I'm sure that was the treatment that Rene and John King were prescribed for their infertility. That doesn't mean that your treatment is going to be a carbon copy of that. That couple is quite a few years older than you, right?
No, don't just assume that Roseanne and Bill's treatments for infertility will work for you either -- or that the doctor will even suggest them. Why not? For one thing, that couple is a few years younger than you -- and the cause of their problems are different from yours.
So what can you expect, you ask?
It's natural to be nervous prior to engaging you and your partner into treatments for infertility. And I suppose it would make life a lot easier for everyone involved if there were just one all-around treatment for infertility.
But the truth of the matter is that treatments for this common problem are as varied and as unique as the couples are who are experiencing it. How your team of doctors and specialists handle your infertility depends on several factors, not the least of which are the root cause of your problem, how long you've actually been infertile, your age as well as that of your partner, and your own personal input into the treatments.
You need to know right from the beginning that some cases of infertility just can't be corrected. A woman, nonetheless, may stay become pregnant thanks to the marvelous increases in modern technology though. Talk about miracles!
The first option most doctors present to couples unable to have a baby is taking fertility drugs. These drugs are of the greatest help to women who experience infertility due to ovulation disorders. The purpose of these medications is to regulate ovulation or in some cases actually induce the system into ovulation.
In many ways they affect your system like a natural hormone would -- especially the follicle-stimulating hormone, FSH, and the luteinizing hormone, LH. This is a very simple and noninvasive method. It makes sense it would be the first avenue that the medical community tries.
Just what drugs you may be taken varies. There's a list of about nine medications that your prescribing physician may have you take.
The first one is called clomiphene. The brand names these go by include Clomid and Serophene. Taken orally, this particular medication is especially useful for women who need their ovulation stimulated because they suffer with polycystic ovary syndrome. But it may also be prescribed for other ovulatory disorders.
It works by triggering the pituitary gland to release more of the hormones FSH and LH, which in turn stimulate the growth of an ovarian follicle which contains an egg.
The drug human chorionic gonadotropin or hCG is usually given in conjunction with this drug. hCG stimulates the follicle to release an egg.
There's another medication, called Human menopausal gonadotropin or hMG doctors may prescribe you as an injection. This particular drug works best for those women who can't ovulate because the pituitary gland itself. For these women, the pituitary gland fails to stimulate the monthly cycle.
This drug bypasses the pituitary gland to influence the ovaries directly. Not surprisingly, hMG -- which is probably given to you under the brand name of Repronex -- contains both FSH and LH.
Another method of stimulating the cycle of the ovaries is simply through the use of giving your system FSH independently -- without any other medication. You'll recognize if you're taking this through the brand names of Gonal-F and Bravelle.
Don't be surprised if along with your prescription of FSH, your physician also hands you a second one for hCG. These two are often used in combination.
If the cause of your infertility is a menstrual cycle that's irregular or erratic, then you may be receiving Gn-RH, known as Gonadotropin-releasing hormone analogs. This specific treatment is quite often used for those women who ovulate prematurely. By that, I mean she has her period before the lead follicle is mature enough.
This form of treatment supplies the pituitary gland with the Gn-RH, enabling the doctor then to induce follicle growth through the use of FSH.
Another medication that you may be given orally is called Metformin -- you'll probably discover the brand name is Glucophage. It's recommended when your physician believes that your infertility is caused by insulin resistance. Insulin resistance, by the way, is suspected as a cause in the development of polycystic ovarian syndrome.
If your menstrual cycle is irregular because you have higher than normal levels of prolactin, then you may very well find yourself taking the medication Bromocriptine. Sold under the name of Parlodel, this is the hormone which triggers milk production in women who have just given birth.
You may find that your doctor wants to prescribe a medication called an aromatase inhibitor. This class of medication, which includes letrozole and anatrozole, has not been approved by the U.S. Food and Drug Administration for use for the problem of infertility.
