What is IUI?
IUI (abbreviation for IntraUterine Insemination), is a treatment for infertility and a form of artificial insemination. IUI is carried out by injecting sperm that has been specially treated directly into the uterus.
IUI is used to treat mild male infertility, women with cervical mucus problems and couples where the infertility is unexplained, as well as enabling the use of donor sperm.

How popular is IUI relative to other types of fertility treatment?
IUI is the most common kind of artificial insemination because it is a relatively simple procedure with minimal side effects. IUI is often the first fertility procedure couples try.
Doctors may advise a couple to have three to six months of IUI treatments before moving on to another fertility procedure if the treatment was not successful.

How is IUI carried out?
Sperm are ‘washed’ to remove chemicals and semen and to separate the most viable sperm – also called sperm preparation or sperm spinning.
Washed sperm are inserted into the uterus using a thin tube called a catheter the day after the ovaries release an egg for fertilization.
Sometimes fertility drugs are used to increase the chance of pregnancy.

What affects the chances of success of an IUI procedure?

• Age of the woman (fertility diminishes with age and the younger the woman, the higher the chances of success)
• Poor egg or sperm quality
• Severe endometriosis
• Damage to the fallopian tubes (usually resulting from infection)

What is Cytoplasmic Transfer?
Cytoplasmic transfer is a fertility procedure and a form of assisted reproductive technology. The aim of the cytoplasmic transfer procedure is to overcome deficiencies in the patient’s egg with donated cytoplasm, while keeping the patient’s genetic material intact.

How is Cytoplasmic Transfer carried out?
In cytoplasmic transfer, cytoplasm – the fluid inside the egg – is taken from a donor egg and transferred into the patient’s egg, where it is fertilized with sperm and transferred into the patient’s womb.

Who is a suitable candidate for Cytoplasmic Transfer?
Cytoplasmic transfer was developed for women with damaged mitochondria within the cytoplasm of their egg. Damaged or deficient mitochondria can lead to problems implanting the embryo in the womb and the poor development of embryos in the IVF process. Cytoplasmic transfer is not generally recommended for patients over the age of 40. Cytoplasmic transfer is often used as a next step when other IVF procedures have failed to result in a baby.

What is Assisted Hatching?
Assisted hatching is used in the IVF procedure in order to increase the chances of pregnancy. Assisted hatching assists the embryo in hatching from the outer protective layer (called the zona pellucida) so it can implant itself on the womb’s wall. Assisted hatching makes a small hole in the protective layer of the embryo.

How is Assisted Hatching carried out?

• IVF procedure is carried out and the fertilized egg – embryo – is incubated in a laboratory.
• On the third or fourth day the embryo is held under a microscope and an acidic solution, laser or micro tool is applied to the outer layer (zona pellucida).
• The acidic solution or laser/ tool creates a small hole in the outer layer of the embryo.
• After being washed, the embryo is placed back in the incubator and transferred into the woman’s womb.

Who is a suitable candidate for Assisted Hatching?
Assisted hatching is most commonly used with IVF in the following cases:

• women aged over 37
• couples where the woman’s FSH level is high on day three of the menstrual cycle
• couples who have poor quality embryos
• couples who have had one or more failed cycles of IVF.

If only one embryo is available for transfer, assisted hatching is not usually carried out due to risk of damaging the only viable embryo.

What are the chances of success with Assisted Hatching?
IVF procedures using assisted hatching are believed to result in higher pregnancy rates, according to some clinicians. Others disagree, believing assisted hatching does not improve the chances of pregnancy.
According to the Human Fertilization and Embryology Authority, in 2006 the percentage of cycles of IVF or ICSI that received assisted hatching resulting in a live birth were as follows:

• ۲۶ percent for women aged under 35
• ۱۹ percent for women aged between 35-37
• ۱۷ percent for women aged between 40-42
• ۶ percent for women aged between 43-44

What is ICSI?
ICSI (IntraCytoplasmic Sperm Injection) is a fertility procedure used within the IVF (in vitro fertilization) process. ICSI fertility treatment is carried out by injecting a single sperm into an egg, which is then transferred into the womb.
ICSI is used as a fertility procedure when the man has a low sperm count, doesn’t produce enough good-quality sperm that are able to reach and penetrate the egg, or has problems concerning anti-sperm antibodies.
ICSI helps bypass the need for donor sperm. Some couples move from IVF treatment to ICSI if they can’t retrieve enough viable eggs to be fertilized in vitro.

How is ICSI carried out?
The woman first takes fertility drugs to stimulate the ovaries for fertilization while the man produces a sample of sperm. If he has no sperm in his semen, doctors extract it under anesthesia using a needle. The doctor removes the woman’s eggs with a needle and a single sperm is injected into an individual egg. The fertilized eggs become embryos and are transplanted into the uterus. Any remaining embryos may be frozen for possible use in the future.

