Infertility specialist in Iran/Methods/cost

Infertility treatment

When a couple cannot get pregnant after one year of sexual intercourse without preventing pregnancy, they are suffering from infertility. Usually 10 to 15% of couples are suffering from infertility. Today; The problem of infertility is very common. When a sign or symptom occurs in a woman or a man or both, we can say that there is a fertility problem. Infertility is more common in women over 35 years old due to chromosomal problems in their eggs.

 

Causes of infertility

Infertility has various causes, which can be related to men or women. Here we discuss the causes of male and female infertility separately. Infertility is more common in women than in men. When any of the stages of the pregnancy process such as; The release of eggs, the amount of released eggs, the amount and motility of sperm, the ability of sperm in fertility, the path of sperm movement, the vagina and fertile and healthy uterus are disturbed.

 

Causes of infertility in women:

endometriosis

Ovulation disorder

Immune system problems

Fallopian tube disorder

Cervical disorder

 

Causes of infertility in men:

Sperm related disorders

Abnormalities related to body structure

sexual impotence

premature ejaculation

 

Signs and symptoms of infertility in women

After a certain period of time, every couple wants to have a child and have the sweet experience of being a mother or father. When a couple has not had a child after almost a year of regular sexual intercourse (without any method of prevention), it can be said that infertility has occurred. It is obvious that one cannot say whether a woman is infertile or not before marriage and regular sexual intercourse for one year.

The main symptom of infertility in women is the couple's inability to conceive within the mentioned time frame. Infertility has no other important symptoms.

 

The most common symptoms of infertility:

As mentioned, the most important symptom of infertility is the couple's inability to conceive after one year. But the following symptoms can be the reason for infertility in women, which include:
 

With increasing age, the probability of fertility decreases, women over 40 have less fertility than younger women.

Stopping menstruation for several consecutive months can also be a sign of infertility.

Painful or irregular periods or missed periods

Ovarian endometriosis (the presence of uterine wall tissue in the ovary that causes frequent miscarriage, pain during sexual intercourse, bleeding, severe pelvic pain, etc.) also increases the probability of infertility in women.

Chronic pelvic infection (bacteria accumulate between the tissues and organs of the pelvic area, which, if the disease becomes acute, have a devastating effect on the uterus, fallopian tubes, and ovaries of the patient)

Repeated abortion (most often, the uterine wall becomes very thin or thick with repeated abortions, which makes the pregnancy process very difficult)

Ovulation disorders that can be genetic.

Long periods that last 40 days or two months can also be signs of infertility.

Early Menopause: Menopause means premature cessation of menstruation. Premature menopause does not have a specific cause, but things like smoking, chemotherapy, radiation therapy, immune system diseases such as AIDS, etc. are effective in early menopause. Obviously, with the occurrence of early menopause, the possibility of fertility drops to zero.

 

Causes of infertility in women:

Diabetes: Diabetes can also cause infertility, diabetes causes the monthly ovulation process to be disrupted, as a result of which fertility does not occur.

Uterine adhesions: Uterine adhesions, which usually occur after curettage, pelvic and uterine surgery, chronic infection, etc., can cause infertility.

Ovarian Cysts

Ovarian laziness

Fallopian tube problems: If there are disorders in the fallopian tube, the probability of infertility increases. Fallopian tube infection can cause infertility. It should be noted that this infection may not have any special symptoms except fever and chills.

 

Infertility treatment with drugs

One of the main ways to treat infertility used for women is to take fertility drugs. This method is mostly used for women who have ovulation disorders. These drugs will cause fertilization by regulating ovulation. Of course, the use of these drugs must be done according to the doctor's prescription and under his supervision, otherwise it will not be effective. Medicines for the treatment of infertility have a wide variety, and after the cause of infertility is determined by a gynecologist, obstetrics and sterility specialist, a specific medicine is prescribed for it. These drugs have a high percentage of success for women who have an almost healthy uterus and their husband's sperm is not a problem.

