I am Dr. Ruchi Malhotra from FS IVF Centre, Delhi. I am a senior consultant. I’ve been working with Lady Hardinge medical college for many years as a senior consultant. Thereafter I worked at All India Institute of Medical Sciences, after which I came into this infertility practice. Today I am going to discuss about Artificial Reproductive Techniques or ART. Now ART is a technique which is used for patients who are suffering from infertility. What is infertility? We define infertility when a couple is living together without any precautions and is unable to conceive after one year without any precautions. When such couple comes to us we need to find what is the cause? why they are not conceiving? and furthermore how do we need to treat them? So there are certain basic tests when the patient comes to us for such a complaint. Most important is the history, whether the couple is living together or not. Sometimes it happens when couple comes to us but the husband is travelling, husband is not living so they are not having a normal sexual activity because of which may be they are missing the ovulation period and may be they are not conceiving.
May be there is some kind of sexual problem with in the couple which also comes out in the history or there could be a problem with the hormones in the female. She might be having delayed periods or early period or prolonged cycle or maybe she is having no cycles at all. So these are the main causes which we find out in the history from the couple and then further we need to decide how we need to treat these patients. So ART includes many methods, most important of which are IUI (Intrauterine Insemination) and IVF (In-Vitro Fertilization ). So first we will discuss about IUI. In IUI, the method is, first we stimulates the ovary of the patient by giving them tablets or by giving them some injections. We make the eggs ready which is called as the follicle which finally give us the baby. These follicles are then followed by a transvaginal ultrasound. In this once we reach the particular follicle size then we give them a trigger injection so that the follicle can rupture and comes out of ovary.
Following which we take the husband’s sperm and we segregate the best sperm and we inject them into the uterus of the female. So this is the process of IUI. Now if we discuss about IVF, it is totally different process and in which basic treatment is we give injections and we will make the eggs ready. Now IVF is all about the number of eggs which we get from the ovaries. We give them gonadotropins and we increase the number of eggs and when these eggs reach a particular size, we under anesthesia need to take out these eggs. These eggs are taken out in a test tube in specific conditions of temperature, air and lab. Then we take the husband’s sperm and we inject the sperm into the eggs.
We leave the eggs and sperm together outside in a lab environment and let the embryos grown. Embryos can grow to stage 3 or stage 5, day 3 or day 5. So the transfer is then prepared, the uterus is prepared and these embryos are then transferred into the uterine cavity. This is the entire process of IVF. After 14 days of transfer we can look for a positive result. Aap bhi is infertility ki samasya se pareshan hain aur apko iska koi ilaj samaj mein nahi aa rha toh aap mere pass visit sakte hain. Mera centre Azadpur Sabzi Mandi ke samne hi hai. Ye adarsh nagar metro station ke paas padta hai. Aap directly bhi yahan aa sakte hain aur via Lybrate bhi aakar mere se mil sakte hain. Online consultation bhi ho sakte hai aur Video Conference bhi ho sakte hai.read more
Mai Dr. Ruchi Malhotra FS IVF Centre mei infertility specialist consultant hoon. Mere paas bahut mariz jinke har jagah treatment fail ho chuki hai voh ate hain or unko yahin success mila hai. Aaj main aapko bataongi ki infertility kya cheez hoti hai aur uska treatment ke liye hamare paas kya kya option hai. Aajkal ke time mein jab mahila aur uska husband saath mein rehte hain or ek saal tak pregnancy nahi ho pati hai toh hum usko infertility kehte hain. Infertility jab patient hamare paas aata hai to hame kuch testing karni hoti hai jis se hame ye pata lagta hai ki usme kya problem hai jis wajah se us couple ko pregnancy nahi ho pa rahi hai. Iske baare mein kuch aap ko samjhana chahungi.
