Author: The Beauty Nation

Vitro Fertilization

IUI is an acronym for IntraUterine Insertion. Sperm is put into the uterus via the cervix. They travel to the tubes, where fertilization takes place. Poor quality sperm can bypass the journey through the vagina and avoid the cervical mucus, which may be hostile. IUI can be combined with IVF.

IVF is an acronym for In Vitro Fertilization. The eggs are retrieved (withdrawn) from the ovary via a needle put into the abdominal wall. The man provides sperm which is mixed with the egg in a test tube (culture dish), and put in an incubator. After fertilization occurs, the resultant embryos are injected into the woman’s uterus. IVF bypasses the tubes, and is appropriate in cases of tubal obstruction.

GIFT is an acronym for Gamete IntraFallopian Tube Transfer. The egg and sperm are collected as above, and then injected directly into the woman’s oviduct. They are not fertilized in a culture dish. Fertilization occurs naturally within the tube, and the egg then travels down to the uterus. GIFT involves the tubes, and is appropriate only if they are healthy.

ZIFT is an acronym for Zygote In Vitro Fertilization, (a zygote is an embryo). ZIFT is a variation of both GIFT and IVE Sperm are “washed”, and then mixed with the egg in a culture dish, where fertilization takes place. The resultant embryo is injected into the oviducts instead of the uterus. ZIFT involves the tubes, and is only appropriate if they are healthy.

PZD is an acronym for Partial Zona Dissection. It is a new technique to help feeble sperm get through the egg’s outer wall. The egg is retrieved and pierced in two places to create a tiny passageway. The sperm can then get in easily. PZD has led to 7 pregnancies so far, and could raise the odds for infertile men.

The implantation rate with GIFT and ZIFT is higher than IVF. It seems that transferring the 2-day-old embryo to the uterus might act like an IUD; it might set up an irritation factor which interferes with implantation. Multiple births occur with in vitro fertilization because the more embryos in the uterus, the better the chance of one implanting. Selective selection involves removing the weaker embryos to give the others a better chance. For some parents-to-be and physicians, selective selection can be a difficult problem involving issues of ethical and moral choice.

There are many different tests to find the cause of fertility problems. They include:

• Evaluation of cervical mucus. This involves an examination of mucus production, which may be scanty and blocking the sperm.
• Postcoital tests. These occur after intercourse to evaluate the progress of sperm inside the vagina.
• Basal body temperature charting. This test checks the timing of ovulation dates.
• Hamster test. Sperm are evaluated to find out whether or not they can penetrate hamster eggs.
• Hormone assay tests. These check the sex hormone levels of the partners.

One major problem with these tests is that they all take time. If the woman is no longer young, it may be suggested that she bypass all tests and goes straight for in vitro fertilization. However, most tests are covered by much medical insurance, and in vitro fertilization often is not.

It is only natural to want to know the cause of infertility. If either partner has a tubal obstruction or corrective surgery works, the problem is cured. If the problem is with the egg or sperm, hormone therapy is highly effective. The couple can then have as many children as they wish. With in vitro fertilization, an entire new program must be undertaken each time for each new baby. No single program can guarantee success.

Research from in vitro programs shows that time is a critical factor in the choice. In’ one program, 35 women over age 40 had their eggs fertilized outside the uterus. When the fertilized eggs were returned to the uterus, only 5 women achieved pregnancy and none carried the fetus to term. Yet when these same women received eggs donated by women under age 35, 20 got pregnant and 15 delivered babies.

A laparoscopy is a surgical procedure to examine the internal structures. A coloured solution is introduced into the uterus via the vagina and cervix. The laparoscope is inserted though a small cut in the abdomen wall. When the tubes are open, the coloured fluid can be seen to flow through them, and out into the pelvic cavity. If some fluid pools in little pockets, there may be scarring. The egg can get trapped in the pocket, and die. The pelvic cavity, ovaries, and uterus are also examined to see if endometriosis, inflammation, or some birth defect could be causing the problem. Where appropriate, surgical procedures to relieve a minor problem will be done at the same time.

