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.
A doctor or WHNP takes a medical history and gives a physical examination. They can also carry out some basic tests on both partners to see if there is an identifiable reason for not having achieved a pregnancy. If necessary, they refer patients to a fertility clinic or local hospital for more specialized tests. The results of these tests help determine the best fertility treatment.
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.
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.
Coping with secondary fertility can be tough. Endless doctor appointments, tests, procedures, and medications. Sleepless nights. Time and energy away from your little one. Guilt over wanting another pregnancy when many women are struggling to have just that. Stress between you and your partner. Sadness when you get invited to yet another baby shower — and guilt for even feeling that way.
Most couples develop a willingness to conceive a child at some point in their life. Generally, couples conceive within the first year, and around 7% of couples conceive in the second year. The inability to conceive within 12 months is defined as infertility. It is recommended to seek help from a reproductive endocrinologist if you are unable to conceive within 12 months. Our modern technology in healthcare has opened a lot of options for women who are facing infertility issues.
That’s about the time frame women between the ages of 35 and 40 should give themselves, before discussing fertility concerns with their doctor. For women under 35, experts recommend trying for about a year—really trying, as in unprotected, well-timed intercourse—before having any testing or treatment; women over 40 may want to consult an obstetrician/gynecologist right away. See your doctor sooner than later if you’ve suffered multiple miscarriages, have a history of pelvic inflammatory disease (a serious complication of some STDs), or experience any other symptoms of infertility. Meanwhile, learn these infertility myths you don’t have to worry about.
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]

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.
First, consider where the information about the success rates is coming from. Generally speaking, IVF success rates in the United States comes from the clinics themselves or from the Center for Disease Control and Prevention. The Society for Assisted Reproductive Technology and the American Society for Reproductive Medicine both contribute to the CDC data.
A body mass index (BMI) over 27 causes a 33% decrease in likelihood to have a live birth after the first cycle of IVF, compared to those with a BMI between 20 and 27.[29] Also, pregnant women who are obese have higher rates of miscarriage, gestational diabetes, hypertension, thromboembolism and problems during delivery, as well as leading to an increased risk of fetal congenital abnormality.[29] Ideal body mass index is 19–30.[17]

A woman normally produces one egg during each menstrual cycle. However, IVF requires multiple eggs. Using multiple eggs increases the chances of developing a viable embryo. You’ll receive fertility drugs to increase the number of eggs your body produces. During this time, your doctor will perform regular blood tests and ultrasounds to monitor the production of eggs and to let your doctor know when to retrieve them.


First, you take medication that makes several of your eggs mature and ready for fertilization. Then the doctor takes the eggs out of your body and mixes them with sperm in a lab, to help the sperm fertilize the eggs. Then they put 1 or more fertilized eggs (embryos) directly into your uterus. Pregnancy happens if any of the embryos implant in the lining of your uterus.
A study presented at the British Fertility Society Annual Conference and covered by The Guardian reported that transferring two embryos where one is of poor quality would reduce the chance of pregnancy by 27%. It is thought that a bad embryo is rejected by the endometrium, compromising the implantation of both embryos. Cumulative research has supported the notion that egg quality outweighs quantity.
When the ovarian follicles have reached a certain degree of development, induction of final oocyte maturation is performed, generally by an injection of human chorionic gonadotropin (hCG). Commonly, this is known as the "trigger shot."[67] hCG acts as an analogue of luteinising hormone, and ovulation would occur between 38 and 40 hours after a single HCG injection,[68] but the egg retrieval is performed at a time usually between 34 and 36 hours after hCG injection, that is, just prior to when the follicles would rupture. This avails for scheduling the egg retrieval procedure at a time where the eggs are fully mature. HCG injection confers a risk of ovarian hyperstimulation syndrome. Using a GnRH agonist instead of hCG eliminates most of the risk of ovarian hyperstimulation syndrome, but with a reduced delivery rate if the embryos are transferred fresh.[69] For this reason, many centers will freeze all oocytes or embryos following agonist trigger.
After your body releases an egg, the hormone progesterone kicks in to build and maintain the lining of the uterus. It makes your body temperature go up slightly. So taking your temperature with a basal thermometer every morning before you get out of bed can help you figure out if you ovulated. You can buy these thermometers at the drugstore. They're inexpensive, but they aren't as accurate as other ways of tracking ovulation.
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.
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