The cry of your baby fills the emptiness of your whole home and it inevitably completes your family. You and your partner gets into the lock of wedding and both of you begin to cultivate the desire to extend your family. Nevertheless, attaining pregnancy is not as easy as for every couple. Things were difficult for such couples a few decades ago. However, they have become easier after the popularity of several infertility options. Dr. Ragini Agrawal throw light on them:

Fertility drugs
Women in the company of infertility issues may be appropriate to make use of fertility drugs, which work by sourcing your body to let go reproductive hormones that organize the ovulation process. Fertility drugs can be useful with a success rate of about forty to fifty percent in women who ovulate, assisting them get pregnant normally within three cycles. They are often exercised as a first alternative for women who have fertility issues.

In vitro fertilization (IVF)
The IVF method involves eggs being taken out from the donor plus fertilized in the lab by way of the partner’s sperm ahead of being implanted in the uterus.

Prior to the process, your doctor of medicine will examine your ovaries as well as the timing of the egg release, making sure that your ovaries is producing eggs, along with that your hormone levels are usual. It is customary to take fertility drugs throughout IVF. These are used to excite the ovaries into producing eggs, which is vital to the process since having more than one egg accessible will increase the odds of becoming pregnant. In those cases where the woman cannot produce eggs, it is likely to use a donor to deliver eggs to make IVF possible.

Surgery
Surgical procedure may be employed in cases while there are blocked Fallopian tubes, to take away endometriosis tissue, to take care of PCOS, or for other anatomical irregularities. It can also amplify the chances of becoming pregnant by means of natural conception.

Artificial Insemination
This is a method where sperm is deposited directly into the uterus by means of a thin catheter in a progression called intrauterine insemination (IUI). Artificial insemination is particularly used when the couples are not capable to have vaginal sex, possibly due to disability or for same-sex couples.

Intra-fallopian Transfers

There are two chief types of intra-fallopian transfers:
• Gamete intra-fallopian transfer (GIFT): The eggs along with sperm are placed in the Fallopian tubes to let fertilization to occur naturally.
• Zygote intra-fallopian transfer (ZIFT): numerous eggs are collected from the ovaries plus mixed with sperm. For the duration of ZIFT, fertilization takes place in a lab plus the zygotes (fertilized eggs) are placed into the Fallopian tubes rather than the uterus, which is the key difference between ZIFT and IVF.

Intra-fallopian transfers can be employed in cases when the woman’s Fallopian tubes aren’t infertile or damaged plus the man has a low sperm count, or there are troubles with the sperm in general. It is also employed where there the couple objects to IVF, for instance, for religious causes or where previous efforts at IVF have failed to outcome in pregnancy.

Services provided under Fertility & IVF are:

Fertility Workup
Your medical history and lifestyle are discussed in detail. It is necessary to clarify all doubts with your doctor. Blood tests are carried out to understand your hormonal levels and to check for any infection or ovarian reserve. Other tests done are Ultrasound Follicular Monitoring and Tube test to know about egg formation and patency of the fallopian tube.

Male Workup:
Getting a detailed medical history and examination is the first part of evaluation. Semen Analysis is the most important test to check male fertility and accordingly an interpretation is made. In few cases advance tests like the DNA Fragment test are done.

Female Workup:
Medical history and lifestyle issues are discussed with you in detail. It is necessary to clarify all doubts with your doctor. Required blood tests are done to understand your hormonal levels and check for any infection or ovarian reserve. Other tests done are Ultrasound Follicular Monitoring and Tube test to know about egg formation and patency of the fallopian tube.

IUI (Intrauterine Insemination)
IUI is inserting washed sperm into a woman’s womb when she is ovulating. This procedure is used for couples with unexplained infertility, minimal male factor infertility, or women with cervical mucus problems. It is often done using ovulation-stimulating drugs. The husband’s sperm or donor sperm is used depending on prevailing conditions. Before IUI, a complete evaluation of the woman is done for tubal patency, any hormonal imbalance, infection, or any structural problems.

IUI is performed usually within 24-36 hours after the LH surge is detected, or after the “trigger” injection of hCG is administered. Ovulation is predicted usually by ultrasound or can be done by a urine test kit or blood test.

In the case of insemination done using the husband’s or a male partner’s sperm, the husband or male partner gives semen specimen at the clinic or doctor’s office. The sperm is then prepared for IUI. Sperm from the male partner or third-party donor are “washed” or separated and the healthiest sperms are selected from the man’s ejaculate, which are then concentrated into a small volume. A soft catheter is passed through a speculum, directly into the woman’s womb to deposit the sperm pallet at the time of ovulation.

