Doctor in Indira IVF - Vashi
Patient Review Highlights
In vitro fertilization (IVF) includes empowering the woman with medicines, taking various eggs from her ovaries, fertilizing them with her partner’s sperm, and inserting a portion of the subsequent embryos into her uterus with the trust that one will form into a fetus.
Tubal ligation reversal, on the other hand, requires a laparotomy, which needs a much bigger entry point on the abdomen, usually around four to six fingers long. Since the skin, each of the muscles, and different tissues of the stomach must be sliced through, there is extensively more uneasiness and a longer recovery time required after the surgery, when compared with a laparoscopic surgery, for example, with a tubal ligation.
- Sperm quality: The male partner needs a sperm test before basic procedures of either of the two. In case that the sperm quality is great, then the couple could consider proceeding. In case that the sperm quality is poor, in vitro treatment is the better alternative. With IVF, poor sperm quality is effectively overcome.
- Tubal status: The length of the remaining tubal stumps after tubal ligation is an important aspect. The more extended the two remaining stumps are on each side, the better and more effective is the pregnancy. The shorter the stumps, the lower are the odds for pregnancy.
- Status of other pelvic conditions: Pelvic endometriosis or any scar tissue in the range of the tubes or ovaries would diminish the chance for accomplishment after tubal ligation reversal. Although, IVF pregnancy achievement rates are usually not influenced by these conditions. Along these lines, in vitro fertilization is most likely a superior alternative in women with noteworthy endometriosis or pelvic scar tissue.
- Female age: Chances for pregnancy with either tubal ligation or IVF decrease in the mid to late thirties and significantly reduce at the age of thirty-eight. By age forty-three or forty-four, not many women will have the capacity to have a baby using either approach.
- Egg amount and quality: A few women have a decrease in either egg amount or quality prior in life than anticipated. In this manner, the woman’s ovarian capacity needs to be tested before a choice is made in regards to whether to continue with either tubal ligation or in-vitro fertilization. AMH levels, ovarian antral follicle number, and day 3 FSH levels are generally done to evaluate ovarian capacity or hold.
- Doctor intervention: The greatest favorable position of tubal ligation reversal over IVF is that once the woman has experienced the surgery she ideally will not require any medication through the doctor, for example, medications or systems, keeping in mind the end goal to get pregnant.
One of the major milestones in a woman’s life is the entry into motherhood. For most women, when this does not happen in the natural logical sequence of things, there is anxiety and lot of pressure from family and friends.
However, with advancements now, there are options like intrauterine insemination and in vitro fertilisation (IUI and IVF) available, which can help increase the chances of conception and pregnancy. IVF is where the egg is retrieved from the woman’s womb, fertilised externally and then transplanted back into the uterus where it grows to full term. However, there are always unanswered questions like how long to wait before going for IVF, is it the right procedure for me, etc.
Read on to know to find answers to some of these.
- Maternal age: As a woman reaches 35 and a man reaches 40, the fertility rates drop significantly. The chances that a woman at 35 will conceive is about 20%, which goes down to 5% if the woman is 40. However, this rate can be significantly increased by using IVF. The quality of the egg would gradually deteriorate, and so if a woman is nearing 40, it is better to consider IVF as the ovarian reserve would be optimal with IVF.
- Failed intrauterine insemination: In couples who have problems with the sperm reaching the uterus, intrauterine insemination (IUI) is first attempted. However, if 3 or more attempts of fail, it is time to consider IVF.
- Duration of inability to conceive: While some couples conceive quite promptly in a month or two, most take about 6 to 8 months of unprotected sex to conceive. Therefore, IVF can be an option if you are failing to conceive even after a year. Less than a year, don’t fret. Take it easy and it might just do the trick.
- Medical health: Both the partner’s medical health should be taken into account. Lifestyle changes like smoking, alcohol abuse, drug abuse should be considered, which can account for poor sexual performance and therefore lead to an inability to conceive. Health conditions like diabetes and heart disease can also lead to infertility. Hypothyroidism in women is another thing that must be ruled out, as it often leads to an inability to conceive.
- Sexual problems with the partner: One of the first things to do before going for IVF is to check that the male does not have any issues. Be it erection issues or ejaculation issues or sperm issues, they need to be ruled out. Sperm quality, quantity, and motility have to be analysed, and if they are optimal, IVF can be considered.
