According to WHO definition, with normal sexual life, without using any contraceptive method, but failed pregnancy in a year.
There are various cause of infertility, approximately male:female factor is 4:6 (combined male and female factor is around 20%).
Not really, although there is only one egg expelled in every cycle, this egg is based on a hundred to thousand primary follicles from the pool (ovary), of which, mostly will be vanished in the process of oocyte maturation, and only one go through full maturation and ovulate. So medications inducing superovulation does not consume more extra eggs and does not cause premature menopause.
According to WHO, abstinence for 3-5 days (not more than 7 days) may have a better semen quality.
- age over 38
- uterine myoma or adenomyosis
- Endometriosis (chocolate cyst)
- blocked tubes, adhesion
- ovulation disorders (stress, medications,hormonal disorders)
- high level of serum Prolactin
- intrauterine adhesion
- low sperm count
- poor sperm motility
- no sperm
- poor sperm morphology
- failed intercourse
In the process of ART, medications to induce superovulation is necessary. Usually, side effects from medication is minimal if used precautiously, but still is a risk. Most mild to moderate cases of OHSS will relieve spontaneously by 1-2 weeks with no management required. But those severe cases need hospitalization to manage ascites, hydrothorax, electrolyte imbalance and hemoconcentration, 4-6 weeks is needed for recovery. The prevalence rate is about 0.5-5%.
A small minority may continue to develop stroke, renal failure, respiratory distress and even death. Medications may usually overcome this problem.
The miscarriage rate in IVF pregnancy is approximately the same as in spontaneous pregnancy around 10-20%. Advanced maternal age also has same higher miscarriage rates in both groups of pregnant women.
1.Advanced maternal age:
Over 35 years of age, reproductive organs are aging, egg quality is reduced, and the probability of chromosomal abnormalities increases.
Insufficiency of the 3 major hormones (Progesterone, Estrogen and HCG)
required for early embryo development will cause the embryo to stop developing and abortion.
Chromosomal abnormalities can also cause the embryo to stop developing and abort.
Exposure of pregnant women to chemicals or bad habits may stop embryos from growing.
Common autoimmune diseases are Lupus erythematosus, Systemic Scleroderma, Mixed Connective Tissue Disease and self-antiphospholipid antibodies can also cause miscarriage.
Ectopic pregnancy is a little bit higher in IVF women, around 1%, early diagnosis has the advantage of medical abortion instead of surgical management
Diagnosis of ectopic pregnancy :
Delayed menstruation with positive pregnancy test but with abdominal pain, vaginal bleeding and rebound tenderness. Consult doctor and follow-up. If diagnosis if made, surgical intervention is the method of choice with a small percentage needing medical treatment.
Herbal medication is of some benefit in recuperation of the body, so combined Herbal medication with Western medicine may have certain benefits.
All infertile couples are requested to consult 2-3 months before for preevaluation of routine tests at their first visit Including hormonal tests, pelvic ultrasound, HSG, and semen analysis.