Infertility Treatment

Treatments are usually offered to couples who are keen to have a baby but are just not able to conceive the natural way. The reality check here is that no treatment guarantees success. If you have never been pregnant before and are now experiencing delay in becoming pregnant you are facing primary infertility. If you have been pregnant before but are now experiencing a delay in conceiving, your problem is defined as secondary infertility.

Health Assessment..

Once you decide to go the professional way, the fertility specialists will check your general health, lifestyle before embarking on any treatment program. For the man, it is important to bear in mind that sperm production takes some 70 odd days so he will stand to gain from these changes to his lifestyle if done for a minimum period of at least 4 months. He will be assessed and advised to:

• Lose weight

• Stop smoking

• Reduce consumption of alcohol

• Abstain from caffeine and drugs

• Reduce stress

• Avoid too much of exercise

• Avoid certain occupations that are hazardous

For the woman, her menstrual cycle and ovulation pattern will be checked to evaluate the key hormone levels. She would be assessed and advised to:

• Lose weight

• Abstain from drinking, drugs and smoking

• Follow a healthy diet

• Exercise regularly

• Get enough sleep

• Learn to relax through techniques like yoga

Routine Fertility Treatments..

Before resorting to high-tech assisted conception treatments it is advisable to check out all other routine fertility treatments. These may include:

Fertility medication such as Clomiphene, a drug used to stimulate ovulation. If the ovulation is irregular or the woman is not ovulating, this may be the route. Taken at some point of the month, these drugs in the form of pills or injections will stimulate a menstrual cycle. The success rate of such drugs is high. The main drawback is your body will produce more eggs per cycle giving rise to multiple births.

Surgery (laparoscopy combined with laser) is performed either to the ovaries or fallopian tubes in case of endometrial scars or minor blockages to the tubes. The same goes for low sperm count which may be treatable with hormones or blocked vas deferens which can be cleared with a procedure. For anything more major there are other methods. Examples of surgeries include fimbrioplasty and tuboplasty, the two main surgical procedures to repair damaged fallopian tubes.

Donor insemination or DI is an option to consider if there is little possibility of using the husband's sperm. The woman will be inseminated with an unidentified donor's sperm. The donor will be carefully screened and the closest match to the husband in terms of physical appearance will be considered. If the woman is not ovulating despite the drug therapy but the man is producing healthy sperm, egg donation could be considered. The egg donor and you will take drugs to synchronize your cycles; once her eggs have been removed and combined with your spouse's sperm the next step is just as IVF.

Assisted Fertility

When medical intervention is necessary, there is a range of options to choose from. The two key groups are artificial insemination and all other methods of assisted conception

Artificial Insemination by the husband or AIH becomes useful for couples where the woman's body is producing antibodies that make the environment inhabitable for the sperm. The sperm gets destroyed before reaching the egg. It is also offered to couples who have sexual difficulties such as vaginismus or male impotence. The procedure involves the male ejaculating the sperm into a container, and its sample is then injected directly into the womb during ovulation.

Intrauterine insemination is a hospital procedure where the sperm is directly introduced into the uterus through the vagina and cervix. It is done in conjunction with fertility treatments: fertility drugs for the woman to produce more eggs and for the man the sperm are treated beforehand to rule out abnormal sperm. It is offered in unexplained infertility situations or impotent cases.

In vitro fertilization or IVF or test-tube babies is a procedure where the fertilization of the egg with the sperm happen outside the woman's body. Fertilization actually takes place in a dish and the resulting embryo is then implanted into the womb where it goes on to develop, if all goes well. With the aid of drugs the ovaries are stimulated to produce eggs; these are collected and mixed with the sperm. Several ejaculations are necessary to get a higher concentration; the sperm are then washed to remove the unhealthy ones. Up to 3 embryos can be placed into the uterus at one time; spare embryos can be frozen for a future pregnancy. Candidates who may qualify for this method include those with sperm of poor quality, hostile cervical mucus, in cases of scarred fallopian tubes and unexplained fertility.

Gamete intra-Fallopian transfer or GIFT follows the same method as IVF in obtaining the sperm and egg; the cell is then inserted into the fallopian tubes so that fertilization occurs inside the female's body. Because of this, GIFT resembles natural conception. It is offered to couples where the problem lies with the sperm or in unexplained infertility. In both IVF and GIFT, the pregnancy will be monitored closely in the initial months.
There are several factors to consider when opting for IVF or GIFT, namely the success rate, the cost, the time invested, the emotional and physical stress, and the higher incidence of multiple pregnancies. Issues such as how important it is to have a baby, how many courses of treatment are you willing to go for until you decide to call it a day, finances etc. need to be discussed with each other before you proceed.

Coping with Reactions..

When a couple has been married for long and are still without a child, receiving blatant comments on the why and the how long etc. are quite common. Such remarks coming from friends and relatives on the childless situation can hurt, especially if you are trying for a baby and if you caught off-guard. It helps to plan in advance how you wish to respond. Your response can either be light-hearted to couch 'the problem' or totally upfront giving the picture as it were. But handle it you must!

The STRESS factor..

Sometimes it is plain old stress that is the culprit. Keeping track of the fertile days, using charts and obsessing about the days when to have sex can take its toll. Sometimes conception takes months and excessive planning makes things go the opposite way. Instead stop counting, plotting, measuring and just do the sex without worrying about the consequences!