Summary of Fertilty Treatment Acronyms
This article is by Islington's Angel Wellbeing Clinic's acupuncturist Orly Barziv and looks at:
ICSI is a highly advanced type of in vitro fertilisation (IVF) treatment where fertilisation is achieved after injecting a single sperm into each egg of the female partner. With the benefit of ICSI it is possible to obtain fertilisation when very few sperms are obtained from men who are sterile. Sperms are taken by the minimally invasive techniques, usually under local anaesthetic.
The female partner’s treatment and egg collection are the same as in the standard IVF protocols.
The sperm cells obtained are prepared in a laboratory and are then ready for injection into the eggs by ICSI. Each egg is injected with one sperm, which has been selected by the embryologist.
If an adequate number of sperm are obtained at the time of the procedure, the sperm and/or testicular tissue containing sperm not used for the ICSI procedure can be frozen for later use.
Intrauterine insemination (IUI) is a relatively low tech assisted fertility treatment. Intrauterine insemination involves preparing the male partners sperm in the laboratory and then placing only those sperm which move well and are normally formed in the women’s uterus. The sperm are transferred into the uterus at the time of ovulation. IUI can be performed with the sperm of the male partner or with donor sperm.
The success of intrauterine insemination depends on 2 factors: The reason it is being performed and whether performed in a drug stimulated or natural i.e. drug free cycle.
In general intrauterine insemination is a good assisted conception treatment.
Treatment starts at the beginning of the woman’s menstrual cycle. Typically, you would commence drug treatment by one injection of Gonal-F on the second day of your period (day two of the cycle). Further injections are given on the fourth, sixth and eighth days of your cycle, and on the ninth or tenth day of the cycle you would need an ultrasound scan.
Depending upon your ultrasound picture, further injections may be given on, or after, the tenth day of the cycle and the dose of drug may be increased or decreased. The aim of the stimulation is to achieve the development of two or three mature eggs to maximise your chances of pregnancy. Eggs are thought to be mature when they develop in follicles that are approximately 2cm in diameter. The number of follicles and the size of the follicles is therefore assessed at ultrasound. You may need two or more ultrasound scans in your treatment cycle to determine the optimum response.
When you have follicles of the appropriate number and size in your ovary, arrangements will be made for you to have a final injection (Ovitrelle). This causes the eggs to be ovulated approximately 24 to 40 hours later. The timing of your injection will be carefully determined to enable insemination to be performed around time of ovulation.
The most important risk of treatment with intrauterine insemination in a stimulated cycle is the risk of multiple pregnancy. Approximately 1 in 4 women who become pregnant following this treatment will have a multiple pregnancy.
Ovarian HyperStimulation Syndrome
The second risk of treatment is Ovarian HyperStimulation Syndrome. As the ovaries are stimulated more than they would be in a natural cycle, they become larger and contain fluid filled follicles that hold the eggs. Rarely the ovaries can become very swollen leading to a condition called ‘Ovarian HyperStimulation Syndrome’.
Intrauterine insemination is a successful treatment if used in appropriate couples, for most couples, up to three cycles of intrauterine insemination may be attempted assuming a good response is being maintained.