Find out the types of medical fertility treatments that you may be offered

Types of fertility treatments

You probably an idea of what IVF involves but when you get to the clinic, you may find there are different types of treatment on offer and lots of confusing acronyms such as ICSI, IVM or PGS. It can be hard to know what’s what, so let’s go through some of the main types of treatment you may be offered.

IVF

In a standard IVF cycle, you will be given drugs to make your ovaries produce several eggs. These eggs are collected, and mixed with your partner’s sperm in the laboratory, where they are left to fertilise. If embryos are produced they can then be transferred to your womb, or frozen for future use.

ICSI

ICSI or intra-cytoplasmic sperm injection was developed in the early 1990s. It is mainly used to overcome male fertility problems and has become very popular. During ICSI, the best sperm from the semen sample are injected straight into the egg. This allows embryologists to use sperm that might not have been capable of breaking into an egg and fertilising it by themselves.

ICSI has been so successful that some clinics perform as many, if not more cycles of ICSI compared to IVF. It may even be suggested to you as a treatment option by a clinic even if there isn’t a male fertility problem because some doctors feel that ICSI can offer higher success rates, (although clinical trials suggest this isn’t the case).

Obviously with ICSI there is more interference with the natural process of fertilisation because the sperm are injected directly into the egg and this is something you may want to take into consideration if you are being offered ICSI but there are no male factor problems to make it a necessary.

Natural-cycle IVF

It is possible to carry out IVF procedures in a natural cycle without using drugs to stimulate your ovaries and make them produce lots of eggs.

Natural-cycle IVF is much cheaper than traditional IVF as there are no drugs to pay for, and there is no danger of over-stimulating the ovaries, but success rates are much lower as there is only one of your eggs for the embryologists to work with.

Soft or mild IVF

Soft or mild IVF is a gentler form of IVF. Lower doses of drugs are used so the ovaries don’t produce as many eggs and it doesn’t involve as much disruption to your body.

This reduces the risk of ovarian hyperstimulation syndrome (OHSS), a common and potentially dangerous side effect of standard IVF. Soft IVF is also cheaper as fewer drugs are used and you don’t need as many injections or as many visits to the clinic, making it less intrusive.

IVM

In vitro maturation or IVM, is a technique that involves taking eggs directly from your ovary when they are still immature. The eggs are then left to develop in the laboratory and then mixed with sperm when they are ripe for fertilisation.

Although you may need to take some drugs if you are having IVM, these will not be as disruptive as the drugs used during IVF and you don’t have the same risk of hyperstimulation.

However, IVM relies on a woman having lots of immature eggs, called resting follicles, in her ovaries. Only younger women, or those who have polycystic ovaries are likely to have enough resting follicles to make carrying out IVM worthwhile.

PGD

Pre-implantation genetic diagnosis or PGD, is used to test for known inherited conditions. If a couple know that they risk passing a condition onto their child they may choose to have PGD.

PGD involves taking one or two cells from an embryo that has divided into eight cells. The cells are tested and only embryos that are clear will be replaced.

PGD can be used to test for a wide range of inherited conditions such as cystic fibrosis, muscular dystrophy, haemophilia and sickle-cell anaemia.

PGS

Pre-implantation genetic screening or PGS, is used to check embryos for chromosomal abnormalities that may cause miscarriage or prevent embryos from implanting.

PGS is sometimes offered to older women and women who are at risk of having a child with chromosomal problems, women who have had recurrent miscarriage or a lot of unsuccessful cycles.

The checking of embryos is performed in the same way as in PGD by making a hole in the embryo and taking out one or two cells to test. However, research has shown that PGS is not always accurate. This is because some embryos contain a mixture of normal and abnormal cells, so extracting one to test can give a false result.

The evidence suggests that PGS is not effective at increasing the chances of having a live birth or cutting the risk of miscarriage and in some cases, it may even result in a reduced chance of pregnancy.

Surgical sperm retrieval

Some men don’t have any sperm in their semen although they ejaculate normally. This can happen if the tube that carries sperm from the testicles is blocked, or it hasn’t developed properly. Sometimes there may be a problem with sperm production.  

Men who have had a vasectomy reversal may find they still don’t have any sperm in their ejaculate because it is not always possible to mend a tube that has been cut or clipped. However, it may be possible in these cases to retrieve the sperm surgically.

Most men have some sperm in the epididymis (the tubes at the top of the testicles where sperm are stored) or in the testicles themselves, even if they are immature sperm). If sperm are found, samples are usually frozen before being used in the future for ICSI. There are several different ways to retrieve sperm.

Frozen embryo transfer

Women often produce more eggs than they are going to use in one cycle and if the eggs fertilise and there are of a good quality, spare embryos can be frozen and returned to the womb in a later cycle.

Not all embryos survive the freezing and thawing process, and success rates are sometimes lower for frozen embryo transfers. However, going through a frozen embryo cycle is far less invasive. There won’t be as many visits to the clinic or as many drugs and it is also much cheaper.

This is from my program ‘Everything you need to know before starting your IVF/ART’.

You can become pregnant. Work with me and let’s get you healthy, fertile and ready for conception and pregnancy.

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