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In Vitro Fertilization (Ivf) Treatment
Intra-Uterine Insemination (IUI) Treatment
Sperm Donor Program
Treatment of Infertility in Women
Natural Cycle Ivf Treatment
Egg Donation Procedure
Intracytoplasmic Sperm Injection (Icsi) Procedure
Embryo Donor Program
Evaluation & Treatment of Infertility
Donor Insemination Surrogacy Procedures
Interventional Diagnostic Procedures
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Patient Review Highlights
Dr Richika Sahay Shukla is one of the best physicians in city. In order to diagnose my problem completely she asked me a number of questions. I was in so much pain due to my fertility. I was not able to conceive due to which I and my usband were suffering. We consulted Dr Richika Sahay Shukla who gave the best possible prescription for my problem.I am happy that I consulted her.
She is not just friendly, but also is very motivating. The Fortis IVF Clinic have proper facilities for disabled patients as well. I consulted Dr Richika Shukla for treatment. Thanks to the expert care and guidance, I feel much better than before. I was suffering from polycystic ovary synDrome. My boss referred me her name.
Never thought I will suffer from thyroid disorders during pregnancy. I consulted Dr Richika, she helped me calm down and explained me the treatment procedure. Its been 3 months now, I feel much better than before and I am hoping for further improvement as well. I owe her a big thank for treating me so well.
With the help of Dr Richika's treatment for trying to conceive I am feeling so great. During the complete treatment program she always supported and motivated me. Her guidance has helped me immensely with my situation. She is so nice that they even at odd hours one can call her in case of emergency.
Thanks to her I am much better now. I was quite concerned, as my problem was increasing day by day, but due to my Richika Sahay Shukla and the in IVF I didn't lose hope. Our family physician personally recommended this Dr Richika Sahay Shukla. he is god sent for me.
No matter how critical be the situation, she is always very calm. The treatment Dr Shukla gave me has helped me immensely with my situation. I was suffering from infertility. Thanks to her that the infertility treatment she gave me has given brilliant results.
Dr Richika ensures that she listens to her patients. Even though my problem was very big, the entire experience of undergoing infertility treatment was very relaxing. Thanks to her I am much better now.
I found the answers provided by the Dr. Richika Sahay Shukla to be very helpful. Thanks man but she got period in evening
I found the answers provided by the Dr. Richika Sahay Shukla to be very helpful. Thanks
Dr. Richika Sahay Shukla provides answers that are very helpful. Thank u v. Much
What is natural cycle IVF?
Natural cycle IVF involves collecting and fertilising the one egg that you release during your normal monthly cycle. No fertility drugs are used in this treatment.
Is natural cycle IVF for me?
It may be worth discussing this treatment option with your clinician if your periods are fairly regular and you are ovulating normally, but:
you are unable to take fertility drugs (for example, cancer patients or those whose clinician has suggested that they are at risk of OHSS “ ovarian hyper-stimulation “ a dangerous over-reaction to fertility drugs) because for personal or religious beliefs you do not wish to have surplus eggs or embryos destroyed or stored.
How does natural cycle IVF work?
The treatment is the same as conventional IVF, but without the fertility drugs that are used to stop natural egg production and hormones that boost the supply of eggs.
As your ovaries are’nt being artificially stimulated, you don’t need to rest as you would after conventional IVF.
If your treatment is unsuccessful, you can try again sooner if you wish
Sequential embryo transfer-(SET) is an improved method of increasing pregnancy rates and implantation rates in infertile couples. According to the American Society for Reproductive Medicine (ASRM), the average pregnancy rate is about 20% for patients undergoing in vitro fertilization (IVF) treatment. Patients undergoing SET have a pregnancy rate of over 50%! SET is the transfer of two groups of embryos in the same menstrual cycle of a woman undergoing IVF treatment for infertility. One group of embryos-the best looking and fastest growing embryos are transferred to the uterus 2 or 3 days after the oocytes (human eggs) are collected from the ovary. The second, more highly developed, group of embryos are transferred to the uterus a few days later-when at least one embryo has reached the expanded blastocyst stage-an advanced stage when an embryo is about to hatch from its shell called the Zona Pellucida and attempts to implant in the lining of the uterus called the endometrium. SET has an increased implantation rate ( embryos implanting from the total number of embryos).
Couples use donor sperm (DI) when the husband/partner has no sperm or a very poor semen analysis (azoospermia, oligospermia, poor motility), or when there is a genetic problem which could be inherited from the male. Single women who want a biological child also use DI.
- One must be psychologically ready to proceed with DI. Most doctors recommend that any patients considering DI see a counselor who is skilled at clarifying feelings about infertility, and about trying DI. It is essential that both partners feel comfortable with the decision and that all fears and questions be openly discussed. For some, it may mean dealing with various moral and ethical questions; for others, exploring questions about donor selection and whether to be open about the decision to do DI and whether to tell a child conceived by DI how they were conceived.
- Before you begin chemotherapy or radiotherapy treatment, your sperm can be frozen and stored until you wish to start a family. Even if the sperm profile is poor, as is common during times of illness, it is usually possible to store sufficient sperm for use in IVF in the future.
- Men who have to travel overseas or work in dangerous situations may also want to have their sperm frozen for possible use in the future.
- About 25-50% of the sperm will survive the process of freezing, and they can be stored for many years. There is a yearly fee for sperm storage.
Donor Egg/ Donor Embryo
If you’re over 40 or can no longer produce healthy eggs, donor eggs can help you carry and deliver a baby. This is also a good option if you’re at risk for passing a genetic disease such as Tay-Sachs disease or sickle cell anemia to your child.
