Infertility Treatment Methods (IVF | ICSI | EGG Donation)

 Normal pregnancy depends on various factors and conditions, in case of any disorder in any of them, the chance of fertility is decreased or even may go to zero. Infertility is one of the unwanted life phenomena that have been recently increased. A couple who couldn’t have a baby after a year of having sex without contraception, they are considered as infertile. All things needed couples know about fertility treatment is described in this post.

Infertility and its affecting factors

A couple is considered infertile if they cannot become pregnant after 12 months of unprotected intercourse. For women over the age of 35, infertility means not having fertility after 6 months of unprotected sex. Various causes can lead to infertility in couples. In general, these factors can be summarized in female and male factors.

Female-infertility factors include the abnormalities in the female reproductive system or poor egg quality that impairs fertility.

Male-Infertility Cause is one-third of couples’ infertility causes. These types of infertility indicate the presence of dysfunction in sperm production or ejaculation in the male.

Research shows that in a third of cases, a combination of female and male factors cause infertility in couples. About 10% of couples also suffer from unknown causes of infertility.

Different methods of fertility treatment

There are different methods of infertility treatment like IVF, ICSI, IUI, and Egg Donation which can help infertile couples and give them a chance to have a baby. Iran is one of the leading countries in the region and in the world in the field of infertility treatment, therefore many couples choose fertility treatment in Iran for infertility treatment.

Several advanced research institutes and hospitals, provide infertility treatment services like IVF in Iran to both local and international patients. Moreover, other fertility services such as Gender Selection are offered in these centers as well for peoples who choose fertility treatment in Iran.

In the following, some of the most important methods of infertility treatment are introduced.

 What is IVF?

In Vitro Fertilization (IVF) is one of the assisted reproductive techniques (ART) in which a man’s sperm and the woman’s egg are combined in a laboratory dish, where fertilization occurs. When the egg is fertilized, the primary cell begins to divide and form the embryo. The resulting embryo or embryos is/are then transferred to the woman’s uterus to implant and develop naturally.

How is IVF done?

IVF is a common procedure, used to overcome a range of fertility issues. It is a multi-step process involving ovulation induction, egg retrieval, Collection and preparation of sperm, fertilization, culture, and embryo transfer. The IVF process can be explained in these five steps:

•           Ovulation induction

The greater the number of oocytes prepared during a treatment cycle, the greater the chance of a healthy fetus forming and subsequently the chance of pregnancy. A doctor prescribes ovulation induction drugs to stimulate the growth of several oocytes in a woman’s cycle.

•           Ovum Pick up:

During a minor surgery, the infertile doctor picks up the mature oocytes using a special needle. This is done under conditions of local or general anesthesia. The procedure usually takes less than 30 minutes.

•           Collection and preparation of sperm

In vitro fertilization of the oocyte with sperm requires the collection of semen. If the male is unable to produce semen, TESE or PESA methods are used to collect sperm.

The collected sperms are washed by a specific method and examined for motility and shape. Finally, high-quality sperms are selected to fertilize the oocytes.

•           Fertilization and embryo culture:

After the ovum picks up, the embryologist examines the obtained egg to select mature eggs that are suitable for fertilization.

The mature eggs are placed in a culture medium and the sperm transferred to an incubator for fertilization. In IVF, high-motility sperms move to the eggs and fertilize them. Once this occurs, the fertilized eggs are considered embryos.

In conditions with a low number and low quality of sperm, the specialist uses intracytoplasmic sperm injection (ICSI). It is an additional part of an IVF treatment cycle in which a single sperm is injected into each egg to assist fertilization.

•           Embryo Transfer

Finally, the selected embryos are prepared for transfer to the uterus. A specialist physician inserts the embryo into the mother’s uterus during a minor surgery without the need for anesthesia.

What is the difference between ICSI and IVF?

The difference between IVF and ICSI is in how the oocyte is fertilized. In IVF, the oocyte is exposed to sperm in an in -vitro container until the highly motile sperm enters the oocyte and fertilizes it. But in the ICSI technique, a selected sperm is injected directly into the oocyte through a special needle. In this method, high quality and motile sperm are separated and ready for injection in a laboratory using a special method. The ICSI method is mostly used in cases where the quality of male sperm is low.

