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.
Uterine exam. Your doctor will examine the inside lining of the uterus before you start IVF. This might involve a sonohysterography — in which fluid is injected through the cervix into your uterus — and an ultrasound to create images of your uterine cavity. Or it might include a hysteroscopy — in which a thin, flexible, lighted telescope (hysteroscope) is inserted through your vagina and cervix into your uterus.
The industry has been accused of making unscientific claims, and distorting facts relating to infertility, in particular through widely exaggerated claims about how common infertility is in society, in an attempt to get as many couples as possible and as soon as possible to try treatments (rather than trying to conceive naturally for a longer time). This risks removing infertility from its social context and reducing the experience to a simple biological malfunction, which not only can be treated through bio-medical procedures, but should be treated by them. Indeed, there are serious concerns about the overuse of treatments, for instance Dr Sami David, a fertility specialist, has expressed disappointment over the current state of the industry, and said many procedures are unnecessary; he said: "It's being the first choice of treatment rather than the last choice. When it was first opening up in late 1970s, early 80s, it was meant to be the last resort. Now it's a first resort. I think that it can harm women in the long run." IVF thus raises ethical issues concerning the abuse of bio-medical facts to 'sell' corrective procedures and treatments for conditions that deviate from a constructed ideal of the 'healthy' or 'normal' body i.e., fertile females and males with reproductive systems capable of co-producing offspring.
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.
Men will need to have sperm testing. This involves giving a semen sample, which a lab will analyze for the number, size, and shape of the sperm. If the sperm are weak or damaged, a procedure called intracytoplasmic sperm injection (ICSI) may be necessary. During ICSI, a technician injects sperm directly into the egg. ICSI can be part of the IVF process.
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.
Wondering if it’s time to seek fertility help from a specialist? Your age can help clue you in to the answer. If you’re younger than 35, it’s perfectly normal for it to take six months to a year to conceive. If, after a year, you haven’t accomplished your conception goal, you’ll want to talk with your practitioner and/or get a referral to a fertility specialist. If you’re older than 35, experts recommend that you seek help from a fertility specialist after six months of regularly trying to conceive without birth control — and you may even want to go after three months. If you’re over 40, you’ll probably want to start off your quest for a second pregnancy with a fertility evaluation from your doctor. Ditto if your partner is over 40, since 35 to 40 percent of fertility problems can be traced back to the man, and a guy’s age affects the quality of his sperm.
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.
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.
If you fit one of these profiles, your fertility team may agree that it makes sense to attempt IUI before considering IVF. Before you begin IUI, it’s good to have a conversation with your partner and doctor about how many cycles you want to attempt. Many people place a limit of three failed IUI cycles, but others may try up to six before moving on.
Ovarian hyperstimulation syndrome (OHSS) occurs in 10% of women going through IVF treatment. For most women, symptoms will be mild, and they will recover easily. For a small percentage, OHSS can be more serious and may require hospitalization. Less than 1% of women going through egg retrieval will experience blood clots or kidney failure due to OHSS.
The live birth rate is the percentage of all IVF cycles that lead to a live birth. This rate does not include miscarriage or stillbirth; multiple-order births, such as twins and triplets, are counted as one pregnancy. A 2017 summary compiled by the Society for Assisted Reproductive Technology (SART) which reports the average IVF success rates in the United States per age group using non-donor eggs compiled the following data:
Secondary infertility is a secret club and one, I've discovered, with permanent membership. I was in a supermarket the other day and ahead of me in the cereal aisle was a woman with a boy of about nine and twin babies in the trolley. As I passed, she turned and looked at us. I saw her clocking my children and their age-gap and she saw I was doing the same with hers. We looked at each other for a moment; she smiled and I smiled back and then we walked on.
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.
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.
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"), 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. Reform Judaism has generally approved IVF.
Sometimes problems getting pregnant for a second or subsequent time are related to a complication that occurred in a prior pregnancy or prior to delivery (damage to the uterus, for instance). But most often, secondary infertility is caused by the same factors that would cause primary infertility — issues like advanced age, obesity, ovulation problems and so on.