Book Clinic Appointment with Dr. Seema Jain
Treatment Of Erectile Dysfunction
Treatment Of Male Sexual Problems
Treatment of Infertility
In Vitro Fertilization (Ivf) Treatment
Treatment Of Female Sexual Problems
Intra-Uterine Insemination (IUI) Treatment
Urinary Incontinence (Ui) Treatment
Sperm Donor Program
Natural Cycle Ivf Treatment
Management of High-Risk Pregnancy
Artificial Insemination Treatment
Preimplantation Genetic Diagnosis (Pgd)
Egg Donation Procedure
Treating Disorders of The Unborn Child
Fertilisation In Vitro - Embryo Transfer (Ivf - Et
Intracytoplasmic Sperm Injection (Icsi) Procedure
Submit a review for Dr. Seema JainYour feedback matters!
Patient Review Highlights
I found the answers provided by the Dr. Seema Jain to be very helpful. Tnq
I am 35 and we are trying to conceive. Dr. have done some test which is as under. Tsh 0.903 Prolactin 12.06 Amh 1.32 Hsg normal Hsa normal PCT normal Now Dr. is asking to do follicular Monitoring. Medications. ovaries plus and folvite for 3 months Letroz 2.5 5 days from periods day 2. Is there any complications? To undergo so many tests and medicine Dr. now advised to do follicular Monitoring. What for? Can pregnancy not happen naturally? I had one miscarriage 1 Yr back. Sonography had shown no heartbeats at 8 weeks Am I going to correct Dr. or should change the Dr. Pls advise.
The ovaries are an important part of the female reproductive system. In a normal scenario, a woman has two ovaries that lie on either side of the uterus. Their main function is to produce eggs and release them into the fallopian tubes. These eggs then travel to the uterus where they may be fertilized. The ovaries are also responsible for the release of estrogen and progesterone. These hormones help regulate the menstrual cycle.
The functioning of the ovaries is directly related to a woman’s age. When a girl is born her ovaries have approximately 2 million eggs. These are in the form of follicles. By the time she reaches puberty, this number would have reduced to around 400,000. It is believed that a woman releases only around 450 eggs during her entire reproductive period. This is less than 1% of the eggs she was born with. During each menstrual cycle, one of the follicles will mature into an egg and be released. At the same time, some follicles may die. Thus, as a woman ages, the number of eggs available reduces. By her 30th birthday, the rate at which eggs are lost increases. By her 40th birthday, a woman’s eggs will die rapidly. Without a healthy egg being released sperm cells will have nothing to fertilize. Thus, ovarian functioning decreases as a woman grows older. This implies that the risk of infertility also increases as a woman grows older.
Along with a decrease in the number of eggs available the quality of eggs also reduces with age. Thus, though the ovaries may release an egg even when a woman is in her 40s, the chance of these eggs being fertilized is very low. Even if the egg is fertilized, women who conceive a child after the age of 40 have a high risk of miscarriage. There is no direct way to assess the quality of a woman’s eggs but some tests may help indicate the chances of getting pregnant. This includes a Basal FSH to indicate the level of follicle stimulating hormones, tests to determine the amount of Estradiol and tests to determine ovarian reserve. Ultrasounds can also help assess the number of follicles in the ovaries. This test is known as an Antral Follicle Count.
Infertility caused by decreased functioning of the ovaries is usually termed as unexplained infertility. In such cases, IVF is often the most preferred form of treatment.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Pregnancy is something, which is quite divisive. The mere prospect of it can really go a long way in scaring people. At the same time, for some others, giving birth to a baby can be the primary cause for a lot of happiness. When a couple is having trouble conceiving, infertility is usually the reason why there is a relationship strain between the two of them. Considering this, doesn’t it make sense to learn a bit about infertility and the truth to all that is said about it so as to separate the wheat from the chafe?
To start with, it is often said that when there is an infertility issue, it is probably due to the lack of fertility of the woman rather than the man. However, this is pretty untrue. It has been found that both men and women are responsible for infertility almost equally. In fact, according to a study, in about a fifth of the cases of infertility, the reason for it was that both the man and the woman were not fertile.
Many people say that, if a woman wishes to have a baby, she should do so before she crosses the age of 35. This is true to some extent as the chances of a woman conceiving do fall to a significant extent after the age of 35. As a matter of fact, a woman can expect to reach the peak of her fertility while she is in her twenties, itself!
Without a shadow of doubt, having sex around the time of ovulation is the key to getting pregnant. However, it is believed by a large number of people that there is no chance of getting pregnant if sex is had too soon or too late after ovulation as sperms only live for a few hours after an intercourse. The truth is that the sperms have the ability to live for several days.
