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]

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.


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.
Injectable medication cycle with IUI: If pregnancy doesn't result from ovulation induction with oral medications, the next step is to use injectable medications. These medications stimulate the ovaries to produce two to four eggs; when combined with IUI, you have an increased possibility of conception. Essentially, the sperm is given more targets to hit. You will come into the office for four to eight monitoring appointments to track egg development and cycle timing.
Abdominal adhesions (scar tissue) bands of scar tissue that form between abdominal organs and tissues. Symptoms of abdominal adhesions are pelvic or abdominal pain. Abdominal adhesions on the intestines can cause bowel obstruction, which is a medical emergency. Treatment for abdominal adhesions is generally surgery to cut the adhesions away from the internal tissues and organs. There is no way to prevent abdominal adhesions.
^ Baker VL, Luke B, Brown MB, Alvero R, Frattarelli JL, Usadi R, et al. (September 2010). "Multivariate analysis of factors affecting probability of pregnancy and live birth with in vitro fertilization: an analysis of the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System". Fertility and Sterility. 94 (4): 1410–6. doi:10.1016/j.fertnstert.2009.07.986. PMID 19740463.
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.
Intracytoplasmic sperm injection (ICSI) is where a single sperm is injected directly into an egg. Its main usage as an expansion of IVF is to overcome male infertility problems, although it may also be used where eggs cannot easily be penetrated by sperm, and occasionally in conjunction with sperm donation. It can be used in teratozoospermia, since once the egg is fertilised abnormal sperm morphology does not appear to influence blastocyst development or blastocyst morphology.[86]
Pelvic inflammatory disease (PID) is the most common and serious complication of sexually transmitted diseases (STDs), aside from AIDS, among women. The signs and symptoms of pelvic inflammatory disease include: fever, vaginal discharge with a foul odor, abdominal pain, including pain during intercourse, and irregular vaginal bleeding. Pelvic inflammatory disease can scar the Fallopian tubes, ovaries, and related structures and lead to ectopic pregnancies, infertility, chronic pelvic pain, and other serious consequences. Pelvic inflammatory disease treatment includes several types of antibiotics.
In IVF, a woman is given more medications to develop lots of eggs. Ideally, they develop around 15 mature eggs. The eggs are removed from the ovaries, fertilized and developed in a lab for a number of days, and subsequently put back into the uterus as an early-stage embryo. While this may sound like a relatively minor difference, it leads to leads to a large number of noteworthy differences.
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.
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.
Ovarian stem cells: it is thought that women have a finite number of follicles from the very beginning. Nevertheless, scientists have found these stem cells, which may generate new oocytes in postnatal conditions.[67] Apparently there are only 0.014% of them (this could be an explanation of why they were not discovered until now).[citation needed] There is still some controversy about their existence, but if the discoveries are true, this could be a new treatment for infertility.
We’re not talking about that uncomfortable throb or dull ache that most women are cursed with during their periods—those cramps are your uterus’s way of telling you it’s contracting to expel its lining. For some women, the message comes through more loudly and clearly than others, but it doesn’t compare to the pelvic pain and severe cramping associated with endometriosis. This kind may begin before your period and extend several days into it, it may include your lower back and cause abdominal pain, and it can get worse over time. Endometriosis occurs when tissue that normally lines the inside of your uterus grows in other locations, such as your ovaries, bowel or pelvis. The extra tissue growth (and its’ surgical removal) can cause scarring, it can get in the way of an egg and sperm uniting, and it may also affect the lining of the uterus, disrupting implantation. Approximately one-third to one-half of women with endometriosis have difficulty getting pregnant. Other symptoms include pain during intercourse, urination and bowel movements.  Here are other conditions that cause stomach pain.
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.
The penetration of the IVF market in India is quite low at present with only 2,800 cycles/million infertile women in the reproductive age group (20–44 years) as compared to China which has 6,500 cycles. The key challenges are lack of awareness, affordability and accessibility.[152] India in 2018 becomes the destination for Fertility Tourism because of most affordable IVF treatment cost. IVF treatment cost in India varies from $2000 to $4000 (roughly between 150000/- INR to 250000/- INR including all aspects of IVF treatment with medicines which is almost 5 times lower than IVF Cost in Western part of the world.

