Since marriage is a contract between the wife and husband during the span of their marriage, no third party should intrude into the marital functions of sex and procreation. This means that a third party donor is not acceptable, whether he or she is providing sperm, eggs, embryos, or a uterus. The use of a third party is tantamount to zina, or adultery.
Ovarian reserve testing. To determine the quantity and quality of your eggs, your doctor might test the concentration of follicle-stimulating hormone (FSH), estradiol (estrogen) and anti-mullerian hormone in your blood during the first few days of your menstrual cycle. Test results, often used together with an ultrasound of your ovaries, can help predict how your ovaries will respond to fertility medication.
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]
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.
There are multiple treatment options including using oral or injectable medications, intrauterine insemination (IUI), assisted reproductive technology using in vitro fertilization (IVF), or a combo of these solutions to help. A 2010 study called the FASTT trial indicated that in vitro fertilization might be the quickest and best route to pregnancy for couples with unexplained infertility.(4)
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  
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.

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.


Ovulation induction (in the sense of medical treatment aiming for the development of one or two ovulatory follicles) is an alternative for women with anovulation or oligoovulation, since it is less expensive and more easy to control.[7] It generally involves antiestrogens such as clomifene citrate or letrozole, and is followed by natural or artificial insemination.
Coping with secondary fertility can be tough. Endless doctor appointments, tests, procedures, and medications. Sleepless nights. Time and energy away from your little one. Guilt over wanting another pregnancy when many women are struggling to have just that. Stress between you and your partner. Sadness when you get invited to yet another baby shower — and guilt for even feeling that way.

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.


Heavy, as in a pad and a tampon still doesn’t feel like enough. Certain medical conditions, like thyroid problems or kidney disease, can cause excessive menstrual bleeding, medications (such as anti-inflammatory drugs or anti-coagulants) may as well; or the reason may be a condition linked to infertility. In a normal menstrual cycle, the hormones estrogen and progesterone work together to regulate the buildup of the lining of the uterus—that’s the stuff that sheds during your period. But if, for example, your ovaries don’t release an egg, the dominoes are tipped: your body produces less progesterone, hormones become imbalanced, the lining in your uterus over-develops, and you end up bleeding extra heavily. Fibroids in your uterus can also cause heavier or longer-than-normal periods; some types of these benign tumors can block fallopian tubes or interfere with the implantation of a fertilized egg. Up to 10 percent of infertile women have fibroids, according to the American Society for Reproductive Medicine. If you soak through at least one pad or tampon an hour for more than a few hours, see your doctor.  This is the worst health advice gynecologists have ever heard.
While many cases of infertility remain unexplained, there may be answers in the epigenome. Unlike one’s genetic code, the epigenome is dynamic and can be modified by environmental factors and lifestyle choices. Fertility in many cases is a state which changes throughout one’s life. Given the lack of clear genetic or physiological causes of unexplained infertility, the epigenome is thought to be altered in this subset of patients. As a result, looking into the epigenetic basis of infertility can help clinicians inform treatment.
iui versus ivf : While approaching an IVF specialist in order to conceive baby, infertile couples come across several options through which they can achieve their goal. These include IUI, IVF and surrogacy. People wishing to carry their child and avoid using a surrogate get to choose between IVF and IUI. But here comes the big dilemma which procedure to choose?
Mutations to NR5A1 gene encoding Steroidogenic Factor-1 (SF-1) have been found in a small subset of men with non-obstructive male factor infertility where the cause is unknown. Results of one study investigating a cohort of 315 men revealed changes within the hinge region of SF-1 and no rare allelic variants in fertile control men. Affected individuals displayed more severe forms of infertility such as azoospermia and severe oligozoospermia.[27]

