There is nothing more stressful to a patient and a caring gynaecologist than to face repeated IVF failure or recurrent pregnancy loss following IVF. So to advice couples who have failed one or more attempts, to keep on trying over and over and over; is not an easy job. Here, one can find solution in Ayurvedic treatment. Ayurveda, through its medicines, diet & lifestyle modifications and panchakarma raises a new hope after IVF failure. Ayurvedic treatment enhances success rate of Artificial Reproductive Techniques (IUI, IVF, ICSI-ET) or increases chance of natural conception as per cause of infertility.

What is Infertility?

Infertility is Inability to conceive even after one year of unprotected coitus or inability to carry pregnancy till full term. There are many causes of infertility; such as tubal block, PID, Endometriosis, PCOD in women and low sperm count, low sperm motility in men. When there is severe tubal disease, severe egg factors, failed IUI treatments, severe male factors, unexplained infertility, grade III & IV endometriosis; Test tube baby is suggested.

What is test tube baby? IVF (In-Vitro-Fertilization)?

It is a laboratory procedure in which processed sperm are either placed with oocyte (IVF) or injected into oocyte (ICSI) in a petridish to achieve fertilization. The resultant embryos are transferred into woman's uterus for implantation.

What are causes of IVF failure?

To work out on IVF failures, we should focus on causes of failure.
One of the most common causes of IVF failure is Abnormal Embryo. Abnormal embryo can be formed due to abnormal egg (oocyte) or abnormal sperm or if both are abnormal.
Another common cause is Implantation failure. Endometrium preparation and its receptivity are more important for implantation of an embryo. Endometrium should be 6 mm or more in thickness preferably 8-10 mm. To know details about endometrium preparation, Color Doppler should be done. It has also been observed that when pregnancy is achieved in absence of endometrial and sub-endometrial flow on the day of embryo transfer (ET), more than half of pregnancy will finish as spontaneous miscarriage. 
IVF cycle can be cancelled even before Ovum Pick Up due to Poor Ovarian Response, in which very few or no follicle growth is seen even after fertility injections.
Most neglected but important cause is Pre-treatment STRESS.
HOPE IN AYURVEDA:

According to Ayurveda, four factors are essential for conception; namely seed (oocyte and sperm), soil (reproductive track), season (fertile period) and water (nutrition).
Ayurvedic fertility treatments regularize metabolism of body, purify reproductive organs, maintain hormonal equilibrium, improve endometrium lining & receptivity, increase egg and sperm quality and relieve stress.
Womb preparation treatment of Ayurveda enhances success rate of IUI, IVF, ICSI-ET.

Womb Preparation Treatments:

Ayurvedic medicines
Ayurvedic herbs and medicinal preparations act as natural tonic to male and female reproductive organs. They maintain biological clock of menstruation; hence hormonal imbalance is corrected. They also help in making most potent and healthy sperm & ovum and eventually a healthy pregnancy.

Panchakarma (Detoxification)
Ayurveda can treat infertility by Panchakarma procedures like Basti, Uttarbasti, Vaman, Virechan, Nasya using different Ayurvedic formulations as per cause of infertility & failure of IVF and according to body constitution of patient.

Basti acts on vata predominantly. It increases strength of reproductive organs 
Uttarbasti is an intrauterine instillation of sterile medicated oil or ghee. It acts on endometrial receptors
Vamana and Virechana detox the whole body and improves digestive fire for proper nourishment of reproductive hormones and organs
Yoniprakshalana (Irrigation of vulva and vagina with warm decoction) and Pichudharan (Insertion of a sterile tampoon soaked in medicated ghee or oil in posterior fornix of vagina) are also helpful in infertility
According to Ayurveda; A Cheerful mind forms the basis of pregnancy; so relaxing panchakarma procedures like massage, steam, head massage, Shirodhara are done to reduce stress and its impact on infertility treatments.

Diet:
Like other fertility treatments, Ayurvedic treatment does not depend only on medicines. In fact, it ensures that patient follows a strict diet rules as per Ayurveda and avoids spicy and salty food. The proper food can help to provide proper nutrition to reproductive organs.

