There’s an intense emotional response to hearing, “There is no apparent reason for your infertility”. It can be difficult, maddening and equally frustrating for both you and your partner. People who do find out a specific cause find their situations difficult, too, of course, but knowing the “whys” makes it more bearable. In cases of unexplained infertility, couples feel that one reason, one cause is lurking in a shadowy corner. It just hasn’t been uncovered yet.
This chart is US national average data on success rates per IVF cycle by female age for 2014. The dark blue line (triangles) shows pregnancy rates per cycle by age. The orange line (circles) shows live birth rates per cycle by age. The rate of singleton live births per cycle is shown by the light blue line. The difference between "pregnancy" rate and "live birth" rate is due to miscarriages.
When you face secondary infertility, you’re dealing not only with the typical ups and downs of TTC, but also with the additional emotional fallout that is unique to those having difficulty getting pregnant with baby number two. In addition to feeling disappointed and upset, you may also be feeling shock (“I got pregnant so easily the first time, there’s no way I could have infertility problems”), guilt (“I already have a child, so I should be happy”) and even isolation (“I can’t connect with the people facing primary infertility and I can’t connect with my friends who have multiple kids”). How do you reconcile these conflicting emotions — and how do you tackle them while trying to raise the child you already have?
If IVF were to involve the fertilisation of only a single egg, or at least only the number that will be implanted, then this would not be an issue. However, this has the chance of increasing costs dramatically as only a few eggs can be attempted at a time. As a result, the couple must decide what to do with these extra embryos. Depending on their view of the embryo's humanity or the chance the couple will want to try to have another child, the couple has multiple options for dealing with these extra embryos. Couples can choose to keep them frozen, donate them to other infertile couples, thaw them, or donate them to medical research.[90] Keeping them frozen costs money, donating them does not ensure they will survive, thawing them renders them immediately unviable, and medical research results in their termination. In the realm of medical research, the couple is not necessarily told what the embryos will be used for, and as a result, some can be used in stem cell research, a field perceived to have ethical issues. 

In December 2015, the Ontario provincial government enacted the Ontario Fertility Program for patients with medical and non-medical infertility, regardless of sexual orientation, gender or family composition. Eligible patients for IVF treatment must be Ontario residents under the age of 43 and have a valid Ontario Health Insurance Plan card and have not already undergone any IVF cycles. Coverage is extensive, but not universal. Coverage extends to certain blood and urine tests, physician/nurse counselling and consultations, certain ultrasounds, up to two cycle monitorings, embryo thawing, freezing and culture, fertilisation and embryology services, single transfers of all embryos, and one surgical sperm retrieval using certain techniques only if necessary. Drugs and medications are not covered under this Program, along with psychologist or social worker counselling, storage and shipping of eggs, sperm or embryos, and the purchase of donor sperm or eggs.[151]
Women who switch from IUI to IVF sooner or begin with IVF get pregnant quicker than those who stick or start with IUI. One study found that undergoing immediate IVF resulted in superior pregnancy rates with fewer treatment cycles compared to those who did two rounds of IUI before switching to IVF.  While the immediate IVF group got pregnant quicker, the overall success after up to 6 IVF cycles was similar.
Bachelor of Arts in Translation and Interpreting (English, Spanish, Catalan, German) from the University of Valencia (UV) and Heriot-Watt University, Riccarton Campus (Edinburgh, UK). Postgraduate Course in Legal Translation from the University of Valencia. Specialist in Medical Translation, with several years of experience in the field of Assisted Reproduction. More information about Sandra Fernández

Cancer. Although some early studies suggested there may be a link between certain medications used to stimulate egg growth and the development of a specific type of ovarian tumor, more-recent studies do not support these findings. There does not appear to be a significantly increased risk of breast, endometrial, cervical or ovarian cancer after IVF.
For women, intake of antioxidants (such as N-acetyl-cysteine, melatonin, vitamin A, vitamin C, vitamin E, folic acid, myo-inositol, zinc or selenium) has not been associated with a significantly increased live birth rate or clinical pregnancy rate in IVF according to Cochrane reviews.[30] The review found that oral antioxidants given to men in couples with male factor or unexplained subfertility may improve live birth rates, but more evidence is needed.[30]

As with any medical procedure, there are some risks to keep in mind. When choosing between IUI and IVF, the risk is certainly something to consider. The chances of experiencing either a miscarriage or multiples are concerns many have when deciding to undergo fertility treatments. So let’s take a look at the odds of either of these things occurring, plus a few other risks to be aware of.