When planning to conceive, many women believe that for about a quarter of a year or three months after they stop making use of the birth control pill, they will not be able to get pregnant. The good news for them is that as soon as the pill is stopped, the levels of a woman’s hormones return back to their pre-pill levels almost immediately and ovulation can be expected to occur at the time of their following cycle.
In case you have a concern or query you can always consult an expert & get answers to your questions!
There can be a number of reasons that lead to infertility in women. Endometriosis is one of them. It is a benign condition where the endometrium, which includes the tissues that form the lining inside the uterus, grows outside the uterus. Apart from infertility, it may also cause pelvic pain in women.
There are no such symptoms of endometriosis apart from pelvic pain and it cannot be detected without surgery. Thus, it is very difficult to diagnose this disease and state how common it is. However, research says that the prevalence of this disease in women in their reproductive age is between 3 to 10 per cent.
It is found that endometriosis sometimes leads to infertility. Here is how:
Abdominal Adhesions and Infertility
Normally, the endometriosis implants develop in the abdomen. Then the body surrounds them with connective tissues. The reason for doing so is isolating the implants, so that they cannot harm your body.
Now, sometimes these adhesions can create a blockage in the opening of the fallopian tube or may also pinch off the fallopian tube. This will result in obstruction in the fertilisation of egg and the sperm and thus fertilization will not take place; so there are no chances of conceiving. These obstructions when diagnosed can be treated with surgery.
Secretions from implants
Endometrium plays a vital role in conception where the tissues secrete a wide variety of hormones and nutrients. Now, the endometrial implant also functions in the same way and secretes those hormones. The difference is that it does not deposit them in the lumen of the womb, and it is released in the abdominal cavity. In these substances, there may be some hormones that are responsible for infertility.
Prostaglandins are other hormones that are secreted by the endometrium normally. It helps in a lot of body processes that include various stages of menstrual cycle and pregnancy.
This hormone is required for a lot of functions such as ovulation, sperm mobility, and regression of corpus luteum, immune interaction, menstrual cramps and contraction of the uterus at birth.
Just like the endometrium, the implants also secrete these hormones. And the problem that is caused by the implant secreted prostaglandin hormone is that they are released in the abdomen and not in the womb. Moreover, they are not secreted at the right time, thus sending a wrong message to the brain.
A woman with a few days of pregnancy may face a miscarriage because the ovary will get a signal to start the menstrual cycle, and the womb lining where the egg is implanted will be expelled.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Infertility can be defined as the inability to get pregnant despite having unprotected sex for more than a year. Infertility can affect both men and women. There are many causes for this. Tubal infertility or infertility caused by blocked or scarred fallopian tubes accounts for around 25% of female infertility. Blockage in the fallopian tubes could also increase the risk of ectopic pregnancies.
The fallopian tubes connect the ovaries to the uterus. When an egg is released by the ovaries, it must travel through the fallopian tubes to reach the uterus. If the egg does not reach the uterus, it cannot be fertilized. There may be many causes for scarring of the fallopian tubes or blockage of the same. Some of the common causes are:
Infertility may be said to be caused by irregularities in the fallopian tubes if no other cause of infertility is found in standard infertility tests. To confirm this diagnosis, a hysterosalpingogram may be conducted. For this test, a dye is injected into the uterine cavity through the cervix. An X-ray is then used to follow the flow of this dye through the fallopian tubes into the abdominal cavity. However, this test does not indicate if the fallopian tubes are scarred. A laparoscopy may also be performed to detect the extent of scarring and damage within the fallopian tubes. In extremely rare cases, tubal catheterization may also be performed to assess the states of the mucus lining the fallopian tubes.
Tubal infertility can be treated in two ways; surgery to treat the fallopian tube scarring or clear blockage and IVF or In Vitro Fertilization. Surgical treatment for tubal infertility depends on the extent of the damage. In the case of scarred fallopian tubes, the scar tissue may be resectioned with lysis of adhesions. In case of blocked fallopian tubes, surgery aims at clearing the blockage so as to reopen the tubes. In some cases, reconstruction of the tubes may also be required.
IVF involves harvesting the eggs from the woman and introducing them to sperm cells in a laboratory. 3-5 fertilized zygotes will then be reintroduced to the woman’s womb. IVF has a much higher success rate as compared to tubal surgery. However, it involves the use of hormone medications and hence is usually considered a last resort. The IVF process can be repeated multiple times in case the pregnancy does not reach full term.
INVO (intravaginal culture of oocytes), also called IVC (Intravaginal culture) is an abetted procedure of reproduction where early embryo development and oocyte fertilization are carried out inside a gas penetrable, air-free plastic tool or device that is placed into the maternal vaginal chamber for incubation. It is a device that helps the future mothers to participate in the evolution and growth of their own embryos present inside their body. The device is composed of an inner cavity with a protective outer rigid shell and a rotating valve.
