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In Vitro Fertilization (IVF) Health Feed

Low Ovarian Reserve - How Can IVF Help?

Neha Lad 85% (20 ratings)
MBBS Bachelor of Medicine and Bachelor of Surgery, MD - Obstetrtics & Gynaecology
IVF Specialist, Nashik
Low Ovarian Reserve - How Can IVF Help?

The available eggs in the ovaries at a time are collectively called an ovarian reserve. Low reserve happens when the production of eggs reduces. This affects the chances of pregnancy. The general cause of low reserves can be aging ovaries. In such cases, the ovary may be healthy and functioning even if the reserve is low. Production of eggs lower as a woman ages. A woman starts with 250,00 to 500,000 eggs at puberty and ends up with 1000 eggs at menopause.

Causes:
Low reserves are caused by

  1. Production of eggs decreases: Chromosomal abnormalities like Turner syndrome (lack of two X chromosomes) and genetic anomalies like Fragile X can decrease egg production.
  2. Ovarian tissue damage: Rough torsion, endometriosis triggered ovarian cysts, malignant or benign tumours, surgical removal of ovary or any other part of it, chemotherapy or radiation, pelvic adhesions, immunological problems or high BMI (Body Mass Index) can destroy the ovarian tissues.

IVF Protocols:
If a woman has low ovarian reserves, then she will be put on the either of the following protocols:

  1. Short GnRHa Flare: Gonadotrophin releasing-hormone-agonist (GnRHa) like Lupron, Nafarelin, Synarel or Buserelin is administered. This therapy is initiated at the onset of menstruation. The goal of the treatment is to stimulate the release of the follicular stimulating hormone (FSH) which augments the ovarian follicular growth.
  2. Combined Clomiphene or Gonadotrophin/Letrozole Stimulation: Older women are mostly administered this protocol. But it is strongly advised not to, as this protocol can potentially harm the egg or the embryo.
  3. Mid-follicular GnRH-antagonist protocol: Once the GnRHa-agonist protocol is commenced, the GnRH-antagonist is given several days later. Once the follicles reach the size of 12mm, GnRHa antagonists like Ganirelix, Orgalutran, Cetrotide and Cetrorelix are added. These drugs stop the pituitary from secreting the luteinizing hormone (FSH leads to secretion of this hormone).
  4. Long GnRHa Pituitary Down Regulation Protocol: This is the usual approach to deal with low ovarian reserves.
  5. Agonist/Antagonist Conversion Protocol: This protocol inhibits FSH production. This protocol generally yields good results.

IVF - A Complete Guide For Men!

Dr. Ritu Prabhakar 86% (18 ratings)
MD - Obstetrtics & Gynaecology
IVF Specialist, Sonipat
IVF - A Complete Guide For Men!

Have you and your partner decided to complete your family by having a baby? Are you unable to conceive even after trying really hard? You are not alone. There are many couples who are facing this problem. But there is nothing to worry about at all. Latest and advanced science is offering solutions for this problem. When none of them are working for you, you should try In Vitro Fertilization or IVF. During IVF treatment, men have as vital a role to play as women. A man needs to really support and care for his partner during this period.

Here is a guide for men for IVF treatment:

  1. Keep a check on your weight: If you are overweight, then your sperm will be affected. Also, some studies have shown that the mobility of the sperm is affected by obesity. It will also affect the sperm count when your BMI value is too high. So, it is always good to maintain the BMI levels required, based on your height, age and gender.
  2. Temperature of the sperm: If you are a cyclist or use a laptop for extended time periods by keeping it on your lap, then the production of sperm could be affected because it is going to increase the temperature of the testicles. Make sure that you take care of this.
  3. Make changes to your lifestyle: If you smoke or drink, then you will have to make sure that you cut down or stop because this is going to affect not just the quality of the sperm but also the quantity of the sperm. Smoking decreases the mobility of the sperm.
  4. Healthy dietA healthy diet means healthy sperm quality and quantity. So, you should always keep a check on what you are eating. You will have high fertility levels if you consume green vegetables, fresh fruits and pulses as part of your daily diet. You should cut down on processed food and make sure that you are eating fresh and healthy food.
  5. Regular Exercise: You will have to maintain good health and for that, you need regular exercise. You do not need to join the gym and lift weights. You can do a few exercises at home. Exercising can also help to get rid of anxiety and stress and help you to stay healthy.

Get advice from experts as they can help you with tips to follow during the IVF treatment or when you are preparing yourself for the IVF treatment. You and your partner can do these things together and achieve better results.

