Doctor in Dynamic Fertility and IVF Centre
Patient Review Highlights
Dr is professionally sound n goes into minute details of treatment process, unlike others she always try n explain the basis behind her decisions, always give nice,patient hearing n remembers details about the patient...
I found the answers provided by the Dr. Nalini Gupta to be very helpful and well-reasoned. Thanks for response and positivity
Hi Mam u r such a wonderful Dr and good nature .very thankful to u give me good life experience.
I found the answers provided by the Dr. Nalini Gupta to be knowledgeable. Thanks
What is recurrent miscarriage?
If you have three or more miscarriages in a row, doctors call it recurrent miscarriage. If you have experienced recurrent miscarriage, your GP or midwife will refer you to a gynaecologist. Your gynaecologist will try to identify the reason for your losses.
Having miscarriage after miscarriage may leave you feeling utterly drained of hope. At times, it may be hard to keep trusting in the future. This experience affects every aspect of a woman’s life from her mental and emotional health to her physical health and social well-being.
If you can, try to draw comfort from the fact that most women who experience recurrent losses do go on to have a baby. This is especially the case if tests can find no reason for the losses. Six out of 10 women who have had three miscarriages will go on to have a baby in their next pregnancy.
Treatment of Recurrent Pregnancy Loss
Treatment for anatomic abnormalities of the uterus involves surgical restoration through removal of local lesions such as fibroids, scar tissue and endometrial polyps or timely insertion of a cervical cerclage (a stitch placed around the neck of the weakened cervix) or the excision of a uterine septum when indicated.
A thin endometrial lining has been shown to correlate with compromised pregnancy outcome. Often times this will be associated with reduced resistance to blood flow to the endometrium. Such decreased blood flow to the uterus can be improved through treatment with sildenafil (Viagra), Terbutaline and possibly aspirin.
Sildenafil (Viagra) Therapy Viagra has been used successfully to increase uterine blood flow. However, to be effective it must be administered starting as soon as the period stops up until the day of ovulation and it must be administered vaginally (not orally). Viagra in the form of vaginal suppositories given in the dosage of 25 mg four times a day has been shown to increase uterine blood flow as well as thickness of the uterine lining. To date, we have seen significant improvement of the thickness of the uterine lining in about 70% of women treated. Successful pregnancy resulted in 42% of women who responded to the Viagra. It should be remembered that most of these women had previously experienced repeated IVF failures.
Terbutaline this is a medication that relaxes the muscle in the uterine wall and so permits improved hormone delivery to the endometrium. The use of Terbutaline will often cause an increase in heart rate. It should not be prescribed to women who have irregular heart beats (arrhythmias), and women who have decreased cardiac reserve.
Aspirin this is an antiprostaglandin that improves blood flow to the endometrium. It is administered at a dosage of 81mg orally, daily from the beginning of the cycle until ovulation.
Selective Immunotherapy Using Intralipid, heparin, aspirin and corticosteroid
Many causes of pregnancy loss or failure can be treated with immunotherapy comprising combinations of aspirin and heparin and corticosteroids (dexamethasone or prednisone) and Intralipid (IL) to regulate increased NKa. Achievement of optimal success with Intralipid/corticosteroid therapy requires that the treatment be initiated well before ovulation takes place (about 7-14 days prior to anticipated implantation). Given the fact that only 10-15% of natural cycles (with or without the use of insemination and/or fertility drugs) will result in a pregnancy, it follows that repeated administration of Intralipid will be required in most cases before a pregnancy will occur. IVF achieves pregnancy rates that are often 2-3 times higher. This often makes IVF a treatment of choice in cases of immunologic recurrent pregnancy loss.
Preimplantation genetic diagnosis (PGD) a procedure whereby the embryo can be tested for genetic or structural chromosomal abnormalities requires the use of IVF to select the best embryo(s) for transfer to the uterus. In cases of structural chromosomal (translocations) egg or sperm donation is often another option worth considering.
In those cases where due to intractable anatomical or alloimmune dysfunction IVF repeatedly is unsuccessful or is not an option, Gestational Surrogacy might represent the only recourse other than adoption.
If a couple with Recurrent Pregnancy Loss is open to all of the diagnostic and treatment options referred to above, a live birth rate of 70% – 80% is ultimately achievable.
I am 27 year old. I am trying to conceive for 5-6 months. But couldn't conceive. I am also taking 5 mg folio acid for one week. please tell me what should I do. What medicine I have to take.
I am 27 years old. Last 7 months trying to conceive for 2nd baby. My height is 5.5 inch and weight is 81 kg. 5 months back my weight is 75. Now its increased to 81 kg. Increasing weight is one of reason for not conceive? Tell diet plan to reduce my weight.
With infertility on the rise due to various reasons, in-vitro fertilization is one of the most effective solutions. This is gaining wide acceptance across the society and medical fraternity. Read on to know more about why IVF and how it is done.
Causes of infertility:
Advanced maternal age: More and more women choosing education and career over marriage and family. There are many women who are not even thinking of having children up until their 30s. Biologically though, the quality of egg deteriorates with age, and women beyond 35 have difficulty conceiving naturally.
- Altered lifestyle including exposure to chemicals and pollutants, which has led to overall decline in the health of individuals.
- Societal changes like urbanization and formation of nuclear families
- Increased stressors in all spheres of life, which is affecting the quality of sperm and egg
- Lifestyle diseases including obesity, diabetes, and hypertension. These are becoming more prevalent in the younger age groups, and therefore infertility is on the rise in these groups.
