Infertility Treatments can be grouped into three categories:
1. Medicines to Improve Fertility:These are sometimes used alone but can also be used in addition to assisted conception.
2. Surgical Treatments:These may be used when the cause of the infertility is found that may be helped by an operation.
3. Assisted Conception: This type of infertility treatment includes several techniques such as:
a) Intrauterine insemination (IUI)
c) In vitro fertilization (IVF)
d) Intracytoplasmic sperm injection (ICSI)
e) Donor Eggs
g) Donor Embryos
h) Gamete intrafallopian transfer (GIFT)
i) Zygote Intrafallopian Transfer (ZIFT)
Let us deep dive in each of them & understand them in detail:
1. Fertility Drugs: Drugs are injected or taken in the form of a pill, the drugs release hormones that trigger ovulation to boost egg production and make the uterus more receptive to embryo implantation. Women who don't ovulate regularly or who have partners with very poor sperm quality are given fertility drugs.
Fertility drugs should be avoided if you have damaged or blocked fallopian tubes or any damage from endometriosis (they require IVF).
2. Surgical Treatments: The situations where an operation may be an option include:
a) Fallopian Tube Problems: Surgery may help some women with infertility caused by Fallopian tube problems. For example, if your fallopian tubes are damaged due to a previous disease, infection, or other problem. Some women who have got sterilization or tubal tie done in the past for contraception may be able to get their fertility restored by tubal surgery. These days, most fallopian tube surgeries are done by keyhole surgery.
b) Endometriosis: This is a condition that occurs when cells from the lining of the womb (uterus) grow in other areas of the body. Surgery may help in improving fertility in women with endometriosis.
c) Polycystic Ovary Syndrome (PCOS):An operation on the ovaries may be suitable for some women with PCOS. The procedure is sometimes called ovarian drilling or ovarian diathermy. Again keyhole surgery is used. The tiny cysts in the ovaries can be removed or destroyed with the help of a heat source (diathermy). It may be done if other treatments for PCOS haven't worked.
d) Fibroids: For women with fibroids, surgery (to remove the fibroid) may be considered if there is no other explanation for infertility. However, small fibroids may not cause infertility.
e) Male Infertility: When sperm are blocked by an abnormality in the tube inside the scrotum that is used to store sperm (epididymis) in the testicle (testis), surgery may help.
A condition where there are varicose veins of the testes (varicocele) in men who have an abnormal sperm count may occasionally be repaired. However, whether it actually improves fertility is still unknown.
3. Assisted Conception: Current infertility treatment techniques are described briefly below. Your specialist will advise on which are options for your particular cause of infertility and will explain the chance of success.
a) Intrauterine Insemination (IUI): Specially processed ("washed") sperm is inserted into the uterus, directly through a thin, flexible catheter during IUI, the most common fertility method. If you opt for this method, your doctor might recommend that you start on fertility drugs as well, to increase the chances of fertilization. This method is used for cases in which men have slow-moving or lower quality sperm or a low sperm count. Also for women who have produced antibodies to their partner's sperm or whose cervical mucus is too scant, acidic, or thick to transport the sperm to the egg.
b) Donor Sperm: Sperm from a man other than the intended father is used during IUI or IVF. This method is used for couples experiencing male infertility issues, men with genetic disorders they don't want to pass on to their children, single women, or lesbian couples.
c) In Vitro Fertilization (IVF): IVF involves a multistep process or in which a woman's eggs are extracted and fertilized with sperm in a lab. After the embryos are developed, one or two are implanted in the uterus and the rest are stored for later use. This method is used for Older women or women with blocked or severely damaged fallopian tubes or scarring from endometriosis; men with very poor sperm quality; couples with unexplained infertility.
d) Intracytoplasmic Sperm Injection (ICSI): In ICSI, an embryologist selects a healthy-looking, single sperm from the male's semen and injects it directly into the egg with a microscopic needle. After the development of an embryo, it's transferred into the uterus through IVF. This method is used for couples in which the man has a very low sperm count or poor sperm quality.
e) Donor Eggs: Eggs are extracted from the ovaries of another woman (usually younger) and fertilized by infusing with a sperm extracted from the recipient's partner. Resulting embryos are then transferred into the recipient's uterus. This method is used when the ovaries of a woman are damaged or prematurely failing, or for women who have undergone chemotherapy and/or radiation; older women with poor egg quality; as well as women with genetic disorders who do not want to pass it along.
f) Surrogacy: The surrogate carries a baby for another woman. Artificial insemination is used to get a surrogate pregnant, using the man's sperm or through IVF with the couple's embryo. Donor eggs and sperm may also be used.
This method is used for women who can't carry a baby because of disease, hysterectomy, or infertility. In rare instances, both partners are infertile.
g) Donor Embryos: Some couples undergoing IVF, who become pregnant and no longer need unused fertilized eggs, donate their embryos. The embryo, which is donated, is then transferred into the recipient. This method is used for couples in which both woman and man are infertile but want to experience a pregnancy.
h) Gamete Intrafallopian Transfer (GIFT): Eggs from the woman are collected, fused with sperm from the man in a petri dish, and then placed directly into the fallopian tubes, where fertilization can occur. This method is used for couples in which the woman has at least one functioning fallopian tube and/or the man has a low sperm count or sperm with poor motility, and couples who are suffering from unexplained fertility or who consider IVF anti-moral or anti-religious
i) Zygote Intrafallopian Transfer (ZIFT): Like IVF, but in this case, the embryo is inserted into the fallopian tube, not the uterus. This method is used for couples who have unexplained infertility or those in which the man has a low sperm count, the woman has at least one tube open, and/or there are ovulation problems.
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