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Female Fertility |
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Assisted Reproductive Techiques - Your Options |
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| 1. |
In-vitro Fertilisation (IVF) |
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A method of assisted reproduction that involves combining an egg with sperm in a laboratory dish. If the egg fertilizes and begins cell division, the resulting embryo is transferred into the woman's uterus where it will hopefully implant in the uterine lining and further develop. IVF may be performed in conjunction with medications that stimulate the ovaries to produce multiple eggs in order to increase the chances of successful fertilization and implantation. IVF bypasses the fallopian tubes and is often the treatment choice for women who have badly damaged or absent tubes.
'Because the eggs are collected through the vagina under ultrasound control, it is often necessary to have a full bladder during the procedure to enable the position of the ovaries to be seen. This is not always the case if the uterus is shaped and placed in the correct way, but if there is tilting or any obstruction, a fuller bladder will be requested.
The operation is carried out as a day-case procedure under sedation or general anaesthetic. You may experience some discomfort following this procedure, but this can be relieved with painkillers. You will also be given antibiotics to prevent infection.
Once the eggs have been collected, they are examined and mixed with the prepared semen before being placed in a special medium. They are then incubated for 24hours to allow fertilization to occur. The developing embryos (zygotes) are then left for 24-48 hours to allow further growth to occur.
The embryos (up to a maximum of three) are transferred to the uterus 48-72 hours after egg retrieval. Hormonal treatment to help maintain the pregnancy is given for the following 2 weeks, involving either three injections of hCG or daily treatment with progesterone tablets inserted into the vagina.
The success rate for vaginal egg collection with embryo transfer, without acupuncture, is about 25-30%. However, this varies depending on the age of the patient.' (Irvine, R, 1996) |
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| 2. |
Intra-uterine Insemination - IUI |
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The process whereby a sperm preparation is injected directly into the uterine cavity in order to bypass the cervix and place the sperm closer to the egg. The sperm are usually washed first in order to remove chemicals that can irritate the uterine lining and to increase sperm motility and concentration.
'First, the ovaries are stimulated with hormonal treatment. This may be given as tablets which are taken between the second and sixth days after the start of the menstrual period, or as a daily injection. The development of the follicles in which the eggs are produced are monitored using ultrasound. Monitoring starts 5-7 days later and is performed on alternate days. The ultrasound scan is also used to measure the thickness of the lining of the uterus to ensure that it is ready for implantation of the embryo.
Ovulation may be induced by an injection of a hormone called human chorionic gonadotrophin (hCG). The eggs will be released 36-48 hours after the hormone has been given, and semen will be injected directly into the uterus. In this technique, hormone levels in the blood are measured to determine when ovulation is occurring.
If ovulation induction leads to the development of three or more follicles of a similar size, the treatment will be abandoned for that month to avoid the possibility of a multiple pregnancy.'(Irvine, R, 1996) |
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| 3. |
Gamete Intrafallopian Transfer (GIFT) |
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An assisted reproductive technology that involves surgically removing eggs from a woman's ovary, combining them with sperm, and immediately injecting the eggs/sperm mixture into the fallopian tube. Fertilization then hopefully takes place inside the fallopian tube. One disadvantage of GIFT is the inability to know whether or not fertilization took place if the woman does not become pregnant. Another disadvantage is the slightly higher rate of ectopic pregnancy due to the placement of egg inside the fallopian tube.
'This procedure is carried out as a day-case operation under a general anaesthetic. It is performed using 'keyhole' surgery and involves making three incisions. Every follicle is examined during the operation, and the eggs together with the fluid from the follicles are withdrawn through a needle using gentle suction. The Fallopian tubes are then checked to ensure that they are normal.
While the tubes are being checked, the eggs are carefully examined by a specialist to asses their quality. The best eggs (up to a maximum of three) are then mixed with the prepared sperm, and then transferred to the fallopian tubes through a thin tube.
Hormonal treatment to help maintain the pregnancy is given for the following 2 weeks, involving either three injections of hCG or daily treatment with progesterone tablets inserted into the vagina.
The success rate of GIFT without acupuncture is approximately 30%, but varies depending on the age of the patient. Any extra eggs collected may be fertilised in vitro and frozen for up to 5 years for use at a later date.'(Irvine, R, 1996) |
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| 4. |
Using Donor Eggs |
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The Fertility Support Company supports the use of donor eggs, and follows two strains of treatment depending on the wishes of the patient.
The first option is a straight transfer treatment (see IVF section), as outlined in the IVF section, to improve the chances of success.
The second option is our preferred one, as it is the health of the woman carrying and wishing to implant the eggs which can make all the difference in the success rate. For an explanation of the three month protocol we offer to increase the success of this artificial reproductive technique by improving maternal health, please go to the 'What can The Fertility Support Company do to improve your fertility' page. |
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