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.
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.
In a bid to understand my chances of IVF success, I took a quick dive through the vast information available from these sources and came away thinking I had the information I needed. I skipped merrily along thinking things looked pretty promising after reading my chances of IVF working the first time was somewhere around the 40% mark. I naively thought that meant I had an 80% chance if I did two cycles, and that I’d definitely have a baby after three rounds at the most. Unfortunately as later reflection revealed, math and statistic just don’t work like this…
Fertility has long been considered a “woman’s problem.” This is simply not true, and men are in fact, equally as infertile as women. Traditionally the metrics for male fertility have been mostly limited to sperm count, morphology, motility, and, occasionally, DNA fragmentation. For females, on the other hand, a vast array of tests are available. These include ultrasound, cervical position, basal body temperature, hysteroscopy, laparoscopy, cycle tracking and a diversity of hormonal tests.
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.
^ Jump up to: a b Moreton C (14 January 2007). "World's first test-tube baby Louise Brown has a child of her own". Independent. London. Retrieved 21 May 2010. The 28-year-old, whose pioneering conception by in-vitro fertilisation made her famous around the world. The fertility specialists Patrick Steptoe and Bob Edwards became the first to successfully carry out IVF by extracting an egg, impregnating it with sperm and planting the resulting embryo back into the mother
Since marriage is a contract between the wife and husband during the span of their marriage, no third party should intrude into the marital functions of sex and procreation. This means that a third party donor is not acceptable, whether he or she is providing sperm, eggs, embryos, or a uterus. The use of a third party is tantamount to zina, or adultery.
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.
By 2012 Costa Rica was the only country in the world with a complete ban on IVF technology, it having been ruled unconstitutional by the nation's Supreme Court because it "violated life."[177] Costa Rica had been the only country in the western hemisphere that forbade IVF. A law project sent reluctantly by the government of President Laura Chinchilla was rejected by parliament. President Chinchilla has not publicly stated her position on the question of IVF. However, given the massive influence of the Catholic Church in her government any change in the status quo seems very unlikely.[178][179] In spite of Costa Rican government and strong religious opposition, the IVF ban has been struck down by the Inter-American Court of Human Rights in a decision of 20 December 2012.[180] The court said that a long-standing Costa Rican guarantee of protection for every human embryo violated the reproductive freedom of infertile couples because it prohibited them from using IVF, which often involves the disposal of embryos not implanted in a patient's uterus.[181] On 10 September 2015, President Luis Guillermo Solís signed a decree legalising in-vitro fertilisation. The decree was added to the country's official gazette on 11 September. Opponents of the practice have since filed a lawsuit before the country's Constitutional Court.[182]
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.
For any woman or couple facing infertility, the task of deciding on your next steps can feel very daunting. Of course, there’s no substitute for the advice of a fertility specialist, but a general idea of what to expect can help give you confidence. You might be wondering what is the difference between In Vitro Fertilization (IVF) and  IUI, or artificial insemination?
In 2008, a California physician transferred 12 embryos to a woman who gave birth to octuplets (Suleman octuplets). This led to accusations that a doctor is willing to endanger the health and even life of women in order to gain money. Robert Winston, professor of fertility studies at Imperial College London, had called the industry "corrupt" and "greedy" stating that "one of the major problems facing us in healthcare is that IVF has become a massive commercial industry," and that "what has happened, of course, is that money is corrupting this whole technology", and accused authorities of failing to protect couples from exploitation: "The regulatory authority has done a consistently bad job. It's not prevented the exploitation of women, it's not put out very good information to couples, it's not limited the number of unscientific treatments people have access to".[101] The IVF industry has been described as a market-driven construction of health, medicine and the human body.[102]
In the US, up to 20% of infertile couples have unexplained infertility. In these cases abnormalities are likely to be present but not detected by current methods. Possible problems could be that the egg is not released at the optimum time for fertilization, that it may not enter the fallopian tube, sperm may not be able to reach the egg, fertilization may fail to occur, transport of the zygote may be disturbed, or implantation fails. It is increasingly recognized that egg quality is of critical importance and women of advanced maternal age have eggs of reduced capacity for normal and successful fertilization. Also, polymorphisms in folate pathway genes could be one reason for fertility complications in some women with unexplained infertility.[59] However, a growing body of evidence suggests that epigenetic modifications in sperm may be partially responsible.[60][61]
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.

