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

Frozen Embryo Transfer or FET is an extremely effective method to conceive a pregnancy. Recent studies have proved that there is a increased chance for pregnancy when the embryos, which get used are frozen and get placed inside the uterus at a time right after the ovaries are stimulated. Still, certain issues can arise with the transfer of frozen embryo, such as:

A Thin Lining of the Uterus
Research has shown that there are not many women who get pregnant if the lining in their uterine does not tend to thicken enough. It is not clear exactly why this problem occurs in most women and moreover there is no sure shot treatment to make the lining of the uterine thick. The experts on fertility would try out different methods like increasing the amount of estrogen or change the way how estrogen is given. There are other instances when women might be given supplemental medicines, while for some, the problem will continue to exist.

What Should Be Done In Case The Problem Persists?

In case the problem continues for some women, then there are certain approaches which experts might look to adopt. The first one is to cancel the transfer of embryo and try once again at any later stage, that too with a different treatment method.
The second option which they could think of is to go ahead with the transfer, wherein they might feel that a thin lining does not necessarily mean that it is impossible for a woman to get pregnant but definitely the efficiency would be reduced.
One last option is to make use of the opportunity for undergoing additional tests which would help them to assess the ability of the uterus to allow implantation of the embryos.
Unexpected Ovulation
For enabling the embryos to get implanted into uterus, placing them very precisely and at the appropriate time is important. This is regarded as the window of implantation. The time taken, is based on the time frame since progesterone reaches the lining of the uterine.

Doctor knows the exact time to place the embryos, right from the time he or she instructs a woman to start having progesterone supplements. In case a woman was to ovulate, the production of progesterone would begin earlier than the normal time and would lead to the shift of the window of implantation. As identifying the correct time of ovulation is almost impossible, so that would lead to some sort of uncertainty into the timing.

Due to this reason, there are doctors who would use medication in order to prevent unexpected ovulation from occurring. Generally an injection called Lupron is usually used as medication.

Timing for the Embryo Transfer is Inappropriate
This is a problem related to early ovulation. There are case when the implantation window is shifted, still the timing of the transfer becomes accurate. Recent studies have shown that quite a nominal percentage of women might have a window of implantation, which could be either earlier or later than normal time. A test called the Endometrial Receptivity Array can help determine at what time is the window of implantation open.

Frozen Embryo Transfer - Complications Associated With It!

When a childless couple is not able to conceive, there are myriad paths that the couple may follow to obtain a solution. If IVF does not help the couple, then they can go in for surrogacy. In this method, another lady conceives, carries and gives birth to the baby created by the sperm and eggs of the intended parents. Let us find out more about surrogacy today.

Who can use it?
Surrogacy can be availed by couples who are not able to conceive due to many conclusive reasons including the absence of a womb or the malfunctioning of the same. Also, recurrent miscarriages can be one of the reasons. Further, a couple who has been through IVF or In Vitro Fertilisation implantation failure a number of times can opt for surrogacy.

How does it Work?
Full surrogacy, as it is known, is a process of implanting an embryo in a host body. This embryo is usually created using the egg and the sperm of the parents, or even a fertilised egg that has been donated by a donor, which is then fertilised using the sperm from the intended father. Also, this embryo may be created by using donor eggs and donor sperms. Partial surrogacy is also a method that may be used. When artificial insemination or intrauterine insemination (IUI) is used to create an embryo with the sperm from the intended father and the egg from the surrogate mother, then the process is known as partial surrogacy.

Chance of having a baby with surrogacy
The chance of having a baby with surrogacy depend on various factors. It depends on the ability of the surrogate to get pregnant, as well as her overall health. Before choosing a surrogate, it is important to put her through all the necessary tests to ascertain a good state of health. Further, the age of the egg donor is also a factor in such cases. The success of related procedures like IVF or IUI will also determine the chances of conception through this method. Furthermore, the quality of the elements used by the couple or the intended parents will also make a difference to the process and its efficacy. Yet, the most important factor includes the age of the woman whose egg is being used.

