Treatment of Mirena (Hormonal Iud)
Pap Smear Procedure
Dilatation And Curettage (D C) Procedure
Proton Therapy Treatment
Preimplantation Genetic Diagnosis (Pgd)
Pregnant Women Counseling
Prenatal And Birth Care
Musculoskeletal Pain Management
Ovarian Ablation Procedure
Treatment Of Female Sexual Problems
Egg Donation Procedure
Treatment Of Menstrual Problems
Treatment Of Menopause Related Issues
Treatment of Polycystic Ovary Syndrome In Adolesce
Pre And Post Delivery Care
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Diagnostic Tests Females
We provide testing for fertility by all modalities ranging from reproductive hormones to diagnostic ultrasound to ascertain the cause. It is advisable that we make you undergo these tests before your final treatment/ plan of management is started.
- Blood tests: These include a whole array of blood investigation ranging from CBC , Urine routine microscopy, RBS, TSH, PROLACTIN, VDRL, HIV, HBSAG, HCV, AMH. And any other test depending on the history of the couple.
- Transvaginal ultrasound: A complete ultrasound of the uterus and adnexa is done to diagnose any anatomical disorder.
- Specific tests: In cases of recurrent implantation failure and recurrent pregnancy loss or if required other tests are also advised.
- Diagnostic Laparoscopy and Hysteroscopy: For many, this test is an important part of a fertility evaluation. Laparoscopy takes place under general anaesthesia with small incisions made at or just below the navel and the pubic hairline. A laparoscope (a small-diameter telescope) is passed through the incision, which enables one to view the ovaries, fallopian tubes, uterus and pelvic cavity for abnormalities. We can check that the tubes are open (tubal patency) by injecting dye through the uterus and observing it spill or not through the ends of the fallopian tubes.
- Hysteroscopy: uses another small-diameter telescope called a hysteroscope. This enables to assess the uterine cavity for abnormalities such as polyps, adhesions or fibroids.
Diagnostic Tests Males:
A basic semen analysis is the main test advised for all males.
- If required we also go for quality semen analysis , sperm survival test.
- Males suffering from more severe problems can also undergo DNA fragmentation test.
- Blood tests like TSH, Prolactin, FSH, LH, Testosterone, SHBG, HIV, HCV, HBSAG, VDRL are also done.
- If required Ultrasound of the Scrotum and Testes is also done.
Natural Cycle IVF
- 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.
We will help you evaluate the benefits of gestational surrogacy and provide you with information about cost, legal issues, and treatment protocols.
In traditional surrogacy, the surrogate is pregnant with her own biological child, but this child will be raised by others. In gestational surrogacy, the surrogate becomes pregnant via embryo transfer with a child that is not biologically her own. The surrogate mother may be called the gestational carrier.
Once a suitable surrogate has been identified, and the screening process is complete, the cycle can begin. Timing depends on the surrogate’s and intended parents/donors menstrual cycle .
Surrogacy Cycle Overview
The surrogate needs to prepare her uterus for implantation with natural estrogen and progesterone. Because each woman is a little different, the dose, duration, and method of administering these hormones may need to be individualized. This can be determined ahead of time by conducting an evaluation cycle. This is a â€œdry runâ€ in which we duplicate each part of the cycle except the actual transfer of embryos in order to determine how to maximize the chances of success. The evaluation cycle can be completed anytime before the actual procedure. In some circumstances, the evaluation cycle can be waived when the response of the uterus to hormonal stimulation is well known. This is fairly common for women who have undergone many treatment cycles in the past.
It is necessary to synchronize the menstrual cycles of the surrogate and the intended parent in order to obtain mature eggs and embryos and transfer these back into a perfectly prepared endometrium (uterine lining) to maximize the chances of pregnancy success. This is done using a variety of hormonal manipulations .We will determine which technique will work best for each circumstance. Once both women’s (surrogate and intended parent) ovarian function is suppressed and their cycles synchronized, they can begin the process of preparing for pregnancy.