A hysteroscopy is a procedure performed through the vagina. A fluid or carbon dioxide gas is introduced into the uterus via the vagina and cervix to expand the area and allow a better view. The mucus-secreting glands of the cervix are examined to see if they are working properly. The cervical canal and uterus lining are checked for structures which might add to the problem: polyps, fibroids, or bands of scar tissue. Some minor surgical procedures can be done at the same time, if appropriate.

A hysterosalpingogram (HSG) is an internal X-ray of the uterus and tubes. A radio-opaque dye is injected into the uterus through the vagina and cervix, and the X-ray is taken. HSG is a painful procedure. Cramps and spasm can give a false-positive result; there appears to be a blockage where, in fact, none exists. The iodine solution in the dye can cause an allergic reaction. HSG has become less popular in recent years.

The first attack of the herpes virus is the most painful and takes the longest time to heal. Within 2 to 20 days after infection, there is a mild tingling or itching. This can be on the labia, clitoris, or vagina opening; more rarely on the vagina wall, the cervix, the buttocks, thighs, or anus. It develops into one or more watery, painful blisters in the next few days. There can be burning or pain on urination, with swollen lymph nodes in the groin. There is an increase in discharge or a feeling of pressure in the pelvic area. In some cases, the entire body reacts with flu-like symptoms: fever, headache, and chills.

Ninety percent of women develop sores on the vagina and cervix during a first infection. The blisters burst quickly and shed highly contagious viruses everywhere. The now-empty blisters turn into shallow ulcers, which can be painful. The ulcers form into crusts, which heal spontaneously within 1 to 5 weeks. Visit the physician as soon as the symptoms appear. At an early stage, diagnosis can be made by sight alone. Help can begin immediately, but a culture test is very expensive.

At least 5 types of herpes virus are known to affect humans. The Epstein Barr virus and-cytomegalovirus causes infectious mononucleosis, also known as glandular fever. The varicella virus causes chickenpox in children, and shingles in adults. There are 2 types of herpes simplex virus. HSV 1 causes cold sores on the lips or nose, also called fever blisters. HSV 2 causes genital ulcers, also called genital herpes.

By adulthood, most people have been infected with the cold sore virus, HSV 1. They develop antibodies against it, and only a few actually get cold sores. Fewer adults have HSV 2 antibodies because the virus is spread by sexual contact. The findings of a recent study suggest that 99 percent of prostitutes have HSV 2 antibodies in their blood, compared with 3 percent of nuns and 29 percent of women in a committed relationship.

About 50 percent of those with HSV 2 have no symptoms. The recent increase in genital herpes is thought to be partly due to this, and partly due to an increase in the practice of oro-genital sex. In some cases, both HSV 1 and HSV 2 cause genital herpes. If suffering from a cold sore, avoid kissing, and any facial or genital contact. This applies to a partner as well.

Not all HSV 2 die after a first attack. The virus coats itself in the person’s own protein substance and retreats along nerve endings to the base of the spine. Here it sets up a permanent home, staying inactive for varying lengths of time. When the virus becomes active again, it usually returns to the same place as the previous attack. Recurring outbreaks can be virulent and painful, or very mild. If mild, a woman may be unaware that she is shedding highly contagious germs.

HSV 2 is particularly dangerous for women. It is linked with cancer of the cervix, The virus can cause miscarriage in the first 3 months of pregnancy. If shed during birth, 1 in 2 babies will be infected. Two out of 3 of those infected babies will die. Half the others suffer brain damage or visual defects. These horrors are now avoided by Caesarian birth. The baby is lifted from the uterus and thus avoids contact with the virus.

As yet, there is no drug to destroy the herpes virus. The drug acyclovir helps reduce the pain of an attack; it may even lessen the number of recurrences. One of the miserable factors of herpes is the permanent risk of passing on the disease. Some physicians believe that this is only during the active phase; others strongly disagree. An infected person cannot be free of this worry.