In vitro fertilization (IVF), is a process where egg cells are fertilized by sperm outside of the womb. “In vitro” is a Latin term that means “within the glass”, and refers to any biological procedure performed in a controlled environment outside of the organism in which it would usually take, often in glass laboratory equipment.
Children conceived in this manner are often referred to as “test tube babies”. The first test tube baby, Louise Brown, was born in the UK on July 25th, 1978. It is estimated that since then, 3 million babies have been conceived using IVF.
IVF is used when there is low probability of sperm fertilizing the egg or when the woman’s ovaries are blocked. It is usually used after other methods have been tried, as it is an expensive, invasive and time consuming procedure.
The success rate of IVF is difficult to establish, as each clinic uses a different method to determine success. Also, the definition of success varies. Some clinics consider a successful implantation to be a success, others consider an ongoing pregnancy to be a success, and others consider only an actual delivery as success. A clinic that reports a higher success rate may not necessarily have more babies born.
It is also difficult to accurately predict the chances of success, as there are far too many variables involved. One thing that is certain, is that chances of success are higher if the woman involved is younger.
The procedure for in vitro fertilization consists of several steps:
- Ovulation induction: The woman is given medications to stimulate ovulation.
- Egg retrieval: Eggs are then extracted from the ovaries. This may be done either by inserting a thin needle in the vagina, or by a slight incision in the abdomen.
- Insemination: The woman’s eggs are mixed with the man’s sperm, and monitored until fertilization.
- Fertilization: If the sperm are unable to reach the eggs, each egg is injected with a sperm under a microscope.
- Embryo transfer: The embryos are allowed to develop for 2-3 days after fertilization. The embryos are then transferred to the woman’s uterus. To increase the chances of success, more than one embryo is often implanted. Because of this, many women who undergo the IVF procedure have twins.
- Pregnancy testing: The woman is monitored to ensure that the embryo has attached itself successfully, and the pregnancy is monitored as normal.
While the in vitro fertilization procedure can be costly, expensive and time consuming, and despite a large amount of controversy, many couples have been able to conceive a child through this procedure when otherwise there was no other option for them.
Wednesday, March 10, 2010
Sunday, February 28, 2010
Gamete Intrafallopian Transfer
Gamete intrafallopian transfer, or GIFT, is an assisted reproductive technology (ART) similar to in vitro fertilization. The main difference is that fertilization occurs inside the woman’s body, rather than in a laboratory environment. GIFT is also generally more expensive than IVF, costing around $15,000 - $20,000.
Gift is one of the less common methods of ART, used in only about 2% of all cases. It is generally used when a couple has religious or moral objections to fertilization occurring outside of the body. It may also be used in cases where the woman has ovulatory disorders or cervical problems.
In order to be a candidate for GIFT, a woman must have at least one functioning fallopian tube, as fertilization occurs within the fallopian tube.
The procedure for GIFT is virtually identical to that used in IVF. The difference comes in where the egg is fertilized and implanted. In IVF, the egg is fertilized in a controlled laboratory environment. In GIFT, the egg(s) and sperm are placed in the fallopian tube using a surgical procedure called “Laparascopy”. Fertilization occurs in the fallopian tube.
Laparoscopy is a minor surgical procedure where a lighted viewing instrument is inserted into the lower abdomen through a small incision. The abdomen is inflated with gas, which pushed the wall of the abdomen away from the organs so that the doctor can see them more clearly. It leaves a very small scar, and is much less risky than traditional surgery. The recovery time is also very short, and a patient will generally be fully recovered in less than a week.
One disadvantage of GIFT, is that if the procedure fails, the doctor is unable to learn about the sperm’s ability to fertilize the eggs, as fertilization occurs inside the body. Also, the embryos cannot be assessed as they can with IVF. There is also a higher risk of ectopic pregnancy, where the embryo implants itself somewhere other than the uterine lining.
A similar procedure exists which combines GIFT and IVF. It is called zygote intrafallopian transfer (ZIFT). The procedure is the same as for GIFT, with the difference being that the eggs are fertilized in a controlled laboratory environment and then inserted into the fallopian tubes.
There are no reasonable estimates of success rates available, as the procedure is rarely used. Still, gamete intrafallopian transfer can be a viable option for infertile couples.
