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What Is Infertility?
Infertility refers to an inability to conceive after having regular unprotected sex. Infertility can also refer to the biological inability of an individual to contribute to conception or to a female who cannot carry a pregnancy to full term. In other words infertility refers to a couple that has failed to conceive after 12 months of regular sexual intercourse without the use of contraception. In this article you will read about IVF treatment cost, how uterine fibroids cause infertility, risk factors of male and female infertility etc.
Studies indicate that slightly over half of all cases of infertility are a result of female conditions, while the rest are due to either sperm disorders or unidentified factors. However, many cases of apparent infertility are treatable. Infertility may have a single cause in one of the partners, or it could be the result of a combination of factors.
Pregnancy is the result of a process that has many steps.
Women need functioning ovaries, fallopian tubes and a uterus to get pregnant. Infertility may result from a problem with any or several of the following steps. To get pregnant:
- A woman’s body must release an egg from one of her ovaries (ovulation).
- A man’s sperm must join with the egg along the way (fertilize).
- The fertilized egg must go through a fallopian tube toward the uterus (womb).
- The fertilized egg must attach to the inside of the uterus (implantation).
Can uterine fibroids cause infertility?
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There are several ways uterine fibroids can reduce fertility: Changes in the shape of the cervix and uterus can affect the number of sperm that can enter the uterus. Fibroids may reduce fertility by as much as 70%. However, if the fibroid is treated, fertility may be restored. Fibroids can also cause pregnancy complications, such as miscarriage, preterm delivery, abnormal position of the fetus, and the need for cesarean (C-section or surgical) delivery. Submucosal fibroids that grow just under the inner lining of your uterus endometrium can alter the lining of your uterus and reduce fertility.
Risk factors for male infertility
- Semen quality – concentration, motility and morphology (shape)
- Erectile dysfunction or premature ejaculation
- Blockage of the ejaculatory duct
- Retrograde ejaculation
- Alcohol and drug use
- Ejaculation disorders
- Undescended testicle
- Being obese or overweight
- Health problems – mumps in adolescence, cystic fibrosis, diabetes & Thyroid disease
- Sexually transmitted diseases
- Radiation and chemotherapy
- Exposure to some chemicals / pesticides
Additional Risk factors for female infertility
- Ovulation problems
- Premature ovarian failure
- Blocked Fallopian tubes
- Uterine problems- PCOS (polycystic ovary syndrome)
- Uterine fibroids – Submucosal fibroids
- Poor egg quality
- Overactive or Underactive thyroid gland
- Some chronic conditions, such as AIDS or cancer
- Poor diet
- Extreme weight gain or loss.
- Severe Athletic training
Infertility tests for males
- General physical exam and medical history
- Semen analysis
- Blood test – testosterone and other male hormones.
- Ultrasound test – ejaculatory duct obstruction, retrograde ejaculation etc
- Chlamydia test
Infertility tests for females
- General physical exam and medical history
- Blood test – hormone levels & progesterone test
- USG – Pelvic ultrasound – uterus, fallopian tubes, and ovaries.
- HSG – Hysterosalpingography – so as to check uterus and the fallopian tubes
- Laparoscopy- So as to check fallopian tubes, uterus and ovaries and endometriosis, scarring, blockages and any irregularities of the uterus and fallopian tubes.
- Ovarian reserve testing to find out how effective the eggs are after ovulation.
- Genetic testing to find out whether a genetic abnormality
- Chlamydia test
- Thyroid function test
- Tubal Patency
How long should women try to get pregnant before calling their doctors?
Most experts suggest at least one year for women younger than age 35. However, women aged 35 years or older should consult a doctor after 6 months of trying unsuccessfully. Some health problems also increase the risk of infertility.
- Irregular periods or no menstrual periods
- Very painful periods
- Pelvic inflammatory disease
- More than one miscarriage
Based on the couple’s test results and other factors, infertility may be treated with:
- Artificial insemination IUI
- Assisted reproductive technology ART
- In vitro fertilization
- Zygote transfer
- Gamete transfer
- ICSI – intracytoplasmic sperm injection.
