Amongst these two patient populations (which we’ll refer to now as PCOS), IUI with clomid and letrozole generally shows no improvement versus when these drugs are taken without IUI. When IUI is coupled with gonadotropins, success rates reach 14 - 26% per cycle, which is higher than almost any other patient class, but still pales in comparison to IVF. It’s also worth noting that PCOS patients who are taking gonadotropins have a very high risk of multiples.
Apart from poor egg quality at advanced maternal age, older women are also less likely to respond to ovarian stimulation hormones that cause the release of multiple eggs. Being able to produce a dozen of eggs significantly increases the odds of success. It allows your fertility practitioner to choose the egg with normal genetic makeup and best likelihood of implantation. In both nature and IVF, not all eggs are suitable to produce a pregnancy. Ideally, you would produce 8-15 eggs after ovarian hyperstimulation so that some of them are genetically normal and perfectly matured.

Israel has the highest rate of IVF in the world, with 1657 procedures performed per million people per year. Couples without children can receive funding for IVF for up to two children. The same funding is available for women without children who will raise up to 2 children in a single parent home. IVF is available for women aged 18 to 45.[153] The Israeli Health Ministry says it spends roughly $3450 per procedure.


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.
It is possible that a significant contributor to unexplained infertility can be attributed to changes in sperm epigenetics. Methylation patterns in sperm DNA which affect the expression of various genes may be the missing link for this unique patient population. By employing epigenetic analysis, we may be able to identify more causes of infertility and suggest the optimal course of therapy. Preliminary evidence even suggests that these epigenetic signatures influence the probability of conception, embryogenesis, and successful carrying of pregnancy to term. Future research on sperm epigenetics holds the promise of revolutionizing reproductive medicine and empowering patients in the process.
Those fearful of conceiving with multiples should strongly consider IVF and only transferring one embryo at a time. In these circumstances, just 1% of pregnancies lead to twins, and triplets are even more rare. Alternatively, 8 - 30% of medicated IUI pregnancies lead to twins. Finally, the least preferable circumstance is do to IVF with multiple embryo transfer, where in women under 38 years of age, 30% of pregnancies culminate in a multiple birth.
This website uses cookies to improve your experience while you navigate through the website. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may have an effect on your browsing experience.
The number to be transferred depends on the number available, the age of the woman and other health and diagnostic factors. In countries such as Canada, the UK, Australia and New Zealand, a maximum of two embryos are transferred except in unusual circumstances. In the UK and according to HFEA regulations, a woman over 40 may have up to three embryos transferred, whereas in the US, there is no legal limit on the number of embryos which may be transferred, although medical associations have provided practice guidelines. Most clinics and country regulatory bodies seek to minimise the risk of multiple pregnancy, as it is not uncommon for multiple embryos to implant if multiple embryos are transferred. Embryos are transferred to the patient's uterus through a thin, plastic catheter, which goes through her vagina and cervix. Several embryos may be passed into the uterus to improve chances of implantation and pregnancy.
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?
One in 8 couples (or 12% of married women) have trouble getting pregnant or sustaining a pregnancy. Infertility is defined as the inability to get pregnant after regular sexual intercourse without the use of any contraceptive methods for 6 months for those 35 years old or over, or 12 months for those under 35.(1)  Under normal circumstances the ability to get pregnant is at the most 25% each month. This number declines over time and starts to decline more rapidly once a women reaches her thirties, so that by age 35, the likelihood of getting pregnant each month is down to about 15%, and by age 40 it’s down to less than 10%.
3-6 months of treatment with Clomid pills (clomiphene citrate) might improve fertility by as much as 2 times as compared to no treatment. This is a very low level infertility treatment. Infertility specialists do not usually recommend Clomid treatment( without insemination) for unexplained infertility for women over the age of about 35. Most fertility specialists do not use it (without IUI) on any couples with unexplained infertility. If a woman is already having regular periods and ovulating one egg every month, giving Clomid, which will probably stimulate the ovaries to release 2 or 3 eggs per month (instead of one) is not really fixing anything that is broken - and is not likely to be successful.
Amenorrhea (including hypothalmic amenorrhea) is a condition in which there is an absence of menstrual periods in a woman. There are two types of amenorrhea: primary and secondary. Treatment of amenorrhea depends on the type. In primary, surgery may be an option and in secondary amenorrhea medication or lifestyle changes may be treatment options. We go over the definition of amenorrhea, causes, and treatment options for amenorrhea.