It can be used for IVF (In Vitro Fertilization) cycles; whether with the mother's own eggs or any donor's eggs. It provides the same successful results as conventional treatments. It works in a very simple way:- when the requisite samples to produce embryos have been acquired or when the eggs have been impregnated in the laboratory, they together with culture medium are placed into the INVOcell device and then the device is inserted into the vagina of the mother and there it is kept for two to three days (for 72 hours culture period). Throughout this time, the mother can lead a practically normal life but she needs to elude taking bath, having intercourse or flying during those days on which she is wearing it.
When fertilisation takes place, it will be the mother's own heat which will supply the best conditions for the proper development of the embryos. Once they are set and ready, the doctor will remove the INVO from the mother's vagina to recover the embryos. The embryos are then evaluated under the microscope to choose the healthiest-looking ones to transfer them into the uterus. Within the uterus they will be embedded in order to begin developing.
Advantages of INVO are:
- It is one of the most cost-effective assisted conception treatments.
- In this method, the embryo incubation is more natural.
- Since in this whole process embryo incubation in the laboratory isn’t required, the possibility of stumbling at the laboratory is diminished.
- In this method, the couple experiencing the treatment is involved more.
- This method has similar efficacy as the IVF treatments.
Disadvantages of INVO are:
- Since the device has to remain for three days in the mother's vagina, it causes some discomfort.
- The patient has to spend much time in the assisted reproduction clinic and visit it more often.
The studies suggest that it could be a usable alternative choice for assisted reproduction.
Almost every man and woman craves to have a child they can call their own. This makes an inability to procreate one of the most dreaded situations. Infertility can be defined as the inability to conceive a child within 12 months of biologically appropriately timed intercourse. Infertility exacts a huge psychological toll on the person.
Infertility often triggers depression in a person. This may be acute and result from specific events such as the holidays, family celebrations of the news of a someone else having conceived a child or could be cyclic and coincide with phases of their fertility cycle. This depression could lead to problems at work and communication with the spouse.
Infertility can also make a person feel helpless and affect their self esteem. Infertility accompanied by depression can trigger the feeling of having lost control over one’s life and can make people withdraw into themselves.
An infertile person may also often feel guilty and make them blame themselves and their prior actions for the condition. This leads them to question their worthiness of being a good spouse and potential parent. A woman who has suffered from an STD earlier or has undergone an abortion earlier can become obsessed with blaming herself for being infertile.
This affects their daily lives and ability to work. An infertile person may also feel guilty for having robbed their partner of the chance to become a parent. This can put a strain on their relationship and in many cases lead to a broken marriage.
When they find themselves unable to conceive a child, a couple may try to time their intercourse with ovulation tools, such as an ovulation thermometer etc. and may try different positions, some of which may be fairly uncomfortable. They may also end up having intercourse more often than desired. In order to prevent sperm from leaking out of the vagina, a woman may also find herself lying in an awkward supine position after intercourse. A combination of all these factors makes the act a chore and with time can lead to a loss of libido.
Infertility can also trigger anger against life for having been treated unfairly or towards other parents. This may also be displaced towards their family and friends leading to situations where they feel ostracized and unsupported.
When dealing with infertility, it is important to understand that neither partner is to blame. Infertility is a physiological condition and can be treated in most cases.
Almost all women with the ability to reproduce develop ovarian cysts at some point or the other but not all of them suffer from PCOS or have infertility issues. PCOS affects only around 10% of women of reproductive age. It is important to note the PCOS or Polycystic Ovarian Syndrome does not cause cysts but leads to the development of follicles. This causes a hormonal imbalance. The results of this hormonal imbalance can be noted in many ways including infertility.
- Infertility can be described as the inability to conceive and reach full term despite having unprotected intercourse at the right time of a woman’s menstrual cycle for over a year. One of the main ways in which PCOS interferes with fertility is by disturbing the natural ovulation cycle. Normally, a woman ovulates once a month. At this time an egg is released by either one of the ovaries. As a result of PCOS, these eggs are not released. This is because the ovaries of a woman suffering from PCOS are much larger than normal and have a number of small antral follicles that do not allow the egg to mature. Without an egg, sperm cells have nothing to fertilize and hence a woman cannot conceive. PCOS also causes irregular menstrual cycles. This makes it difficult to determine the period of ovulation.