In case you have a concern or query you can always consult an expert & get answers to your questions!
It is as important for the man as it is for the woman to undergo certain tests before the IVF cycle is started. Fertility is not only an issue for a woman, but it also might be for the man in question. There are certain tests that need to be conducted on men before they can gear up for IVF:
1. Semen Analysis: One of the most important tests for male infertility is semen analysis. Sometimes, a man may be completely healthy, but his sperm production could be of poor quality. Semen analysis is done to provide an accurate evaluation of sperm number, the ability to move (motility), size and shape (morphology), as well as the consistency and volume of the sample collected.
2. Binding Test: Sometimes agglutination occurs where the sperms might stick to each other by their heads or tails. Sperm antibodies might cause this problem. The IVF treatment's success might be compromised if this happens. A simple binding test is done to determine this.
3. Trial Wash: This is also known as sperm wash. It is mostly done to remove chemicals from the sperm. Not doing a sperm wash might end up affecting the later stages of the IVF treatment. In this process, the misshapen and immotile sperm is separated so a clean sample of motile and healthy sperm can be collected.
4. TUNEL Assay: Since sperms build up about half of a child's genetic makeup, a TUNEL Assay or 'sperm DNA test' is required. This test is done to measure the sperm population that have fragmented DNA. Negative impacts on genetics can hamper the success of the fertility treatment.
TUNEL Assay is usually recommended to men with:
- Leukocytes detected by the sperm analysis
- Age approaching 50
- A history of diabetes II type or prostatitis
- Exposure to chemicals or prolonged heat at workplaces
5. Screening for Infectious Diseases: This test is done for both the partners to check for diseases like AIDS, Hepatitis C, and so on. In case you have a concern or query you can always consult an expert & get answers to your questions!
Ovarian cysts are a common development in many women. Cysts are sacs filled with fluid which are formed in the female ovaries. Most cysts are harmless and do not even show any symptoms. However, some cysts do show outward symptoms like heavy bleeding, clotting, nausea, vomiting, stomach pain during the menstrual cycle, and pain during sex.
If you feel any of the above-mentioned discomforts, it will be in your best interest to book an appointment with your gynaecologist and get a check-up done. Most cysts are manageable unless they are very severe. In fact, it is best that cysts come to light at the right time and are efficiently managed, unless they develop into severe issues in the future.
Management of cysts
- Oftentimes, medical practitioners resort to what is called ‘watchful waiting’.
- At times, ovarian cysts disappear in a few months.
- It is recommended to take a blood test and an ultrasound to see the progress of the cyst.
- If you have already experienced menopause, then these tests are carried out every four months. This is because in such cases the risk of an ovarian cancer is at its highest and regular monitoring of the cyst is necessary.
Treatment of cysts
Ovarian cysts can be treated in their earlier stages. Here are some of the most popular treatments.
- Laparoscopy is one of the most popular treatments. It is a surgery carried out under general anaesthesia. The tummy is cut to a radius of a key hole and a laparoscope is inserted. This helps the doctor to see the internal organs, which is then used to remove the cyst. This method is less painful and has a quick recovery time.
- Laparotomy is the other method used for removing a cyst. In case the cyst is large, then one single large hole is made in the body to access the cyst. At times, the cyst and the ovaries are removed and sent for further laboratory inspection. This inspection is done to detect whether the samples are cancerous or not. This procedure is more complex than the previous one and might need the patient to stay in the hospital for a few days.
- In case you have a cancerous cyst, then your reproductive part itself would have to be removed rendering you barren for your life.
Ovarian cyst is very much treatable and is best to be detected at an earlier stage for better and faster treatment. Thus, it is best to go for regular check-ups and report in case of any disturbing symptoms. In case you have a concern or query you can always consult an expert & get answers to your questions!
PGS or Pre-implantation Genetic Screening is a test conducted to decipher the chromosome count of the embryo. Today, if you are planning to get pregnant or using alternative technologies for pregnancy; there are several tests that need to be conducted so that the child is born healthy and stable. One such test is the PGS, it determines whether or not the count of chromosomes is normal, which is forty six, is present in the embryo. If there are abnormal numbers of chromosomes present in the embryo then it might lead to additional problems in the future. In such cases, special treatments and procedures are conducted.