Infertility mein bachha na hone mein 50% contribution husband ka hota hai aur 50% contribution wife ka hota hai. Husband ki testing main toh bahut simple cheez hai. Semen check kiya jata hai jis mein hum sperm ka number dekhte hain, uski motility dekhte hain ki woh kitne chalte hai, woh dekhte hain. But female mei, cheezein thodi si complicated hoti hai. Yahan pe main aapko samjha paongi. Yeh ek female reproductive system hai. Yeh do andedani hoti hain yani andkosh. Yeh do nalee hoti hain tubes jinko bola jata hai aur yeh bachedani hote hai. Normal course mein anda yahan se nikal kar tube k andar jata hai or yahan husband ke semen se mil k bachedani main tyar hoke bachha badta hai. In main se kuch bhi, kahin bhi agar problem ho to pregnancy age thahertei nahi hai ya badti nahi hai. Jaise ki ande. Ande main kahin khrabi hai. Jaise ajkal Polycystic ovary kafi logon ko hai.
Ya phir hormone ki koi aur kami ho, ya thyroid ho. In sab vajaha se anda nahi banta hai. Doosra agar anda ban raha hai aur tube main kahin bhi blockage hai, jaise TB k vajha se blockage hai, ya pehle kabi pregnancy hue uske vajha se blockage ho sakti hai. Tab yeh anda tube main se hoke is bachedani mein nahi jata. Jab anda yahan nahi paonchega toh pregnancy hone ke chances bilkul zero ho jate hain. Teesri cheez bachedani ke ander koi problem ho sakti hai. Jaise bachedani ke ander koi fibroid ho sakta hai, ya septum ho sakta hai, ya tuberculosis ho sakta hai ya endometerosis ho sakta hai. In sab situations mein bhi pregnancy aage nahi badd sakti.
Toh jab aap ek doctor ke paas jate hain, ek specialist ke paas jate hain toh vo apko identify kr ke btate hain ki apki problem kya hai or uss problem ka kya samadhan hai. Aaj ki date mein hamare paas most problems ka samadhan hota hai. Jaise ande nahi ban rahe hain to hamere paas injections hote hain jin se hum ande bana sakte hain. Tube blockage hoti hai to hame IVF karna padta hai. Bachedani mein koi problem ho to Histeroscopy kr ke hum bachedani thik kar sakte hain. Yeh sare cheezein specialist hi aapko guide kar sakte hain ki kaise aapko aage badhna hai apne treatment ke liye.read more
Lybrate.com has a number of highly qualified IVF Specialists in India. You will find IVF Specialists with more than 43 years of experience on Lybrate.com. You can find IVF Specialists online in Delhi and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.
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Caesarean Section Procedure
Treatment Of Female Sexual Problems
Termination Of Pregnancy Procedure
Treatment Of Pregnancy Problems
Well Woman Healthcheck
Treatment Of Female Sexual Problems
Treatment Of Medical Diseases In Pregnancy
Treatment Of Menstrual Problems
Intra-Uterine Insemination (IUI) Treatment
Medical Termination Of Pregnancy (Mtp) Procedure
Gynecology Laparoscopy Procedures
Pap Smear Procedure
Family Planning Procedure
Management of Surrogacy
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Patient Review Highlights
Dr. Ruchi Malhotra provides answers that are very helpful. Thank you
Parth Dileep Tulsiani
I found the answers provided by the Dr. Ruchi Malhotra to be knowledgeable. Thank you Doctor. Your answer makes me feel very comfortable and easy going with thoughts in my head.
Overall experience is very good, nice doctor and staff. Best IVF Doctor! Highly recommend for IVF treatment
She was very helpful and cordial . A very skilled and understanding doctor . Overall good experience
Dr. Ruchi Malhotra provides answers that are very helpful. Thank you so much
Dr. Ruchi Malhotra provides answers that are well-reasoned. I am impressed..
I am very very Happy with all the staff members and doctor. They have done an excellent job. I felt FSIVF as my second home. I don’t have words to express my feelings and happiness. I got positive result, it Is like a dream coming out to be true. God bless all of you. I love you all. KEEP IT UP. Never visited any other IVF Center other than FSIVF
She is a very competent and compassionate doctor I sent couple of my friends too to her She provides rejoices in life of infertile couples She gives excellent results at an affordable package
My experience was very good. I had tried at many places but did not get any result and got positive result here by Dr Rushi's FSIVF and I am very happy Facilities.
