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]

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.
^ 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.

The main durations of embryo culture are until cleavage stage (day two to four after co-incubation) or the blastocyst stage (day five or six after co-incubation).[71] Embryo culture until the blastocyst stage confers a significant increase in live birth rate per embryo transfer, but also confers a decreased number of embryos available for transfer and embryo cryopreservation, so the cumulative clinical pregnancy rates are increased with cleavage stage transfer.[30] Transfer day two instead of day three after fertilisation has no differences in live birth rate.[30] There are significantly higher odds of preterm birth (odds ratio 1.3) and congenital anomalies (odds ratio 1.3) among births having from embryos cultured until the blastocyst stage compared with cleavage stage.[71]


People who have suffered primary infertility tell me that the only way they can get by is to avoid everything and anything to do with babies. But for the secondary infertility sufferer, this is not an option. You are confronted on a daily basis at the school gates by pregnant women, people with babies, large families squashed into multiple buggies. School drop-off becomes a terrible tableau of everything you want but cannot have.
Obesity: The obesity epidemic has recently become is a serious issue, particularly in industrialized nations. The rising number of obese individuals may be due in part to an energy-rich diet as well as insufficient physical exercise.  In addition to other potential health risks, obesity can have a significant impact on male and female fertility. BMI (body mass index) may be a significant factor in fertility, as an increase in BMI in the male by as little as three units can be associated with infertility. Several studies have demonstrated that an increase in BMI is correlated with a decrease in sperm concentration, a decrease in motility and an increase DNA damage in sperm. A relationship also exists between obesity and erectile dysfunction (ED). ED may be the consequence of the conversion of androgens to estradiol. The enzyme aromatase is responsible for this conversion, and is found primarily in adipose tissue. As the amount of adipose tissue increases, there is more aromatase available to convert androgens, and serum estradiol levels increase. Other hormones including inhibin B and leptin, may also be affected by obesity. Inhibin B levels have been reported to decrease with increasing weight, which results in decreased Sertoli cells and sperm production. Leptin is a hormone associated with numerous effects including appetite control, inflammation, and decreased insulin secretion, according to many studies. Obese women have a higher rate of recurrent, early miscarriage compared to non-obese women.
By 2017, many centers have adopted embryo cryopreservation as their primary IVF therapy, and perform few or no fresh embryo transfers. The two main reasons for this have been better endometrial receptivity when embryos are transferred in cycles without exposure to ovarian stimulation and also the ability to store the embryos while awaiting the results of pre-implantation genetic testing.

In males with hepatitis B, The Practice Committee of the American Society for Reproductive Medicine advises that sperm washing is not necessary in IVF to prevent transmission, unless the female partner has not been effectively vaccinated.[37][38] In females with hepatitis B, the risk of vertical transmission during IVF is no different from the risk in spontaneous conception.[38] However, there is not enough evidence to say that ICSI procedures are safe in females with hepatitis B in regard to vertical transmission to the offspring.[38]

In the UK, previous NICE guidelines defined infertility as failure to conceive after regular unprotected sexual intercourse for two years in the absence of known reproductive pathology.[11] Updated NICE guidelines do not include a specific definition, but recommend that "A woman of reproductive age who has not conceived after 1 year of unprotected vaginal sexual intercourse, in the absence of any known cause of infertility, should be offered further clinical assessment and investigation along with her partner, with earlier referral to a specialist if the woman is over 36 years of age."[12]
Availability of IVF in England is determined by Clinical commissioning groups. The National Institute for Health and Care Excellence recommends up to 3 cycles of treatment for women under 40 years old with minimal success conceiving after 2 years of unprotected sex. Cycles will not be continued for women who are older than 40 years old.[156] CCGs in Essex, Bedfordshire and Somerset have reduced funding to one cycle, or none, and it is expected that reductions will become more widespread. Funding may be available in "exceptional circumstances" – for example if a male partner has a transmittable infection or one partner is affected by cancer treatment. According to the campaign group Fertility Fairness at the end of 2014 every CCG in England was funding at least one cycle of IVF".[157] Prices paid by the NHS in England varied between under £3,000 to more than £6,000 in 2014/5.[158] In February 2013, the cost of implementing the NICE guidelines for IVF along with other treatments for infertility was projected to be £236,000 per year per 100,000 members of the population.[159]
A Cochrane review came to the result that endometrial injury performed in the month prior to ovarian induction appeared to increase both the live birth rate and clinical pregnancy rate in IVF compared with no endometrial injury. There was no evidence of a difference between the groups in miscarriage, multiple pregnancy or bleeding rates. Evidence suggested that endometrial injury on the day of oocyte retrieval was associated with a lower live birth or ongoing pregnancy rate.[30]
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.  
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]

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.


Addressing lifestyle issues is not meant to be a quick fix, and typically does not lead to instant success. However, with unexplained infertility every little bit counts, so don’t fret or give up. Do not assume just because the cause of infertility is unexplained, it is untreatable or there is no pathway to parenthood. When a specific cause is not determined for women, and male infertility has also been ruled out, our fertility specialist may begin a course of treatment to improve the chances of conception and pregnancy. The speed with which interventions are offered depends on each individual’s own needs and desires as determined by age and other factors.
Life isn’t fair – there’s no doubt about it. That’s why it helps to have faith in God, to know He loves you and wants you to have the best possible life. My husband and I can’t have children, and it was the most disappointing discovery of my life. Trusting God when you can’t get pregnant is not easy – especially if you’ve been trying to conceive for months or even years.
Success varies with many factors. The age of the woman is the most important factor, when women are using their own eggs. Success rates decline as women age, specifically after the mid-30’s.  Part of this decline is due to a lower chance of getting pregnant from ART, and part is due to a higher risk of miscarriage with increasing age, especially over age 40.  