There are several advantages of PGS. Some of them are highlighted in details below.
- Healthy pregnancy: Interestingly, a man can produce sperms throughout his lifetime. But a woman is born with the eggs already created. The chances of producing a healthy baby with those eggs decrease as the age of the woman increases. It is seen that those women who think of delivering a child in their older ages are often found with chromosome deficiencies in the embryo. Thus, to avoid such a situation, it is best to perform PGS.
- Reduces the chance of miscarriage: Pregnancies which occur without having performed any prior tests like the PGS have high chances of resulting into a miscarriage at the slightest of carelessness. But research has found that those pregnancies which take place after considering the chromosomal health of the embryo have reduced the risk of being abnormally terminated.
- Time reduction between two IVF Circles: For those who do not know IVF stands for In-Vitro Fertilisation. It is a process which aids a woman in becoming pregnant. It is often opted by those who are having issues in naturally conceiving a child. PGS here plays an important role. If the test detects abnormal embryo, then the next IVF circle can be started right away without wasting any time. But if the PGS detects a normal embryo then the IVF circle is deemed to be successful and the woman can continue with the pregnancy.
Thus, these are some of the main advantages of Pre-Implantation Genetic Screening. This helps to determine whether the embryo is of the desired choice or not and whether the baby born out of it would be healthy and normal. It is one of the tests which need to be conducted preceding implantation to provide better results after the implantation process is carried out. In case you have a concern or query you can always consult an expert & get answers to your questions!
In case you have a diseased uterus, which makes you infertile, you can undergo a procedure known as uterus transplant or uterine transplant to get pregnant. In the process of sexual reproduction, a diseased uterus does not allow embryonic implantation. This factor is referred to as uterine factor infertility or UFI. As a result, you will not be able to get pregnant.
Who requires a uterus transplant?
This procedure involves women who have UFI and women who had their uterus removed by hysterectomy. Women who have a damaged uterus on account of an injury or infection, which does not function anymore, can also undergo a uterus transplant procedure. Women from the age of 21 to 45 are eligible for this procedure. Many women are born without having a uterus. This condition is called Mayer-Rokitansky-Küster-Hauser syndrome.
Uterus transplantation begins with undertaking a uterus retrieval surgery on the uterus donor. The uterus, which is recovered has to be stored and transported to the location of the patient undergoing the transplant. An ischemic tolerance may last over 24 hours. Three major surgeries have to be carried out with the recipient. Firstly, a transplantation surgery is required in which the donor’s uterus gets transplanted. In case pregnancy develops, a caesarean section surgery has to be performed. The patient is given immune suppressive therapy. After childbirth, a hysterectomy is done in order to terminate the immune suppressive therapy.
Will the women be able to get pregnant after having sex?
Women receiving a uterus transplant will not be capable of becoming pregnant without undergoing fertility treatments. The transplanted uterus is not connected with the fallopian tubes, which is the location of the normal fertilisation process. The women will require to carry out IVF or in vitro fertilisation to become pregnant after a uterus transplant. IVF is a process in which the eggs are removed from the ovaries and get fertilised in a laboratory. Then, they are implanted in the uterus. After undergoing the uterus transplant procedure, a woman has to wait for a period of one year. The uterus requires time for healing and after recovery, the embryo may be implanted for pregnancy. After giving birth successfully, a woman will be able to keep the transplanted uterus.
She has the option to get pregnant again. However, after giving birth twice, a hysterectomy must be carried out for the removal of the uterus. This is done so that the woman can stop using the immune suppressant drugs, which are associated with major risks. Uterus transplant is a relatively new technology. In October 2014, the first healthy baby was born to a woman who had undergone a uterus transplant. This surgery is kind of experimental in nature and is usually the last option for getting pregnant.
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. In case you have a concern or query you can always consult an expert & get answers to your questions!
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.
Here’s the short version of the steps involved in an IVF treatment cycle:
- 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.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Women are not really sure about frozen embryos’ ability to result in pregnancy. Ironically, the success of Frozen Embryo Transfer has dramatically improved over the last few years. In the days gone by, the chance of women getting pregnant through the use of frozen embryos seemed to be on the lower side compared to that from the transfer of fresh embryos. Recent data related to this suggests that this is no longer the case.
