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The couple after the fertility assessment will be counselled about fertility status of the couple, the treatment options available.

After discussing with the couple, the further plan of treatment can be fixed. Plan can be tailored made as per the couple convenience.

Confidentiality about the couples information’s will be maintained at all the levels.

For Women who are not ovulating regularly the goal of treatment is to have a single mature egg.

This can be done by using drugs like Clomiphene from day 3 to day 7. Serial Ultra sounds scans are done from day 9 for follicular tracking. Once the egg is mature enough hormone injection HCG (Trigger shot) is given which triggers ovulation approximately 36-40hours later. Those who do not respond to Clomiphene, FSH may be added to the protocol. Ovulation induction may be done alone or in combination with IUI.

In vitro Fertilization (IVF), eggs are taken from wife’s ovaries after controlled ovarian stimulation and then fertilized with husband’s sperm outside the body in the laboratory to produce embryos. The embryos are then transferred into the mother’s uterus. If it implants successfully in the uterus, pregnancy is established.

Couples Eligible for IVF

• Where woman’s fallopian tubes are blocked or absent.
• Endometriosis.
• Ovulatory dysfunction
• Immune disorder causing infertility
• Reduced sperm count or motility
• Un-explained Infertility
• Couples who have failed to conceive despite repeated attempts with conventional treatment of infertility.

Starting Treatment

Treatment will be usually started on Day 2 of the menstrual cycle after basic TV scan and hormonal assay

Ovarian Stimulation and Monitoring

Treatment starts with drugs that stimulate the ovaries. This enables us to collect more egg containing follicles for insemination.

During the stimulation period, the patient is serially monitored for the development of the eggs by TVS and Hormonal assays.

Ovarian Stimulation and Monitoring

Treatment starts with drugs that stimulate the ovaries. This enables us to collect more egg containing follicles for insemination.

During the stimulation period, the patient is serially monitored for the development of the eggs by TVS and Hormonal assays.

Trigger Injection

Once the follicles are ready, the stimulation with an injection that matures the eggs in the follicles, ready for egg collection. Hormone injection HCG (Trigger shot) is given which triggers ovulation approximately 36-40hours later.

Egg Collection

After36-40 hours of the trigger injection, patient will be called for Ovum Pick Up (OPU). The procedure is done under sedation. Through vaginal route with the help of transvaginal probe, a fine needle is introduced into the ovaries to collect the eggs.

Providing Sperm

Fresh semen sample is generally used to provide the required sperms. If fresh sample is not available on the day of egg collection, Frozen semen sample can be used.

If you already have sperm in storage, or have chosen a sperm donor, the sample will be thawed on the same day that the eggs are collected.

Embryo Development monitoring

The embryos are carefully monitored in the period after insemination: first to check for fertilisation, then for signs for development which indicate the embryo is growing.

Scheduling Embryo Transfer

Once the embryos are ready, decision about the embryo transfer is taken depending on the number and quality of the embryos.

Embryo Transfer

A tiny drop of culture medium containing two or three embryos is carefully deposited in the uterus using a thin catheter with the help of trans abdominal ultra sound with full bladder.

The remaining embryos if any can be freezed and stored for future cycles after consulting with the couples.

The Wait

The couple are asked to wait for a period of 2 weeks and then blood test will be conducted to confirm pregnancy. During this wait period necessary hormonal treatment is given for the support of implantation of the embryo.

Outcome

If the patient is tested positive for pregnancy, necessary medications for continuation of the pregnancy will be provided.

If the patient is negative, further plan of treatment will be discussed with the couple.

Advantages of IVF

• Those patients who are not able to have a baby otherwise can have a baby through IVF.
• It is more successful than other forms of assisted reproductive technology methods such IUI.
• It also helps to diagnose fertilization problems, which is otherwise not easily clear.
• If excess embryos are developed they can be frozen to be used in further cycle or donated to other needy persons.

In ICSI, a single sperm is injected into the egg with a fine glass needle.

Advantages of ICSI over IVF

• Best suitable for male infertility
• Better results in case of older women
• There is usually a higher fertilisation rate, therefore, couples have a higher number of embryos to transfer, than would be the case with IVF
• There is the option of using the male partner's sperm instead of donor sperm.

A blastocyst is an embryo that has developed after about 5 days after fertilization. By this time it has developed from a single cell to a hollow ball of cells, with a ‘clump’ of cells in the cavity. In Blastocyst transfer, embryos are cultured in the laboratory for five days after fertilisation.

Only one or two Blastocysts are transferred to reduce the risk of multiple pregnancy as they have a greater ability to implant.

AH benefits women who are over 40 or women who fail to fall pregnant despite repeated embryo transfers with good quality embryos. Implantation occurs after the embryo ‘hatches’ from the gel-like shell and attaches itself to the wall of the womb. In some women, the shell may be too thick or tough and traps the embryo inside.

Making controlled cuts on the shell of the embryo just before replacing them in the womb, makes it easier for the embryo to hatch thereby improving the chance of pregnancy.

Patients who have spare embryos after embryo transfer can choose to freeze their remaining good quality embryos for a subsequent embryo transfer. The cost of a thaw cycle is much less than a fresh cycle with no decrease in chances of pregnancy.

Advantages of Embryo freezing

• Reduced risk of multiple pregnancies if there are a large number of good quality embryos available for transfer.
• It decreases the need of ovulation stimulating drugs.
• Enables doctor to select best possibly viable embryo for transfer.

Pursuing this route will enable us to efficiently standardize the targeted, tactical and nimble attitude; this is why a visionary emotional intelligence enhances target pre-plans ahead of schedule. Core meeting and requirement strategically structure a measure, whereas the enablers generate cornerstones reaped from our double-digit improvement..

Pursuing this route will enable us to efficiently standardize the targeted, tactical and nimble attitude; this is why a visionary emotional intelligence enhances target pre-plans ahead of schedule. Core meeting and requirement strategically structure a measure, whereas the enablers generate cornerstones reaped from our double-digit improvement.

Pursuing this route will enable us to efficiently standardize the targeted, tactical and nimble attitude; this is why a visionary emotional intelligence enhances target pre-plans ahead of schedule. Core meeting and requirement strategically structure a measure, whereas the enablers generate cornerstones reaped from our double-digit improvement.

Pursuing this route will enable us to efficiently standardize the targeted, tactical and nimble attitude; this is why a visionary emotional intelligence enhances target pre-plans ahead of schedule. Core meeting and requirement strategically structure a measure, whereas the enablers generate cornerstones reaped from our double-digit improvement. .

Pursuing this route will enable us to efficiently standardize the targeted, tactical and nimble attitude; this is why a visionary emotional intelligence enhances target pre-plans ahead of schedule. Core meeting and requirement strategically structure a measure, whereas the enablers generate cornerstones reaped from our double-digit improvement.

Pursuing this route will enable us to efficiently standardize the targeted, tactical and nimble attitude; this is why a visionary emotional intelligence enhances target pre-plans ahead of schedule. Core meeting and requirement strategically structure a measure, whereas the enablers generate cornerstones reaped from our double-digit improvement..

Pursuing this route will enable us to efficiently standardize the targeted, tactical and nimble attitude; this is why a visionary emotional intelligence enhances target pre-plans ahead of schedule. Core meeting and requirement strategically structure a measure, whereas the enablers generate cornerstones reaped from our double-digit improvement.