes. But the chance of an ectopic pregnancy rises. However, without medical help, pregnancy will not be possible if both tubes are completely blocked. 

What are the causes of blocked fallopian tubes?

Pelvic inflammatory disease is the most typical cause of blocked fallopian tubes. Although not all pelvic infections are connected to STDs, but sometimes pelvic inflammatory disease is the outcome of a sexually transmitted disease. Additionally, even in the absence of PID, a history of PID or pelvic infection raises the possibility of blocked tubes.

Blockage of the fallopian tubes can also result from:

• Chlamydia and gonorrhea can result in pelvic inflammatory disease and scarring.
• Pelvic inflammatory disease can cause scarring or hydrosalpinx.
• Endometrial tissue can accumulate and block the fallopian tubes.
• Past ectopic pregnancy can scar the fallopian tubes.
• Fibroids can grow and block the fallopian tube, particularly, when they grow near the opening of fallopian tubes into the uterus
• Past abdominal surgeries, especially on the fallopian tubes themselves, can lead to pelvic adhesions that block the tubes.

How to diagnose a blocked fallopian tube?

A hysterosalpingogram(HSG) or Sonosalpingography (SSG), is a test to check for the patency of fallopian tubes. 

One of the primary fertility tests that every couple having trouble getting pregnant gets is an HSG or SSG. A small tube is used to inject a dye or saline into the cervix during the test. The dye should pass through the uterus and fallopian tubes before spilling out around the ovaries and into the pelvic cavity if everything is normal. X-rays of the pelvic region are taken after the dye has been injected in HSG. Similarly, pelvic ultrasound is done to see if saline is present in the pelvic cavity. But if the dye doesn’t get past the tubes, then you may have a blocked fallopian tube.

Your doctor may use laparoscopy to perform additional testing if the tubal patency test  is unable to provide a conclusive diagnosis. 

How to treat blocked fallopian tubes?

Your doctor may perform laparoscopic surgery to remove any scar tissue or adhesions that are blocking your fallopian tubes and open them. However, it may not be able to treat the blockages in your fallopian tubes if there is a significant amount of scar tissue or adhesions present. 

Surgery may be an option to restore tubes that have been harmed by an infection or ectopic pregnancy. Here is what you need to know about surgery for blocked tubes:

• Laparoscopic Surgery: Laparoscopic surgery may often be able to clear scar tissue or unblock blocked tubes. Unfortunately, it isn’t always effective. The possibility of success is influenced by your age, the position and severity of the blockage, as well as its underlying cause. The likelihood of becoming pregnant following surgery is good if there are only a few adhesions between the tubes and ovaries.
• In Vitro Fertilization: Women with blocked tubes had no other alternatives for getting pregnant before the introduction of in vitro fertilization (IVF), especially if repair surgery didn’t work or wasn’t an option. IVF has made it possible for such women to get pregnant as the fertilization occurs in the lab so the work of fallopian tubes are bypassed.

Takeaway

When only one fallopian tube is blocked, it may still be possible to conceive naturally or with minimal medical assistance. Surgery or IVF treatment, however, can be required when both tubes are blocked.

Following treatment for blocked fallopian tubes, pregnancy is possible. However, the type of treatment you receive and how severe the block is will affect your chances of getting pregnant.  The likelihood of a successful pregnancy increases if the blockage is close to the uterus. If the blockage is at the fallopian tube’s end, close to the ovary, the success percentages are lower. 

Oligospermia: Symptoms, Causes & Treatment

When a person’s sperm count is below the standard set by the World Health Organization (WHO) for healthy sperm counts—15 million sperm per milliliter of semen—this condition is referred to as oligospermia or oligozoospermia. Oligospermia, which is characterised by a low sperm count, can affect your ability to conceive naturally.

What are the causes of Oligospermia?

It’s normal for your sperm count to change over the course of your life, especially as you become older. However, a person’s risk of oligospermia can also be increased by health issues and lifestyle choices.

