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A closer look at the data suggest that the benefit of letrozole over clomid depended on the BMI of the participants. For patients with a BMI of less than 30 kg/m2, the cumulative live birth rate was approximately 30% for each group. However, for patients with a BMI over 30 kg/m2, twice as many patients had a live birth in the letrozole group than the clomid group.

Problems with the uterus: There are many conditions related to the uterus that can cause secondary infertility. Scarring can occur during a dilation and curettage (D&C) or Cesarean delivery that can create adhesions inside the uterus that interfere with future pregnancies Fibroids or polyps are benign (non-cancer) growths inside the uterus that can impair pregnancy. A retained placenta can cause infection and uterine scarring.


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]

Having no period means ovulation isn’t taking place at all, so a pregnancy can’t happen because no eggs is making itself eligible to be fertilized. Similarly, having irregular periods makes achieving pregnancy difficult, because it’s hard to time intercourse properly -- if sperm and egg aren’t at the same place at the same time, there is no chance of pregnancy.


Stay positive. Search for success stories — there are so many out there. Look within your personal network or support groups to find other women who have similar experiences with infertility. Connect with them and share your stories. Learn what they have done, what doctors they have worked with, and what contributed to their successful pregnancies.
Deciding whether to undergo in vitro fertilization, and how to try if the first attempt is unsuccessful, is an incredibly complicated decision. The financial, physical, and emotional toll of this process can be difficult. Speak with your doctor extensively to determine what your best options are and if in vitro fertilization is the right path for you and your family. Seek a support group or counselor to help you and your partner through this process.
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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.
When transferring more than one embryo, the risk of pregnancy and newborn complications also increases.1 Among IVF babies, twins are 12 times more likely than singletons to be delivered prematurely, 16 times more likely to be underweight and 5 times more likely to suffer from respiratory complications. Among IVF mothers, mothers of twins are 2.5 times more likely to have pre-eclampsia, over 8 times more likely to have premature preterm rupture of membranes and 4 times more likely to require a Caesarean section.
^ 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
He will need to produce a sperm sample the same day as your IUI. Drop-off is scheduled 1.5 hours before the IUI. The specimen should not be produced longer than 2 hours from appointment time. Patients are provided with a specimen cup so he can produce in the comfort of his home. If he chooses to use a collection room, that is also available in some SGF locations.
Fertility expert Zita West has noticed this increase at her London clinic. "The main reason," she explains, "is age. Women are having babies later." Exhaustion also plays a part. "The sleeplessness of life with a small child can't be underestimated," she says. "You might still be breastfeeding, you might be sharing a bed with a toddler, you might be holding down a job at the same time. Basically, there's not a lot of sex happening."
Egg Development – This step is either part of the woman’s natural egg development or stimulated with medications and lasts roughly 5-14 days. Once your follicles are optimal size, a trigger medication may be given to finalize egg maturation and trigger ovulation. This phase of egg development may or may not be accompanied by ultrasound and bloodwork monitoring.
A recent controversy in California focused on the question of whether physicians opposed to same-sex relationships should be required to perform IVF for a lesbian couple. Guadalupe T. Benitez, a lesbian medical assistant from San Diego, sued doctors Christine Brody and Douglas Fenton of the North Coast Women's Care Medical Group after Brody told her that she had "religious-based objections to treating her and homosexuals in general to help them conceive children by artificial insemination," and Fenton refused to authorise a refill of her prescription for the fertility drug Clomid on the same grounds.[111][112] The California Medical Association had initially sided with Brody and Fenton, but the case, North Coast Women's Care Medical Group v. Superior Court, was decided unanimously by the California State Supreme Court in favour of Benitez on 19 August 2008.[113][114]

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Prior to the retrieval procedure, you will be given injections of a medication that ripens the developing eggs and starts the process of ovulation. Timing is important; the eggs must be retrieved just before they emerge from the follicles in the ovaries. If the eggs are taken out too early or too late, they won't develop normally. Your doctor may do blood tests or an ultrasound to be sure the eggs are at the right stage of development before retrieving them. The IVF facility will provide you with special instructions to follow the night before and the day of the procedure. Most women are given pain medication and the choice of being mildly sedated or going under full anesthesia.

IVF is the most successful method of fertility treatment utilized today to help couples to conceive. The basic components of the IVF process include stimulation of the ovaries to produce multiple eggs at a time, removal of the eggs from the ovary (egg retrieval), fertilization of the eggs in the laboratory, and subsequent placement of the resulting embryos into the uterus (embryo transfer). The chance of pregnancy from IVF depends primarily on the age of the woman, the cause of infertility, and factors related to the quality of the IVF laboratory.


