Male Infertility Condition and Fertility Treatments for It

IVF & ICSI as Treatments for Azoospermia

IVF_with_IMSIAccording to the American Society of Reproductive Medicine, one third of infertility cases are due to male factor, one third are attributed to female factor, and the remaining third are unexplained and typically involve problems on both sides. Although azoospermia affects about two percent of the male population, it accounts for nearly 20 percent of all male infertility cases. The good news is major recent advances in reproductive medicine such as introduction of ICSI allow successful fertilization with immature sperm or sperm obtained directly from testicular tissue.

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Ask Our Fertility Doctors

IVF

Issues pertaining to infertility and fertility treatments are complex and certainly create a lot of questions in the minds of individuals who are either undergoing fertility treatments or seriously considering those. Since it would be impossible for us to provide answers to all the questions we receive on our website, we decided to set up a more appropriate venue for questions our clients may have. This is how this blog was born. Our fertility doctors (e.g. reproductive endocrinologists, OB/GYN doctors, embryologists, etc.) agreed to answer questions pertaining to infertility and fertility treatments.

In case you are wondering about qualifications of our doctors, during the selection process of our IVF clinics, we went an extra mile to ensure our clients will receive the same high quality IVF advice and/or treatments as those available in the U.S. Our partner clinics follow the standards of the American Society for Reproductive Medicine (ASRM) and are accredited in the U.S. Our partner doctors are board certified and often hold Ph.D. on top of their M.D. degrees.

Our hope is that this blog will serve as a professional, discrete environment where one can ask questions and hopefully find answers pertaining to fertility treatments. Our doctors agreed to answer questions concerning:

• General questions about infertility
• Questions in regards to effectiveness of Assisted Reproductive Technology (ART)
• Questions pertaining to tests (e.g. blood work, genetic testing, PGD etc.)
• Questions about the IVF process and what happens during specific treatments
• And of course questions pertaining to symptoms and problems during the course of the treatment

We hope we can answer most of your questions and in the process help you with starting or expanding your family. Feel free to email me with your questions (Darya.Mikhailova@theMedVacation.com).

Darya Mikhailova, MD

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I am concerned that my eggs may be of poor quality. How can one determine the quality of her eggs?

We can have some basic notion about the quality of eggs by examining the size of the follicle and the level of Estradiol in the middle of the cycle. However, as the woman ages, we often deal with such factors as thickening of the external wall/skin of the egg, which in turn makes it harder for sperm to penetrate the egg.

In reality, it is impossible to determine the quality of one’s eggs until we extract those from the follicles, examine them under the microscope and see the stage of their development. There are some easier methods of testing the ovarian reserve and the quality of eggs. These are chlomiphenom test, and the tests to determine the level of Follicle Stimulating Hormone (FSH) and Inhibin B. All these tests although helpful, are still not as effective as examining eggs under the microscope.

Do ovarian cysts affect my chances of getting pregnant?

The research shows that any ovarian cysts of 10 mm or larger reduce one’s chances of getting pregnant. For instance, studies show that women who underwent IVF treatments while they had 10 mm cyst in the beginning of the cycle were twice as unlikely to get pregnant as women who didn’t have cysts (all other factors being equal). Therefore, cysts will not prevent one from getting pregnant but will significantly reduce woman’s changes of doing so.

Can I fly and how long can I be in the air, after embryo transfer?
 
Yes, you may travel by plane. Air travel does not pose any danger to pregnancy as long as constant air pressure is maintained. Modern airplanes……….. as a rule…….. don’t have sudden air pressure changes.

We received a couple of inquiries about reversing tied tubes and getting pregnant after that.

Our doctors recommend IVF treatments, if you have your tubes tied and are thinking about getting pregnant. You may have heard this already from doctors in the U.S. or from research you’ve done. Getting pregnant a traditional way after reversing tied tubes may be a dangerous endeavor.

First, our IVF doctors say that reversing tide tubes is typically not an effective procedure. Moreover, even if the reversing tied tubes procedure is done, chances of having tubal pregnancy (situation when the fertilize egg implants itself outside uterus) are very high for that person. That is the reason why doctors recommend to have IVF in this case.

To summarize the recommended treatment course for women with tied tubes, our doctors would perform ovulation induction and egg extraction without reversing tied tubes for the patient.

Several individuals asked us how many eggs are typically harvested from a donor and what happens to the unused eggs.

On average, our clinics harvest 10 to 18 eggs per donor. As a rule, we fertilize all of the retrieved eggs with sperm. Certain number of fertilized eggs grow to become embryos. Our doctors transfer 1-2 embryos (more often two) in the transfer stage of the IVF process. In rare cases, in the situation of severe infertility, the doctors may recommend transferring 3 embryos.

The embryos which are left after the IVF cycle can be frozen. Our clinics use the latest cryopreservation approach, which dramatically increase cryosurvival (percentage of eggs/embryos that are alive after thawing) of embryos. Traditionally, IVF clinics used the slow freezing method that has been used since the 1980’s. Our clinics use rapid freezing technique recently developed in Japan called Vitrification. With Vitrification, the temperature is lowered at 23,000 degrees C° per minute. That is 70,000 times faster than in traditional approach. Such rapid cooling coupled with cryoprotactant fluids prevents formation of ice crystals in embryos.

You may be wondering why it is important to have as little ice crystal formation as possible. It is important in the embryology, because ice crystal formation is very damaging to frozen eggs and embryos. In other words, eggs do not fertilize well after thawing. The slow freezing approach produces disruption in the membrane, which causes a block to the conventional fusion and penetration of sperm with the egg surface.

Our IVF clinics do all of their embryo freezing at the blastocyst stage. Upon request from our clients, our clinics can also freeze eggs rather than embryos. We freeze embryos, because statistics show that pregnancy rates are just as high in properly frozen embryos as in fresh embryos which have never been frozen. The same cannot be said for frozen eggs; pregnancy rates for frozen eggs are 15-20 lower than those for frozen embryos.
You can email us your questions to info@theMedVacation.com