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In Vitro Fertilization is a one assisted reproductive technology (ART) commonly referred to as IVF. IVF is the process of fertilization by manually combining an egg and sperm in a laboratory dish, and then transferring the embryo to the uterus. Other forms of ART include gamete intrafallopian transfer (GIFT) and zygote intrafallopian transfer (ZIFT).

IUI (Intra Uterine Insemination)

This is an office procedure which involves placing "washed" sperms into the womb, with a small plastic tube called catheter. Sperms are taken from the husband. If required frozen or donor sperms can be used, depending upon patient's situation and also needs written consent. The sperms are washed several times to remove substances like prostaglandins that can cause cramping or shock. Once the semen is washed and good motile sperms are separated, it is transferred into the womb of patient via a catheter to achieve best chance of pregnancy. This procedure is preceded by ovulation monitoring by transvaginal ultrasound and if required ovarian stimulation with gonadotrophins or clomiphene citrate. There are different methods of processing the semen and the cost of each process may be different.

IVF (InVitr Fertilization)

IVF can be used to treat infertility with the following patients:

  • Blocked or damaged fallopian tubes
  • Male factor infertility including decreased sperm count or sperm motility
  • Women with ovulation disorders, premature ovarian failure, uterine fibroids
  • Women who have had their fallopian tubes removed
  • Individuals with a genetic disorder
  • Unexplained infertility

What is involved with in vitro fertilization?

There are five basic steps in the IVF and embryo transfer process:

  • Monitor and stimulate the development of healthy egg(s) in the ovaries.
  • Collect the eggs.
  • Secure the sperm.
  • Combine the eggs and sperm together in the laboratory and provide the appropriate environment for fertilization and early embryo growth.
  • Transfer embryos into the uterus.

What is involved with in vitro fertilization?

There are five basic steps in the IVF and embryo transfer process:

  • Monitor and stimulate the development of healthy egg(s) in the ovaries.
  • Collect the eggs.
  • Secure the sperm.
  • Combine the eggs and sperm together in the laboratory and provide the appropriate environment for fertilization and early embryo growth.
  • Transfer embryos into the uterus.

Step 1: Fertility medications are prescribed to stimulate egg production. Multiple eggs are desired because some eggs will not develop or fertilize after retrieval. Transvaginal ultrasound is used to examine the ovaries, and blood test samples are taken to check hormone levels.

Step 2: Eggs are retrieved through a minor surgical procedure that uses ultrasound imaging to guide a hollow needle through the pelvic cavity to remove the eggs. Medication is provided to reduce and remove potential discomfort.

Step 3: The male is asked to produce a sample of sperm, which is prepared for combining with the eggs.

Step 4: In a process called insemination, the sperm and eggs are mixed together and stored in a laboratory to encourage fertilization. In some cases where there is a lower probability of fertilization, intracytoplasmic sperm injection (ICSI) may be used. Through this procedure, a single sperm is injected directly into the egg in an attempt to achieve fertilization. The eggs are monitored to confirm that fertilization and cell division are taking place. Once this occurs, the fertilized eggs are considered embryos.

Step 5: The embryos are usually transferred into the woman’s uterus three to five days following egg retrieval and fertilization. A catheter or small tube is inserted into the uterus to transfer the embryos. This procedure is painless for most women, although some may experience mild cramping. If the procedure is successful, implantation typically occurs around six to ten days following egg retrieval.

ICSI(INTRA CYTOPLASMIC SPERM INJECTION)

It is a specialized technique in which the eggs are removed and each egg is injected with a single motile sperm by this technique men with count as low as 0.5 millon or men with no sperm (Azoospermia) can become father

SPERM FREEZING

Sperm freezing and storage is the procedure whereby sperm cells are frozen to preserve them for future use. Sperm cells have been frozen and thawed successfully for more than 40 years. By using special technology and then keeping sperm in liquid nitrogen at minus 196C, it can be stored for many years while maintaining a reasonable quality.

EMBRYO FREEZING

The extra embryos formed during an IVF or ICSI are frozen with the technique like vitrification and stored in liquid nitrogen at -196 degree centigrade these can be used by the patient in subsequent cycle.

COUNSELLING

Patient education and counselling session are offered by our expert doctors at our center

IVF counseling is a highly recommended step in the process of seeking in vitro fertilization. Going through the whole process can be challenging both physically and emotionally, and counseling can give couples the support they need. These counseling sessions are offered by us at our fertility clinic and we do offer the procedure, so it is easy for couples undergoing IVF to access it.

Spandan Test Tube Baby & Advance Reproductive Centre offers mandatory pre-treatment counseling as a part of the treatment while also provides optional counseling during and after the process. This is in accordance with laws concerning Assisted Reproductive Treatments or ARTs, which require all individuals and couples to undergo at least one session of counseling prior to the start of the treatment.

