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Infertility Treatments progress

Infertility Treatments progress

Worldwide, more than 3 million babies have now been born through in vitro fertilization (IVF). Other therapies are successful, too — at least half of couples who seek treatment for infertility will get pregnant.

Symptoms of Infertility

Most couples should consult a doctor after a year of trying to conceive unsuccessfully. This is the main sign of infertility. If the woman is over age 35 and hasn’t conceived after trying for six months or has an irregular menstrual cycle, it’s best to see a doctor as soon as possible. Remember that the man should be evaluated, too. Male infertility is just as common as female infertility.

Male Infertility

In about 40% of infertile couples, the cause is traced to the man. Common problems include:
Low sperm count
Poor sperm motility
Malformed sperm
Blocked sperm ducts

Female Infertility

In another 40% of cases, the woman is diagnosed with a problem, such as:
Irregular ovulation (release of eggs)
Blocked fallopian tubes
Abnormalities in the cervix or uterus
In about 20% of infertile couples, no cause can be found.

Tracking Ovulation

In some cases, poor timing is the main obstacle. To find out when you’re ovulating (and determine the best time for sex), you can use over-the-counter ovulation tests. These detect a hormonal surge that occurs 12 to 36 hours before the ovary releases an egg. If the tests never yield a positive result, consult your doctor. Irregular ovulation accounts for about a third of all cases of infertility.

Fertility Drugs

If your doctor determines you’re not ovulating normally, fertility drugs can help. The most common choice is clomiphene citrate, better known by the brand names Clomid and Serophene. This drug is relatively inexpensive and effective. About half of women who take clomiphene will get pregnant, usually within three cycles. By causing the release of more than one egg at a time, Clomid increases the chances of multiple births.

Injectable Hormones

If you don’t get pregnant after taking clomiphene for six months, your doctor may recommend injections of fertility hormones. A wide range of hormonal drugs are available, and they are highly effective in stimulating ovulation. Of those who ovulate, about half become pregnant. Like clomiphene, injectable hormones increase the chances of becoming pregnant with multiples.
Surgery for Blocked Fallopian Tubes

Some women have trouble getting pregnant because scar tissue prevents eggs from traveling down the fallopian tubes. This scarring can be caused by endometriosis, the overgrowth of tissue that lines the uterus, a history of pelvic infections, or previous surgeries. Laparoscopic surgery can remove scar tissue in the reproductive tract and boost the odds of getting pregnant for some women.

Intrauterine Insemination (IUI)

Intrauterine insemination (IUI) is a popular option for a wide range of fertility problems. In this procedure, the sperm is placed directly into the woman’s uterus while she is ovulating. This reduces the distance the sperm must swim to reach the egg. IUI is often used in combination with drugs that stimulate ovulation. It is less expensive and less invasive than IVF, but pregnancy rates are notably lower.

In Vitro Fertilization (IVF)

VF offers hope when other infertility treatments are unsuccessful. It eliminates any barriers between egg and sperm by combining them in a lab. The growing embryos are then placed inside the uterus.

IVF With ICSI

When a man’s sperm count is extremely low or the sperm don’t move well, they may not be able to fertilize an egg without help. A procedure called intracytoplasmic sperm injection (ICSI) can overcome this problem by inserting a single sperm directly into an egg. The resulting embryos are then transferred to the uterus through the normal IVF procedure. The majority of IVF cycles now use ICSI.
IVF with Blastocyst Transfer

A recent breakthrough in IVF technology is known as blastocyst transfer. In standard IVF, embryos are transferred to the womb when they reach the two- to eight-cell stage. In the newer procedure, the embryos are allowed to grow for five days until they reach the blastocyst stage. The healthiest one or two blastocysts are chosen for transfer. This eliminates the possibility of triplets while maintaining a high success rate.