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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.
A genetic disorder. If you or your partner is at risk of passing on a genetic disorder to your child, you may be candidates for preimplantation genetic testing — a procedure that involves IVF. After the eggs are harvested and fertilized, they're screened for certain genetic problems, although not all genetic problems can be found. Embryos that don't contain identified problems can be transferred to the uterus.
The diagnosis of infertility is often very overwhelming for patients. There is a plethora of information served to them. First is, they can conceive a child only through medical treatment. Second is, the insurmountable amount of information that is hard to comprehend. New medical jargon along with recommendations for treatments and tests that are completely unfamiliar can be very intimidating for the newly diagnosed. Indira IVF's Reproductive Specialists believe in creating a partnership with the patient, and we have found that the most successful partnerships occur when the patient is well-informed and can play an active role in their treatment. We value an open and ethical relationship with each patient in an environment that fosters trust and mutual respect, an environment where questions are welcome and encouraged.

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.
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?
The first step in finding the right treatment is to find out if there is an actual cause for unexplained infertility. Taking treatment helps to increase the chances of conceiving, and also makes it likelier that you will get pregnant sooner. The treatment of luteal-phase defects is as controversial as the diagnosis. They can be treated by using clomiphene, which may help by augmenting the secretion of FSH and thus improving the quality of the follicle (and therefore, the corpus luteum, which develops from it). Direct treatment with progesterone can also help luteal-phase abnormalities. Progesterone can be given either as injections or vaginal suppositories.
Dr. Gorka Barrenetxea provides us with a practical case of secondary infertility that occurs more commonly than one may think. A couple, throughout their lifetime, can have children with 20, 25, 30 and 35 years, but when they decide to have a second or third child, they may encounter trouble conceiving due to the passage of time itself, Dr. Barrenetxea states.
The treatment options for unexplained infertility are several and the treatment results are promising. Expectant management can be recommended if the woman is under 28-30 years of age and the infertility duration is less than 2-3 years. In vitro fertilization (IVF) has revolutionized the treatment of infertile couples, as well as profoundly increasing the basic understanding of human reproduction. IVF can be used as both a diagnostic and a therapeutic tool in couples with unexplained infertility. The pregnancy rates with IVF are good, at 40% per treatment cycle. In addition, the outcome of pregnancies among women with unexplained infertility is generally comparable to that of spontaneous and other pregnancies using assisted reproductive technologies.
Dr. Gorka Barrenetxea provides us with a practical case of secondary infertility that occurs more commonly than one may think. A couple, throughout their lifetime, can have children with 20, 25, 30 and 35 years, but when they decide to have a second or third child, they may encounter trouble conceiving due to the passage of time itself, Dr. Barrenetxea states.
Each case of infertility is different from the other. Hence it is extremely crucial, to be honest with your doctor about all your symptoms and problems. The doctor needs to know all the details regarding your reproductive health including any previous miscarriages, or abortions if any. This helps in diagnosis and formulating a correct treatment for infertility.

While PGD was originally designed to screen for embryos carrying hereditary genetic diseases, the method has been applied to select features that are unrelated to diseases, thus raising ethical questions. Examples of such cases include the selection of embryos based on histocompatibility (HLA) for the donation of tissues to a sick family member, the diagnosis of genetic susceptibility to disease, and sex selection.[97]
We don't know what causes most cases of secondary infertility, says Jamie Grifo, M.D., Ph.D., program director of the New York University Fertility Center, in New York City. "The majority of the time, though, it reflects the fact that you're older now, so it's simply more difficult to get pregnant." The reality is that for women, fertility peaks at age 25 and drops by half between ages 30 and 40. As we age, egg quality declines and we're more likely to develop fibroids and endometriosis, which contribute to infertility. Other factors such as adding extra weight, taking new meds, or having surgery since your last pregnancy can be an issue. It may also be that your partner's sperm quality or production is now poor.
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