 

These drugs include:

Clomiphene

Human gonadotropins or HMG

Follicle stimulating hormone or FSH

Human fetal gonadotropins or HCG

Gonadotropin-releasing hormone (GnRH) analog

Aromatase inhibitors

Metformin (Glucophage)

Bromocriptine

 

Infertility treatment with surgery

In some cases, infertility may occur due to blockage of the fallopian tubes of the uterus and problems such as this. In these cases, infertility can be treated with surgery. The first issue that should be considered about surgery is to what extent the surgery is satisfactory for the couple and can bring them to what they want. Today, new methods for women's surgery have become common in the treatment of infertility. Laparoscopy is a surgery that has been performed in recent decades on women who have problems with fertility, including endometriosis (growth of tissue related to the uterus outside the uterus), closing of the fallopian tubes, fibroid (benign mass inside the uterus) and other complications. are infertile, laparoscopic surgery is performed on them. This surgery is done by creating a hole under the navel and advanced and delicate cameras that allow viewing the inside of the abdomen.

 

Infertility treatment with ART

This method, which is an assisted reproduction technology, can be of great help in the treatment of infertility. ART is more successful in women who ovulate well and have a healthy uterus. The most common form of ART is in vitro fertilization (IVF), which is one of the most effective methods of treating infertility. Infertility is treated by removing a mature egg from a woman's body and fertilizing it with a man's sperm in the laboratory. After about 3 to 5 days, the fetus is placed in the mother's womb. Normally, in all these methods, when the woman's uterus has used the donated egg well, a pregnancy test is performed after two weeks of placing the embryo in the mother's uterus.

 

Infertility treatment with IUI

One of the methods used to treat infertility is IUI. Problems related to infertility may be due to diseases or complications in the woman, the man, or both of them. However, there are different methods for treating infertility for These couples have been considered. The most basic of them is IUI. If this method is not successful, people can do other methods such as IVF, which will be much more complicated and expensive.

 

What is IUI?

In these methods, the sperms prepared from the man are separated in such a way that the sperms that are more natural or that have good quality and motility are separated from other sperms and by Dr. Ghazaleh Mousavizadeh, Gynecology and Obstetrics Specialist in West of Tehran is injected into the uterus. By performing this method, the probability that the sperm and egg will be transplanted into the uterus and fertilization will occur increases. By performing this method, the probability of the couple getting pregnant increases by several percent. IUI is without anesthesia. Sperms that have been washed by specialized methods are guided into the uterus through a thin and delicate tube (catheter) through the vagina. Sometimes, in order to increase the percentage of success in pregnancy, along with this method, pregnancy stimulating drugs are also prescribed by gynecologists, obstetrics and sterility to increase the amount of released eggs and increase the probability of pregnancy.

 

It is better for those who have the following problems to do the IUI method.

Men with low semen and sperm

In those who have a lot of undesirable sperm

The presence of antisperm in men's semen, which prevents sperm from being fertile.

Lack of sperm motility

Problems related to ovulation and the presence of dangerous secretions in the uterus

Inability to have an erection and ejaculation in men

Infertility for other reasons

 

Infertility treatment with IVF

IVF or in vitro fertilization is used to treat infertility problems or other genetic problems. During the treatment, mature eggs will be taken from the ovaries and fertilized by sperm in a laboratory environment. Then, these fertilized eggs are implanted inside the uterus.
 

The success rate of this treatment method depends on several factors, including the age of the mother and the cause of infertility. If more than one embryo is implanted in the uterus, the possibility of twins and multiples increases.

 

Some of the reasons for doing IVF are:

- Damage or blockage of fallopian tubes

- Ovulation disorders

- Endometriosis

- Uterine fibroids

- Insufficient sperm production

- Genetic disorders

 

Procedures before IVF

Before starting this treatment, some tests and screening tests should be done, including:

- Examination of the ovaries, in order to determine the quantity and quality of the eggs. Also, the concentration of follicle stimulating hormone (FSH) and estradiol in the blood is measured.

- Analysis of sperm fluid

-Examining infectious diseases such as AIDS

Stages of IVF

Ovulation induction

If your own eggs were used in the treatment process, first the ovaries are stimulated by combined and synthetic hormones to produce more eggs. In this treatment, several eggs are needed, because some of the eggs will not be able to be fertilized.

