Tubal Ligation

Pills and female sterilization are the leading family planning methods of married Filipino women 15 to 49
years of age, based on the results of the 2002 Family Planning Survey (FPS). Fifteen percent were using
pills and 11 percent were using female sterilization.

Between 2001 and 2002, the percentage of married women using pills increased from 14.1 percent to
15.3 percent. On the other hand, the percentage using female sterilization leveled at 11.0 percent in the
last two years.

Tubal ligation prevents an egg from traveling from the ovaries through the fallopian tubes and blocks
sperm from traveling up the fallopian tubes to the egg. The procedure doesn't affect your menstrual
cycle.

-known as having your tubes tied or tubal sterilization — is a type of permanent birth control. During
tubal ligation, the fallopian tubes are cut, tied or blocked to permanently prevent pregnancy.

-can be done at any time, including after childbirth or in combination with another abdominal surgery,
such as a C-section. Most tubal ligation procedures cannot be reversed. If reversal is attempted, it
requires major surgery and isn't always effective.

- is one of the most commonly used surgical sterilization procedures for women. Tubal ligation
permanently prevents pregnancy, so you no longer need any type of birth control. However, it does not
protect against sexually transmitted infections.

- may also decrease your risk of ovarian cancer, especially if the fallopian tubes are removed.

Risks
Tubal ligation is an operation that involves making incisions in your abdomen. It requires anesthesia. Risks
associated with tubal ligation include:

 Damage to the bowel, bladder or major blood vessels

 Reaction to anesthesia
 Improper wound healing or infection
 Continued pelvic or abdominal pain
 Failure of the procedure, resulting in a future unwanted pregnancy

Tubal ligation is a safe and effective form of permanent birth control. But it doesn't work for everyone.
Fewer than 1 out of 100 women will get pregnant in the first year after the procedure.
https://www.mayoclinic.org/tests-procedures/tubal-ligation/about/pac-20388360
https://psa.gov.ph/content/pills-female-sterilization-are-leading-family-planning-methods

Reproductive Technologies

Artificial Insemination

Infertility these days has become a common medical issue. Dealing with infertility perhaps is something a
couple would never want to experience in their lives. The child-rearing phase is like a dream come true
for a couple.

Intrauterine Insemination also known as artificial insemination, is an Assisted Reproductive Technology

(ART) typically used for infertility treatment. IUI treatment is a procedure in which washed sperm is
transferred directly into the uterus using a thin catheter. The treatment is performed to increase the
number of sperm that enters the uterus.
Sperm that have been washed and concentrated are placed directly in your uterus around the time
your ovary releases one or more eggs to be fertilized.

The hoped-for outcome of intrauterine insemination is for the sperm to swim into the fallopian tube and
fertilize a waiting egg, resulting in a normal pregnancy. Depending on the reasons for infertility, IUI can
be coordinated with your normal cycle or with fertility medications.

Why it's done

A couple's ability to become pregnant depends on many different factors. Intrauterine insemination is
used most often in couples who have:
  Donor sperm. For women who need to use donor sperm to get pregnant, IUI is most commonly
used to achieve pregnancy. Frozen donor sperm specimens are obtained from certified labs and
thawed before the IUI procedure.

 Unexplained infertility. IUI is often performed as a first treatment for unexplained infertility along with
ovulation-inducing medications.

 Mild male factor infertility (subfertility). Your partner's semen analysis, one of the first steps in the
medical assessment of infertility, may show below-average sperm concentration, weak movement
(motility) of sperm, or abnormalities in sperm size and shape (morphology). IUI can overcome some
of these problems because preparing sperm for the procedure helps separate highly motile,
normal sperm from those of lower quality.