On about the same day, the surrogate and intended parent will begin hormonal therapies to prepare the appropriate target for pregnancy success. The surrogate will begin taking estrogen to stimulate endometrial (uterine lining) growth and the intended parent will begin taking FSH to stimulate egg production. These treatments are monitored with ultrasound and blood estrogen levels until the eggs are ready to be retrieved and the uterus is ready to accept an embryo. Usually these treatments will take approximately two to three weeks and require five office visits for ultrasounds and blood tests.
Subsequently IVF and embryo transfer is done.
In successful cycles, the hormonal supplements are continued through the first trimester (12 weeks) of the pregnancy. Once the first trimester is completed and the placenta has matured to the point where it can provide for all the hormonal needs of the pregnancy, no further supplements are required. We will monitor blood levels of estrogen and progesterone at the end of the first trimester and taper off the hormone supplements gradually. Once the hormone supplements are stopped, the rest of the pregnancy is indistinguishable from any other pregnancy!
Multivitamins & Infertility
Nutrients that can help to support a healthy conception include:
- Antioxidants “ protect cells from damage by free radicals in environmental and other toxins
- Coenzyme (Q10) “ an important antioxidant and ˜energy nutrient within every cell
- Vitamin E “ an antioxidant that may promote circulation to the reproductive system, including to the placenta
- Vitamin C “ an antioxidant important within the ovary itself. As the developing egg needs vitamin C to mature and ovulate, more vitamin C is used up around the time of ovulation
- Mixed carotenoids “ Vitamin A (retinoid) is involved in creating DNA. In small amounts it is essential for healthy foetal development, particularly for the immune system and eyes. However, you should avoid taking too much Vitamin A
- Manganese “ involved in enzyme functions that have antioxidant effects and transfer genetic information
- Zinc “ one of the most important nutrients for a healthy reproductive system. Involved in sexual development, ovulation and the menstrual cycle
- Selenium “ an antioxidant that supports normal conception
- Omega-3 fatty acids “ improving omega-3 fatty acids ensures that a woman’s fat tissue stores retain a reserve of these fatty acids for the developing foetus, a healthy pregnancy and optimally fed newborn
- B-Vitamins “ Vitamin B12, B6 and folate are three B vitamins significant for the reproductive system
Frozen Embryo Transfer
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.
Storing frozen embryos
When you go through an IVF treatment cycle any excess embryos will be stored where they will be kept frozen in cryostorage until you decide to either use, donate or discard them.
How does embryo freezing work?
Embryos can be frozen from Day 2 (four cell stage) to Day 5 (Blastocyst). They are placed in thin plastic straws, sealed at both ends, and labelled with your name and identification number.
They then go into a freezing machine, where the temperature rapidly drops to -150° Celsius. The straws are then placed in goblets, and put into tanks filled with liquid nitrogen, which keeps the temperature at -196° Celsius.
Success rates with frozen embryos
many of our births, over many years, have come from the transfer of frozen and thawed embryos. On average the success rate is about 30%, but this mainly depends on the age of the woman’s eggs when the embryos are frozen.
So, if you were to freeze your embryos in your first IVF cycle at the age of 38, and then use them when you’re 42, your fertility chance will be relative to that of a 38-year-old woman rather than a 42-year-old.
What to do with any remaining embryos?
Once you feel that your family is complete, and you have no further personal use for your frozen embryos, you may decide to donate them to another couple who are unable to conceive with their own embryos. Your specialist can discuss all your options with you
Freezing embryos for fertility preservation
If you or your partner is undergoing fertility treatment for a serious illness or cancer you might consider freezing embryos for future pregnancy attempts.
Emotional Health, Counselling and Fertility Treatment
Few couples are prepared for the diagnosis of infertility, and for most, this will be one of the greatest challenges they face together. Fertility treatment can affect a couples work, family, relationship, social life and self-esteem.
