In vitro fertilisation (IVF) is a process of fertilisation where an egg is combined with sperm outside the body, in vitro ("in glass"). It is a type of assisted reproductive technology used for infertility treatment and gestational surrogacy, in which a fertilised egg is implanted into a surrogate's uterus, and the resulting child is genetically unrelated to the surrogate.read more
I am Dr Ruby Sehra, consultant Sri Balaji Action Medical Hospital and Director of Progeny IVF Centre at Punjabi Bagh, New Delhi.
Today we have just going to talk about 10 things which you should keep in your mind before undergoing any medical abortion. As everybody knows that tablets for medical abortion are available on the chemist counter, but they are really been misused, a chemist is not doctors and your pregnancy is a human pregnancy respect it and carefully abort it, under the supervision of a doctor. I would like to mention that there are certain things which you should always keep in your mind before undergoing a medical abortion, number one that never takes the tablets on your own, always consult your gynaecologist or doctor. Secondly, try it to recollect, when did you have your normal periods, when was a normal flow of the period. Sometimes the flow is scanty next two periods and you start counting and you have scanty periods, the pregnancy started when you had normal periods. That means you had last month scanty periods but normal periods but 2 months back, so the pregnancy will not be of the 4 weeks it will be 8 weeks. So, bigger pregnancies cannot be dealt with a tablet. So make sure that you remember correctly when you had normal periods. Thirdly, never hide from the doctor that you ever had pills in between suppose you had scanty pills or the pregnancy test was positive, you took the pills but you never abort it. So this should be also told to the doctor that you had the pills but you never aborted, you tried to hide it is going to create complications. Then you should never hide from your doctor that you have undergone any surgery you had any complications during pregnancy or during medical termination of pregnancy like you had severe bleeding, you had a perforation of the uterus or there was some problem during getting an abortion done. This has an impact on your abortion during this time if it was perforated the uterus is weak this time again the complication can arise, so the doctor will choose whether you have to undergo a medical abortion or you have to go a surgical abortion. So never hide that you had this complication during your delivery, during any surgery, or during last medical termination of pregnancy. As I told you, you should always consult your gynaecologist before you undergo any medical abortion so that she can properly guide you that how the tablets are to be taken and what should be timing and how many tablets are to be taken. In market only one kit is available you just you don't know what time to take whether its just food related or not and you just take the tablets and you never take antibiotics after that and you just keep on bleeding-bleeding-bleeding and once after 2 months you realise that next period has also not gone now you will go to the hospital or a doctor but then you already landed up in complication. So, always consult before taking tablets on your own consult your doctor or qualified a gynaecologist. Then seven-point is that if the doctor has prescribed you medicine you please take it as prescribed further the doctor and do not try to take haphazardly because food and other things have an impact on the medical termination of pregnancy. Remember it is a painful procedure, it should never be taken when you are alone at home you need somebodies help, if you have pain you should have somebody else also who can help you out to take to the doctor. Secondly, then once you have taken your tablet and you are completely awarded or not that has to ascertain with the help of a fresh ultrasound, that means after abortion you must get an ultrasound done, after a week or 5 days because so as to rule out that there are no retained products of conception and you don't require any further treatment. That means if she doesn't get it then if the product keeps lying you will keep bleeding, you will have septicemia and it is going to be a big problem for you. Then never hesitate the last but not the least never hesitate to get a DNC done, that is a cleaning of the uterus, if the products are remaining inside the uterus it needs to be cleaned otherwise you will not have normal periods, it will cause septicemia and it will further the periods will be regulated.
If you have any further queries about this problem or any other gynaecological problems or IVF related problem you can consult doctor Ruby Sehra.read more
I’m Dr.Ruby Sehra consultant gynecologist of Sehra medical center and head of department of balaji section behalf.
