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Pune IVF Centre is one of the best IVF centers in Pune with the largest team of Gynecologists and Embryologists in one place.

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Frequently Asked Questions About Infertility

1. Defining infertility

What is infertility?

Infertility is when you are not able to get pregnant or conceive after one year or longer of unprotected sex.

Is infertility a male or female problem?

Men and women both contribute to the challenge of infertility. It isn’t only a male or female problem.

Even though I had a baby once, can I get infertile?

It can happen that you had a baby once but later on you might face trouble during your next pregnancy.

Has infertility become a common issue these days?

Infertility has become common these days since couples wait to have children later in life. Also, late marriages have become common.

 

Present lifestyle and food habits also have become a major challenge.

Does age impact fertility?

Age affects fertility of men and women. It is one of the biggest factors to affect a woman’s ability to conceive. A woman’s fertility starts reducing after the age of 30 and even more after 35 years.

As women age risk of pregnancy complications rise. Male infertility also declines but is more subtle. Men’s age affects the partner’s chances of getting pregnancy. Male age over the age of 45 years increases the risk of miscarriage. The child can face mental health issues or developmental disorders.

Does stress impact fertility?

Stress alone cannot cause infertility. But it can impact the ability of a woman to get pregnant. Women with history of depression can face the challenge of infertility.

Can we prevent infertility?

Most forms of female infertility cannot be prevented. But some factors that impact fertility and chances to get pregnant can be controlled to prevent the condition.

Men can also improve their lifestyle to better their chances of fertility.

Is there a cure for infertility?

Most doctors recommend treatments to overcome infertility and treat issues that might stop a woman from getting pregnant. Treatments might help to conceive naturally.

2. Causes of fertility

What does Fallopian Tube Obstruction mean and why does it impact fertility?

Fallopian tubes connect to the ovaries and uterus and form the female reproductive organs. When a woman ovulates every month, the fallopian tubes carry the egg from ovary to uterus. Conception happens in the fallopian tube. When the egg fertilizes it goes through the fallopian tube to the uterus for implantation.

When the fallopian tube is blocked, the passage for the sperm to reach the egg and the path for the fertilized egg to reach the uterus also are blocked. This leads to infertility.

What is PCOS?

PCOS is a condition of high levels of male hormones in the body, which prevent the ovary from releasing an egg, which is called as an ovulation.

An imbalance in the production of hormones indicates irregular egg ovulation making it tough for the woman to get pregnant.

What is Ovarian Reserve?

It refers to the reproductive potential of a woman’s two ovaries based on the number and quality of eggs. Diminished ovarian reserve is the loss of the reproductive potential in the ovaries as the count lowers or the quality of egg diminishes.

What is Endometriosis?

Endometrial tissue is the inner lining of the uterus where the embryo implants.

But when this endometrial tissue starts developing in places other than the lining of the uterus it is called as endometriosis. This endometriosis can affect fertility by affecting the egg quality and causing disturbances in Tubo-Ovarian relationship.

What is Irregular menstrual cycle?

When menstrual cycle is shorter than 24 days, or more than 38 days long or from month after month the duration of the periods keeps varying it is called as irregular periods.

What are Fibroid, Polyps, Adenomyosis and other Uterine Problems?

Fibroids, Polyps and Adenomyosis affect your ability to become pregnant in various ways.

In simple words it is just an over growth of normal uterine tissue which hinders fertility.

A thorough detailed sonography can help you find out the reasons for infertility.

What is Frequent Miscarriage?

In case of two or more miscarriages it’s referred as Frequent Miscarriage. After three repeated miscarriages a detailed physical examination and tests are advised.

 

This is more common among older women and occurs when the embryo gets an abnormal number of chromosomes while fertilizing. It is a genetic problem.

What is secondary infertility?

It is possible that you conceive naturally the first time but find it difficult to conceive again. This is referred as secondary infertility.

What is necessary to be done by us before we consult the doctor?

Maintain a healthy lifestyle. Avoid smoking as it lowers your chances of conceiving. If you are taking any medicines consult the doctor to find out if it will impact your fertility.

May it be over the counter medicines, supplements or herbal remedies, they might adversely impact your fertility. Also, avoid vaginal lubricants.