- PCOS can be managed with medication but there is no cure for this condition. Thankfully, infertility caused by PCOS can be treated and these women can have healthy pregnancies. For this, you will need to consult a fertility specialist. There are two forms of medication to treat infertility caused by PCOS. Birth control pills, with a combination of synthetic estrogen and progestin, can help regulate the menstrual cycle. In some cases, a doctor may prescribe progestin-only pills. These pills need to be taken daily for two weeks for up to 2 months. Medication may also be prescribed to stimulate ovulation. This medication may be the form of pills or injections.
- Lifestyle changes can also help improve your fertility. For example, being overweight or obese can aggravate hormonal imbalances. With a healthy diet and regular exercise, you should be able to reduce your weight. This, in turn, can make menstrual cycles more regular. In addition, you should quit smoking, meditate and reduce your exposure to stress and pollution. This makes your body healthier and increases your chances of conceiving a baby.
They say you need to have intercourse only once to get pregnant. However, this isn’t always the case. Many couples struggle for months and years trying to conceive a baby. The inability to get pregnant despite having unprotected sexual intercourse for over a year is defined as infertility. Infertility in women may be caused by a number of factors. This includes PCOS, ovulation disorders, side effects of medication, radiation etc.
However, in some cases, the cause of infertility may be difficult to pinpoint. In such cases, the patient may be diagnosed with unexplained infertility.
- Unexplained infertility can be very frustrating as all your and your partner’s test results are normal. However, it is important to remember that modern medicine can only test for certain fertility factors. For example, there is no way to test the quality of an egg being released by the ovaries. Some of the other probable causes for unexplained infertility include nutritional deficiencies, low levels of cervical mucus, thyroid issues, hormonal imbalances, long-term use of medication etc.
- Unexplained infertility is common amongst all infertility cases. In fact, according to some studies, it accounts for almost 50% of all infertility cases. Certain factors can increase the risk of unexplained infertility. Women over the age of 35 years are more susceptible to this type of infertility. Mild endometriosis could also contribute towards this condition. Stress is another factor that could influence unexplained infertility. In the case of unexplained infertility, conceiving a baby without treatment has a very low probability.
- IVF or In Vitro Fertilization is the most common form of treatment for this type of infertility. Hormone treatment is the first stage of IVF. This causes the ovaries to produce multiple eggs instead of one egg. This medication is given in the form of injections. Just before these eggs are released from the ovaries, your doctor will harvest them. At the same time, the sperm will be collected from the male partner. These sperm cells will then be introduced to the harvested eggs in a laboratory so that the eggs may be fertilized. The fertilized eggs may be kept under observation for up to 5 days. Once the embryos are ready, one or more embryos will be transferred to the woman’s uterus. In most cases, up to three embryos are implanted. When it comes to unexplained infertility, IVF has a relatively high success rate. In case the IVF is not successful, you may choose to restart the process. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
Aye Zindagi, Gale Lagale
or a couple trying to conceive, it feels punishing to accept the fact that they may not be able to conceive naturally. But then, it’s just going to be a bit difficult, not impossible! With the help of technology and various refinements in the existing treatment protocols, most of the fertility problems are treatable with high success rates.
Which factors will help decide my treatment?
Age of both partners
Duration of Infertility
Condition causing Infertility
Your own choices
A thorough analysis of the above factors along with medical examination and testing is followed by a course of medical action best suited for you.
I want to know about the available treatments?
Due to the technological advancements in the field of medical science, infertility, to a large extent, is treatable. So do not push yourself to the edge of frustration, patience is the key. Once your physical and mental wellbeing is ensured, you may be subjected to fertility treatment of help you out. Let us introduce you to some of the fertility treatments available -
In Vitro Fertilisation
Third Party Reproduction
Will I be directly subjected to IVF / ICSI?
o. Not necessarily. Two of the most important deciding factors for the treatment options are the age of the woman and the cause and duration of infertility. Women with ovulation problems or unexplained infertility will usually conceive with treatment options like Ovulation Induction with or without artificial insemination. You may check on to the Fertility Management Ladder for more information. Women with poor ovulation reserve, blocked fallopian tube & cases of severe male infertility may be recommended to directly go for IVF / ICSI. Click to know more.
he creation of a baby usually involves a male & a female partner. In cases, where two of you are not enough (or in some rare cases where your doctor recommends), involvement of a third person in the form of a donor (egg, sperm or embryo) or a surrogate (wherein a baby is grown in other woman’s womb) maybe required.
Depending upon your exact fertility situation, you will be offered the most optimal method to help you out. Do not drive yourself towards negativity. Half the solution to any problem lies in defining it. Stick to positivity and things shall change in your favour. We are here to assist you through your difficulties. We will try and make sure that life embraces you by bringing a healthy and smiling baby in your arms!!!
If you want to discuss any other problem, Consult IVF Specialist.