Today I’m just going to talk about post-menopausal bleeding. Post-menopausal bleeding means any abnormal bleeding once you finish your periods that means you have stopped having your periods but after six months you are again having bleeding, this is an abnormal bleeding. This can be cancerous or non-cancerous. It can be because of the just endometrium hypoplasia i.e. thickening of uterine lining or it can be because of the polyps i.e. the extra growth which could be cancerous or non-cancerous. I don’t think that you should take it lightly. The incidence you must be knowing that it is around every four to five women after fifty years of age. In one lac women are suffering from this cancerous abnormal uterine cancer. This cancer has become little less in incidence because of the early diagnosis. So, I suggest you to not ignore this symptoms of abnormal bleeding after 50 years or after your menopause and get yourself investigated the earliest possible. Immediately consult your doctor, get investigations done, get all the procedures small procedures done and get your surgery done. Because this is the only cancer which gives us an indications at an earliest age. If we don’t listen to it or if we don’t pay attention to it than we are going to land up in big complication. Endometrial cancer is thickening of the inner lining of the uterus that u can see here that this is the uterus this is the growth in the inside the cavity of uterus this can be here in the cavity or in the lower down.so, once you have abnormal bleeding the other symptoms can be that you are having a foul smelling discharge. Then the chances of having a cancer is high. If u have in your past have had high bleeding, PCOS or you had any estrogen dependent medicine taken and you have diabetes and you have a hypotension then you are all more at risk of a endometrial cancer. Once you had this cancer the myths are that it will go away, don’t worry about it…NO! This is the indication, god is giving you. Take an appropriate action at appropriate time so that you don’t land up in big complications. How?? You should go to the doctor that’s why the screening is done to know it earlier. Once you know it earlier that you have good chances of that you will not have any other problem. Once you had this problem then you should go to the doctor get your ultrasonography done to know how much thicken is your endometrium and you should get your pap smear done. If advice you may have to go your MRI undergo. If your endometrial thickening is more than 4 mm then it is definitely an indication to undergo a surgery. Surgery is quite easy and it’s just consist of total abdominal hysterectomy or laparoscopic hysterectomy with bilateral salpingectomy. But the total recovery period after laparoscopic hysterectomy is just a week or ten days and you go walking on the third day of surgery and you are self-sufficient and you can take care of yourself and you don’t need anybody’s help. But the only thing is that you have to be in time. In case, the cell, growth has spread in various adjacent organs then we have to for a bigger surgery. Once you gone to the doctor, got your DNC done, your hysteroscopy done and the ultrasound done. If the biopsy says that it is a cancer then you should get hysterectomy done immediately and without any delay. So as to get a good success rate of survival. Chemotherapy and other things are really painful so in case it is detected earlier then you will not have to undergo this chemotherapy and radiation and you will be taken completely care off.
Thank you.read more
Today I’m going to tell you about how natural conceptions take place and what the pre requisites for the conception are. 50% of the part is played by the male and 50% of the part is played by female. What we require in the female is you can understand the uterus the tubes and the ovaries and the male in male what we require is sperm count of at least 60 to 1 million per ml and motility of 40%. In female these are the female reproductive organs, you can see uterus and the right and the left tubes and ovaries.
Every month when you ovulate when you start having your period’s one of the egg is selected out of the millions of eggs in your ovaries. One of the egg which is normally 0.005ml increases to size to up to 24mm within 10 to 14 days of your periods. Once it reaches a 24mm size this follicle has a pressure trigger pressure due to which this follicle ruptures, It releases its eggs. The egg which is picked up by the tube and the part which is left behind is the corpus luteum.
This eggs forms a baby, corpus luteum forms hormones to support the pregnancy. Once it has been thrown into the peritoneal cavity, the tubes picks it up or sucks it up and goes into the fimbrial end of the tube. Once it is reached to the tube then if you have intercourse then the sperms are deposited here. Millions of sperms in the semen they have the veg’ing tails they also travel to the uterine cavity and you can see it travels through the tube and they also reached the fimbral part of the tube.
One of the sperm out of millions of sperms enters into the egg and this fertilization take place. This fertilization induces a rapid division in the cell and from one cell to 2 to 4 as well as it forms a ball of cells and side by side it is transported from the tube to the uterus. What happens in the once it reaches a uterus the endometrial cavity which is already formed a carpet further the embryo, embryo buries into the endometrium and then it starts developing further like this from the various shape and finally the baby reaches into your lap.
So what we require from the female is that she should have normal ovary which is ovulating every month and she should have tubes which is patent so as it can transfer the sperms it can pick up the egg and then it can fertilize the egg and side by side which should be able to transferred because of its cilia. It should be able to transferred the embryo from the tube to the uterus and you can understand that this endometrial lining should also be thicker enough that is around 10mm thicker enough so that the baby can implant inside a endometrial cavity nicely.