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]
Toto jsou internetové stránky společnosti IVF Clinic a.s., se sídlem Horní lán 1328/6, Nová Ulice, 779 00 Olomouc, IČ: 29358914, zapsané v obchodním rejstříku vedeném Krajským soudem v Ostravě, oddíl B, vložka 10467. Společnost IVF Clinic a.s. je členem koncernu SynBiol, řízeného společností SynBiol, a.s., se sídlem Praha 4, Pyšelská 2327/2, PSČ 14900, IČ: 26014343, zapsanou v obchodním rejstříku vedeném Městským soudem v Praze, oddíl B, vložka 14742.
Since most IVF cycles start with collecting a number of eggs after ovarian stimulation, you should have on average 12-15 eggs to use. This means that you do not need to use all of them for ICSI or conventional IVF. A Split-ICSI strategy incorporates both – some eggs are injected with selected sperms using ICSI, where the rest are incubated with sperm in the conventional way. Trying both provide a safety net against failed fertilization with either strategy.
In contrast, a study in 2016 compared outcomes of IVF and ICSI in patients with unexplained infertility and normal semen quality and showed promising results using ICSI 3. It was found that ICSI oocytes (84.5%) had a significantly higher fertilization rate compared to those inseminated by conventional IVF (67.6%). Moreover, there were no cases of complete fertilization failure (CFF) in the ICSI group, but CFF occurred in 7.9% of the IVF group.
The cost of an IUI is almost certainly less on a per cycle basis, but because IVF has much higher success rates and IUI is a poor option for some, the higher per cycle cost of IVF can actually be more affordable in the long run – in terms of the cost to bring home a baby.  Because most successful IUIs happen in the first three or four-cycle, it eventually becomes very expensive to bring home a baby with an IUI.
The cost of IVF rather reflects the costliness of the underlying healthcare system than the regulatory or funding environment,[168] and ranges, on average for a standard IVF cycle and in 2006 United States dollars, between $12,500 in the United States to $4,000 in Japan.[168] In Ireland, IVF costs around €4,000, with fertility drugs, if required, costing up to €3,000.[169] The cost per live birth is highest in the United States ($41,000[168]) and United Kingdom ($40,000[168]) and lowest in Scandinavia and Japan (both around $24,500[168]).

• Women having irregular periods. Regular periods indicate that you are ovulating regularly. Eggs are produced through ovulation two weeks prior to the next period. Ovulation of the egg is essential for pregnancy, and any irregularity in this process leads to an inability to conceive. If you have irregular periods then it is better to get evaluated from a reproductive endocrinologist.


In the United States, women seeking to be an embryo recipient undergo infectious disease screening required by the U.S. Food and Drug Administration (FDA), and reproductive tests to determine the best placement location and cycle timing before the actual Embryo Transfer occurs. The amount of screening the embryo has already undergone is largely dependent on the genetic parents' own IVF clinic and process. The embryo recipient may elect to have her own embryologist conduct further testing.
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.
Another major cause of infertility in women may be the inability to ovulate. Malformation of the eggs themselves may complicate conception. For example, polycystic ovarian syndrome is when the eggs only partially develop within the ovary and there is an excess of male hormones. Some women are infertile because their ovaries do not mature and release eggs. In this case synthetic FSH by injection or Clomid (Clomiphene citrate) via a pill can be given to stimulate follicles to mature in the ovaries.
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."
After a year of trying to conceive, couples should consider infertility as a possible reason and seek professional help. Women actively trying to get pregnant may wish to consult a doctor earlier if they are over the age of 40, have irregular or painful periods, have a history of miscarriages, have been diagnosed with pelvic inflammatory disease or endometriosis, or have been treated for cancer.
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.
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.
This is less extensively studied. It is not yet known whether the ovarian stimulation and the insemination have independent beneficial effects or whether their beneficial effects are only seen when they are used in combination. Most likely they both independently increase fertility potential, with relatively more fertility benefit coming from the IUI component.
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.
Spend quality time with your child. In the midst of your infertility problems, you may feel especially upset about shifting your focus from the child you already have to the child you’re longing to have in the future. You may even feel guilty about your inability to give your little one a sibling or about the sadness you are sure is spilling over into her life. The best thing you can do for your child in this situation is to keep life as normal as possible, and ideally, find some quality time to be together. Whether it’s a chat about her day before you tuck her into bed or an afternoon romp in the park, those rituals will go a long way toward keeping your tot’s world stable and happy — even if you sometimes feel your world is spinning out of control. (You might find that focusing on your child lets you live in the moment — at least for a little while — which can help you cope with secondary infertility.) If you’re in a particularly bad place and fear that you may have a hard time handling your true emotions in front of your child (say, your pregnancy test just came up negative for the zillionth time in a row), see if you can arrange to send her to a friend’s house, or enlist your partner or mother-in-law to take over for a bit. Allowing yourself the time to compose yourself can make it much easier to face your little pride and joy with a smile.
Typically, genetic parents donate the eggs to a fertility clinic or where they are preserved by oocyte cryopreservation or embryo cryopreservation until a carrier is found for them. Typically the process of matching the embryo(s) with the prospective parents is conducted by the agency itself, at which time the clinic transfers ownership of the embryos to the prospective parents.[89]

Treatment with Clomid tablets plus IUI improves fertility rates. For unexplained infertility, studies have shown that for women under 35, monthly success rates for Clomid plus insemination are about 10% per cycle. This pregnancy rate holds up for about 3 tries and the success rate is considerably lower after that. More about success rates with IUIs is on the insemination page and on the Clomid for unexplained infertility page. The insemination component boosts fertility more than the Clomid does - but success rates are higher when both are used together.
In order for pregnancy to happen, sperm has to meet the egg. This normally takes place at the end of the fallopian tube, and this is called fertilization. There are a number of obstacles that can prevent this from happening, and the process itself even in healthy young fertile women is very complex- hence the low pregnancy rate each month. Obstacles such as cycle timing, low sperm count, poor sperm motility, blocked fallopian tubes, or endometriosis must be overcome to achieve a pregnancy. Timing is often the most common obstacle to conception. What does it mean for you when common causes of infertility are ruled out and you’re told you have unexplained infertility? It should mean a time of hope.
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