• Artificial insemination of the surrogate mother with the husband’s (or male partner’s) sperm to fertilize the surrogate mother’s egg.
• Artificial insemination by donor, when both partners adopting the child are infertile, using donor sperm to fertilize the surrogate mother’s egg.
• Egg donation, when the prospective mother is not ovulating, but can maintain a pregnancy to term if she receives a donated egg.
• In vitro fertilization with embryo transfer, in which the male partner’s sperm is used to a donor egg resulting in an embryo which is then implanted in the surrogate.

One of the major costs of using a surrogate is the legal paperwork to establish the child’s parentage. Legal costs vary greatly by method.

• Using a donated egg to accomplish pregnancy in the female partner of the marriage (because she is not ovulating, but while she can still become pregnant) is relatively uncomplicated legally and usually involves legal fees of less than $5,000 in the US. Neither husband nor wife has to adopt the child the wife has carried to term in her own uterus.
• Artificial insemination of the surrogate mother with the male partner’s sperm usually does not result in litigation, but the contract for the procedure is usually very detailed. It’s not unusual to spend $20,000 on lawyer’s fees for the contract, but most contracts are written in a way that avoids future court costs. Usually the wife, but not the husband, must adopt the child after the surrogate gives birth.
• In vitro fertilization and embryo transfer are complicated both medically and legally. If the husband donates sperm, the wife must adopt the child after the surrogate gives birth. If the surrogate is implanted with an embryo created from donated egg and sperm, both husband and wife must adopt the child.

In some states, such as Florida, payments to women who donate their eggs and to surrogate mothers are limited to direct expenses. The surrogate would not be expected to pay for visits to her OB-GYN or for the delivery, but she would not be compensated for her time or risk. In other states in the USA and other countries, parents typically pay $10,000 to $100,000 for the surrogate’s services, although the surrogate herself sometimes receives only a small part of this fee.

It’s always important to have the legal and financial arrangements for surrogacy finalized before beginning medical procedures. And it’s always essential to enlist the services of an attorney who is knowledgeable in this area of the law.

Sometimes cervical mucus traps sperm, preventing fertilization. And some women wish to conceive without having sexual intercourse with a male partner, and without having to visit a sperm bank.

The Total Conception is a method of artificial insemination designed to avoid the need for professional intervention. Not a method of intrauterine insemination, The Total Conception transfers semen as far as possible in the cervix itself, short of the uterus. The distance the sperm has to travel to fertilize the egg is greatly reduced, but is still longer than in medically directed intrauterine insemination.

The Total Conception is heavily marketed to lesbian couples and single women who have men willing to donate sperm. Packaged in a sterile container, each Total Conception kit is intended for one-time use. Using the kit requires the woman to be able to find her own cervix, a process some women find a little nerve wracking. The ability to use the catheter to deposit semen also requires a certain amount of fine muscle control that women report is a learned skill. After one or two practice sessions, however, women usually report feeling empowered to use the technique.

Although The Total Conception enables many women to conceive, it cannot replace services that have to be offered by attorneys or physicians. There may be legal issues of paternal rights, or, for lesbian couples, adoption or guardianship questions. The system does not prevent the transmission of sexually transmitted disease, and it is not a part of required prenatal care.

The Total Conception does not interact with any known medications or supplements, but pregnancy is more likely in women who do not drink for several days prior to ovulation, or, since they may be pregnant, at any time after using the kit and before taking a pregnancy test.  Women who have unusually short or unusually long periods may benefit from using a system like the ClearBlue Fertility Monitor to calculate their fertility window.

But for women who can deal with the legal and sexual health issues surrounding pregnancy, The Total Conception provides an inexpensive and unfettered method of achieving pregnancy.

IUI is also not effective for couples facing severe endometriosis, severe male factor infertility or if a woman has damaged or blocked tubes.  Female age has a lot to do with the success of IUI and is also not very beneficial for a woman with a significantly reduced ovarian reserve.  Intrauterine insemination and low sperm count is unlikely to work which is why it is generally done as a last option if other methods have failed to result in conception.

IUI is most commonly used for handling problems related to unexplained infertility and can be beneficial for ovulation related and mild male factor infertility issues.  Other factors can influence whether or not IUI insemination is successful and can depend on:

• Female age
• Number and quality of sperm
• Cause of infertility
• Duration of infertility
• Type of ovarian stimulation used

Success rates are higher in women under 35 years old and over the age of 40, these rates drop significantly.  Couples using IUI due to unexplained infertility have varying degrees of success and the chances of conceiving are approximately 8% within the first month.

Intrauterine insemination and low sperm count studies have shown the procedure can be relatively successful. However, when sperm count is less than 5 million the chances for conceiving and pregnancy are substantially lowered.  In cases like this, IUI is generally done in conjunction with ICSI which involves directly injecting sperm into the egg.