Aromatase inhibitors are drugs made specifically for breast cancer. Many doctors though prescribe it when clomiphene citrate is not effective. This is reserved for women who can't ovulate on their own. You need to speak with your physician about this if he recommends this drug. The manufacturer itself has warned physicians to refrain from using this. Its use may cause adverse health effects including birth defects and miscarriages.
Ah! The question has crossed your mind. The use of fertility drugs may mean that you're giving birth -- and that's what you want. But it may also mean you may have a multiple birth. This is especially risky when you use the types of drugs which are injected into your system. While the oral medications also increase the odds of you giving birth to more than one child, they are not as high as with the injections.
Now that's not to mean you'll end up with eight children. Not by any stretch of the imagination. But you may have twins or even triplets.
That's why -- and you'll discover this as you take the treatments yourself -- that your specialist monitors the use of these drugs very carefully. While you're on these drugs you'll be taking blood tests, hormone tests and ultrasounds. The last of these is to measure the size of the ovarian follicle.
Multiple births raise the risk of your babies being born prematurely which in turn put them at a greater risk of health and developmental problems.
There are some ways in which the risk of experiencing a multiple birth can be mitigated. For example, if a woman is taking hCG injections, the ultrasound shows the physician the amount of follicles that have developed. If it appears that there are two many -- which increase the risk for a multiple birth -- the physician may withhold an injection.
If too many babies are actually conceived, physicians may also remove one or more the existing fetuses. Called multifetal pregnancy reduction, this gives the remaining fetus better odds at survival -- and at thriving even.
This procedure though also carries serious questions -- both emotional and ethical ones -- for many couples. This is one of those possible complications in fertility treatment that is best discussed before treatment begins. It's a decision that just can't be made lightly.
Depending on your cause of infertility, your physician may recommend that you undergo surgery. Used in many instances to remove blockages in the fallopian tubes, new laparoscopic techniques allow delicate operations on the fallopian tubes that prior generations could not have imagined.
ART has arrived and it has revolutionized the way doctors now approach and treat infertility. Every year thousands of babies are born to couples formerly unable to have children thanks to ART, assisted reproductive technology.
These couples are now blessed with their own biological child or in some cases children. ART is indeed an art form in itself. This approach to infertility is a team approach.
ART is most effective when the female part possesses a healthy uterus and responds well to fertility drugs. It's also effective when the woman ovulates naturally or uses donor eggs.
For the male partner's part, these varied techniques stand the best chance of succeeding when he has healthy sperm, or through the use of donor sperm. ART loses some of its inherent effectiveness as a treatment for couples after they turn age 35.
A couple using this treatment has on their team not only their physician, but psychologists, embryologists, laboratory technicians, nurses as well as a variety of allied health professionals to assist them.
Assisted reproductive technology takes many forms, depending on the specific needs and situations of the couples involved. One of the most popular of these is in vitro fertilization or IVF for short. It's not only one of the most popular treatment for infertility, it's also recognized worldwide as the established therapy for this condition.
Considering its popularity, you may be surprised to learn that less than five percent of the infertile couples use this procedure.
If you and your partner are considering this procedure, you'll discover that the first step is the administration of hormones designed to stimulate your ovaries into producing several eggs.
Once the eggs have been produced then a surgeon inserts a needle through the vagina and on into the ovaries in order to retrieve the eggs as well as the fluid the eggs in which the eggs are residing.
Testing occurs to insure that eggs are indeed within the fluid.
At the same time, the male partner provides the laboratory with a semen sample. He's requested to refrain from sex for several days prior to his giving this sample. The sperm, then, are separated from the semen itself.
Now, is the moment you've been waiting for. The sperm are combined with the eggs in a laboratory dish. This is the part of the procedure from which we get its name: in vitro fertilization. The "in vitro" part of the name refers to a process (and technically any process) which occurs in a laboratory outside a living creature.
Surprisingly, it takes only 18 hours to know if the sperm has fertilized the eggs and if they have begun the process of growing as embryos. If the sperm "have done their job" then the eggs are incubated. Laboratory staff then carefully monitors the progress for the following two to three days.