What is IUI – Intrauterine Insemination?
Intrauterine insemination (IUI) is an infertility treatment that is often called artificial insemination. In this procedure, specially prepared sperm are inserted into the woman’s uterus.The doctor may give a low dose of ovary stimulating hormones to the woman. IUI is more common when the man has a low sperm count, decreased sperm motility, or when infertility does not have an identifiable cause. The procedure is also helpful for males suffering from severe erectile dysfunction. When ovulation occurs, the doctor inserts a fine catheter through the cervix into the uterus to place a sperm sample directly into the uterus. The doctor wash the sperms in a fluid and selects the best specimens.
Cost of IUI In India varies according to the cities and the fertility clinics and its doctors. Following are the price range of IUI in India in various cities:
- Mumbai- Ranges from 10000 to INR 15000.
- Bangalore- Ranges from 8000 to 9500 INR.
- Kolkata- Around INR 4000 which may vary as per the fertility clinics.
- Pune- Around 4000 to 5000 INR.
- Chennai- Ranges from 4000 to 5000 INR.
- Delhi- Around INR 6000- INR 8500.
What is ART – Assisted Reproductive Technology?
Assisted Reproductive Technology (ART) includes all fertility treatments in which both eggs and sperm happens outside of the body. ART procedures involve surgically removing eggs from a woman’s ovaries, combining them with sperm in the laboratory and returning them to the woman’s body.
ART procedures sometimes involve the use of donor eggs for the women who cannot produce eggs (eggs from another woman), donor sperm or previously frozen embryos. Also, donor eggs or donor sperm is sometimes used when the woman or man has a genetic disease that can be passed on to the baby. An infertile woman or couple may also use donor embryos. These are embryos that were either created by couples in infertility treatment or were created from donor sperm and donor eggs. The donated embryo is transferred to the uterus.
How often is ART- Assisted Reproductive Technology Successful?
Success rates vary and depend on many factors:
- Infertility diagnosis
- Age of the woman undergoing the procedure
- Correctness of the procedure
What are the different types of assisted reproductive technology (ART)?
- In vitro fertilization (IVF) is where fertilization happens outside the body. Sperm are placed with unfertilized eggs in a Petri dish with the aim to fertilize the egg. The embryo is then placed in the uterus to begin a pregnancy. Sometimes the embryo is frozen for future use (cryopreserved).
- Zygote intra fallopian transfer (ZIFT) This is also called tubal embryo transfer. This treatment is used when a blockage in the fallopian tubes prevents the normal binding of sperm to the egg. Egg cells are removed from a woman’s ovaries and fertilization occurs in the laboratory. Then the very young embryo, zygote is transferred to the fallopian tube.
- Gamete intra fallopian transfer (GIFT) This involves transferring the sperm and eggs which are just mixed together before being inserted and with luck one of the eggs will become fertilized inside the fallopian tubes. Fertilization occurs in the woman’s body.
- Intra cytoplasmic sperm injection (ICSI) This is often used for couples with male factor infertility. In ICSI, a single sperm is injected into a mature egg to achieve fertilization. The fertilized egg (embryo) is then transferred to the woman’s uterus.
What Is IVF? How Much Does IVF Treatment Costs?
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In Vitro Fertilization (IVF) is getting highly popular in India because of the increasing rate of infertility. According to studies, in India, there are almost 22-33 million couples suffering from prolonged infertility during the reproductive age.
Earlier, if a couple couldn’t conceive a baby, people would blame the woman. But progress in science show that the male counterpart can be equally infertile. As per different studies on infertility rates and ratios, the female factor contributes to 40%-50% whereas the male factor accounts for 30%-40%. The male infertility is increasing at an alarming rate.
In Vitro Fertilization or IVF is referred as ART or Assisted Reproductive Technology. This is a process of fertilization of human egg and sperm by artificial means. IVF is comprised of extraction of eggs from the female counterpart and collection of sperm sample from the male counterpart. Then the egg and the sperm fertilize in a laboratory. When the embryo starts forming, the doctor transfers it to the womb of the female.