Gift is one of the less common methods of ART, used in only about 2% of all cases. It is generally used when a couple has religious or moral objections to fertilization occurring outside of the body. It may also be used in cases where the woman has ovulatory disorders or cervical problems.
In order to be a candidate for GIFT, a woman must have at least one functioning fallopian tube, as fertilization occurs within the fallopian tube.
The procedure for GIFT is virtually identical to that used in IVF. The difference comes in where the egg is fertilized and implanted. In IVF, the egg is fertilized in a controlled laboratory environment. In GIFT, the egg(s) and sperm are placed in the fallopian tube using a surgical procedure called “Laparascopy”. Fertilization occurs in the fallopian tube.
Laparoscopy is a minor surgical procedure where a lighted viewing instrument is inserted into the lower abdomen through a small incision. The abdomen is inflated with gas, which pushed the wall of the abdomen away from the organs so that the doctor can see them more clearly. It leaves a very small scar, and is much less risky than traditional surgery. The recovery time is also very short, and a patient will generally be fully recovered in less than a week.
One disadvantage of GIFT, is that if the procedure fails, the doctor is unable to learn about the sperm’s ability to fertilize the eggs, as fertilization occurs inside the body. Also, the embryos cannot be assessed as they can with IVF. There is also a higher risk of ectopic pregnancy, where the embryo implants itself somewhere other than the uterine lining.
A similar procedure exists which combines GIFT and IVF. It is called zygote intrafallopian transfer (ZIFT). The procedure is the same as for GIFT, with the difference being that the eggs are fertilized in a controlled laboratory environment and then inserted into the fallopian tubes.
There are no reasonable estimates of success rates available, as the procedure is rarely used. Still, gamete intrafallopian transfer can be a viable option for infertile couples.
Monday, February 15, 2010
Fertility Drugs: A Closer Look
Couples that have been trying to conceive for 12 months unsuccessfully while not using contraceptives are considered to be infertile. There are a wide variety of drugs available to help a couple conceive a child, and in this article we’ll take a look at two of the most commonly used ones.
Fertility drugs are the primary treatment for women with ovulation disorders. Some are taken orally, and some must be injected. They cause the release of hormones that trigger and regulate ovulation. They are also used with assisted reproductive techniques, such as in vitro fertilization (IVF) or gamete intrafallopian transfer (GIFT).
Clomiphene Citrate is one of the most commonly used fertility drugs. It is also known by the brand names Clomid, Milophene and Serophene. It is taken orally for 5 consecutive days early in the menstrual cycle. Most women will take it for 3 to 6 months. It has not proven to be effective past the six month point. Clomiphene works by stimulating the release of hormones needed to cause ovulation. The side effects of Clomiphene include ovarian hyper stimulation, hot flashes, irritability, nausea, abdominal pain, headaches, thick cervical mucus, breast tenderness, blurred vision and hair loss. There is also a 5-8% chance of a multiple pregnancy when taking Clomiphene.
Human Menopausal Gonadotropin (hMG) is another common fertility drug. It contains luteinizing hormone and follicle stimulating hormone, both of which are needed to help trigger ovulation. These hormones are found in the urine of postmenopausal women. hMG is taken as an injection for 7-12 days, at which point a shot of human chorionic gonadotropin (hCG) is given to tell the ovaries to release mature eggs. It is taken for up to 6 months and is administered through injection. Side effects of hMG are an increased chance of miscarriage, ovarian enlargement, ovarian hyper stimulation, headache and abdominal pain. As with clomiphene, there is also an increased chance of multiple pregnancy.
The same drugs that are used to treat infertility in women can also be used to treat infertility in men. They do not perform as well and are only about one third as effective. Also, they have not been approved by the FDA for use in men, but a specialist can prescribe them. It is worth noting that these drugs only help men with certain hormonal imbalances, such as hypogonadotropic hypogonadism. The drugs stimulate the same hormones in men as in women, which help men to produce more sperm.
While these drugs may not work for every couple that is trying to conceive, they are a good choice as a first treatment as they are cheaper and less invasive than other alternatives. As with any drug, you should ensure that you understand the uses, risks and side effects before taking them. Always consult your doctor before taking medication of any kind.
Fertility drugs are the primary treatment for women with ovulation disorders. Some are taken orally, and some must be injected. They cause the release of hormones that trigger and regulate ovulation. They are also used with assisted reproductive techniques, such as in vitro fertilization (IVF) or gamete intrafallopian transfer (GIFT).
