The definition of infertility by the World Health Organization (WHO): the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.
There are many reasons on why infertility may occur and is possible in both men and women. In general, the probability of being female-caused is about 40%, that of male-caused is also about 40%, and the chance of both men and women having problems is almost 20%.
Ovulation injections will not cause early menopause! In humans, the pituitary gland secretes FSH that nourishes only one egg to grow and mature per month so there is only one egg for ovulation every month. With the use of ovulation injections (with high FSH content) , eggs that could not get enough nourishment will be able to grow and mature and more eggs will be available for ovulation. You can think of this as a “resource recovery” and will not exhaust the original stock of eggs at all nor will it cause early menopause. In recent years, because of long-acting ovulation injections, advances in technology in preimplantation genetic screening and diagnosis (PGS, PGD), and cryopreservation of embryos , avoidance of ovarian overstimulation with decreased injections, prior screening for healthy embryos before transfer to improve implantation rates , and thereby realizing the realm of so-called "reproductive-friendly medicine."
Many patients consulting in infertility clinics often ask: How long should sexual abstinence be to achieve optimal fertility? According to the recommendations of the World Health Organization (WHO), 3-7 days of sexual abstinence is enough to achieve maximum quality sperm and exceeding the 10-day abstinence duration will compromise the quality of the sperms.
1) advanced age 2) uterine fibroids and adenomyosis 3) polycystic ovary syndrome
4) chocolate cysts of the ovary 5) fallopian tube obstruction or adhesions 6) ovulation dysfunction
7) hyperprolactinemia 8) endometrial adhesions
1) low sperm count 2) low sperm motility 3) Azoospermia
4) abnormal sperm morphology 5) unable to complete sexual intercourse
The probability of abortion in pregnancies achieved by IVF and that of a natural pregnancy is similar, about 10%-20%. Advanced maternal age carries a higher risk of miscarriage rate. When pregnancy is achieved after IVF treatment, close follow-up with ultrasound or blood tests can detect the possibility of abortion.
The most common cause of a miscarriage is usually the abnormality of the embryo itself and the largest factor is accounted for by chromosomal abnormalities. Other factors may be fetal structural abnormalities, uterine malformations, or a deficiency in luteinizing hormone. Miscarriage is still possible with “normal” couples, so there is no need to blame each other.
In general, early abortions may be complete and will not require further intervention. When a miscarriage occurs at around 12 weeks gestation, heavy bleeding may occur and abortion may be incomplete so that further intervention may be required such as “Dilatation and curettage” to completely clean the products of conception.
Usually, there is only one mature egg for ovulation per menstrual cycle. In order to increase the chances of assisted reproduction, it is sometimes necessary to use ovulation drugs to increase the number of mature eggs. In general, ovulation drugs do not cause any side effects, but there are still a few patients who might have some complications; and the most serious is “ovary hyper-stimulation syndrome (OHSS).” Most of ovarian hyperstimulation syndrome will resolve on its own, but there may be severe cases that will require hospitalization for observation and treatment.
The ovaries also secrete substances that increase the permeability of the blood vessels, causing the outflow of water, electrolytes, proteins, etc. from blood vessels that may collect in the abdominal cavity called ascites or or in the chest cavity called pleural effusion. If this happens, replacement of water, electrolytes, and proteins should be done in moderation whether orally or by intravenous infusion.
Most patients recover in 7-10 days, but for those who recover slowly or are pregnant, the condition may last for several weeks. When there is ovarian hyperstimulation syndrome, daily urine output should be at least 500cc; if the amount of urine excreted is less than 500cc or other symptoms more severe, your physician in charge will advise hospitalization for treatment as the case requires. Severe symptoms may even require termination of pregnancy. The incidence of severe ovarian hyperstimulation syndrome is 0.5% to 5%, and in these cases, although rare, stroke, renal failure, adult respiratory distress syndrome, and even death may occur.
Women received ovarian stimulation for infertility treatment has a slightly higher chance of developing ectopic pregnancy than that of normal pregnant women. The reason for this may be that people who receive treatment for infertility themselves have problems with the fallopian tubes so the probability of ectopic pregnancy occurring is higher than the average person. Therefore, it is necessary to follow-up closely with ultrasound and blood tests for the patient conceived after infertility treatment.