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What Is The Incidence Of Infertility Worldwide ?

The World Health Organization (WHO) estimates that approximately 8-10% of couples experience some form of infertility problem. On a worldwide scale, this means that 50-80 million people suffer from infertility. However, the incidence of infertility may vary from region to region. In France, 18% of couples of childbearing age said that they had difficulties in conceiving.

Is Infertility Exclusively A Female Problem ?

No. The incidence of infertility in men and women is almost identical. Infertility is exclusively a female problem in 30-40% of the cases and exclusively a male problem in 10-30% of the cases. Problems common to both partners are diagnosed in 15-30% of infertile couples. After thorough medical investigations, the causes of the fertility problem remain unexplained in only a minority of infertile couples (5-10%).

Can Fibroid S Interfere With IVF?

Fibroids are benign tumors consisting of fibrous tissue and muscle which grow in the uterus. The significance of fibroids relates to not only their size but also their location. Even small fibroids located inside the cavity of the uterus where embryos need to implant, may interface with success and need to be removed. Fibroids that do not encroach on the cavity of the uterus are generally not significant unless they are larger than 5 cm in diameter and also if there are many fibroids causing significant uterine enlargement.

I Have Endometriosis, Does This Affect My Fertility & Also Success With IVF?

Endometriosis is a condition where cells that usually remain confined to the cavity of the uterus, grow outside of the uterus usually on or in the ovaries and also on the surface of the pelvic pain and may also decrease the chances of natural conception by about one-third Patients who require IVF who have endometriosis still have the same chances of a successful outcome as patients of the same age without endometriosis as long as immunological factors that may accompany endometriosis are identified and treated appropriately.

What Are The Most Common Causes Of Infertility ?

The most common causes of female infertility are ovulatory disorders and anatomical abnormalities such as damaged fallopian tubes. Less frequent causes include, for example, endometriosis and hyperprolactinemia. Causes of male infertility can be divided into three main categories: Sperm production disorders affecting the quality and/or the quantity of sperm; anatomical obstructions; Other factors such immunological disorders. Approximately a third of all cases of male infertility can be attributed to immune or endocrine problems, as well as to a failure of the testes to respond to the hormonal stimulation triggering sperm production. However, in a great number of cases of male infertility due to inadequate spermatogenesis (sperm production) or sperm defects, the origin of the problem still remains unexplained.

Where Is The Problem?

About a third of the time, infertility can be traced to the woman. In another third of cases, it is because of the man. The rest of the time, it is because of both partners or no cause is found. 1. Pregnancy is the result of a process that has many steps. 2. To get pregnant: A woman must release an egg from one of her ovaries (ovulation). 3. The egg must go through a Fallopian tube toward the uterus (womb). 4. A man's sperm must join with (fertilize) the egg along the way. 5. The fertilized egg must attach to the inside of the uterus (implantation). 6. Anything which affects one or more of these processes can cause infertility.

How Successful Is Infertility Treatment ?

When talking of success rates for any type of infertility treatment, one should bear in mind that the average chance to conceive for a normally fertile couple having regular unprotected intercourse is around 25% during each menstrual cycle. It is estimated that 10% of normally fertile couples fail to conceive within their first year of attempt and 5% after two years. Comparable to normal fertility rates, effective treatments can be expected to have, on average, up to a 25% success rate per cycle of treatment, and may therefore need to be repeated several times before a pregnancy is achieved. Simple ovulation induction to compensate for hormonal imbalances has a very high success rate; more than 80% of women suffering from such disorders are likely to conceive after several cycles of treatment with drugs such as clomiphene citrate or gonadotrophins.

What Is ICSI?

Intra Cytoplasmic Sperm Injection (ICSI) is a modification of IVF. ICSI is a procedure in which one immobilized sperm is sucked into a very narrow pipette and then injected inside the egg, allowing fertilization to take place. It is usually employed when sperms are unable to enter eggs by their own power. Most forms of male infertility can be solved by use of ICSI and sperm donation is less necessary. ICSI can also be used to maximize the yield of embryos.

