Theoretically, IVF could be performed by collecting the contents from a woman's fallopian tubes or uterus after natural ovulation, mixing it with sperm, and reinserting the fertilised ova into the uterus. However, without additional techniques, the chances of pregnancy would be extremely small. The additional techniques that are routinely used in IVF include ovarian hyperstimulation to generate multiple eggs, ultrasound-guided transvaginal oocyte retrieval directly from the ovaries, co-incubation of eggs and sperm, as well as culture and selection of resultant embryos before embryo transfer into a uterus.
There is a risk of multiples, which includes twins, triplets, or more. Multiple pregnancies can be risky for both the babies and the mother. It's important to discuss with your doctor how many embryos to transfer, as transferring more than necessary will increase your risk of conceiving twins or more. When embryos have been tested with PGT, typically only a single embryo is transferred.
If both partners are young and healthy and have been trying to conceive for one year without success, a visit to a physician or women's health nurse practitioner (WHNP) could help to highlight potential medical problems earlier rather than later. The doctor or WHNP may also be able to suggest lifestyle changes to increase the chances of conceiving.[62]
While it’s always recommended to consult with a medical provider before making any treatment decisions, this article serves as a great jumping point for those looking to get pregnant using assisted reproductive technologies (ART). In it, we discuss everything you need to know about IUI and IVF.  We start things off with a high-level overview, then jump into the different types of each treatment, discuss treatment details, key decisions within each treatment, success rates, cost comparisons, risks, and who each treatment might be a good fit for.
Intrauterine insemination (IUI) is one of the simpler, “low-tech” treatments for infertility and the starting point for many individuals and couples who are having difficulty with conception on their own. Patients who have been diagnosed with unexplained infertility, mild male factor infertility, a cervical factor, or irregular or absent ovulation are often good candidates for IUI.

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.


The grief and anxiety of SI is, of course, self-perpetuating. You find yourself in a double-bind: you're constantly told that the chances of conceiving are maximised if you can relax and eliminate stress, but it's hard to let go of something so all-consuming, so elemental, as infertility. People were always saying to me: "If you just forgot about it, you'd get pregnant straight away." For the record, this is the most unhelpful thing you can say to someone with fertility problems. West explains that "couples become more and more anxious about the gap [between children]".
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.

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]

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.


The average cost of an IVF cycle in the U.S. is $12,400, according to the American Society of Reproductive Medicine. This price will vary depending on where you live, the amount of medications you're required to take, the number of IVF cycles you undergo, and the amount your insurance company will pay toward the procedure. You should thoroughly investigate your insurance company's coverage of IVF and ask for a written statement of your benefits. Although some states have enacted laws requiring insurance companies to cover at least some of the costs of infertility treatment, many states haven't.
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.[86]
Obesity: The obesity epidemic has recently become is a serious issue, particularly in industrialized nations. The rising number of obese individuals may be due in part to an energy-rich diet as well as insufficient physical exercise.  In addition to other potential health risks, obesity can have a significant impact on male and female fertility. BMI (body mass index) may be a significant factor in fertility, as an increase in BMI in the male by as little as three units can be associated with infertility. Several studies have demonstrated that an increase in BMI is correlated with a decrease in sperm concentration, a decrease in motility and an increase DNA damage in sperm. A relationship also exists between obesity and erectile dysfunction (ED). ED may be the consequence of the conversion of androgens to estradiol. The enzyme aromatase is responsible for this conversion, and is found primarily in adipose tissue. As the amount of adipose tissue increases, there is more aromatase available to convert androgens, and serum estradiol levels increase. Other hormones including inhibin B and leptin, may also be affected by obesity. Inhibin B levels have been reported to decrease with increasing weight, which results in decreased Sertoli cells and sperm production. Leptin is a hormone associated with numerous effects including appetite control, inflammation, and decreased insulin secretion, according to many studies. Obese women have a higher rate of recurrent, early miscarriage compared to non-obese women.
IVF is a type of assisted reproductive technology used for infertility treatment and gestational surrogacy. A fertilised egg may be implanted into a surrogate's uterus, and the resulting child is genetically unrelated to the surrogate. Some countries have banned or otherwise regulate the availability of IVF treatment, giving rise to fertility tourism. Restrictions on the availability of IVF include costs and age, in order for a woman to carry a healthy pregnancy to term. IVF is generally not used until less invasive or expensive options have failed or been determined unlikely to work. 