Clomiphene Citrate is one of the most commonly used fertility drugs. It is also known by the brand names Clomid, Milophene and Serophene. It is taken orally for 5 consecutive days early in the menstrual cycle. Most women will take it for 3 to 6 months. It has not proven to be effective past the six month point. Clomiphene works by stimulating the release of hormones needed to cause ovulation. The side effects of Clomiphene include ovarian hyper stimulation, hot flashes, irritability, nausea, abdominal pain, headaches, thick cervical mucus, breast tenderness, blurred vision and hair loss. There is also a 5-8% chance of a multiple pregnancy when taking Clomiphene.
Human Menopausal Gonadotropin (hMG) is another common fertility drug. It contains luteinizing hormone and follicle stimulating hormone, both of which are needed to help trigger ovulation. These hormones are found in the urine of postmenopausal women. hMG is taken as an injection for 7-12 days, at which point a shot of human chorionic gonadotropin (hCG) is given to tell the ovaries to release mature eggs. It is taken for up to 6 months and is administered through injection. Side effects of hMG are an increased chance of miscarriage, ovarian enlargement, ovarian hyper stimulation, headache and abdominal pain. As with clomiphene, there is also an increased chance of multiple pregnancy.
The same drugs that are used to treat infertility in women can also be used to treat infertility in men. They do not perform as well and are only about one third as effective. Also, they have not been approved by the FDA for use in men, but a specialist can prescribe them. It is worth noting that these drugs only help men with certain hormonal imbalances, such as hypogonadotropic hypogonadism. The drugs stimulate the same hormones in men as in women, which help men to produce more sperm.
While these drugs may not work for every couple that is trying to conceive, they are a good choice as a first treatment as they are cheaper and less invasive than other alternatives. As with any drug, you should ensure that you understand the uses, risks and side effects before taking them. Always consult your doctor before taking medication of any kind.
Monday, February 1, 2010
Louise Brown, World’s First Test Tube Baby
July 25th, 1978 was a historic day, and one that would change the lives of millions of infertile couples the world over. For John and Lesley Brown, it was one of the happiest days of their lives. It was the day that their first daughter, Louise Joy Brown, was born.
John and Lesley had been trying to conceive unsuccessfully for nine years because of Lesley’s blocked fallopian tubes. That all changed nine months earlier when Lesley Brown underwent the first successful in vitro fertilization (IVF) procedure in history.
Drs. Patrick Steptoe and Robert Edwards had been looking for a solution to help couples with blocked fallopian tubes to conceive a baby since 1966. Up until Louise, they had been successful in fertilizing an egg outside of a woman’s body, but had been unable to implant the resulting embryo with any success. By 1977, none of the pregnancies resulting from this new procedure had lasted more than a few weeks.
Before Louise, the doctors had waited 4 to 5 days before replacing the fertilized embryo into the mother’s body. With Louise, they decided to wait only 2 and a half days. The pregnancy continued without incident until Louise was delivered by Caesarian section nine months later, a healthy, normal baby. Since then it is estimated that over 1,000,000 babies have been conceived through IVF.
Predictably, the birth sparked a flurry of ethical debates on the morality of the practice.
Fueled by B-grade science fiction films, people worried about soulless clones and taking the place of God. A quote from an article on the birth from the Milwaukee Journal of Aug 3, 1978, states: “Religious leaders are asking, is man treading recklessly into the realm of God’s works – or happily fulfilling a divine commandment?”
Much like the first heart and kidney transplants, the birth of Louise Brown forced the world to face issues that it had not considered before outside of the realm of science fiction. Today, IVF is considered a normal, common place and even uninteresting practice, as the world has answered these questions and moved on to other issues.
Contrast that with Louise herself, who has been faced with constant press coverage her entire life. She is proud to have been the first “test-tube baby”, but is uncomfortable with all the attention.
Recently, Louise gave birth to a child of her own. The baby, a boy, was conceived naturally and was born just before Christmas of 2006. Louise’s sister, Natalie, also conceived by IVF, was the first “test-tube baby” to have a child of her own in 1999.
Louise Brown remains a symbol of hope for millions of infertile couples the world over, and an example of what man can achieve when put to the test.
