• Male factors causing infertility. Male infertility is due to the reduced number of sperms or low-quality sperms. In such cases, TESE is performed in which by making a small incision single sperm is extracted from the testis and is injected through intracytoplasmic sperm injections (ICSI) directly into a mature egg. This ICSI-IVF enabled method can help you achieve pregnancy.
IVF Michigan Fertility Centers, one of the leading fertility clinics in the world, provides a wide variety of infertility treatments as well as in vitro-related procedures. With over 60 years of collective experience and locations in Bloomfield Hills, Ann Arbor, Dearborn, East Lansing, Macomb, Petoskey, Cheboygan, Saginaw and Toledo, Ohio, the fertility experts at IVF Michigan Fertility Center are available to help couples throughout the Midwest and abroad. Treatment options available at IVF Michigan Fertility Center include IVF-ICSI, IUI (artificial insemination), gender selection, comprehensive chromosomal screening through PGT, screening for hereditary diseases through PGT-M, diagnosis of and treatment for male infertility, egg donation, fertility preservation and much more.
Medical treatment of infertility generally involves the use of fertility medication, medical device, surgery, or a combination of the following. If the sperm are of good quality and the mechanics of the woman's reproductive structures are good (patent fallopian tubes, no adhesions or scarring), a course of ovulation induction maybe used. The physician or WHNP may also suggest using a conception cap cervical cap, which the patient uses at home by placing the sperm inside the cap and putting the conception device on the cervix, or intrauterine insemination (IUI), in which the doctor or WHNP introduces sperm into the uterus during ovulation, via a catheter. In these methods, fertilization occurs inside the body.
Benign uterine growths are tissue enlargements of the female womb (uterus). Three types of benign uterine growths are uterine fibroids, adenomyosis, and uterine polyps. Symptoms include abdominal pressure and pain, pelvic pain, pain during intercourse, and pain during bowel movements. Diagnosis and treatment of benign uterine growths depends upon the type of growth.
In vitro fertilization (IVF) is a treatment for infertility or genetic problems. If IVF is performed to treat infertility, you and your partner might be able to try less-invasive treatment options before attempting IVF, including fertility drugs to increase production of eggs or intrauterine insemination — a procedure in which sperm are placed directly in your uterus near the time of ovulation.
The diagnosis is one of exclusion — that is, one which is made only after all the existing tests have been performed and their results found to be normal. This is why the frequency of this diagnosis will depend upon how many tests are done by the clinic — the fewer the tests, the more frequent this diagnosis. And the better the tests, the more likely you are getting a diagnosis instead of being told it's "unexplained."
Most parents have a mental image of their ideal family, and if they find themselves unable to make that happen, it can be devastating. Infertility is heartbreaking and stressful, whether you have a child or not. In fact, being a parent adds a layer of complexity. For one thing, parents are immersed in the world of kids, so it's impossible to avoid all the babies and pregnant bellies that remind you of what you're missing. Plus, "parents with secondary infertility don't often get much sympathy, so they end up feeling as though they don't have a right to be sad," says Marie Davidson, Ph.D., a psychologist at Fertility Centers of Illinois. In fact, they're often told to appreciate the child they have (as if they don't). Finally, many parents feel guilt on two fronts: for not giving their child a sibling and for directing some of their focus and resources away from that child.
This chart is US national average data on success rates per IVF cycle by female age for 2014. The dark blue line (triangles) shows pregnancy rates per cycle by age. The orange line (circles) shows live birth rates per cycle by age. The rate of singleton live births per cycle is shown by the light blue line. The difference between "pregnancy" rate and "live birth" rate is due to miscarriages.
Our specialized team of andrologists prepare each sperm sample with a procedure commonly known as "sperm washing" in one of our andrology laboratories. Sperm washing involves placing the sperm sample in a test tube and then a centrifuge, which results in the sperm collecting in a "pellet" at the bottom of the test tube. The andrologist removes the seminal fluid and places the fluid (media) above the sperm. The most active sperm will then swim up into the media. The final sample consists of the most active sperm concentrated in a small volume of media. A single IUI is usually performed when a patient is using fresh sperm. If a patient is using a frozen sperm sample, the clinician can likely perform one or two IUIs.
Federal regulations in the United States include screening requirements and restrictions on donations, but generally do not affect sexually intimate partners. However, doctors may be required to provide treatments due to nondiscrimination laws, as for example in California. The US state of Tennessee proposed a bill in 2009 that would have defined donor IVF as adoption. During the same session another bill proposed barring adoption from any unmarried and cohabitating couple, and activist groups stated that passing the first bill would effectively stop unmarried people from using IVF. Neither of these bills passed.