Egg donation

Infertility is not always cured by prescribing medication or using advanced methods of infertility treatment. In cases where a woman’s ovarian reserves are low or the quality of eggs is low, but the uterus and other reproductive organs are healthy, the only fertility way is to receive an egg donated by a volunteer. For a consult of our doctors and specialists and to use the service of Egg Donation in Iran, you can contact us through HayatMedTour website.

Fertility treatment in Iran

With over 30 years of experience in infertility research and treatment, Iran is one of the world’s pioneers in effective infertility treatment.  There are more than 80 specialized fertility treatment centers in Tehran, Urmia, Yazd, Isfahan, and other cities of Iran. These clinics with the up-date of knowledge and equipment in the world; offer various methods for infertility treatments with the best quality and reasonable prices.

The high quality and affordable cost of fertility treatments in Iran have led many medical tourists to choose this destination for the treatment of their infertility problems.

Infertility Treatment Methods

 

fertility tests for men

Fertility Tests for Men: Options and How They Work

Many infertile couples have more than one cause of infertility, so it's likely you will both need to see a doctor. It might take a number of tests to determine the cause of infertility. In some cases, a cause is never identified.

Infertility tests can be expensive and might not be covered by insurance — find out what your medical plan covers ahead of time.

Diagnosing male infertility problems usually involves:

• General physical examination and medical history. This includes examining your genitals and asking questions about any inherited conditions, chronic health problems, illnesses, injuries or surgeries that could affect fertility. Your doctor might also ask about your sexual habits and about your sexual development during puberty.
• Semen analysis. Semen samples can be obtained in a couple of different ways. You can provide a sample by masturbating and ejaculating into a special container at the doctor's office. Because of religious or cultural beliefs, some men prefer an alternative method of semen collection. In such cases, semen can be collected by using a special condom during intercourse.

Your semen is then sent to a laboratory to measure the number of sperm present and look for any abnormalities in the shape (morphology) and movement (motility) of the sperm. The lab will also check your semen for signs of problems such as infections.

Often sperm counts fluctuate significantly from one specimen to the next. In most cases, several semen analysis tests are done over a period of time to ensure accurate results. If your sperm analysis is normal, your doctor will likely recommend thorough testing of your female partner before conducting any more male infertility tests.

Your doctor might recommend additional tests to help identify the cause of your infertility. These can include:

• Scrotal ultrasound. This test uses high-frequency sound waves to produce images inside your body. A scrotal ultrasound can help your doctor see if there is a varicocele or other problems in the testicles and supporting structures.
• Transrectal ultrasound. A small, lubricated wand is inserted into your rectum. It allows your doctor to check your prostate and look for blockages of the tubes that carry semen.
• Hormone testing. Hormones produced by the pituitary gland, hypothalamus and testicles play a key role in sexual development and sperm production. Abnormalities in other hormonal or organ systems might also contribute to infertility. A blood test measures the level of testosterone and other hormones.
• Post-ejaculation urinalysis. Sperm in your urine can indicate your sperm are traveling backward into the bladder instead of out your penis during ejaculation (retrograde ejaculation).
• Genetic tests. When sperm concentration is extremely low, there could be a genetic cause. A blood test can reveal whether there are subtle changes in the Y chromosome — signs of a genetic abnormality. Genetic testing might be ordered to diagnose various congenital or inherited syndromes.
• Testicular biopsy. This test involves removing samples from the testicle with a needle. If the results of the testicular biopsy show that sperm production is normal your problem is likely caused by a blockage or another problem with sperm transport.
• Specialized sperm function tests. A number of tests can be used to check how well your sperm survive after ejaculation, how well they can penetrate an egg, and whether there's any problem attaching to the egg. These tests aren't often used and usually don't significantly change recommendations for treatment.

 

fertility tests for men

Increase Your Chances of IVF Success

How to Increase Your Chances of IVF Success

If you are looking to increase your chances of conceiving during IVF, here are 8 tips from 5 different fertility doctors.

