Infertility treatments can be stressful and invasive. Prepare yourself by asking your specialist these questions before starting any treatment for infertility.
By Nisha Salim
After two years of marriage and one year of trying for a baby, 29 year old freelance writer, Revati Nair*, decided to consult an infertility specialist in Chennai. “The whole process was very stressful. I was nervous and uncomfortable, and detested the invasive vaginal exams,” says Revati.
According to the International Institute of Population Sciences, infertility has increased by 50% from 1981 to 2001, especially in Indian cities. A study on the Trends of Infertility and Childlessness in India suggests that infertility rate is high among urban Indian women, which could be because of the higher age of marriage or lifestyle factors.
These statistics get a nod from Dr. K.G. Madhavan Pillai, Managing Director of Samad IVF Hospital, Trivandrum, as well. “Young people these days are in highly stressful job situations. The marrying age has increased, and so has the age at which Indian women start trying for children,” says Dr. Pillai.
Revati felt that she was just another consultation number at the hospital and was not particularly pleased with the entire experience. “I was surprised when the doctor suggested IUI because I was only in my 20s and we had been trying only for a year. They were offering me solutions without bothering to tell me what the problem was,” states Revati.
“Because of the sheer number of patients, doctors are often not able to provide detailed information to everyone. The personality factors also come into play. Some doctors and patients are just not chatty enough,” Dr. Pillai offers a counter opinion.
It is important to take ownership of your own health and body if you don’t want anyone else to dictate terms to you. Some of the most popular Assisted Reproductive Technology (ART) procedures are Intrauterine insemination (IUI), fertility drugs, Intra-Cytoplasmic Sperm Injection (ICSI), and In Vitro Fertilisation (IVF). Do your homework and ask questions before saying yes to any particular treatment.
According to Dr. Pillai, regardless of the final treatment, there are certain questions you need to find the answers to:
– What is the reason for our infertility (since issues could rest with the man, or woman, or both)?
– What is the total cost and expected duration for this procedure?
– What does the procedure involve?
– Are there any risks or side effects?
For specific treatment options, let us take a look at the questions that you must ask before you make the final decision.
IUI is a procedure that involves depositing sperm directly into a woman’s uterus to facilitate conception. IUI is typically used when the sperm count is low, or when there is a problem with the woman’s cervical mucus.
Some questions you may want to ask before IUI:
– How long before the procedure should the sperm be collected?
– What is the best time for IUI and how is it determined?
– Do I have to take any drugs or make lifestyle changes to improve the chances of conception?
– What is the success rate for IUI?
– What does an IUI feel like? Is it painful?
– Do I have to lie down after the procedure? How soon can I resume normal activities, including intercourse?
– How many IUIs should I try before moving on to other procedures?
– When can I expect implantation to occur if the procedure has been successful?
– What kind of monitoring is involved before, during, and after the procedure?
Fertility drugs manipulate hormone levels to improve the chances of conception. Fertility drugs are typically prescribed when the woman has ovulation problems, PCOS, thyroid disorders, excess prolactin, or weight problems.
Here are some questions to ask your doctor:
– What does this drug do? Which particular condition are you attempting to treat?
– Am I at risk for future complications because of the fluctuating hormone levels?
– What changes can I expect while undergoing treatment? Will I gain weight, or will I experience mood swings? Are there any symptoms that I should inform you about immediately?
– What is the dosage and for how long do I have to take it?
– Is the medication in the form of injections or tablets?
– Is the drug available under different brands? What are the pros and cons for each? How have you determined the best brand for me?
– How do I store the medication?
– What are the chances of multiple pregnancies? What are the possible options in that situation?
ICSI involves injecting a single sperm directly into the egg to fertilize it. Pronounced ick-see, it is usually used as a part of IVF (in-vitro fertilization) treatment, where the egg is fertilized by the sperm outside the body, giving rise to the popular term “test-tube baby”. Your doctor may recommend natural cycle or mild stimulation IVF. ICSI is recommended when there is severe male factor infertility, or when other IVF procedures have failed.
ICSI typically has 5 stages – down regulation, ovarian stimulation, egg collection, insemination, and embryo transfer.
Here are the questions to ask if you have been recommended to undergo ICSI or any other IVF procedure:
– What drugs will I be on for different stages of the cycle? What is the function of each drug?
– How and at what times do I have to take these drugs?
– Why these particular drugs? Are there alternatives?
– How will my body react to the drugs? What happens if there is a drug overdose?
– How frequently do I have to come in for monitoring?
– Where and how will you perform the egg collection?
– Is egg collection painful? Will I be given something for pain relief?
– Is there anything we can do to improve the quality of the sperm and egg?
– How many viable embryos can we expect? How do you select the embryo for implantation?
– What type of embryo transfer procedure do you recommend? Is it possible to do a single embryo transfer?
Treatments for infertility can be trying, no doubt. But arm yourself with knowledge before you take the plunge, and talk to the specialist about your concerns with confidence. If the doctor is hesitant to answer your questions, it may be in your best interests to find someone more compassionate.
*Name changed on request.
*Photo credit: Michal Zacharzewski.
Nisha Salim is a self-employed writer and a social media junkie.
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