The goal of this treatment is to increase the number of sperm that reach the Fallopian tube and subsequently increase the chance of fertilization. IUI provides the sperm an advantage by giving it a head start, but still requires the sperm to reach and fertilize the egg on its own. Depending on your fertility diagnosis, IUI can be coordinated with your normal cycle or with fertility medications.
3-6 months of treatment with Clomid pills (clomiphene citrate) might improve fertility by as much as 2 times as compared to no treatment. This is a very low level infertility treatment. Infertility specialists do not usually recommend Clomid treatment( without insemination) for unexplained infertility for women over the age of about 35. Most fertility specialists do not use it (without IUI) on any couples with unexplained infertility. If a woman is already having regular periods and ovulating one egg every month, giving Clomid, which will probably stimulate the ovaries to release 2 or 3 eggs per month (instead of one) is not really fixing anything that is broken - and is not likely to be successful.
Ovarian reserve testing. To determine the quantity and quality of your eggs, your doctor might test the concentration of follicle-stimulating hormone (FSH), estradiol (estrogen) and anti-mullerian hormone in your blood during the first few days of your menstrual cycle. Test results, often used together with an ultrasound of your ovaries, can help predict how your ovaries will respond to fertility medication.
In the natural process of conception without treatment, a woman’s ovaries produce a mature egg each month, which leaves the ovary and travels along the fallopian tube towards the uterus. Sperm that has been deposited in the vagina through intercourse travels through the cervix through the uterus and up the fallopian tube toward the egg. Millions of sperm are lost in the cervix and do not travel to the fallopian tube. When the two meet, they join to form the early stage of an embryo which then travels down the fallopian tube into the uterus. If all goes well, it will implant in the lining of the womb and pregnancy begins.
Secondary infertility can be traced to either partner or both partners. About one-third of cases originate in women and about one-third originate in men. In the remaining one-third, the cause is due to a combination of factors or isn’t known. Increased age, complications from a prior pregnancy or surgery, increased weight, medications, sexually transmitted diseases, impaired sperm production, alcohol abuse, and smoking are all examples of secondary infertility in women and men.

