Men's Articles

Visiting A Fertility Clinic For First Time

So you've been married a few years and trying for a baby without success. Perhaps something is wrong with one, or both of you. To get answers, you need a doctor. It is easy to get to see a doctor who specialises in fertility issues. One can call a fertility clinic directly for an appointment.

The specialist will then run a few tests to determine the problem before recommending treatment. All clinics may vary slightly but in general the same areas are investigated. On the first visit, the doctor will do a physical examination and talk to the couple to obtain a detailed medical history, including the woman's menstrual history, past illnesses and surgeries and any previous fertility treatment.

Ideally, both husband and wife should make this visit. The husband needs to give blood and semen samples for analysis. Two blood samples are taken from the woman, the first during the menstrual period and another 20 to 22 days later. This is to determine her hormone levels at different points of her cycle.

If the blood tests indicate the woman is not ovulating, that is, her ovaries are not releasing eggs, fertility pills maybe prescribed. If the man has a low sperm count or poor sperm quality, he will be examined to determine the cause. He may need to visit a urologist. If the blood and sperm analyses do not show any abnormalities, the next step is to check the tuning of ovulation.

This is usually done with an ultrasound scan of the ovaries on the 12th day of the menstrual cycle. The doctor will determine when ovulation is likely to occur and the couple should have intercourse on that day. The next day, the clinic will do a second ultrasound scan to check if ovulation had occurred. Then a drop of mucus from the woman's cervix is taken for a post-coital test.

The sample is put under a microscope to observe the interaction of the husband's sperm with the mucus. This procedure may be repeated, especially for couples who have never undergone fertility testing before. If the woman is unable for some reason to visit the clinic, the doctor may allow her to use a kit to test her own urine and determine the timing of the ovulation. However, the self-test kit is not as reliable as an ultrasound scan.

If the post-coital test does not indicate any abnormality and the woman is still not getting pregnant even though sex is being rimed to coincide with ovulation, the next step is an hysterosalpingogram (HSG). A tube is inserted into the uterus, a dye injected and an X-ray shows up any blockages in the woman's uterus and fallopian tubes.

If there are blockages and they are the type that can be removed, the next step would be an operation to correct the problem. If the woman has had past infections and surgeries or the doctor has strong reason to suspect she may have scars and other problems with her uterus and tubes, he may order a laparoscopy instead.

This is a minor operation done under general anesthetic in which a small cut is made at the patient's navel and a fibre optic - telescope passed through. The procedure allows the doctor to examine the uterus and tubes as well as take some corrective measures, such as removing scars.

If the husband's sperm count is low or the quality is poor, the doctor may resort to intra-iderine insemination (IUI). The sperm is collected, the best ones selected and concentrated, then artificially inseminated deep in the uterus so they have a shorter distance to travel before reaching the egg.

IUI may also be tried if the couple is unable to have satisfactory intercourse for various reasons, or if the woman has problems with her cervix so the sperm is unable to survive after intercourse. If all else fails, or if the woman has blocked tubes that. cannot be repaired, or if the reason for infertility cannot be determined, the last resort is in-vitro fertilization (IVF).

This is the method in which the wife's eggs are harvested, the husband's sperm collected, fertilization occurs in a laboratory and the resulting embryo is transferred into the uterus. The woman has to administer daily self-injections of drugs to stimulate the development of more than one egg in a cycle so that they can be harvested.

Fulfill Your Dreams To Be Parents

As a married couple, it is only natural to have dreams of parenthood, of starting a family. But sometimes, couples may just need a little help in adding the happy pitter-patter of little feet in the house. Read on to find out which of these treatment techniques are more suited to your needs:

Ovulation Induction By Genadotrophins (OIC)

In a natural cycle, only one egg develops. In fertility treatment, to increase the chance of being successful, daily hormone injections are given to make several eggs develop in the ovaries. Each egg develops in a little sac called a follicle. The development and growth of the follicles are monitored by ultrasound scanning of the ovaries, and blood tests to measure the female hormone levels. When the follicles have reached their target size, a further single hormone injection is given to induce the final maturation of the eggs, which takes place about 36 hours later.

Intra Uterine Insemination (IUI)

This treatment is suited for couples who have problems conceiving despite the female having no obvious fertility problems and the male having reasonable sperm numbers, movement and shape. IUI is a process where we introduce a quantity of washed and concentrated sperm into the wife's womb. This is done during the time when eggs are released from the ovaries (ovulation) in order to increase the chance of pregnancy. The best IUI results can be achieved when insemination is coupled with ovulation induced by fertility hormones.

In-Vitro Fertilisation (IVF)

Commonly referred to as the 'test-tube baby' program, this treatment has helped many childless couples conceive after the first test-tube baby was born in 1977. IVF involves the removal of eggs from the ovaries of the wife and mixing the husband's sperm with the eggs outside the body in the laboratory. The objective of this procedure is to allow one sperm to enter one egg to produce an embryo.

One to three embryos will then be placed into the wife's womb, usually two to three days later, in a process known as embryo transfer (ET). These embryos will then attach or implant themselves to the inner lining of the uterus, called the endometrium, and develop into one to three babies.

Intra Cytoplasmic Sperm Injection (ICSI)

ICSI is recommended for patients with low sperm count, poor sperm quality or have difficulties with fertilisation in the past. This is a process where a single sperm is injected directly into the centre of an egg to assist in fertilisation. After fertilisation, the fertilised eggs (embryos) are monitored for a few days before they are transferred back to the womb.

Embryo And Sperm Freezing (Cryopreservation)

Freezing is a procedure in which sperms or embryos are subjected to extreme cold temperature (-196°C). The purpose of freezing sperms and embryos is to store them for future use. The frozen embryos and sperms can be stored for a long time (between five to 10 years).

Microsurgical Epididymal Sperm Aspiration (MESA)

This treatment is offered to patients who have no sperm in the ejaculate. The male patient will undergo general anaesthesia. During this procedure, under an operating microscope, sperm is aspirated from the epididymis (fine tubes in the testes) by a very fine tip. If sperms are found, they are processed using the ICSI technique or frozen for future ICSI.

Frozen Embryo Transfer

Excess good quality embryos that are frozen can be thawed and transferred into the respective patients' wombs. Patients do not need to undergo egg recovery again. The time of transfer is monitored closely by ultrasound scanning. Blood tests may also be necessary. There is no maximum limit of embryos that can be frozen, but only up to three embryos can be transferred as in an in-vitro fertilisation (IVF) cycle. The frozen embryo transfer is exactly the same as for fresh embryo transfer.


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