Lifestyle modification:
Nowadays infertility has become a part of lifestyle diseases. Ayurvedic Doctor can guide you to modify lifestyle according to your body constitution (Dinacharya) and seasonal variations (Rutucharya). It is always better to avoid cigarette smoking, tobacco and alcohol as they reduce fertility. Exercise is an inevitable part of lifestyle. One should learn exercise, yogasana (e.g. Surya Namaskara, Gomukhasan, Sarvangasan, Pavanmuktasan, Ardhamatsyandrasan, Naukasan, Dhanurasan, Shalabhasan etc.) and Pranayam from an experienced teacher.  

IVF Failure: Hope In Ayurveda!

In vitro fertilisation (IVF) is a medical procedure followed for those women or couples suffering from infertility or for certain specific genetic problem. In the normal course, women or couples experience positive results within a few IVF cycles. However, in spite of reasonable pregnancy rates, some women may require few more cycles to achieve pregnancy. In such cases, in order to ensure a healthy pregnancy, the gynecologist may suggest the women undergo Endometrial Scratching before IVF. 

Endometrium explained in brief: 

The uterus is located in the pelvic region and it is in the size and shape of a pear. The inner cavity of the womb or uterus is protected by the tissue lining called endometrium, also called endometrial. The endometrium plays a significant role in supporting the pregnancy. 

The enhanced success of achieving pregnancy: 

The endometrial scratching procedure is a very simple one, which is resorted, so as to improve the results of IVF procedure. In this procedure, the gynecologist uses a very fine catheter and makes a small scratch on the endometrial lining. In fact, the scratch causes a kind of inflammatory reaction in the uterus. This inflammatory reaction induces the endometrium to be highly receptive to embryos during the successive menstrual cycle. This added receptivity enhances the success of pregnancy during the next menstrual cycle. 

Considering the higher level of success in achieving pregnancy, the endometrial scratching procedure has gained popularity in the IVF procedure. However, some of the other issues related to endometrial scratching may be as follows: 

Endometrial scratching optimises the uterine lining and thereby, makes it easier to continue the embryo implanting procedure. Normally, before the endometrial scratching procedure, the gynecologist may suggest endometrial biopsy. 
The endometrial procedure is usually suggested for those women who had two or more unsuccessful IVF procedures, despite having good quality embryos. However, in some cases, depending on the health of the patient and various other factors, the gynecologist may suggest this endometrial scratching at the very first IVF procedure. This procedure can be availed either for fresh embryos of the couple or frozen embryos or for the donor egg. 
Although this is a part of a surgical procedure; endometrial scratching is very simple and painless and it is done without administering anesthesia. The procedure does not require any hospitalisation. In fact, the patient can go home soon after the procedure. Except for a few pain killers, this procedure does not require any extensive medication. 
This is a safe and easy procedure. Neither does it lead to any side effects, nor is the procedure burdensome for your wallet. Many couples have been benefited by this endometrial scratching procedure.

Endometrial Scratching and IVF - Can it Help You Get Pregnant?

The fallopian tubes are not mere passages for the egg to travel from the ovaries to the uterus. It is here that conception occurs and hence healthy fallopian tubes are essential for the fertilization of an egg. 

Damaged fallopian tubes are the most common cause of infertility. This damage can fall under three categories. 

 Blocked fallopian tubes
 One blocked and one open fallopian tube
 Tubal scarring

The third is usually an effect of pelvic infections or natural healing after a pelvic surgery. Sadly, in most cases, this condition is discovered only after infertility has been diagnosed. Other causes of fallopian tubal scarring include:

 Stds such as chlamydia trachomatis and neisseria gonorrhea
 Adhesions caused by ruptured ovarian cysts
 Appendicitis
 Peritonitis
 A history of ectopic pregnancies

Fallopian tubal scarring has no recognizable symptoms. Chronic pelvic pain is the only known symptom of this damage and that too can be seen only in severe cases of tubal scarring. On diagnosing infertility, your doctor will perform one of these tests to determine the condition of your fallopian tubes.

