Infertility Treatment
Male factor infertility treatment
Male factor fertility problems can be difficult to treat. Surgery can sometimes help. Occasionally medication may be prescribed. Specialised infertility units at hospitals or urologists will advise in this area.
I.C.S.I. (Intra Cellular Spermatozoa Injection)
This treatment is similar to I.V.F. The main difference is that it can be suitable for men with low sperm counts. Eggs (Ova), having been taken from the woman, can be fertilized in the laboratory each having been injected with just one sperm. This requires referal to a specialist unit.
Donor insemination
Donor insemination has been practiced as a medical treatment in the U.K. and U.S. for over a hundred years. There is also evidence of it being common practice in many cultures throughout the ages.
Staff at our clinic were involved in setting up the first donor insemination (D.I.) unit at the Well Woman Centre in 1979 and have been providing the service at the Morehampton Clinic for over sixteen years.
There is currently no legislation in Ireland concerning Donor Insemination. There are E.U. directives governing Fertility Treatment and we are currently working towards E.U. Accreditation.
All donor sperm is frozen and donors, having been thoroughly screened, are matched by physical characteristics to the couple, particularly the husband.
The donor sperm we use is brought in from Denmark. There are no adequate facilities available in this country for screening donors.
In Denmark procedures for screening are extremely rigorous and all samples are quarantined for a minimum of six months. After that time, donors have all blood tests repeated before the samples are released for use.
We have chosen to use clinics in Denmark as physical characteristics are easy to match and we are guaranteed reliability.
Donors are generally students, though this is not a pre-requisite. They are not paid for their samples, just given small sums of money for their time.
They do, however, have to be committed as they undergo many tests and counselling sessions. They are guaranteed anonymity, so tracing of donor by recipients or vice versa would be impossible.
The donor sperm is frozen in straws and stored in liquid nitrogen until needed and then defrosted just before use. The treatment, though less expensive than many more technological treatments, is costly as the extensive screening of donors, transport and storage involves obvious expenses.
We have two different treatments using frozen sperm:
D.I. (Donor Insemination)
This is the direct insemination of the defrosted frozen sperm sample to the cervix (neck of the womb). It is a five minute painless procedure, and is the procedure commonly used since the 1960s. Success rate is approx. 8% per cycle, though this can vary considerably.
Advantages: Low tech. Painless procedure. Relatively inexpensive.
Disadvantages: Less successful than I.U.I.D.
I.U.I.D.(Intrauterine insemination using donor sperm)
This procedure involves the sperm sample being inseminated directly into the womb (uterus). Success rate is approx. 11% - 12% per cycle.
Advantages. Because the sperm is placed directly into the womb, which is an ideal atmosphere for the sample to survive in, the sperm should survive for longer.
Painless procedure.
Comparatively better success rate.
Disadvantages: More expensive than D.I.
Donor insemination is also suitable for couples who have a male factor fertility problem or are known to have a genetically inherited disorder, carried by the man or the couple, which they do not wish to pass on to their children.
Counselling and medical examination are pre-requisites, these can be arranged by phoning the clinic.
Female factor infertility
Ovulation problems.
If following investigation the woman is found to have problems ovulating (producing an egg each month) medication may be prescribed to improve the situation. Usually a mild medication is sufficient but in some situation it may be necessary to prescribe something stronger. It is most important that the womans cycle is carefully monitored while on prescribed treatment. This is done by ultra-sound scans.
Many women will be taking ovulation stimulation medication while having treatment with donor insemination. All women having I.V.F. or I.C.S.I. will be on some form of medication.
Blocked tubes
There are many reasons why a woman’s tubes may not be patent (clear and open). Previous surgery, adhesions, previous infection and endometriosis are just some causes. Very often no cause can be found. While surgical procedures may free up the tubes and enable conception to take place I.V.F. may be the only solution for some women.
I.V.F. (In Vitro Fertilization) (this requires referal to a specialist unit)
A great deal has appeared in the media over the past twenty five years since the first I.V.F. baby, Louise Brown, was born, and today it is common procedure in many hospitals around the world.
In simple terms it involves the woman having ovulation stimulation drugs that should cause her to “superovulate”, ie produce many eggs. These are taken from her ovaries to the laboratory, mixed with her husband’s sperm, and if the eggs fertilize, two or three of these are replaced in her womb.
Nowadays it is possible to freeze the remaining embryos (fertilized eggs) to use if the first treatment is unsuccessful, or for a subsequent pregnancy.
Most doctors recommend I.V.F, but it depends on circumstances.
Advantages. Success rates are approx. 17% per cycle and improving all the time.
Disadvantages. Expensive and many women experience discomfort while on the medication.
Counselling
Counselling, while not a treatment, is very much a part of our management.
Not all couples will conceive and appropriate counselling can be of great value in assisting a couple to cope with this.
Sessions with a counsellor can take many different forms according to individual needs. Some people simply need information about what is available and where, while others will need one or more sessions to help with a decision or help to cope with the issues of fertility and infertility.
Many people attend us for counselling only, others will wish to avail of our treatments, while referral to other units will be most appropriate for others.
We require couples contemplating treatments with us to have at least one counselling session before treatment is started.
Couples, or one or other partner will be encouraged to return as necessary, for counselling as they feel the need.
Confidentiality is always absolute and guaranteed.
