Success rates vary with the number of embryos transferred. However, transferring more and more embryos at one time does not increase the chance of live birth significantly, but may only increase the risk of a multiple pregnancy, and its associated risks. The impact of the number of embryos that are transferred also varies with the age of the woman.  
Upwards of 30% of couples seeking fertility care are labeled with unexplained infertility. Given that over 50% of couples’ infertility struggles are at least partially attributable to the male, understanding the source of male infertility could allow for improved care. The limited set of male tests can only detect the major causes of infertility (i.e., azoospermia) leaving the less obvious factors invisible.
For women, problems with fertilisation arise mainly from either structural problems in the Fallopian tube or uterus or problems releasing eggs. Infertility may be caused by blockage of the Fallopian tube due to malformations, infections such as chlamydia or scar tissue. For example, endometriosis can cause infertility with the growth of endometrial tissue in the Fallopian tubes or around the ovaries. Endometriosis is usually more common in women in their mid-twenties and older, especially when postponed childbirth has taken place.[55]
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.
For women, problems with fertilisation arise mainly from either structural problems in the Fallopian tube or uterus or problems releasing eggs. Infertility may be caused by blockage of the Fallopian tube due to malformations, infections such as chlamydia or scar tissue. For example, endometriosis can cause infertility with the growth of endometrial tissue in the Fallopian tubes or around the ovaries. Endometriosis is usually more common in women in their mid-twenties and older, especially when postponed childbirth has taken place.[55]
Embryos are transferred to the uterus. Embryos that have developed from the fertilization process will be placed in the uterus, normally 3 to 5 days after retrieval, so that they can embed. If this process is successful, pregnancy will occur and IVF is considered a success. If it’s not, you may use a frozen embryo that you have saved from a previous round of IVF to try again.
How will you handle a multiple pregnancy? If more than one embryo is transferred to your uterus, IVF can result in a multiple pregnancy — which poses health risks for you and your babies. In some cases, fetal reduction can be used to help a woman deliver fewer babies with lower health risks. Pursuing fetal reduction, however, is a major decision with ethical, emotional and psychological consequences.
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.

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.
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.
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.
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.
There can be medical causes of SI, says West. "The thyroid is always something we check. Birth can put the thyroid out of kilter." Anwen, a woman in her 40s, tried for five years to have a second child. "I had my daughter when I was 30," she says, "which, at the time, seemed very early. I was the first among all our friends to have a baby." She decided to try for a second when her daughter was three. "But a year went by and nothing happened. I went to the GP and he told me not to worry. 'If you've already given birth, there won't be a problem,' he said. But my daughter turned five and I still wasn't pregnant." Eventually, Anwen persuaded her GP to refer her to a fertility consultant who, after some simple investigations, informed her she had polycystic ovarian syndrome. "He said I'd probably had it all my life and that my daughter was an amazing one-off. I had no idea that anything was wrong." She was given a prescription for the fertility drug Clomid; two months later, she conceived her son.
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.
^ 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

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.
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