John and Lesley had been trying to conceive unsuccessfully for nine years because of Lesley’s blocked fallopian tubes. That all changed nine months earlier when Lesley Brown underwent the first successful in vitro fertilization (IVF) procedure in history.
Drs. Patrick Steptoe and Robert Edwards had been looking for a solution to help couples with blocked fallopian tubes to conceive a baby since 1966. Up until Louise, they had been successful in fertilizing an egg outside of a woman’s body, but had been unable to implant the resulting embryo with any success. By 1977, none of the pregnancies resulting from this new procedure had lasted more than a few weeks.
Before Louise, the doctors had waited 4 to 5 days before replacing the fertilized embryo into the mother’s body. With Louise, they decided to wait only 2 and a half days. The pregnancy continued without incident until Louise was delivered by Caesarian section nine months later, a healthy, normal baby. Since then it is estimated that over 1,000,000 babies have been conceived through IVF.
Predictably, the birth sparked a flurry of ethical debates on the morality of the practice.
Fueled by B-grade science fiction films, people worried about soulless clones and taking the place of God. A quote from an article on the birth from the Milwaukee Journal of Aug 3, 1978, states: “Religious leaders are asking, is man treading recklessly into the realm of God’s works – or happily fulfilling a divine commandment?”
Much like the first heart and kidney transplants, the birth of Louise Brown forced the world to face issues that it had not considered before outside of the realm of science fiction. Today, IVF is considered a normal, common place and even uninteresting practice, as the world has answered these questions and moved on to other issues.
Contrast that with Louise herself, who has been faced with constant press coverage her entire life. She is proud to have been the first “test-tube baby”, but is uncomfortable with all the attention.
Recently, Louise gave birth to a child of her own. The baby, a boy, was conceived naturally and was born just before Christmas of 2006. Louise’s sister, Natalie, also conceived by IVF, was the first “test-tube baby” to have a child of her own in 1999.
Louise Brown remains a symbol of hope for millions of infertile couples the world over, and an example of what man can achieve when put to the test.
Sunday, January 24, 2010
Cost of Infertility Treatments
Couples who have been having problems trying to conceive are faced with more problems than just infertility. The costs of treatment can be formidable. For example, one cycle of IVF (In-Vitro Fertilization) can cost anywhere from $8,000 to $15,000. When you consider that most couples require up to three cycles of IVF to conceive a child, the costs can quickly ad up.
Fortunately, not all procedures have such high costs associated with them. While fertility drugs can be expensive, they are a fraction of the cost of other procedures. Still, the cost of some drugs, like Clomid, can be as high as $4000.
While many infertility treatments are covered by insurance, the patient is required to pay up front and seek reimbursement after the fact. With possible costs of over $30,000, it can be very difficult to cover the costs until reimbursement comes. To make matters worse, some procedures aren’t covered by insurance at all! Surrogate parenting, for example, can cost anywhere from $15,000 to $60,000, and none of it is eligible for coverage.
Before proceeding with treatments, couples are advised to carefully go over their insurance coverage to ensure that they meet all of the requirements set out in their insurance policy.
There are also other, non-monetary costs associated with treatment as well. Couples will need to take time away from work in order to receive the treatments. The procedures can also be very physically and emotionally draining, especially when success is not guaranteed.
Despite the astronomical costs involved, there are several resources that couples can turn to in order to help finance treatments. Some of these are:
• Friends and family: Often friends and family are willing to help cover some of the costs.
• Flexible spending accounts: An employee benefit offered to help pay costs of medical procedures that are not covered by insurance.
• 401(k) plan: In some cases, you may be able to withdraw funds from your 401(k) plan. Be aware that you will need to repay these funds at a later date. Check with your employer for more details.
• Loan: A home equity loan or line of credit may be a viable source of funding.
• Shared Risk Programs: Some clinics offer a shared risk program, where the couple pays for treatment up front and is refunded if the treatment is not successful. Be aware that not everyone will qualify, and the definition of “success” may not mean taking home a baby.
While the costs of infertility treatment can be very high, with careful planning and research, couples can often find the resources necessary to pay for treatments.
Fortunately, not all procedures have such high costs associated with them. While fertility drugs can be expensive, they are a fraction of the cost of other procedures. Still, the cost of some drugs, like Clomid, can be as high as $4000.
