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The Fertility Enigma |
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Treatment Assisted Conception Ovulation stimulation Fertility drugs (e.g. Clomid - Clomiphene citrate) may be used if the woman is not ovulating (making and releasing eggs) properly. Usually, stimulation is monitored with a few scans to asses if ovulation is taking place. It is sometimes used alongside other treatments, such as IVF. Patients with PCOS benefit well from stimulated ovulation. Sometimes a woman has her own ovulation and Clomid is used to strengthen it. Intrauterine insemination (IUI) If the woman’s fallopian tubes are healthy, IUI is a simple fertility treatment when a woman has difficulty conceiving. Some of the man’s sperm is put into the woman’s womb at ovulation time(the release of an egg), increasing chances of getting pregnant. Ovulation stimulation is normally used to encourage eggs to be released. The healthiest sperm is selected from the man, or donor’s sperm from a donor can be used. In vitro fertilisation - IVF: During IVF, fertilisation occurs outside the body. The woman takes fertility drugs to stimulate the ovaries to produce more eggs to increase the chances of pregnancy. (Different stimulation options depending on the situation – either short or long protocol.) Eggs are then removed from her ovaries, fertilised with sperm in a laboratory, and then put back inside the woman’s womb to develop. Intracytoplasmic sperm injection (ICSI):
In this procedure a single sperm is injected into the cytoplasm or centre of a single egg. This is then transferred to the
womb using the same process as IVF. This procedure is carried out to overcome male infertility problems e.g. low sperm count
or poor motility (mobility or movement) or abnormally shaped sperm. ICSI may also be used following previous unsuccessful
attempts at fertilisation using IVF and when sperm has been retrieved directly from the epididymis or the testicles. Egg and sperm donation: Sometimes problems with fertility result from low egg or sperm quality – in this situation the couple may be able to receive eggs or sperm from a donor to increase the chances of successful pregnancy. The procedure is carried out during IVF.
Blastocyst transfer
This treatment is sometimes used for women whose embryos are of good quality but they do not attach well to the womb lining
where they can develop. An embryo that has developed for five to six days is called a blastocyst. Blastocyst transfer relies
on embryos developing to the blastocyst stage in a laboratory before being placed in the womb. Blastocyst transfer
differs from IVF because the embryos are developing for a two days longer in the laboratory. This means the best quality embryos
can be selected to put into the womb. Assisted hatching
Before an embryo attaches itself to the wall of the womb, it breaks out (hatch) from a gel-like membrane (shell)called the zona pellucida. This membrane can be too thick or hard in some women and some fertility experts argue it can prevent the embryo from implantation into the womb. To help the embryo break through, the embryologist make a little hole in the shell before it is put back into the womb to help it to hatch. This technique may be used for women over 40 who are producing harder eggs, or younger women who are not producing many eggs at all. |
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