Having a baby is a sweet feeling that lots of couples all over the world wish to experience. However, some couples do not find it easy to have babies due to some physical and genetic problems that one or both of them may have. The process of detecting and curing the fertility problem can be time-consuming and costly. Even more, the process is not available in all countries; therefore, a large number of couples with fertility problems travel to other countries to receive the treatment in the most effective way with an affordable price. Iran is one of countries which is considered a desirable destination for seeking fertility services.
Why Fertility Services and Infertility Treatments in Iran?
Iran is considered a great destination for medical tourism and particularly fertility problems; whereas, Iranians couple with infertility had to go abroad to receive the most effective treatment services to experience having a baby last decades. Thanks to progress in the area of infertility in Iran, many patients from all around the world travel to Iran to receive the helpful treatments.
The supreme specialized infertility centers and clinics enjoying well-experienced staff and providing high quality services with the most reasonable prices for treatment procedures besides a low cost trip to Iran are regarded as what distinguishes Iran as a leading country in terms of fertility treatment services.
Why Fertility Services and Infertility Treatments in Yazd?
Yazd benefits from some institution with an internationally high reputation in fertility treatments and receives a large number of Iranian and international couples seeking infertility treatments each year. As the first Iranian infertility treatment center, Yazd Reproductive Sciences Institute (YRSI), enjoys the latest achievements and provides innovative facilities which have made it a prominent center for thousands of patients receiving treatment procedures. In addition to being a medical center, it is considered an academic pivot for infertility as it provides the possibility of education and researching on different fields of reproduction and genetics carrying out many projects annually which help develop infertility sciences universally.
Fertility Tests for Men
Through these tests the cause of male fertility problem will be identified:
- Scrotal ultrasound: This is a safe and painless test that uses high-frequency sound waves to produce images of the testicles. Through scrotal ultrasound, your doctor can detect varicocele or other problems in the testicles.
- Hormone testing: This is a blood test that measures testosterone and other hormones produced by the pituitary gland, hypothalamus and testicles. These hormones play a key role in sexual development and sperm production. Abnormalities in the hormonal system are considered another reason that may lead to infertility.
- Post-ejaculation urinalysis: It is a test that examines the presence of sperm in the urine. In such cases which is called retrograde ejaculation, semen flows back to the bladder instead of flowing out your penis at the time of ejaculation.
- Genetic testing: This is a blood test that indicates changes in the Y chromosome that are signs of a genetic abnormality. This test is done to diagnose various congenital or inherited syndromes. Low sperm concentration has a genetic cause as well.
- Testicular biopsy: In this test, a small portion of testicle is removed with a needle to be examined under a microscope. This test determines if you have an abnormal sperm count, otherwise your problem is probably caused by other problems relating to sperm transport.
- Specialized sperm function tests: There are a number of tests that can determine if the sperm is in a good quality to fertilize an egg.
- Transrectal ultrasound: Transrectal ultrasound imaging is a procedure that sues sound waves to create an image of the prostate gland and look for any blockages of the tubes that carry semen.
Male Infertility Treatments
The fertility treatments that you will receive in Iran for male infertility include:
- Surgical treatment: There are several surgical treatments that are done to improve male fertility. For example, in those cases that no sperm presents in the semen, sperm is retrieved directly from the testicles or epididymis through sperm retrieval technique. varicocelectomy is another procedure which is performed when veins become enlarged inside your scrotum.
- Infection treatment: If there is an infection in the reproductive tract, it can be cured with antibiotics. Of course, this treatment is not always a cure for infertility.
- Sexual intercourse treatment: Problems such as erectile dysfunction or premature ejaculation can lead to infertility. In such cases, medication or counseling can help.
- Hormone therapy: In some cases, fertility problems are caused by high or low levels of certain hormones or problems with the way the hormones are used in the body. In situations like this, your doctor may recommend hormone replacement therapy or using medications.
- Assisted reproductive technology (ART): ART treatments is a procedure through which sperm is obtained for fertility purposes depending on your specific case. The sperms are then used for intracytoplasmic sperm injection, in vitro fertilization procedure, or simply inserted into the female genital tract.
Causes of Female Infertility
There may be a number of problems that keep a female partner from getting pregnant which include:
- Damaged Fallopian Tubes: The eggs produced in the ovary move toward the fallopian tubes to meet sperms and get fertilized. Then, the fertilized egg moves down to the uterus to implant. Pelvic infections, endometriosis, and pelvic surgery can cause fallopian tubes to get damaged and blocked, which can prevent sperm from reaching an egg in the tube.
hormonal imbalance: It refers to a condition in which you cannot get pregnant since the body does not undergo normal hormonal changes that cause the egg to be released from the ovary and thickening of the uterus lining.
- Cervix problems:Sometime there is a condition that sperm is prevented from passing through the cervical canal.
