Infertility In Women - Lifestyle Changes

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For these reasons, some doctors now suggest that women skip the gonadotropin-stimulating injection step, and that couples who fail to conceive after three cycles of IUI combined with clomiphene pills proceed directly to IVF.

In Vitro Fertilization (IVF)

Most assisted reproductive technologies procedures use in vitro fertilization (IVF). An in vitro procedure is one that is performed in the laboratory. Advances in these procedures have dramatically increased the rate of live births. IVF can be performed with a woman’s own eggs and sperm, or with donor eggs and sperm.

In the past, IVF was used mainly to treat women with damaged fallopian tubes. It is now used as a fertility treatment for cases when the woman has endometriosis, the man has fertility problems, or the cause of a couple’s infertility is unexplained.

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A standard IVF cycle is divided into the following steps:

• Ovarian Stimulation. Ovarian-stimulating drugs, such as clomiphene, are used to prompt the ovaries to produce multiple eggs. About 8-14 days later, another type of drug [usually human chorionic gonadotropin (hCG)] is given to foster egg maturation.
• Egg Retrieval. About 34 - 36 hours after the hCG injection, the eggs are retrieved before ovulation begins. A cycle may be canceled at this stage if not enough follicles are produced or if there is a risk of ovarian hyperstimulation syndrome (see Medications section).To retrieve the eggs, the doctor inserts an ultrasound-guided probe into the vagina. A needle is then used to drain the liquid from the follicles, and several eggs are retrieved.
• Fertilization and Embryo Culture. The doctor will examine the eggs to evaluate their quality and maturity. Selected eggs are placed in a culture in the laboratory and transferred to an incubator. They are then inseminated with sperm, either by placing sperm together with the egg or injecting a single sperm into the egg (see ICSI section below).
• Embryo Transfer and Cryopreservation. One or more embryos are implanted in the woman’s uterus 1 - 6 days after egg retrieval. The doctor will discuss with the patient the appropriate number of embryos to be implanted. Excess embryos may be frozen and saved for future use. (The live birth rate is usually lower with cryopreserved embryos.) It takes about 2 weeks to determine if pregnancy has been achieved.