Infertility is commonly defined as failure to conceive following one year of unprotected sexual intercourse, however this is not a complete definition because infertility is a very wide term and it covers the problems with Male and Female both. There are a number of factors that can contribute to an individual or couple’s inability to conceive. It is very important for the doctor to take into consideration a step-by-step approach for investigating the cause of infertility.
What to expect from a fertility Evaluation Process?
Secondary infertility is the inability to become pregnant or to carry a baby to term after previously giving birth to a baby. Secondary infertility shares many of the same causes of primary infertility.
What are the possible causes for Secondary Infertility?
Having a child after marriage is one of the finest gifts of nature to a couple willing to have family. It is painful for someone wanting a child and not being able to reproduce due to infertility but the IVF-ICSI is another great invention of medical science facilitating in birth of a child.
So, couple willing to have family can achieve the goal either through natural process of through ART (Assisted Reproductive Technology) once they have become parents, what will happen to the remaining Embryos? Medical science gives you an opportunity to donate your embryos in-turn you become a reason to bring smile on someone not having a child yet willing to have one.
What is an Embryo?
Embryo is an unborn human offspring still in the process of development awaiting to take a human form. In simple words life developed inside the womb in a time duration of second to eighth week after fertilization. (In medical terms after eighth week word foetus is used for the life growing inside mother’s womb).
What is Embryo donation?
Embryo donation is an option that is open to IVF patients who have embryos that they do not wish to use themselves. They can donate or make their embryos available to other couples who are attempting pregnancy. In this process as first step a woman must consult with her IVF-ICSI specialist to confirm that she is able to physically proceed through embryo donation and carry a baby to term. Physically, the embryo donation process is similar to proceeding through the second half of an IVF cycle (no egg stimulation is necessary).
Intrauterine Insemination (IUI) is the simplest method of facilitating fertilization. Insemination is a fertility treatment procedure that involves insertion of specially selected sperms inside a woman’s uterine cavity for assisted reproduction. The core objective of giving an IUI treatment is to increase the number of sperms that reaches the fallopian tube and subsequently increases the chances of fertilization. Since the deliberately chosen healthy sperm are directly put inside the uterus, the sperms get an artificial head start to meet the eggs.
IVF (In-Vitro Fertilization) is a process of fertilization where an egg is combined with sperm outside the body in a Vitro (Test Tube, that is why in common world the method is known as test tube baby technique). It’s one of the most widely known types of Assisted Reproductive Technology (ART). IVF works by using a combination of medicines and surgical procedures to help sperm fertilize an egg and help the fertilized egg implant in your uterus. The process involves monitoring and stimulating a woman’s ovulatory process, removing an ovum or ova from the woman’s ovaries and letting sperm fertilize them in a liquid in a laboratory.
What is ICSI treatment?
Infertility is a problem, that can happen to the male as well as female partner. In rare cases it can be with the couple itself (meaning there by that both the partners are infertile to some extent) so ICSI treatment takes place if male partner is having a fertility issue.
If male partner has been diagnosed with infertility problems such as a low sperm count or an inability for the sperm to penetrate the egg, conventional IVF is unlikely to result in fertilisation. This is the condition when Intracytoplasmic Sperm Injection (ICSI Treatment) is recommended. ICSI can also be used if the male partner has previously had a vasectomy.
Common Reasons for Male Infertility are as follows
The process involves injection of a single sperm into each egg, using very fine micromanipulation equipment. As the human egg is one tenth of a millimetre in diameter and the sperm 100 times smaller, this is a very delicate procedure performed by highly skilled embryologists under a microscope.
Why Sperm Retrieval?
Sperms retrieval method is adopted when pregnancy is the goal, but the male partner has infertility problems and he cannot help the female partner in getting conceived through natural intercourse. It is for men who have little or no sperm in the semen, or men who aren’t able to ejaculate properly. In these cases, sperm can be collected from other parts of the reproductive tract. For good pregnancy rates, sperm retrieval is used with In Vitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI)
As mentioned above the sperms can be retrieved through any of the procedure viz. TESA, PESA, TESE and MESA. Each procedure has its own utility and is specifically used.
TESA (Testicular Sperm Aspiration) is performed by inserting a needle in the testis and aspirating fluid and tissue with negative pressure. Whereas TESE (Testicular Sperm Extraction) is a surgical biopsy of the testis. The aspirated tissue is then processed in the embryology laboratory and the sperm cells extracted are used for ICSI.
PESA (Percutaneous Epididymal Sperm Aspiration) does not require a surgical incision. A small needle is passed directly into the head of the epididymis through the scrotal skin and fluid is aspirated. The embryologist retrieves the sperm cells from the fluid and prepares them for ICSI.
MESA (Microsurgical Epididymal Sperm Aspiration) is used in conditions like obstructive azoospermia, involves dissection of the epididymis under the operating microscope and incision of a single tubule. Fluid spills from the Epididymal tubule and pools in the Epididymal bed. This pooled fluid is then aspirated. Because the epididymis is richly vascularized, this technique invariably leads to contamination by blood cells that may affect sperm fertilizing capacity in vitro.