Ovary are stimulated with drugs to produce more eggs. In cases of employing an injection very careful monitoring is required by ultrasound and blood tests. When egg maturity is detected  an HCG injection is given to provide a trigger.

If the husband has no or very low sperm count, donor sperm is used after proper prepration. All donors are checked for infection thoroughly. It is a quick OPD procedure, although women may experience some discomfort.


IVF

In Vitro Fertilization (IVF)
In natural or unassisted conception, the egg and sperm are fertilized inside a woman’s body and resulted embryo implants in womb and grows for 9 months . and finally couple blessed
with a child. But it is not true for all. Many couples trying to conceive for many years remain unsuccessful. When all treatments fail they resort to IVF but sometime certain conditions like advanced age or, male factor infertility, make it impossible to do anything but IVF. it is a form of assisted reproductive technology (ART), where special medical techniques are used to help a woman to get pregnant.

Five steps of IVF:
Ovulation induction – to produce more eggs
Egg Retrieval
Insemination and Fertilization
Embryo Culture
Embryo Transfer
Intra Cyto Plasmic sperm injection (ICSI): is a procedure used in IVF specially for male infertility specially when sperm count and motility is very low. Only one sperm is needed for fertilization as it is injected directly in egg. Then fertilized egg is transferred in womb

ICSI is likely to be recommended if male partner has:

A very low or zero sperm count.
A high percentage of abnormally shaped sperm.
Sperm  collected from the testicles or from the duct where sperm is stored .
In cases of erectile dysfunction

ICSI
Intracytoplasmic sperm injection (ICSI) is a procedure used in IVF specially for male infertility specially when sperm count and motility is very low. Only one sperm is needed for fertilization as it is injected directly in egg. Then fertilized egg is transferred in womb.

ICSI is likely to be recommended if male partner has:

A very low or zero sperm count.
A high percentage of abnormally shaped sperm.
Sperm collected from the testicles or from the duct where sperm is stored. In cases of erectile dysfunction

Donor Egg IVF
Women with advanced maternal age (between 43-50 years old), or failed multiple IVF cycles, premature ovarian failure or poor egg quality ,donor egg program IVF is a way to have pregnancy. If prior IVF cycles are resulting in poor egg/embryo quality , these women are also benefitted by donor eggs.. if couple goes for egg donation and sperms are from male partner they both are biological parents and father is genetic parent too. The process is completely anonymous and kept 100% confidential. Egg donation is usually from agency or some time sharing is done by some other couple and remove/delete Micro TESE completely

Surrogacy
Surrogacy is a system in which a woman carries and delivers a baby for another couple, she is known as surrogate mother. Process involves impregnating surrogate mother using some form of assisted reproductive technology, frequently IVF. After successful impregnation surrogate mother carries the baby to term and gives birth, after this baby is released from hospital to the couple.

Surrogacy is recommended if there is any type of medical condition that makes it impossible or poses life risk for a woman, in case if she gets pregnant.

These medical conditions are:

absence or malformation of the womb
recurrent pregnancy loss
repeated in vitro fertilisation (IVF) implantation failures
How is Surrogacy Performed?

Surrogacy involves the implantation of an embryo to Surrogate mother, created using either:

the eggs and sperm of the intended parents
a donated egg fertilised with sperm from the intended father
an embryo created using donor eggs and sperm
Legality

Surrogacy, although legal in India, however, is still an issue of discussion. It involves complicated legal issues and its always recommend to seek legal advice from expert on this topic, before making any decisions. It is also advisable to receive counselling before starting the surrogacy process, to help you think about all the questions involved.

TESA/TESA (Testicular Sperm Extraction/Aspiration)
If male partner do not have sperm in semen but they wish to conceive by their own sperm TESE is technique to extract sperm from testicles and can be used in IVF & ICSI.

Either defect in seminal ducts (tube which carry sperm from testes to epidydmis or faulty production of sperm). Sperms can be extracted directly from the seminal ducts if there is seminal duct is defective.

In this procedure  a needle biopsy of the testicle is done to take a sample of testicular tissue  directly from the testis to extract sperm. If enough sperm is found, it can be frozen for future use. The procedure can be repeated on the day of egg retrieval. The procedure is done preferably under local anaesthesia.

It can be used in man who has gone under sterlization (VASECTOMY) and want to produce there own child.

 
Copyrights ©2014: Derma Science Clinic