Choosing a Fertility Clinic

When choosing a fertility clinic, ask plenty of questions about the available procedures and costs. Make sure the clinic offers the latest technologies and keeps patients involved in treatment decisions. The CDC maintains a database comparing IVF success rates for clinics around the nation. But don’t base your choice solely on these rates. Infertility treatment is a long-term process, and you want to feel comfortable with your clinic.

Acupuncture for Infertility?

Acupuncture has shown promise in treating many conditions, ranging from asthma to headaches. Now some couples are trying the popular form of Chinese medicine to address infertility. Research suggests acupuncture may improve sperm quality, improve blood flow to the uterus, normalize ovulation, and boost IVF success rates.

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How to Choose a Best Fertility Clinic

How to Choose a Best Fertility Clinic

Before you take the next step in your journey to become pregnant, it’s worth seeking out a good fertility clinic.

Let’s say you’ve been getting advice from your gynecologist, who’s run a blood test for hormones or had you record your basal body temperature for a couple of months. At the same time, your husband has had his plumbing checked out by a urologist. When it comes time to diagnose where the problem may be and suggest solutions, you may wish there were a single doctor you both could see. That’s where the infertility specialist comes in, providing big-picture advice. Women over age 35 or who have a history of three or more miscarriages; men with a poor semen analysis; and couples who have tried for at least two years to get pregnant, should plan on seeing a specialist, recommends Resolve, an infertility support group.

However, you need to do some homework first. Before you step foot into the fertility clinic, find out what kind of invasive tests or procedures might lie in wait for you. And give some thought ahead of time to how far you’re willing to go with this process. Advanced reproductive technology can cost many thousands of dollars, can involve strong drugs or hormones, and can be an emotional roller coaster. Knowing your limits will keep you from being talked into some nifty new procedure that you really don’t want and can’t afford.

When it comes to choosing a clinic, do thorough research ahead of time. One useful resource is a federal database kept by the national Centers for Disease Control and Prevention that contains the success rates of fertility centers around the country. The statistics are updated every few years, so check the date. Keep in mind that some fertility centers that looked great several years ago may have had high staff turnover and declined in quality. But the numbers give you a place to start. Also, ask a lot of questions of every fertility clinic you’re considering.

“You shouldn’t look at the report and say ‘Center A has the highest success rate, I’m going there,'” says Arthur Wisot, MD, an infertility specialist in Los Angeles, Calif., and author of ”Conceptions & Misconceptions,” a book about choosing infertility care. “Just be sure they have a success rate that’s at least above the national average.”

We’ve all heard the scary stories about embryos ending up in the wrong womb or ugly legal disputes over someone’s frozen eggs. To be sure you don’t become the next reproductive-technology headline, check that the clinic has good quality control and strong ethics.

Questions to Ask of a Fertility Clinic
Wisot recommends asking:

How long has the fertility clinic’s medical director been there?
How long have the doctors and technicians been there? High staff turnover can be a sign of bad management and can contribute to mistakes.
Which procedures do you do, and how often? Be sure the clinic has a wide range of infertility remedies available and is familiar with the latest technology, such as something called blastocyst transfer.
Do you have age limits for treatment? If so, it’s a good sign that the clinic is concerned about ethical issues.
When you do an advanced procedure that involves fertilizing the eggs outside the woman and then planting them inside her, who decides how many eggs go back in — the doctor or patient? Wisot recommends steering away from a clinic that gives complete control to the doctor. This is important because the more eggs planted, the greater the chance for multiple births.
How many cycles per year do you do? Wisot notes that some clinics handle so many patients — each of whom may be treated for multiple menstrual cycles — that patients end up feeling like a number.
What does treatment cost? While you don’t want to choose strictly on price, it’s good to know costs ahead of time so you know what you’re getting into. Beware of clinics that offer a money-back guarantee if you don’t get pregnant — the doctor may have a financial incentive to treat you more aggressively than you want.
If you call the clinic and they say they’re too busy to answer your questions, try elsewhere. They may not have time for your questions once you’re a patient, either. For more on the subject, check the information-packed web site at Resolve, a respected national support organization.

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