- Uterine Problems: The presence of polyps and fibroids can interfere with getting pregnant. Uterine polyps are growths attached inside the uterus wall (endometrium). There are some other abnormalities related to the uterus that can interfere pregnancy.
- Unexplained infertility: In some cases, the exact cause of fertility problem remains unknown even after an infertility work-up.
How Is Female Infertility Treated?
- Laparoscopy:In this procedure, a laparoscope is sent into the patient body through a cut near the belly button for treating endometriosis, opening blocked tubes, or removing an ovarian cyst.
- Hysteroscopy:This procedure is done by inserting a hysteroscope into your uterus through your cervix in order to remove polyps and fibroid tumors, divide scar tissue, and open the blocked tubes.
- Medication:Depending on the doctor’s diagnosis, a specific drug is prescribed to treat each of the conditions that affect infertility:
To treat ovulation problems medications such as clomiphene citrate (clomid, serophene), gonadotropins (such as Gonal-F, Follistim, Humegon, and Pregnyl) or letrozole are prescribed. These drugs by increasing the number of eggs released, may increase your chance of becoming pregnant.
If you have unexplained infertility, gonadotropin will be prescribed.
And, if you are insulin resistance or PCOS (Polycystic Ovary Syndrome), you are prescribed to use metformin (glucophage) that may help you ovulate normally.
- Intrauterine insemination (IUI): In this procedure, the semen will be placed into your uterus when you’re ovulating. It is often done during the time you are taking medicines that help you release an egg.
- In vitro fertilization (IVF): In this technique, you take gonadotropins that trigger the development of more than one egg. Your doctor collects your mature eggs by using an ultrasound and a needle. Then, sperm are collected too and added to the eggs in a dish. After several days, the fertilized eggs or embryos are transferred into the uterus with a device called intrauterine insemination catheter. The extra embryos can be frozen and saved to use later.
- intracytoplasmic sperm injection (ICSI): This method is used in cases where the male sperm is not in a good quality in terms of number, motility or shape, or even for those couples who had unsuccessfully undergone one or more IVF cycles. In ICSI, the sperm is directly injected into the egg in a dish and then is placed into your uterus.
Options of Fertility Treatment in Iran
There are a variety of methods and procedures that infertile women seeking a fertility treatment in Iran can go under based on their doctor’s opinion depending on their condition:
Surgery can help treating genetic defects, open blocked fallopian tubes, remove fibroids, remove the tissue of endometriosis, and treat PCOS (polycystic ovarian syndrome).
The gynecological problems can be fixed through two common surgical procedures: laparoscopy and laparotomy.
In laparoscopy a thin instruments including a lighted camera will be inserted into your body through some small cut in the abdomen.
In laparotomy the abdominal incision is larger than the one in laparoscopy.
The medical condition and the kind of surgery that is used to treat the problem, play important roles in surgery success.
- There is a chance of about 40% for women with minimal or mild endometriosis. They can get pregnant by 8 – 9 months after laparoscopic treatment;
- The women whose fallopian tubes are opened will have a chance of 21- 59% to conceive;
- There is a chance of about 50% for women with PCOS who have ovarian drilling surgery to become pregnant within one year.
- Intrauterine Insemination (IUI)
This procedure involves placing partner or donor sperm directly in a woman’s uterus by passing a catheter through the cervix. It should be noted that the women are prescribed to use fertility drugs before the procedure which probably increase the risk of having twins or more. The Intrauterine insemination can also be effective in treating cervical conditions, ejaculation dysfunction, and unexplained infertility.
For couples with unexplained infertility the chance of conceiving is 7 – 16 % in every stimulated IUI cycle.
- Intracytoplasmic Sperm Injection (ICSI)
Intracytoplasmic sperm injection procedure is a technique for the treatment of male infertility which is often added to an IVF treatment. During ICSI, a single sperm cell is injected directly into the cytoplasm of an egg. Then, the fertilized egg will put back to the uterus. It should be noted that the man’s sperm is probably needed to be obtained from the testicle with a surgical biopsy or a microscopic needle. Although, the process is less painful than it is expected, the man has to avoid strenuous physical activities for 5 – 10 days.
Through this procedure, 50 – 80% of eggs will successfully be fertilized. The couples who use ICSI have the chance of being parents just like those who have used IVF.
- 40% for women aged 34 and under;
- 31% for women aged 35 to 37;
- 21% for women aged 38 to 40;
- 11% for women aged 41 to 42;
- 5% for women aged 43 and over.
- Donor Eggs and Embryos
In this procedure, an egg donated by another woman is mixed by the sperm of your partner by using the IVF technique. Then, the embryos or fertilized eggs will transfer to your uterus. Your doctor prescribes you some medications in order to prepare your uterine lining for pregnancy. It is important to note that if you transfer multiple embryos, the risk of having twins or more will increase.