• Varicocele: Varicocele, or enlarged veins in the scrotum, can reduce testosterone production, impair spermatogenesis that is sperm production, and cause oxidative stress, all of which can have a detrimental effect on sperm count. Nearly 15% of males have a varicocele, making it a rather prevalent condition. Since the symptoms of varicocele are normally modest, it often goes unrecognised during adolescence.
• Exposure to heat: Heat exposure has the potential to generate oxidative stress and impairment of sperm production, which has been demonstrated to have an adverse effect on semen parameters. A drop in sperm count, motility, and viability is linked to heat stress, which can be caused by sitting for lengthy amounts of time each day, using saunas or hot baths, positioning computers or other heat-producing gadgets close to your genitals, or dressing tightly.
• Exposure to toxins and radiation: The quantity of sperm can be significantly impacted by radiation exposure as well as by contact with chemicals, metals, pesticides, and petrochemicals. You may have a higher chance of acquiring low sperm count if you work in the military, agriculture, pesticides, plastic manufacturing, tobacco processing, or welding industries, among others.It has been established that individuals who work in these type of  high-risk workplaces not only have lower sperm counts but the quality of the and sperm is also affected.
• Hormone imbalance: Numerous hormones, including testosterone, follicle-stimulating hormone, and luteinizing hormone, are responsible for male fertility. These hormones, along with a few others, are crucial for the development of sperm. Your sperm count along with other sperm health parameters may alter if any of these hormones are out of balance.
• Smoking, Drugs and Alcohol use: It has been found in various studies that smoking not only reduces the number,motility and morphology of the sperm but also has adverse effects on DNA material of sperm. The use of various drugs, such as cocaine and marijuana, may lower sperm counts. Drinking too much also has the same effect.

What are the signs and symptoms of oligospermia?

The main sign or symptom of oligospermia is the inability to conceive a baby with a partner after one year of unprotected sexual intercourse.

How does oligospermia affect fertility?

Some oligospermic men can still conceive even though their sperm counts are low. However, fertilisation might be more challenging. It can take more tries than it would for couples without a  fertility issue.

Men are more likely to experience various fertility problems as a result of some of the most typical oligospermia causes. This involves issues with sperm motility. 

Sperm motility describes how active the sperms are. Active sperms can easily swim in the direction of an egg. However, sperms may not travel sufficiently to reach an egg if they have abnormal motility.

How is oligospermia diagnosed?

Analysing the semen is the main diagnostic procedure for oligospermia. A lab technician does a semen analysis by examining a sample of semen under a microscope to count and evaluate the sperm. A condition like oligospermia or azoospermia is normally diagnosed by two consecutive abnormal semen analyses.

Most of the time, a person with oligospermia won’t be aware of it until they start trying to conceive and have trouble.

How to treat oligospermia?

Depending on your situation, several oligospermia treatment options may be used:

• You may require surgery to close off enlarged veins in order to redirect blood flow to the testicles if a varicocele is the cause of your oligospermia.
• You could need correction of hormones if a hormone imbalance is the cause of your oligospermia in order to increase sperm production and restore a healthy balance.
• You might require a course of treatment if you have a virus or bacterial infection in order to get rid of the infection and inflammation. The treatment may not help the sperm count improve depending on how far advanced the infection is, but it can stop further declines in sperm count.
• Your sperm counts might increase with weight loss and appropriate weight maintenance. Additionally, it might lower your risk for a variety of other illnesses. Stop smoking, using tobacco, alcohol, and other substances to increase sperm production and to stop further damage to sperms.

How to conceive with oligospermia?

There are various treatment modalities available for conception. However, the final line of treatment is decided after evaluating the couple. 

• Intrauterine insemination (IUI): In this fertility procedure, sperm is washed (processed) and then put right into the patient’s uterus. IUI can increase the likelihood of pregnancy for people with mild to moderate oligospermia, according to studies. IUI is an excellent first-line treatment choice before attempting more invasive or expensive techniques like IVF and ICSI because it is one of the least invasive and least expensive assisted reproductive therapies.
• In vitro fertilization (IVF): For the purpose of encouraging fertilisation outside of the body, this process requires extracting oocytes from the ovary and combining them with sperm. The embryos are grown in the lab for three to five days.Then the embryo/ embryos are transferred into the uterine cavity. IVF success rates can vary based on the age of the female partner, quality of embryo etc.  
• Intracytoplasmic sperm injection (ICSI): In this form of treatment, single sperm is injected in an egg for fertilization and placed in an incubator. Then, like IVF the embryos are grown in the lab for three to five days and then transferred into the uterus . According to one study, the pregnancy rate for individuals with oligospermia is 36.4%. ICSI can be a promising assisted reproductive method for persons who have low sperm count as a result of an obstruction (such as those with obstructive azoospermia).