#BridgingBabySteps | Infertility & Treatments

When you think about it, getting pregnant is quite simple. You just need to have an egg and a sperm and the two should meet an opportune time. However, as simple as it may seem, it's not that easy.
Struggling with infertility can be debilitating, with a series of hope and despair that can take you out fast. But because no one wants to discuss the situation, nothing gets done.
Infertility issues desperately need the kind of awareness that helped bring other health-related matters out of the shadows.

Every journey will be different for patients but you have to give permission to do this journey in whatever way makes the most sense.

Infertility was the main topic of the talk that was held recently at Makati Shanrila. In this day and age, there are several possible treatments options available.

Anthony Marc B. Ancheta,MD , FPOGS, FPSRM, Department of Obstetrics and Gynecology, The Medical City Hospital, discussed the 3 main treatments for infertility - Timed Intercourse, IUI or Intrauterine Insemination, last would be IVF or In-Vitro Fertilization.

What they will try to do for Timed Intercourse is an oral medication will be given to the patient in the form of either Letrozole or Clomiphene to stimulate the ovaries to produce eggs. In the usual month, the ovaries only produce 1 or 2 eggs at a time. There will be an ultrasound scan afterwards to ensure that the eggs are being produced quite well. Aside from monitoring the size of the egg, the uterine lining will be checked if it's thick enough.

The uterine lining of the womb or the uterus is where the embryo attaches itself. If it's too thin, there is no way for the embryo to attach.

Once the egg is released, it only has roughly 24 hours to meet the sperm. If they don't meet, the cycle continues again then you'll have your menstrual cycle after 2 weeks.

Pre Requisites :

There should be a good quality egg

The fallopian tubes have to be open

There should be an adequate number of rapidly swimming and “good-looking” sperms

Chances of getting pregnant : 25 percent (20-30 y/o)

< 10 percent (above 35)

With IUI, they allow patients to produce an egg, and around the time the egg will be released, then they will ask for a sperm sample.
The patient's spouse should abstain for at least 3 to 5 days before the actual IUI to collect good quality sample. If one abstain too long, only sluggish or dead sample will be collected. Too often, on the other hand, will compromise the volume. They will then pre-select the sperms prior to sperm washing process which is the separation of sperm from the seminal fluid. Good sample will be deposited directly to uterine cavity.

Pre Requisites :

There should be a good quality egg

At least ONE of the fallopian tubes have to be open

Total motile sperms inseminated : 5 Million

Chances of getting pregnant : 15 - 20 percent per cycle

IVF or commonly known as Test Tube Baby. Previously they were using test tubes but it was later eliminated. If the female patient only produces one egg in the usual cycle, they will give injectables to be given around 10 to 12 days to encourage the ovaries to produce more than the usual number of eggs. With continuous monitoring of follicles prior to egg retrieval. Egg retrieval is an OPD procedure that will only take 15 minutes to remove the eggs from the ovaries. The more good quality eggs, the more good quality embryos that can be formed.

For the usual IVF procedure, every single egg that they will collect, usually a handful of sperms, they will mix them in a dish, allowing nature to take its course. But for the past 10 years, Intracytoplasmic Sperm Injection (ICSI) is being done. A very effective method to fertilize eggs in the IVF lab after they have been aspirated from the female. Its main use is for significant male infertility cases.

Once fertilization takes place, they will allow embryos to culture then transfer them at around day 3 to day 5.

For the Embryo transfer, there will be a process of placing embryos into the uterine cavity during an IVF procedure. Also an out patient procedure, which will only take 15 minutes. Pregnancy support for the next 2 weeks. Remember that the most crucial would be the next 12 weeks of pregnancy at whatever age.

Pre Requisites :

There should be a minimum number of developing follicles

The fallopian tubes are NOT required

There should be a minimum number of “good-looking” sperms

Chances of getting pregnant : 41 percent (< 35 y/o)

< 12 percent (41-42 y/o)

Age can be one of the factors for infertility but it doesn't necessarily tell the whole picture. Other factors would be history of conceiving or hormone levels, if you have endometriosis or polycystic ovarian syndrome that play a huge role to infertility.