Although everyone is different, there are some common questions that come up for many couples. Have you wondered about any of the following:
- How to deal with your friends who are getting pregnant and having babies?
- Who to tell and what to tell?
- How to fend off unwanted questions and/or comments?
- How to relieve tension?
- How to keep your relationship strong?
- How to deal with the workplace and frequent absences?
- How to find strength and strategies to keep going cycle after cycle?
It is strongly recommended that anyone undergoing fertility treatment attend at least one counselling session at the start of treatment. At our Centre, you have the opportunity to use a complimentary counselling session once during every stimulated cycle. You will find out more about the emotional processes involved in fertility treatment, realistic expectations of outcomes, both physical and emotional, and how to prepare for and manage the rollercoaster of emotions.
It is very common to fear that getting counselling means that there is something wrong with you or that it confirms a weakness and inability to handle treatment. But this is not the real scenario infertility helps you manage emotions, cope better with day to day stresses, whether these are related to treatment or not, and ultimately prevent long-term problems, such as depression or anxiety.
Overall, our goal is to help you gain a greater sense of control and reclaim life amidst treatment. It is therefore our role as Counsellors to help you identify which strategies would suit you the best. We become support person, educator, counsellor, therapist, mediator, and life coach.
ICSI (Intracytoplasmic Sperm Injection)
If you are diagnosed with male fertility problems, such as a low sperm count, previous history of vasectomy in male partner ,recurrent ivf failure then conventional IVF is unlikely to result in fertilisation. It is also done when sperms are not present in the semen and they have to be obtained surgically from testicles.This is when Intracytoplasmic Sperm Injection (ICSI treatment) is recommended. It is like IVF only the main difference is the technique we use to achieve fertilisation.
How is ICSI done ?
A single sperm is injected into each egg, using very fine micro-manipulation equipment. As the human egg is one tenth of a millimetre in diameter and the sperm 100 times smaller, this is a very delicate procedure performed by highly skilled embryologist under a micro-manipulator.
Is ICSI successful?
Together with IVF, ICSI is one of the most common techniques used in Assisted reproductive technology. Since it was introduced, it has led to the birth of many thousands of babies worldwide.
It suits women who are producing low levels of hormones for ovulation, or who are not ovulating at all. These females are given medication (as tablets or through injections) to stimulate there hormones.
How does Ovulation Induction work?
First, we’ll confirm your ovulation cycle by:
Taking blood samples to measure hormone levels at specific stages of the cycle,
Carrying out a transvaginal ultrasound to see the development of follicles in the ovaries, and the thickness and appearance of the lining of the womb.
The Ovulation Induction cycle
Day 1: (of your menstrual cycle) Call the clinic to arrange an appointment for a blood test.
Day 2-4: Start taking medication.
Day 10 or 11: Visit the clinic for a blood test to determine your hormone level. /an ultrasound.
Day 14: (approximate) Attend the clinic for an ultrasound test. This will determine if you are about to ovulate.
For women who don’t have a normal menstrual cycle, it may take some time to ovulate. In fact, it is not unusual for ovulation to occur much later in their cycle (after Day 14). You would then need to continue attending the clinic until you ovulate.
There are various treatments to treat ovulation disorders.
These medications may cause multiple follicle development, with the risk of multiple pregnancy. For this reason you need to undergo regular ultrasounds to determine the number and rate of growth of these follicles. If more than one follicle develops, your fertility specialist will discuss the risks of multifollicular ovulation.
The Trigger: After the follicle has developed we may use another injection of synthetic human chorionic gonadotropin (hCG) to trigger the release of the egg from the follicle.The fertile time is for 36 hours from the time of trigger.
IVF (In vitro fertilization)
In Vitro Fertilisation means Fertilisation “ in- glass that is fertilization outside the human body . It was initially developed for fertility in females who had blocked or unfunctional fallopian tubes. At present IVF is recommended to patients who are unable to conceive due to several other causes also.