Have regular intercourse during the fertility part of your cycle.

Do both of us need to be tested?

Yes, both man and woman need to be tested as either or both of you could be infertile. Finding out the reason is vital to choose a treatment.

3. Fertility tests and consultation

What are the Fertility tests for women?
  • Blood tests
  • Chlamydia test
  • Ultrasound scan
  • X-ray
  • Laparoscopy
What are the Fertility tests for men?
  • Semen analysis
  • Chlamydia test
Should we consult a specialist?

Doctors often suggest specialist if you:

  • Have Endometriosis or damaged tubes
  • Or had one or more miscarriages
  • Irregular menstrual cycle
  • If a woman is above the age of 35 years
  • In case of abnormal semen analysis
  • You had a pelvic infection
  • Not been able to conceive despite test being normal
How much time does it take to get a conclusive answer?

The entire testing and diagnosing takes around a month since particular tests need to be done at a specific time as per the menstrual cycle.

Others are repeated over a few months. If you are above the age of 35 and if you are worried about the whole process, consult your doctor. Some patients feel they are wasting time as age keeps catching up.

What can be done if all my tests are normal?

As much as 10 to 15 percent of couples are not able to know the reason for infertility despite taking tests.

The diagnosis is mentioned as “unexplained infertility.” Though there exist reasons but they have don’t get revealed in the tests. Some more tests can clarify the situation. You can choose to take second opinion.

Couples are advised standard treatments like IVG or IUI.

Are there any options besides medical treatment?

When fertility becomes an issue, the couple has to understand what components about parenting are vital. Counselling can help to assess various priorities and options.

 

But if becoming a parent is the most vital factor for a couple, they can pursue adoption. While some couples may decide to mentor or nurture their nieces, nephews or friend’s children. Other might end up associating themselves with an organization working towards nurturing children.

What will happen first? How is the cause of infertility identified?

A couple will have to take a medical appointment together. The couple will be interviewed on various topics.

A man will be asked about puberty developments, if ever he has fathered a child. He will be asked if he has had any infection or illness, medicines he has been taking, operations involving genitals.

If at all he has been consuming any recreational drugs, or smoking heavily. The kind of lifestyle will also be analyzed.

A woman’s lifestyle will also be queried. She will be asked about her reproductive history, including her menstrual cycle, abortions, previous pregnancies, miscarriages, genealogical issues or any infections. She will be queried about the medicines she is consuming.

Both have to share their information frankly to arrive at the right diagnosis.

Are we likely to get pregnant if we adopt?

It isn’t true that if you adopt a child you are likely to get pregnant. This is a myth that can be hurtful for couples who want to conceive.

Can we opt for adoption while we are trying for pregnancy?

You can opt for adoption whenever both wish to. Some couple choose to adopt instead of consulting a doctor for treatment.

While some wish to go in for treatment before choosing adoption. Other couples simultaneously pursue both the options.

Pursuing both can be a challenge. Some agencies will not accept a couple’s application who is undergoing medical treatment.

Also, it takes time, money and efforts to pursue both adoption and medical treatment at the same time. It is actually a fine balance to maintain. At time couples get disappointed when they choose to postpone adoption while the treatment fails. They realize that they have spent a lot of time on treatment.

Do doctors discuss about adoption?

Yes, doctors do speak about adoption with couples. But not all doctors have complete information about it. You and the doctor should discuss frankly about family building before you opt for medical treatment. At times mid way through the treatment the couple might think of adoption and they should be able to share this with the doctor.

4. Infertility programs

Do all infertility programs offer similar treatments?
  • Even though couple of infertility programs provide the same treatment the approach won’t be same for every couple. It depends oN various factors like:

    The program might offer high tech treatments like IVF. But if you just started to work on a treatment then initial treatments should be better.

    At times various types of specialists are involved. Ease of communication among specialists with regards to larger programs is vital. Couples might require more than one type of treatment.

    Also, couples might have different approach towards taking risk. Some might not want to take excessive risk while some might be fine with it.
Will we be treated immediately?
  • You might not be able to start the treatment immediately. Some programs require waiting lists, if detailed laboratory test are required. Ask the doctor how long you will have to wait and the schedule of the treatment and if you need more tests before beginning the treatment.