IVF has many steps, and it takes several months to complete the whole process. It sometimes works on the first try, but many people need more than 1 round of IVF to get pregnant. IVF definitely increases your chances of pregnancy if you’re having fertility problems, but there’s no guarantee — everyone’s body is different and IVF won’t work for everyone.
Fertility is often something people do not consider until they are actively trying to start a family, or in many cases after they have started having trouble conceiving. What many don’t realize is that couples ages 29-33 with normal functioning reproductive systems only have a 20-25% chance of conceiving in any given month. Add in any number of infertility factors from either gender and those chances can decrease significantly.
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.
Intrauterine insemination (IUI) and in vitro fertilization (IVF) have been the therapeutic mainstays for those with unexplained infertility. The former involves inserting sperm directly into the uterus, while the latter works by uniting the sperm and the egg cells in a laboratory dish. IVF is expensive, but has a higher success rate. However, some patients continue to struggle and suffer the associated financial burden of repeated cycles.
Have you considered the potential complications associated with using donor eggs, sperm or embryos, or a gestational carrier? A trained counselor with expertise in donor issues can help you understand the concerns, such as the legal rights of the donor. You may also need an attorney to file court papers to help you become legal parents of an implanted embryo.
Bloating: Fertility medications can heavily impact how your body retains water, leading to the dreaded side effect of bloating. This is especially common in your midsection, where fluid can build up near the ovaries (creating abdominal tenderness, too). You can combat bloating by increasing your fluid intake and participating in light exercise such as walking.
^ Jump up to: a b Broer SL, van Disseldorp J, Broeze KA, Dolleman M, Opmeer BC, Bossuyt P, Eijkemans MJ, Mol BW, Broekmans FJ (2012). "Added value of ovarian reserve testing on patient characteristics in the prediction of ovarian response and ongoing pregnancy: an individual patient data approach". Human Reproduction Update. 19 (1): 26–36. doi:10.1093/humupd/dms041. PMID 23188168.
Treatment depends on the cause of infertility, but may include counselling, fertility treatments, which include in vitro fertilization. According to ESHRE recommendations, couples with an estimated live birth rate of 40% or higher per year are encouraged to continue aiming for a spontaneous pregnancy.[63] Treatment methods for infertility may be grouped as medical or complementary and alternative treatments. Some methods may be used in concert with other methods. Drugs used for both women and men[64] include clomiphene citrate, human menopausal gonadotropin (hMG), follicle-stimulating hormone (FSH), human chorionic gonadotropin (hCG), gonadotropin-releasing hormone (GnRH) analogues, aromatase inhibitors, and metformin.
Psychological factors: Studies on infertile groups of men and women have produced contradictory findings of the importance of psychological factors in causing infertility. Emotional disturbances undoubtedly appear to have some significance. This is only reasonable if you realize that the whole hormonal cycle, with its delicate adjustments, is controlled from the brain. This is an area which needs further investigation.
Embryos are transferred to the uterus. Embryos that have developed from the fertilization process will be placed in the uterus, normally 3 to 5 days after retrieval, so that they can embed. If this process is successful, pregnancy will occur and IVF is considered a success. If it’s not, you may use a frozen embryo that you have saved from a previous round of IVF to try again.

If a couple has been actively trying for over a year, it may be time to consider seeing a specialist. One thing we hear time and time again from our Glow Fertility Program partner physicians is that they wish their patients would come in sooner. Seeing a specialist as soon as you suspect you may have a problem trying to conceive can save you both time and money.
The cost of an IUI is almost certainly less on a per cycle basis, but because IVF has much higher success rates and IUI is a poor option for some, the higher per cycle cost of IVF can actually be more affordable in the long run – in terms of the cost to bring home a baby.  Because most successful IUIs happen in the first three or four-cycle, it eventually becomes very expensive to bring home a baby with an IUI. 

