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If a couple decides to have IUI using their own sperm, the man will be asked to provide a sperm sample at the fertility clinic by masturbating into a specimen cup. This usually happens on the same day that IUI takes place.
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An instrument called a speculum is inserted into the woman's vagina to keep it open. A thin, flexible tube called a catheter is then placed inside the vagina and guided into the womb. The sperm sample is then passed through the catheter and into the womb.
Discuss personal lifestyle choices to optimize your health in order to produce the best sperm to create the embryos. There are small lifestyle choices that you can make to ensure that your sperm is as strong and healthy.
If needed, we will recommend lifestyle changes that will help maximize production of healthy sperm to obtain the best DNA possible. At your next visit you will produce a sperm specimen, which will be screened and cryopreserved until the eggs are ready for fertilization.
There are many options now available for same-sex couples interested in conceiving a child. These options may involve taking eggs or sperm from one or both partners or having one partner carry the child. Some of the most common treatments include IUI, IVF, and donor sperm.
Our Indianapolis fertility doctors use sperm freezing during IVF cycles when sperm collection and the egg retrieval cannot occur simultaneously. Cryopreservation of sperm is also helpful for patients who need certain medical procedures, as radiation, chemotherapy and surgery can all affect sperm production. In addition, people with testes can choose to freeze sperm before beginning gender reassignment.
The first step of sperm freezing is collecting the sperm. We require patients to abstain from ejaculation for two to five days before collection. Doing so helps ensure that they produce a high-quality sample. For collection, there are various methods and locations patients can use.
Surgical retrieval. In some situations, patients require surgical retrieval of sperm. There are different procedures our Indianapolis fertility doctors can use to collect sperm when working with reproductive urologists.
Microsurgical epididymal sperm aspiration (MESA) consists of a doctor collecting sperm from the coiled tube that lies behind and above each testicle. In contrast, testicular epididymal sperm extraction (TESE) involves the removal of tissue from the testicle. An andrologist immediately evaluates the tissue for the presence of sperm, the concentrations, motility and morphology. The andrologist then performs the cryopreservation of sperm.
Sperm freezing involves a flash freezing technology called vitrification. This process involves the andrologist placing the sperm in cryogenic vials and mixing it with a cryoprotectant to draw out water. This cryoprotectant protects the sperm from damage during freezing.
Next, the andrologist flash-freezes the sperm in storage tanks containing liquid nitrogen. These tanks maintain the appropriate temperature and ensure the biological processes of the cells pause. Sperm can remain in storage indefinitely.
Infertility is most commonly defined1 as the inability to achieve pregnancy after 1 year of regular, unprotected heterosexual intercourse, and affects an estimated 10-15% of heterosexual couples. Both female and male factors contribute to infertility, including problems with ovulation (when the ovary releases an egg), structural problems with the uterus or fallopian tubes, problems with sperm quality or motility, and hormonal factors (Figure 1). About 25% of the time, infertility is caused by more than one factor, and in about 10% of cases infertility is unexplained. Infertility estimates, however do not account for LGBTQ or single individuals who may also need fertility assistance for family building. Therefore, there are varied reasons that may prompt individuals to seek fertility care.
A broad array of diagnostic and treatment services may be necessary to assist in fertility (Table 1). Diagnostics typically include lab tests, a semen analysis and imaging studies or procedures of the reproductive organs. If a probable cause of infertility is identified, treatment is often directed at addressing the source of the problem. For example, if someone has abnormal thyroid hormone levels, thyroid medications may help the patient achieve pregnancy. If a patient has large fibroids distorting the uterine cavity, surgical removal of these benign tumors may allow for future pregnancy. Other times, other interventions are needed to help the patient achieve pregnancy. For example, if a semen analysis reveals poor sperm motility or the fallopian tubes are blocked, the sperm will not be able to fertilize the egg, and intrauterine insemination (IUI) or in-vitro fertilization (IVF) may be necessary. These procedures also facilitate family building for LGBTQ and single individuals, with use of donor egg or sperm, with or without a gestational carrier (surrogacy).