Sperm counts are not going to give a perfect indication of success rates, but after consulting with a fertility specialist a couple can get a better idea of what to expect.  With help from a fertility specialist and sometimes using IUI, a couple can become pregnant and welcome a baby into the world.

However, Dr. A. Tandberg of Haukeland University Hospital in Bergen found that once the babies that were assisted with the help of artificial insemination, the rate of triplet births tripled.

This study wasn’t actually investigating the reasons behind the increase in non-ART births, but the scientists suggested that a reason behind the numbers is the increase in use of the ovulation-stimulating drug clomid (clomiphene citrate). Clomid is since 1960s often used to stimulate female hormone and thus stimulate ovulation, so the researchers believe Clomid might be the main reason behind the doubling the sets of triplets born in Norway since 1960s.

Researchers investigated more than 2 million pregnancies in the past 40, to be more exact from 1967 and 2006. In this 40 years almost 500 triplets sets were born (triplets sets – OMG… this sounds like a production…) and more than 270 hundred twin pairs.

After the year of 1988, when the ART was introduced, Norway introduced a separate registry for artificially conceived births, thus these births were researched separately.

For example, before ART was introduced (meaning before the year of 1988) the birth rate of triplets was bellow one per mile, and after 1988 the rate was approximately 3 per mille, which means that there were 3.3 triplet sets born per 10,000 pregnancies. Between 1988 and 1991 the rate triplet births peaked at 3.5 per milles, which means that 7 sets of triplets were born per 2000 pregnancies. However between 2002 and 2006 the numbers declined to 2.7 per 10,000 pregnancies. Researches also observed that triplets had a 10-fold bigger risk of dying shortly after birth than single infants and artificial reproductive technology did not change this risk.

Additionally, it is interesting observation that triplet births were more common among older women.

Central Park Clinic in Manhattan (phone 212.721.4545) offers 30 years of experience both with IVF and with genetic testing. They specialize in treating couples in which both partners have reproductive difficulties.

The NYU Fertility Center is an academic center that has developed many new techniques in assisted fertility. They offer donor and non-donor in vitro fertilization, artificial insemination, assisted hatching, intracytoplasmic sperm injection (ICSI), and genetic diagnosis and screening. A world-renowned fertility center, it has one of the highest fertility rates in the nation. The NYU Fertility Clinic can be reached at (212) 263-8990.

And over 250 other clinics in New York offer not just IVF (in vitro fertilization) but also ICSI (a more recent technique called intracytoplasmic sperm injection, which involves the injection of a single sperm into a harvested egg).

Since New York offers so many options for assisted fertility in the same place, couples are far more likely to be able to find a practice that meets their needs. Even where medical standards are very high, however, it is extremely important to achieve an understanding with the clinic before beginning treatment. Here are four of the most important considerations:

1. Make sure you receive a clear statement, in writing, of the costs of various procedures that you will and might need.

2. Make sure you have a directive, in writing, stating how many of your embryos will be implanted and that you will decide what happens with any unused embryos.

3. Make sure you can contact a physician any day of the week, and at night, throughout your enrollment in the fertility program.

4. Make sure you are treated efficiently and politely by support staff. The treatment you receive at the front desk is an indication of how you and your embryos will be treated by the physicians.

This are the exact words introduced in a new regulation by the Turkish ministry of health that prevents couples who have trouble conceiving to legally access artificial insemination treatment.

Artificial insemination is already illegal in Turkey, but women have until now at least been able to go overseas to seek sperm donors. I think that enforcing a law like that is horrible and it is a step back for a country such as Turkey. As already said, artificial insemination has been banned in Turkey for several years and fertility doctors were often directing their patients to insemination centers outside of Turkey. Actually it is estimated that more than 5,000 Turkish couples annually receive artificial insemination abroad.

However, if the a new regulation by the Turkish ministry of health will be accepted as a law, couples that are unable to conceive naturally could face jail if they decide to go abroad and get the artificial insemination treatment overseas.

Yes, it is very possible it will soon be a crime for a Turkish woman to become pregnant with sperm from a foreign donor, and couples will face punishment of one to three years in prison for doing so. It is interesting however how the government plans to enforce the law like that…

Absurd. I mean what is the point of a law like this I wondered.

And here is the answer government officials came up with. The new law is based on protecting the racial purity of the nation and ensuring a child’s paternity is not concealed. Personally I think an answer like this hides behind religion although it is forbidden in Turkey by Constitution to have any religious arguments for a law. Afterall Turkey’s a secular country, but the government that supports laws like that has some religious roots, so I think it is their interpretation of Islam.

When trying to conceive and getting a diagnosis of endometriosis, a woman should not give up hope of becoming a mother.  In cases of moderate endometriosis, natural conception is entirely possible and not unheard of, but if the disease is severe and requires surgical treatment, it can mean more difficulty when trying to become pregnant.  In severe cases, an endometriosis fertility drug may be needed in order to help the woman get pregnant, but this can only be determined after careful medical consideration and the advice of a fertility specialist.