• 1. Maintain a healthy weight.

"Maintaining a healthy weight is extremely important in fertility and IVF," says Linnea Goodman, MD, Assistant Professor of Obstetrics and Gynecology at the UNC School of Medicine. "We know that being obese (BMI >35) and underweight (BMI <19) increases time of conception by 2 and 4 times respectively, and negatively effects IVF success rates. Being overweight also makes monitoring the ovaries during IVF more difficult and increases the chance of complications during egg retrievals."

This is best implemented with changes in diet and activity with professional help.

"Working with dietitian, and in some programs enrolling in a cardio metabolic weight loss program can help achieve these goals," says Zaraq Khan, MD, reproductive endocrinologist at Mayo Clinic in Rochester, MN.

2. Optimize sperm health.

"Use of multivitamins and maintaining optimal body weight, as well using boxers over briefs, could improve sperm quality," says Dr. Khan. "Under appropriate care, men can also be started on medications that can help boost sperm numbers and quality that can have a beneficial impact on IVF outcome. In certain cases, sperm aspirated directly from the testicle over ejaculate could also be beneficial. Involving a male infertility specialist for any form of abnormalities in semen analyses is key."

• 3. Partner with an excellent doctor and embryology laboratory.

"Choosing an excellent reproductive endocrinologist is twofold: in addition to experience and commitment to evidence-based medicine, look for someone with whom you feel comfortable and connected. Your doctor will accompany you on this very emotional journey and it is important for you to feel supported and heard," says Elizabeth Fino, MD, fertility specialist at NYU Langone Fertility Center. "Asking for recommendations from friends and family who know you best can help guide you to a knowledgeable physician with whom you feel comfortable, but also be sure to do your research."

In a world of online reviews, it can be difficult to determine credibility.

"Be careful of online reviews—they are often completed by select patients who had an extreme experience for one reason or another and may not be universally applicable. FertilityIQ offers a unique model which hones in on specific aspects of the experience after vetting patient reviews.

To find an excellent embryology laboratory, look for a long history of exceptional outcomes. One source is the Society for Assisted Reproductive Technology which details the clinic's volume and live birth rate."

4. Reduce your stress.

"Basal stress levels can influence natural and assisted conception rates," says Dr. Khan. "Reducing stress troubles during an IVF stimulation cycle can be one of the hardest things to achieve for couples. Several reports suggest improvement of pregnancy outcomes with the use of acupuncture and other stress relieving techniques, like enrolling in mind-body programs, stress reduction, and resilience training workshops."

5. Quit smoking

"Smoking can drastically decrease chance of success while doing IVF because it effects egg and sperm quality," says Dr. Khan.

But you don't have to do it on your own.

"Quitting smoking is not an easy task and often requires a great deal of personal as well as professional support. Try to involve your friends and family to help encourage you in the process. For smoking cessation, structured programs and/or pharmacological assistance have proven to be most successful," says Dr. Fino.

6. Look into taking supplements

"DHEA and CoQ10 are supplements that have shown some promise in association with an increase in egg quantity and quality," says Dr. Fino. "Talk to your doctor to see if he or she recommends them for you."

Multivitamins may also be helpful, adds Dr. Khan.

7. Ensure you have adequate levels of vitamin D

"Over 40% of individuals are deficient in Vitamin D, and there is emerging data on its association with infertility and worse IVF outcomes," says Tarun Jain, MD, medical director of Northwestern Medicine Fertility and Reproductive Medicine Oakbrook Terrace. "Ask your doctor to check your vitamin D level, and consider taking a vitamin D supplement."

8. Focus on persistence and patience.

"Many patients require more than one cycle of IVF to achieve an embryo for transfer and outcomes may vary significantly from cycle to cycle," says Shannon DeVore, MD, at NYU Langone Fertility Center. "If your first cycle wasn't successful, your doctor may be able to adjust the medications to optimize a subsequent one. Other times, it just means keeping at it. Try not to be discouraged by sub-optimal outcomes and setbacks—you are doing everything right. The single biggest thing to remember is that most (or all) of this is out of your control. Nobody likes lack of control, but sometimes letting go can help you endure the journey. Take care of yourself and don't blame yourself when things don't go well. You are not alone, it often takes a village to build a family."