After that, the doctor transfers what are now referred to as embryos from the laboratory dish into your uterus. He or she does this by going through the cervix using a catheter. For an hour after this occurs, you need to stay in a resting position.
For the two weeks which follow, you'll be given more hormones. If the implantation takes hold, the eggs actually attach themselves to the uterine wall and continue to grow. You'll be given a pregnancy test, to confirm that indeed that everything is on course. And yes, it'll show loud and clear that you are indeed pregnant. Congratulations!
This procedure is often recommended when both fallopian tubes are blocked. It's also used in the presence of endometriosis, cervical factor infertility, and various disorders which disruption regular ovulation. A doctor may also recommend this procedure when the cause of fertility can't be established or when the infertility is caused by some disorder of the male.
The only disadvantage to this treatment is the increased risk of multiple births. And it only goes to reason since there is more than one fertilized egg being implanted into the female partner. IVF requires quite a bit of monitoring as well, in the form of frequent blood tests and daily hormone injections.
ICSI, or Intracytoplasmic sperm injection (now you see why it's been shortened to ICSI), is another form of ART. In this one, a single sperm is injected directly into an egg for the purpose of fertilization. Once the egg is fertilized then the IVF process is used. Especially effective in couples who have tried all the other standard treatments, ICSI it's also extremely helpful for those situations in which the man's concentration of sperm is low.
Isn't that an appropriately named procedure -- GIFT? Of course you know it's an acronym. And wouldn't you know its real name leaves most of us in the dark: Gamete intrafallopian transfer.
Yeah, now that's romantic. Well, it might not sound romantic, but the gift of GIFT has allowed many couples to experience, ultimately, the gift of a biological child of their own.
This procedure resembles IVF very closely. But where IVF fertilizes a woman's egg outside of her body, this technique allows the egg to become fertilized in her fallopian tubes.
Let me explain. Both the male and female germ cells -- or gametes-- are injected into the woman's fallopian tubes specifically for fertilization. In a man, a gamete is the sperm. A woman's game is the eggs, or ova.
Specifically, health professionals stimulate the female eggs using various medications. Then they're collected using a process called aspiration. From here, three or four of the eggs are combined with no less than 200,000 sperm inside a catheter and then transferred inside the fallopian tubes of the woman using a surgical procedure called a laparoscopy.
GIFT is classified as a more invasive procedure than IVF because it does make use of the surgical procedure. It's most useful when ovulatory disorders or cervical problems lie at the core of the couple's infertility problem.
But it's also a very useful procedure if the male is experiencing a low sperm count.
You've probably already have guessed that the success of this procedure depends upon the health of the woman's fallopian tubes. If your tubes are blocked, this would not be the appropriate treatment.
But many females experiencing endometriosis find this to be successful for them.
Approximately 35 percent of the couples who use this procedure actually get pregnant and 27 percent of the couples experience a live pregnancy
Couples are drawn to this particular technique because it allows them to deliver a baby as close to natural means as possible. Some women prefer GIFT for the sole reason that it allows for the fertilization of the egg inside their bodies, instead of in a "cold, sterile lab."
As with any procedure, there are some disadvantages to it. One of them is the more invasive nature of the technique compared to IVF. GIFT also possesses a greater risk of multiple births, which in turn can create pregnancy complications -- some of which may be serious.
Babies produced in this manner in general have a lower birth weight than those conceived through other techniques. But not only that, there seems to be a greater risk of the baby being born with some type of birth defect.
Used in men with spinal cord injuries an ART procedure called electric or
vibratory stimulation has been very effective for some couples. The electric stimulation helps to facilitate the ejaculation in order to obtain the necessary semen.
Another method of retrieving sperm from the male is called surgical sperm aspiration. This technique actually removes sperm from an area of the man's reproductive system, such as the vas deferens, testicle or the epididymis. In this way the sperm is retrieved should the ejaculatory duct be blocked.