 

Some medications are also required, including:

- Medicines to stimulate the ovaries by injection, to stimulate more eggs.

- Medicines to prevent premature release of eggs

- Medicines such as progesterone supplements, to prepare the uterus and embryo implantation

 

Egg retrieval

This stage is done 34 to 36 hours after the last injection or before ovulation. In this step, the ovaries and follicles are examined, and the eggs will be taken from the follicles. Then the mature eggs are placed in a suitable environment and mixed with sperm.

 

Sperm recovery

Sperm is separated from semen in a laboratory environment.

 

fertility

Approximately 12 days to two weeks after egg retrieval, pregnancy is diagnosed through a simple blood test. In case of infertility, progesterone injection is stopped, and menstruation begins. In case of no period or abnormal bleeding, be sure to inform your doctor.

The probability of having a healthy child and a good delivery after IVF treatment depends on factors such as the age of the mother, the condition of the fetus, the history of using this method of treatment in previous births, the cause of infertility, or lifestyle.

One of the most important issues that are raised these days is that half of the causes of infertility in couples are due to men and they have an equal share with women in the incidence of infertility.

 

Causes of infertility in men

Various reasons are involved in the treatment of male infertility, the most important of which are the following:

 

Varicocele: One of the most common causes of male infertility is men suffering from varicocele. As a result of this disease, the veins in the testicles of men swell and become an obstacle in the way of fertility.

In fact, the swelling of the testicles causes sperm not to be produced enough, as a result, the chance of fertility of those affected by this disease decreases.

 

Ejaculation-related disorders: Blockage of the ducts and the passage channel of the sperms causes that the sperms cannot have a natural fertilization. Some men have retrograde ejaculation. In a normal state, the semen leaves the body, but in men who suffer from retrograde ejaculation, the semen returns to the bladder and is not discharged.

 

Reduction in the quantity and quality of sperms: for a natural conception, a certain number of sperms must have been produced in the body so that the fertilization process takes place properly, if the quantity of men's sperms is reduced or if they are not of sufficient quality, fertility will not be possible. Was.

 

Anti-sperm antibodies: Sometimes due to disorders in the male immune system, the sperm produ

ced are destroyed by anti-sperm antibodies.

 

Treatment of male infertility

The most important step in the treatment of male infertility is to diagnose the main cause of infertility in them. Because until the cause is determined, one cannot hope for the right treatment method.

On the other hand, the treatment method is tailored to the problem and the cause of infertility is determined, and the treatment method is different for different people.

 

The most important treatment methods:

Drug therapy: The drugs that are prescribed for men with infertility are the following:

Clomiphene citrate, menotropin, letrozole.

Medicines are prescribed for people whose male hormones are disturbed. For example, men who do not have enough sperm for a successful conception use clomiphene citrate.

 

Surgery: Surgery is performed for men who have varicocele disease. In the surgical process, the obstacles in the way of sperm passages and channels are removed, and the sperm transfer process is successfully carried out.

 

Microinjection: This treatment method is used in cases where a man suffers from retrograde ejaculation.

In addition, for all cases, there are other assisted reproductive methods that are widely used these days. Like IVF, IUI.

 

In these methods, by harvesting a part of male sperm and female egg and combining it in the laboratory, they can transfer it into the uterus after the formation of the embryo. Therefore, in this method, fertilization is done artificially, but it has the highest results.

 

Infertility treatment costs in Iran

Infertility treatment in Iran	Cost(dollar USA $)
ICSI(Egg donation)	3500
ICSI(Sperm donation)	3000
Intracytoplasmic sperm injection	2500
ICSI(Embryo donation)	3500
Freeze embryo transfer	800
Freeze annual fee(egg/sperm/embryo)	200
PGS	1000
PGD	1000
PGD+PGS	1600
Hysteroscopy	800
Laparoscopy	2500
TESE	800
Prolapse of the uterus an bladder	600-1100
Ovarian cyst	500-1000
IVF	2500
Total abdominal hysterectomy	750-1200
Surrogacy and IVF	12800