 

Increase Your Chances of IVF Success

How does IVF work

IVF is a common treatment for people who are unable to conceive naturally

Usually in IVF, the woman has medicines (fertility hormones) to stimulate the ovaries to produce several eggs. The eggs are then collected and mixed with sperm in a laboratory.

IVF is carried out when the sperm quality is considered to be ‘normal’ If there are issues with the sperm quality such as low motility or numbers, a procedure called intracytoplasmic sperm injection (ICSI) may instead be used – this is where a single sperm is injected into the egg by an embryologist

If fertilisation is successful, the embryos are allowed to develop for between two and six days. This helps the embryologist to select the strongest embryo, which is then transferred back to the woman’s womb to hopefully continue to a successful birth.

Often several good quality embryos will be created. In these cases, it's normally best practice to freeze the remaining embryos because putting two embryos back in the womb increases your chance of having twins or triplets, which carries health risks. You can use your frozen embryos later on if your first cycle is unsuccessful or you want to try for another baby.

What does IVF involve?

This process outlines a single cycle of IVF following the most commonly used procedure. You may find that your treatment is slightly different depending on your history and what your clinic thinks is best for you.

• Usually, the first step is to use medication to stimulate the ovaries to produce eggs. There are different ways this can be done. One way is to suppress natural hormones before taking hormone medication to stimulate the ovaries. This treatment, often called a long protocol, involves taking a daily injection or nasal spray to suppress hormone production. A scan checks the woman’s natural cycle is fully suppressed. If it is, hormone treatment (usually gonadotrophin) is started to boost the number of eggs the body produces.
• Some clinics may use the ‘antagonist protocol’. This involves taking medication (an antagonist) to suppress your hormones for a few days after you have taken the hormone medication (usually gonadotrophin) to boost the number of eggs the body produces.
• Whichever way the ovaries are stimulated to produce eggs, you will be closely monitored for a few days by the clinic. This may involve having blood tests or ultrasound scans.
• The eggs will be collected whilst under sedation or general anaesthetic. The procedure takes around half an hour and you may feel a little sore or bruised.
• Whilst the eggs are being collected, the man will be asked to come to the clinic to produce a sperm sample, or your donor sperm will be taken from the freezer, for mixing with your eggs.
• Medication will help to prepare the lining of the womb. This is usually taken as a pessary or gel which you can insert yourself into the vagina / rectum.
• The eggs will be mixed with the sperm in a laboratory. The aim is for the eggs and sperm to fertilise to create an embryo.
• If fertilisation happens, the resulting embryo(s), will be monitored to check how it’s/they’re developing.
• Two to five days after fertilisation, the embryo(s) will be transferred to the womb. You won’t need any kind of anaesthetic for this unless you have a condition that would make the procedure painful. You’ll be given a date to do a pregnancy test. Although you’ll understandably be excited at this stage, try not to do this early as you may get a false result.

IVF for male infertility

Sometimes, IVF for male infertility is the best treatment option. When the semen analysis is abnormal and identifies a male factor, it’s important to look for the cause. If the low sperm count appears to hormone-related, caused by an infection or related to a male anatomic abnormality, basic treatments may be used. If these do not work, or if it is a more severe case of male infertility, IVF is usually the treatment of choice.

Options other than IVF for male infertility

For hormonal imbalances like a low testosterone level, Doctor may choose medications like Clomid or fertility shots. The partners of men with decreased sperm counts and normal hormone levels will often undergo IUI. This is a simple and relatively inexpensive treatment for mild cases of male infertility.

Anatomical abnormalities that contribute to male infertility often require further evaluation by a urologist. Urologists are specialists regarding the male reproductive system. They will work with Doctor to determine what treatment is necessary.

If the sperm count is too low for IUI, IVF for male infertility may be the best treatment option. This treatment is a very successful option for couples with male factor infertility.

When do we recommend IVF for male infertility?

If a semen analysis reveals a very low concentration of normal sperm, Doctor often will recommend IVF for male infertility. This is because the chances of success are much better than with timed intercourse or IUI.