Remember the phrase artificial insemination?
Well, it's now called Intrauterine insemination!
Confused? Many couples are. However confused you may appear initially, it's worth your time and effort to take a look at IUI -- intrauterine insemination.
It's by no means a new technique. But did you realize that it's been an option for couples since the 1940s. Who knew?
IUI can be a very effective treatment option for certain couples. It's especially effective when the female partner is younger than 41. If you have any of the following problems though, this procedure isn't a viable treatment:
IUI, in fact, is usually the treatment of choice for infertility that has no apparent cause. But it has also proved to be a godsend for those couples in which the woman is suffering with endometriosis or other problems with ovulation as well as infertility caused by the disorders of the cervix.
IUI may also be used if the infertility has been determined to be on the part of the male.
According to many medical specialists, Insemination is a logical treatment to use in the initial stages of infertility therapy. Used for a maximum of four months on women who are ovulating -- that is producing and releasing an egg every month, it can be used longer in some special incidences.
A woman with polycystic ovaries (PCOS) for example or is currently taking drugs to stimulate ovulation, though, may find that IUI therapy lasts for longer than this recommended length of time.
Now that I've prepared you for IUI, you're naturally curious to what's actually involved in the process. And that's reasonable.
Your first step in the IUI technique is taking medication that stimulates the development of more than one egg. The insemination is then timed to coincide with your ovulation or the release of your eggs.
The male partner produces a semen specimen either at home or in the office through masturbation following a minimum two day period of abstinence from ejaculation.
This sample is then "washed" in the laboratory. You'll hear this part of the technique referred to as either sperm processing or sperm washing. In this portion, the sperm separates from the other parts of the semen so it can be concentrated into a small volume. Sperm washing is performed through a variety of media and techniques. It doesn’t take long, at most 60 minutes.
The vagina is prepared for entry and the cervical area is gently cleansed. This is portion of the procedure may vary from individual to individual. Your doctor may choose to place the sperm in your cervix, in which case, this procedure is technically an intracervical insemination or an ICI.
If he instead places it farther up in the uterine cavity, then it's technically called an intrauterine insemination. In either version, he'll use a sterile, flexible catheter to accomplishment the placement of sperm.
And the last option used in Assisted Reproductive technology is called assisted hatching. Even though it sounds as if it's something performed in a chicken coop, it's a treatment for infertility that gets relatively good results. The technique assists with the implantation of the embryo into the lining of the uterus.
As with any medical treatment some couples may experience complications. One of the most prevalent is multiple births. The number of quality embryos kept and then matured to fetus status and birth is in the final analysis made by the couple themselves.
It's not an easy decision to make -- and it's a decision most couples don't have a lot of experience in making. If too many babies are conceived, the couple does have the option, as we stated earlier of removing one or more of them Called multfetal pregnancy reduction, this may improve the chances that those fetuses still in the mother will survive.
Another possible complication of these treatments is ovarian hyperstimulation syndrome, or OHSS for short. A woman's ovaries, if over stimulated, may enlarge causing her bloating and pain. While treatment is seldom necessary for the mild to moderate symptoms, the actual pregnancy may delay the woman's recovery.
In rare instances, fluid accumulates in the woman's abdominal area as well as the chest. This causes abdominal swelling as well as shortness of breath.
But there are other problems that can arise from this fluid accumulation as well. This includes a depleted volume of blood and a low blood pressure. In some severe cases, emergency treatment is necessary.
The younger the woman undergoing this treatment, the greater the odds are that she'll experience this complications. Additionally, women with polycystic ovary syndrome also find themselves at a greater risk of OHSS.
Every invasive procedure carries with it the risk of excessive bleeding or acquisition of an infection. This can be said for any of the ART techniques as well.
Some research reveals that there may be an increased risk of birth defects when couples conceive through an ART procedure. Currently, there is not enough research confirming this. This piece of information needs to be in the front of your mind while you're weighing your treatment options.
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