|
Que
1: If Sperm count reports are very
low then what can be done ?
Que 2: What is ICSI ?
Que 3: What is oligospermia ?
Que 4: What is azoospermia ?
Que 5: Are there any treatments for azoospermia
?
Que 6: What is PESA ?
Que 7: What is TESE ?
Que 8: What is Surgical Sperm Aspiration
(SSA) ?
Que 9: What is semen cryopreservation
?
Que 10: How many Specimens should I have
frozen ?
Que 11: How many Specimens should I have
frozen ?
Que 12: Will Repeated IVF treatment damage
my ovaries ?
Que 13: Will previous operation procedure
make it impossible to retrive the eggs ?
Que 14: What if I ovulate before oocyte
(also called egg or ovum) retrival ?
Que 15: It is very rare, if the technique
does not produce a pregnancy on the first attempt, how
soon can the procedure be repeated ?
Que 16: How many times will IVF be repeated
per couple ?
Que 17: Can we have intercourse during
the two-week period before a IVF procedure is performed
?
Que 18: After the IVF procedure, how
long must we wait to have intercourse ?
Que 19: What about other activities?
How soon can I resume my normal routine ?
Que 20: How soon will I know if I'm pregnant
?
Que 21: I had my tubes tied (tubal ligation)
several years ago.Would I be a candidate for IVF ?
Que 22: What drugs are given to stimulate
the ovarian follicles and maintain the lining of the
uterus prior to implantation of pre-embryo ?
Que 23: What side effects, if any can
these drugs cause ?
Que 24: Will I have an egg in every follicle
?
Que 25: Is there a possibility of multiple
births with IVF ?
Que 26: Is there an increased chance
of birth defects if I become pregnant through IVF ?
Que 27: How much time does the entire
procedure require ?
Que 28: What happens to any extra pre-embryos
?
Que 29: What is ovarion Hyperstimulation
Syndrome (OHSS) ?
Que 1:
If Sperm count reports are very low then what can
be done ?
Ans 1: Treatments for male factor infertility vary
from intrauterine insemination (IUI) to in vitro fertilization
with Intracytoplasmic Sperm Injection (ICSI). Individualized
Medical treatment protocols are provided by the physician
after the diagnostic evaluation is completed.
Que 2:
What is ICSI ?
Ans 2: Severe male-factor infertility is treated
very successfully by a relatively new laboratory technique
called ICSI. ICSI involves injecting one sperm directly
into the egg using a microscope with specialized micromanipulation
equipment. ICSI is always used in conjunction with in
vitro fertilization. For ICSI various sperm retrival techniques
are used like PESA, MESA, TESA, TESE.
Que 3: What
is oligospermia ?
Ans 3: The term "oligo" means few. Oligospermia
is the presence of fewer than the normal number of sperm
in the semen. Men with fewer than 20 million sperm/ml
are usually defined as having oligospermia, or a low sperm
count.
Que 4:
What is azoospermia ?
Ans 4: Azoospermia is the complete lack of sperm
in the ejaculate.
Que 5:
Are there any treatments for azoospermia ?
Ans 5: Yes. There are two different types of azoospermia.
Obstructive azoospermia is the complete lack of sperm
in the ejaculate due to a blockage in the male reproductive
tract or the absence of the part of the reproductive tract
that carries sperm from the testicle to outside the body.
A blockage, or obstruction, may have been present at birth
or may have occurred as a result of an infection or severe
trauma to the testicles or the tubules surrounding the
testicles that transport the sperm out of the body. Men
with obstructive azoospermia almost always have some sperm
in their testicles, but these sperm are not found in the
semen because of the blockage or absence of part of the
reproductive tract.
Que 6:
What is PESA ?
Ans 6: For treating obstructive azoospermia, a
procedure called Percutaneous Sperm Aspiration, or PESA,
is used to aspirate sperm from the epididymis.
Que 7:
What is TESE ?
Ans 7: For treating nonobstructive azoospermia,
a procedure called Testicular Sperm Extraction, or TESE,
is used to obtain sperm directly from the testicle, where
the sperm are being produced. The TESE procedure involves
the removal of very small pieces of testicular tissue.
Que 8:
What is Surgical Sperm Aspiration (SSA) ?
Ans 8: When Semen analysis shows zero sperm count
the cause may be either obstructive azoospermia or nonobstructive
azoospermia. For such cases sperms are retrived from tract
by different method known as Surgical Sperm Aspiration
(SSA). They are like PESA, MESA, TESA, TESE.
Que 9:
What is semen cryopreservation ?
Ans 9: Semen cryopreservation (the freezing of
sperm) is a way to store sperm for future use. Sperm is
routinely frozen and maintained in the Center.
Que 10:
How many Specimens should I have frozen ?
Ans 10: The general recommendation is to collect
and freeze up to three specimens, collected two to seven
days apart. However, depending on your particular situation,
the recommended number of days between collection and
the number of specimens for storage may vary. The number
of specimens to be frozen also may vary depending on the
number of sperm and the sperm motility in each specimen.
Que 11:
How many Specimens should I have frozen ?
Ans 11: Semen is stored in liquid nitrogen at -248°
Fahrenheit. Because of the freezing process, the number
of motile sperm in the sample decreases; however, based
on current information, we believe samples stored this
way will be usable indefinitely.
Que 12:
Will Repeated IVF treatment damage my ovaries ?
Ans 12: There are no evidence to suggest that either
normal laparoscopy or ultrasound egg retrival damages
the ovaries. In fact, some reports in the medical literature
suggest that following ovarian biopsy, pregnancies occur
in couples with long-term history of infertility.
