Medical Procedures and Interventions - TTC

<h2>Steps of having a baby</h2>
Having a baby happens naturally for most couples. Most couples have sex under the right circumstances and then have a baby. But about 1 in 7 couples are sub/infertile, they have tried for some time getting pregnant without success.&nbsp;
<h2>1 in 7 couples are sub or infertile and often go through the following steps:&nbsp;</h2>
<ol>
<li>Tried and did not get pregnant</li>
<li>See Obgyn</li>
<li>Basic fertility evaluation</li>
<li>See a fertility specialist</li>
<li>Have a semen analysis</li>
<li>Do bloodwork</li>
<li>Have genetics test</li>
<li>Do a hysterosalpingogram (hsg)</li>
<li>Do a saline US sonogram/ultrasound</li>
<li>Have an endometrial biopsy</li>
<li>Have another ultrasound</li>
<li>Have a hysteroscopy</li>
<li>Have a laparoscopy</li>
<li>If no ovulation take Clomid</li>
<li>Have intrauterine insemination IUI</li>
<li>Then have in-vitro fertilization IVF</li>
<li>Have ICSI</li>
<li>Have PGI</li>
<li>Embryo transfer</li>
<li>Frozen embryo transfer</li>
<li>No implantation</li>
<li>Try again</li>
<li>Get pregnant</li>
<li>Miscarriage</li>
<li>Try again</li>
<li>Stay pregnant</li>
<li>Raise Hope</li>
<li>Have a baby</li>
</ol>
&nbsp;
The following three causes of infertility comprise over 80% of all major infertility issues. During infertility workup, over 80% of infertile couples have one or more of these problems:
<ol>
<li>Ovulation Problems (often related to the mother's age):&nbsp; Anovulation and low egg quality</li>
<li>Male Factors (sperm problems): Low sperm count and low quality sperm&nbsp;</li>
<li>Pelvic factors (for example, problems with the fallopian tubes) Fallopian tube problems</li>
</ol>
&nbsp;Below are facts concerning the percentage distribution of fertility problems:
<ul>
<li>About 25% of cases of infertility are due to ovulation problems such as anovulation and polycystic ovary syndrome (PCOS);</li>
<li>30% are caused by pelvic factors such as endometriosis, adhesions, or tubal disease, and</li>
<li>35% are due to male factors such as an abnormal sperm count (for example, oligospermia or not enough sperm, increased semen viscosity, decreased sperm motility, or decreased semen volume).</li>
<li>Less than 5% of infertility is caused by abnormal cervical mucus penetration, antisperm antibodies, or corpus luteum defects (CLP).</li>
<li>In about 10-15% of couples, no specific reason for infertility can be found on initial evaluation. This is called (unexplained infertility). But on further evaluation and treatment, occasionally factors such as poor sperm penetration or abnormal-appearing oocytes (eggs) are discovered.</li>
</ul>

At BabyMed we provide fertility ovulation pregnancy conception tips and fertility information to women trying to get pregnant.

The Steps of Getting Pregnant with Infertility 

General <a href="/labor-delivery/anesthesia-during-labor-and-delivery">anesthesia</a> is rarely used during labor and delivery. When a woman is given a “general”, as it is commonly called, she loses consciousness and feeling. This prevents her from interacting with the attending physician and leaves her unable to push during labor. Typically, general anesthesia is reserved for C-section deliveries that have complications. Benefits of General Anesthesia If there is a complication with a vaginal birth, general anesthesia may be used so the doctor can quickly perform a C-section. General anesthesia takes only a few moments to place the woman into a deep sleep so doctors can remove the baby through an abdominal incision. Negatives of General Anesthesia General anesthesia comes with a long line of potential risks and side effects for the woman and her baby. The most important are cardiovascular function and oxygen exchange. The anesthesiologist will monitor both the woman and her baby, with the help of doctors and nurses, during the C-section delivery under general anesthesia. Risks to baby may include a decrease in blood flow from the uterus and neonatal depression. Administration of General Anesthesia After choosing to place the woman “under”, the anesthesiologist will give her a sedative through an IV leaving her in a semiconscious state. Then, nitrous oxide is given via mask to achieve the unconscious state needed for quick delivery of the baby. Once “under” a tube will be run down the throat to prevent inhalation of vomit and to maintain a clear airway. There are very few reasons to choose a general anesthesia over other forms of pain management during labor and delivery. Due to the potential health risks to woman and her baby, doctors typically choose some other form of medication if a quick delivery is needed.
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General anesthesia is rarely used during labor and delivery. General anesthesia is reserved for C-section deliveries that have complications.