With the help of the video I will just demonstrate how the egg is ruptured? How the tubes picks up the eggs? How the sperms travel through the tube? And how this baby is formed? And then finally transported to the uterine cavity. You can see the sperms are entering in the uterine cavity and finally they are travelling towards the tube to meet the egg which is already lined in the fimbral part of the tube. Millions of eggs they are touching the eggs but only one of them is successful to penetrate this egg.
Once the sperm has entered into the egg this embryo forms is travelling. You can see this travelling through the tube to reached the endometrial cavity where it implants itself and will finally forms a baby in the uterine cavity. This is the division of the cells. This embryo being transported from the tube to the uterine cavity. The endometrium has already laid a carpet where it burry itself and finally grow. You can see the egg has buried inside the carpet which is being laid by the tick endometrium. So I have explain you about the conception. In case you have any queries related to your conceptions please contact Progeny AN IVF-ICSI center at Punjabi Bagh, New Delhi.read more
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IVF is a useful process for people who want to become parents but have exhausted all other means of being so. However, the in-vitro fertilization method is definitely not suitable for everyone. Here are some facts you need to know about the procedure and they will help you determine whether you are suited for the program or not.
1. IVF Takes Time
Even though most clinics may not tell you this, but the IVF procedure takes a bit of time to deliver the desired results. On an average, the treatment can take anywhere between four weeks to a couple of months to produce results, depending on the patient’s ability to respond to the medicines used. The procedure involves artificially stopping the menstrual cycle of the woman. Next, the ovulation process is stimulated so that the healthy egg can be extracted from the womb. The eggs chosen are then fertilized and left to undergo embryo culture for another six days. After this, the eggs are implanted back into the mother’s body.
2. The process Can Be Stressful
IVF treatment and pregnancy can be quite a stressful period of time for the parents in question. The mother needs to be constantly monitored to check for any abnormal response to the pregnancy. Regular checkups by the doctor along with blood tests may also be suggested. However, this stress has very little chance of affecting the quality of the pregnancy. So, do not worry that overstressing yourself will lead to complications for the embryo.
3. More Than One Cycle Needed For Pregnancy
IVF treatment occurs in cycles. Each cycle involves transplanting a fertilized egg into the womb. However, pregnancy, right after completion of the first cycle, is quite rare. In fact, almost all patients need to undergo several similar cycles in order to get pregnant. So, do not be disheartened if you do not get pregnant after undergoing the very first cycle of IVF treatment.
4. IVF Is Costly
Not everyone is able to afford the high cost of IVF. Others may be able to afford the cost of undergoing a couple of cycles of the same, after which the high costs can become a burden. Only a select few can bear to carry on with the treatment until the pregnancy arises. So, consider your financial condition prior to signing on for such a treatment option.
At any rate, consult with an expert to get an even better idea about the IVF procedure and the consequent pregnancy.
In vitro fertilisation (IVF) is a process of fertilisation where an egg is combined with sperm outside the body, in vitro ("in glass"). It is a type of assisted reproductive technology used for infertility treatment and gestational surrogacy, in which a fertilised egg is implanted into a surrogate's uterus, and the resulting child is genetically unrelated to the surrogate.
IVF or In Vitro Fertilization is a process where the egg or ovum is fused with the sperm in a laboratory. In vitro is a Latin word meaning “in glass” wherein the process takes place. The procedure of fertilization is induced in a laboratory setting and the zygote sits for 3 to 6 days before it is finally transferred into the uterus of the woman willing to carry it and the process of pregnancy as is known continues forward. This method is a blessing for women who are unable to conceive naturally and it is resorted to as the last step in trying to conceive for it is a costly process not everyone can avail.
Apart from that, the fact that it is restricted in a lot of countries has given birth to “fertility tourism” whereby people move to other countries where it is legal to get IVF. IVF comes with its set of risks and it is important to keep in mind that the process is not 100% effective all the time. While being a ray of hope for many women, it has its own complications that you need to be aware of before you decide to take a plunge into this expensive treatment:
- Ectopic Pregnancy: This is a rare condition where the embryo, which is placed in the womb, somehow develops in the fallopian tubes. It is not clear as to why this happens and studies show that it may occur more in women who have defective fallopian tubes but this can give rise to some serious complications; such as extreme pains in the abdomen, unprecedented increase in amount of pregnancy hormones, even some vaginal bleeding.
