IVF - Surrogacy Blog

04May/18

IVF after Vasectomy

You underwent a vasectomy thinking you never want to get another woman pregnant, but then again, the circumstances changed. Reversal of the surgery is possible but it may or may not bring the desired results, which is why IVF after vasectomy is generally recommended to the men planning parenthood again.

IVF after a vasectomy can be done using surgical sperm retrieval, followed by ICSI treatment has high chances of success, given all the other factors affecting your fertility are well.

 

What is Vasectomy?

A vasectomy, also called the snip, is a minor surgical procedure which acts as a permanent form of contraception. During a vasectomy, the tubes linking the testes to the urethra—the vas deferens—are cut and tied, thereby preventing sperm from leaving the testes.

Pregnancy after Vasectomy

A vasectomy is considered to be a very reliable way of preventing pregnancy; instead of relying on contraceptives (and dealing with their side-effects), the men can simply undergo this procedure for male sterilization.

According to data from the National Survey of Family Growth, every year over 500,000 men in the US undergo vasectomy.

Couples are usually advised to consider the option of a vasectomy carefully before making their decision, as even though there are options to reverse the procedure, future pregnancies will be much more difficult to achieve. 


Sometimes, after undergoing a vasectomy, a man can realize he is very keen to have a baby again. It could be because of remarriage after divorcing your current partner, the death of a wife or child, or a renewed desire to expand your family.

Even though vasectomy reversal is possible; it may not always work.

 

When does vasectomy reversal not work?

The surgery and its subsequent reversal may leave scar tissue in the vas deferens, which could obstruct with the sperm passage even after the tubes are rejoined.

There is another reason why vasectomy reversal may not be a good idea. The Hospital Corporation of America explains that the testicle continue to procedure sperm even after the initial vasectomy. Since that sperm is not being transported outside, it could be mistaken as foreign object and attacked by the body’s immune system.

So vasectomy reversal will not be useful if your own body has decided to destroy your sperm.

In this case you could go for surgical sperm extraction followed by IVF. A technique called testicular sperm aspiration (TESA) allows the sperm to be removed directly from your testes, which is then used to fertilize the female egg.

 

Procedure of IVF after vasectomy

Sperm retrieval after vasectomy

There are different techniques that may be used to retrieve sperm directly from the testes following a vasectomy. All of these techniques are relatively straight forward and only require local anaesthetic or sedation.

They may be performed in either your doctor’s office or an operating room. The main difference between these techniques is the site from which the sperm is retrieved.

1.      PESA (Percutaneous Epididymis Sperm Aspiration)

A needle attached to a syringe is passed into the epididymis (a tube behind the testes that carries sperm). Sperm is then aspirated directly from here.

2.      TESA (Testicular Sperm Aspiration)

A needle attached to a syringe is passed through the scrotum and sperm is aspirated directly from the testicle.

3.      TESE (Testicular Sperm Extraction)

This is slightly different to the other two aspiration techniques as it involves taking a small biopsy of tissue from the testicle. This tissue is then processed in a laboratory, in order to extract the sperm cells. This is usually performed if no sperm was retrieved using PESA or TESA.

ICSI technique, followed by IVF

Once the sperm has been retrieved from the testes, it can be injected into eggs which have been retrieved from the female partner in a technique known as ICSI.

This fertilized egg will then be cultured for between 3 and 5 days and the resulting embryo will be transferred back into the female’s womb, in the process of IVF.

 

Cost of IVF after a vasectomy

IVF is an expensive process and all additional treatments come with added expenses. ICSI can add on up to $1,500 to the cost of your IVF treatment, while sperm retrieval can cost around $2,000 when taking into account sperm freezing, anesthesia, operating room charges, etc.

Whilst the cost of treatment can vary significantly depending on the country and clinic that you decide upon, the costs of IVF, ICSI and sperm retrieval are considerably lower in countries like Thailand, Malaysia, Spain, Mexico, India, etc.

 

Chances of success of IVF after a vasectomy

As a vasectomy should cause no damage or changes to sperm quantity or quality, your chances of success with ICSI/IVF should be just as high as prior to your procedure. At a good IVF clinic, the fertilization rate following ICSI treatment is typically between 70% and 80%.

IVF success is comparable to that of natural, spontaneous conception. Research shows that testicular sperm extraction is a safe and effective method of sperm retrieval and the pregnancy rates achieved by using such sperm in IVF are similar to those of other IVF cycles.
 