Ovulation induction (in the sense of medical treatment aiming for the development of one or two ovulatory follicles) is an alternative for women with anovulation or oligoovulation, since it is less expensive and more easy to control.[7] It generally involves antiestrogens such as clomifene citrate or letrozole, and is followed by natural or artificial insemination.
There are multiple treatment options including using oral or injectable medications, intrauterine insemination (IUI), assisted reproductive technology using in vitro fertilization (IVF), or a combo of these solutions to help. A 2010 study called the FASTT trial indicated that in vitro fertilization might be the quickest and best route to pregnancy for couples with unexplained infertility.(4)
Your doctor will also monitor whether or not the treatment led to a multiple pregnancy. IVF has a higher risk of conceiving multiples, and a multiple pregnancy carries risks for both the mother and the babies. Risks of a multiple pregnancy include premature labor and delivery, maternal hemorrhage, C-section delivery, pregnancy induced high blood pressure, and gestational diabetes.
4. IVF or In-Vitro Fertilization - IVF means eggs are collected and fertilized outside the body, in a laboratory. This is followed by transferring the embryos into the uterus. This advanced technology has resulted in many successful pregnancies in women who had lost hope. During IVF - In-Vitro Fertilization, women can choose to freeze their healthy eggs for future use.

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.
I found that I couldn't avoid the sense that we were not yet all here, that there was a person missing. In one of those strange confluences, I was, at the same time, writing a novel about a woman who had just given birth. I was spending my days at the fertility clinic and my evenings writing about the strange, shadowy world of early motherhood. My husband, coming into my study and finding me in tears again, laid his hand gently on the manuscript and said, "Do you ever think that writing this book might not be helping?" But you don't choose the books; they choose you. And if I couldn't bring a baby into being in real life, I was damn well going to do it in fiction.

Initial blood work, cycle tracking and fertility analysis is done. To begin IVF, your doctor or fertility specialist will evaluate your hormone levels and menstrual cycle to determine what medications and plan of action may be needed. You may also undergo a transvaginal ultrasound to examine your ovaries and reproductive system, ensuring that they are healthy.

Post transfer – You’ll likely take progesterone and estrogen to improve implantation and pregnancy rates. If the transfer is successful, a blood pregnancy test will be positive in 10-14 days. From there, ultrasounds are used to ensure the implantation site as well as check for a heartbeat. The good news is that once a heartbeat is detected, the pregnancy has a 90-95% probability of the pregnancy resulting in a live birth.

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.
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.
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]
Within the Orthodox Jewish community the concept is debated as there is little precedent in traditional Jewish legal textual sources. Regarding laws of sexuality, religious challenges include masturbation (which may be regarded as "seed wasting"[129]), laws related to sexual activity and menstruation (niddah) and the specific laws regarding intercourse. An additional major issue is that of establishing paternity and lineage. For a baby conceived naturally, the father's identity is determined by a legal presumption (chazakah) of legitimacy: rov bi'ot achar ha'baal – a woman's sexual relations are assumed to be with her husband. Regarding an IVF child, this assumption does not exist and as such Rabbi Eliezer Waldenberg (among others) requires an outside supervisor to positively identify the father.[133] Reform Judaism has generally approved IVF.[129]
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.
Gene mutations in men and obscure viruses in women can cause infertility. Here’s a basic list of the most commonly known reasons men and women can’t get pregnant, plus four research studies that describe lesser known causes of male and female fertility problems. If you’ve been trying to get pregnant for more than a year,… Read More »Causes of Infertility for Men and Women Who Can’t Get Pregnant
4. IVF or In-Vitro Fertilization - IVF means eggs are collected and fertilized outside the body, in a laboratory. This is followed by transferring the embryos into the uterus. This advanced technology has resulted in many successful pregnancies in women who had lost hope. During IVF - In-Vitro Fertilization, women can choose to freeze their healthy eggs for future use.
Undergo minor surgery to retrieve eggs. Following a round of injections, your doctor will determine the best date to retrieve eggs from the follicles of your ovaries. If you choose to use donor eggs, the retrieval process will occur with the donor, or the frozen eggs may be collected and used. A partner’s sperm or donor sperm will also be collected.
Obesity: The obesity epidemic has recently become is a serious issue, particularly in industrialized nations. The rising number of obese individuals may be due in part to an energy-rich diet as well as insufficient physical exercise.  In addition to other potential health risks, obesity can have a significant impact on male and female fertility. BMI (body mass index) may be a significant factor in fertility, as an increase in BMI in the male by as little as three units can be associated with infertility. Several studies have demonstrated that an increase in BMI is correlated with a decrease in sperm concentration, a decrease in motility and an increase DNA damage in sperm. A relationship also exists between obesity and erectile dysfunction (ED). ED may be the consequence of the conversion of androgens to estradiol. The enzyme aromatase is responsible for this conversion, and is found primarily in adipose tissue. As the amount of adipose tissue increases, there is more aromatase available to convert androgens, and serum estradiol levels increase. Other hormones including inhibin B and leptin, may also be affected by obesity. Inhibin B levels have been reported to decrease with increasing weight, which results in decreased Sertoli cells and sperm production. Leptin is a hormone associated with numerous effects including appetite control, inflammation, and decreased insulin secretion, according to many studies. Obese women have a higher rate of recurrent, early miscarriage compared to non-obese women.
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