Is word of mouth a good way to choose a program?

You can know about various treatment experiences by discussing with friends, relatives and support group members. They can share their emotional ups and downs, physical impact, and effect on daily life. Couples can alert you about potential frustrations or the support you will need.

You will become aware if the schedules run on time and if the doctor answered all their queries. Was the staff cooperative in financial matters.? But you cannot decide on the basis of other’s experience, success or failure.

What kind of emotional support can I expect from the doctor and the team?

Emotional support is necessary to cope with infertility and the treatment too. It’s a crisis for most women and men. It is upsetting for the couple so emotional support is vital. The treatment can also cause stress on the couple.

At each step the couple goes through many emotions so some programs provide emotional support but vary in their services they offer. A counsellor can help to evaluate these emotions while starting the treatment and as it proceeds. Support group help is also offered by some doctors and relaxation techniques are also taught to ease stress.

You can independently seek the help and guidance from a counsellor.

Can it be predicted if I will be pregnant?

Every couple has unique set of challenges so there are limitations in predicting how you will respond to the treatment. You will be given an estimate of the chances of you getting pregnant. This will be based on the diagnosis and result of the tests and prior experience.

Be cautious if you are given a guarantee or an unrealistic estimate. You need to ask on what basis an estimate or a prediction was made.

Is it possible for a doctor to deny treatment?

Yes, doctors can decide whom to accept as a patient based on their discretion. A doctor should use professional judgement if a treatment is possible or reasonable in your case.

The doctor can accept you as a patient or refuse to continue with the treatment. But doctors should have clarity about screening policies.

Do we need to take medical and psychological test unrelated to infertility?

Doctors will ask you to undergo certain medical and psychological tests. You may have to take some tests to check for infection transmitted during pregnancy or tissue transplant like HIV or Hepatitis. Over a certain age women will be asked to take extra medical tests to check if they are able to withstand the physical demands of pregnancy.

Psychological tests are also necessary to gauge a woman’s stability and ability to take decisions in case of complex treatments.

How is the decision about infertility treatment different from other medical decisions?

Infertility treatment is similar to other types of treatment in many ways. But there are certain differences:

  • Treatment involves equal participation from both partners.
  • Your decision should be based on clear medical evidence of the benefits and risks.
  • Cost may be high at times and predicting accurately is tough.
  • The treatment might impact you psychologically so a counsellor might be able to guide you.
Is second opinion necessary?

There are differences in opinions among doctors. Often infertility experts ask patients to seek second opinion. A second opinion might help to get prior medical intervention when you go for new approach or re-evaluating if you need to continue care.

When you go for a second opinion carry your records and test results.

What information is necessary before you agree to go ahead with a treatment?

A doctor is required to obtain your informed consent before treating you.

Before you agree to getting treated you should have the following information:

Some of these will be applicable to IVF and variations of this treatment.

  • A proper description of the treatment.
  • What are the chances of you becoming pregnant and delivering a baby?
  • Experience of the doctor in handling varied treatments.
  • What are risks involved in the medications and procedures?
  • What is the success rate of that particular treatment in the field?
  • Chances of multiple pregnancy and risk of the mother and the pregnancy.
  • You should know what are the complications involved?
  • Ways to minimize multiple pregnancy.
  • Problems that can occur during pregnancy and how it might affect both the baby and you.
  • What are the fees involved?
  • What is the use of the eggs and embryos not utilized during your treatment?
  • What are the other treatments offered and the non medical options including adoption?
What if new treatment is offered to us?

Infertility treatment is evolving at a rapid pace. Doctors now are learning new procedures and older ways are altered. They are eager to implement these innovations. But a technique should not be offered without prior experience in performing it.

Be sure you have all these answers when you begin the new treatment.

  • How safe is it and the evidence for it?
  • What have been the results till now? How successfully has it been executed?
  • What will be the charges for it?
  • What is the technique and how much time does it take?
  • How long will the procedure take?
  • Would this program or technique lead to changes in my treatment or prenatal care?
  • At this point, would most doctors consider the procedure experimental?

It all depends on your decision to accept the treatment. If you decide not to go ahead there should be standard treatments available.

Should I opt for surgery?