- In Vitro Fertilization (IVF)
In Vitro Fertilization is one of the common fertility treatments in Iran through which an egg and a sperm are combined together under laboratory conditions. In this technique the eggs are removed from the ovaries and mixed with the partner or donor sperm in a dish. On day 5, the resulting embryo or embryos will be transferred to the uterus so that the embryonic development process continues naturally.
Preimplantation Genetic Diagnosis (PGD) Method
In addition to receive a fertility treatment in Iran, the couples can also benefit from fetal sex determination which is done by preimplantation genetic diagnosis (PGD), using FISH or PCR techniques in this country. In this method, the success rate for choosing the desired gender is up to 95%. In PGD, eggs are removed after ovarian stimulation and fertilized in a laboratory using microinjection method.
To make use of PGD the couple has to go through routine IVF procedure so that several embryos can be tested when they are just three days old. After fertilization, the embryo will grow to eight cells. Typically, one or two cells are removed by biopsy and are tested by FISH or PCR techniques, in order to determine embryo’s gender. Finally, the embryos with the desirable gender by the couple will be transferred into a woman’s uterus.
IVF procedure step by step
1. Preliminary Sonography or Ultrasound Radiologic Evaluation
The preliminary sonography examines the condition of the uterus and provides information about the condition of ovaries, follicles and the blood flow to ovaries.
2. Secondary Sonography
On the fifth day of menstruation cycle, another sonography is done in order to check the growth of follicles and the thickness of the endometrium. The follicle growth leads to ovulation and estrogen production. At this time, two blood tests will be done to measure the level of estrogen. The hysteroscopy technique may also be used to increase the success rate of IVF according to scientific studies.
3. IVF Procedure Preparation
If you have irregular menstrual cycle, your doctor will prescribe progesterone before starting the IVF procedure. After 6 days taking progesterone, some medications may be prescribed to induce ovulation.
4. Proceeding with IVF
On the second day of menstrual cycle, blood tests and vaginal sonography are done which respectively examine the size of follicles and determine the level of estrogen and estradiol.
5. Testing and Stimulating the Ovaries
At this stage, injectable fertility medications are prescribed which can provide direct ovarian stimulation and control the growth of oocyte (immature egg). These medications have to be injected one or four times a day for a period of 7 to 10 days.
6. Oocyte Maturation
HCG (Human Chorionic Gonadotropin) is a pregnancy hormone that should be injected at this stage. In HCG injection, timing is an important factor. If HCG is injected prematurely, the egg will not fully mature, and if the injection is postponed, the egg will become too mature. HCG is usually injected when the follicle size reaches to 18 to 20 mm and the level of estrogen reaches to more than 2000 pg/ml.
Is IVF surgery painful?
IVF includes several stages: the hormone injection stage, the egg retrieval stage, and the embryo transfer stage. You will experience no pain in hormone injection and embryo transfer stages. The egg retrieval stage is also performed as an outpatient surgery with anesthesia for the pain.
When can the process be repeated for the second time after an IVF failure?
Actually, it is better to postpone the IVF cycle for 2 to 3 monthly periods. The main reason is to give a chance to the patient to return to her normal period cycle.
Is spotting after the egg retrieval process normal?
Yes. Because the follicles have been suctioned out through the walls of the uterus by a needle, you may have 42 to 48 hours of spotting.
Fertility Treatment Clinics in Iran
As a leading country in the Middle East in terms of infertility treatments, Iran has about 100 infertility centers and clinics in different cities such as Tehran, Mashhad, Isfahan, Tabriz, Shiraz, etc. One of the most important infertility treatment centers is Yazd Reproductive Sciences Institute (YRSI), which attracts numerous couples from different countries. The center offers various types of infertility treatment techniques such as IVF, IMSI, IVM, IUI, TESE, ICSI, ovulation induction, sperm donation, egg donation, embryo donation, surrogacy, etc.
Fertility Treatment Cost in Iran
Due to the sanctions against Iran, the value of Iran currency has decreased sharply. In addition to the cost of treatment processes, this sharp decrease has made the everyday living expenses such as accommodation, food, transfer fees etc. more affordable for the couples to decide to receive infertility treatment services in Iran.
If you need to learn more about exact costs in Iran and our treatment packages, click on the links.
Experience a Higher Rate Success of Fertility Treatment in Iran
By choosing to perform a fertility treatment in Iran, the desire of being parents will no longer be unattainable. As you may know, Iran is taking advantage of well-equipped hospitals and clinics with global reputation and is one of the most advanced countries in the field of infertility treatment. Considering the high percentage of satisfaction of international patients with fertility problems who have used Iran fertility treatment services, we can conclude that the high reputation of infertility treatment centers in Iran is due to all these successful results.
Before starting your fertility treatment in Iran, your selected physicians will review all your medical conditions and guide you on the exact treatment process you may need to go under.