While many infertility treatments are covered by insurance, the patient is required to pay up front and seek reimbursement after the fact. With possible costs of over $30,000, it can be very difficult to cover the costs until reimbursement comes. To make matters worse, some procedures aren’t covered by insurance at all! Surrogate parenting, for example, can cost anywhere from $15,000 to $60,000, and none of it is eligible for coverage.
Before proceeding with treatments, couples are advised to carefully go over their insurance coverage to ensure that they meet all of the requirements set out in their insurance policy.
There are also other, non-monetary costs associated with treatment as well. Couples will need to take time away from work in order to receive the treatments. The procedures can also be very physically and emotionally draining, especially when success is not guaranteed.
Despite the astronomical costs involved, there are several resources that couples can turn to in order to help finance treatments. Some of these are:
• Friends and family: Often friends and family are willing to help cover some of the costs.
• Flexible spending accounts: An employee benefit offered to help pay costs of medical procedures that are not covered by insurance.
• 401(k) plan: In some cases, you may be able to withdraw funds from your 401(k) plan. Be aware that you will need to repay these funds at a later date. Check with your employer for more details.
• Loan: A home equity loan or line of credit may be a viable source of funding.
• Shared Risk Programs: Some clinics offer a shared risk program, where the couple pays for treatment up front and is refunded if the treatment is not successful. Be aware that not everyone will qualify, and the definition of “success” may not mean taking home a baby.
While the costs of infertility treatment can be very high, with careful planning and research, couples can often find the resources necessary to pay for treatments.
Thursday, January 14, 2010
Adoption: An Alternative to Infertility
Sometimes a couple that has been trying to conceive has to face the inevitable fact that they are unlikely to ever have children of their own. While this can be a heartbreaking thing to accept, there are still options available for the couple to raise a child. The most common of these is adoption.
While adoption is relatively rare in the US, it is still a widely accepted practice. Most adoptions are of children that are related to the adoptive parents. The majority of adoptions of unrelated children in the US are from infertile couples.
You can adopt a baby, a child, a teenager, or siblings. You can adopt a child domestically or internationally. Anyone can adopt a child, but there are many laws governing adoption in different states and countries. For example, anyone adopting a child from Korea cannot weigh 30% more than the recommended weight for their height.
Adoption can cost thousands of dollars; expenses may include agency fees, legal fees, medical and living expenses, and counseling for the birth mother. There is a lot of paperwork involved and it can be a long, frustrating process.
The Child Welfare Information Gateway lists the following steps that must be followed in order to adopt a child:
- Educate Yourself
o Learn about adoption, find out what’s involved, what you need to do, what is expected of you.
- Understand the law
o Learn the laws associated with adoption. You will have to comply with the laws of your own state, as well as any laws in the state or country of the child you are adopting.
- Explore your options
o Do you with to adopt a domestic child, or a child from another country? What agency will you use?
- Complete a home study
o Once you have chosen an agency, you must complete a “home study”. A social worker from the agency will help educate you, help you with preparations, and gather information about you and your household.
- Engage in the placement process
o You must now begin your search for a child. Your agency will connect with other agencies to try and find a match that works for both you and the child.
- File necessary legal documents
o All adoptions must be finalized in court. Typically the child must live with you for six months before the adoption can be finalized. During this time your agency will continue to work with you and assist you with any questions or problems you may have.
- Parent your child
o Adopting a child is a lifelong process. Parent your child, get to know them. Get any support that is needed for you or your child. Your agency will continue to work with you as needed.
Adoption can be a long, frustrating, and expensive process full of red tape and delays. It can also be a blessing to infertile couples who have tried everything else and have come up empty.
While adoption is relatively rare in the US, it is still a widely accepted practice. Most adoptions are of children that are related to the adoptive parents. The majority of adoptions of unrelated children in the US are from infertile couples.
You can adopt a baby, a child, a teenager, or siblings. You can adopt a child domestically or internationally. Anyone can adopt a child, but there are many laws governing adoption in different states and countries. For example, anyone adopting a child from Korea cannot weigh 30% more than the recommended weight for their height.
Adoption can cost thousands of dollars; expenses may include agency fees, legal fees, medical and living expenses, and counseling for the birth mother. There is a lot of paperwork involved and it can be a long, frustrating process.
The Child Welfare Information Gateway lists the following steps that must be followed in order to adopt a child:
- Educate Yourself
o Learn about adoption, find out what’s involved, what you need to do, what is expected of you.
