Every human being is made from an ovum – an egg cell – and a sperm cell. These sex cells are called gametes. Problems with these gametes are a major cause of infertility. Here we will look such problems that can lead to infertility or difficulty conceiving caused by issues with the egg cells of the potential mother. These problems are, generally of three types: firstly periods may have stopped, or no eggs are being released during menstruation (periods); second there could be too few eggs or, finally, the eggs released are of poor quality.
Fertility drugs can do little to address these last two issues as, unlike men who produce sperm cells throughout their lifetime, a woman’s ova are formed while she is still in her mother’s womb, and, like each and every other cell in the human body, they too age and die. Conception may still occur using eggs removed and screened for viability or, should these problems prove intractable, using donated egg cells.
Menstruation, is the shedding of the lining of the womb (uterus) that builds up each month to allow implantation of an embryo should an egg cell be fertilized by a sperm cell. This is the final stage of a long process stimulated and regulated by protein messengers called hormones. The two crucial hormones in controlling menstruation and, therefore, fertility are estrogen and progesterone. Some women who are finding it difficult to conceive are surprised to learn that they may not be releasing an egg cell each month as their periods may be regular and seem normal or heavy. For other women, their periods may be infrequent, unpredictable or may have ceased altogether.
One of the first approaches to remedying infertility when it has been established by a sperm count that the semen of the potential father contains sufficient numbers of viable sperm cells is to use fertility drugs. One such is Clomifene/Clomiphene. This drug is also known as Clomid, Clomifert, Milophene, and Serophene and is often used to treat women who suffer from polycystic ovaries or polycystic ovary syndrome.
How Does Clomifene Work?
The active ingredient in Clomifene is 2-[4-(2-chloro-1,2-diphenylethenyl]phenoxy)-N,N-diethyl-ethanolamine a bit of a mouthful usually known generically as Clomifene citrate. To use the technical terminology, Clomifene is a selective estrogen receptor modifier (SERM). In other words, it signals to receptors that tell the body to stop producing estrogen passing on this message to the brain so the levels of this hormone which can inhibit menstruation are decreased. This first leads the pituitary gland in the brain to increase the production of follicle stimulating hormone (FSH) that acts on the ovaries to ripen the eggs ready for release. In turn, this leads to higher levels of a hormone, luteinising hormone (LH) that tells the ovaries to release an egg so stimulating menstruation.
To lessen the levels of prolactin in a man’s body and get his sperm production to its normal activity, men are often prescribed with bromocriptine. However, in order for the male fertility drugs to be effective, it needs to be taken for at least four consecutive weeks
Antiestrogen agents – the lack of gonadtropins can lead to testosterone deficiency. In order to stimulate the gonadropin substances in a male’s body, man can be prescribed with anti-estrogen infertility drugs.The usual forms of antiestrogen agent that can be given to men include clomiphen (clomid) and tamaxifen (nolvadex).
However, men receiving anti-estrogen medications should always watch theiri testosterone level because this therapy can boost testosterone production in male above the normal levels. When testosterone is above normal levels, there is a possibility that there will be a negative impact on sperm production.
Testosterone – hypogonadism is a condition characterized by a lack of testosterone. When this is the main reason of the infertility problem in men, they can be prescribed by synthetic testosterone. These types of drugs are designed in such a way that they mimic the naturally occurring testosterone substances in a male’s body. This medication can be administered through the form of oral pills, transdermal gel or patch or through injections.
How does IUI procedure function?
When IUI procedure is undertaken, it is carried out with three steps.
- IVF meds are given, and your ovulation cycle is monitored
- The sperm sample will be provided by your partner, or it can be donated by the donor. Then it is washed specially and prepared for insemination
- The doctor injects the prepared sperm into your uterus
How to get ready for IUI procedure?
To start with intrauterine insemination procedure you have to visit the fertility specialist and undergo pre-IUI procedures. In the pre-IUI procedure, the doctor will check whether your health is quite good for the process. The doctor will analyze the hormonal levels whether they are in normal range and also check whether your uterus is healthy, suitable to support the pregnancy.
Before starting the IUI procedure, your doctor prescribes the ovulation drugs and monitors your health with a blood test and ultrasound procedures facilitating to assess the eggs’ health. It will also help your doctor to fix the appropriate timing for sperm injection.
You will also have tests to find out the time of ovulation. Before ovulation, there will be a surge in LH (luteinizing hormone). Ovulation occurs within one to two days after the surge of LH. This facilitates your doctor to inject the sperm into your uterus at the appropriate time to get conceived.
How to prepare the Sperm sample for the process of IUI?
You doctor will get the sperm sample from your partner, which is washed well and prepared for IUI procedure. The washing and preparation of Sperm help to remove the potentially toxic chemicals if any present in the sperm sample so that it would not react negatively. There are also possibilities for allergic reaction in women if the sperm contains toxic chemicals that hinder the pregnancy procedure. Thus washing the sperm sample minimizes the adverse effects that may occur after IUI procedure. Moreover, washing or motes the concentration of the sperm supports the healthiest mobile sperm to reach the egg, thus promoting IUI success rates.
IUI or Artificial insemination may include the following procedures: Assisted Reproductive Technology and Sperm Donation. Both these procedures necessarily involve the artificial medical procedure to bring in close contact male sperms and woman’s ovaries, so as to achieve a successful pregnancy in the woman. IUI is the laboratory procedure which separates out the slow or sluggish moving sperms from the fast moving ones and introducing the fast moving sperms into a woman’s womb, at the time of ovulation when the ovaries release eggs in the middle of the monthly cycle. This useful IUI treatment will medically assist in the process of reproduction.
IUI treatment is used as an intermediate level intervention procedure before going for an advanced medical procedure IVF. It can be used for several of such medical causes, as long as there is a presence of at least one patent Fallopian tube – Severe Vaginismus, Male factor infertility, Cervical factor infertility, Unexplained infertility, Stage 1 or 2 Endometriosis, and Ejaculatory Dysfunction