Some of the questions you need to ask about the reproductive surgery are as follows:

Why should I undergo surgery or choose this particular approach?

What will the recuperations? How much time will it take?

How soon can I start trying to conceive?

If I choose to undergo a surgery what are the chances of conceiving?

What is the success rate in the past two years?

What if my partner or I have been sterilized?

At times a tubal ligation or vasectomy is possible to be reversed surgically.  Though the success rate depends on the procedure followed and how long ago you had it. Also, other factors related to fertility in both of you will decide the success rate. Doctors might advise IVF instead of a surgical reversal to help you conceive.

Should I use drugs that boost fertility?

Fertility drugs boost the ovulation process among women ovulating irregularly or not at all. Due to the drugs several eggs mature in a single menstrual cycle at ovulation. This helps to improve the challenges faced while conceiving during intercourse or along with other treatments like IVF. You need to understand the advantages and disadvantages. Discuss it with your doctor.

Can safety of fertility drugs and likelihood of conceiving be improved?

When you and your doctor work in agreement to use the drugs properly it does improve the chances of conceiving.

But you need to be monitored properly and injectable fertility drugs should be used under doctor’s care. Your responses need to be tracked by using blood tests and ultrasound.

Follow all instructions. The process needs to re-evaluated at regular time intervals. Fertility drugs and should not be used on regular basis.

5. Infertility Treatment

What is IUI (Intra Uterine Insemination)?

Intrauterine Insemination (IUI) is a treatment for infertility wherein sperms are washed, processed and concentrated prior to placement within the uterus. IUI is a basic infertility treatment. IUI can be offered for unexplained infertility, ovulatory disorders like PCOS, mild to moderate male factor infertility, sexual dysfunction, and IUI with frozen semen sample.

Should I use IUI?

Before you undergo IUI it is necessary to understand the benefits and risks. Ask your doctor:

  • Why are you advising me to opt for IUI?
  • What is its success rate among couples similar to us?
  • When and how the semen is collected?
  • What are the other options to IUI?
  • Do we need to use fertility drugs along with insemination?
What is In Vitro Fertilization (IVF)?

In this process the ovaries are stimulated to produce multiple eggs with the help of medicines and daily hormonal injections. This helps to retrieve the mature eggs, later these eggs are allowed to fertilize with the sperms in the Petri dish in the IVF lab.

When they grow in 3 to 5 days, the fertilized egg (embryo) is placed in the uterus. IVF is used to treat certain hormonal conditions, and blocked fallopian tubes that lead to infertility.

Men with severe and untreatable oligospermia or low sperm count can be treated by using the IVF method.

How do I decide if should go for IVF?

Whether you need to undergo IVF is a major decision so you should assess medical, emotional and financial aspects. Speak with your doctor, infertility counsellor or a support group. Ask these questions to your doctor:

  • Why do you recommend me IVF?
  • What are the other options other than IVF for me?
  • What are the risks involved?
  • What do women go through at each step of the process? What is the emotional and physical impact?
  • What are the chances of conceiving?
  • How is it compared to other treatments?
What are the alternatives to IVF?

It all depends on the fertility challenges you face. Based on the challenge you can decide a lower tech treatment or no treatment at all.

Some other alternatives are:

GIFT- In gamete intrafallopian transfer

The first two steps are similar to IVF. But eggs are not fertilized in the laboratory. Instead a mixture of sperm and eggs get placed into the woman’s fallopian tube; either one or both.

In GIFT, fertilization and the embroys’ reach the uterus by travelling in natural environment of the fallopian tubes.

ZIFT – zygote intrafallopian transfer

This process combines elements of IVF and GIFT.

The first three are the same as IVF. But the embryos are not transferred into the uterus. They are placed in the woman’s fallopian tubes; one or both.

ART – assisted reproductive technologies

This is a general term that is utilized for all treatments involving the removal of a woman’s eggs and getting it together with a sperm outside the body. This includes IVF, ZIFT and GIFT.

Once we agree to undergo IVF, what decisions need to be made?

