Statistically, the biggest decline in live births happens between the ages of 40 and 42+. In other words, a woman who has just turned 40 has a much higher chance of conceiving and delivering a baby than a woman who has just turned 42. Of course, these numbers and trends concern women using their own eggs. With donor eggs, consider the age of the woman at the time the eggs were harvested and use that age.
Infertility problems and miscarriage rates increase significantly after 35 years of age. There are now options for early egg retrieval and storage for women in their 20's. This will help ensure a successful pregnancy if childbearing is delayed until after age 35. This is an expensive option. However, women who know they will need to delay childbearing may consider it.

In contrast, a study in 2016 compared outcomes of IVF and ICSI in patients with unexplained infertility and normal semen quality and showed promising results using ICSI 3. It was found that ICSI oocytes (84.5%) had a significantly higher fertilization rate compared to those inseminated by conventional IVF (67.6%). Moreover, there were no cases of complete fertilization failure (CFF) in the ICSI group, but CFF occurred in 7.9% of the IVF group.
Any embryos that you do not use in your first IVF attempt can be frozen for later use. This will save you money if you undergo IVF a second or third time. If you do not want your leftover embryos, you may donate them to another infertile couple, or you and your partner can ask the clinic to destroy the embryos. Both you and your partner must agree before the clinic will destroy or donate your embryos.
Headaches and mood swings: Headaches and mood swings are common IVF treatment side effects. Over-the-counter medications can ease headaches, and while no medication can help with mood swings, knowing that they’re a normal part of IVF treatment helps. If you find mood swings are disrupting your day, be sure to seek out self-care practices such as enjoying alone time, reading a book, taking a nice bath, or sharing feelings with a friend or loved one.
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.  
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.
An IUI procedure is the process of directly injecting sperm into the top of the uterus. This increases the odds of conception by reducing the distance the sperm must travel to meet the egg. That said, when most people talk about IUIs, they’re referring to the steps leading up to and after the actual procedure. An IUI treatment can be summarized into a few steps:
A woman's age is a major factor in the success of IVF for any couple. For instance, a woman who is under age 35 and undergoes IVF has a 39.6% chance of having a baby, while a woman over age 40 has an 11.5% chance. However, the CDC recently found that the success rate is increasing in every age group as the techniques are refined and doctors become more experienced.
4. Significant Hair Growth (or Hair Loss): Polycystic ovarian syndrome causes small cysts to form on the outside of the ovaries, and it also causes the body to produce an excess of male hormones. If you notice hair growing in unusual places like your face, arms, chest or back, this could be a warning sign. On the flip side, hair loss or thinning could be a sign of other infertility related conditions like thyroid issues, anemia or autoimmune disorders. 

Having no period means ovulation isn’t taking place at all, so a pregnancy can’t happen because no eggs is making itself eligible to be fertilized. Similarly, having irregular periods makes achieving pregnancy difficult, because it’s hard to time intercourse properly -- if sperm and egg aren’t at the same place at the same time, there is no chance of pregnancy.
Odds of multiples. Because more than one embryo may be placed in your uterus, your chance of having twins or more is about 20 percent. Though many couples consider this a blessing, multiple fetuses increase your risk of miscarriage and other complications, such as preterm labor. Some doctors will advise you to consider selective reduction if three or more embryos implant successfully. This is a serious decision with major emotional and psychological consequences. IVF researchers are working on techniques to prevent multiple fetuses.
^ Damian BB, Bonetti TC, Horovitz DD (January 2015). "Practices and ethical concerns regarding preimplantation diagnosis. Who regulates preimplantation genetic diagnosis in Brazil?". Brazilian Journal of Medical and Biological Research = Revista Brasileira de Pesquisas Medicas e Biologicas. 48 (1): 25–33. doi:10.1590/1414-431X20144083. PMC 4288489. PMID 25493379.
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]
If both partners are young and healthy and have been trying to conceive for one year without success, a visit to a physician or women's health nurse practitioner (WHNP) could help to highlight potential medical problems earlier rather than later. The doctor or WHNP may also be able to suggest lifestyle changes to increase the chances of conceiving.[62]
^ Siristatidis C, Sergentanis TN, Kanavidis P, Trivella M, Sotiraki M, Mavromatis I, Psaltopoulou T, Skalkidou A, Petridou ET (2012). "Controlled ovarian hyperstimulation for IVF: impact on ovarian, endometrial and cervical cancer—a systematic review and meta-analysis". Human Reproduction Update. 19 (2): 105–23. doi:10.1093/humupd/dms051. PMID 23255514.
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.
Gathering the eggs. Your doctor gives you an anesthetic and inserts an ultrasound probe through your vagina to look at your ovaries and identify the follicles. A thin needle is then inserted through the vaginal wall to remove the eggs from the follicles. Eight to 15 eggs are usually retrieved. You may have some cramping and spotting for a few days afterward, but most women feel better in a day or two.

