Credit: zetson via Flickr Creative Commons.

What is ZIFT?

ZIFT stands for zygote intra-fallopian transfer. Like with IVF — invitro fertilization — egg and sperm come together in a lab setting, after which the resulting zygote is placed inside the body of the woman who is intending to carry the pregnancy. With IVF, that zygote (fertilized egg) is placed in the woman’s uterus. ZIFT fertility treatment places the zygote in one of the woman’s fallopian tubes, leaving it to make its own way to the uterus.

How is ZIFT performed?

The initial steps of the ZIFT process are identical to IVF; induction of hyperovulation and collection of eggs, collection of sperm, and placing the two together in a petri dish. Following those steps, the resulting zygote is placed inside the woman’s selection fallopian tube through laparoscopy. One ZIFT cycle takes around five weeks from start to finish.

Why haven’t I heard of ZIFT?

Lots of women need IVF because their fallopian tubes were blocked, scarred, or damaged for a variety of medical reasons. ZIFT is not suitable for women with such conditions. And, ZIFT doesn’t just require the zygote to travel further, from the fallopian tubes to the uterus, than with IVF… it also means an extra hurdle to actually get the fertilized egg to the tube, namely the laparoscopic procedure. Studies have shown that IVF has the same chances for success as ZIFT or, as of 2004, better success rates. This leaves few couples who would choose to undergo zygote intra-fallopian transfer. ZIFT may still be a good option for couples who have experienced failure of other assisted reproduction techniques.

Credit: Blurdom via Flickr Creative Commons.

The thyroid gland, located in your throat, is a little organ few people spend any time thinking about. Among other things, problems with the functioning of the thyroid gland can lead to infertility. The symptoms of thyroid problems are general symptoms that could be caused by a number of things, and many times, a woman won’t even be aware that she has any symptoms. Yet, according to estimates, around 60 million American women suffer from thyroid conditions. Could you be one of them?

Depending on whether the thyroid is working to quickly or too slowly, some of the symptoms of thyroid problems include sudden weight loss or weight gain, hair loss, depression, excessive sweating, changes in menstruation and the menstrual cycle, and a lack of ovulation. The latter two are linked to infertility, although many women won’t know that they are not ovulating. Regardless of the possible cause of infertility, using ovulation tests to find out whether a woman is ovulating is always a good first point, when she is worried about infertility. And, it may give you clues you have thyroid issues as well.

Ask your doctor about thyroid conditions if you suspect this may apply to you. Thyroid disorders are often not diagnosed for a variety of reasons, and it can help if you specifically insist on blood tests to determine whether you have hypothyroidism or hyperthyroidism. Remember, you can ask for a second opinion if your doctor doesn’t see a reason to do tests.

“IVF abroad” — that’s a popular google search, and one that will immediately direct you toward fertility clinics in Turkey, the Czech Republic, Cyprus, and cheap fertility clinic directory lists… Clinics in Russia, India, and the Ukraine are also very popular among fertility tourists, and Americans often consider Mexico too. The appeal of IVF clinics in other countries is purely financial for many. Those who are looking into foreign fertility clinics may be amazed at the price difference compared to clinics in their own countries.  What’s more, fertility clinics in countries such as Russia and India will offer treatment without any waiting lists, and often offer donor eggs immediately and at a relatively low cost to those who need them.

But how do you go about finding a reputable fertility clinic in other countries, what other country do you choose? Determining the price range of IVF cycles is not so difficult, and this is a good place to start — don’t, of course, forget to check the price of plane tickets as well. Next up, those who are considering fertility tourism should contact the ministry of health, medical board, or equivalent organization and ask for a list of licensed IVF clinics. The process of finding a reputable clinic will be easier for you if you have friends or relatives in the country you are looking into, but it will be possible to get most information you need even without that. In order to get a better feel for the level of expertise offered, it pays off to take a critical look at the country’s overall quality of healthcare.

Once you have made contact with a clinic, ask thorough questions about the education of your healthcare team. Look at their medical licenses. And don’t assume that they’re real or current; check with the relevant authority. This goes for private physicians in any country of course. I’m not saying terrible doctors only practice “abroad” (whatever that means for you), only that it may be more difficult to catch cowboys out in a country you don’t live in and know nothing about.

