Treatment process for a subfertility patient

To heal the subfertility, a proper treatment depending on its cause round by examination is required, and the treatment needs to be repeated. A doctor and patient should work and participate in the treatment sedulously.

Artificial insemination

It specially handles semen, choose sperms with good activity and insert then directly into the uterine cavity. It can prevent loss of sperms passing through cervix, save motility of sperms and enable being pregnancy.
For the treatment, a patient have normal fallopian tubes and minimum number of sperms.

Indicant of artificial insemination

• When the cervical mucus is not enough
• When there are difficulties in accepting sperms
• When a number of sperms is not enough
• When the cause of subfertility is unknown
• Mental/physical cause: impotence, dysspermia, serious dyspareunia

How to conduct the treatment

Conduct ovulation ultrasound hormone examination, surmise the exact time of ovulation and select sperms with high motility from specially processed semen from masturbation. Insert a slender catheter into the endocervix and put sperms into the uterus.
Ovulation inducing agent is often used to raise the rate of pregnancy. And it does not hurt.

Test tube baby (external fertilization and transplantation: IVF-ET)

It is an active treatment for subfertility which can make a patient who had a failure in being pregnant capable of pregnancy. It collects ovum from ovary and sperm from men and conduct ovulation in culture medium, outside of human body, incubate eggs for 3-5 days and transplant them to uterus.

Indicant of test-tube baby treatment

• Subfertility due to abnormality of fallopian tubes: closure of fallopian tubes, adhesion of pelvis, failure of fallopian tubes regeneration surgery, decotions of fallopian tubes
• Cases when there are difficulties in accepting sperms
• Male subfertility
• Endometriosis
• Subfertility by unknown causes
• When there were several failures of artificial insemination
  • Inducing ovarian hyperstimulation
    It is a method that uses one or several kinds of ovulation inducing agent at once. A person who can normally conduct ovulation can generate several follicle by administering this agent and get some mature ovum. As a result, acquisition of several embryos and increase of pregnancy rate is possible.
    Usually taking the ovulation inducing agent starts at the third day of period and use hormone drug for 7 to 10 days depending on the degree of maturity of ovum. To judge the degree of maturity of ovum, hormone examination and ovulation ultrasound test are executed.
  • Collection of ovum and sperm
    When it is thought that the ovum is mature after inducing the ovulation, collect ovum from ovary utilizing ultrasound. The process can be simply conducted under a simple intravenous anesthesia. Collecting sperms also can be conducted simply after 2-3 days of moderation. Collection of sperms are conducted by masturbation, and if possible, conducted at the same day with ovum collection.
  • Insemination and ovulation in test tube
    Collected ovum is ovulated in culture medium for 6-8 hours. Fertilize the ovum and sperm prepared by washing and wait for the next day to observe the result. Keep the ovulation, and 8th period of cell in the third day, blastula stage in the fifth day are shown.
  • Transplantation of embryo
    About 72 hours after the collection of ovum, put 8th period embryo that normally developed into a slender catheter and execute transplantation of embryo into the uterus. Sometimes 5th period embryo can be utilized.
    Transplantation in period of cell (5th day) : high rate of pregnancy is still possible after sorting out abnormal embryos and small number of transplantation of fertilized eggs. But there is one unsolved problem. The high possibility of loss of embryo during the development before the period of cell (5th day). Therefore the method is not suitable for every IVF patient yet.
    Indicant of transplantation in period of cell (5thday) : young patient / large number of ovum / when a patient succeeded in former test tube baby treatment
  • Confirmation of pregnancy
    10 days after the embryo transplantation, chech whether the embryo is implanted through a simple blood test (B-hCG/pregnancy check is possible).

Intracytoplasmic Sperm Injection(ICSI)

It is a method of insemination by direct injection of sperm into the cytoplasm of ovum using fine microscope control when the insemination failed under a normal external fertilization. If serious male subfertility or immunologic cause led to the failure of fertilization, it can be one option of the latest supplementary surgery for reproduction. Especially it can be an innovative big help to male subfertility (including aspermia).