What Is IUI, IVF

Infertility

Infertility means inability to bear their own child. Its incidence is 10-15%. And the cause may be in male or female or in both. If husband and wife have normal sexual life for one year and wife is not able to conceive than this couple comes under definition of infertile couple. Infertility is 40% due to problem in Female and 40% due to Male and 20% due to problem in both.

Main Cause of Infertility in Female

• No ova formation in female. (Anovulation)
• Defective or damaged fallopian tubes (both)
• Abnormality in uterus eg. Fibroid, Congenital defects, Adenomyosis
• Problems in hormone production
• No definite cause

Cause of infertility Due to male Factor:

• Low Sperm Count
• Low Sperm Motility
• Absence of Sperm
• Abnormal genetal organs
• Hormonal Disturbances

Investigation:

Female:

• Blood Hormone levels (D2-like FSH, LH, TSH, Prolactine, E2 etc.)
• sound of female organs (Including colourdoppler)
• Laparoscopy & Hysteroscopy (Only if needed)
• Hysterosalpingography etc. (If require)

Male:

• Semen examination- It is single most important examination done in male.
• Other Investigation are blood test, hormone levels, testicular blopsy where sperm totally absent.

Treatment Modalities for Infertile Couples:

When all medical treatments fails, following treatment done for infertile couples:

• IUI (Intra uterine Insemination of sperm)
• ART (Assisted reproductive techniques)

ART- This includes (also called test tube baby)

• IVF (In Vitro Fertilization)
• ICSI (Intracytoplasmic Sperm Injection)

IUI (Intra Uterine Insemination of sperm):-

This is simple technique in which good quality sperms Separated from Husband's Semen Sample with the help of Special Preparation Media are injected into the uterus of Wife at the time of ovulation.

So good sperm and ova meets naturally and pregnancy occurs. IUI is done only when female have cervical mucus in compatibility or sperm are low in count. Success rate of IUI is about 10-15% per cycle and done 6 times (maximum).

ART (Assisted Reproduction Technology):-

This is the most important and advanced technique and is available only at infertility centres which are doing exclusive work in the field of infertility. ART is also called test tube baby technique because here 4-6 embryos are first made outside body means in test tube or four well dish and then transferred to female's uterus.

IVF (In Vitro Fertilization):-

In this technique female is given hormonal. Injections to stimulate her ovary and several ova are formed. Then those ova are taken out under anesthesia and combined with husband sperm in a carbon dioxide incubator. After fertilization when embryos attain 4-8 cells stage (after 2-3 days of ovum pick up), then 2-3 embryos transferred to wife's uterus and thus pregnancy occurs. IVF is done for many indications including damaged tube, endometriosis, anovulation, PCOS, failed IUI cycles, unexplained infertility etc. Success rate of this procedure is near about 30% - 40%in whole world.

ICSI:-

This method is applied when male sperm count is low or Spontaneous fertilization does not occur. Here under high magnification microscope sperm is injected into ova directly so that fertilization can occur. Success rate remains same 30% - 40% here also. Few other methods like assisted laser hatching etc also done in indicated cases but these methods only used when their is any indication. These method do not improve the success rate significantly.

Surrogate Mothers:-

It is a way to have your own genetic baby when female losses her uterus due to congenital cause or have anatomically distorted uterus. Here husband's sperm & wife's ova are taken out, their embryos formed and transferred to a lady who wishes to keep child in her womb for 9 months and after the birth baby is given to genetic mother & father. It is a legal procedure.

Few Important Things to Remember:-

• IVF (TEST TUBE BABY) – Is a technique which helps infertile couples to have there child but it do not assure them 100% chances The success rate is about 30% - 40%.
• It is an expensive procedure because hormones used to stimulate the ovary are expensive and are imported.
• It is expensive because of high cost of Instruments & high maintenance costs.

How is it Done

In simple terms, IVF means fertilization outside the body. After ovarian stimulation, eggs are collected from women's ovaries and then fertilised by husband's proccessed sperms in a petridish or a test tube in a controlled laboratory environment. The resulting embryos are deposited in to the women's uterus by embryo transfer under ultrasound guidance. If the process is successful, one or more embryos will implant in the lining of the womb and the women will become pregnant.