What Is The Duration Of One IVF Or ICSI Cycle?

One complete IVF or ICSI cycle takes approximately six to eight weeks. First, the normal menstruation cycle of the woman is down regulated by injection of specific hormones each day. This part of the cycle can vary from a few days to several weeks. When the ovaries have become inactive, shown on ultrasound and laboratory findings, the stimulation of the ovaries start by intra muscular or subcutaneous injections of hormones. The mean stimulation period is 12 days, depending on the reaction of the ovaries. The ovum pick up takes place within two days after stopping the stimulation. Now the real IVF or ICSI follows in the laboratory. When fertilisation occurs, embryo's are transferred into the uterus after three to five days and drugs supporting the pregnancy are given. After approximately 15 days, a pregnancy test will show whether the IVF treatment has been successful or not.

Will The IVF Baby Born Be Normal?

The risk of birth defects in the general population is 1-3% of all births. And, indeed, babies born from in vitro fertilization may also have birth defects. There are, however, a number of confounding factors that may lead to overstating the risk associated with the IVF process itself. First, birth defects occur more frequently in cases of multiple births and the incidence of multiple births is much higher with IVF, largely due to the purposeful transfer of multiple embryos, rather than being due to the technology itself. Second, the incidence of birth defects increases with advancing maternal age, and on average, women who conceive through IVF tend to be older than women who conceive naturally. Third, and perhaps most important of all, is the fact that couples who have infertility seem to have a higher rate of birth defects than the general population even if no fertility treatments are used. It follows that studies which use birth defect rates from the general population as a comparison to IVF, probably overestimate the risk from IVF.

Does Ovarian Stimulation Affect The Store Of Eggs Resulting In Early Menopause ?

Definitely not. Ten or more follicles may be encouraged to ripen during stimulation, but this happens during a normal cycle too. The only difference is that most of the follicles die during a normal cycle, leaving only one or two survivors. With IVF they all ripen. In other words, ovarian stimulation saves many of the eggs which would otherwise be lost. In the early part of her fertile years, a woman has more than 400,000 egg cells on average, most of which die spontaneously as the years pass. Stimulation draws on a large reserve of eggs which would otherwise remain almost completely unused.

Are The Hormone Treatments Harmful For Me Or For Our (Future) Child?

As stated in this guide, the hormones administered during IVF treatment may have some side-effects. Fortunately, they are not serious and are only temporary. Claims that the hormones used in IVF treatment can be carcinogenic or have other ‘harmful’ effects are not founded on medical data. Moreover, these hormones were administered to women with infertility problems on a large scale long before IVF treatments were developed, without any harmful effects. Also with regards to children born from IVF/ICSI up until now no study has proven that (certain) cancers would occur more frequently than with children who were conceived without hormonal stimulation. Having said that, research regarding the effects of hormone treatments is still conducted worldwide in the interests of safety.

How Can We Be Sure That The Embryos Transferred To The Womb Are Really Our Own?

The CRG follows very strict and highly reliable procedures to identify eggs, sperm and embryos. We take no risks whatsoever. In our laboratory, the precise source identities of all eggs, sperm and embryos are tested carefully by two people, separately from each other. Also, during treatment your name will be asked for repeatedly; now you know the reason why. In practice, errors (read switches) are excluded.

Is It A Sensible Idea To Freeze Embryos For Use At A Later Date?

The new legislation regarding assisted fertilization and everything related specifies that prior to commencing your treatment you must decide what needs to be done with surplus embryos. These are embryos that originated from your treatment, but that you didn’t need for transfer. You need to stipulate in the consent form that you sign prior to your treatment whether you want to have those frozen or not. If you chose to have them frozen, you will first have to use the frozen material at the next IVF attempt or if you wish another child, unless there is a good medical reason to use fresh embryos again and thus to start over the whole IVF treatment.

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