Life
can sometimes throw surprises. Starting a family may seem easy, but for many,
the dream is hampered by delay. Just as surprising is the number of Filipinos
who have difficulty conceiving — one in 10 Filipino couples are currently
experiencing infertility, according to a recent survey by Synovate.
Some
couples may opt to wait and try to conceive naturally, but when couples are
over 35 years old, waiting is a luxury. Women are born with about one million
eggs throughout their lifetime, but by the time they reach puberty, only
300,000 are left. Of that number, only about 300 eggs are ovulated during a
woman’s reproductive years, at the rate of one egg per month. Generally, women
are most fertile in their 20′s, after which, fertility begins to decline. After
age 35, the chances of a woman having a baby naturally decline by about 50% —
and further decline by about 90% past their 40s. Before reaching menopausal
stage, a woman’s reproductive capabilities slow down and become less effective
at producing mature and healthy eggs. Closer to menopause and her ovaries no
longer respond well to the hormones that are responsible for helping the
ovulation.
Fortunately,
there are a number of treatment options available today to help couples take
immediate action. These options are can range from oral or hormonal therapies
to Assisted Reproductive Technologies or ART, such as In Vitro Fertilization
(IVF).
It
is important to take the time to learn about the treatment options, once the
doctor establishes the causes of fertility difficulties. Fertility tests are
essential to truly determine the course of action and to monitor the treatment
along the way.
ORAL MEDICATION
If the female partner is not ovulating, the
doctor may recommend she takes tablets to help her produce eggs for conception
to take place. The most commonly used tablet is called clomiphene citrate.
These drugs are 35–50% effective in helping you
conceive if you are not ovulating and everything else is normal. The dosage may
need to be increased before ovulation is established. Generally if these drugs
are successful ovulation and pregnancy occur within 3 to 6 months. Generally,
this treatment can be taken for up to 8 months before being abandoned.
HORMONE TREATMENT
Men and women rely on their hormones to ensure
they are producing enough healthy sperm and eggs.
If one or both partners have a problem producing
the necessary hormones, these can be supplemented with hormone injections.
Modern hormone treatments can be given with simple pen devices for easier
administration. You will usually be able to administer the injections
yourselves at home, returning to the clinic only for regular checkups to ensure
that the hormones are effective and the dosage is correct.
Clinical studies have shown that hormonal
therapies have a good safety profile. However, as with all prescription
medications, there are possible side effects. Your doctor will discuss any
potential effects and monitor your response to therapy. Remember to report all
symptoms to your doctor.
Not all injections are the same and you should
ask your doctor to explain the differences between them.
If this treatment is ineffective on its own it
may be combined with another therapy.
Expect to be having hormone treatment for 2 to 6
months depending on the effect of the treatment.
If the couple is producing enough healthy eggs
and sperm and the fallopian tubes are normal, then the problem is likely to be
one of fertilization.
THE “ART” OF CONCEPTION
Assisted Reproductive Technology (ART) is a set
of treatment options that employ modern techniques to assist the natural process
of fertilization. These can sometimes be outside of the body (this is called in
vitro fertilization or IVF) and some involve introducing sperm into the woman’s
body, along with increasing the number of eggs released at the time of
ovulation for fertilization to take place (this is called super ovulation
combined with intrauterine insemination or IUI).
If the previous treatment steps have not been
successful, the doctor may suggest using donor eggs or sperm as part of these
techniques.
In Vitro Fertilization (IVF)
After an examination, a doctor will devise a
fertility protocol for the woman, highlighting all of her recommended fertility
procedures, such as medications and blood tests. It is important that a woman
follow this protocol carefully.
A woman is first given fertility drugs to
stimulate her ovaries. Many doctors may prescribe birth control pills for the
first two months, since the hormones in oral contraceptives can help the
ovaries to produce as many mature eggs as possible (instead of the usual one
per monthly cycle), thereby increasing the chances of fertilization. These
pills can also help regulate the menstrual cycle, so the doctor knows what is
happening at specific times, and when would be the best time to begin the IVF
cycle.
Next, the eggs are retrieved using a needle
inserted into the ovary. The eggs and sperm are combined and fertilized in a
culture dish.
Finally, the best-quality embryos are selected
and then transferred into a woman’s uterus. If all goes well, normal pregnancy
ensues.
IVF can be used to help couples with a variety of
fertility challenges to get pregnant. As with natural conception, success rates
are higher in younger women (generally under 40 years of age). There are many
factors that determine IVF suitability, and couples need to consult with a
fertility specialist before determining whether IVF can help them get pregnant.
Rather than looking at IVF as a last resort,
couples should view it as the ultimate treatment that provides immediate action
for those who cannot afford to wait.
OTHER PROCEDURES
Couples should be prepared to undergo multiple
treatment cycles, and possibly, multiple treatment options or procedures.
Pregnancy is a result of a complex combination of factors and events. Even if
doctors are able to identify the barriers preventing pregnancy, conception
still takes a lot of work. Many couples go through several cycles before they
succeed.
The chance of multiple pregnancies with fertility
treatments is higher than usual but can be minimized. This is primarily due to
the practice of transferring several embryos into the uterus to increase
chances for success. However, the chances of multiple births can be minimized,
so couples should discuss this with their doctors.
In the Philippines, the
average success rate of IVF/ICSI is between 30-50%, depending on the age group,
with success rates naturally higher within the under 35 age group. While there
are some instances of multiple births, majority have resulted in single live
births.
While treatment success rates have been on a
constant rise due to advancements in technology and greater efficacy in
medications, there is no absolute success rate for fertility treatments. The
outcomes are different for every individual couple and each clinic or fertility
center. Success depends on several factors including age, lifestyle and the
cause of the difficulties in conceiving.
With patience, a positive attitude, and the
appropriate treatment, most couples will eventually achieve their dream of
starting a family.
Fertility treatment is time-consuming and
strenuous – physically and emotionally. A couple’s commitment and ability to
cope with stress can also affect the outcome. Couples should ask their doctor
what they should expect throughout the treatment process.
Source: http://fertilityphilippines.com/fertility-facts/
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