This treatment can be done by using the eggs and sperms of the couple as well as using donor’s egg/sperm. If the couple or anyone of them cannot produce healthy egg/sperm, then the doctor prescribe to use donated egg/sperms for the fertilization process. Cost of IVF treatment increases if you have to use donated embryos.
Your doctor might recommend IVF for you if –
- There are unexplained infertility issues with you or your partner.
- Blockage in the fallopian tubes of the women due to certain health problems or any other reasons.
- If IUI or any fertility drugs cannot help you conceive.
- Fertility problem in the male partner.
- IUI is not suitable for you but you have to use the frozen sperms of your partner or donor.
- You have to use donor’s egg or frozen eggs of your own.
- You don’t want to pass any genetic health issue to your child and you are considering embryo testing for the same reason.
- There is ovulation problems in the woman or ovarian failure, fibroids in the uterus etc.
- Removal of the fallopian tubes due to certain problems.
- Women with PCOS or polycystic ovary syndrome can opt for this process as many of them face issues with fertility.
- Women who have endometriosis.
Who shouldn’t opt for IVF treatment?
It is as vital as to know who is ideal for this procedure. It is not for every couple who cannot conceive. As cost of IVF treatment is comparatively a hefty amount, you should also take this into account while considering IVF.
- If a couple cannot produce healthy sperm or egg, they have to use donated eggs/sperms. But if they don’t want to use the same, there is only a fraction chance of success of IVF treatment.
- The age plays a major role in IVF treatment. If the female partner is over the age of 35 then the chances are less for getting success from IVF.
- Cost of IVF treatment might also increase with an increase in the age as the risk factors also increases. You will also require a higher number of embryos.
The process of IVF treatment is dependent on the individual circumstances as everyone has different issues and problems. It also varies according to the clinics and the doctor’s vision. You should discuss with the doctor about the complete process which is suitable for you and your partner.
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Before starting the IVF treatment:
- You have to give the consent to the doctor to proceed with the tests and finally the IVF procedure.
- There are certain tests which you and your partner may have to undergo. Both the partners will have to undergo tests for HIV, hepatitis B, C along with human T-cell lymphotropic virus both I and II.
- The doctor might also recommend an ultrasound to detect any problem with the ovaries and fallopian tubes or the uterus.
Steps of IVF treatment:
The natural monthly hormonal cycle is suppressed –
For about two weeks, your doctor will give you a nasal spray or injections so as to suppress the natural cycles of hormones. You have to do this step by yourself or you can have an attendant for injecting you the medicine.
Egg supply has to be increased –
So as to get better results from IVF treatment, your egg supply has to boost. After suppressing the natural hormonal cycle of your body, the doctor will give you fertility drug. This is in injection form which you need to take for 12-14 days continuously. Hence, will boost your egg production.
Monitoring the progress –
The fertility clinic and the doctor will be monitoring your progress after you start taking the drugs and the injections. They will do ultrasounds and blood tests to monitor your progress. So as to help the egg/s mature, you will inject you with hormonal drug. This happens just 34-38 hours before the collection of your egg/s.
Egg/s collection –
The doctor collects the eggs with the help of ultrasound technique. During this process of collection of eggs, the doctor might give you sedatives. From the follicles of each ovary, the doctor will collect the eggs with the help of hollow needle. The needle will be attached to the ultrasound probe.
There might be little pain or bleeding from the vagina. You might also feel cramps but these are temporary and you can have medicine for the same.
After the collection of eggs, you will be provided with medicines in the form of injections. This will help your womb to form the lining for accepting the embryo.
Sperm Collection –
The doctor collects the egg/s from the female partner. Male partner produces the sample of his sperm. Then the doctor washes the sperm to separate the fast moving and healthy sperms from the poor quality ones. In case if the doctor uses frozen sperms, then they take it out of the refrigeration unit and prepares accordingly.
The doctor mixes the egg/s and the sperm and keeps for culturing process in the laboratory. Then after 16-20 hours the doctor checks the mixture to monitor the signs of fertilization if any.
If any of the egg/s fertilizes and forms as an embryo, the doctor will place it in an incubator. They will keep it in the laboratory for next 6 days for developments or growth.