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What is IVF? who can do it? How it is done? What are its advantages and disadvantage? Please tell me something about this.

Dr. Richika Sahay Shukla 91% (659 ratings)
DNB (Obstetrics and Gynecology), MBBS
IVF Specialist, Delhi
Can you come at our centre India Ivf centre Noida Delhi Gurgaon can explain you in details you can seek appointment with us at
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Hi, We have decided to go for IVF, can someone explain what is IVF? What are the measures we should follow?

Pooja Choudhary 91% (63 ratings)
MBBS, DGO, DNB
Gynaecologist, Noida
IVF stands for in vitro fertilization.In this procedure the female will be given few hormonal injections for preparing the ovary and the uterus and mature egg will be extracted out. Similarly male partners semen will be processed and the sperms will be mated with the egg outside the body in sterile environment. After fertilisation the embryo will be transferred to the uterus and pregnancy will be confirmed by blood test after 15 days. Once pregnancy occurs it will be followed up.
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HI, A lot of information is given in precautions to be taken in 1 st trimester. Would like to know expertise opinion on what precautions and restrictions should be taken during early pregnancy. I am 6 weeks pregnant post IVF conception with DCDA twins.

Dr. Bhumika Kalathiya 92% (192 ratings)
Mbbs, MS(obstetrics and gynecology), Fellowship in laproscopic gynecological surgery
Gynaecologist, Delhi
You have precious pregnany. Avoid bumpy travel, prolonged standing, intercourse, avoid eating fruit like papaya, pineapple. Drink plenty of fluids, take healthy deit, all medicine regularly.
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I am 31 year old and 7 year completely marriage life but I have no child because of my tubes are failed with tuberculosis water. My question is can I conceive with IVF without operation of tubes. Please reply.

Dr. Jayanthi. R. 90% (195 ratings)
MBBS, Certified IVF Specialist, MS - Counselling and Psychotherapy
IVF Specialist, Chennai
I am 31 year old and 7 year completely marriage life but I have no child because of my tubes are failed with tubercul...
Hai since your tubes are already damaged and not functional, it is best to tie them up near the uterus thro laparoscope to avoid dribbling of the fluid into the cavity, disturbing implantation and to avoid pregnancy happening inside the tubes. Best wishes.
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Preparing For An IVF Procedure - Screening Process and Clarifications

Dr. Aradhana Gupta 89% (125 ratings)
MS - Obstetrics and Gynaecology, MBBS Bachelor of Medicine and Bachelor of Surgery, FELLOWSHIP IN REPRODUCTIVE MEDICINE
IVF Specialist, Bhopal
Preparing For An IVF Procedure - Screening Process and Clarifications

IVF or In-vitro fertilization is an assisted reproductive technology, whereby the eggs of a woman who is unable to conceive naturally is collected and mixed with sperms for fertilization to take place. The resulting healthy embryo is then transferred into the female uterus to facilitate the implantation process followed by the pregnancy.

Before undergoing an IVF procedure, both the partners have to undergo few vital screenings and health check-ups, which would assist the doctor in having a better understanding of the fertility problem.

The Screening process before an IVF
The success of an IVF depends on many factors including the quality and quantity of the egg and sperm, or any defects in the female reproductive organs.

  1. For males, doctors perform a semen analysis to evaluate and examine the sperm (quality, quantity, morphology, mortality).
  2. In case the analysis shows any abnormality (such as low sperm count, sperm unable to penetrate the egg or an unsuccessful fertilization in the previous IVF attempts) doctors opt for Intracytoplasmic Sperm Injection or ICSI. ICSI is an advanced procedure whereby a specialist (embryologist) collects a single active sperm and injects it directly into the egg to bring about the fertilization of the egg.

In extreme cases of no sperms, a doctor may opt for Testicular Sperm Extraction (TESE) or Percutaneous Epididymal Sperm Aspiration (PESA) to retrieve the sperm.

  1. In females, the fertility problems can be brought about by a myriad of triggers, especially hormonal imbalance, the medical conditions that affect the hormonal balance and the reproductive organs (such as PCOS, endometriosis, cancer of the reproductive organs, obesity). Thus, for a female, a blood test to analyze the levels of the reproductive hormones- prolactin (PRL), luteinizing hormone (LH), thyroid stimulating hormone (TSH), and follicle-stimulating hormone (FSH) are crucial.
  2. Imbalance in the Prolactin, TSH or an elevated FSH: LH level (indicative of PCOS or an unhealthy ovarian reserve) once treated, enhances the effectiveness of IVF by several folds.
  3. To understand the condition of the fallopian tubes and the uterine cavity, a hysterosalpingogram (HSG) is performed on the 8th day of the cycle.
  4. The doctor may even perform an ultrasound scan of the vagina to examine the uterus (morphology), AFC (antral follicle count), the thickness of the endometrium and ovarian volume. In most cases, a woman is also tested for HIV, TB, VDRL, Hepatitis-B.