Alternatives to IVF after Vasectomy

IVF after a vasectomy ensures the contraceptive value of the vasectomy remains and can help to overcome any issues with female fertility as well.

The downside is the high cost of treatment, the invasive nature of the procedure, and the side effects of the associated medication.

There are a few alternatives to undergoing traditional IVF treatment following a vasectomy. These include:

1.      Vasectomy reversal

This is a surgical procedure whereby the vas deferens is reconnected. This procedure is fairly complicated and is not guaranteed to work. It would also mean that you would need to use other forms of contraception in the future.

Also, as explained above, vasectomy reversal may not always bring the desired results.

2.      Sperm retrieval with IUI

This is less invasive than IVF treatment; however, you need to have retrieved a good quantity of fully mature sperm to have a chance of success with IUI.

3.      IUI with donor sperm

This presents a viable option. However, the obvious drawback to this is that the male partner would not be biologically related to the child.

It is very important to research carefully into all of your options before making a final decision. You should take into account, your particular circumstances as well as the fertile health of both you and your partner.

If you plan to undergo IVF after vasectomy, it is imperative you discuss in detail with your fertility specialists.

 

To learn more about the cost and other details of IVF after vasectomy in Thailand, Malaysia, India, or Spain, get in touch with us via the form on this page.
15Apr/18

Secondary Infertility – Causes and Treatments

If you have trouble conceiving after previous successful pregnancies, you may be suffering from secondary infertility. This can come as quite a surprise, especially if you have conceived easily previously.

Whilst those suffering from secondary infertility are not childless, the emotional pain of being unable to expand your family can be intense.

Here we discuss the causes of secondary infertility, when to seek help, and what treatment you can expect to receive.

 

What can cause secondary infertility?

The causes of secondary infertility can be similar to those of primary infertility (trouble conceiving with your first pregnancy).

These include:

Female fertility problems

  • Ovulation problems, for example, with Polycystic Ovarian Syndrome (PCOS)
  • Endometriosis
  • Certain medications, for example, chemotherapy drugs
  • Autoimmune or thyroid disorders
  • A hormonal imbalance
  • Structural problems, such as fallopian tube blockage
  • Age – fertility starts to decline around the age of 35
  • Lifestyle factors – obesity, smoking, and excessive alcohol consumption.

Male issues

  • Decrease in sperm count, quality, or motility
  • Testicular damage, may be due to infection, cancer or surgery
  • Ejaculation problems
  • Hormonal imbalances
  • Certain medications
  • Lifestyle factors – Excessive heat of testicles, drug or alcohol abuse, smoking, etc.

Besides the above, there also may be a specific reason why you are struggling to conceive after a previous pregnancy, which could be:

  • Advanced age – even a couple of years between pregnancies can greatly affect your fertility
  • Previous Caesarean section(s) – as this can leave scarring or uterine adhesions which may create fertility problems
  • Previously retained placenta – this can also leave scarring
  • Declining health – worsening of previous reproductive disorder
  • Male infertility issues – such as advanced age or changes in health
  • Lifestyle changes

When should I see my doctor?

It is usually suggested that if after a year of unprotected sex, you have not conceived then you should consult your doctor for further tests.

If you have a specific medical condition, such as endometriosis, which you believe is affecting your fertility, then you should seek medical help sooner.

Likewise, if you are over 35 you may wish to consult your doctor sooner—after about six months of trying but not being able to conceive. Secondary infertility is quite common; according to a National Health Statistics report, over 3 million women in the US alone have difficulties conceiving after having one child.

What tests will be performed?

Your doctor will initially perform a series of tests to investigate what is happening. These will be the same as fertility tests for women with primary infertility.

Your doctor may also wish to carry out some tests on your partner in order to rule out any male infertility issues.

The following tests are usually recommended:

  • Physical examination – to check the pelvis for signs of infection, lumps or problems such as endometriosis
  • Weight check – to ensure that your BMI isn’t too high
  • Blood test – to determine hormone levels and check to see if you are ovulating
  • A hysterosalpingogram (HSG) – this is a dye contrast X-Ray test which can determine whether your fallopian tubes are blocked
  • An ultrasound scan – to check for any structural problems with the womb, ovaries and fallopian tubes
  • Laparoscopy – this is keyhole surgery, where a camera is inserted to look more clearly at your womb, ovaries and fallopian tubes. This is usually only advised if other scans suggest there is a blockage or structural problem present.
  • Hormone analysis – any imbalance in fertility hormones such as FSH, Prolactin, LH, AMH, and testosterone may indicate a problem.