Fertility drugs that can help a woman experiencing endometriosis can include Clomid, injectable hormones, Pregnyl, Novarel, Ovidrel and Profasi, Pergonal, Repronex, Metrodin, Follistim, Bravelle or Gonal-F, along with many others.  Severe cases of endometriosis can hinder or prevent pregnancy and must be treated in order to be alleviated.  Approximately 40% of women with the disease will experience infertility, but with early diagnosis and treatment, it does not have to be the same in every case.

For a woman that has already had a baby and may be trying to conceive another child, endometriosis can be the reason why it is not happening.  Several research studies have indicated that a woman suffering from the condition can use an endometriosis fertility drug and still become pregnant. There are many possible solutions when a woman is experiencing endometriosis-related infertility, such as artificial insemination and other assisted reproduction technologies.

When fertility drugs are used in a woman with endometriosis, it can stimulate the ovaries to release eggs which can be fertilized.  If a woman has laparoscopic surgery and tries to become pregnant, the success rates are even higher.  No matter what the odds may be, when a woman has endometriosis and wants to become pregnant, it is important to seek medical treatment and follow the advice of a fertility specialist in order to increase her chances of having a baby.

Clomid (Clomiphene) is a fertility drug that induces ovulation. It is prescribed to women that have problems with regular menstrual cycles or that do not ovulate at all.

Other drugs that stimulate ovulation are also: Gonadotrophins and Bromocriptine.

Hormone pump is a form of treatment that releases gonadotropins.

Pergonal, Metrodin, Humegon, Fertinex are all hormone stimulators – as the name says their goal is to stimulate the low production of sexual hormones in woman’s body.

In case of high prolactin levels Parlodel (bromocriptine mesylate) is prescribed.

Treatments that include assisted conception are performed in a form of

• artificial insemination
• semen concentration methods- this method is used with artificial insemination in cases of male fertility problems, most common in case of low sperm counts
• donor insemination – a male semen donor is applied; this technique is used in cases of male infertility, but is accompanied by quite complex emotional and legal issues.

Assisted reproductive technologies (ART) are another form of applying technology in reproductive health.

• In vitro fertilization (IVF) also known as the “test tube baby” technology.
• Gamete intrafallopian transfer (GIFT) – a reproductive technology that is applied when female fallopian tubes are normal and an egg is placed with sperm in fallopian tubes.
• Zygote intrafallopian transfer (ZIFT) – a reproductive technology that represents a combination of IVF and GIFT; ZIFT is a transfer of a single cell zygote.
• Pronuclear stage transfer (PROST) represents a reproductive technology when transfer of the sperm and ovum occur in an early stage before a fully formed gamete has occurred.
• Tubal embryo stage transfer (TEST) – similar to ZIFT but transferring a multi-cell embryo (2-call, 4-cell, 8-cell).
• Micro-injection fallopian transfer (MIF) – this reproductive technique is applied in low sperm counts: a microscopic injection of a sperm into an ovum and transferred to fallopian tubes.
• Donor egg IVF – use of a donor female ovum with IVF (or any type of ART)
• Frozen embryos

Detoxification diets are not only advisable before IVF but also between the cycles. Detoxification diet includes elimination of coffee, alcohol, medications, smoking and avoiding smoky atmospheres.

Studies show both smoking and alcohol consumption result in lower pregnancy rates and they not only represent hazard to woman’s health, but also expose woman to a greater risk of miscarriage. Coffee and caffeine products have been shown to affect fertility, and as little as one cup in the morning reduces woman’s chances of conceiving for as much as 50%. Fertility specialist also suggest to avoid chocolate, sugary foods, salty snacks, processed foods, tea, cola and all fizzy drinks.

Some clinics suggest when preparing for IVF, woman should reduce salt and potassium from her diet. This is because diet high in salt and potassium prevents hyperstimulation.

Woman should consume a well balanced diet, high in healthy proteins, wholegrains, veggies and fruits, and she should drink at least 8 glasses of water. She should also include prenatal supplements or consume diet that will enable her following vitamins and minerals:

• Folic acid to help prevent fetus defects
• Vitamin C and E: they help enrich the fluid which surrounds and nourishes woman’s eggs and to help her repair quickly after the egg retrieval, enabling readiness to receive the incoming embryos.
• Mineral zinc is essential mineral for hormone production,
• Magnesium and vitamin A are vital for egg production.
• Selenium and magnesium are both important because they improve fertilization rates
• Iron and Co-enzyme Q10 are important because they both enrich the womb lining.
• Healthy essential fatty acids are vitally important because they help balancing hormones and support ovarian health, and are found in fish, olive oil, flaxseed oil, nuts …