- Multiple Births: Since there’s always a risk that IVF may not be successful at the first go, sometimes to increase the chances multiple embryos are planted. This can lead to extremely dangerous consequences like multiple births, twins or triplets even. It poses a considerable health risk for the mother and the child, more so than what comes with a singleton birth. It can lead to miscarriages, raises the chances of neonatal deaths by considerable amounts and premature births.
- Draining resources: Since the problem with IVF is that the success rate depends from person to person, if you fail at the first go, you have to keep trying which is not a very feasible option for each time the treatment costs a lump sum amount. Notwithstanding, there is also the matter of emotional and physical exhaustion and the heavy amounts of hormone treatments that can get to your head and impose immense psychological stress on both partners. It is essential that you surround yourself with supportive family members and friends, who can understand what you are going through.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Women undergo menopause in their 40s and this is primarily known as the age after which they can't bear children in their wombs any more. The ability to develop and maintain a healthy pregnancy wanes as a woman crosses the age of 30, which according to research is the optimal time for a woman to become a mother.
The body undergoes changes as it gets older and women slowly start losing the perfect conditions for pregnancy. However, with the rise of the IVF treatment for infertility, a great number of people are choosing to embrace parenthood at a relatively advanced age. However, the question is, can the same IVF treatment prove effective for a woman after her menopause?
The answer is yes. There have been several instances where a woman past menopause has been implanted with a fertilized egg and has been able to conceive a healthy offspring from the same. However, such an IVF treatment is much more complex and can require a lot of external hormonal treatments on the side as well.
How can IVF help menopausal women?
Women, who have gone into menopause more than 6 months ago, require additional care to achieve pregnancy through IVF. The uterus is usually shrunken in such people and the endometrial lining also develops a resistance to estrogen. Several cycles of estrogen treatment are needed for such women to achieve a healthy pregnancy.
Most doctors suggest at least a couple of months of estrogen and progesterone treatment prior to taking the actual IVF treatment. However, there is no guarantee that the same will be effective in every case.
By any chance, if the menopausal woman chose to store her eggs prior to her menopause, she can get those eggs fertilized and implanted after menopause, using the IVF method, in order to achieve a healthy pregnancy. Through, this procedure, the woman can not only become pregnant after menopause but can also ensure that she is the biological mother of the child who would be born.
At any rate, it is best to undergo the IVF treatment before menopause, as this improves the chances of conceiving. The hormonal treatments are often easier and most women can completely forego the progesterone and estrogen supplementation in such a case. This will not only reduce the time required to complete the treatment but will also significantly reduce the cost that the parents have to bear. In case you have a concern or query you can always consult an expert & get answers to your questions!
Oligospermia is the condition where men have a less than adequate amount of sperm cells in their semen. Due to this condition, it may be difficult to reproduce but it is not impossible. However, as a result of oligospermia, men may face certain fertility issues. Low sperm count may be a result of some hormonal issues, and they generally indicate the presence of a medical problem that should be treated as soon as possible. Obesity and diabetes are some conditions that may be associated with oligospermia.
Oligospermia and IVF
When it comes to reproduction, oligospermia may come in the way. That is why, oligospermia males may sometimes opt for the in vitro fertilization method, where the egg is fertilized with the sperm in a laboratory dish and then planted in the female embryo.
What is TESA?
TESA refers to testicular sperm aspiration, which is a surgical procedure that helps in solving problems associated with male fertility. Men who have obstructive azoospermia, which is a condition that leads to negligible or nonexistent sperm count as a result of an obstruction, can opt for TESA.
The surgical procedure only takes around five to ten minutes to complete. The sperm is retrieved, in time with egg retrieval of the female partner when the couple is in the process of undergoing in vitro fertilization in order to have a baby. Doctors insert a needle into the man’s testicle and sperm or tissue is aspirated. Before that, local anesthesia is administered and the procedure may even be carried out in the doctor’s office or clinic. In occasions where enough sperm or tissues are unavailable, an open testicular biopsy may be conducted to move the process along.
Why is TESA the best option for oligospermic males?