We try to provide you with the utmost services :
Your initial consultation : It is an initial visit in which you open up with your doctor and know your doctor and the doctor knows you. A detailed history is taken of the couple.
Pretreatment preparation and planning management : This will include a detailed blood workup which will include your hormonal assays , a uterine assessment, semen analysis and other tests if required. We review the whole history and all the tests and then only a definitive management is planned for you.
Start of oral contraceptive pills : You will be put on oral contraceptive pills for a short span of two to four weeks if your cycle needs to be synchronized with that of an egg donor or surrogate . These help the ovaries to be cyst free and help in planning of your cycle.
Ovarian induction : The IVF cycle begins with ovarian stimulation with injectable hormones on a daily basis and serial ultrasound monitoring. A baseline ultrasound is done before starting the stimulation to assess egg production. The hormone levels will also be monitored . Once the follicles reach the optimal size , you are prepared for egg retrieval.
Visits : Prior to egg retrieval three to five visits are done in that IVF cycle.
Egg Maturation : An injection is given 34-36 hrs prior to egg retrieval.
Egg retrieval : It is a procedure done transvaginally under ultrasound guidance under short general anesthesia . You need to be six hrs. fasting prior to the procedure.A long thin needle is passed through the vagina in the ovary and the follicular fluid is aspirated .The follicular fluid is collected in test tubes under strict temperature control and immediately given to the embryologist in the embryology lab. The embryologist searches for the eggs .The eggs are rinsed counted and placed in an incubator . After few hrs , they are fertilized with the sperm either through IVF or through ICSI.
An anesthesiologist is there to give you pain relief and comfort during the procedure. Chances of injury during egg retrieval is extremely rare .Structures near the ovary such as bladder,bowel or blood vessels could possibly be damaged and may require further surgery. Minimal bleeding from ovaries might occur but the risk of transfusion is extremely rare. Infection during this procedure is also extremely rare. You will be discharged four hrs. after the procedure.
Embryo Assessment : During IVF embryos are assessed for 2-5 days in a temperature controlled incubator. The embryos are assessed and the day of transfer is determined between day 2-day 5 . We call you to update you about the embryos.
Embryo Transfer : Embryo is transferred back in the uterine cavity between day 2-day5 when it becomes multi celled /blastocyst . This requires no anesthesia and the female is happy to see her embryos being implanted in the cavity . We discuss the number of embryos and made and the number to be transferred so that you have the highest probability of success keeping in mind the risk of multiple birth associated with it. For embryo transfer you need to come on a full bladder and the procedure is done via an embryo catheter transferred vaginally under ultrasound guidance.
Pregnancy test : We schedule a pregnancy test 10-15 days after the transfer . If the first test is positive we repeat beta hcg repetitively every 48-72 hrs. and an obstetrical ultrasound is planned two weeks following the pregnancy test when we look for the no. of embryos and fetal cardiac activity.
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
A Holistic Approach To Fertility
We have various associations and provides a supportive, personal and holistic approach. The different therapies include yoga, meditation. Each offers a different method of help and can be used in conjunction to conventional and evidence-based treatments, providing many benefits as part of an integrated health plan.
Couples who combine their IVF treatment with these therapies frequently report they feel calmer, emotionally stronger, and more able to cope with the demands of the IVF regimen, and importantly, feel more hopeful about the outcome.
Research has examined the interplay between fertility and environmental and lifestyle factors as well as the impact of specific complementary therapies.
Herbal Medicine, Supplements and Naturopathy
Herbal medicines and supplements can increase fertility, however they can also interact with drugs you may have been prescribed if undergoing IVF treatment and if used incorrectly, they can interfere with your fertility and chances of success.
We work closely with expert Naturopaths who are highly experienced in this area.
Herbal medicines should only be used in between IVF cycles and discontinued at the beginning of an IVF cycle.
