What Is Infertility



Infertility is the inability to conceive after 12 months or more of unprotected intercourse without pregnancy.

Sterility is when there is no chance for pregnancy. This is rather different from infertility which represents a reduced potential for pregnancy.

Most childless couples where the female is under or around 43 to 44 years of age, that are having problems getting pregnant are considered to be infertile but not sterile.

Infertility affects nearly 15 percent of all couples trying to conceive, that is one in every six couples have a problem with conception.

If you are under the age of 35 and have been trying to conceive for one year without success; or if you are over the age of 35 and have been unsuccessful after trying to conceive for six months, it is time to seek medical treatment for infertility.

 
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Reasons for Infertility



Besides a women’s age, male infertility is the single biggest factor why a couple may not be able to conceive naturally.

Other causes of infertility might be:

  • Ovulation Disorders
  • Tubal Disease
  • Endometriosis
  • Combination of male and female reproductive issues.

How can we help?



The diagnosis of infertility can often be overwhelming for patients. Not only are they faced with the news that conceiving a child is only possible through medical treatment, they are also presented with information that is totally new to them.

Infertility affects both women and men equally. Both partners should be tested to determine the cause and chart an individualized treatment strategy. Everyone is different. In order to maximize your chances of success and minimize inconveniences, your treatment will be specifically tailored to your individual needs.

Sometimes, a little helping hand is all that you need to achieve the dream of having a baby. When you undergo fertility treatment with our team, you are certain to receive the highest standard of treatment available in a caring and compassionate environment.

 
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The expectation of success



A delivery rate up to 50% can be obtained in good prognosis patients. The success rate is dependent on the patient’s age, cause, duration of infertility, and embryo quality.

Counseling regarding a patient’s individual prognosis will be done at the time of your initial consultation. Multiple pregnancies can occur with IVF. It is our goal to minimize the occurrence of multiple pregnancies.

While there is no guarantee that your desire for a child will be fulfilled, we do assure you that our Center for Reproductive Medicine is committed to doing everything within its power to assist you in the best manner possible.

 
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IVF/ICSI



If you are unable to conceive in the natural way, for whatever reason, then In-Vitro Fertilization (IVF) may be the solution.

IVF can be effective in achieving conception in the following infertility situations:

Gynecological causes: closed fallopian tubes or absence of fallopian tubes; endometriosis; ovulation problems.

 
  • Andrological causes: if the man is less fertile.
  • Immunological problems: if the man or woman produces antibodies against sperm cells.
  • Unexplained fertility: after a number of years of trying to conceive, some couples are still unable to do so, without there being an apparent cause.

In all the above cases, IVF will provide a good chance of conception, where other treatments fail. IVF, now often combined with ICSI, has progressed enormously and helped countless childless couples to achieve parenthood. At the UZ Brussels- Center for Reproductive Medicine over 15,000 children were born in the last 25 years.

 
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Your Lifestyles and IVF: Quit Smoking



It is absolutely vital that you stop smoking if you are to commence IVF treatment. Various studies have shown that women who smoke need about twice as many IVF attempts in order to achieve a pregnancy.

 
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IVF/ICSI in a Nutshell



During IVF, fertilization does not take place in the fallopian tube as in nature, but rather in a dish in the laboratory. This is where the name of the treatment originates from (In –vitro being Latin for in glass).During a classical IVF procedure, egg cells from the women are placed together in a dish with sperm from the man, where the sperm then fertilize the eggs. The dish is then placed in an incubator which replicates the temperature and atmospheric conditions found in the fallopian tube.

ICSI is an in vitro fertilization procedure in which a single sperm is injected directly into an egg. This procedure is most commonly used to overcome male infertility problems; although it may also be used where eggs cannot easily be penetrated by sperm.

The technique was developed by Paul Devroey and Andre Van Steirteghem in 1991 at the UZ Brussels-Center for Reproductive Medicine has refined ICSI to its definitive form in which it is applied with great success all over the world.

 
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Difficult but not painful



In-Vitro fertilization is both an easy and a difficult treatment. Physically, it is relatively straightforward and uncomplicated. It involves a number of generally painless interventions which carry very little risk. Side effects are few and certainly not dangerous.

The psychological impact of the treatment however can be more severe. The many test and examinations during the process will need you to organize your life around the treatment for a while and not the other way around. Stress factors such as wondering whether it is all going to be worth it can sometimes put enormous strain on spousal relationship.

We do our best to help everyone as much as we possibly can. Fulfilling your desire to have children and ensuring your comfort during your treatment is our utmost priority

 
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Lose Weight



In women, obesity can lead to subtle hormonal changes which can eventually lead to infertility, mostly because of ovulation problems. But it also reduces the chances of IVF being successful.A recent study suggested that overweight women were a third less likely to deliver a child after IVF, than women with normal weight.

 
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The IVF process is divided into several phases or steps:



     
  • Suppression: The physician will suppress your natural hormones so that he can take control of your stimulation with gonadotropins.

  • Stimulation: Daily gonadotropin injections (usually 8-11 days) stimulate the ovary to form a number of follicles which contain the eggs. Once the follicles have reached their ideal size, an injection of HCG to mimic the female body’s hormonal LH surge is given which causes final maturation of the eggs prior to retrieval.

  • Egg Retrieval: 36-40 hours after receiving the HCG shot, the oocyte retrieval is performed at our dedicated procedure room within our center. Under ultrasound guidance, a very thin needle is passed through the upper portion of the vagina into the ovarian follicles and the fluid containing the egg is aspirated and subsequently identified by our embryologist in the laboratory.

  • Percutaneous Sperm Aspiration (PESA): The most commonly used method of retrieving sperm. A fine needle is inserted through the scrotum into the epididymis and sperm are collected.

  • Intra Cytoplasmic Sperm Injection (ICSI): Only metaphase II eggs with a polar body are injected with a single sperm.

  • Fertilization: In 18-20 hours, the injected eggs are checked for fertilization occurs, a zygote is formed with two nucleus; and two polar boadies which in two days will develop into an embryo and in five days will develop into a blastocyst.

  • Tubal Transfer: Zygote Intrafallopian Transfer (ZIFT). Your eggs are fertilized with your partner’s sperm. The physician will then place the embryos into fallopian tube by laparoscope.

  • Uterine Embryo Transfer: Transfer is done under ultrasound guidance with the patient full awake on Day 5-2 from retrieval using a special catheter.

  • Blastocyst Transfer: Transfer is done under ultrasound guidance with the patient fully awake in day 5-6 retrieval. Transfer at this stage allows the selection of the best embryos prior to transfer.

  • Assisted Hatching: A portion of the “zona pellucid” (egg shell) is removed to allow the embryo to hatch and escape, hence improving implantation.

  • Supplementation: After transfer, progesterone and estrogen supplementation will be taken by the patient to support her luteal phase for the next 10-15 days. And they will continue if the pregnancy test was positive.

  • Pregnancy Test: A blood pregnancy test will be performed approximately 2 weeks from the retrieval date. An ultrasound will be performed at approximately 5-6 weeks of pregnancy.


Have Folic Acid



All women trying to get pregnant should take supplement of 0.4mg of folic acid as it decreases the risk of child developing Spina Bifeda. Other benefits include a reduction in morning sickness during the first weeks of pregnancy and possibly a reduced risk of premature birth.

 
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