Assisted Conception: The Facts
Sometimes pregnancy continues to elude couples even after repeated trying over a period of time, leading many to seek medical advice. While in most cases it’s just a case of needing more regular sex at your most fertile time in the month, some couples may require some form of treatment to assist with conception.
Assisted Conception – Facts to consider
Today assisted conception technologies - also known as assisted reproductive technologies (ARTs) - offer a ray of hope to many couples who previously have been unable to conceive, with an average of about one in five couples giving birth to their baby using assisted conception techniques. Survey findings show that during the year 2000 in the UK there were 580 cycles of fertility treatment per million people, and an average of 1057 per million in other Northern European countries.At the same time, the journey – from selecting the assisted conception route through to the treatment process (which may include an unsuccessful round) - can be emotionally, physically and financially demanding, which is why most doctors recommend assisted conception only when other options have been exhausted.
Further, whilst in most cases there aren’t any adverse health effects associated with assisted conception, some techniques do pose a greater risk of birth defects. The procedures are invasive and you also have higher chance of a multiple pregnancy which - albeit an extremely welcoming prospect - does have certain risks attached to it. Also, whilst its offers you a chance of unmatched joy of having your own baby, it is common that couples get successful after one or two unsuccessful attempts at assisted conception.
The good news is that with advances in modern research, there is an increase in the success rate of these treatments. Combining assisted conception treatments with conventional therapies also helps increase success rates.
If you are willing to do whatever it takes to have a baby of your own, your doctor will help you understand and decide which option is best for you.
Here gurgle gives you a heads-up on some common assisted conception procedures and what they entail.
IUI (intrauterine insemination)
This procedure is performed during the most fertile part of the woman’s cycle, sometimes two or three days consecutively to maximise results. The best quality ‘washed’ and treated sperm is inserted through a fine tube into the woman’s vagina through the cervix and into the uterus. The objective is to get the sperm closer to the area of fertilisation, using the partner’s sperm or donor sperm.IVF (in vitro fertilisation)
This procedure involves gathering ripened eggs from a woman's ovaries, fertilizing them with semen in a flat glass dish, incubating the cells in a laboratory, and then transferring the embryos into the woman's uterus at the precise time. The entire procedure can take between four to six weeks and the success rate depends on a number of factors, including the woman's age.Generally in this process, a woman is usually be given fertility drugs to stimulate her ovaries to develop several mature eggs for fertilization as opposed to a normal menstrual cycle where usually only one egg is released a month. During this period, she will have to frequently undergo blood tests to monitor estrogen levels and ultrasounds to check the developing ovarian follicles. Once the follicles reach maturity, the woman is given an hCG injection that triggers egg release. About 34 to 36 hours later, the eggs are removed from the ovaries (under an anesthetic).
About the same time, the male partner is then asked to provide a fresh sperm sample and the most viable sperms will be incubated with the woman’s eggs. The sperm and eggs are combined and fertilised in a glass dish containing a nutrient medium, which is then cultured in an incubator.
If the fertilized eggs (embryos) are developing normally, they will be transferred some days later, into the woman’s uterus (requires no anesthesia). Usually, one or two embryos are transferred. The number of embryos transferred will depend on your age and your chances of success.
A pregnancy test done about two weeks later will indicate whether the procedure has been successful or not.
Doctors often suggest IVF for women who have endometriosis, irreversibly blocked fallopian tubes, a cervical factor problem, ovulation disorders, unexplained infertility, or if the male partner has a very low sperm count.
GIFT (gamete intrafallopian transfer)
GIFT is an assisted conception procedure similar to IVF except that the eggs and sperm instead of being fertilised in a laboratory, are done so in the woman’s fallopian tubes. Once egg collection is complete, the embryologist collects small amounts of sperm for three of the ‘best’. The unfertilized eggs and sperm are then placed into a woman's fallopian tubes through a laparoscopic procedure. If successful, the egg is fertilized in the fallopian tube, moves down into the uterus, and implants as in a regular conception process.GIFT is recommended in cases of mild endometriosis, unexplained infertility, cervical or male factor problems, and as a better chance of pregnancy for women over 40 with at least one normal fallopian tube.
ZIFT (zygote intrafallopian transfer)
ZIFT shares similarities with GIFT and IVF. The egg and sperm are fertilized in the laboratory as in IVF, before they are transferred into a woman's fallopian tubes - usually by laparoscopy - much sooner than in the case of IVF since the natural environment of the body is considered a more viable place to encourage an embryo to develop than a laboratory dish. In a ZIFT procedure, the embryologist can confirm whether a woman's eggs are able to be fertilized by her husband's sperm.ICSI (intracytoplasmic sperm injection)
Introduced in 1992, ICSI is a relatively new technique that can be used as part of an IVF (in vitro fertilisation) treatment, where male fertility is the problem i.e. where the man has had an irreversible vasectomy; has a very low sperm count; produces few good-quality sperm; has a problem with anti-sperm antibodies in his semen; or has no sperm in his semen due to missing tubes or blockages in his reproductive organs.As in IVF, the woman is given fertility drugs to stimulate her ovaries to develop several mature eggs for fertilisation. Once the eggs are ready, the man may produce a sperm sample himself. However, if there is no sperm in his semen, doctors can retrieve sperm with a needle from a testicle under anesthetic. If this doesn't remove enough sperm, the doctor performs a procedure called testicular sperm extraction (TESE). It's sometimes done before the treatment cycle begins, and the retrieved sperms are then frozen.
After giving the woman a local anesthetic, the doctor removes her eggs and a lab technician then isolates individual sperm and injects them into individual eggs. Two days later the fertilised eggs become embryos. The procedure then follows the same steps as in IVF. A pregnancy test done about two weeks later will indicate whether the procedure has been successful or not. One cycle of ICSI takes four to six weeks to complete.
It can be comforting to know that there are other couples too who are grappling with infertility and probably considering assisted conception. Our fertility chat forum is a great place to meet others who are trying for a baby as well as those who have already tried assisted conception. You can share your thoughts, discuss your doubts and fear or probably just get an idea about assisted conception from some real experiences!
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