In many cases, TESA is the best option because the sperm cannot be retrieved in any other way due to an obstruction. This would be a major hindrance to the smooth progression of the process of IVF pregnancy if not for TESA, which is a safe, short and effective procedure. Men who do not produce sperm in the seminal fluid are specially benefited by TESA. In case you have a concern or query you can always consult an expert & get answers to your questions!
The In-vitro-Fertilization method has revolutionized reproductive technology and has made natural conception possible for so many expectant families. Despite its popularity, many individuals still fail to see to their well-being during treatment. Not only does it affect the probability and success of conception, it can also lead to further mental stress that can only be destructive towards your psychological health and perhaps your upcoming pregnancy. Here are a few ideas on how you can best take care of yourself during the treatment period:
1. Proper Sleep
A sufficient amount of sleep every night goes a long way to ensuring a peaceful state of mind. As you are anticipating conception, you should schedule your timings such that you can sleep for at least 8 hours every night. Additionally, adopt a nightly ritual so you can ease yourself into bed at a regular time every night. This allows your body clock to be standardized through the treatment period and provide you with optimal energy for the day.
2. Keep Hydrating
Fluids are ideal for flushing out the negative toxins from your body. As a result of the treatment, your body is going through a number of chemical and biological changes. Thus water and other fluids like vegetable and fruit juices help your body maintain a healthy count of blood cells and ward off side effects that may arise during the IVF treatment.
Clinical tests have proven that certain acupuncture procedures strengthen the flow of blood into the uterus and the ovaries. Most specialists recommend that you undergo a session of acupuncture the day of the embryo transfer so that you do not activate your stress hormones. As IVF treatments often become quite trying for the couple in question, you might want to try this method to release anxiety.
4. Take Walks
Though it is not recommended that you exert yourself too much physically, engaging in light walks should only help you ease into your IVF cycle. Not only will it maintain your balance and coordination, it can also improve your mood and help you maintain an appropriate weight for conception.
Even if you may not realize it at the time, this period could turn out to be one of the most significant periods of your life. Becoming a mother is a complex challenge yet a wonderful privilege and you might want to document your experiences while you are going through the treatment. Not only is it incredibly soothing, it might help you prepare for your upcoming journey by letting you recognize and accept your emotions.
In vitro fertilization or IVF is an advanced process of fertilisation, which involves the combining of an egg with a sperm in a laboratory dish. This is followed by the implantation of the embryo(s) [a developing unborn offspring formed by the combination] in your uterus. Being one of the most successful and widely opted methods of assisted reproductive technology, IVF is considered to be highly advantageous for couples who seek a child but have fertility issues.
1. IVF proves to be a boon for couples who are normally unable to conceive: Couples who have fertility issues generally opt for IVF to fulfil their wish of having a child. IVF works against fertility problems like blocked fallopian tubes, PCOS, endometriosis (a condition where a fraction of the womb lining grows outside it), premature ovarian failure or menopause among women and unusual sperm size, low sperm count, and inadequate sperm mobility among men.
2. It has been in use since long and is proven to be safe: IVF was first used in 1978 to give life to the baby Louise Brown, safely. Since then, the enhancements in technology and techniques have resulted in large numbers of successful cases, where IVF has proved to be a safe method for conceiving.
3. It has higher success rates in comparison to other types of technologies used for assisted reproduction: Though various types of assisted reproductive technologies like IUI (Intrauterine insemination) are available for couples seeking a child, the success rate and effectiveness of IVF is the highest. This is due to the fact that IVF has undergone significant levels of enhancement over the years in comparison to other such techniques.
4. It proves to be of great help to same-sex couples and single women: Same-sex couples and single women are hugely benefitted through IVF as it helps them in becoming parent(s) by using donor sperms.
5. It can help you to eliminate genetic disorders: IVF helps in preventing the conceived child from inheriting any general disorders present in the parents through the process of pre-implantation genetic diagnosis (PGD – a reproductive technology that accompanies an IVF cycle to detect genetic diseases in the embryo before the implantation happens). Moreover, opting for pre-implantation genetic screening (PGS) increases the probability of success as it entails a screening of the embryos that helps in identifying chromosomal disorders like Down’s syndrome. In case you have a concern or query you can always consult an expert & get answers to your questions!
