Infertility. For a man and woman who so much want to have children, this is just about the worst news either of them could get. Years ago when a woman was infertile her only option was to adopt. Never could she have her own child. Today, things are a lot different. We've made great advances in this area and women who are infertile can actually have children through a variety of procedures.

One of these procedures is called Assisted Hatching. An embryo in its early stage is surrounded by an outer coating called the zona pellucida. The zona holds the cells of the embryo together. When the embryo makes its way into the uterus, the outer zona coating dissolves. This allows the embryo to hatch and grow larger. You can't do implantation until the embryo hatches. In some women, natural hatching doesn't occur. A process called assisted hatching may help embryos from these women.

So which women are considered good candidates for assisted hatching?

The ideal candidate for this procedure would be 38 years of age or older, has a high follicle stimulating hormone level, has failed to get pregnant in a prior in vitro procedure, having embryos fertilized using intracytoplasmic sperm injection and having used frozen-thawed embryos. The benefits of this procedure is that it increases the success rate of in vitro fertilization.

However, there are risks involved. The procedure may increase the rate of monozygotic twins. There could also be an elevation in the woman's blood pressure, increase in salt or water retention, higher susceptibility to infection, mood swings, insomnia, osteoporosis, nausea and allergic reactions. The antibiotic used may increase skin sensitivity to sunlight. and may also increase the risk for vaginal yeast infection.

Another option is microsurgical tubal repair. This is repair of the fallopian tubes which may be the cause of the woman not being able to carry a child. The procedure is performed under a general anaesthesia and the operation usually takes about 2 hours. After that it's another two to four hours in the recovery room before they are allowed to go home. The doctors advise a few days of inactivity after the procedure. Most women are able to return to work in about two or three weeks.

The best candidates for this procedure are women who have undergone sterilization with minimal tissue damage.

The risks of this surgery are many. The most dangerous is bleeding after the surgery is completed. This is the main reason why inactivity after the surgery is so important. A very skilled surgeon is required for this surgery, one who will make sure that the tissue itself is handled with extreme care. Aside from bleeding other risks include infection and injury to other structures in the surrounding area, although this is very rare.

The cost of this procedure is expensive. However there are facilities that specialize in these procedures that usually can do the procedure at a reduced cost. Because this is elective surgery most insurance will not cover it.

In future articles we'll go over other ways for women to have children who normally can't.