Fertility treatments have advanced tremendously over the years. All these advancements have helped countless couples achieve their dreams of parenthood. For fertility specialist Dr Fabian James Kurian, choosing which of these treatments is best for a couple will depend on the findings after an initial assessment of both the woman and the man. While a woman’s age and underlying cause of fertility problems do matter, so does sperm quality.
“In a natural cycle, women usually produce one follicle and one egg per month. In IVF, we try to stimulate the ovary to produce more follicles, thereby giving us more eggs that we can fertilise with the male partner’s sperm,” explains Dr Fabian. “We then place a predetermined concentration of sperm in a well with the egg. Nature will help sort out the best sperm in that group to fertilise that egg.”
As for ICSI, he says that the process involves selecting a single viable normal sperm and then injecting it into a suitable egg to increase the chances of fertilisation. This is done when there are abnormalities in the sperm, in terms of concentration (count), motility (movement) or morphology (shape). Sperm quality can be quite variable, and as such, the decision if ICSI is required is based on the sperm parameters on the day the eggs are retrieved.
The embryo transfer is a critically important procedure and is the last step of the process. Embryos are transferred to the uterus several days after fertilisation and hormonal treatments are administered to promote embryo implantation into the uterine lining. Any extra embryos are frozen for future use.
Men may not always be aware of their sperm deficiency, according to Dr Fabian. “They may have very low sperm counts or no sperm at all (azoospermia),” he notes. They usually function just fine sexually, but sometimes, it is only after they get tested that they are made aware of the problem.”
It is best to seek help earlier, the success of fertility treatments is crucially related to women’s age. Women above 35 who have been trying for more than 6 months should visit a fertility specialist with their spouse to get a full evaluation and to possibly start on a treatment plan.
“As couples start on their journey towards parenthood, they should understand that this is a journey that should be made together. It is not about what problem or where the fault it is, rather, it is about supporting each other and working towards the solution.”
Dr Fabian James Kurian
Obstetrician & Gynaecologist and Fertility Specialist
TMC Fertility & Women’s Specialist Centre (http://www.tmcfertility.com).
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