To get IVF done many vital decisions need to be made:

  • When will the eggs be retrieved?
  • What is the dosage of fertility drugs?
  • How many embryos have to be transferred to the uterus in a cycle?
  • Do we need to freeze the embryos for later cycles?
  • How long do we need to culture the embryos even before they are inserted into the uterus?
  • Understand the impact of these choices on your chances of conceiving and on the type of treatment to choose.

It all depends on the response you have given to prior treatments and the variations of IVF that were suggested. Each suggestion adds to the cost and the risk as well.

Some of the choices are:

  • ICSI Intracytoplasmic Sperm Injection
  • Assisted Hatching
  • Blastocyst Transfer
Why are donors required?
  • Donor semen are used by couples to create pregnancy in cases of male factor infertility.
  • In cases where the couple wishes to avoid transmitting a genetic disease.
  • Women wishing to become pregnant without having a male partner.
  • In case of severe male factor infertility, couples are offered a choice; using donor semen or using IVF with ICSI.
  • Using donor semen is less expensive and less invasive.
  • Donor eggs are used in IVF when women don’t want to transmit a genetic disease or they cannot produce usable eggs because their menopause is nearing.
Where does donor semen come from?

Frozen donor semen are accessible from semen bank from where they are purchased. Sometimes infertility programs offer their own semen bank. Semen banks have their donors.

It’s important to know how they select these donors and the kind of information available to you.

 

Where do donor eggs come from?

Donor eggs are collected and utilized immediately, unlike donor semen that is frozen. Young adult women are egg donors recruited and screened by the donor programs. Donors’ health conditions are studies and they undergo medical procedures.

Can donor semen pass any infectious diseases?

Yes, semen also houses bacteria and viruses causing illnesses in the recipient. So semen donors should be regularly tested for infections. A man might not test positive for HIV until many months even after he is exposed to it. So, the donor semen has to be frozen for at least 180 days and not released to be donated until the donor tests negative. Ensure that you are fully confident about the quality of precautions taken by the semen bank for prevention of transmission of any infectious diseases.

Can donor eggs pass infectious diseases?

It is possible to pass infection through a donor egg. Most treatment programs test egg donors for infections while testing semen donors.

You have to rely on egg donor’s current HIV test results or the embryos have to be frozen after the donor is restested.

Can there be birth defects or inherited diseases coming from donor semen or eggs?

When a donor has a genetic disease or has no health issue but carries a gene that is related to a genetic disease, it gets transmitted while donating the semen or egg.

Your donor bank should go through genetic histories and perform tests to check genetic issues. But many genetic abnormalities can’t be detected. Share with your doctor about any genetic issue that run in the family or common in your ethnic group. You can seek genetic counselling before proceeding.

What can be done in case an egg donor develops medical issues?

Donors get complications from fertility drugs or the process of egg removal. In rare circumstances it’s a serious condition that needs hospitalization. Review all the information of your donor to ensure her treatment is acceptable.


In case your donor develops complications find out who holds the financial responsibility.

What information we can have about the donor?

The kind of information available to you varies as per the programs. Some provide few details while matching, others provide biographical information and test results. You should have medical information to choose an appropriate donor. In case you carry a recessive genetic disease ensure that your donor is not a carrier.

Should we reveal to our child that we used a donor?

That is entirely upto you. In the past children were not told about the donor but today things have changed. Parents and doctor quite often share this information.

Should we reveal it to our relatives and friends that we used a donor?

This too is entirely your decision. If you plan to inform your child about the donor then only inform the relatives and friends.

Will my child meet other children who will be blood relative through donation?

Not quite possible. Another child who was conceived by using semen or egg from similar donor is just genetically half sibling of your son or daughter. If your child meets his or her genetic sibling will depend on the number of children born from the same donor.

Will the donor find out about us?

The donor should not know about the parents if you are using the commercial semen bank. He will most likely not know if anyone got pregnant after his semen was used.

In case my child wants the medical information of the donor or wishes to know about the donor?

You and your child can get this information. At some banks this information is revealed. But if you wish to share this information with your child is your prerogative.

In case my child wants the medical information of the donor or wishes to know about the donor?

You and your child can get this information. At some banks this information is revealed. But if you wish to share this information with your child is your prerogative.

No matter the reason, We can help you.

There are so may ways to start your fertility journey.
Please choose the path that best suits your stage, or give us a call for guidance.

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