What is Infertility?

Infertility is defined by the failure to achieve a clinical pregnancy in 1 year of regular unprotected sexual intercourse.

This means, that they are not be able to have a child at all.
Therefore, recently the word 'Subfertility' is used instead of infertility.

When is the right time to have examination?

If the both partners are healthy and young, under the age of 30, it is recommended to wait for one more year.
If they have not sufficient sexual intercourses, they may need to wait for two years.
However, women over the age of 35 have been trying to conceive for 6 months without success, a visit to an infertility center could be helpful. It is recommended the male partner takes a semen quality test as well.


What are the causes of infertility?

Infertility can be caused if there any interruptions and structural abnormalities on any stages of pregnancy, production of reproductive cells for either or both male and female (sperm and egg), fertilization of sperm and egg, development of fertilized egg and importing into the uterus of fertilized egg.

Causes in Females

1.Fallopian tubal factors
 
Blockage, Adhesion, Hydrosalpinx

2.Ovulatory factors
 
Polycistic ovarian syndrome,
   Hypofunction of ovary,
   Removal of ovary from former surgery.

3.Peritoneal factors
 
Endometriosis, Adhesion by pelvic inflammatory

4.Anatomical factors
 
Hysteromyoma, Adenomyoma,
   Endometrial polyp, Adhesion

5.Congenital factors
 
Uterinr anomaly, Septum, Undeveloped uterus

6.Immunologic factors

Causes in Males

1.Spermatogenetic problems
 
Hypospermatogenesis, azoospermia
   Destroyed by orchitis

2.Deferent duct problems
 
Blockage, Disorder from vasectomy reversal

3.Pathological disorders
 
Hydrocele, Varicocele

4.Congenital disorders
 
Retained testis (Undescended testis),
   Non0creation of deferent duct

5.Functional disorders
 
Erectile dysfunction, ejaculatory disturbance


When is the right time to have examination?

Tests on Females

Basic examination
It is carried out to see if there are any health problems.
It includes blood type test, anemia test, basic liver function test, test for sexually transmitted diseases (syphilis, AIDS, other infections), rubella immunity test, urine analysis.

 

Hormone Examination
It includes test for hormoness involving in ovulation and blood test in consider of polycystic ovary. It tests hormones such as follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen (E2), thyroid stimulating hormone (TSH), prolactin (PRL), progesterone, testosterone (DHEAS).

Hysterosalpingogram : HSG
Hysterosalpingography is a method to test if there are any intrauterine lesions and whether the Fallopian tubes are opened or blocked.
The test is done with radiographic contrast medium injection to be determined whether there are any lumps in the uterine cavity, whether ther is uterine malformation, whether the Fallopian tubes are opened or blocked and to investigate the shape of the uterine cavity.
It can be done in the follicular phase of the cycle, from the end of periode to 7 days prior to ovulation, when the possibility of pregnancy can be excluded.

 

Ovulation Test
It is generally performed with ultrasonic testing device to directly determine whether the ovulating has occurred. However, for those who have irregular periods, it is tested by recording basal body temperature. And it can be confirmed whether the ovulating has occurred by measuring progesterone in a week after the ovulation.
 

Postcoital Test (PCT)
The Postcoital test (PCT) is a test to directly examine mucus of the cervix and sperm motility.
The infertile couple is asked to have sexual intercourse in close to ovulation. The woman's cervical mucus is aspirated and examined by observing the nuber of motile sperms and their motility using a microscope.

Progesterone Test & Endometrial Biopsy
Progesterone test, using blood and endometrial biopsy, to determine the lutal phase defect may be carried out in a week after ovulation.
 

Diagnostic Laparoscopy
This test may be done when there is no abnormal findings from basic infertility examination and it is determined to perform upon consideration of patient's age, surgical history and result of hysteromucography (HSG).
It is the most accurate test to diagnose infertility caused by disorders of the Fallopian tubes and peritoneum.
The laparoscopy detects the pathological symptoms such as the peritubal adhesion and endometriosis from 20~25% of the patients resulted of having no abnormal findings from basic infertility examination. When it is determined, that the further treatment is needed during the test, the treatment can be done simultaneously to help conception.

 

Diagnostic Hysteroscopy
Similar to the laparascopy. It can detect micro-lesions and micro-adhesion. Provided to increase possibility of fertility.
 