As with any medical procedure, there are some risks to keep in mind. When choosing between IUI and IVF, the risk is certainly something to consider. The chances of experiencing either a miscarriage or multiples are concerns many have when deciding to undergo fertility treatments. So let’s take a look at the odds of either of these things occurring, plus a few other risks to be aware of.
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.
With egg donation and IVF, women who are past their reproductive years, have infertile male partners, have idiopathic female-fertility issues, or have reached menopause can still become pregnant. Adriana Iliescu held the record as the oldest woman to give birth using IVF and a donor egg, when she gave birth in 2004 at the age of 66, a record passed in 2006. After the IVF treatment some couples are able to get pregnant without any fertility treatments.[3] In 2018 it was estimated that eight million children had been born worldwide using IVF and other assisted reproduction techniques.[4]
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]
First, you take medication that makes several of your eggs mature and ready for fertilization. Then the doctor takes the eggs out of your body and mixes them with sperm in a lab, to help the sperm fertilize the eggs. Then they put 1 or more fertilized eggs (embryos) directly into your uterus. Pregnancy happens if any of the embryos implant in the lining of your uterus.
Ovary stimulation. For eight to 14 days near the beginning of your menstrual cycle, you take a gonadotropin, a type of fertility drug that stimulates your ovaries to develop multiple mature eggs for fertilization (instead of just one). You also need to take a synthetic hormone like leuprolide or cetrorelix to keep your body from releasing the eggs too early.

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.
The percentage of cycles cancelled between egg retrieval and embryo transfer is an indication of failed fertilization. This figure is halved with ICSI as compared to conventional IVF, indicating that it can indeed improve fertilization when the sperm is at fault. However, there are no differences in pregnancy, miscarriage or live birth rates between conventional IVF and ICSI, indicating overall similar success rates1.

The number to be transferred depends on the number available, the age of the woman and other health and diagnostic factors. In countries such as Canada, the UK, Australia and New Zealand, a maximum of two embryos are transferred except in unusual circumstances. In the UK and according to HFEA regulations, a woman over 40 may have up to three embryos transferred, whereas in the US, there is no legal limit on the number of embryos which may be transferred, although medical associations have provided practice guidelines. Most clinics and country regulatory bodies seek to minimise the risk of multiple pregnancy, as it is not uncommon for multiple embryos to implant if multiple embryos are transferred. Embryos are transferred to the patient's uterus through a thin, plastic catheter, which goes through her vagina and cervix. Several embryos may be passed into the uterus to improve chances of implantation and pregnancy.


Using the information that you enter below, this tool allows you to estimate your chance of having a live birth using in vitro fertilization (IVF)—the most common type of Assisted Reproductive Technology (ART). This information is calculated based on the experiences of women and couples with similar characteristics. The estimates are based on the data we have available and may not be representative of your specific experience. Additionally, this IVF success estimator does not provide medical advice, diagnosis, or treatment. Please speak with your doctor about your specific treatment plan and potential for success.
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.
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]
If IVF were to involve the fertilisation of only a single egg, or at least only the number that will be implanted, then this would not be an issue. However, this has the chance of increasing costs dramatically as only a few eggs can be attempted at a time. As a result, the couple must decide what to do with these extra embryos. Depending on their view of the embryo's humanity or the chance the couple will want to try to have another child, the couple has multiple options for dealing with these extra embryos. Couples can choose to keep them frozen, donate them to other infertile couples, thaw them, or donate them to medical research.[90] Keeping them frozen costs money, donating them does not ensure they will survive, thawing them renders them immediately unviable, and medical research results in their termination. In the realm of medical research, the couple is not necessarily told what the embryos will be used for, and as a result, some can be used in stem cell research, a field perceived to have ethical issues.

In cases where the man's sperm count is extremely low or there is poor motility (movement of the sperm), doctors may combine IVF with a procedure called intracytoplasmic sperm injection. In this procedure, a sperm is taken from semen -- or in some cases right from the testicles -- and inserted directly into the egg. Once a viable embryo is produced, it is transferred to the uterus using the usual IVF procedure.

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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