One appealing thing to do is to google the name of a clinic you’re king at for reviews. Beware that reviews you come across are often actually hidden adverts, placed on the internet by the clinics themselves. I have seen the same thing occur on public forums on the web too. One needs more than a little common sense to find a good IVF clinic in a country one is not familiar with.

Endometriosis is not an uncommon condition, with over five and a half million women affected in North America alone. Endometriosis comes in different variations, ranging from mild to severe. Those women who are affected by it are certainly more likely to encounter fertility problems than those who are not. However, many women with endometriosis do get pregnant naturally, often without any problems.

Around 20 percent — in other words, 20 out of every 100 women with “endo” — will not be able to get pregnant naturally. That does mean, on the upside, that the overwhelming majority of those with endometriosis will  be able to conceive naturally, without medical intervention. Unfortunately, endometriosis does make a miscarriage more likely.

Women who have mild endometriosis should consult with their doctor before trying to conceive, but will probably get the “green light” to try naturally without any specific measures against endometriosis. Clomid can sometimes be of help to those couples affected by endometriosis who have not been able to conceive, and surgery to remove the tissue build up and adhesions can greatly increase a woman’s chances of conceiving, especially within the first year following such surgery. In combination with surgery, medications like Lupron may improve your chances of getting pregnant. If you would like to know more about this possibility, make sure to discuss it with your doctor.

Also see: Pregnant with endometriosis — what to expect?

When I suffered a miscarriage at 12 weeks, we buried the tiny fetus, along with its amniotic sac, in the garden. I thought of taking it to the doctor, for testing or whatever it is they do with the “products of miscarriage”, but I felt strongly that this little being deserved a funeral of sorts, so that’s what we did. After that happened, we got back to trying to get pregnant.

I know women who light candles for their babies lost to miscarriage in church, and those who have little statues representing their baby. One friend got a tattoo to commemorate her baby, lost 1t 16 weeks. Other mothers have pendants they wear, to keep the memory of their lost baby alive. Most of these things (except perhaps the tattoo, because it was a stylized little fetus my friend got) allow the mom to honor her baby in a way that is not obvious to others. Yet, these things give you something tangible by which to remember.

Some women will benefit from talking to a counselor after a miscarriage. Many people are not comfortable talking about grief, so your friends and relatives – and even your partner – may not offer you the shoulder to cry on you need. Grief counselors may be a better option for women who want to work through their feelings about after a miscarriage.

IUI success rates vary per fertility clinic, and your age and reason for having IUI also play big roles in determining your odds of getting pregnant during any one cycle. Generally speaking, the success rate for women who are using fertility drugs in combination with intrauterine insemination is around 15 percent each cycle. Does that mean that your chances for success do not diminish with each cycle you get pregnant, however?

Before commencing IUI treatment, it is good to discuss a “plan of action” with your doctor. If you are going to be on Clomid, you should know that it is not considered safe to have more than 12 cycles of Clomid (in total, not necessarily consecutively). Women who were prescribed Clomid to induce ovulation – without the IUI – would have no more than six cycles in a row.

Some doctors feels strongly about not doing more than three IUI cycles in a row. They hold the opinion that, after three attempts have failed, it is clear that this particular fertility treatment will not work for the patient in question, and it is time to discuss other options such as IVF. Other doctors will do more than three cycles of IUI, but the same doctors who disagree with so many IUI cycles also warn against continuing to pursue pregnancy in the same way, without a clear strategy.

It certainly makes sense to sit down with your doctor, and to look at your personal odds of getting pregnant with IUI. Before your first cycle, talk about the possibilities that are open to you if you fail to get pregnant within three intrauterine insemination cycles.

Heterosexual couples may come to the decision of using a sperm donor only after looking into other fertility treatments, and with a lot of heartache. While sperm donation is often hushed up, society is often very compassionate toward couples who can’t have biological children, and respects their “right” to have a child, including through adoption or sperm donation.

Where does the donor-conceived child fit into this story?

This is perhaps the most important question for couples who are considering sperm donation to conceive a baby, but the heartbroken stories from adults who were conceived with donor sperm – which can be found all over the internet these days – should warn couples that their child may not share their views of what “family” means. Indeed, their whole life can be dominated by the wish to find their biological father, and they may feel very ambivalent toward the family in which they grew up if they were not told about their origins from an early age.