General Anesthesia

A spinal is not unlike an epidural during the administration process, but the effects on the body are far different. Spinals are pain medications delivered via the spinal column in one dose. The medication is fast acting and can achieve a complete block of pain in as little as 2-3 minutes. During labor and delivery, the total block means the woman giving birth cannot feel the lower half of her body, which can make pushing impossible. That's why a spinal anesthesia is usually given exclusively for a cesarean section, while an epidural is done for labor or cesareans. Benefits of Spinal Anesthesia Women who enter the hospital in the latter stages of labor and need a cesarean may not have enough time to get prepped for birth and receive an epidural. In these cases, pain spinal. Spinal pain relief can last up to two hours. Negatives of Spinal Anesthesia As is the case with any pain relief, there is potential health risks associated with a spinal. Most notably, there is a "high spinal" and women may experience a blocking of pain and feeling that spreads into the chest area. This can cause difficulty breathing. Other common side effects include dizziness, itching, convulsions, low blood pressure and severe headache. Localized infections can occur if spinal equipment is not sterilized properly. While this risk is extremely low, moms should always be aware of the risk associated with any medical procedure. Effects on the Baby The same increased risk of C-section and assisted birth that comes with an epidural, can also occur with a spinal. Other than this increased risk, there are no potential side effects for the baby. Spinal anesthesia is usually not chosen as pain relief during labor and delivery.because it&nbsp; blocks movement which can make giving birth vaginally more difficult. Epidurals provide the same pain relief without paralyzing the lower body.
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Spinals are pain medications delivered via the spinal column in one dose. The medication is fast acting and can achieve a complete block of pain in as little as 15 minutes. 

Spinal Anesthesia

<h2>World Health Organization Reference Limits for Human Semen Characteristics</h2>
These are the new 2009 guidelines for spermanalysis and spermcount and semen parameters by the World Health Organization (WHO)&nbsp;At the end of 2009 the World Health Organization (WHO) has published new reference guidelines for semen parameters.
These guidelines were generated by evaluating 4,500 men in 14 countries whose partners had less than or equal to 12 months time to pregnancy (TTP). WHO found that with a 95% confidence, men whose partners had TTP of 12 or fewer months had NO LESS than the following:
One-Sided Lower Reference Limit (Fifth Centiles With 95% Confidence Intervals)
<ul>
<li>Semen Volume 1.5 mL (1.4-1.7)</li>
<li>Total Sperm Number 39 million per ejaculate (33-46)</li>
<li>Sperm Concentration 15 million/mL (12-16 million/mL)</li>
<li>Vitality 58% Live (55-63%)</li>
<li>Progressive Motility 32% (31-34%)</li>
<li>Total Motility (Progressive + Non-Progressive) 40% (38-42%)</li>
<li>Morphologically Normal Forms 4.0% (3.0-4.0)</li>
</ul>
A diagnosis of male fertility&nbsp;or infertility cannot reliably be made based solely on a&nbsp;single semen parameter.
This group of fathers had significantly better semen quality than semen samples tested in the general population. It is important to note that falling below these levels does not necessarily mean that a male factor is causing a couples infertility. However, with lower numbers, it is a possible that there is a male factor in the couple's failing to conceive.
It is important that any clinic performing a semen analysis for a couple use these WHO guidelines to evaluate and interpret the sample. &nbsp;

These are the new 2009 guidelines for spermanalysis and spermcount and semen parameters by the World Health Organization (WHO)