 Hysterosalpingogram: this is a type of x-ray. Your doctor will open the vagina with a speculum and inject a liquid into the uterus with the help of a catheter. If the liquid does not pass through the fallopian tubes, it is said to be blocked. This however, does not say much about tubal scarring.
 Laparoscopy: a small incision is made below the belly button and a slim, flexible tube with a camera is passed through the incision. This gives your doctor a clear view of the condition of your fallopian tubes. A laparoscopy can also be used to rule out other causes of infertility such as endometriosis or blocked fallopian tubes. 

Treatment for infertility caused by tubal scarring is of two types:

 Surgery: this is suggested in cases where tubal scarring is minimal. Depending on the intensity and placement of scar tissue, your doctor may decide to perform one of many types of surgeries. He may choose to remove the scarred section of the fallopian tube, create a new opening (in case of blockages) or rebuild the damaged edges of the fallopian tubes.
 In vitro fertilization (ivf): women with badly scarred fallopian tubes usually have poor chances of conceiving naturally. Hence, ivf is the preferred treatment route. However, your doctor may still advise you to undergo surgery and remove the damaged tubes prior to ivf to prevent the tubes from filling with fluid.

Tubal Scarring and Infertility

Daljindar Kaur's inspiring story of motherhood: How IVF became her savior

The success of In vitro fertilization continues in India as a septuagenarian woman gives birth to a baby boy. Even after 46 years of marriage, the couple from Amritsar was childless. Daljinder Kaur, along with her 79-year-old husband, Mohinder Singh Gill, had been visiting National fertility and the Test Tube Baby Centre in Hisar since 2013 and did not give up even after two failed IVF cycles. They had faced ridicule for their inability to have a baby and yet they kept their hopes up.
On the 19th of April, the couple was blessed with a baby boy who is nothing less than a miracle. The groundbreaking achievement of the embryologists from Hisar has been an inspiration and a beacon of hope for couples all across the country. Once again, IVF has proved to be one of the most successful procedures to have babies for couples with fertility issues. Following are some of the advantages of In vitro fertilization, which you should know about-
1. It can be used by anybody
In-vitro fertilization is not necessarily used by the going to be a mother. It can be used by gestational carriers or by a surrogate as well. So it depends on whether the parents want to take the help of a surrogate or themselves want to be involved in the pregnancy. IVF gives an opportunity to single women and same-sex couples to become parents.
2. Use of donated eggs and sperms
There might be circumstances when the doctor can recommend using donated sperms or eggs. In that case, the eggs can be fertilized manually in the lab and the fetus developed can be used for in vitro fertilization. This increases the chance of pregnancy by a fair amount.
3. Control over timing
In vitro fertilization is a solution for couples who have a very engaging professional life, and can be an option for people who want to have babies after a certain point of time. Eggs and embryos can be preserved for future use. It is also helpful for couples who already have a child and plan to have another later.
4. Decreases chances of miscarriage
Genetic abnormality is one of the primary causes of miscarriage. The technique of preimplantation genetic diagnosis (PGD) is used to ensure the viability of the embryo much ahead of time so that the mother can have an uncomplicated pregnancy and carry her baby full term.



Daljindar Kaur's inspiring story of motherhood: How IVF became her savior

As we all know that IVF stands for In vitro fertilisation. It is a method of stimulating the ovaries in a female body, to release an ovum (egg), which is taken out of the body and fertilised artificially in the laboratory with the help of a sperm. After this, the embryo is transferred back to the uterus where it grows and develops naturally.

Understanding the Procedure

The doctor attempts to have complete control over your menstrual and ovulation cycles, so as to know the correct time of the month when you ovulate. This includes, charting basal body temperatures, hormonal therapy drugs etc.
Frequent blood tests, ultrasound will be required to map the progress of ovulation.
Injections, drugs will be prescribed in required dosage to stimulate the ovaries.
During this time, the doctors will monitor the growth of oocytes (eggs).
After a suitable growth of the oocytes follicles, the eggs are retrieved for artificial insemination. (Fertilisation with the use of sperm cells in the laboratory).
After the successful fertilisation, the embryo is transferred back to the uterus.
Can IVF have side effects?