Physical benefits of complementary therapies:
A healthy diet along with exercise helps to build a strong foundation for pregnancy and improved fertility.
Complementary therapies such as acupuncture, herbal medicine, meditation and yoga can help regulate your menstrual cycle, improve fertility, vitality and boost ovulation.
Improved health before conception can help enhance the quality of sperm and egg, lower the rate of miscarriage and increase fertility.
Emotional benefits of complementary therapies:
Holistic care can be helpful in lowering your anxiety and dealing with emotional stress while also increasing the chances of conception.
We are here to support you!
You may experience intense feelings and stress at various times on your journey from initial contact right through to becoming a parent. We understand and our entire team is committed to supporting you and helping you to cope as effectively as possible.
We believe that Counselors can be an integral part of your journey providing additional one-on-one support when you need it.
Whether you need a little extra support as an individual or with your partner, We are always there for you.
We are all here to help guide you through your medical treatment, the uncertainty of the outcomes and can provide advice and assistance in dealing with family, friends, work and the fertile world during this time.
We believe in comprehensive care for the body, mind, emotions and spirit and will ensure you receive the best possible advice on the most appropriate complementary support for you.
Can Complementary Therapies support fertility?
Many people use complementary or alternative therapies to improve their overall physical and emotional health. This could include medicines, such as herbal, vitamin, mineral, homoeopathic, nutritional and other supplements, and therapies such as , chiropractic, naturopathy, osteopathy, acupuncture, homoeopathy, reflexology and aromatherapy.
There is limited evidence of the beneficial impact of complementary and alternative medicines and therapies on fertility. While improving your general health is clearly beneficial, we do not routinely recommend their use to improve your chance of conception.
If you would like to try alternative therapies while also seeking medical support for conception, it is important that you tell your doctor. While some complementary medicines may interfere with fertility treatments, acupuncture and vitamin supplements are generally not considered to be incompatible with treatments.
Egg freezing allows a woman to preserve her fertility until she is ready to start her family. During an egg-freezing cycle, a patient will go through many of the same steps that are involved in a typical IVF cycle: ovulation stimulation, ultrasound monitoring, and egg retrieval. After egg retrieval, the eggs will be cultured for a few hours and then frozen the same day for future use.
Embryo freezing is a technique that is recommended when high-quality embryos remain after embryo transfer. These embryos remain frozen until the patient is ready to use them. If patients have completed their families, they have the option to donate these frozen embryos to research, another couple, or training; the embryos can also be discarded.
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.
A miscarriage is generally characterized by the loss of a fetus before the passage of around one forty days of pregnancy. In medical terminology, a miscarriage is usually referred to as a spontaneous abortion, precisely because it happens spontaneously. According to studies, about 50% of all pregnancies end up in miscarriages and around 80% of miscarriages occur within the first three months of pregnancy. If they happen to occur after the passage of twenty weeks of gestation, they are normally termed as late miscarriages.
The most common cause of miscarriages is primarily due to the presence of some fatal or critical genetic problem in the unborn baby, which may or may not be in any way related to the mother. Apart from this, there is a host of other causes which are held responsible for miscarriages. These may include:
- Cervical insufficiency (weakness of the cervix)
- Hormonal imbalances
- Physical problems in the mother
- Medical problems in the mother
- Immune system responses
- Uterine abnormalities
Here are a few indicators of a miscarriage:
- Bleeding (which can vary from light to heavy bleeding)
- Abdominal pain
- Severe cramps
- Back pain
- Treatment of miscarriages normally involves three steps - a pelvic exam, an ultrasound test and blood tests to confirm whether or not it is a miscarriage.
- If the miscarriage is complete and yet the uterus is still not emptied of its contents, then it may be necessary for you to undergo a dilation and curettage operation.
- If you have gone through multiple miscarriages in the past, then the treatment will probably involve a pelvic ultrasound, a hysterosalpingogram or a hysteroscopy.
If you wish to discuss about any specific problem, you can consult a gynaecologist.