Difference between IVF and Surrogacy
In IVF, the eggs are gathered from the woman and the sperm is taken from her partner before an embryo is created and affixed in the uterus of the intended mother. In surrogacy, it is actually another woman who carries this lab-created embryo through methods like artificial insemination. The sperm may come from the father and the egg may be donated by someone else, in many cases involving full or partial surrogacy.

What is Surrogacy and how it is different from IVF

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!

Intrauterine insemination (IUI) and in vitro fertilization (IVF) are two commonly used methods of fertility treatment, which increase a couple s chance of becoming pregnant.

The Procedure

IUI- IUI is a procedure during which processed and concentrated motile sperm are inserted directly into a woman s uterus. This procedure is timed according to a woman s ovulation, and may be performed one to two times in the days immediately following the detection of ovulation. After ovulation a woman s egg is picked up by the fallopian tube and waits there for the sperm. Since the IUI procedure deposits higher concentrations of good quality sperm close to where the egg is waiting, the chances that the egg and sperm will find one another are increased.

IVF- IVF is the most successful method of fertility treatment utilized today to help couples to conceive. The basic components of the IVF process include stimulation of the ovaries to produce multiple eggs at a time, removal of the eggs from the ovary (egg retrieval), fertilization of the eggs in the laboratory, and subsequent placement of the resulting embryos into the uterus (embryo transfer). The chance of pregnancy from IVF depends primarily on the age of the woman, the cause of infertility, and factors related to the quality of the IVF laboratory.

Success Rates

IUI Treatment: There is a marked difference between IVF and IUI pregnancy rates. IUI has a success rate between 5% and 20%, but it can even be as low as 1-2 %, depending on the woman s age and fertility levels. The chances of conceiving through IUI is higher if fertility drugs are administered along with the treatment.

IVF Treatment: IVF has a high success rate   between 20% and 35% and it can even go as high as 40%. This may not seem like a lot, but it is very high, considering that an average young and fertile couple has only a 15-20% chance to conceive in a month. It is important to understand what IVF and IUI success rates mean and the factors that affect it before deciding on a fertility treatment. You can also use any reliable online IUI vs IVF comparison tool to determine your approximate success rates with each of these treatments, depending on your age, lifestyle, and medical history.

You should use online sources of information to understand more about fertility problems, how age affects fertility levels, and whether freezing your eggs is a good option for you. However, discuss all these issues with your doctor to ensure that you have the right information and that you have understood it correctly. Fertility specialists provide you with personalized fertility plans based on your health which is why you should always talk to them before you make any decision.

IVF or IUI - Which One Should You Opt for?

It is as important for the man as it is for the woman to undergo certain tests before the IVF cycle is started. Fertility is not only an issue for a woman, but it also might be for the man in question. There are certain tests that need to be conducted on men before they can gear up for IVF:

1. Semen Analysis: One of the most important tests for male infertility is semen analysis. Sometimes, a man may be completely healthy, but his sperm production could be of poor quality. Semen analysis is done to provide an accurate evaluation of sperm number, the ability to move (motility), size and shape (morphology), as well as the consistency and volume of the sample collected.

2. Binding Test: Sometimes agglutination occurs where the sperms might stick to each other by their heads or tails. Sperm antibodies might cause this problem. The IVF treatment's success might be compromised if this happens. A simple binding test is done to determine this.

3. Trial Wash: This is also known as sperm wash. It is mostly done to remove chemicals from the sperm. Not doing a sperm wash might end up affecting the later stages of the IVF treatment. In this process, the misshapen and immotile sperm is separated so a clean sample of motile and healthy sperm can be collected.

4. TUNEL Assay: Since sperms build up about half of a child's genetic makeup, a TUNEL Assay or 'sperm DNA test' is required. This test is done to measure the sperm population that have fragmented DNA. Negative impacts on genetics can hamper the success of the fertility treatment.

TUNEL Assay is usually recommended to men with:
a) Leukocytes detected by the sperm analysis
b) Age approaching 50
c) A history of diabetes II type or prostatitis
d) Exposure to chemicals or prolonged heat at workplaces

5. Screening for Infectious Diseases: This test is done for both the partners to check for diseases like AIDS, Hepatitis C, and so on.

Tests Suggested for Men Before IVF

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