Australia IVF - In Vitro Fertilisation - Infertility Treatments Information

ICSI is the injection of a single sperm directly into the egg using a specially prepared needle. It is recommended for severe cases of male infertility and where there has been no fertilisation following IVF previously. 

With ICSI (Intra Cytoplasmic Sperm Injection), very few sperm are required and the ability of the sperm to penetrate the egg is no longer important as this penetration is bypassed by the ICSI technique. It is important to remember that whilst ICSI is a technique used in the laboratory to help fertilisation occur, it does not guarantee it. Couples go through the same preparatory processes as with IVF, namely ovulation induction and egg collection.

ICSI can only be carried out on a mature egg. Unfortunately egg maturity can only be truly identified under the microscope and it is, therefore, possible that following egg collection, none of the eggs are suitable for ICSI. This situation is fortunately rare.

A small percentage of eggs (fewer than 1 in 10) will be damaged by the injection process and the damage is evident at the time of the injection procedure. These eggs can no longer be used. Of the remaining eggs, however, on average 6 out of 10 are fertilised following the ICSI procedure. The fertilised embryos are allowed to develop as for standard IVF treatment prior to embryo transfer.

One of the Treatment Options for infertility is by using  Ovulation inducing and cycle monitoring. If a woman has an irregular menstrual cycle, monitoring with ultrasound scans and hormone assessments may help to identify the fertile time of the month and so improve the chances of natural conception. If ovulation is not occurring, then drugs may be administered after the onset of menstruation to stimulate egg production. The simplest treatment is with tablets (Clomiphene and Tamoxifen) given within the first few days of the cycle. The response is monitored by ultrasound scans. These are not always effective and more powerful fertility injections may be necessary to stimulate egg production in the ovaries. With these more potent drugs there is a greater risk of increased egg production and, therefore, the risks of multiple pregnancy are greater. Women receiving fertility injections are monitored by ultrasound scans and hormone assessment.

The normal values for semen test result:

Volume: >2.0ml
Concentration: >20 million/ml
Total Cells: >40 million
Motility: ~50%
Normal Forms: >14%
 
If one or more parameters of the test for semen results is not within the normal value, it is recommended to repeat the test several weeks later. Sperm is continually produced in the testes. Its production is affected by health such as fever, nutrition, stress level and other factors, and it takes about 2  months until the sperm matures. For this reason, a single poor sperm test may not be a true indication of the man’s fertility.

Additional factors that may appear on your sperm tests include:
-Semen Viscosity - Coagulated sperm should liquefy within an hour. If it does not, sometimes IUI will solve the problem.
-White & red blood cell counts - If these are abnormally high, antibiotics may be recommended.
-Sperm Agglutination - Sperm that clump together. This may be a sign of anti sperm anti bodies - when your own body mistakes your sperm as an external organism. Sperm agglutination can also be caused by infection.

This table below summarises the organs of the males reproductive system.

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Problem in conceiving a baby comes as a surprise to some couples. Many of them have no medical history to suggest a infertility problem, and  in fact,  they have spent years trying to prevent pregnancy. They assume that once birth control is stopped, conception will soon follow without any problem. While this is true for many couples, others find out that having a baby is not as simple as they expected.

up to 90% Infertility problem can be treated using conventional therapies, such as surgery, or medication . these treatment success rates are continually improving.

Potential male factors are described throughout this section of the site. Whatever are the cause, solving the problem with infertility is never easy. Many men feel robbed of their virility when they discover a fertility problem, and some struggle with feelings of poor self-esteem. These responses are normal. The key to overcoming them is a support by the wife. Whether difficulty conceiving is related to male factors, female factors, or both, infertility is a couple’s shared challenge.

Here are some of the causes of infertility in men, which related  to sperm:

• Sperm Creation
• Sperm Quality        

Causes of infertility can be related to the female or male.
Male Infertility
Male Infertility results from an ability to produce sufficient motile sperm for fertilization. If there are no sperm (azoospermia) or very few (oligospermia) then the couple will usually need to use Artificial Insemination or a technique like ICSI (Intracytoplasmic sperm injection) to conceive. If the sperm have defective tails or some other major abnormality then natural conception will be impossible. Most severe problems are caused by abnormal genes or chromosomes.
 

Female Infertility
Total female infertility results from either tubal damage or some condition (usually genetic or chromosomal) that permanently inhibits ovulation. There could be an absence of eggs or some other developmental defect. however,  however if there is difficulty getting pregnant but no tubal damage and there are cycles of some sort, whether long or irregular or low in mucus or they don’t match temperature charts or you can’t detect ovulation with home kits, it is very likely that the problem can be addressed by changes in lifestyle.

Causes of Infertility

• Immunological Infertility
• Hormonal Infertility
• Unexplained Infertility
• Tubal Ligation
• Male Causes

-Ovulation Induction

Ovulation Induction involves the administration of either oral or injectable fertility medication, to either establish ovulation , where a woman otherwise does not ovulate to improve the ovulation process or convert the usually unifollicular, monthly ovulation process into a polyfollicular process, to enhance conception chances. Whatever the indication for ovulation induction treatment, a conversion to a polyfollicular response will always take place. The woman has a greater chance of getting pregnant, but, consequently, any form of ovulation induction will be characterized by an increased risk of multiple births.

-Intrauterine Insemination (IUI) | Artificial Insemination

IUI  is usually recommended to accompany ovulation induction cycles to increase pregnancy chances. When an IUI is performed, the partner’s semen, after its seminal plasma has been washed off is directly injected into the uterus. IUIs empirically improve pregnancy rates over regular intercourse, when male infertility is a factor. IUI also improve pregnancy rates if cervical factor infertility is present (i.e. the cervical mucus inactivates semen motility) and in the presence of mildly abnormal semen, which can constitute a case of general male infertility .

-Donor Insemination

Artificial insemination is also performed through donor insemination, which involves the same process as described for IUI, except that the semen sample comes from a donor. 
 

-Gynecoradiology

Gynecoradiology is a term of the use of xray equipment to diagnose and treat causes of infertility.  Most other fertility centres refer patients to radiology departments