Ovarian Hyperstimulation Syndrome occurs in women undergoing in vitro fertilization. It can also occur during ovulation induction and intrauterine insemination. It is a condition when the ovaries become swollen after a hormonal medicine is injected in them. These medications are injected to stimulate egg production. The overstimulated ovaries release chemicals into the bloodstream. However, the symptoms can range from mild to severe depending on your ovaries.
Mostly, the symptoms develop within 10 days of getting hormonal injections or medicine. They include:
1. Mild to Moderate-
- Rapid Weight Gain
- Thrombosis where blood clots are formed in the legs
- Difficulty in Breathing
- Less urination and also the urine may be dark in color
If you are experiencing any of the symptoms, you should consult a gynecologist and your IVF doctor. However, the risk of getting ovarian hyperstimulation syndrome is greater for women suffering from-
- Polycystic Ovaries
- Under 30 years of age
- Had ovarian hyperstimulation syndrome before
- Increase number of follicles
- Low body weight
If you are suffering from mild to moderate OHHS, it can get resolved within 7-10 days. Moreover, by taking care of yourself at home you should be better. Start having plenty of fluids. If you are experiencing pain, take paracetamol but avoid having anti-inflammatory medicines. However, if you have a severe case of OHHS, then other methods are used. They are:
- Changing Medications- The drug used to stimulate the ovaries is gonadotropins. Alternatively, if you have polycystic ovary and are undergoing IVF treatment, then your doctor can give you proper medications.
- Coasting- Women having high estrogen levels may have increased number of follicles. In such a case, your doctor may stop hormonal injections and wait a few days before injecting HCG (human chorionic gonadotropin).This is known as coasting.
- Alternatives to HCG injections- As a shot of HCG can lead to OHHS, alternative to this hormonal drug have been developed like leuprolide (Lupron).
- Freezing embryos- When undergoing IVF treatment, your follicles can be removed from your body. These can then be fertilized and frozen, allowing your body to rest. You can resume the IVF treatment at a later stage.
However, if you develop OHHS and get pregnant at the same time, it may increase your complications and can become risky for your health. In such a situation, it is advisable to consult your doctor and wear socks at all times to avoid thrombosis. But, there is no information regarding any harm being done to your baby due to OHHS. So it’s not a scary thing and there is nothing dangerous or harmful to your baby.
Pregnancy is a beautiful phase for any woman, and should be enjoyed to the fullest. That being said, pregnant women need to take care of their health at all times, as a young life depends on them. Taking into account how paranoid a to-be mother can be, any form of bleeding during pregnancy can cause a lot of trepidation. However, a lot of this worry is not really required at all.
A lot of pregnant women bleed during the first trimester of their pregnancy. As a matter of fact, many who bleed do not know or realise just how common it really is, and as a result, they get quite a lot more worried than they should. In fact, it happens to about one in five women who are pregnant.
Why bleeding occurs?
- It is quite likely that if a miscarriage is to occur, it will occur during the first trimester, or the first twelve weeks. As a matter of fact, bleeding is most likely to occur between weeks five and eight. A woman would get to know that she is having a miscarriage if there is tissue which is being passed, and at the same time, she feels some very intense cramps in the lower part of the abdomen.
- Another reason why women bleed, which is also quite likely to occur during the first trimester, is due to the process of implantation. However, this sort of bleeding is not heavy by any measure. The ironic thing is that a lot of women discover that they are pregnant by this form of bleeding and it usually occurs within a week to about twelve days after the conception has taken place.
- One of the more baffling reasons for bleeding when a woman is pregnant is bleeding which occurs after sexual intercourse. While it may seem odd that something which is supposed to be pleasurable should actually end up causing blood loss, all this is a sign of is that the tissues around the vagina are receiving a great amount of blood supply. It is to be noted, that no risk is caused the foetus because of this as it is located in the uterus.
What to do if you bleed?
- No matter how light or heavy the bleeding, the midwife or the doctor must be kept up to date with the situation at hand. This is because if there is any corrective action which is to be taken, the delay in time is to be kept to a minimum.
- A cause for genuine concern over the period of the pregnancy is if there is bleeding post 20 weeks. In most circumstances, bleeding is not worth the mental trouble.
In case you have a concern or query you can always consult an expert & get answers to your questions!