After the embryologist is satisfied with the growth of the embryo/s. They will choose the best one from them. They will then prepare it for the transfer.
Transfer of Embryos
- Doctor/s transfer a maximum of 3 embryos to the IVF candidate with an age over 40. For the candidates under 40 years, doctors normally transfer 1-2 embryos.
- So as to make the cervix visible, doctor inserts a speculum into the vagina. A really fine catheter, one which is like a tube will be connected to the cervix with ultrasound method. Through the catheter, the doctor transfers the embryo/s to the uterus/womb.
- This procedure is painless.
- After the embryo transfer, the doctor will monitor the growth of the embryo in the womb and accordingly prescribe medicines. As this is an artificial process, you need to take extra care.
- Doctor advises periodic ultrasound and blood tests.
Before opting for the procedure, your clinic will inform you about all the possibilities and risks factors associated with IVF treatment. You should also cross-check with few other doctors to be safe from any misinterpretation or misunderstanding of your condition. There are certain risks which go hand in hand with this process, which are given below:
- Reaction to fertility drugs – You might experience certain temporary reactions which are normally mild in nature. There might be hot flushes along with irritation or depression symptoms. Restlessness and headaches might also disturb you.
- Ovarian hyperstimulation syndrome – The ovaries may become over sensitive due to the fertility drugs. This might cause nausea, vomiting, stomach pains and swelling of the stomach.
- Miscarriage – The risk of miscarriage is similar to normal conception. You should always take care. Also, your doctor should always monitor to prevent miscarriage.
- Multiple Births – This is a risk which is there in any artificial fertilization process. This might be happy news for few but it is completely dependent on your body. If your body doesn’t have the capacity to hold twins, then the babies will be at risk and so are you.
IVF treatment cost in India
The cost of IVF treatment also varies according to the fertility clinics and the city you are residing. The average cost of IVF in India is within a range of INR 100000 to INR 120000. Couples usually pay over 2 lakhs for the treatment. This is a price which includes other tests, medicines and related procedures for attaining better results out of IVF treatment.
In the metropolitan cities like in –
- The IVF treatment cost in Mumbai is around a hefty amount of INR 2 lacs and above.
- IVF cost in India Chennai within INR 1.45-1.6 lacs.
- IVF cost in India Delhi is around INR 90 thousand to 1.25 lacs.
- Kolkata, the IVF treatment cost is nearly 1 to 1.2 lacs.
- The IVF treatment cost in Pune fertility clinics ranges between INR 1 to 1.2 lacs.
- The IVF cost in India Bangalore is nearly INR 1.6 to 1.75 lacs.
If the IVF candidate requires donated eggs/sperms then the cost of donated sperm is around INR 20000. This is why cost of IVF treatment varies according to the condition of the candidate also.
The cost with donated eggs will be much higher as donated eggs will only cost you around INR 50 thousand.
The IVF cost in India also increases substantially, if the IVF candidates require donated embryos. This is done for the couples who have serious issues related to reproductive health.
The cost of IVF treatment in India might include the cost of frozen embryos if required. The IVF price will then increase.
To check and compare the cost of IVF Treatment in your nearby clinic and hospitals Click Here. Fill up the following form on the website and get the service at affordable prices.
Chances of Success
The chances of success vary according to the age of the candidate. If the age of the woman partner is under 35 years, the chances of conceiving with IVF treatment are around 32.2%. However, this percentage gradually decreases with an increase in the age. For women over the age of 40, the chances are 13% to 5%. If you have crossed the age of 45, the chance is only a mere 1.9%.
India is one of the best places for medical tourism. The prices and the charges for various medical treatments provided in India are way less than the rest of the world. India being one of the best places for treating infertility, cost is lower than many countries across the globe. Comparing to the western nations, the average cost of IVF in India is extremely reasonable. Couples from the neighboring countries, who are reproductively challenged, often choose India over any other countries for infertility treatment.
IVF price varies according to the type of IVF process you are opting for. If you are using a donor, then the cost of IVF treatment will shoot up accordingly.