Reasons behind the low success rate of frozen embryo transfer in the past
Previously during the frozen embryo transfer process, the embryos which had to get frozen were the ones that did not get chosen for the fresh embryo transfer initially. The reason being that the embryologist had gone ahead to choose the best possible embryos for getting them transferred initially. As far as the fresh embryo transfer is concerned, quality of embryo has got a major effect on the chance of a woman getting pregnant. On the other hand, if quality of embryos frozen is not good, the rate of survival after it gets thawed along with the rate of pregnancy would be on the lower side.
The second important reason is the amount of embryos that got transferred. Let us consider a couple who produce four very good quality embryos. Two of them are transferred during fresh In Vitro Fertilization Process and the remaining two are frozen. This leads to pregnancy and the woman gives birth to a baby. Later on, the couple once again decides to go for pregnancy by using the frozen embryos. Though only one embryo survives after getting thawed. The frozen embryo transfer is that of a single embryo. The success rate of a frozen embryo transfer through a single embryo is always going to be on the lower side than what it will be when multiple embryo transfer is involved.
Finally the method of freezing embryos has seen a sea change quite a number of years ago. Nowadays the freezing of embryos takes place by a fast method, known as vitrification. This process has got a much better survival rate when embryos get thawed along with good rates of pregnancy when those particular embryos are transferred in a much better manner.
Studies about high success rate of frozen embryo transfer
There have been studies performed in women, who have had quite a vigorous stimulation of their ovaries and were considered to be at high risk for Ovarian Hyperstimulation Syndrome. The physicians took the decision of skipping the process of embryo transfer and instead go ahead to freeze all the embryos for use at a later stage.
This tends to significantly decrease the risk of having serious Ovarian Hyperstimulation Syndrome along with decrease in complications. Other cases involved, physicians deciding to move on with a fresh embryo transfer depite the risk of Ovarian Hyperstimulation Syndrome. In both the scenarios the couples have quite a large number of embryos and the embryos selected for transfer were the best embryos.
The studies have shown no difference in the rates of pregnancy between fresh or frozen embryos or for that matter higher rate of pregnancy with frozen embryos. In case you have a concern or query you can always consult an expert & get answers to your questions!
Pregnancy loss could be devastating. Not only does it affect a woman mentally, but it also often takes a huge toll on her confidence. Post miscarriage trauma is a common phenomenon in this case. The range of emotion a woman might go through include denial, guilt, anger, depression, envy and yearning. Although the process of grieving takes a lot of time, the first step towards post miscarriage trauma is to accept the inevitable and move on.
Here is a list of tips that will greatly help a woman to cope up with the loss:
- Take time: While listening to friends and family seems to be the best course of action around this time, your loved ones need not get priorities at this time. If you believe that clearing your baby’s belongings is causing pain to you, take the time to prepare yourself. Clear away the stuff only when you are emotionally ready to do so.
- Create memories: While a lot of people suggest to completely get rid of all the memories that are attached to the baby, it may not be a great thing to do. Studies have shown that creating a memory about your loss helps to heal faster. So go ahead and take a picture with your baby, plant a tree, take a footprint or christen the baby. Good memories attached to your baby will not haunt you about the loss.
- Take care: Do not neglect your personal health and well-being. Eat well, take enough rest, quit smoking and drinking and seek pleasure in your loved one's company. The more you embrace life, better are your chances to get back to the grooves. Following an old hobby or working out one hour per day goes a long way in the process of healing.
- Get your partner’s help: Being open about your emotions is a good thing to do. Express your feelings about the baby to your partner. The process of coping up can be entirely different from each other. What matters is to let each other’s feelings known. Your partner’s broad shoulder is your best bet to come out of your loss.
- Set the expectations right: Women often get cranky and irritated after a miscarriage. Speak to your loved ones and let them know about your feelings. This will help you to get your loved ones support you and let you heal quickly from your loss.
- Support group: It is very comforting to share your feelings with people who have already experienced the kind of loss you have faced. Sharing in person can reduce your pain a great deal. A spiritual healer or a professional psychiatrist can also play a crucial role in your recovery.
In case you have a concern or query you can always consult an expert & get answers to your questions!