The following test may be offered to your partner:

  • Semen analysis – to check the sperm count, quality, and motility

 

Secondary infertility treatment options

Your treatment options will depend upon the results of your tests. The treatments for secondary infertility are usually the same as for primary infertility.

1.      Medications

You may be offered medications, which are typically used to treat problems with ovulation. Commonly used fertility medications include:

  • Clomifene (Clomid)
  • Tamoxifen
  • Metformin (typically used for women with PCOS)

In some women these medications may cause certain side effects such as nausea, headaches, and hot flushes, but they are usually temporary and go away in a few days.

2.      Surgery

If you have been diagnosed with structural abnormalities, in the womb or fallopian tubes, you may be offered surgical treatments.

  • Myomectomy – to remove fibroids or cysts. It is usually performed laparoscopcally.
  • Ovarian drilling – Helpful in bursting cyst membranes to trigger normal ovulation in women suffering from PCOS
  • Fallopian tube surgery – to break up any scar tissue in your tubes

Also if your partner has been diagnosed with a blockage preventing the release of sperm or if he has had a vasectomy, you may be offered surgical sperm retrieval.

3.      Assisted Conception

Usually this will be offered to you after other, less invasive measures have been ruled out. Treatment options include:

 

Lifestyle modifications to improve fertility

Certain lifestyle modifications may just help you to conceive and if not, they will certainly get you healthier, ready for your pregnancy.  

Lifestyle improvements recommended to improve fertility include:

  • Losing weight
  • Doing moderate exercise
  • Limiting your caffeine intake
  • Stopping smoking
  • Cutting down alcohol consumption, or even better, eliminating it
  • Taking prenatal vitamins

 

Secondary infertility – chances of conceiving?

Once the cause of your infertility problems has been identified and treatment sought, it should be possible to have a successful pregnancy.

In fact, research shows that the prognosis for secondary infertility is usually better than that for primary infertility. This has been associated with a higher proportion of ovulation problems in women with secondary infertility, which can be more easily treated.

It has also been shown that having a previous pregnancy increases the likelihood of your success with IVF treatment.

Therefore, you should seek medical treatment as soon as possible in order to find out what is happening. Fertility testing and the whole treatment planning can take quite a while, so it important to start this process early, especially if you are somewhere in your mid 30s.

 

For affordable secondary infertility treatment options, get in touch via the form on this page.
29Mar/18

How can acupuncture improve your chances of pregnancy?

Can acupuncture help you conceive? If you have been struggling to conceive, and looking for ways to improve your chances of conceiving, it is quite likely that you came across the suggestion to try acupuncture improve your chances of pregnancy. But on what grounds are they suggesting this? Is there really any merit to this claim? We dig:

There is ongoing research being carried out looking at the effects of acupuncture on fertility and the results do appear promising.

The beneficial effects of acupuncture are not just limited to natural conceptions alone; it may also help to increase your chances of success with IVF, ICSI or IUI cycles.

 

What is acupuncture?

Acupuncture is an alternative treatment originating from ancient Chinese medicine practices. It has been widely used as a complementary treatment to improve fertility.

During acupuncture treatment, thin needles are inserted into the skin at specific points. Chinese medicine states that there are energy pathways (meridians) which flow from these points and that stimulating them can help to treat a range of medical conditions.

 

Acupuncture benefits

Acupuncture has some great general health benefits which will help you on your journey to pregnancy. These include:

  • Reducing anxiety and stress

    Struggling to conceive and undergoing fertility treatment can definitely trigger problems with stress and anxiety. You may find yourself feeling overwhelmed with everything at certain stages of your treatment.

    Hormones that are released when the body is stressed and anxious have been shown to reduce fertility in women trying to conceive.

    Research has also pointed that in women undergoing IVF, those who had acupuncture reported lower stress levels before and after their embryos were transferred. They also achieved a higher pregnancy rate than those who did not receive acupuncture.

    This indicates that the reduction of stress using acupuncture can help to improve your chances of pregnancy. This may or may not be a placebo effect; however the outcome remains the same.

  • Reducing insomnia

    When we are asleep, our bodies are doing amazing things to repair and replenish themselves. This includes regulating our hormones and in particular our fertility hormones.

