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Female Infertility::
Ovulation Induction (OI)
This
is the treatment of women who do not ovulate with medication to help
them produce eggs.
Artificial Insemination (Intrauterine
Insemination – IUI)
This
is the simplest assisted conception treatment. It essentially
involves the insertion of prepared partner’s sperm into the uterine
cavity close to the time of ovulation. The ovaries are stimulated
with hormone tablets (clomiphene) and injections (gonadotrophins, eg.
follicle stimulation hormone – FSH) to develop a few follicles to
increase the chances of success.
This treatment is only appropriate for couples where the male
partner has a normal sperm count and motility (or when there is a
mild abnormality) and the female partner has patent Fallopian tubes.
It is usually the first treatment for couples with unexplained
infertility, or a slightly low sperm count.
There is a regime of administering FSH injections on alternate days,
starting on day 2 then day 4, 6 and day 8.
The response to stimulation varies from person to person and so the
dose of FSH is adjusted according to response. Your Consultant will work out your treatment plan and will go through it with you. |
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Invitro Fertilisation (IVF)
This is the fertilisation of human
eggs in the laboratory after culturing them with partner’s sperm.
IVF was developed to assist couples with blocked or absent Fallopian
tubes, who cannot conceive. The gametes are approximated outside the
body (in-vitro), and embryos are placed in the uterine cavity to
allow implantation to occur.
After the egg collection, eggs are then placed in
a culture dish and prepared partner’s sperm is added. The eggs are
placed in a special incubator and examined after 18-20 hours to
confirm fertilisation. Usually 70% of the eggs fertilise in IVF. A
complete fertilisation failure occurs in 5% or so of IVF cycles and
usually due to sperm function defect, which cannot be detected prior
to IVF. For these couples, microinjection (ICSI) is performed on the eggs. This is usually performed in the subsequent treatment cycle, whereby a single sperm is directly injected into the
egg. Commonly, 3 or 4 embryos are transferred into the uterus and this is because human embryos have a 15% implantation potential. To achieve a pregnancy rate of 30%, up to three embryos
are usually required. Multiple implantation and multiple pregnancies occur because science is still unable to determine which embryos will implant. Certain factors such as previous
pregnancies, age and quality of embryos are used to decide on the number of embryos to transfer.
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Gamete Intra
Fallopian Transfer (GIFT)
This procedure involves the collection of mature eggs
from the ovarian follicles and placing them together with prepared
partner’s sperm into the Fallopian tubes. This procedure mimics
nature as the gametes (sperms and eggs) fertilise in the outer
portion of the tubes. Its success depends on the functional
normality of the tubes, and quality of sperm
GIFT is indicated for couples with unexplained infertility, who have
proven fertility, either from a previous pregnancy or from normal
fertilisation in IVF. It can be offered as a primary procedure for
couples undergoing their first IVF treatment, if the Fallopian tubes
are patent. It allows the placement of gametes in the tube and with
a 35% chance of conception. Any eggs not transferred can be
inseminated for IVF and the embryos frozen for later use. |
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Laser Assisted Embryo Hatching
This has recently ben introduced at the DG&FC. It
will help patients with repeated failure with IVF or ICSI. A laser
beam is used to “shave off” a portion of embryo or shell.
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