In order to have a successful IVF pregnancy, the first few weeks need special care. When you undergo IVF, you will be continuously monitored throughout the process by skilled doctors. Constant supervision reduces the complications associated with pregnancy. By understanding the IVF process and following your doctor’s instructions, you can enjoy the journey of your healthy pregnancy.
IUI: An IUI can be done with no medications or a number of different medications to help develop and ovulate one or two eggs. Around day 14 of a woman’s cycle, the insemination takes place which deposits sperm inside the uterus. This greatly increases the number of sperm at the junction of the uterus and fallopian tubes, the distance they have to swim to meet the egg, and thus increases the chances of natural conception for many people.
Take a look at your lifestyle. Have any of your habits changed since you conceived baby number one? For instance, is your diet still on track, or is there room for improvement? Getting your eating plan up to baby-making speed may help you close in faster on conception. Has your caffeine consumption gone up now that you’re a mom? That’s understandable, but too much caffeine isn’t great for fertility. Has your smoking habit returned? If yes, it’s time to kick butt, since smoking ages your eggs and decreases fertility. Are you getting way too little sleep? That may be likely, especially if your first child is keeping you up at night, but skimping on sleep can mess with your hormones — and possibly your fertility. If any new unhealthy habit has slipped into your lifestyle, now’s a great time to put the brakes on it. And it’s not just about your habits. Is your partner kicking back one too many beers each night? That could be affecting his sperm quality. Ditto for smoking or an unhealthy diet. If your partner’s lifestyle needs a little fine-tuning, make efforts to get his back on track, too.
"Demographers tend to define infertility as childlessness in a population of women of reproductive age," whereas "the epidemiological definition refers to "trying for" or "time to" a pregnancy, generally in a population of women exposed to" a probability of conception.[8] Currently, female fertility normally peaks at age 24 and diminishes after 30, with pregnancy occurring rarely after age 50.[9] A female is most fertile within 24 hours of ovulation.[9] Male fertility peaks usually at age 25 and declines after age 40.[9] The time needed to pass (during which the couple tries to conceive) for that couple to be diagnosed with infertility differs between different jurisdictions. Existing definitions of infertility lack uniformity, rendering comparisons in prevalence between countries or over time problematic. Therefore, data estimating the prevalence of infertility cited by various sources differs significantly.[8] A couple that tries unsuccessfully to have a child after a certain period of time (often a short period, but definitions vary) is sometimes said to be subfertile, meaning less fertile than a typical couple. Both infertility and subfertility are defined as the inability to conceive after a certain period of time (the length of which vary), so often the two terms overlap.
Dr. Ajay Murdia is a renowned Doctor whose research has been published in a well-known medical journal called "The Lancent" in the UK. With a vision to eradicate infertility from India, Dr. Ajay Murdia established Indira Infertility Clinic in the year 1988. Initially, the main focus of Indira Infertility Clinic was male infertility, although now it aims to provide advanced fertility center across India for both men and women.
Benign uterine growths are tissue enlargements of the female womb (uterus). Three types of benign uterine growths are uterine fibroids, adenomyosis, and uterine polyps. Symptoms include abdominal pressure and pain, pelvic pain, pain during intercourse, and pain during bowel movements. Diagnosis and treatment of benign uterine growths depends upon the type of growth.

For five to six days following fertilization, the developing embryos are cultured in the laboratory until the blastocyst stage of development has been reached. This represents growth of about 200 cells. We at RMA culture embryos exclusively to the blastocyst stage, because published data demonstrates that extended embryo culture results in improved implantation rates and pregnancy outcomes. This means we will never do an embryo biopsy – or an embryo transfer – at three days, or anything less than the blastocyst stage.

In order for pregnancy to happen, sperm has to meet the egg. This normally takes place at the end of the fallopian tube, and this is called fertilization. There are a number of obstacles that can prevent this from happening, and the process itself even in healthy young fertile women is very complex- hence the low pregnancy rate each month. Obstacles such as cycle timing, low sperm count, poor sperm motility, blocked fallopian tubes, or endometriosis must be overcome to achieve a pregnancy. Timing is often the most common obstacle to conception. What does it mean for you when common causes of infertility are ruled out and you’re told you have unexplained infertility? It should mean a time of hope.

Nowadays, there are several treatments (still in experimentation) related to stem cell therapy. It is a new opportunity, not only for partners with lack of gametes, but also for homosexuals and single people who want to have offspring. Theoretically, with this therapy, we can get artificial gametes in vitro. There are different studies for both women and men.[65]