    Therefore, if you manage to improve the quantity and quality of sleep that you are getting, using acupuncture, this can help to improve your chances of pregnancy as well.

 

Effect of acupuncture on women’s fertility

The different ways that acupuncture may specifically help to improve your fertility and chances of conception include:

  • Regulating your fertility hormones and correcting any hormonal imbalances
  • Restoring absent or regulating erratic menstrual cycles
  • By stabilizing hormone levels, acupuncture can bring improvement in PCOS associated infertility
  • Improving the blood flow to your reproductive organs

Effect of acupuncture on men’s fertility

Acupuncture not only has proven fertility benefits for women, it may also help with men’s fertility issues. It is believed that even before sperm was discovered by Antonie van Leeuwenhoek in 1677, Chinese herbal medicine was proving useful for male infertility.

Some of the ways in which acupuncture is said to boost male fertility include:

  • Increasing sperm number
  • Increasing sperm motility
  • Improving sperm morphology

Acupuncture is known to improve blood flow to the testicular artery and lower the temperature in your scrotum, which are both favorable for healthier sperm.

 

Effect of acupuncture on IVF and IUI success

Besides improving your natural fertility, acupuncture can also be used alongside assisted reproductive technology, such as IVF and IUI to improve your chances of success.

You may be wondering if it is worthwhile trying acupuncture alongside the many treatments that you already have to undergo. Well, research shows that pregnancy rates are significantly higher in IVF/ICSI patients who have had acupuncture during their treatment cycle.

Likewise, women who underwent traditional Chinese medicine (both acupuncture and medicinal herbs) alongside their IUI procedure were shown to have significantly higher rates of pregnancy and birth.

Some fertility doctors themselves may actually recommend that you try acupuncture to reduce your stress levels, which will help your treatment to go more smoothly and therefore have more chance of working.

 

When should I have acupuncture treatment?

When having acupuncture, it is important to get the treatment regularly in order to make the most of its effects. Although how often you can get treatment may depends upon your unique situation and your finances. Treatment can be costly.

When having acupuncture for infertility problems you may want to get treatment once or twice a week during the cycles you are trying to conceive.

If you plan to undergo acupuncture alongside your IVF cycle, it is recommended that you consult with a credible therapist, who has good experience with patients in your situation.

It is generally recommended as:

  • During follicle stimulation – have acupuncture twice a week for optimal effects.
  • Have acupuncture before and after your embryo transfer.
  • After that you can have acupuncture sessions regularly until your pregnancy test.

Acupuncture can be carried on throughout your pregnancy and may help to prevent miscarriage and control symptoms, such as morning sickness.

It is imperative that it is carried out by a registered acupuncturist, familiar with pregnancy treatment to avoid any risks.

 

Are there any risks?

As long as your acupuncture is carried out by a registered practitioner the risks should be minimal.

As mentioned above, the procedure needs to be adapted during pregnancy as using the wrong acupuncture points may harm the baby. So it is very important to ensure your acupuncturist is aware of your pregnancy.

Whilst acupuncture does not guarantee success following IVF or IUI treatment, it can definitely boost your chances of a successful pregnancy. Whether you, your partner or both of you decide to have acupuncture, it can be a great way to relieve some of the stress and anxiety associated with your treatment.

 

About the author:

Rachael Bailey

This article is written by Rachael Bailey, PhD. Below she shares her personal experience with acupuncture and infertility:

My name is Rachael Bailey and I suffered from infertility before the birth of my son in 2016. At the time I started trying to conceive, I was only 27 and so infertility came as a shock to me.

I did not regain my regular periods back after being on contraceptives for many years, and this led to complications conceiving.

After 3 years of trying, I was offered Clomid treatment to help me to conceive. The doctors prescribed me three cycles of treatment, after which, if no success, I would be referred on for IVF treatment.

My first two cycles of Clomid treatment were unsuccessful. At this point I was very disheartened and willing to try alternative therapies in my desperation to conceive. This led me to trying complementary acupuncture treatment alongside my final cycle of Clomid.

To my absolute surprise, having twice weekly acupuncture sessions alongside this cycle led me to success! I carried on with my sessions after finding out I was pregnant, and they also helped me out greatly with my extreme morning sickness.

As a scientist I was never convinced by alternative therapies, however I have been well and truly converted now!

 

Do you have any experience with acupuncture and fertility? Please share in the comments below: