IVF & Infertility - Question and Answers

What is infertility?

If a couple is infertile, this means that they have been unable to conceive a child after 12 months of regular sexual intercourse without birth control. Primary infertility means they have never had a child. Secondary infertility means that the infertile person has had one or more children in the past, but a medical problem is impairing fertility. Many people may be infertile during their reproductive years.

Is infertility a women's problem?

No, infertility is not always a woman's problem. In only about one-third of cases is infertility due to the woman (female factors). In another one-third of cases, infertility is due to the man (male factors). The remaining cases are caused by a mixture of male and female factors or by unknown factors

What causes infertility in men?

Infertility in men is most often caused by: Problems making sperm -- producing too few sperm or none at all Problems with the sperm's ability to reach the egg and fertilize it -- abnormal sperm shape or structure preventing it from moving correctly.

Sometimes a man is born with problems that affect his sperm. Other times problems start later in life due to illness or injury. For example, cystic fibrosis often causes infertility in men.

What causes infertility in women?

The most common female infertility factor is an ovulation disorder. Other causes of female infertility include blocked fallopian tubes, which can occur when a woman has had pelvic inflammatory disease or endometriosis. Congenital anomalies (birth defects) involving the structure of the uterus and uterine fibroids are associated with repeated miscarriages. Aging is also an important factor in female infertility. The ability of ovaries to produce eggs declines with age, especially after age 35.

How infertility is diagnosed?

Couples are generally advised to seek medical help if they are unable to achieve pregnancy after a year of unprotected intercourse. You may be advised to seek out care from the specialist if you are older than 35 years old. The doctor will conduct a physical examination of both partners to determine their general state of health and to evaluate physical disorders that may be causing infertility. Usually both partners are interviewed about their sexual habits in order to determine whether intercourse is taking place properly for conception.

If no cause can be determined at this point, more specific tests may be recommended. For women, these include an analysis of body temperature and ovulation, an x-ray of the fallopian tubes and uterus, and a laparoscopy. For men, initial tests focus on semen analysis.

What is the treatment for infertility?

Depending on the test results, different treatments can be suggested. Eighty-five to 90 percent of infertility cases are treated with drugs or surgery.

Various fertility drugs may be used for women with ovulation problems. It is important to talk with your healthcare provider about the drug to be used. You should understand the drug's benefits and side effects. Depending on the type of fertility drug and the dosage of the drug used, multiple births (such as twins) can occur in some women.

If needed, surgery can be done to repair damage to a woman's ovaries, fallopian tubes, or uterus. Sometimes a man has an infertility problem that can be corrected by surgery.

What is IVF?

IVF is short for in vitro fertilization - which literally means "fertilization in glass" (IVF babies are sometimes referred to as "test tube babies"( even though fertilization doesn't take place in a test tube). IVF refers to a technique of assisted reproduction where the egg and sperm are fertilized outside of the body to form an embryo. This embryo is then transferred to the uterus to hopefully implant and become a pregnancy.

What are the other assisted reproductive technologies?

Assisted reproductive technology (ART) describes several different medical procedures that help a woman become pregnant. The most common type of ART is in vitro fertilization (IVF); during IVF, eggs and sperm are mixed in a laboratory dish to fertilize, and some of the fertilized eggs (zygotes) are then transferred to the woman's uterus.

There are numerous types of ART procedures. Your reproductive endocrinologist can help to determine which procedure is best suited to you.

The types of ART include:

o IVF (In Vitro Fertilization).
o GIFT (Gamete Intrafallopian Transfer).
o ZIFT (Zygote Intrafallopian Transfer).
o TET (Tubal Embryo Transfer)

ART procedures sometimes involve the use of donor eggs (eggs from another woman) or previously frozen embryos. Donor eggs may be used if a woman has impaired ovaries or has a genetic disease that could be passed on to her baby.

How does age affect a woman's ability to have children?

Age can be a great factor in a woman's ability to have children. Many women these days wait until their 30s or 40s before they decide to have children. Statistics show that about 20 percent of American women now have their first child after the age of 35, and about one-third of the couples in which a woman is over that age experience infertility problems.

Age affects the woman's ability to have a baby in the following ways:

a. The ability of her ovaries to release eggs for fertilization declines.
b. The health of the eggs released from her ovaries declines.
c. The chances of miscarriage increase.

How often assisted reproductive test is successful?

Success rates vary and depend on many factors. Some things that affect the success rate of ART include:

1. Age of the partners
2. Reason for infertility
3. Clinic
4. Type of art
5. If the egg is fresh or frozen
6. If the embryo is fresh or frozen

ART can be expensive and time-consuming. But it has allowed many couples to have children that otherwise would not have been conceived. The most common complication of ART is multiple fetuses.

However this is a problem that can be prevented or minimized in several different ways.

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