Semen Analysis Sperm Analysis WHO Guidelines 2009

<h2>How does fertilization take place?</h2>
Of course, you know that your egg needs to be fertilized in order to have a baby, but what exactly is fertilization and how does it happen? Fertilization is the joining of the egg and the sperm and occurs within 12-24 hours after ovulation in the fallopian tube. Fertilization occurs in the outer third of the fallopian tubes, not in the uterus.&nbsp;The fertilized egg then takes about a week to travel down the tube into the uterus.&nbsp;<a href="/fertility-tools/implantation-calculator" target="_self">Implantation</a>, on the other hand, does occur in the uterus about 6-12 days after ovulation/fertilization.
<blockquote>
<h2>If fertilization does not happen within 12-24 hours after ovulation, the egg dies off.</h2>
</blockquote>
Implantation, the attachment of the embryo to the uterine lining, happens on average about 9 days after ovulation/fertilization (between 6 and 12 days). Implantation is vital because the embryo must implant in the uterus in order for the embry to continue to grow and to become a fetus.
Calculate:&nbsp;<a href="/when-am-i-fertile-today-calculator">Am I fertile today?</a>
If you take a blood pregnancy test, it will become positive 3-4 days after implantation, while the urine pregnancy test takes several more days to produce a positive result.
<h2>What aids in fertilization?&nbsp;</h2>
Knowing when your fertile window is and when you will ovulate is half the battle of conceiving.&nbsp;Your fertile window is composed of the 5-6 fertile days of your menstrual cycle. This is when intercourse will most likely result in a pregnancy.&nbsp;This fertile window starts 5 days before the day of ovulation until the day&nbsp;of ovulation. The most fertile days are the two days before plus the day of ovulation.&nbsp;Having sex more than 24 hours after the day of ovulation is not likely to improve your chances of getting pregnant.
<h2>Role of sperm</h2>
Researchers identify the glucose molecule that makes the outer layer of the egg cell ‘sticky’ which is important for capturing the sperm and egg and fusing them. <a href="/tips-improving-sperm-count" target="_self">Sperm is optimal</a> when it ha the proper balance of quantity, quality, and motility.

Fertilization of the egg by the sperm occurs within 12-24 hours after ovulation in the fallopian tube.

What Is Fertilization?

Researchers have studied the effect of electronic monitoring on infant mortality, but the studies have included so few participants that the outcome was negligible. In an attempt to make a clear connection between reduced risk of infant death and electronic heart rate monitoring prior to birth, researchers gathered nearly two million birth records collected in the 2004 National Birth Cohort.
The researchers involved in the study aimed to give doctors sufficient proof that electronic heart rate monitoring is an important part of reducing infant mortality. Birth and death records were pulled from the 2004 National Birth Cohort. Doctors and researchers scoured through the information to connect the dots between electronic fetal monitoring and reduced risk of infant death.
The study results revealed that nearly 90% of infants received electronic heart rate monitoring in 2004. Those infants had a significantly lower risk of infant mortality when compared with the 10% of fetuses that were not monitored. Furthermore, low-risk pregnancies resulted in infants being born with high APGAR scores. High-risk pregnancies showed a reduced instance of infant seizures after birth when electronic heart rate monitoring was used.
The final outcome – infants receiving electronic heart rate monitoring during labor have a reduced risk of mortality by 50% over infants not monitored. These results were delivered at The Pregnancy Meeting, an annual event held by the Society for Maternal-Fetal Medicine.
Source: Vicki Bendure. Society for Maternal-Fetal Medicine. 14&nbsp;February,&nbsp;2011.

In an attempt to make a clear connection between reduced risk of infant death and electronic heart rate monitoring prior to birth, researchers gathered nearly two million birth records collected in the 2004 National Birth Cohort.

Effects of Electronic Monitoring on Infant Mortality

Q: When should I do IUI after the hCG shot?
A: Pregnancy rates are generally higher when insemination is done before&nbsp;rather than after ovulation. Doing IUI after ovulation would be too late as it doesn't get you pregnant. A study (Fertility and Sterility, Volume 72, Number 4, pp. 619-622) reviewed pregnancy success rates in three groups: two IUIs 12 and 34 hours after hCG; one IUI at 34 hours after hCG; two IUIs 34 and 60 hours after hCG. Patients who had two IUI procedures 12 and 34 hours after the hCG shot had more than twice the pregnancy success rate (30.4%) when compared with women in the other two groups (14.4% and 10.9%).

Pregnancy rates are generally higher when insemination is done before rather than after ovulation. Doing IUI after ovulation would be too late as it doesn't get you pregnant. 

IUI (Intrauterine Insemination) After hCG Shot

Q: My boyfriend's ejaculate looks funny. What does that mean?
A: Just by looking at it, smelling it, feeling it, or tasting it, the average person can't really assess whether the ejaculate is fertile or not.
The best way to examine the quality of the ejaculate is by examining it in a laboratory -- doing a spermanalysis. The spermanalysis checks the amount of the ejaculate, the amount of spermatozoa (sperm) per cc, as well as assessing the shape and movement of the spermatozoa.
If you think that should be done, your boyfriend could have the test done and be reassured that everything is OK.