As a side effect it has a major chance of multiple pregnancies. People intending to have just one child, may not be mentally or economically prepared to take the responsibility of more than one child.
The drugs and medicines used throughout the IVF procedure may create hormonal complications in the long run. It bears a risk of ovarian hyperstimulation syndrome, if the mother has to go through the cycle multiple times.
But it offers a number of benefits too...

IVF increases the chance of pregnancy by a large percentage. It is one of the most successful methods of boosting fertility and pregnancy.
Couples, who have repeatedly failed to bear children naturally, can opt for this treatment to produce their own offspring.
In case the couples are completely infertile, donor eggs or sperms may be used in the process. However, in that case, the offspring will not bear the DNA of both parents.
IVF can greatly reduce the chance of surgery on the fallopian tubes.
IVF also provides an opportunity to choose the healthiest embryos before implanting it back in the uterus. A procedure, known as the pre-implantation genetic diagnosis, determines the presence of any abnormal genes or other chromosomal absurdity.
The procedure of IVF has a very high success rate and with technological advancements in the field of medicine, it has also become much safer.
IVF allows women, who go into premature menopause, to be able to bear a child. This treatment is mostly for women who decide to experience motherhood at a slightly older age.
IVF allows same sex partners and single women to bear an offspring.
It is extremely helpful for women who have their fallopian tubes damaged, blocked or surgically removed.

IVF - 9 Benefits You Must Know!

Egg Freezing, which is also known as mature oocyte cryopreservation, refers to the method through which reproductive potential is restored among women. Eggs get harvested from the ovaries, frozen and in an unfertilized manner and are stored for purpose of using them later on. The egg freezing procedure is recommended for those women, who would like to delay conceiving baby due to various kinds of reasons.

Before the freezing of eggs, it is important to first retrieve the eggs. Let us look at how the eggs are retrieved, followed by the procedure of egg freezing through two different ways.

Retrieval of Egg

Egg Retrieval takes place just like it is done in case of in vitro fertilization (IVF). Women would need to be put under medication for hormones or through injections, which shall lead to the stimulation of ovaries, leading to more eggs getting matured. After this women would receive the necessary medication to stimulate ovulation and then the extraction of eggs takes place through the use of a needle. Specialists perform this whole procedure by putting women under the effect of anesthesia and are also guided by ultrasounds. Once the extraction is completed, the freezing takes place.

There are two different techniques involved in the egg freezing process. They include:

Slow Egg Freezing Method

A substance called cryoprotectant is used in order to protect the biological tissues from getting damaged out of freezing. This slow freezing method of getting eggs freezed relies on low initial concentrations of crytoprotectant. The cryoprotectant in low concentration is introduced when the egg is at a relatively warm temperature and still continues to experience the usual functions of a living cell. Then the cryptoprotectant would spread all throughtout thus fill the egg, hence replacing most of the water inside the egg. The egg is then inserted into a small container made of plastic and ultimately get placed inside a cooling chamber. The lowering of temperature, to around -6 degree centigrade, takes place through injecting very tiny amounts of liquid nitrogen into the cooling chamber. The cooling process is controlled by a computer.

The main purpose of these techniques is to avoid ice crystals from getting formed in the egg. During the spreading of the cryoprotectant, if the ice crystals are still present, they can cause damage to the egg and hence the egg may not survive the process of thawing. Then the temperature is lowered further to around -32 degree centigrade. By this time, the egg s metabolic rate become slow. The container where the egg was placed, is then dipped inside the liquid nitrogen, forming a solid.

Rapid Egg Freezing Method or Vitrification

At the time of rapid freezing method, there is high concentration of initial cryoprotectant whereas the cell remains at room temperature. The egg is unable to stay for long in this temperature and thus gets poured immediately onto the liquid nitrogen. Cryoprotectant spreads at a rapid rate so as to avoid ice-crystal from getting damaged. Vitrification is a very new method for freeing eggs. Recent research has shown that vitrification of eggs largely improves the possibility for survival after thawing and the rates of pregnancy.

Different Techniques That Can Be Used For Egg Freezing!

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