AT WHAT POINT DOES IVF BECOME NECESSARY AMONG INFERTILE COUPLES?

Introduction

Infertility is a global problem and a public health concern in many parts of sub-Saharan Africa. Infertility remains a common gynecological and social problem.

It is a disease of reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.

SOME FACTS ABOUT INFERTILITY:

  • 8-12% of couples worldwide are affected.
  • 6% and 10% in the United Kingdom and United States of America respectively.
  • 30-40% In sub-Saharan Africa.
  • 20-30% in Nigeria.

ASSISTED REPRODUCTIVE TECHNOLOGIES

  • This refers to all treatments or procedures that include the handling of human oocytes or embryos for the purpose of establishing a pregnancy. It could be any of the below procedures:
  • Ivf :-     in vitro fertilization.
  • Icsi :-   intracytoplasmic sperm injection.
  • Imsi :-   intracytoplasmic morphologically selected sperm injection.
  • Gift :- gamete intrafallopian transfer.
  • Zift :- zygote intrafallopian transfer.
  • Gamete/ embryo cryopreservation, oocyte/embryo donation.





What is IN VITRO FERTILIZATION?
It is a technique of letting fertilization of the male and female gametes occur outside the female body.

 

WHEN IS IVF NEEDED: It is needed when there are indications below:

INDICATIONS CURRENT STATUS
Tubal Factor Severe: Absolute-Mild-Moderate: Relative
Male Factor Severe : Absolute- Mild-Moderate: Relative
Endometriosis Relative
Anovulation Relative
Immunological (Antisperm antibody) Relative
Unexplained Relative
 

Fertility Preservation

 

Absolute for Oocyte & Embryo Cryopreservation

 

Pre-Implantation Genetic Diagnosis

& Screening

 

Absolute

Advice

Any couple with any of the above should consult fertility expert. You can also consult the site fertility specialist.

Summary

  • IVF/ICSI/IMSI has revolutionalized the management of infertility.
  • Although single ET has been advocated, DET OR 3ET increases pregnancy rate but with risk & complications of multiple pregnancy.
  • USS guided ET improves pregnancy rate.
  • Luteal support is beneficial but no clear cut recommendation on the best approach.

 

 



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