In vitro fertilization (IVF) is a treatment for infertility or genetic problems. If IVF is performed to treat infertility, you and your partner might be able to try less-invasive treatment options before attempting IVF, including fertility drugs to increase production of eggs or intrauterine insemination — a procedure in which sperm are placed directly in your uterus near the time of ovulation.
There can be medical causes of SI, says West. "The thyroid is always something we check. Birth can put the thyroid out of kilter." Anwen, a woman in her 40s, tried for five years to have a second child. "I had my daughter when I was 30," she says, "which, at the time, seemed very early. I was the first among all our friends to have a baby." She decided to try for a second when her daughter was three. "But a year went by and nothing happened. I went to the GP and he told me not to worry. 'If you've already given birth, there won't be a problem,' he said. But my daughter turned five and I still wasn't pregnant." Eventually, Anwen persuaded her GP to refer her to a fertility consultant who, after some simple investigations, informed her she had polycystic ovarian syndrome. "He said I'd probably had it all my life and that my daughter was an amazing one-off. I had no idea that anything was wrong." She was given a prescription for the fertility drug Clomid; two months later, she conceived her son.
Risk of ovarian hyperstimulation syndrome (OHSS). OHSS can happen when women respond too well to fertility drugs and produce too many eggs. About 10 to 20 percent of women who take gonadotropins develop a mild form of OHSS, a condition marked by weight gain and a full, bloated feeling. Some also have shortness of breath, dizziness, pelvic pain, nausea, and vomiting. If you have OHSS, your ovaries swell to several times the normal size and produce fluid that accumulates in your abdominal cavity. Normally this resolves itself with careful monitoring by a physician and bed rest. But in rare cases it's life threatening, and you may have to be hospitalized for more intensive monitoring or treatment.
"Demographers tend to define infertility as childlessness in a population of women of reproductive age," whereas "the epidemiological definition refers to "trying for" or "time to" a pregnancy, generally in a population of women exposed to" a probability of conception.[8] Currently, female fertility normally peaks at age 24 and diminishes after 30, with pregnancy occurring rarely after age 50.[9] A female is most fertile within 24 hours of ovulation.[9] Male fertility peaks usually at age 25 and declines after age 40.[9] The time needed to pass (during which the couple tries to conceive) for that couple to be diagnosed with infertility differs between different jurisdictions. Existing definitions of infertility lack uniformity, rendering comparisons in prevalence between countries or over time problematic. Therefore, data estimating the prevalence of infertility cited by various sources differs significantly.[8] A couple that tries unsuccessfully to have a child after a certain period of time (often a short period, but definitions vary) is sometimes said to be subfertile, meaning less fertile than a typical couple. Both infertility and subfertility are defined as the inability to conceive after a certain period of time (the length of which vary), so often the two terms overlap.
The severity or complexity of infertility for you and your partner as a whole is also critical. Generally, patients are characterized as “subfertile” if there is only one infertility factor such as mild endometriosis, which can be improved through surgeries like laparoscopy. However, if both partners contribute infertility factors or one partner has multiple infertility factors, the chance of IVF success is significantly decreased.
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.
Studies have indicated that IVF mothers show greater emotional involvement with their child, and they enjoy motherhood more than mothers by natural conception. Similarly, studies have indicated that IVF father's express more warmth and emotional involvement than fathers by adoption and natural conception and enjoy fatherhood more. Some IVF parents become overly involved with their children.[136]
Risk of multiples. IUI with fertility medication carries a significant risk of multiple pregnancies, including higher-order multiples (triplets or more). A good clinic will carefully monitor your follicles to make sure that only a safe number are mature before the IUI, but they cannot entirely eliminate the risk. Recent advances in IVF (including blastocyst transfer) mean that most modern fertility clinics now transfer only one or two embryos per IVF cycle. As a result, the risk of multiple pregnancies for IVF patients is much lower than it used to be.
At the same time, in older women, the IVF success rates can vary dramatically, and that’s why it’s so important to focus only on live births. For example, a clinic may have a very high pregnancy rate among older women, but a low live birth rate. Or, the rates may be quite high – 40% or even 50% – but only after four or five rounds. That makes a very big difference, especially in the overall cost of treatment!
Other health related problems could also cause poor egg health, low ovarian reserve, or abnormal immunological responses, which can affect conception. Stress could also play a role. We all know that menstrual cycles can be altered during times of extreme duress- and this can be emotional, physical, or environmental stressors. In these instances, the first steps should be to avoid life stressors, maintain a healthy weight, routinely exercise, avoid smoking, and reduce alcohol intake, all of which may be contributing to unexplained infertility issues.
×