Monthly Archives: Октябрь, 2022

Early menopause or «premature ovarian insufficiency» describes a condition where the function of the ovaries is reduced and they produce mature oocytes significantly less often than normally (every month). The term “premature ovarian insufficiency” is used when the woman is under 40. The important thing in this case is that, although more difficult, getting pregnant is possible.

CAN IN VITRO FERTILIZATION CAUSE EARLY MENOPAUSE?

 There are myths that the treatment of infertility by in vitro fertilization causes a serious side effect — early menopause. These perceptions are due to the fact that controlled ovarian hyperstimulation (COHS) aims at the maturation of 10-20 follicles, instead of 1-2, as in a normal menstrual cycle, thus hypothetically reducing the ovarian reserve.

 The truth is that during a normal menstrual cycle (one without COHS), approximately 10-20 follicles begin to mature in a woman’s ovaries but only 1-2 reach ovulation . The rest are simply absorbed by the body.

 Another reason for the early menopause myth are some side effects caused by fertility medications: fluid retention, mood swings, hot flashes, headache. These unpleasant sensations largely resemble the symptoms of menopause, but disappear after finishing your fertility treatment.

 In conclusion, no, IVF does not cause early menopause. On the contrary, it is an opportunity for women suffering from this problem to become mothers.

TREATMENT OPTIONS

Premature ovarian insufficiency can have many causes. Depending on your diagnosis, your obstetrician-gynecologist will inform you about the possible solutions in your case.

If you are undergoing cancer treatment, we advise you to freeze your eggs before the treatment begins. According to the Center for Assisted Reproduction’s new regulations, the state will now finance egg freezing for cancer patients. The reason is that frozen eggs can be stored for years and their quality corresponds to your age at the time of freezing. In other words, they are of better quality, not only because they have not been exposed to the toxic effects of chemo- or radiation therapy, but also because of their younger biological age.

If your obstetrician-gynecologist decides that you can try IVF with your own eggs, it must be taken into account that when the ovarian reserve is exhausted, both the number and the quality of the eggs are  reduced.

There are other options for conception, such as using donor eggs. You can use an egg  from an anonymous donor or from a relative. New Life Medical Center has a donor egg program. We work with one of the largest donor egg banks in Europe to offer you more opportunities to make your dream come true.

If you’re keen to start planning your family, it’s a good idea to check your ovarian reserve. Anti-Mullerian hormone (AMH) is considered the most objective hormonal indicator of ovarian reserve. The test can be done in any laboratory, on any day of your menstrual cycle.

If you think that you might be at risk of premature ovarian failure, we recommend that you schedule an appointment with a reproductive specialist.

There is no identical answer for how long the process of trying to conceive should take, as the path for each of us is different.

Statistics show that approximately one in seven couples may have difficulty trying to conceive. Whether it’s a question of blocked tubes, polycystic ovaries, a bad sperm test result, endometriosis, or an unexplained infertility factor, the struggles every couple goes through are something that’s still rarely talked about. Although there may be a number of reasons why they keep their experiences secret, knowing what to expect can help patients in the overall process of choosing a clinic, doctor and the most appropriate treatment method.

Fertility evaluation is essential to determine the cause of infertility and choose the best course of treatment and assisted reproduction technique. In the following lines, we will pay attention to the main reasons related to the male and female factor of infertility, as well as when we should contact a reproductive specialist.

About a 1/3 of infertility cases are related to the so-called female factor. The reasons why a woman cannot conceive spontaneously are numerous, as the treatment is different depending on the specific case.

Some of them are:

DISORDERS IN OVULATION

Ovulation disorders are observed in nearly 40% of women suffering from infertility. Among them, polycystic ovary syndrome and prematurely exhausted ovarian reserve are the most common.

ENDOMETRIOSIS AND THE ACCESSORY OF FALLOPIAN TUBE

Obstruction of the fallopian tubes can be due to endometriosis, past sexually transmitted infections or surgical interventions. It prevents fertilization, as well as the movement of the embryo to the uterine cavity (implantation). One of the mandatory tests in the diagnosis of infertility is the hysterosalpingography — a procedure assessing the patency of the fallopian tubes. Endometriosis is the growth of endometrial tissue (i.e. the lining) in places outside the uterine cavity (uterine musculature, ovaries, tubes, internal sex organs, fallopian tubes and other organs). In the case where the endometriosis is in the tubes, this leads to the formation of adhesions that can block the fallopian tubes and prevent the sperm from reaching the egg and fertilization from taking place. Endometriosis is estimated to occur in 8-15% of the female population of childbearing age.