 Cervical factor infertility. Your cervix, at the lower end of the uterus, provides the opening between
your vagina and uterus. Mucus produced by the cervix around the time of ovulation provides an
ideal environment for sperm to travel from your vagina to the fallopian tubes. But, if your cervical
mucus is too thick, it may impede the sperm's journey. The cervix itself may also prevent sperm from
reaching the egg. Scarring, such as that caused by a biopsy or other procedures, can cause the
cervix to thicken. IUI bypasses your cervix, depositing sperm directly into your uterus and increasing
the number of sperm available to meet the awaiting egg.

 Ovulatory factor infertility. IUI may also be performed for women who have infertility caused by
problems with ovulation, including an absence of ovulation or a reduced number of eggs.

 Semen allergy. Rarely, a woman could have an allergy to proteins in her partner's semen.
Ejaculation into the vagina causes redness, burning and swelling where the semen contacts the
skin. A condom can protect you from the symptoms, but it also prevents pregnancy. If your
sensitivity is severe, IUI can be effective, since many of the proteins in semen are removed before
the sperm is inserted.

It is suggested in most clinical guidelines that 3-6 repeat cycles of IUI may be done, granting that there
are no serious causes of infertility identified. If unsuccessful, then in vitro fertilization or IVF is the next
appropriate treatment option.
https://www.mayoclinic.org/tests-procedures/intrauterine-insemination/about/pac-20384722
http://www.ivfphilippines.com/

IVF

“Our success rates are now at 35 to 50 percent for pregnancy, and 20 to 25 percent for live births,”
says Virgilio M. Novero, Jr., M.D., head of CARMI and one of the pioneers of IVF practice in the
Philippines. “The success rates depend on the patient’s profile, the competence of the medical staff,
the quality and standards of the IVF lab, and of course the use of cutting-edge technology." A decade
ago, IVF can cost from somewhere to Php500,000 to even a million pesos especially if you were having
the treatment abroad. At CARMI, one IVF cycle--that’s extraction, fertilization, and implantation--for an
average patient can start from Php280,000 to Php300,000. It can include hospital charges, medications,
and doctors' professional fees.

What is IVF?
In vitro fertilization (IVF) is a method of assisted reproduction in which a man's sperm and a woman's
eggs are combined outside of the body in a laboratory dish. One or more fertilized eggs (embryos) may
be transferred to the woman's uterus, where they may implant in the uterine lining and develop. Excess
embryos may be cryopreserved (frozen) for future use.

-was used to treat women with blocked, damaged, or absent fallopian tubes. Today, IVF is used to treat
many causes of infertility, such as endometriosis and male factor, or when a couple's infertility is
unexplained or in women with advanced maternal age where her chances for pregnancy are rapidly
declining and IVF remains as the best possible option.

During IVF, mature eggs are collected (retrieved) from ovaries and fertilized by sperm in a lab. Then the
fertilized egg (embryo) or eggs (embryos) are transferred to a uterus. One full cycle of IVF takes about
three weeks. Sometimes these steps are split into different parts and the process can take longer.

IVF is the most effective form of assisted reproductive technology. The procedure can be done using
your own eggs and your partner's sperm. Or IVF may involve eggs, sperm or embryos from a known or
anonymous donor. In some cases, a gestational carrier — a woman who has an embryo implanted in
her uterus — might be used.

Your chances of having a healthy baby using IVF depend on many factors, such as your age and the
cause of infertility. In addition, IVF can be time-consuming, expensive and invasive. If more than one
embryo is transferred to your uterus, IVF can result in a pregnancy with more than one fetus (multiple
pregnancy).

In vitro fertilization (IVF) is a treatment for infertility or genetic problems. If IVF is performed to treat
infertility, you and your partner might be able to try less-invasive treatment options before
attempting IVF, including fertility drugs to increase production of eggs or intrauterine insemination — a
procedure in which sperm are placed directly in your uterus near the time of ovulation.
Sometimes, IVF is offered as a primary treatment for infertility in women over age 40. IVF can also be
done if you have certain health conditions. For example, IVF may be an option if you or your partner
has:

 Fallopian tube damage or blockage. Fallopian tube damage or blockage makes it difficult for an
egg to be fertilized or for an embryo to travel to the uterus.