IVF is also a good option when there are multiple fertility factors, such as a low sperm count in combination with a blocked tube, difficulty in ovulation or advanced age of the woman. IVF can be the most effective treatment for couples in these situations by increasing the chance for fertilization of the egg.

The reason why is as follows:

How to Increase Chances of IVF Success

If you are looking to increase your chances of conceiving during IVF, here are 8 tips from 5 different fertility doctors.

 

1. Maintain a healthy weight.
"Maintaining a healthy weight is extremely important in fertility and IVF," says Linnea Goodman, MD, Assistant Professor of Obstetrics and Gynecology at the UNC School of Medicine. "We know that being obese (BMI >35) and underweight (BMI <19) increases time of conception by 2 and 4 times respectively, and negatively effects IVF success rates. Being overweight also makes monitoring the ovaries during IVF more difficult and increases the chance of complications during egg retrievals."

This is best implemented with changes in diet and activity with professional help.

"Working with dietitian, and in some programs enrolling in a cardio metabolic weight loss program can help achieve these goals," says Zaraq Khan, MD, reproductive endocrinologist at Mayo Clinic in Rochester, MN.

What are the risks of IVF?

IVF doesn't always result in pregnancy, and it can be both physically and emotionally demanding. You should be offered counselling to help you through the process.

There are also a number of health risks involved, including:

• side effects from the medications used during treatment, such as hot flushes and headaches
• multiple births (such as twins or triplets) – this can be dangerous for both the mother and the children
• an ectopic pregnancy – where the embryo implants in the fallopian tubes, rather than in the womb
• ovarian hyperstimulation syndrome (OHSS) – where too many eggs develop in the ovaries

Read more about  risks of IVF.

What happens during IVF

IVF treatment involves 6 main stages:

1. suppressing your natural cycle – the menstrual cycle is suppressed with medication
2. boosting your egg supply – medication is used to encourage the ovaries to produce more eggs than usual
3. monitoring your progress and maturing your eggs – an ultrasound scan is carried out to check the development of the eggs, and medication is used to help them mature
4. collecting the eggs – a needle is inserted into the ovaries, via the vagina, to remove the eggs
5. fertilising the eggs – the eggs are mixed with the sperm for a few days to allow them to be fertilised
6. transferring the embryo(s) – 1 or 2 fertilised eggs (embryos) are placed into the womb

Once the embryo(s) has been transferred into your womb, you'll need to wait 2 weeks before taking a pregnancy test to see if the treatment has worked.

 

What happens during IVF

 

 

 

What Are The Costs of IVF?

The average cost of an IVF cycle in the U.S. is $12,400, according to the American Society of Reproductive Medicine. This price will vary depending on where you live, the amount of medications you're required to take, the number of IVF cycles you undergo, and the amount your insurance company will pay toward the procedure. You should thoroughly investigate your insurance company's coverage of IVF and ask for a written statement of your benefits. Although some states have enacted laws requiring insurance companies to cover at least some of the costs of infertility treatment, many states haven't .Costs-of-IVF

 

 

 The cost of IVF in Iran is more affordable than in other countries. Also, in Iran, the infertility treatment services such as IVF have a high quality in the region and in the world. The low-cost of IVF in Iran is due to the low doctors’ wages and inexpensive services in the clinic. The medications cost are the same all over the world. Learn more about IVF cost in Iran: The cost of IVF in Iran

 

What Causes of Infertility Can IVF Treat?

When it comes to infertility, IVF treatment may be an option if you or your partner have been diagnosed with:

• Endometriosis
• Low sperm counts
• Problems with the uterus or fallopian tubes
• Problems with ovulation
• Antibody problems that harm sperm or eggs
• The inability of sperm to penetrate or survive in the cervical mucus
• Poor egg quality
• Genetic disease of mother or father
• An unexplained fertility problem

IVF is never the first step in the treatment of infertility except in cases of complete tubal blockage. Instead, it's reserved for cases in which other methods such as fertility drugs, surgery, and artificial insemination haven't worked.

 

What Causes of Infertility Can IVF Treat?