After 2 miscarriages I'm finally able to hold my own baby in my arms. Words can't explain how grateful I am to Dr.Ruchi for making my dream come true.
Thank you FSIVF for our happiness. After a long journey now we are parents because of you. You are giving us a smiling face. Thanks a lot
Very Good staff and cooperative team of doctors, Everything is taken care of by doctors.Treated like a family
The most understanding, experienced and amazing Gynaecologist in the city. I would recommend her to everyone
Dr Ruchi is extremely comforting and one of the most friendly and skilled doctor I’ve consulted
It is one of the best IVF center in Delhi who have a very high ratio of success of IVF.
I found the answers provided by the Dr. Ruchi Malhotra to be very helpful. Good
Dr. Ruchi Malhotra provides answers that are knowledgeable. Thanx mam
Doctor Ruchi is very caring and understanding. My experience has never been this good with any other doctor. She is very dedicated to her work and is very professional. She understands the problem completely to provide the best suitable treatment. I had several previous failed IVF cycles in other centres, but when I came to her, I conceived in the first time. Thank you so much doctor.
Dr Ruchi is one of the great gynecologists. Perfect analysis of the problem of patients. Nice experience. Staff is cooperative and very positively helpful for the patients. Thank you.
I am trying to conceive pregnancy therefore I did HSG test and in report they mentioned" Both fallopian tube show beaded appearance. What is meaning of this and what to do now. Any suggestions and is this issue why I am not getting pregnant.
Donor egg IVF is used by more than 70 percent of infertile women above 45 years to conceive. More than 8,000 babies are born in the US to women of all age groups by this method of Assistive Reproductive Technologies (ART). This kind of fertility treatment will become even more popular, in the days to come, because of advances in the egg-freezing technology.
What are donor eggs
Donor eggs are eggs given by a healthy, fertile woman to an infertile woman for in-vitro fertilisation or IVF.
How does the Donor Egg IVF program work?
Before you start this course of treatment, you must consult your doctor regarding its feasibility and effect on your health. Typically, the process has the following steps;
- After a donor has been identified, the infertile woman (referred to as ‘you’) and the donor are given medication so that the menstrual cycles of both are synchronised. You are also given medication so that your endometrium lining is ready for womb transfer.
- After their donation, the eggs are fertilised using the In Vitro Fertilization technique.
- Since the donor is under 35, not more than three embryos are transferred from her to your womb.
- Embryos are formed after fertilising donor egg with partner sperm.
In some cases, the embryos may be transferred after they have been fertilised. This line of treatment is undertaken to reduce the stress of this treatment on you.
In cases of men, the following procedures are followed;
- Unless the sperm belongs to another man, your partner will be required to give a sample of his sperm to check sperm quality.
- The partner must give another sample on the day the eggs are collected.
- In the next stage, the eggs and sperm are mixed together and in vitro fertilised.
The chances of you conceiving through this program are 60-70%. This strike rate is significantly higher than a conventional IVF line of treatment.
How to start with Donor Egg IVF program?
- Finding an egg donor is not that difficult these days. You can find a donor through a fertility clinic, an egg bank, an egg donation agency, a family member or a close family friend. Donors coming from a frozen egg bank are usually screened for health and other reasons. Most donors are in the age group of 21-35 years.
- Make it legal i.e while getting donors is easy, the tricky part is to comply with the various legal issues. Consult your spouse, doctor and your attorney before taking this step.
- Get counselling i.e. you need expert counselling before you conceive because, let us face it, your baby is not your biological offspring. You and your spouse need to be adequately psychologically prepared for this important development in the family.
Pregnancy is a stage which needs to be cautiously enjoyed by all expectant mothers. The word ‘cautiously’ is used and stressed upon by medical practitioners because it is a period where two lives are at stake i.e the mother’s and the baby’s. Both their health and nutrition are of the utmost importance during this stage. In the third trimester, which includes the seventh, eighth and ninth month, when the delivery date is knocking on your doorstep, you should be more cautious than ever.
Some of the precautions to be taken during these months are listed below.