Pubic lice, also known as ‘crabs’, is a condition which occurs when certain parasitic insects are present in the genitals. These insects cause red spots to form on the vagina which result in itching. Crabs are also known to affect other parts of the body such as eyebrows, eyelashes and beards. This disease is extremely contagious in nature; it can be passed on from one person to another via sexual intercourse, hugging and kissing. In some cases, this condition can also be passed on from the parent to the child.
If you are affected by crabs then you will have itching and pain in the genitals. The saliva of the insect can cause allergic reactions on the skin, resulting in the itch. The itching tends to worsen at night. Bluish or red spots may appear on the affected area. The lice are usually around 2 cm long and can’t be spotted easily.
Contrary to popular belief, pubic lice or carbs are not caused by poor hygiene. This disease spreads via bodily contact with an infected person and they feed on human blood to survive. Lice usually spread via sexual intercourse which may be anal, vaginal or oral.
Treatment for pubic lice
Treatments for pubic lice involve shampoos, lotions and insecticide creams. Some of the treatments for pubic lice need to be applied locally while others require full body treatment. Apart from following the treatment procedures, you need to take preventive measures to prevent infestation. Avoid sharing personal items such as toiletries, as lice can spread through it. If you wish to discuss about any specific problem, you can consult a gynaecologist.
IVF (In vitro fertilization)
In Vitro Fertilisation means Fertilisation in- glass that is fertilization outside the human body. It was initially developed for fertility in females who had blocked or unfunctional fallopian tubes. At present IVF is recommended to patients who are unable to conceive due to several other causes also.
We at India IVF Clinic try to provide you with the utmost services:
- Your initial consultation
- Pretreatment preparation and planning management
- Start of oral contraceptive pills
- Ovarian induction
- Egg Maturation
- Embryo Assessment
- Egg retrieval
- Embryo Transfer
- Pregnancy test
During the first 20 weeks of pregnancy, 20 to 30% of women have vaginal bleeding. In about half of these women, the pregnancy ends in a miscarriage. If miscarriage does not occur immediately, problems later in the pregnancy are more likely. For example, the baby's birth weight may be low, or the baby may be born early (preterm birth), be born dead (stillbirth), or die during or shortly after birth. If bleeding is profuse, blood pressure may become dangerously low, resulting in shock.
The amount of bleeding can range from spots of blood to a massive amount. Passing large amounts of blood is always a concern, but spotting or mild bleeding may also indicate a serious disorder.
The most common cause is:
A miscarriage: There are different degrees of miscarriage (also called spontaneous abortion). A miscarriage may be possible or certain to occur (inevitable abortion). All of the contents of the uterus may be expelled or not (incomplete abortion). The contents of the uterus may be infected before, during, or after the miscarriage (septic abortion). The fetus may die in the uterus and remain there (missed abortion). Any type of miscarriage can cause vaginal bleeding during early pregnancy.
The most dangerous cause of vaginal bleeding is:
Rupture of an abnormally located (ectopic) pregnancy—one that is not in its usual place in the uterus—for example, one that is in a fallopian tube.
Another possibly dangerous but less common cause is rupture of a corpus luteum cyst. After an egg is released, the structure that released it (the corpus luteum) may fill with fluid or blood instead of breaking down and disappearing as it usually does. If an ectopic pregnancy or a corpus luteum cyst ruptures, bleeding may be profuse, leading to shock.
In pregnant women with vaginal bleeding during early pregnancy, the following symptoms are cause for concern:
- Fainting, light-headedness, or a racing heart—symptoms that suggest very low blood pressure
- Loss of large amounts of blood or blood that contains tissue or large clots
- Severe abdominal pain that worsens when the woman moves or changes positions
- Fever, chills, and a vaginal discharge that contains pus mixed with the blood
When to see a doctor:Women with warning signs should see a doctor immediately. Women without warning signs should see a doctor within 48 to 72 hours.
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.
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.