Que 13:
Will previous operation procedure make it impossible
to retrive the eggs ?
Ans 13: Not Ordinarily. The surgeon must be able
to see the follicles in order to guide the needle to the
proper spot for retrival of the eggs whether by sonographic(ultrasound)
or surgical methods.
Que 14:
Will previous operation procedure make it impossible
to retrive the eggs ?
Ans 14: Not Ordinarily. The surgeon must be able
to see the follicles in order to guide the needle to the
proper spot for retrival of the eggs whether by sonographic(ultrasound)
or surgical methods.
Que 15:
It is very rare, if the technique does not produce
a pregnancy on the first attempt, how soon can the procedure
be repeated ?
Ans 15: This depends on the individual. The primary
reason for delay is to allow the patient's normal menstrual
cycle to resume, which may take 2 to 3 cycles.
Que 16: How
many times will IVF be repeated per couple ?
Ans 16: There is no specific number. This is determined
by the couple togater with the physician.
Que 17: Can
we have intercourse during the two-week period before
a IVF procedure is performed ?
Ans 17: Most definitely. We recommend that the
husband refrain from ejaculation for at least 48 hours,
but for no more than 5 to 6 days preceding egg retrieval.
This precaution assures that the semen sample obtained
for IVF will contain a maximum number of healthy, motile
sperm.
Que 18:
After the IVF procedure, how long must we wait to
have intercourse ?
Ans 18: Although a definite time of abstinence
to avoid damage to the pre-embryo has not been determined,
most experts recommend abstinence for two to three weeks.
Theoretically, the uterine contractions associated with
orgasm could interfere with the early stages of implantation.
However, intercourse the night before pre-embryo transfer
is acceptable.
Que 19:
What about other activities? How soon can I resume
my normal routine ?
Ans 19: The IVF team recommends that the patient
be sedentary for a full 24 hours following pre-embryo
placement in the uterus. Strenuous exercises such as jogging,
horseback riding, swimming, etc. should be avoided until
pregnancy is confirmed. Otherwise, the patient is free
to return to her regular activities.
Que 20:
How soon will I know if I'm pregnant ?
Ans 20: Pregnancy can be confirmed using blood
tests about 14 days after egg aspiration. Pregnancy can
be confirmed by ultrasound 30 to 40 days after aspiration.
Que 21:
I had my tubes tied ( tubal ligation) several years
ago. Would I be a candidate for IVF ?
Ans 21: Perhaps, in certain situations, IVF may
be cheaper and physically less demanding than surgery
to repair you fallopian tubes.
Que 22:
What drugs are given to stimulate the ovarian follicles
and to maintain the lining of the uterus prior to implantation
of the pre-embryo ?
Ans 22: Four to five medications normally are given:
- Leuprolide acetate or Brucerelin
(Lupron), an injectable drug that blocks secretions
of the pituitary gland, thereby optimizing the number
of oocytes retrieved;
- Human menopausal gonadotropin
(HMG) or Follicle Stimulating Hormone (FSH), hormones
that stimulate ovarian activity, are injected daily
for about 6-10 days prior to the procedure;
- Injuction GNRH antagonist. If
antagonist protocol is to be used.
- Human chorionic gonadotropin (HCG),
a hormone that mimics the action of the hormone which
naturally induces ovulation, is injected 34 to 36
hours before retrieval and may be used after retrieval
to supplement natural progesterone production;
- Progesterone, a natural hormone
that enables the uterus to support pregnancy, may
be used as a daily injection after egg retrieval.
Que 23:
What side effects, if any, can these drugs cause ?
Ans 23: No pronounced side effects have been associated
with any of these drugs. However, the patient should inform
the physician of ANY allergies she has or of any previous
adverse reactions to drugs.
Que 24:
Will I have an egg in every follicle ?
Ans 24: It varies from patient to patient . As
many as half of the follicles may not contain an egg in
some patients.
Que 25:
Is there a possibility of multiple births with IVF
?
Ans 25: Yes, when multiple pre-embryos are transferred.
25%. of pregnancies with IVF are twins. (In normal population,
the rate is one set of twins per 80 births.) Triplets
are seen in approximately 2-3% of pregnancies.
Que 26:
Is there an increased chance of birth defects if I
become pregnant through IVF ?
Ans 26: There are no known ill effects. Abnormal
pre-embryos, even those produced through normal fertilization,
do not seem to mature. However, any long-term effects
of IVF remain to be determined.
Que 27:
How much time does the entire procedure require ?
Ans 27: Approximately three weeks (all as an outpatient).
Fertility drugs are administered to stimulate the ovaries.
Then during the four to six days prior to ovulation, the
patient is monitored by ultrasound as well as by hormone
levels.
Que 28:
What happens to any extra pre-embryos ?
Ans 28: A maximum of four pre-embryos will be transferred
to the uterus for possible implantation. Patients will
have several other options regarding the disposition of
the remaining pre-embryos. One option is to freeze pre-embryos
for your later use. Other options are to donate or simply
dispose of them. Excess pre-embryos, if any, belong to
you, and you will determine what is to be done.
Que 29:
What is Ovarian Hyperstimulation Syndrome (OHSS) ?
Ans 29: When we stimulate ovaries with genadotrophin
it may get overstimulated sometimes producing more than
many follicles. This may lead to very high level of estrodial
& patient may land with OHSS. If this complication
is mild to moderate, can be treated. But sever OHSS may
lead to hospitalization. Pregnency if occurs will add
fuel to problem.
|
Home