The grief and anxiety of SI is, of course, self-perpetuating. You find yourself in a double-bind: you're constantly told that the chances of conceiving are maximised if you can relax and eliminate stress, but it's hard to let go of something so all-consuming, so elemental, as infertility. People were always saying to me: "If you just forgot about it, you'd get pregnant straight away." For the record, this is the most unhelpful thing you can say to someone with fertility problems. West explains that "couples become more and more anxious about the gap [between children]".
According to the data collected for 2014, these are the IVF success rates nationally, when using non-donor eggs, per egg retrieval. (These are not per cycle. In other words, these are the odds of a live birth after one egg retrieval, which may mean conception with fresh eggs/embryos in the cycle of the egg retrieval ​or after a frozen embryo transfer cycle in the following months.) 
PCOS: Polycystic ovarian syndrome (PCOS) is an ovarian issue that can cause irregular menstrual cycles and make it difficult for women to ovulate — a crucial part of the conception and pregnancy process. Women with PCOS do not release eggs regularly, and their ovaries often have many small cysts within. IVF is a strong option for women with PCOS, since it can help their bodies ovulate to achieve pregnancy.
All pregnancies can be risky, but there are greater risk for women who are older and are over the age of 40. The older the women the riskier the pregnancy. As women get older, they are more likely to suffer from conditions such as gestational diabetes and pre-eclampsia. If older women do conceive over the age of 40, their offspring may be of lower birth weight, and more likely to requires intensive care. Because of this, the increased risk is a sufficient cause for concern. The high incidence of caesarean in older mothers is commonly regarded as a risk.
Anger, sadness, and anxiety are common among parents struggling to expand their family. "Having a child already doesn't make going through infertility any easier," says Alice D. Domar, Ph.D., executive director of the Domar Center for Mind/Body Health, in Waltham, Massachusetts, and author of Conquering Infertility. Meeting with a mental-health professional or seeking out blogs and online groups for secondary infertility can help. The website of  the National Infertility Association, resolve.org, is a good place to start.
If you’re worried that you might be an infertile woman, don’t lose your hope. Be encouraged, and know that many women get pregnant even after being diagnosed with infertility. Know that there is a reason for what you’re going through. I trust God and I rely on His power, peace, and joy every day. I know there is a reason why we struggled with infertility – and perhaps the reason is so I could write about fertility and encourage couples like you to keep the faith.
The eggs are retrieved from the patient using a transvaginal technique called transvaginal oocyte retrieval, involving an ultrasound-guided needle piercing the vaginal wall to reach the ovaries. Through this needle follicles can be aspirated, and the follicular fluid is passed to an embryologist to identify ova. It is common to remove between ten and thirty eggs. The retrieval procedure usually takes between 20 and 40 minutes, depending on the number of mature follicles, and is usually done under conscious sedation or general anaesthesia.
The laboratory – This is when the harvested eggs are fertilized by an embryologist. Once fertilized, they’re grown 3-5 days until they’re able to be transferred into the woman’s uterus. Prior to the transfer, the embryos can be genetically tested. Although testing isn’t right for everyone, it’s useful for some people as it may help prevent miscarriage, passing on known genetic disorders, and can also be used to choose the sex of the child.
Sunni Muslim nations generally allow IVF between married couples when conducted with their own respective sperm and eggs, but not with donor eggs from other couples. But Iran, which is Shi'a Muslim, has a more complex scheme. Iran bans sperm donation but allows donation of both fertilised and unfertilised eggs. Fertilised eggs are donated from married couples to other married couples, while unfertilised eggs are donated in the context of mut'ah or temporary marriage to the father.[176]

Ovary stimulation. For eight to 14 days near the beginning of your menstrual cycle, you take a gonadotropin, a type of fertility drug that stimulates your ovaries to develop multiple mature eggs for fertilization (instead of just one). You also need to take a synthetic hormone like leuprolide or cetrorelix to keep your body from releasing the eggs too early.