- Lifestyle habits like smoking, alcohol abuse, drug abuse, etc., which are also poorly affecting fertility rates.
However, with all these, medical technology is also improving. For those who are faced with infertility due to the above issues, there is a lot of hope in terms of options like IVF which have provided a definitive solution to infertility.
Steps of IVF: By definition, in vitro fertilization is when the egg and sperm are fertilized or fused in a glass (vitro is for glass) and then implanted into the womb where it grows further.
- The first step is to induce ovulation. Fertility medicines are given and hormone levels are monitored to ensure egg release happens. Normally, the ovaries produce only one egg. However, with IVF, the ovary is made to produce multiple eggs, so that the chances of fertility is increased.
- The egg is then retrieved and moved into an incubator.
- Sperm sample is obtained either from the partner or a donor, and the healthiest sperm is chosen for fertilization. The sperm and the egg are then allowed to fertilize in the incubator
- A healthy fertilized embryo is then transferred into the womb. The woman is advised bedrest for about 1 to 2 days.
- Blocked fallopian tubes, which do not allow for the sperms to travel up to the uterus
- Advanced maternal age, women of more than 30 years of age, this is an effective option.
- Uterine scarring or endometriosis caused infertility can also be managed through IVF
I am 24 year old and I'm married I am trying for baby but after sex all sperm get out of vagina I keep pillow under my back, after getting from bed all sperms get out of vagina is it possible to get pregnant? Please advise
In vitro fertilization or IVF is deemed as one of the wonder treatments for couples who are facing infertility issues. Whether it is due to poor sperm quality of blocked fallopian tubes, IVF has proven to be a safe and effective solution. However, like with all new techniques, IVF also has some myths which need to be understood before signing up for the procedure. With so much at stake in terms of finances and time, understanding the process will help set realistic expectations and improve the success rate of IVF.
Myth 1: High success rate. While IVF has very high success rates, some women just fail to get pregnant. This could be about 5% of the women and may not be attributable to any particular cause. Each woman responds differently, and failure to conceive through IVF could be due to no explainable cause. What is interesting is that though the first attempt failed, subsequent attempts may be successful. Failing the first cycle does not mean failure in subsequent cycles. Also, success rate differs from clinic to clinic, and so choose one which has a proven track record and good success rates. It should not just have good doctors but also the essential technology and infrastructure to support the IVF technique.
Myth #2: IVF leads to multiple births. While achieving multiple births is easier through IVF, it always does not lead to multiple births. Multiple embryos are implanted, only to improve the chances of success. It does not necessarily translate into multiple births. In women over 38 years of age, it is mandatory to only transfer a single embryo as multiple births are very likely to be complicated.
Myth #3: Rest and time off work. It is believed that IVF has a higher success rate with proper rest and time off work. Rest is definitely required the first few days after embryo transplant but it definitely later assumes a normal course of things. It is not that too much time off work is required, just because you had an IVF. Your body might be different and require more rest, but that could have been the case even with a normal pregnancy.
Myth #4: The medications with IVF are going to have lots of side effects. While the hormones given to promote egg release do have their side effects of making you feel moody and emotional, it is only transient. Once the egg release happens, fertilization is done, and embryo transplant is done, then things should settle down. The effects should wear down once the embryo is implanted and then things should settle down. Of course, pregnancy brings its own hormonal changes, which will run their course through pregnancy.
In case you have a concern or query you can always consult an expert & get answers to your questions!
IVF or In Vitro Fertilization is a procedure carried out in a laboratory where a female egg is fertilized manually with male sperm. After this, the embryo is introduced into the uterus. IVF is of great help to those couples who face fertility problems due to varied reasons. With each passing day, the success rate is increasing steadily. But, before seeking such assistance, you need to know and consider various factors.
Here is a list of few facts that you must know before opting for IVF.
What is IVF?
The very first thing you must know is that if you ever became pregnant in natural manners, then the chances of getting a positive result with IVF increases in your case. This is such a procedure which is beneficial to people with nearly all kinds of infertility complications. If you have such an infertility condition where fertility medications also proved to be unsuccessful, then you may choose IVF in that situation.
Eggs are first taken out from the ovary of a would-be mother and then fertilized outside before replacing it inside her womb. The treatment procedure is a bit lengthy. Before the collection of the egg, the woman needs to take prescribed medications and visit the clinic for check- ups or scans for a couple of weeks. The procedure of egg collection takes nearly an hour and after that, the patient must return to the clinic for the transfer of embryo and also pregnancy blood test. In total, the treatment takes approximately four to five weeks. Various shorter treatment forms are also available as well as other essential things that you must know before opting for IVF.
Are there any risks?
Many patients seeking fertility treatment from IVF generally have a misconception that the risk of breast cancer, ovarian cancer, endometrial cancer increases if this procedure is tried. But, you need not worry at all as IVF has no link with the increased risk of such diseases.
In many cases, it is seen that a couple possesses extra healthy embryo other than one. In that case, if the couple feels like, then they can donate the extra embryo to others. In conditions of male infertility, donated sperms are also used. A woman whose age is more than 45 usually has very fewer chances of becoming pregnant with her own egg, she may take the help of donor eggs.
You need not feel ashamed of infertility as it is a common phenomenon. With a success rate of 40%, many couples seek this procedure to get conceived. Besides infertile people, single women and same-sex couples also opt for this procedure. It means one in fifty babies is seeing the light of the Earth using IVF.
In case you have a concern or query you can always consult an expert & get answers to your questions!