- Understand the law
o Learn the laws associated with adoption. You will have to comply with the laws of your own state, as well as any laws in the state or country of the child you are adopting.
- Explore your options
o Do you with to adopt a domestic child, or a child from another country? What agency will you use?
- Complete a home study
o Once you have chosen an agency, you must complete a “home study”. A social worker from the agency will help educate you, help you with preparations, and gather information about you and your household.
- Engage in the placement process
o You must now begin your search for a child. Your agency will connect with other agencies to try and find a match that works for both you and the child.
- File necessary legal documents
o All adoptions must be finalized in court. Typically the child must live with you for six months before the adoption can be finalized. During this time your agency will continue to work with you and assist you with any questions or problems you may have.
- Parent your child
o Adopting a child is a lifelong process. Parent your child, get to know them. Get any support that is needed for you or your child. Your agency will continue to work with you as needed.
Adoption can be a long, frustrating, and expensive process full of red tape and delays. It can also be a blessing to infertile couples who have tried everything else and have come up empty.
Friday, January 8, 2010
IUI Procedure
Intrauterine Insemination (IUI) is a low tech method of assisted conception. Also known as artificial insemination, IUI has been used with farm animals since the early 1900’s and in humans since the 1940’s.
IUI is a very low risk procedure and one of the least invasive assisted conception procedures. There is no surgery required and there is very little discomfort to the woman’s body. It is not effective for couples where the woman has blocked fallopian tubes, ovarian failure, advanced endometriosis, or where the woman is over 40. It is also not effective for couples where the man has severe fertility problems.
IUI is used mostly for cases of unexplained infertility. It is also used where the man has a low sperm count or poor sperm motility, although sufficient levels of healthy sperm are required to make the treatment work. Otherwise, other techniques, like in vitro fertilization, are more suitable. It can be used for couples who are unable to have intercourse due to disability or injury. It is also commonly used for women who do not have a male partner using donated sperm.
The procedure is fairly simple and straightforward. The woman may be given fertility medications prior to the procedure. However, if only the male partner has fertility problems or the fertility problems are unexplained, fertility drugs will not be used as there is a much greater risk of multiple pregnancy. Around the time of ovulation, a semen sample is acquired (or, in the case of donor sperm, the semen may be acquired in advance). The semen is “washed” in a laboratory. This consists of separating the sperm from other fluids and concentrating them in a small volume, as well as removing any non-motile or otherwise unhealthy sperm. The cervical area of woman is gently cleaned
And the concentrated sperm is placed in the cervix or uterus using a catheter. The woman is often invited to lie down for a short period afterwards, although this does not increase the success rate
Although it is a low tech method with a long history, intrauterine insemination is by no means outdated and remains a viable option for couples who have been unsuccessfully trying to conceive.
IUI is a very low risk procedure and one of the least invasive assisted conception procedures. There is no surgery required and there is very little discomfort to the woman’s body. It is not effective for couples where the woman has blocked fallopian tubes, ovarian failure, advanced endometriosis, or where the woman is over 40. It is also not effective for couples where the man has severe fertility problems.
IUI is used mostly for cases of unexplained infertility. It is also used where the man has a low sperm count or poor sperm motility, although sufficient levels of healthy sperm are required to make the treatment work. Otherwise, other techniques, like in vitro fertilization, are more suitable. It can be used for couples who are unable to have intercourse due to disability or injury. It is also commonly used for women who do not have a male partner using donated sperm.
The procedure is fairly simple and straightforward. The woman may be given fertility medications prior to the procedure. However, if only the male partner has fertility problems or the fertility problems are unexplained, fertility drugs will not be used as there is a much greater risk of multiple pregnancy. Around the time of ovulation, a semen sample is acquired (or, in the case of donor sperm, the semen may be acquired in advance). The semen is “washed” in a laboratory. This consists of separating the sperm from other fluids and concentrating them in a small volume, as well as removing any non-motile or otherwise unhealthy sperm. The cervical area of woman is gently cleaned
And the concentrated sperm is placed in the cervix or uterus using a catheter. The woman is often invited to lie down for a short period afterwards, although this does not increase the success rate
Although it is a low tech method with a long history, intrauterine insemination is by no means outdated and remains a viable option for couples who have been unsuccessfully trying to conceive.
Subscribe to:
Comments (Atom)