STRUCTURAL ABNORMALITIES

A large part of the congenital structural anomalies is asymptomatic and are discovered incidentally, when searching for the cause of an irregular cycle, prophylactic examination, infertility or spontaneous abortion. This group includes various congenital anomalies in the shape of the uterus — unicornuate, bicornuate uterus, double uterus, septum (partial or complete partition in the uterine cavity), etc. This includes adhesions that are the result of infections, trauma or surgical interventions that can disrupt implantation, leading to reproductive problems.

CAUSES OF FAILURE OF GETTING PREGNANT ARE NOT JUST A WOMAN’S PROBLEM

Male factor of infertility, which is about 50% of cases of infertility in a couple, can be due to a number of causes that include genetic factors, past illnesses, trauma, medications, and general aspects of health and lifestyle. These factors can contribute to problems related to spermatogenesis or sperm release. Regardless of the reasons, their diagnosis begins with an examination by a urologist. After taking a detailed history of past illnesses, infections, especially in childhood, operations, etc., as well as the current objective condition, the necessary tests and laboratory tests are prescribed.

A basic and indicative study is the SPERMOGRAM, which in most cases can give the diagnosis of male infertility. In the standard sperm analysis, four main parameters are examined — volume, concentration (of spermatozoa in seminal fluid in mil/ml), motility (of spermatozoa in percentage), morphology (of spermatozoa in percentage). The reference values ​​of the World Health Organization (WHO) and the Kruger criterion for morphology are used in determining the conclusion. The extended spermogram differs from the ordinary one in that it includes an additional more detailed analysis and evaluation of the morphology of the spermatozoa. In order for the spermogram to be accurate, the man must have 3-5 days of sexual abstinence, no alcohol during these days and no antibiotics in the last month.

REPRODUCTIVE SPECIALIST — WHEN?

With regular sexual intercourse, without protection, if pregnancy does not occur:

For women under 36 years old — up to 1 year

For women over 36 years old – up to 6 months

The path of one dream to become a reality is always different, but you should never lose faith in achieving it!

Source : Apteki Zapad

POLYCYSTIC OVARY SYNDROME AND IVF

Intrauterine insemination (IUI) is one of the first assisted reproductive techniques offered to couples diagnosed with infertility. The procedure is quick, discomfort is minimal and the cost is lower compared to  in vitro fertilization (IVF)

WHAT IS THE PROCEDURE LIKE?

 During IUI, sperm, which have been separated from the seminal fluid, are injected into the uterine cavity using a thin catheter. After normal intercourse, nearly 90% of the ejaculated sperm die in the vagina. The goal of IUI is to get as many sperm as possible to reach the egg, thus increasing the chances of fertilization.

 IUI can be performed with both partner and donor sperm. Before proceeding with insemination, the patient’s ovulation is monitored by ultrasound and by examining the levels of LH and estradiol on certain days of the menstrual cycle. Additionally, it is possible, but not necessary, to stimulate ovulation with medication such as clomiphene.

Sperm remain viable in the female reproductive system for up to 5 days. The egg can be fertilized up to 24 hours after ovulation. Therefore, the best time to perform the insemination is about 12-24 hours before the woman has ovulated.

 The procedure itself lasts 5-10 minutes. The patient sits in a gynecological exam chair. The sperm are injected through a very thin sterile catheter, after which the woman rests for about 30 minutes. Discomfort is minimal, with some comparing the feeling to a pap smear.

WHAT TO EXPECT AFTER IUI?

 Most women feel completely normal after intrauterine insemination. Mild abdominal cramping is possible. You can return to your normal lifestyle as long as you feel well.

 If you develop a fever or notice vaginal discharge, contact your treating obstetrician-gynecologist. Two weeks after the procedure, you can take a home pregnancy test, the result of which will be confirmed with a blood test.

WHO IS A SUITABLE CANDIDATE FOR IUI?

Couples who can benefit from IUI are:

Couples with male factor infertility

Unexplained infertility

Presence of antisperm antibodies produced by either partner

Couples with a negative postcoital test

IUI with donor sperm is suitable for:

 Women in LGBTQ relationships or those without a partner

Couples in which the man is diagnosed with azoospermia

Couples in which the man is a carrier of genetic mutations with a high risk of transmission to the offspring

 A mandatory condition is that the woman has no fallopian tube obstructions and responds to ovulation stimulation. The success of the procedure is age-related and is generally not recommended for women over 40.

 To find out if intrauterine insemination is the right approach for you, you can make an appointment for an examination with our reproductive specialists. They will order the necessary tests and create a plan tailored to your case.

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