Bachelor of Arts in Translation and Interpreting (English, Spanish, Catalan, German) from the University of Valencia (UV) and Heriot-Watt University, Riccarton Campus (Edinburgh, UK). Postgraduate Course in Legal Translation from the University of Valencia. Specialist in Medical Translation, with several years of experience in the field of Assisted Reproduction. More information about Sandra Fernández

Epigenetic testing may allow patients to forgo the cost of multiple rounds of IVF by predicting whether embryos will fail. Equipped with this information, couples can have their IVF cycles optimized to account for embryonic versus fertilization issues. This represents a significant leap for the medical community given that 36% of couples struggling with unexplained infertility are currently over-treated.
Secondary infertility can be traced to either partner or both partners. About one-third of cases originate in women and about one-third originate in men. In the remaining one-third, the cause is due to a combination of factors or isn’t known. Increased age, complications from a prior pregnancy or surgery, increased weight, medications, sexually transmitted diseases, impaired sperm production, alcohol abuse, and smoking are all examples of secondary infertility in women and men.
The AMIGOS study suggested that clomid provided the best balance of a high pregnancy rate with a reasonably low multiple rate among couples with unexplained infertility. However, the authors of the Huang study concluded that on balance letrozole was better. From our vantage point, given that clomid more commonly causes multiple eggs to be ovulated, it seems like the slightly better option between the two because the whole point of treatment in unexplained infertility patients is to increase the odds of delivery by increasing the number of eggs ovulated.
We’re not talking about that uncomfortable throb or dull ache that most women are cursed with during their periods—those cramps are your uterus’s way of telling you it’s contracting to expel its lining. For some women, the message comes through more loudly and clearly than others, but it doesn’t compare to the pelvic pain and severe cramping associated with endometriosis. This kind may begin before your period and extend several days into it, it may include your lower back and cause abdominal pain, and it can get worse over time. Endometriosis occurs when tissue that normally lines the inside of your uterus grows in other locations, such as your ovaries, bowel or pelvis. The extra tissue growth (and its’ surgical removal) can cause scarring, it can get in the way of an egg and sperm uniting, and it may also affect the lining of the uterus, disrupting implantation. Approximately one-third to one-half of women with endometriosis have difficulty getting pregnant. Other symptoms include pain during intercourse, urination and bowel movements.  Here are other conditions that cause stomach pain.

Secondary infertility is the inability to conceive a child or carry a pregnancy to full term after previously giving birth. To classify as secondary infertility, the previous birth must have occurred without help from fertility medications or treatments, like in vitro fertilization. Secondary infertility typically is diagnosed after trying unsuccessfully to conceive for six months to a year. A related condition is recurrent pregnancy loss where patients and couples are able to conceive but are unable to carry to term.


Risk of ectopic pregnancy. Women who have difficulty getting pregnant have an increased risk for ectopic pregnancy, regardless of how they conceive. And all assisted reproductive technology treatments, including IVF, also make an ectopic pregnancy more likely. An ectopic pregnancy occurs when an embryo implants in a fallopian tube or the abdominal cavity rather than in the uterus. It's treated with the medication methotrexate or by surgically removing the embryo to prevent it from severely injuring the mother by continuing to grow.
Infertility can have a profound impact on one’s mental health. When men and women find out that they can’t conceive, they may experience the same painful emotions as anyone coping with grief or profound loss. Common reactions include shock, frustration, grief, anger, decreased self-esteem, anxiety, and depression, but feelings about infertility can vary greatly depending on the source of the problems. Men, in particular, find it far easier to deal with a partner’s infertility than with their own.
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