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!
