In case of sparse or absent ovulation, the woman can be treated with tablets or hormone injections. Ultrasound checks are done to follow the developing follicle and the timing of ovulation.
Insemination (IUI) can be performed either in the woman’s natural menstrual cycle or with a lighter ovulation stimulation. In IUI treatment, prepared sperm are introduced into the woman’s uterus at the most fertile point in her menstrual cycle. IUI can be performed with partner’s sperm or with sperm from a donor.
IVF - in vitro fertilization
IVF or in vitro fertilization is a form of assisted fertilization where the woman’s ovaries are stimulated and the eggs are taken from the ovaries to be fertilized with sperm outside the woman’s body. That is why the method is called ” in vitro ”, which simply means ”in glass”.
The method is used in all forms of infertility; female, male and unexplained infertility. In IVF, the woman’s ovaries are stimulated with hormones so that more eggs will mature. The eggs are removed from the ovaries by the doctor, guided by ultrasound, inserting a thin needle through the vagina into the ovaries. This only takes a few minutes and the woman usually receives pain relief and a mild sedative. Sperm samples are prepared. Sperm and egg are brought together either through standard IVF or ICSI (please see below) so that fertilization can occur. After 2–5 days, one or two embryos are returned to the woman’s uterus.
If the sperm sample is normal, standard IVF is usually chosen. This means that the sperm can fertilize the eggs on their own.
Microinjection or intracytoplasmic sperm injection, ICSI, is a method where a sperm is injected directly into the egg. The method is used when the man’s sperm have a low probability of being able to penetrate the egg themselves. ICSI is also used in sperm donation. The method was developed in the early 1990s and is recommended for male infertility.
Often with Standard IVF or ICSI treatment, there may be good quality embryos left over after embryo transfer. Often with Standard IVF or ICSI treatment, there may be good quality embryos left over after embryo transfer. Instead of discarding them, there is the option to freeze them to use i the future (in case treatment doesn´t work for example, or to try for a sibling). Embryos can also be frozen to preserve fertility so it may be possible to have a baby at a later date. According to Swedish law, embryos may be frozen for a maximum of 10 years.
The woman undergoes hormone stimulation in the same way as in IVF treatment to make more eggs mature. The mature eggs are taken out as above and frozen the same day they are picked, through the vitrification method which protects the eggs. In the frozen state, the eggs do not age. This means that although the woman herself ages, the eggs remain the same age and the woman can use her eggs later in life.
After thorough investigation and sampling, sperm freezing for fertility preservation can be offered. Sperm freezing is a relatively easy procedure. Sperm samples from the man are prepared in the laboratory and frozen according to a standard routine. Sperm normally retains its quality frozen and can be stored for many years.
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