- By this time, the essential features of the baby, such as hands and legs are fully developed. In fact, the baby might just start moving and should be given some space. Thus, expectant women must be watchful of the weight they carry. At no cost must their spine be injured or hurt. This can be disastrous for both the mother and the baby.
- It is best to avoid stairs, if possible and certainly use the elevator for higher floors. In case you have to take the stairs, then holding the railings would give you the support you need. For physical exercises, you can go for a walk or just practice simple breathing exercises to keep you active.
- Extra sleep is required during this month; and that too on the left side. Sleeping on the right side should be avoided. This helps in smooth blood circulation.
- This month is crucial for the baby as it is nearing delivery. As an expectant mother you should be able to understand the signs your body gives you. It is best to avoid heavy weight lifting and too much of work. You should drink lots of water and keep yourself hydrated all the time.
- Avoid dust, animal excretes and stale food is important as it might hinder the brain development of the unborn child.
- Overeating should be avoided.
- You must take a break from household chores.
- Exercises must be continued under supervision.
- Fish must be avoided as at times they contain mercury which is not good for the unborn baby.
- Travelling is a strict no-no during this month.
- You must decide on the process of the delivery—natural or C-section beforehand.
- Going for regular check-ups is mandatory.
These are some of the precautions which must be taken during the last three months of your pregnancy. It would ensure the good health and well-being of your baby as well as your own.
It is no hidden fact that miscarriages hurt you deeply. The trauma that comes with it is unbearable, but you will have to get through it. Don’t blame yourself for the situation, you may not know it but miscarriages are quite common. Doctors have said that one out of four pregnancies ends up in a miscarriage. If you have experienced more than two consecutive miscarriages then you are suffering from a recurrent miscarriage. If you are going through recurrent miscarriages then there are some medical conditions to blame.
Is miscarriage the end?
A recurrent miscarriage may sometimes complicate things a little, but don’t think that it is the end. As the medical research has progressed, there are several ways for you to get pregnant or have a child. There is in vitro fertilization or IVF which is one of the best ways to cope with a miscarriage. Even if you are having some problem with your fallopian tube IVF can solve your problems and fertilization will be done in the lab and the embryo will be implanted.
How to cope with the emotional stress?
Miscarriages are hard in itself, and you need to deal with the post-miscarriage situation with the utmost maturity to keep your psychological and physical state under complete care. Emotionally good health will go a long way and let you think clearly about your options. If the stress and sadness of the miscarriage have brought you down, then seek the counseling of psychiatrist. Don’t feel ashamed to share your feeling and never suppress them. Talk about them and if needed join a support group that will help you to get through the tough situation.
Remember one thing that if you are emotionally aggrieved and suppress your feelings then that will take a toll on your relationship with your partner. With IVF becoming so developed, there is no need to lament about miscarriage.
How can I improve my fertility?
You may be suffering from recurrent miscarriages, but you should not lose your hope. Keep on trying and you may succeed. You never know. Visit the specialists and let them know your medical history. With special care, IVF can solve all your problems.
But only IVF would never work. Opt for a healthy lifestyle by doing exercises, eating healthy foods, quit smoking, and reduce your alcohol and caffeine intake. You should take a multivitamin rich in folic acid every day. You should also restrict your exposure to environmental chemicals and toxins. It is advisable that you leave behind any kind of heavy lifting, strenuous physical exercises, and any dangerous contact sports. Try not to take stress by taking up yoga or tai chi. And most importantly, try to maintain a healthy sexual relationship with your partner and contact your doctor to know when can you get pregnant again.
4 Dietary Changes that can Increase Your Chances of Getting Pregnant
At times being able to conceive becomes a challenge due to certain biological reasons. Feeling positive and eating healthy naturally takes you a step nearer to getting pregnant. In case of no medical condition acting as an obstruction, consuming the right food can increase your chances of getting pregnant.
1. Choose whole grains over refined carbohydrates: Reducing the intake of refined carbohydrates (found in milk, potatoes, corn to name a few) can reduce inflammation of the genitals, which will help increase fertility. You can still continue to have your favourite foods, but ensure they are low GI (glycaemic index- a figure used to represent the ability of carbohydrate to increase glucose in blood) carbohydrates.
