IVF/ Infertility
Introduction
Fertility treatments often include medications that help with hormones and ovulation, sometimes combined with minor surgical procedures. Assisted Reproductive Technology (ART) describes several kinds of procedures that can help you have a baby. ART includes procedures that make it easier for sperm to fertilize an egg, and help the egg implant in your uterine lining.
Men will get a physical exam and often a sperm analysis, which tests the health of the sperm.
For a woman, testing begins with a medical history and physical exam, including a pelvic exam. The doctor then makes sure that she ovulates regularly and that her ovaries are releasing the eggs. Blood tests are taken to measure hormone levels. The ovaries and uterus may be examined by ultrasound, and a specific X-ray test can check the uterus and fallopian tubes.
In about 80% of couples, the cause of infertility is either an ovulation problem, blockage of the fallopian tubes, or a sperm problem. In 5%-15% of couples, all tests are normal
Infertility in men and woman can also be treated with assisted reproductive technology, or ART. There are several types of ART:
IUI (intrauterine insemination): Sperm is collected and the placed directly inside the woman's uterus while she is ovulating.
IVF (in vitro fertilization): The sperm and egg are collected and brought together in a lab. The fertilized egg grows for 3 to 5 days days. Then the embryo is placed in the woman's uterus.
GIFT (gamete intrafallopian transfer) and ZIFT (zygote intrafallopian transfer): The sperm and egg are collected and quickly placed in a fallopian tube. With GIFT, the both sperm and eggs are placed into the fallopian tube. With ZIFT, the sperm and eggs are brought together in a lab and then a fertilized egg is placed into the tube at 24 hours.
Types of Cosmetic Surgery
Two of the most common fertility treatments are:
intrauterine insemination (IUI)
Healthy sperm is collected and inserted directly into your uterus when you're ovulating.
in vitro fertilization (IVF)
Eggs are taken from your ovaries and fertilized by sperm in a lab, where they develop into embryos. Then a doctor puts the embryos into your uterus.
Cryopreservation (aka freezing your eggs, sperm, or embryos), egg or embryo donation, and gestational carriers (aka surrogacy) are also forms of ART.
Donor sperm, donor eggs, and surrogates are often used by same-sex couples or single people who want to have a baby. You can also use sperm and/or eggs from a donor if a problem with your own sperm cells or eggs is causing infertility issues.
Talking with a doctor who specializes in pregnancy and/or infertility can help you figure out which treatments are best for you. Your family doctor or gynecologist can refer you to a fertility specialist. You may also be able to get fertility treatments, or help finding a fertility specialist in your area, from your local Planned Parenthood health center.
Risk Factors
Risk factors include:
- Numerous factors have been associated with reduced fertility problems that cover demographic (e.g. age), reproductive history (e.g. menstrual cycle characteristics, history of pelvic surgery) and current lifestyle habits (e.g. alcohol consumption, smoking). The aim of the present study was to establish knowledge regarding risk factors associated with infertility in a young, university sample, who should demonstrate the highest level of fertility knowledge one should expect from young people. Seven risk factors were selected based on their relevance for a young population; age, weight, smoking, alcohol consumption, stress and STIs. There is a plethora of research associating age, weight, smoking and STI to the reduced fertility. There is also emerging, but inconsistent, evidence of associations between alcohol consumption. there is sufficient evidence to recommend that couples attempting to conceive should limit or abstain from consuming alcohol. Similarly, there does appear to be converging evidence that increasing levels of stress are associated with reduced fertility. It would therefore be important to ascertain whether young people know the potential influence of these factors. Knowledge about these seven risk factors was examined and compared with the knowledge and beliefs about other factors associated with fertility (as below).
- As a taboo subject people accumulate many myths about reproductive health and fertility. It describe unusual events occurring due to a person carrying out a relatively normal behaviour and there are a number of tales or fertility myths regarding increasing the chances of becoming pregnant. For example, women conceiving naturally immediately after adopting a child. Other myths concern post-coital techniques, that would keep the oocyte and sperm in closer contact and facilitate fertilization. Although all are relatively harmless in that they do not involve risky behaviour, there is no empirical research that these factors have an effect on pregnancy. Another source of misconception is falsely believing that not engaging in unhealthy habits actually increases health (Blenner, 1990). For example, that 'never' smoking or drinking, or exercising and maintaining a healthy weight is conducive to better fertility. Although such abstinence is a positive way to act the healthy habits typically maintain baseline fertility and do not in and of themselves increase or decrease fertility. In the present study perceptions of fertility associated with seven myths (three regarding post coital behaviours; two regarding living area; one on healthy eating and one about adoption) and seven healthy habits linked to the risk factors (e.g. 'never' smoking, 'never' drinking alcohol) was examined.