Anti-Mullerian Hormone (AMH)
As woman age, the remaining eggs in the ovaries also have the age and the nuber of eggs decreases.
There are multiple methods to examine reproductive ability and reserve capacity of the ovaries.
AMH test is to investigate the ability of the ovaries and is used as an index test of the ovaries that are unaffected by external hormone changes and is measured regardless of woman's period.

 


Tests on Males

Basic examination
It is carried out to see if there are any health problems as well as the females.
It includes blood test, urine analysis and hormone test.

 

Examination of Semen
Since more than 40% of infertility cases are due to male infertility, it can be a basic examination for the males. It is a significant test to diagnose male infertility by examining the amount of seminal fluid and semen morphology, count and motility. It is the basic examination, which the accurate and predicitve result decides if the assisted reproductive technology such as intrauterine insemination, in-vitro fertilization and intra-cytoplasmic sperm injection will be used.
 


Information of Treatment

We provide useful and helpful information of fertility treatment

We offer to patients a wide range of safe fertility treatment options including Intrauterine Insemination,
In-vitro Fertilization and Intra-cytoplasmic Sperm Injection.


Intrauterine Insemination
Intrauterine Insemination, also known as artificial insemination, is a fertility procedure in which sperm is injected directly in woman's vagina, cervical canal, Fallopian tubes or uterus. It is the most common fertility procedure.

In-Vitro Fertilization
In-Vitro Fertilization and Embryo Transfer were firstly introduced for the female patients who became infertile because of physical cause such as Fallopian tube disorder and their objects are recently expanded to the infertility by unknown cause, immunologic factor, endometriosis, cervical factor, ovarian dysfunction and the male infertility.

In-Vitro Fertilization is a process of recruiting multiple eggs matured by controlled ovarian from the woman's ovaries and combining with sperm outside of the body, in-vitro. The cultured fertilized eggs are then transferred to the woman's uterus using long thin catheter.

Intro-cytoplasmic Sperm Injection
Intro-cytoplasmic Sperm Injection is a fertilization procedure in which a single sperm is injected directly to the cytoplasm of an egg, using the micropipette, of which internal diameter is smaller than about 5μm.
It can be used in male infertilization with oligozoospermia, asthemozoospermia, teratozoospermia and oligoasthenoteratozoospermia to overcome the unfertilization or low fertilization rate.
It can be applied to increase fertilization rate in the patients who either could not succed by IVF before or have low fertilization rate.

 

Assisted Hatching
Assisted Hatching is a procedure of assisted reproductive technology of making a hole in the zona pellucida of the embryo or thinning the zona pellucida.
Embryo in the blastocyst stage is needed to be hatched, the procedure of being pushed out of the zona pellucida.
However, embryos of aged patients or having abnormally thick zona pellucida have difficulties to be implant in the uterus because of poor hatching process. It is applied to overcome such problems.

 

Embryo Glue
When the embryo is cultured in the embryo glue, implantation promoting medium containing highly concentrated hyaluronic acid for certain period of time, the implantation rate can increase by activating the signal system between the embryo and endometrium.


Cryopreservation *

Semen Cryopreservation
The male partner who is either apart from the female parnter for long period or needed radiation therapy may preserve sperm cells and use them for the in-vitro fertilization procedure after thawing.
For the patient with aspernia, semen can be obtained from the testicular tissues and used for fertilization procedure by using cryopreservation.
Also we run the semen bank, preserving donated semen for the patient with aspernia.

 

Embryo Cryopreservation
Because multiple eggs are recruited from ovarian hyperstimulation, necessity of cryopreservation of leftover embryos after a cycle of intrauterine insemination is increasing.
Embryos will be frozen by vitrification method and preserved in liquid nitrogen with temperatute of -196ºC.
Normally developed healthy embryos can be transferred directly to recepients after thawing.

 

*By cryopreservaion

1. Rate of plural pregnancy can decrease
2. Patients can have economical advantage by having chance  to transfer embryos for multiple times with one controlled ovarian and cumulative pregnancy rate can increase
3. Embryo transfer can be postponed for the patients with ovarian hyperstimulation syndrome (OHSS) to prevent severe and critical side effects and to expect safe pregnancy later