Can’t get pregnant? These fertility treatments can come to your rescue
The road to parenthood isn’t the same for every couple. Some might find success in the form of conception right from the get-go, while for others it might take years and medical intervention.
If you too have been facing obstacles in your journey to get pregnant, then it is important to know about the many fertility treatments that can help you start a family. That’s why we have enlisted the help of Dr. Rupa K.S—who is a fertility specialist with over 15 years of experience and the medical director of Reach Fertility Clinic in Bengaluru—to decode the different assisted reproductive techniques that exist today.
But before we get there, let’s first understand a few things-
When to see a fertility specialist
Seeking help for your fertility issues at the right time can make all the difference when it comes to getting pregnant. But what is the right time? Explains Dr Rupa: “When not using any sort of protection or contraceptive, most couples conceive within the first year of trying for a baby. The remaining usually get pregnant within another year of unprotected intercourse. So if trying for more than two years has not yielded pregnancy, then you need to see a fertility specialist.”
The right time, however, also varies according to the age of the couple—especially if the woman is over 35 years and they have been trying for a pregnancy for six months and more. “If there are any known issues like low sperm count or a problem with the fallopian tubes, amongst others, then the couple should seek fertility treatment urgently,” adds Dr. Rupa.
Tried and tested fertility treatments that can help you out
Put the words' fertility and treatment together and the first thing that comes to mind is IVF. While in-vitro fertilisation does indeed show promising results—it’s not the only option that exists for couples who are trying to get pregnant. In fact, here are some of the most common infertility interventions that specialists rely on:
1. Intrauterine insemination or IUI
As heavy as the name sounds, this procedure is actually a type of artificial insemination. “Intrauterine insemination is a process where the woman is stimulated so that one or more eggs develop,” explains Dr Rupa. “She undergoes follicular study to follow growth of the follicles, and when the follicle matures, she gets a trigger injection for final maturation and release of the ovum,” she adds.
Thirty six to 42 hours after this, the male partner’s sperm is processed and placed into the uterus. “So basically the sperm is processed but the egg doesn’t come out of the body—and fertilisation happens inside the body,” she says, adding that in younger and healthy couples the rate of conception with IUI is one in five. For older couples, it drops to eight to 10% per cycle.
2. In-vitro fertilisation or IVF
Perhaps the most publicised assisted reproductive technique, IVF has been around since the late 70s. Explaining what IVF entails, Dr Rupa says: “In IVF, the fertilisation of the egg and sperm happens outside the body. The egg is taken out of the woman’s body, and sperm from the man.”
IVF involves controlled hyper-stimulation of the ovaries, using injectable hormones, to produce more than one egg. “We usually try to do a mild to moderate stimulation to get about eight to 10 eggs. The growth of the ovarian follicles is monitored using serial ultrasounds. And whenever the follicle matures, a trigger injection is given for final maturation,” she elucidates.
After 36 hours, the oocytes are recovered from the ovaries, using a transvaginal needle under ultrasound guidance. On the same day, the male partner gives a semen sample, which is processed. “The semen and oocyte are incubated in the lab, where they develop over the next three and five days. After this, one or two embryos are transferred into the womb of the female,” says Dr. Rupa.
The rest of the embryos—if they are of good quality—can be frozen at -195 degrees for upto five years.
3. Intracytoplasmic sperm injection or ICSI
A relatively unheard-of procedure, ICSI is actually a part of IVF. While traditional methods of fertilisation in IVF include putting the sperm and egg in a lab dish and letting things happen naturally—ICSI involves injecting one sperm into the center of the egg.
While the rest of the process remains the same—ICSI-IVF works best for people who have been trying for long, have problems with sperm motility amongst other things, and have not had successful traditional IVF cycles.
IUI, IVF, or ICSI—which fertility treatment is right for you?
IUI is usually the first line of defence when it comes to infertility. As compared to other assisted-reproductive techniques, IUI is inexpensive and less invasive—which is why many experts suggest starting with two to three rounds of the procedure before moving onto more advanced techniques. IUI can prove to be especially beneficial, however, where donor sperm is being used.
As laborious as they might be, IVF and ICSI tend to show better results in cases of infertility—especially when preexisting conditions are keeping the couple from getting pregnant. Says Dr. Rupa: “If a couple has been trying for a long time, without any results then IVF-ICSI is highly recommended.”
“In cases where women have subfertilities like endometriosis or adenomyosis, and their male partners have infertility issues too—IVF-ICSI is recommended sooner than later,” she explains. And there’s a good reason for it. You see, a woman’s eggs are as old as she is because she is born with them. Younger eggs make for better embryos, while older ones have a lower fertility potential. Because of this, maternal age also has bearings on the success rate of IVF and ICSI.
The bitter truth is that male and female infertility is on the rise all over the world. You can blame it on environmental factors or the age at which couples are getting married and planning for a baby—but seeking treatment for fertility issues before it’s too late is crucial. If you have pre-existing health or reproductive conditions, are above the age of 35, or have been trying for over a year—Dr. Rupa suggests seeking help as soon as possible.