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.
Studies show that sperm count and sperm movement decrease as men age, as does sexual function. But there isn't a cutoff age that makes a man too old to father a child. One study found that it took men age 45 or older longer to get a woman pregnant once the couple started trying. If your partner is older, you may want to talk to your doctor about ways to boost your chances.
Sit down with your partner and make a "fertility road map" that outlines what you're willing to try and for approximately how long, suggests Dr. Davidson. "Would you do in vitro fertilization? Would you consider an egg donor? How much money can you spend on treatment? Then build in a timeline," she says. "When you at least loosely define a time frame, dealing with infertility doesn't feel like an endless void."
One of the worst parts of infertility – or the fear of being infertile – is friends and family members getting pregnant accidentally! “Today, my child-hating friend who vowed never to have kids no matter what, announced that she’s pregnant,” says Charity. “I’ve had three IVF (in vitro fertilization) cycles, spent $90,000 in fertility treatments, and still can’t conceive a baby. WTF?”
Upwards of 30% of couples seeking fertility care are labeled with unexplained infertility. Given that over 50% of couples’ infertility struggles are at least partially attributable to the male, understanding the source of male infertility could allow for improved care. The limited set of male tests can only detect the major causes of infertility (i.e., azoospermia) leaving the less obvious factors invisible.
I conceived my first child, a son, with no trouble at all. When he was two, we thought we might have another. A year or so later, when nothing had happened, we saw a fertility specialist, who gave us every test there was. We passed each one, as the consultant put it, "with flying colours". Which left us relieved but also confounded. All I had was a new adjective to add to my diagnosis: Unexplained Secondary Infertility.
Assisted hatching. About five to six days after fertilization, an embryo "hatches" from its surrounding membrane (zona pellucida), allowing it to implant into the lining of the uterus. If you're an older woman, or if you have had multiple failed IVF attempts, your doctor might recommend assisted hatching — a technique in which a hole is made in the zona pellucida just before transfer to help the embryo hatch and implant. Assisted hatching is also useful for eggs or embryos that have been previously frozen as the process can harden the zona pellucida.
While many cases of infertility remain unexplained, there may be answers in the epigenome. Unlike one’s genetic code, the epigenome is dynamic and can be modified by environmental factors and lifestyle choices. Fertility in many cases is a state which changes throughout one’s life. Given the lack of clear genetic or physiological causes of unexplained infertility, the epigenome is thought to be altered in this subset of patients. As a result, looking into the epigenetic basis of infertility can help clinicians inform treatment.

IVF is a type of assisted reproductive technology used for infertility treatment and gestational surrogacy. A fertilised egg may be implanted into a surrogate's uterus, and the resulting child is genetically unrelated to the surrogate. Some countries have banned or otherwise regulate the availability of IVF treatment, giving rise to fertility tourism. Restrictions on the availability of IVF include costs and age, in order for a woman to carry a healthy pregnancy to term. IVF is generally not used until less invasive or expensive options have failed or been determined unlikely to work.
Every woman is born with a set number of eggs, which declines as she ages. To get pregnant, an egg released from a woman’s ovaries must be fertilized by sperm, travel down the fallopian tube, and attach to the side of her uterus. At any stage along the way, a problem may occur, resulting in a case of infertility. For women, the most common causes of infertility are primary ovarian insufficiency (early menopause), ovulation disorders affecting egg release, uterine or cervical abnormalities, endometriosis (where tissue grows outside of the uterus), fallopian tube blockage or damage, polycystic ovary syndrome, and various hormonal imbalances. Certain cancers and their treatments can also negatively impact a woman’s fertility.

Deciding whether to undergo in vitro fertilization, and how to try if the first attempt is unsuccessful, is an incredibly complicated decision. The financial, physical, and emotional toll of this process can be difficult. Speak with your doctor extensively to determine what your best options are and if in vitro fertilization is the right path for you and your family. Seek a support group or counselor to help you and your partner through this process.


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.
Intracytoplasmic sperm injection (ICSI): This procedure involves direct injection of a single sperm of the male partner into the eggs of the female for fertilization. Just like IVF procedure, in ICSI, the sperm and egg are collected from both the partners. The only difference is the fertilization process as in IVF the sperms and egg are mixed naturally, and in ICSI the sperms are injected into the egg using a needle.
In 2006, Canadian clinics reported a live birth rate of 27%.[11] Birth rates in younger patients were slightly higher, with a success rate of 35.3% for those 21 and younger, the youngest group evaluated. Success rates for older patients were also lower and decrease with age, with 37-year-olds at 27.4% and no live births for those older than 48, the oldest group evaluated.[12] Some clinics exceeded these rates, but it is impossible to determine if that is due to superior technique or patient selection, since it is possible to artificially increase success rates by refusing to accept the most difficult patients or by steering them into oocyte donation cycles (which are compiled separately). Further, pregnancy rates can be increased by the placement of several embryos at the risk of increasing the chance for multiples.

Oral drugs used to stimulate ovulation include clomiphene citrate and aromatase inhibitors. While taking these drugs, you will be monitored to see if and when ovulation occurs. This can be done by tracking your menstrual cycle or with an ovulation-predictor kit (an at-home urine test). You may be asked to visit your doctor for a blood test or ultrasound exam.
Of course, if you have a history of infertility or any factors that might impede fertility, it makes sense to arm yourself with the right help right from the start. Once you make that appointment with a fertility specialist, you and your doctor will follow the same treatment plan that would be put into place if you were dealing with primary infertility.
Oral drugs used to stimulate ovulation include clomiphene citrate and aromatase inhibitors. While taking these drugs, you will be monitored to see if and when ovulation occurs. This can be done by tracking your menstrual cycle or with an ovulation-predictor kit (an at-home urine test). You may be asked to visit your doctor for a blood test or ultrasound exam.
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.
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