How often is ICSI used?
According to the Centers for Disease Control and Prevention, nearly half of all IVF procedures in the United States involve ICSI. ICSI is one of the most successful procedures for treating male infertility.

What are the chances of success with ICSI?
The chances of a successful ICSI varies between clinics and are dependent on the woman’s age, male and female reproductive health, doctor’s experience and methods used, among other factors.

According to the Human Fertilization & Embryology Authority from the UK, the percentage of ICSI cycles in 2006 that resulted in a live birth was as follows:

What is Cryo-Preservation for Embryos?
Cryo-preservation for embryos, also known as embryo storage or embryo freezing, is a procedure for the storage of embryos. Cryo-preservation is used in IVF when more embryos than currently needed are produced. The process preserves embryos through cooling to sub-zero temperatures, which stops the biological activity that leads to cell death. The embryos are taken out of storage in a later treatment cycle for transfer into the uterus. Frozen embryos can also be donated.

How is Cryo-Preservation for Embryos carried out?

• Embryos are frozen at any stage of the IVF incubation period.
• The embryo is protected and stored in liquid nitrogen at a very low sub-zero temperature.
• The embryo is thawed by removing it from the liquid nitrogen and keeping it at room temperature, then storing it in an incubator before transfer.
• The transfer of a cryo-preserved embryo to the uterus is carried out during a natural cycle, a cycle using hormone replacement or a stimulated cycle.

Who is a suitable candidate for Cryo-Preservation for Embryos?

• Women at risk of developing severe ovarian hyperstimulation syndrome after IVF treatment.
• Women whose IVF treatment is stopped due to a bad reaction to fertility drugs or illness near the time of transfer.
• Women who wish to donate embryos to other women.
• Cryo-preservation for embryos can also used to preserve embryos before treatment for cancer – chemotherapy or radiotherapy.

What are the chances of success of Embryos Cryo-Preservation?
Some experts claim that the chances of having a baby are lower with frozen embryos than with fresh embryos. Others claim there is no difference in the chances of success between these two methods. According to the Human Fertilisation and Embryology Authority (HFEA), not every embryo survives the cryo-preservation process and there is a survival rate of around 75 to 80 percent.

What are the ethical considerations for Cryo-Preservation for Embryos?
Patients consider how long their embryos should be stored, what will happen to the embryos should the patient or her partner die or if the couple divorces, and whether the embryos may be donated to infertile couples if they are not needed by the patient. The patient who provided the eggs or the partner who provided the sperm may withdraw consent for the embryos to be used, at any time during the cryo-preservation procedure.

What is IVF?
IVF (In Vitro Fertilization) is treatment to assist couples with fertility problems to have a baby.
IVF is a procedure where eggs are fertilized outside the body in the laboratory and then the fertilized eggs are inserted into the uterus to develop.
IVF can be an infertility treatment option when the man has a low sperm count, the woman has problems with the uterus or fallopian tubes, or the reason for infertility is unexplained.

How is IVF carried out?

• The woman is given a drug to suppress the natural monthly cycle as an injection or nasal spray, to be taken for around two weeks.
• A fertility hormone is administered for around 12 days to stimulate the body to produce more eggs.
• Eggs are collected by inserting a needle through the vagina into each ovary.
• The eggs are mixed with the man’s sperm in a laboratory.
• The fertilized eggs – embryos – are incubated and then transferred into the womb.
• Prior to the transfer, the woman prepares the uterus for the embryo by taking progesterone to thicken the lining.
• For women aged under 40, one or two embryos are placed in the womb.
• For a woman aged over 40, three embryos are implanted.

How popular is IVF compared to other fertility treatment options?
IVF is not usually the first step in fertility treatment. IVF can be a costly and complex procedure, and only around 5 percent of couples with infertility problems carry it out.

What affects the chances of success of an IVF procedure?

• The reason for infertility
• The age of the woman (the younger the woman, the higher the chances of success)
• The experience and ability of the doctors carrying out the procedure

What are the chances of success with IVF?

A study by the New England Journal of Medicine published in 2009, analyzed the results of 14,000 IVF cycles done by over 6,000 women.
Here is a summary of the results:

A study by the National Health Service in the UK, the percentage of IVF cycles in 2006 that resulted in a live birth was:

This information is intended for general information only and should not be considered as medical advice on the part of Health-Tourism.com. Any decision on medical treatments, after-care or recovery should be done solely upon proper consultation and advice of a qualified physician.

What are the options available for helping conception in case of a low sperm count?