- The main aims of the study were to first ascertain knowledge/awareness of the effect of certain risk factors on a woman's chance of achieving a pregnancy in a sample of 149 young men and women. Assessing risk is not an easy task. A significant proportion of the public have difficulty understanding numerical risk information with people often grossly overestimating risks and being influenced by particular ways in which numbers are presented. Risk and risk perception are defined in a number of diverse ways and is often interpreted differently by individuals. Recommendations have been made to improve the validity of risk assessment and these were used in the present study. Instructions clearly stated the rationale behind the task and the method of ascertaining risk perception used graphical representations and numerical information to increase comprehension of risk. Specifically, participants were asked to rate the impact that the different factors (risks, fertility myths and healthy habits) would have on the chances of 100 women getting pregnant using a graphically presented sliding scale. A second aim was to determine whether participants could distinguish between factors that have an effect on pregnancy rates (risk factors) and those that do not (myths and healthy habits). In line with the research reviewed, it was hypothesized that the participant’s knowledge concerning the factors that affect fertility would be poor.
Procedure
Procedure include:
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In vitro fertilization (IVF) is a treatment for infertility or genetic problems. If IVF is performed to treat infertility, you and your partner might be able to try less-invasive treatment options before attempting IVF, including fertility drugs to increase production of eggs or intrauterine insemination — a procedure in which sperm are placed directly in your uterus near the time of ovulation.
Sometimes, IVF is offered as a primary treatment for infertility in women over age 40. IVF can also be done if you have certain health conditions. For example, IVF may be an option if you or your partner has: -
Fallopian tube damage or blockage. Fallopian tube damage or blockage makes it difficult for an egg to be fertilized or for an embryo to travel to the uterus.
Ovulation disorders. If ovulation is infrequent or absent, fewer eggs are available for fertilization.
Endometriosis. Endometriosis occurs when the uterine tissue implants and grows outside of the uterus — often affecting the function of the ovaries, uterus and fallopian tubes.
Uterine fibroids. Fibroids are benign tumors in the wall of the uterus and are common in women in their 30s and 40s. Fibroids can interfere with implantation of the fertilized egg.
Previous tubal sterilization or removal. If you've had tubal ligation — a type of sterilization in which your fallopian tubes are cut or blocked to permanently prevent pregnancy — and want to conceive, IVF may be an alternative to tubal ligation reversal.
Impaired sperm production or function. Below-average sperm concentration, weak movement of sperm (poor mobility), or abnormalities in sperm size and shape can make it difficult for sperm to fertilize an egg. If semen abnormalities are found, your partner might need to see a specialist to determine if there are correctable problems or underlying health concerns.
Unexplained infertility. Unexplained infertility means no cause of infertility has been found despite evaluation for common causes.
A genetic disorder. If you or your partner is at risk of passing on a genetic disorder to your child, you may be candidates for preimplantation genetic testing — a procedure that involves IVF. After the eggs are harvested and fertilized, they're screened for certain genetic problems, although not all genetic problems can be found. Embryos that don't contain identified problems can be transferred to the uterus.
Fertility preservation for cancer or other health conditions. If you're about to start cancer treatment — such as radiation or chemotherapy — that could harm your fertility, IVF for fertility preservation may be an option. Women can have eggs harvested from their ovaries and frozen in an unfertilized state for later use. Or the eggs can be fertilized and frozen as embryos for future use.
Women who don't have a functional uterus or for whom pregnancy poses a serious health risk might choose IVF using another person to carry the pregnancy (gestational carrier). In this case, the woman's eggs are fertilized with sperm, but the resulting embryos are placed in the gestational carrier's uterus.
Range of Treatment Cost
| Procedure | Min Cost ₹(INR)/$ |
Max Cost ₹(INR)/$ |
|---|---|---|
| IVF-ICSI | 200000/2750 | 300000/4150 |
| IVF-ICSI with PESA/TESA | 250000/3450 | 350000/4850 |
| IUI (Intra uterine insemination) husband | 12000/165 | 15000/206 |
| T.D.I. (donor) | 15000/206 | 25600/350 |
| Laser Assisted Hatching | 25000/350 | 45000/620 |
| Donor Sperm | 7000/100 | 9000/150 |
| Embryo Freezing | 15000/220 | 20000/300 |
| Cryopreservation for Embryo - per year | 23000/350 | 45000/650 |
| Sperm Freezing | 6000/150 | 7500/200 |
| Sperm Freezing for IVF cycle | 3500/100 | 6000/200 |
| Cryopreservation for Sperm - per year or part thereof | 6000/200 | 8000/300 |
| Embryo (self) Thaw and Transfer | 62000/850 | 70000/900 |
| Donor Embryo Transfer | 119000/1650 | 140000/1950 |
| Semen Analysis | 750/100 | 900`/200 |
| Quality Semen Analysis | 2900/500 | 3500/700 |
| Endometrial Biopsy (Lab extra) | 6400/100 | 8000/200 |
| Sonosalpingography | 7500/200 | 9000/300 |
| Cyst Aspiration | 9300/300 | 10000/500 |
| Dilatation | 8000/400 | 10000/500 |
| PESA/TESA | 32000/450 | 40000/500 |