If a physician believes infertility is a concern, a number of tests will be administered. For women, these may include ovulation testing, ovarian reserve testing, hormone testing, and hysterosalpingography (X-rays of the fallopian tubes) or other imaging tests. Assessing male infertility involves semen analysis, which examines the number of sperm, as well as their motility and morphology (shape). Other tests for men may include hormonal and genetic testing, testicular biopsy, and additional imaging.
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With each year that passes, your chances of conceiving decrease significantly, says Julie Tan, M.D., a gynecologist at the Cleveland Clinic Center for Reproductive Medicine, in Ohio. Sometimes even doctors downplay infertility, she notes. Most experts recommend seeing your doc after a year of unsuccessful unprotected sex if you're under age 35 and after six months if you're over 35. But if you're worried sooner, speak up. "If it's been three months and you're concerned, it's not too early to get evaluated, even though it may be premature to treat," explains Dr. Grifo. "Waiting a year to find out there's an issue with sperm count or egg supply can lead to a lot of heartache." You can start with your primary-care doc or ob-gyn but if you're not pregnant after a few months or feel your doctor isn't taking the situation seriously, see a fertility specialist.
Nonmedicated cycle with IUI: Also known as natural cycle IUI, a non-medicated cycle with IUI is often used by single women or same-sex female couples who are not directly experiencing infertility, but rather a lack of sperm. This treatment involves tracking the development of the egg that is naturally recruited during a menstrual cycle and then introducing the donated sperm. You will come into the office for two to four monitoring appointments to track egg development and cycle timing.
The Catholic Church opposes all kinds of assisted reproductive technology and artificial contraception, on the grounds that they separate the procreative goal of marital sex from the goal of uniting married couples. The Catholic Church permits the use of a small number of reproductive technologies and contraceptive methods such as natural family planning, which involves charting ovulation times, and allows other forms of reproductive technologies that allow conception to take place from normative sexual intercourse, such as a fertility lubricant. Pope Benedict XVI had publicly re-emphasised the Catholic Church's opposition to in vitro fertilisation, saying that it replaces love between a husband and wife.[127]
^ Tan K, An L, Miao K, Ren L, Hou Z, Tao L, Zhang Z, Wang X, Xia W, Liu J, Wang Z, Xi G, Gao S, Sui L, Zhu DS, Wang S, Wu Z, Bach I, Chen DB, Tian J (March 2016). "Impaired imprinted X chromosome inactivation is responsible for the skewed sex ratio following in vitro fertilization". Proceedings of the National Academy of Sciences of the United States of America. 113 (12): 3197–202. Bibcode:2016PNAS..113.3197T. doi:10.1073/pnas.1523538113. PMC 4812732. PMID 26951653.
For any woman or couple facing infertility, the task of deciding on your next steps can feel very daunting. Of course, there’s no substitute for the advice of a fertility specialist, but a general idea of what to expect can help give you confidence. You might be wondering what is the difference between In Vitro Fertilization (IVF) and  IUI, or artificial insemination?
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.
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?”

Impaired sperm production or function. Below-average sperm concentration, weak movement of sperm (poor mobility), or abnormalities in sperm size and shape can make it difficult for sperm to fertilize an egg. If semen abnormalities are found, your partner might need to see a specialist to determine if there are correctable problems or underlying health concerns.

Time. The factor of time cuts both ways when you are weighing up these two options. IUI is a much shorter process than IVF, so if your first cycle is successful, it could be the quickest route to bringing home a baby. However, because of the gap in success rates between the two treatments, some patients in their late 30s to early 40s may get pregnant faster by going directly to IVF rather than waiting until they have had several failed IUI cycles.


Many people have never heard the term "secondary infertility"; fewer understand it. I discovered it a year into my struggle to conceive a second child and fell on it, amazed. What I was undergoing had a name! I wrote it down and immediately felt better, as if the phrase exuded a talismanic power that might protect me from the likes of my neighbour.
A risk of ovarian stimulation is the development of ovarian hyperstimulation syndrome, particularly if hCG is used for inducing final oocyte maturation. This results in swollen, painful ovaries. It occurs in 30% of patients. Mild cases can be treated with over the counter medications and cases can be resolved in the absence of pregnancy. In moderate cases, ovaries swell and fluid accumulated in the abdominal cavities and may have symptoms of heartburn, gas, nausea or loss of appetite. In severe cases patients have sudden excess abdominal pain, nausea, vomiting and will result in hospitalisation.
Clomiphene citrate (Clomid, Serophene) is a medication commonly used for the treatment of women with ovulation disorders as reflected by infrequent or irregular menstrual cycles. Clomid is a pill taken orally for 5 to 7 days, typically on day 3 of a woman’s menstrual cycle to induce ovulation. Clomid works at the level of the brain and pituitary gland and facilitates the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). FSH and LH, in turn, stimulate the ovaries to produce eggs and the ovarian hormones estradiol (E2) and progesterone (P4). The initial prescribed dosage of clomid is 50 to 100 mg (one or two tablets) daily at bedtime, or as prescribed by your physician.

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.
Fertility tourism is the practice of traveling to another country for fertility treatments.[citation needed] It may be regarded as a form of medical tourism. The main reasons for fertility tourism are legal regulation of the sought procedure in the home country, or lower price. In-vitro fertilization and donor insemination are major procedures involved.
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.
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.
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