Tuesday, October 1, 2013

Why do some women have so much trouble conceiving?

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Q. I just want to know, what are the main causes of infertility in females besides age? Why do some women have such problems conceiving?
I wasn't even trying to get pregnant and wasn't even thinking about babies at all and I became pregnant with triplets, although they're identical. My girls are beautiful and lovely but they're 15 now.


Answer
Many other conditions besides age can cause infertility or pregnancy delay in women. It can be as complex as a uterine or ovarian defect such as PCOS or as simple as too much caffeine in your diet. For me, it was timing. I thought that I ovulated on a certain date but it turned out (with the help of a Clearblue Easy Fertility Monitor) that I was way off and after trying to conceive for 2 whole years (25 months to be exact) after a miscarriage, we used that monitor for 1 month and got pregnant right away. For some women it is more complex. I have a friend who was raped as a child and had so much internal tearing that the Dr.'s said she would never conceive and that it was best to not even try. Well she did because that is what she desired. It took her 12 years but she got her little one. For other women it may be as simple as a diet change or weight loss. Many many factors affect fertility and it is hard to pinpoint each case. All I know is women with infertility are some of the strongest I have ever encountered and I am so blessed to have dealt with infertility and came out victorious. Now I have a beautiful testimony that I will meet on November 1st!

What are the chances of having twins when you go through artificial insemination?




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And what form of egg fertilization is more likely to make you have more than one child at a time?


Answer
I just wanted to clear up some misinformation that Doodlestuff gave you and clear up a few things so she is not misinformed any longer. Number one, IVF is not artificial insemination (AI). AI is when sperm is placed into the cervix or the uterus. With IVF, you are stimulated, eggs are collected, fertilized with sperm, and they are transferred back to you. And, according to SART - Society for Assisted Reproductive Technology who collects data from clinics in the USA (who transfers it directly to CDC) regarding IVF pregnancy rates, failed cycles, and live births, the twin birth rate is 25% and the triplet birth rate is 1.4%. Far from 1/3. With clinics that follow the strict SART guidelines, IVF twin rates decreased to 20.3%. Unfortunately the RARE clinic like the one Octomom went to did not follow the guidelines and altered those rates. With IVF you have more control than medicated AI cycles and so the multiple rate is lower. The ASRM guidelines do not recommend transferring one embryo. It is no more than two depending on a number of factors including age, prognosis, embryo quality etc. And, with one embryo transferred back to you there is a statistically significant reduction in the likelihood of live birth. Ironically enough, transferring more than one does not greatly increase your chance of multiples but does increase your odds of conception. You are more than twice as likely to give birth when having two embryos transferred than opting for a single embryo transfer. When you have been through the ringer with fertility treatments and have to dig deep in your pockets to pay $10,000+ for an IVF cycle, you will want to do anything possible to increase your odds of success.

AI does not increase the chance of multiples unless the woman has been given drugs to stimulate her ovaries. Many will monitor her ovulation and once she is close to ovulation will get inseminated with sperm. With stimulated AI cycles such as IUI, the rate of multiple gestation pregnancies is close to 30%. So with AI, your chances of conceiving multiples is higher. Some women with medicated AI cycles produce more follicles than her doctor wanted. If the women does this, the cycle is often canceled as not to risk a high order multiple (HOM) pregnancy. But, in some cases, the couple ignores their doctor's advice not to have intercourse. Jon and Kate Gosslin are an example of that. One thing to mention, if you did conceive multiples it does not necessarily mean you will carry them to term. I conceived twins via IVF after transferring 2 embryos (My other IVF attempts I did the same and only conceived a singleton twice). I lost both.

Women going through IVF today face a much lower risk of a multiple pregnancy. Most clinics, when possible, do a 5 day blastocyst transfer and transfer no more than two.

Do know that the goal of ALL fertility treatments is one baby and most doctors strive to reach that goal. Multiple pregnancies and births are risky, to the children and the mother.




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