 Ovulation disorders. If ovulation is infrequent or absent, fewer eggs are available for fertilization.

 Endometriosis. Endometriosis occurs when the uterine tissue implants and grows outside of the
uterus — often affecting the function of the ovaries, uterus and fallopian tubes.

 Uterine fibroids. Fibroids are benign tumors in the wall of the uterus and are common in women in
their 30s and 40s. Fibroids can interfere with implantation of the fertilized egg.

 Previous tubal sterilization or removal. If you've had tubal ligation — a type of sterilization in which
your fallopian tubes are cut or blocked to permanently prevent pregnancy — and want to
conceive, IVF may be an alternative to tubal ligation reversal.

 Impaired sperm production or function. Below-average sperm concentration, weak movement of

sperm (poor mobility), or abnormalities in sperm size and shape can make it difficult for sperm to
fertilize an egg. If semen abnormalities are found, your partner might need to see a specialist to
determine if there are correctable problems or underlying health concerns.

 Unexplained infertility. Unexplained infertility means no cause of infertility has been found despite
evaluation for common causes.

 A genetic disorder. If you or your partner is at risk of passing on a genetic disorder to your child, you
may be candidates for preimplantation genetic testing — a procedure that involves IVF. After the
eggs are harvested and fertilized, they're screened for certain genetic problems, although not all
genetic problems can be found. Embryos that don't contain identified problems can be
transferred to the uterus.

 Fertility preservation for cancer or other health conditions. If you're about to start cancer treatment
— such as radiation or chemotherapy — that could harm your fertility, IVF for fertility preservation
may be an option. Women can have eggs harvested from their ovaries and frozen in an
unfertilized state for later use. Or the eggs can be fertilized and frozen as embryos for future use.

Women who don't have a functional uterus or for whom pregnancy poses a serious health risk
might choose IVF using another person to carry the pregnancy (gestational carrier). In this case,
 the woman's eggs are fertilized with sperm, but the resulting embryos are placed in the gestational
carrier's uterus.

https://www.smartparenting.com.ph/pregnancy/getting-pregnant/what-you-need-to-know-about-ivf-in-the-philippines-
a00041-20160915-lfrm
https://www.youtube.com/watch?v=q4Ok93mViNI
https://www.youtube.com/watch?v=e65OYoaqAog

Surrogate Motherhood
There are two kinds:

Traditional surrogate. It's a woman who gets artificially inseminated with the father's sperm. She then carries
the baby and delivers it for you and your partner to raise.

A traditional surrogate is the baby's biological mother. That's because it was her egg that was fertilized by
the father's sperm. Donor sperm can also be used.

Gestational surrogates. A technique called "in vitro fertilization" (IVF) now makes it possible to gather eggs
from the mother, fertilize them with sperm from the father, and place the embryo into the uterus of a
gestational surrogate.

The surrogate then carries the baby until birth. She doesn't have any genetic ties to the child because it
wasn't her egg that was used.

A gestational surrogate is called the "birth mother." The biological mother, though, is still the woman whose
egg was fertilized.

Who Uses Surrogates?

If you're a woman, you may consider a surrogate for several reasons:

 Medical problems with your uterus

 You had a hysterectomy that removed your uterus
 Conditions that make pregnancy impossible or risky for you, such as severe heart disease

You may want to think about surrogacy if you tried but couldn't get pregnant with a variety of assisted-
reproduction techniques, such as IVF.

Surrogates have also made parenthood an option for people who might not be able to adopt a child,
perhaps because of their age or marital status.

If gay men decide to use a traditional surrogate, one of them uses his sperm to fertilize the surrogate's egg
through artificial insemination. The surrogate then carries the baby and gives birth.

A gay couple might also choose an egg donor, fertilize that donated egg, and then have the embryo
implanted in a gestational surrogate to carry until birth.

https://www.webmd.com/infertility-and-reproduction/guide/using-surrogate-mother#1