^ Damian BB, Bonetti TC, Horovitz DD (January 2015). "Practices and ethical concerns regarding preimplantation diagnosis. Who regulates preimplantation genetic diagnosis in Brazil?". Brazilian Journal of Medical and Biological Research = Revista Brasileira de Pesquisas Medicas e Biologicas. 48 (1): 25–33. doi:10.1590/1414-431X20144083. PMC 4288489. PMID 25493379.
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.
If a man and woman 35 or younger have had unprotected sex for at least 12 months (or six months if older than 35) without getting pregnant, they should suspect secondary infertility. This especially applies to women older than 30 who have experienced pelvic inflammatory disease, painful periods, irregular menstrual cycles or miscarriages, and to men with low sperm counts.
A surge in LH triggers your ovaries to release an egg. The surge usually happens 36 hours before the egg is released. Ovulation kits check LH levels in your urine to help you pinpoint the day of ovulation. These kits, which you can buy at the drugstore, are convenient and highly accurate. You may want to test 1-2 days before you expect the surge so you can note the rise in LH.
West states that the "hardest thing about secondary fertility issues is that you want a sibling for your child." Fiona, who has a son of five and has been trying to conceive a second child for two years, says she can no longer look out of the window at her son playing in the garden. "It breaks my heart. He just looks so alone out there. All I want is a sibling for him but I don't think it's going to happen."
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.
Patients with hypothalamic dysfunction are not producing signals within their brains to tell the ovary to mature an egg. They are diagnosed because they have an extremely low FSH and a low LH (almost zero). Neither clomid nor letrozole will help them. For these patients, IUI must be accompanied by gonadotropin to be effective. From here on in this section, none of the data we’ll reference refers to patients with hypothalamic dysfunction.
The Rand Consulting Group has estimated there to be 400,000 frozen embryos in the United States in 2006. 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.
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.
Other health related problems could also cause poor egg health, low ovarian reserve, or abnormal immunological responses, which can affect conception. Stress could also play a role. We all know that menstrual cycles can be altered during times of extreme duress- and this can be emotional, physical, or environmental stressors. In these instances, the first steps should be to avoid life stressors, maintain a healthy weight, routinely exercise, avoid smoking, and reduce alcohol intake, all of which may be contributing to unexplained infertility issues.
In some cases, laboratory mix-ups (misidentified gametes, transfer of wrong embryos) have occurred, leading to legal action against the IVF provider and complex paternity suits. An example is the case of a woman in California who received the embryo of another couple and was notified of this mistake after the birth of her son. This has led to many authorities and individual clinics implementing procedures to minimise the risk of such mix-ups. The HFEA, for example, requires clinics to use a double witnessing system, the identity of specimens is checked by two people at each point at which specimens are transferred. Alternatively, technological solutions are gaining favour, to reduce the manpower cost of manual double witnessing, and to further reduce risks with uniquely numbered RFID tags which can be identified by readers connected to a computer. The computer tracks specimens throughout the process and alerts the embryologist if non-matching specimens are identified. Although the use of RFID tracking has expanded in the US, it is still not widely adopted.
While ICSI is a more invasive procedure, some have suggested it may help by reducing the risk of failed fertilisation. However, it's emerging that IVF is probably the preferred treatment, at least in the first cycle, in "unexplained" infertility. IVF allows for healthy competition between sperm, is less expensive, avoids trauma to the egg and may produce more embryos, with better pregnancy and live birth rates
In 2006, Canadian clinics reported a live birth rate of 27%. Birth rates in younger patients were slightly higher, with a success rate of 35.3% for those 21 and younger, the youngest group evaluated. Success rates for older patients were also lower and decrease with age, with 37-year-olds at 27.4% and no live births for those older than 48, the oldest group evaluated. Some clinics exceeded these rates, but it is impossible to determine if that is due to superior technique or patient selection, since it is possible to artificially increase success rates by refusing to accept the most difficult patients or by steering them into oocyte donation cycles (which are compiled separately). Further, pregnancy rates can be increased by the placement of several embryos at the risk of increasing the chance for multiples.
Consider your health status. Have you started any medications that might be interfering with conception? What about a change in your health status (a new chronic condition that’s cropped up since your first baby was born, for instance)? Any changes to your health could be putting a dent in your conception plans. Perhaps some simple health modifications — like switching to a more fertility-friendly medication, for instance, or getting your chronic condition under control — could bring you closer to the second baby of your dreams.
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.