What do we want with this blog post? We’re not aiming to deter anyone from using donor sperm – but we do want to draw attention to the donor-conceived person’s side of the story. If you are currently looking into conceiving with donor sperm, here are some suggestions for you:

• Read the blogs of donor-conceived people, and look beyond your current infertility to the needs of your future child.
• Use a known donor, or at least an identity-release donor.
• Seek psychological counseling before deciding to use a sperm donor – specifically, discuss your feelings toward having a child that is biologically connected to only one of you, and focus on the potential child’s feelings.
• Tell any donor-conceived children the truth about their origins right from the start.

Not every Christian individual holds the same views about IVF and other fertility treatments. And, depending on which denomination you belong to, your Church may or may not have official views on IVF. If you and your partner are facing fertility problems and have been told that you would need IVF to get pregnant, it may very well be the first time to serious think about fertility treatments.

Not every couple will come to the same conclusions. What all Christians can probably agree on is the need for plenty of prayer – together as a couple and alone – to help receive clarity about your future family and what God has in mind for you. Some couples, after prayer, find that they are called to get pregnant through IVF. Others think IVF is not what God wants for them, and are led in other directions.

Interestingly, Christian bloggers who are infertile and chose IVF often write about their experiences of being judged by others for choosing IVF. If you are in this situation yourself, that can be very difficult to deal with. It may help to remember that – no matter how one may feel about fertility treatment in general – families with the same faith may make totally different decisions. You may be feeling called to do IVF while some other family will be guided otherwise.

Infertility is extremely hard to deal with, and those who have never faced trouble conceiving naturally may not understand what you are facing – that is no surprise. Of course, nobody takes the decision to have fertility treatments easily, and it would be good if more people could be compassionate towards those of us who are infertile, rather than judging our actions.

One case in which families may consider selective reduction is when a fetus has a congenital birth defect, that is either incompatible with life outside of the womb or would result in very difficult life circumstances for the baby once born. Such diagnoses would be made following prenatal testing, such as amniocentesis.

Selective reduction for medical reasons can also take the mother’s health into consideration. A pregnancy with multiple fetuses can pose risks for a mother, a risk that increases with the number of babies that are present. Selective reduction for this reason rarely happens with twins, but for triplets and upward, doctors may even strongly recommend the family to think about selective reduction because of the strain such a pregnancy puts a woman’s body under.

Likewise, a uterus that is populated by many fetuses is not an environment that leaves much chance for babies to grow. Triplets, quadruplets, and upward are very often born extremely prematurely for this reason. Selective reduction can be a decision made to give the remaining fetus or fetuses a better chance at going to term in the womb, thereby increasing the chance they are born healthily.

This procedure is, of course, controversial. It is not a choice anyone in this situation makes lightly, but many families also know before they conceive that they would not be able to have a selective reduction, for ethical or religious reasons. If that is the case for you, and you need IVF to get pregnant, we strongly recommend that you look into single embryo IVF to lessen the chance they you will be pregnant with multiple babies, and the resulting potential medical problems.

Many young kids are fascinated by babies and pregnancy. A lot of them will, eventually, ask “how the baby got in there” if their mother is pregnant. That would leave the typical parent feeling slightly uncomfortable and with the dilemma whether to give the details of human reproduction, or tell a “cute story” instead. For parents who feel uncomfortable talking about sex with their young children, explaining fertility treatments may actually be easier than explaining natural conception.

You can explain your fertility treatment in age-appropriate terms, saying that your doctor is helping you to get pregnant with the child’s baby brother or sister. You can explain the actual fertility treatment you will have in more detail if your child asks for more information, or just leave it at that if your kid seems satisfied with the answer. You may want to explain that mommy’s egg and daddy’s seed come together in a small dish if you are having IVF, for instance, or say that the fertility clinic will help daddy’s seed get to the egg if you are having intrauterine insemination.

If you are comfortable with it, it may be useful to explain natural conception at the same time, and to point out that women can get pregnant in different ways. Some get pregnant naturally, while others need a little more help. You could even take your child to your fertility clinic once, during the monitoring stage of IVF, for example. That way, what happens at a fertility clinic will become clearer for the child.