Many patients lack access to fertility services, largely due to its high cost and limited coverage by private insurance and Medicaid. As a result, many people who use fertility services must pay out of pocket, even if they are otherwise insured. Out of pocket costs vary widely depending on the patient, state of residence, provider and insurance plan. Generally, diagnostic lab tests, semen analysis and ultrasounds are less expensive than diagnostic procedures (e.g., HSG) or surgery (e.g., hysteroscopy, laparoscopy). Meanwhile treatment using fertility medications is less expensive than IUI and IVF, but even the less costly treatments can still result in thousands of dollars of out of pocket costs. Many people must try multiple treatments before they or their partner can achieve a pregnancy (typically medication first, followed by surgery or fertility procedures if medications are unsuccessful). A study of nearly 400 women undergoing fertility care in Northern California demonstrates this overall trend, with the lowest out of pocket spending on treatment with medication only and the highest costs for IVF services (Figure 3). Prior research showed the cost of just one standard cycle of IVF was approximately $12,500 in 2009, but is likely higher today due to rising health care costs overall. Furthermore, many patients require several rounds of treatment before achieving a pregnancy, with costs accruing each cycle making these interventions financially inaccessible for many. In addition to costs for the actual treatment, patients can be saddled with out of pocket expenses for office visits, diagnostic tests/procedures, genetic testing, donor sperm/egg use and storage fees and wages lost from time off work.
Veterans Affairs (VA): Infertility services are covered by the VA medical benefits package, if infertility resulted from a service-connected condition. This includes infertility counseling, blood tests, genetic counseling, semen analysis, ultrasound imaging, surgery, medications and IVF (as of 2017). However, the couple seeking services must be legally married, and the egg and sperm must come from said couple (effectively excluding same sex couples). Donor eggs/sperm, surrogacy or obstetrical care for non-Veteran spouses are not covered.
Iatrogenic, or medically induced, infertility refers to when a person becomes infertile due to a medical procedure done to treat another problem, most often chemotherapy or radiation for cancer. In these situations, persons of reproductive age may desire future fertility, and may opt to freeze their eggs or sperm (cryopreservation) for later use. The American Society for Reproductive Medicine (ASRM) encourages clinicians to inform patients about fertility preservation options prior to undergoing treatment likely to cause iatrogenic infertility.
However, the cost of egg or sperm retrieval and subsequent cryopreservation can be prohibitive, particularly if in the absence of insurance coverage. Only a handful of states (CT, DE, IL, MD, NH, NJ, NY, and RI) specifically require private insurers to cover fertility preservation in cases of iatrogenic infertility. No states currently require fertility preservation in their Medicaid plans.
These scientists then went on to turn their lab-created PGCs into sperm and eggs that worked. The sperm fertilized an egg that resulted in a healthy pup and the egg was fertilized with the same result. So with a bit of work (well, a lot of work), they had managed to at least partly get to where we need to go.
In vitro fertilization brings about new life in a petri dish. Children engendered through IVF are sometimes known as "test tube babies." Several eggs are aspirated from the woman's ovary after she has taken a fertility drug which causes a number of eggs to mature at the same time. Semen is collected from the man, usually through masturbation. The egg and sperm are ultimately joined in a glass dish, where conception takes place and the new life is allowed to develop for several days. In the simplest case, embryos are then transferred to the mother's womb in the hope that one will survive to term.
Obviously, IVF eliminates the marriage act as the means of achieving pregnancy, instead of helping it achieve this natural end. The new life is not engendered through an act of love between husband and wife, but by a laboratory procedure performed by doctors or technicians. Husband and wife are merely sources for the "raw materials" of egg and sperm, which are later manipulated by a technician to cause the sperm to fertilize the egg. Not infrequently, "donor" eggs or sperm are used. This means that the genetic father or mother of the child could well be someone from outside the marriage. This can create a confusing situation for the child later, when he or she learns that one parent raising him or her is not actually the biological parent.
In fact, the identity of the "donor," whether of egg or sperm, may never be known, depriving the child of an awareness of his or her own lineage. This can mean a lack of knowledge of health problems or dispositions toward health problems which could be inherited. It could lead to half brothers and sisters marrying one another, because neither knew that the sperm which engendered their lives came from the same "donor." 041b061a72