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How is Infertility Diagnosed ?
Couples are generally advised to visit a gynecologist if they do not conceive after a year of unprotected intercourse, it also depends on the age. The doctor will assess what could be causative factor and guide the couple accordingly.
The tests include a semen analysis, a few blood tests to assess for ovulation and the Tubal patency Test (HSG). We will be asking for few routine blood tests if not done earlier.
What is In Vitro Fertilization ?
Women who have blocked fallopian tubes, Endometriosis, or where men have low sperm counts, in vitro fertilization (IVF) offers a good chance.
In IVF the woman is given hormone injections to get a good crop of eggs. These are removed under sonography guidance and inseminated with the sperms of the partner. The fertilization is confirmed and embryos are transferred back in the womb.
Is In Vitro Fertilization Expensive ?
All inclusive packages are available on request. The cost depends on the type and number of hormone injection required. Additional stay if required can be arranged in the hospital for out of station couples.
What are the causes of infertility in men ?
Lifestyle changes can influence the seminal parameters. Certain medications and febrile illnesses (like malaria, typhoid)–can temporarily reduce sperm quality.
The causes of sperm production problems can exist from birth or develop later as a result of severe medical illnesses, including mumps and some sexually transmitted diseases, or from a severe testicle injury, tumor, or other problem. Inability to ejaculate normally can prevent conception, too, and can be caused by many factors, including diabetes, surgery of the prostate gland or urethra, blood pressure medication, or impotence.
What is the treatment for infertility ?
Initial test results will help the consultant to guide the couple. Most of the times making couple understand the physiology and the planned relations will give good results.
Induction of ovulation with only the oral medicines first and then if required costly gonadotrophin injections, correcting subtle endocrinopathies will help. We can think of, for tubal factor, either corrective endoscopic surgery or cornual cannulation depending on the site of obstruction. There is good chance of conception with IVF If surgery can not restore fertility in Tubal factor.
Unexplained infertility and early endometriosis cases Controlled ovarian stimulation with IUI has given some promising results.
There is no arithmetic rule. Treatment is directed towards the cause.
Can we have injections and USG monitoring after office hours ?
Yes. The centre is open till 9 pm (Except Sunday) and follicular monitoring can be arranged late with prior intimation.
Will so many injections cause pain ?
How many embryos transferred ?
This is a technical decision depending on the quality of embryos and usually Two or Three will be transferred. Embryo freezing is the option for storing the remaining good quality embryos.
When do I go for pregnancy test after IVF ?
Usually the date on which one needs to do the pregnancy test will be communicated on discharge but it is 14 days after the Embryo Transfer.
How do I know if I am a candidate for IVF or ICSI ?
Clear Indications for IVF –ET are blocked fallopian tubes, low sperm count, some cases of endometriosis and unexplained infertility where repeated IUI have not yielded results.
Is there any increased chance of me getting an abnormal child after ART ?
The abnormality chance, according to the studies is not more than that of the general incidence. Infact, PGD (Pre implantation Genetic Diagnosis) comes handy in cases of high risk pregnancies or recurrent spontaneous abortions.
What is a typical IVF calendar ?
The sequence of events depends on the treatment protocol that has been planned for you. Usually OPD based injections are started on D-20 of previous menses, further gonadotrophins with follicular monitoring and blood tests start from 2nd day of menses for about 10 days. You may need to get admitted oocyte retrieval as you will be administered anesthesia. Two days later you will come back for Embryo transfer which is an OPD USG guided procedure.
What is the average success rate of IVF and ICSI ?
Successful depends on the quality of the eggs, sperm and embryos. Age does play a role- younger the better. On an average 25 to 30 % success is expected though it is very difficult to predict the outcome.
Is the abortion rate more after IVF-ET ?
The spontaneous miscarriage rate is slightly more.
What is ICSI ?
ICSI meansintracytoplasmic sperm injection is used in cases of very low sperm counts. The single sperm after preparation is injected in the oocyte. The sperm can be an ejaculated or aspirated from testis or epidydamus. This is an advanced ART procedure and technically demanding
What are the risks of IVF ?
Ovarian Hyper stimulation, Ectopic pregnancy, multiple pregnancy are seen occasionally. Risks at oocyte retrieval of bowel and vascular injuries are mentioned in the literature.
What is IUI ?
IUI is a simple OPD procedure. In this procedure washed capacitated sperms are put in the uterus. The ovary is stimulated by giving hormone injections to produce multiple follicles and the procedure is carried out when the eggs are about to be released. We have had a good success rate with this method and recommend it as the first line of treatment in patients who have patent tubes and a reasonably good semen count.
What is the average success rate of IUI?
Success rate varies according to the indication but around 15% to 18% can be considered good.
How many cycles of IUI can we try?
Most couples conceive within first three cycles of IUI, in subsequent cycles the positive outcome is less. One can try up to six IUI cycles then probably turn to IVF-ET
Can semen be collected at home?
Yes, but it must be brought to our lab within half an hour. The specimen must be collected in a container provided at the centre.
What is the time taken to prepare sperms?
Native raw semen sample cannot be used for IUI. Depending on the method of preparation ( Swim up or Swim down) it will take anywhere between half an hour to one and a half hour to complete the wash.
When is the insemination done?
Usually the insemination is done few hours prior to ovulation. The timing is assessed by serial ultrasound and time is fixed after the injection for follicular rupture.
What is the minimum sperm count required for IUI?
Ideally 5 million post wash count is considered alright. In a native sample, a sperm count of 15 to 20 million with average motility one can opt for IUI.
Do we need anesthesia for IUI?
IUI is an OPD procedure done without anesthesia. Some times abdominal cramps are noted after the procedure. This is due to the uterine contraction and usually subsides in short time.
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