• Drug treatments: There are many drugs to treat a low sperm count, including androgens, testolactone, FSH injections, steroids, kallikrein, clomiphene and antioxidants. Antibiotic treatment to clear an infection of the reproductive tract may also help treat male infertility.
• IVF: IVF, in vitro fertilization, takes sperm and injects it directly into the egg, bypassing problems with sperm delivery.
• IUI: IUI, intrauterine insemination, is artificial insemination carried out by injecting specially treated sperm into the womb.
• ICSI: ICSI, intracytoplasmic insemination, is an IVF procedure that injects a single sperm into an egg and transfers it to the uterus.
• PESA: A small amount of sperm is removed through a thin needle and used in ICSI.
• TESA: Mature sperm are extracted using a thin needle and used in the ICSI procedure.
• TESE: Sperm is removed through extracted tissue from the testicles and used in ICSI.

What is PGD?
PGD (Preimplantation Genetic Diagnosis) is also referred to as embryo screening and is a procedure used on embryos before implantation, to screen for a variety of disorders. The most common disorders in question include cystic fibrosis, sickle cell disease, Huntington’s disease and spinal muscular atrophy.
PGD is a procedure used alongside IVF and is carried out in order to increase the likelihood of an ongoing pregnancy and to prevent an inherited condition being passed on to the child.
PGD is also sometimes used for sex selection.

How is PGD carried out?
The woman undergoes IVF in order to collect eggs and fertilize them with the man’s sperm in a laboratory. The embryo develops in the laboratory for two to three days after which one or two cells are removed for genetic testing. The embryos that are found healthy from genetic diseases are transferred to the womb. Any unused embryos may be frozen for future use.

What affects the chances of success of a PGD procedure?
While there is little data available on the success rates of PGD, many factors can affect its success.

• The age of the woman (the younger the woman, the higher the chances of success)
• The underlying cause of infertility
• Lack of embryos available to be transferred to the womb (for reasons of not enough eggs, damaged embryos or lack of viable embryos)

Is PGD legal in all countries?
PGD is a controversial technique and is not offered at all health centers. In many countries PGD is prohibited, in others it is controlled by the state.

This information is intended for general information only and should not be considered as medical advice on the part of Health-Tourism.com. Any decision on medical treatments, after-care or recovery should be done solely upon proper consultation and advice of a qualified physician.

What are the treatment options for Endometriosis?
There is no cure for endometriosis but it can be treated in the following ways:

• Pain medication: Typical pain medications for endometriosis treatment are non-steroidal anti-inflammatories (NSAIDs) like ibuprofen and naproxen. These medications relieve pain and cramping but have no effect on the position of the womb lining.
• Hormone treatment: Endometriosis treatment with hormones limits or stops estrogen production in the body, easing symptoms. Hormone treatment may involve progestogens, antiprogestogens, the combined oral contraceptive pill or gonadotrophin-releasing hormone (GnRH) analogues.
• Laparoscopic surgery: A laparoscopy procedure accesses the inside of the pelvis through keyhole surgery to cut out or burn endometriosis tissue.
• Laparotomy: Laparotomy is a more invasive option if endometriosis is severe. The surgeon cuts and opens up the affected area to remove endometriosis tissue.
• Hysterectomy: The removal of the womb is a major operation and is usually considered a last-resort treatment of severe endometriosis.

How do you decide which treatment for Endometriosis is right for you?
Correct endometriosis treatment depends on the extent of your symptoms, your age, whether you are planning pregnancy, and whether or not you have tried any treatment before.
Surgery for endometriosis treatment is recommended when your symptoms are severe or if your fertility is affected.

What are the treatment options for Endometriosis?
There is no cure for endometriosis but it can be treated in the following ways:

• Pain medication: Typical pain medications for endometriosis treatment are non-steroidal anti-inflammatories (NSAIDs) like ibuprofen and naproxen. These medications relieve pain and cramping but have no effect on the position of the womb lining.
• Hormone treatment: Endometriosis treatment with hormones limits or stops estrogen production in the body, easing symptoms. Hormone treatment may involve progestogens, antiprogestogens, the combined oral contraceptive pill or gonadotrophin-releasing hormone (GnRH) analogues.
• Laparoscopic surgery: A laparoscopy procedure accesses the inside of the pelvis through keyhole surgery to cut out or burn endometriosis tissue.
• Laparotomy: Laparotomy is a more invasive option if endometriosis is severe. The surgeon cuts and opens up the affected area to remove endometriosis tissue.
• Hysterectomy: The removal of the womb is a major operation and is usually considered a last-resort treatment of severe endometriosis.

How do you decide which treatment for Endometriosis is right for you?
Correct endometriosis treatment depends on the extent of your symptoms, your age, whether you are planning pregnancy, and whether or not you have tried any treatment before.
Surgery for endometriosis treatment is recommended when your symptoms are severe or if your fertility is affected.