Treatment: What to expect
- If you decide on an anonymous egg donor, you can find her through your fertility clinic. You’ll usually be able to choose based on her physical characteristics, ethnic background, educational record, and occupation. Most donors are between 21 and 29 years old and have undergone psychological, medical, and genetic screening. Ask how your clinic screens candidates ” some do less extensive tests and background checks than others. If you choose to use donor embryos, you can either pick unrelated egg and sperm donors or use a frozen embryo donated by a couple that had extras.
- Once you pick a donor, both you and she will take birth control pills to get your reproductive cycles in sync ” she needs to ovulate when your uterine lining can support an embryo. She’ll also take a fertility drug to help her develop several mature eggs for fertilization, while you will receive estrogen and progesterone to prepare your uterus for pregnancy. Once her eggs are mature, your doctor will give her an anesthetic and remove her eggs from her ovaries by inserting a needle through her vaginal wall using an ultrasound for guidance.
- From here on out, the procedure is just like that of in vitro fertilization (IVF). Your partner’s sperm or a donor’s sperm will be combined with your donor’s eggs in a dish in a laboratory. Two to five days later, each of the fertilized eggs will be a ball of cells called an embryo. Your doctor will insert two to four embryos into your uterus through your cervix using a thin catheter. Although it’s not a common practice, many experts say couples should consider transfer of a single embryo to avoid the risk of twins or triplets. Extra embryos, if there are any, may be frozen in case this cycle doesn’t succeed. If the treatment does succeed, an embryo will implant in your uterine wall and continue to grow into a baby. In about 40 percent of ART pregnancies using donor eggs, more than one embryo implants itself and women give birth to multiples.
Hi madam. I am 28 yrs. Trying to get conceive but I am not get it. But my period is regular. Can I know which is the right time to get it done. After the periods of 5 days complete. I want to know from 7th day can we try. If the tensions is the means can't get conceive.
PESA / TESA / MESA
The main methods of surgical sperm retrieval available include:
- PESA: percutaneous epididymal sperm aspiration.
- MESA: microsurgical epididymal sperm aspiration.
- TESA: testicular sperm aspiration. This includes testicular fine needle aspiration (TFNA).
- TESE: testicular sperm extraction.
- Microdissection TESE.
- Perc biopsy: percutaneous biopsy of the testis.
Which method is used depends on the nature of the problem in the male partner, which needs to be explored carefully first.
Tests required before surgical sperm retrieval
A man that produces no sperm in his semen is said to have azoospermia. This may be because of a blockage in one of the tubes that carry sperm from the areas of the testes where they are produced, out to the penis during ejaculation. Obstructive azoospermia can be caused by testicular cancer, as the tumour presses on the vas deferens. This type of cancer is common in young men and can be treated successfully. It can, however, lead to infertility, so surgical sperm retrieval may be performed to store some sperm before treatment begins.
Other conditions cause non-obstructive azoospermia, including having an abnormal cystic fibrosis gene. Men with this condition may not show all the symptoms, but they often have no vas deferens. Surgical sperm retrieval is possible but there is a 50:50 chance that the embryos produced by subsequent ICSI and IVF will have the same genetic abnormality. Options then include using a sperm donor and intrauterine insemination (IUI) or IVF, or having pre-implantation genetic diagnosis (PGD) performed on the embryos to select ones that carry the normal gene.
If the problem that underlies poor sperm production is physical rather than genetic, or if a couple wants to have children after the male partner has had a vasectomy that cannot be reversed, surgical sperm retrieval can go ahead.
Myself and my wife are trying to conceive a baby. During intercourse, when I penetrate deeper, she feels some pain and hence I restrain myself from going deeper. Does this in way affect our chances of pregnancy? Please help.
Common Cause of Infertility in Males
- You must produce healthy sperm.Initially, this involves the growth and formation of the male reproductive organs during puberty. At least one of your testicles must be functioning correctly, and your body must produce testosterone and other hormones to trigger and maintain sperm production.
- Sperm have to be carried into the semen.Once sperm are produced in the testicles, delicate tubes transport them until they mix with semen and are ejaculated out of the penis.
- There needs to be enough sperm in the semen.If the number of sperm in your semen (sperm count) is low, it decreases the odds that one of your sperm will fertilize your partner’s egg. A low sperm count is fewer than 15 million sperm per milliliter of semen or fewer than 39 million per ejaculate.
- Sperm must be functional and able to move.If the movement (motility) or function of your sperm is abnormal, the sperm may not be able to reach or penetrate your partner’s egg.
Any excess healthy embryos from the IVF process can be frozen, in case more than one treatment cycle is needed. Freezing embryos, also known as cryopreservation, takes place for some 60% of all patients having IVF treatment – and frozen embryo transfers accounts for around 50% of all IVF births in our program.
Why do we freeze embryos?
- Embryo freezing provides more opportunities for a pregnancy from each IVF stimulated cycle. For example, if a number of normal embryos are obtained in an IVF cycle, we might suggest transferring one or two of them and freezing the other four or five. This would generally allow further embryo transfers in later cycles without the need to undergo a full stimulated IVF cycle if pregnancy did not occur in the first cycle. If a baby is conceived in the stimulated IVF cycle then the frozen embryos can be used subsequently to try for another pregnancy without the need for further hormone stimulation
- Embryo freezing gives more opportunities for a pregnancy for each hormone stimulation cycle and egg collection.
- During a typical IVF cycle, we’ll be able to create more than one embryo, however there are serious risks associated with multiple pregnancies, so generally we won’t transfer more than one embryo at a time.
- For example, if we manage to obtain two or three normal embryos (this does not always happen) we’ll usually recommend transferring one, and freezing the others. If you do not become pregnant in that first cycle, we can transfer another embryo.
- This is called a Frozen Embryo Transfer (FET), and means you won’t have to undergo another cycle of hormone stimulation and egg collection.