Infertility is a relatively common condition affecting one in 6 couples. Despite this, it remains a taboo. It affects the couple psychologically, economically and socially. They avoid meeting people as “children” will be a topic of conversation. Everybody you meet wants to suggest options. Seeing an infertility clinic is one of them. With the word “infertility clinic” many couples freak out.
‘Smoking is injurious to health’. This applies to reproductive health as well. Passive smoking is equally harmful, but not many women are aware of this. One survey of female hospital employees found that less than 1 in 4 knew that smoking could hurt their fertility or increase the risk of miscarriage.
Infertility can affect women of any age and from any background. In fact, approximately one out of every seven couples trying to conceive today experience difficulties with infertility. The Centers for Disease Control and Prevention (CDC) reports that 12 percent of women in the U.S. ages 15 to 44 have difficulty getting pregnant or carrying a pregnancy to term. That’s nearly one in five women in the U.S. So it’s likely that you know someone struggling with infertility, whether they choose to share it or not.
IVF (In-vitro fertilization) or test tube baby as it is commonly called is a procedure in which the eggs and the sperms are fertilized outside the body and then transferred back to the womb after 2-5 days.
Step 1: Once you have decided to go ahead with IVF, you will undergo a daycare procedure called hysteroscopy to assess the suitability of the uterus to hold the baby. It is generally done one month before your IVF cycle and involves the introduction of a small camera into the womb through the vagina to visualize the inside of the uterus. You will be given anesthesia during the procedure and hence there will be no pain.
Step 2: Your husband has to freeze one semen sample as a backup.
Step 3: Typically your treatment would begin on the second or third day of periods. It involves a scan and hormone tests followed by daily injections for about 8-10 days, along with monitoring by scan and hormone tests in between. Once the eggs are sufficiently grown as per the scan and hormone tests, you will receive injection Hcg as an ovulation trigger.
Step 4: Egg retrieval is performed transvaginally 35 – 36 hours later, with light anesthesia, using transvaginal ultrasound guidance. You will be discharged the same evening unless there are problems associated with bleeding, undue pain or ovarian hyperstimulation.
Step 5: After retrieval, eggs are assessed for their maturity. Meanwhile, the husband has to give a fresh semen sample. Mature eggs are injected with the sperms on the same day and grown in the incubator for 3-5 days.
Step 6: The final step is the embryo transfer. 3-5 days after your egg retrieval, two or three embryos are selected and gently transferred into the womb using abdominal ultrasound guidance. The procedure is usually painless, no anesthesia is required and you will be discharged in about two to three hours.
Step 7: You will be given certain supportive medications starting from the day of egg retrieval until your pregnancy check. You will be called for a pregnancy check 16-17 days after your embryo transfer.
It is done 3-5 days following the egg retrieval, which will be decided by your clinician. No anesthesia is required as it is a painless procedure. Rarely during your initial assessment, if it is found that getting into the uterus is difficult or if you are very uncooperative, you may be given light anesthesia. Your bladder has to be full before the procedure as it is done under abdominal scan guidance. Do not wear perfume/ deodorant or powder on that day as they are harmful to the embryos. Two or Three embryos are gently transferred to the uterus using a small catheter. You will lie down for about 15 – 30 minutes after the procedure and later you can pass urine. No need to take bed rest until your pregnancy check. This does not increase your chances of becoming pregnant.
ICSI – Intracytoplasmic Sperm Injection, is an IVF procedure in which a single sperm is injected directly into an egg whereas in IVF, about 50,000 to 1,00,000 sperms are inseminated around the eggs and one of them penetrates the egg on its own. ICSI increases the fertilization rates especially in male factor infertility and cases of previous fertilization failure.
The success rate varies with multiple factors especially the age of the women, egg and the sperm quality and the underlying cause of infertility. Overall the success varies between 40-50 %. Success decreases as the age of the woman increases.
Surplus embryos after your transfer can be frozen and kept in liquid nitrogen at -180 degree Celsius, for later use.
You will be tested for beta HCG – a blood test to confirm pregnancy 14 to 16 days after your embryo transfer.
There is no evidence to show that IVF babies have an increased rate of abnormalities. The pregnancy outcome will be like a normal conception but your doctor may have a low threshold for intervention when the problem arises.
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Most couples experience the struggle in much the same way. This is related to the traditional ways men and women have been trained to think, feel and act. Women are typically seen, by others as well as themselves, as the emotional caretakers or providers of the relationship.
Women typically feel responsible not only for everyone’s bad feelings but also for anything bad that happens. When women try to repress feelings, their emotions can become more ominous until they finally feel out of control. Their emotions can become a monster about to swallow them whole.
Women in infertile couples often protect their husbands from their own pain and feelings of failure by taking much of the responsibility for the treatments upon themselves. When it is suggested that men accompany their wives for appointments, couples get concerned about issues like income loss, use of time, etc. While these concerns are usually relevant and important, they also serve the purpose of protecting husbands from their own responsibility in the conception process and from their own feelings, which could easily be intensified by so much contact with the medical process.
Men are traditionally seen as the financial providers of the relationship and are responsible for protecting the family from real or imagined dangers. Men usually feel more threatened expressing themselves since they have often been conditioned to repress their emotions. They are trained to be more instructional to take charge, to make decisions and to think without being sidetracked by emotions.
Males in infertile couples often feel overwhelmed by the intensity of their partner’s emotions as well as an inability to access their own. They tend to focus their energy back into their work, a place where they feel they can have more success.
As a result of taking responsibility for the emotional impact of infertility, the woman experiences intense feelings, such as pain, anger, fear, etc., which, combined with the messages that her way of dealing with things is in some way dysfunctional or “crazy”, causes her to feel an anxious depression. As feelings spill out, she feels out of control and doesn’t really know how to ask for what she needs, especially from the husband she is struggling so hard to protect. She may yearn for an emotional connection/interaction at one moment and in the next withdraw emotionally from her husband when she fears she has disappointed him.
Men find themselves in a position where, regardless of how well they’ve been trained to solve problems, they are helpless to make this situation better for the woman and, as a result, may give off messages that she is “too” emotional or sensitive, hoping that this will calm her down. The wife hears this as a criticism of her coping and caretaking skills rather than as an expression of her husband’s fears.
This is the time when couples cling together for dear life, feeling that they’ve failed in the most basic of all roles: reproduction. Couples are hesitant to admit problems in their marriage, feeling that having difficulty coping would mean that their marriage is also a failure.
Luckily, there are ways that men and women can help each other balance thinking and feeling as they struggle side by side on their journey toward parenthood.
Seeing an Infertility doctor does not mean you have to do an IVF
The questions then arise:
As pregnancy hormones increase the blood supply to your breasts, you may feel a tingling sensation around your nipples.
This can be one of the earliest symptoms of pregnancy and is sometimes noticeable within a week or so of conception. Once your body gets used to the hormone surge, this sensation will subside.