When weighing the options, the pros and cons of intrauterine insemination (IUI) and in vitro fertilization (IVF) will, of course, be explored fully in discussion with your physician. In general terms, you can expect IUI to be a simpler process, less invasive, and lower cost. Some fertility specialists recommend attempting one or more cycles of artificial insemination before moving to IVF but this does not apply to everyone. For example, for an older woman, to try artificial insemination first may take up valuable time and the recommendation could well be to move straight to IVF. But before you can compare the two treatments, you need to know what exactly you could expect from IVF.
Since most IVF cycles start with collecting a number of eggs after ovarian stimulation, you should have on average 12-15 eggs to use. This means that you do not need to use all of them for ICSI or conventional IVF. A Split-ICSI strategy incorporates both – some eggs are injected with selected sperms using ICSI, where the rest are incubated with sperm in the conventional way. Trying both provide a safety net against failed fertilization with either strategy.
Monitoring of egg development is usually done with E2 and LH blood hormone tests and ultrasound scans of the ovaries to determine when the egg is mature. The ultrasound allows the physician to visualize the thickness of the uterine lining and the ovaries, more specifically the number of follicles within them. The bloodwork shows the trend of pre- to post-stimulation hormone levels; increased levels of estrogen indicate follicular development.
A 2013 review and meta analysis of randomised controlled trials of acupuncture as an adjuvant therapy in IVF found no overall benefit, and concluded that an apparent benefit detected in a subset of published trials where the control group (those not using acupuncture) experienced a lower than average rate of pregnancy requires further study, due to the possibility of publication bias and other factors.[34]
jsme velice rádi, že stávající situace nám opět umožňuje spustit provoz naší kliniky. Vaše bezpečí je pro nás na prvním místě, proto budeme zahajovat jednotlivé druhy léčby postupně. Abychom Vám poskytli tu nejkvalitnější, ale zároveň bezpečnou zdravotní péči, řídíme se doporučeními odborné společnosti SAR ČGPS a proto budeme jednotlivé druhy léčby zahajovat postupně.
The Rand Consulting Group has estimated there to be 400,000 frozen embryos in the United States in 2006.[83] The advantage is that patients who fail to conceive may become pregnant using such embryos without having to go through a full IVF cycle. Or, if pregnancy occurred, they could return later for another pregnancy. Spare oocytes or embryos resulting from fertility treatments may be used for oocyte donation or embryo donation to another woman or couple, and embryos may be created, frozen and stored specifically for transfer and donation by using donor eggs and sperm. Also, oocyte cryopreservation can be used for women who are likely to lose their ovarian reserve due to undergoing chemotherapy.[84]
Treatment with Clomid tablets plus IUI improves fertility rates. For unexplained infertility, studies have shown that for women under 35, monthly success rates for Clomid plus insemination are about 10% per cycle. This pregnancy rate holds up for about 3 tries and the success rate is considerably lower after that. More about success rates with IUIs is on the insemination page and on the Clomid for unexplained infertility page. The insemination component boosts fertility more than the Clomid does - but success rates are higher when both are used together.
This tool is also very useful because it also provides you with an indication of the risk/reward of doing two single embryo transfers, vs using multiple embryos in your first transfer. Using only one embryo at a time when doing IVF pretty much eliminates the risk of having twins, however it can be more expensive doing it this way making it a tough decision for many couples. The SART IVF success rate predictor tool can help you quantify these risks for your personal set of circumstances.
In vitro fertilisation (IVF) is a process of fertilisation where an egg is combined with sperm outside the body, in vitro ("in glass"). The process involves monitoring and stimulating a woman's ovulatory process, removing an ovum or ova (egg or eggs) from the woman's ovaries and letting sperm fertilise them in a liquid in a laboratory. After the fertilised egg (zygote) undergoes embryo culture for 2–6 days, it is implanted in the same or another woman's uterus, with the intention of establishing a successful pregnancy.
We also care about not only your physical well being, but also your emotional health. In fact, these issues as important enough to us that one of our core team members is a psychologist. Julianne Zweifel is an expert in addressing the mental aspects of secondary (and primary) infertility and she can promote emotional well being in a way that few others have the training or experience to do. If you should feel you do not wish to talk a specialist, but are struggling emotionally, please at least let other team members know-the more we hear from you, the easier it is for us to help.  
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