You can consume whole grains, which help in reducing insulin levels that in turn reduce the risk of heart diseases and diabetes and also help lower cholesterol levels. Try having whole grain bread instead of white bread and porridge instead of sugary processed cereals to reduce your GI ingestion.
2. Harness the power of Proteins: Proteins are an important part of your diet and the type of proteins you require careful consideration as they help make new hormones. Try having 25gms of vegetable protein like seeds, legumes and nuts instead of animal protein.
Add dairy foods to your diet as they are also a rich source of protein. They provide vital minerals and nutrients like magnesium, calcium and vitamin B12 to the body and at the same time are low in calories. Include milk, yoghurt and cottage cheese to your meals so that you have a minimum of three servings of dairy products a day, which is essential to meet your nutritional needs and increase your chances of having a baby.
3. Welcome Good Fats: Processed foods, fatty meats and takeaways are high in saturated fats including trans fats. These lead to inflammation and an increase of oxygen free radicals in the body, which decrease fertility. So, incorporate good fats in your diet in controlled quantities. Try having avocado and tomato on a whole grain toast, for instance.
4. Make folate an integral part of your diet: Folate is an essential nutrient that helps in decreasing the incidence of birth defects in babies, while ensuring a healthy conception. Along with the prescribed supplements, try to increase its intake in its natural form. The best way to do this is by having green leafy vegetables, which are a rich source of folate. You can also have veggie sticks and vegetable soup along or green vegetable dishes to increase your folate intake.
What is IVF?
IVF stands for In Vitro Fertilization and is a method of artificial insemination that dramatically increases the chances of pregnancy. It is one of the assisted reproductive technologies methods used as fertility treatment across the world where other methods have had drastic results.
In simpler terms, a man's sperm is inserted in woman's egg using controlled laboratory environment to proceed with fertilization. These embryos are then carefully put back into the mother's uterus after 4 to 5 days of fertilization in incubator in hopes that the embryo would grow in a full baby. The embryo transfer process needs to be carefully done in order for successful fertilization in the mother's womb.
There are many reasons why IVF is conducted:
- Poor sperm quality - Males having poor sperm quality are unable to achieve fertilization and increase the chances of conception with their female partners. This is male factor infertility due to which people move towards IVF.
- Fallopian tube problems - This is a female factor infertility, in which fallopian tubes either get blocked, or damaged making it complicated and stressful for the embryo to travel to the uterus.
One must approach IVF treatment with patience and a willingness to comply with all the tenets that the treatment is built upon. IVF clinics may vary the treatment a little according to what the patient's condition demands and different clinics may have different methods. The basic methods of IVF treatment however, remain the same. The first step to the treatment is to find the right clinic which complies with factors like availability of resources, cost and quality of treatment. After deciding the clinic, the next step is to understand that IVF treatment happens in cycles and the success rate of conception varies. Patients must also be ready to face any disappointment.
- Ovarian stimulation. Your doctor prescribes a course of drugs for you to take to stimulate your ovaries into hopefully producing 12 to 15 mature eggs.
- Monitoring of your drug response. To monitor the progress of your ovarian stimulation you undergo an ultrasound examination and blood tests.
- Egg maturation. Two days before your eggs are due to be collected you have a hormone injection, which triggers maturation of the eggs.
- Egg collection. You receive a light general anaesthetic for this simple, short procedure, and your doctor retrieves your eggs using an ultrasound-guided technique.
- Sperm production. On the day of egg collection, your partner provides a sperm sample.
- Fertilisation. The embryologist puts sperm and eggs together in the lab and, if all goes well, the eggs fertilise and early embryo development begins.
- Embryo transfer. Two to five days after egg collection, your doctor places one or two embryos in your uterus. Frozen transfer can be planned after a gap of 1 month.
- Embryo freezing. If you have additional embryos suitable for use, they can be frozen and kept for future transfers. Also, frozen embryos are available.
- Pregnancy test. About two weeks after embryo transfer you have a blood test to find out whether the treatment worked.
- If the test is positive, you have your first pregnancy scan two weeks later.
- If the test is negative, you and your partner need to talk to your doctor and decide whether to try the treatment again.