FOLICULAR STUDY

Follicular monitoring or follicular study is a vital component of in-vitro fertilization (IVF) assessment and timing. It basically employs a simple technique for assessing ovarian follicles at regular intervals and documenting the pathway to ovulation.

Next step is documentation of ovulation. Ovulation is sonographically determined by the following sonographic signs:

  • Follicle suddenly disappears or regresses in size
  • Irregular margins
  • Intra-follicular echoes. Follicle suddenly becomes more echogenic
  • Free fluid in the pouch of Douglas
  • Increased perifollicular blood flow velocities, on doppler

SEMEN ANALYSIS

The semen analysis is the most important infertility test. Semen analysis is the first step in the medical evaluation of male infertility. The semen analysis is usually performed after 3-5 days of sexual abstinence. Semen is collected in a sterile, wide mouth, non toxic, disposable plastic containers and labelled with patient identification information. A normal semen test is reassuring. If the test is abnormal the test needs to be repeated two to three times over two to three months to confirm whether the abnormality is persistent or not. At our centre there is a separate and comfortable room for collection of semen. Apart from routine analysis we also offer facilities for semen culture, TB-PCR, sperm function tests and anti-sperm antibody testing.

ALL HORMONAL INVESTIGATION

Hormones affect growth, reproduction, mood, sexual function and metabolism. Even small imbalances can cause huge problems. To stay balanced, hormone levels can be tested in three ways. Measuring hormone levels in blood, urine and saliva can help evaluate proper functioning of the glands and organs that produce hormones.

Establishment of normal hormone levels

  • Step 1 : Confirm the normal hormone level for the hormone you are having tested. According to the National Medical Library, the normal hormone level varies, depending on the gender, age and the specific hormone being tested.
  • Step 2 : Make an appointment with your doctor for a blood test to measure hormone level. A medical doctor uses blood tests to measure DHEA, cortisol, testeosterone, thyroid hormones, progesterone, and estrogen. He draws blood from the vein into a test tube and the specimen is taken to a laboratory for testing.
  • Step 3 : Consult your doctor for a urine test. Depending on the specific hormone being tested, the urine test may need repeating for several days or at several times within a certain time frame. Urine tests are common to determine hormonal changes due to ovulation and pregnancy. Follow the directions precisely on a home urine test kit to get the correct results.
  • Step 4 : Refrain from eating or drinking for two hours prior to a saliva test. Swallow all the saliva in your mouth, then chew paraffin tablets 60 times per minute for three minutes. The concentration of the hormone being tested will be evaluated by a lab technician or medical professional.

ALL KIND OF LAPAROSCOPY

Laparoscopy, also known as diagnostic laparoscopy, is a surgical diagnostic procedure used to examine the organs inside the abdomen. It’s a low-risk, minimally invasive procedure that requires only small incisions.
Laparoscopy uses an instrument called a laparoscope to look at the abdominal organs. A laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front. The instrument is inserted through an incision in the abdominal wall. As it moves along, the camera sends images to a video monitor.
Laparoscopy allows your doctor to see inside your body in real time, without open surgery. Your doctor also can obtain biopsy samples during this procedure.

The most common risks associated with laparoscopy are bleeding, infection, and damage to organs in your abdomen. However, these are rare occurrences.

  • fevers or chills
  • abdominal pain that becomes more intense over time
  • redness, swelling, bleeding, or drainage at the incision sites
  • continuous nausea or vomiting
  • persistent cough
  • shortness of breath
  • inability to urinate
  • lightheadedness

ALL KIND OF HYSTEROSCOPY

Hysteroscopy is a procedure that allows your doctor to look inside your uterus in order to diagnose and treat causes of abnormal bleeding. Hysteroscopy is done using a hysteroscope, a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus. Hysteroscopy can be either diagnostic or operative.

Your doctor may perform hysteroscopy to correct the following uterine conditions:

  • Polyps and fibroids —Hysteroscopy is used to remove these non-cancerous growths found in the uterus.
  • Adhesions Also known as Asherman’s Syndrome, uterine adhesions are bands of scar tissue that can form in the uterus and may lead to changes in menstrual flow as well as infertility. Hysteroscopy can help your doctor locate and remove the adhesions.
  • Septums— Hysteroscopy can help determine whether you have a uterine septum, a malformation of the uterus that is present from birth.
  • Abnormal bleeding— Hysteroscopy can help identify the cause of heavy or lengthy menstrual flow, as well as bleeding between periods or after menopause. Endometrial ablation is one procedure in which the hysteroscope, along with other instruments, is used to destroy the uterine lining in order to treat some causes of heavy bleeding.

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