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IN VITRO FERTILISATION (IVF)
During the IVF process, the woman’s eggs are removed by a small surgical procedure under trans vaginal ultrasound guidance under short GA, and fertilised in a laboratory using a specimen of sperm from the woman’s partner, or donor sperm if necessary. The fertilised egg is called an embryo, is transfered into the uterus (womb) of the woman.
The IVF process:
- The woman is given fertility drugs (usually by injection) to stimulate egg production.
- Egg production is monitored with a vaginal ultrasound scan and blood tests.
- The eggs are then collected when a surgeon passes a fine needle through the vagina and into the ovaries. This is usually carried out under a mild sedation or general anaesthetic.
- A sperm sample is taken from the husband or sperm from a donor (if husband has no sperm or other causes) is used.
- The sperm and eggs are mixed together in a laboratory in a culture dish; eggs that become fertilised are called embryoes.
- The woman is given progesterone, which helps thicken the lining of the uterus and prepares it for pregnancy.
- Next, one to three of the most viable embryos are collected and placed, through the vagina, into the uterus by a catheter. This happens around two to three or five days after the eggs have been collected and fertilised
- Two weeks later ß HCG is done, 3 weeks after Embro transfer ultrasound is done to see pregnancy excess good embryos are forzen (vitrifield) for future use.
INDICATION OF IVF/ICSI
IVF-ICSI in indicated in couples who have failed to concieve after many attempts proper infertility treatment(medicines, IUI, IVF) and also have one or more of following condition.
- Tubal blockage or severe tubal damage.
- Pelvic adhesions with distorted pelvic anatomy.
- Advanced stage of endomotriosis.
- Reduced ovarian reserve (low quantity and quality) due to advanced age, previous ovarian surgeries, chemo or radiotherepy etc.
- Ovarian failure (Due to advanced age) 38yrs, menopause, genetic diseases with no periods (amenorrhea)
- Male factor inferlility (low sperm count, poor morphology or motility) Azoospermia by (TESA, PESA, MESA, TESE etc).
- Failed 2-4 times ovarian stimulation and IUI.
- Unexplained infertility (Unexplained infertility means standard fertility tests have not found the cause).
- Severe PCOD with failed ovalation induction and IUI.
- Routine investigation
- CBC, ESR, sexually transmitted diseases (VDRL, HBSAg, HIV) blood sugar, urine routine
- Serum FSH, LH, estradiol on day 2/3 of cycle, AMH
- Serum prolactin T3, T4, TSH
- Tests for ovulation (ovulatory or anovulatory)- Antral follicle count , follicle monitoring
- Detailed history and examination
- Examination of testis, vas, epididymis, volume of testis in case of azoospermia by Doppler USG
- Semen analysis and culture
- ROS test in semen sample
- DNA fragmentation test
- General Tests – CBC, ESR for sexually trasmitted diseases (VDRL, HBSAg, HIV, HCV) blood sugar, urine routine and culture
This term describes the process when the embryos grow for longer(5-6 days) in the laboratory,and undergo critical developmental chages before being returned to the womb.
This period of extended culture helps our experts select the most competent embryo(s) for transfer to your womb,and can help to indicate which embryos have the best growth potential.Therefore,blastocyst culture maximizes the chance of you achieving viable pregnancy.
By the time an embryo has reached the blastocyst stage,its already undergone several cell divisions and achieved its first cell differentiation into two distinct cell types.
Although this period of extended culture doesn’t necessarily improve the quality of the embryos,or gurantee that they reach the blastocyst stage.
we have impressive success rates for this treatment.
Who needs Blastocyst culture?
You are likely to benefit from this treatment if you have large number of embryos.That’s because not all embryos have the ability to form a blastocyst,and the number of embryos progressing each day may decrease. This advanced technique allows the most competent embryo(s) to be selected for the transfer on fifth day following egg collection. The treatment cycle is exactly same as of IVF,except that the embryos will be cultured longer in laboratory.This simply means the day of your embryo transfer will be five days after egg collection.
Embryos are often frozen during an IVF cycle when fresh embryos are transferred(2 to 3) and extra embryos created in that cycle ,but not transferred at the time ,are frozen.Sometimes,due to medical reasons all embryos are kept frozen.They can be stored for your future use for upto 5 years.(acc to ICMR guidelines.)
Who needs Embryo freezing?
- This may be an option for woman who are facing sugeries or cancer therapies that may affect your ability to produce healthy eggs in future,either with sperm of your partner or donor semen.
- Surplus good quality embryos for future use.
- Embryo freezing for medical reasons like to avoid hyperstimulation, poor endometrium or if any problem with patient’s health
Frozen Embryo Transfer
It means replacing warmed frozen embryos in the womb at the optimum time for implantation.Oral medications and/or minimal amount of injections required for endometrial lining preparation.This helps the woman avoid undergoing injections for growth of eggs again.
Sperm freezing and banking is a form of fertility preservation,intended to keep open your options for having child in future.
Who needs sperm freezing?
Impending surgery or treatment that may damage your fertility infailure e.g vasectomy and treatment of cancer. In cases of low sperm count we do back up semen freezing for short term. Renewal of sperm freezing is done every 12months in cases of long term freezing and every 3mths in case of short term freezing after proper approval from the patient.
Surgical sperm retrieval technique (SSR)-(TESA, PESA, TESE, MESA) is a minor surgical procedure that’s used to harvest sperm directly from a males testis or epididymis.
Who needs Surgical Sperm Retrieval (SSR)?
The surgical retrieval of sperm may enable the 1-2% of patients who have no sperms in the semen.(a condition known as azoospermia).This may be due to: .Failure of the sperm passage to develop(congenital absence of the vas deferens) A blockage of the sperm transport tubules( rete,epididymis or vas deferens) A previous vasectomy operation. Insufficient sperm production in testis due to various diseases,congenital problem and X-ray treatments.
A. PESA stands for (Percutaneous epididymal sperm aspiration), this procedure is usually done under sedation with pain relief but can also be done under General anesthesia. Sperms are directly extracted from epididymis(duct above the testis) by using a fine needle which is passed through the skin of scrotum ,small amount of fluid is obtained and examined for sperms.If sperms are found,they are used for ICSI/or kept frozen.
B. TESA stands for (testicular sperm aspiration) , this procedure is usually done under GA. Sperm is extracted directly from the testicles by passing a fine needle directly into the testicle,small amount of tissue is extracted and examined and preserved for sperm.
Here are some salient feature which make Vansh Clinic and Test Tube Baby Center trustworthy.
- Educating the infertile couple so that they can take informed decision.
- Entire treatment under one Roof.
- Dealing with patient with empathy and care
- Indiviualized treatment .
- Team approach with core being the patient.
- IVF Lab strictly as per international standards.
- In house embryologist.
- Availability and accessibility to clinician.
- .A perfect amicable atmosphere brimming with positivity.
- Honest opinions unbiased by materialistic gains.
By IVF – ICSI (Test tube baby)
By Intrauterine Insemination (IUI) with husband semen with Donor
Treatment of Infertility by medicine.