Some vital questions that every individual should ask before an IVF
Every individual or couple undergoing an IVF should be aware of the procedure:

  1. If the physician is specialized and qualified enough to perform the IVF.
  2. How expensive is the procedure and if they are a suitable candidate for IVF?
  3. Are there any life-threatening side-effects or complications associated with IVF?
  4. What are the chances of the IVF being a success?

IVF - Questions That Most People Seek Answers For!

Dr. Chandrashekhar Sakolikar 89% (39 ratings)
MBBS Bachelor of Medicine and Bachelor of Surgery, MD - Obstetrics & Gynaecology
IVF Specialist, Navi Mumbai
IVF - Questions That Most People Seek Answers For!

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.

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
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Step By Step Embryo Transfer Procedure In IVF!

Dr. Ritu Prabhakar 86% (18 ratings)
MD - Obstetrtics & Gynaecology
IVF Specialist, Sonipat
Step By Step Embryo Transfer Procedure In IVF!

Once a couple decides to go through IVF, they prepare themselves and go through various steps to reach the final stage of embryo transfer into the uterus. Read on to know more about the journey of IVF culminating in embryo transfer. From there it is another journey through to pregnancy.

  • Step 1: The nurse will help identify day 1 of your menstrual cycle, and this is important. 
  • Step 2: The ovaries usually produce an egg between the 12th and 16th day of the menstrual cycle. After identifying day 1, ovary-stimulating medicines (higher doses of hormones) are given to support the release of more eggs. The ovaries may be subjected to ultrasound imaging to monitor the development of eggs.
  • Step 3: About 8 to 15 eggs are then retrieved under anaesthesia, these are carefully picked to ensure higher success rate of IVF. The process takes about 30 to 40 minutes in the clinic and the woman can go home and rest after this process. 1 or 2 embryos can be transferred at day 2, 3 or 5 stage of embryos.

Factors you need to consider while making a decision

  • Sperm selection: Either fresh sperm or frozen sperm can be used by the couple. Fresh sperm is collected the same day as egg retrieval. Frozen sperms are thawed before use. Sperms of good quality are chosen after careful examination under a microscope to improve success rates of fertilization.
  • Fertilization: This is where the name IVF is derived from. In-vitro (meaning in the glass, from the glass dish used) is where the fertilization occurs.
  • Embryo development: Once fertilized, the embryo is kept in a conducive environment so that it can continue to grow optimally. The couple of kept updated on the progress here, as they would be wanting to know the status. After 5 to 6 days of fertilization, it can be implanted into the uterus.
  • Embryo transfer: Once the medical team confirms that you are ready for an embryo transfer, you will be called into the doctor’s office. This is usually painless, but some women may have a slight abdominal discomfort. You will be advised to drink water and come with a full bladder. The uterus is scanned to see whether the embryo is getting placed, and having a full bladder helps clearly outline the uterus. The embryo is placed inside you via a catheter through the cervix into the uterus, under ultrasound guidance. The doctor has about 1 mm area within which it should be placed correctly for good implantation. Therefore, this placement is very critical. One embryo is placed, and the others are frozen and may be used in case of failure.
  • Confirmation: After a two-week wait (2WW), a blood test is done to test for HCG levels and confirm pregnancy.

Embryo Grading - For Successful IVF!

Dr. Richika Sahay Shukla 91% (659 ratings)
DNB (Obstetrics and Gynecology), MBBS
IVF Specialist, Delhi

Many factors affect the success of an IVF cycle, but embryo quality may be the most important factor.  The majority of all miscarriages, about 60 percent, are caused by abnormalities in the embryo.  If you’re having IVF treatment, transferring the best quality embryos increases your chance of a successful pregnancy.  Your fertility center’s embryologists play an important role in selecting which embryos to transfer to your uterus and which to freeze and store, so you have a second chance at IVF if you need it.  The process of embryo grading may sound mysterious, and it does require a huge amount of training and skill, but it’s a normal part of every IVF cycle.

How Embryos Develop

In a natural pregnancy, sperm fertilizes an egg as it travels down the fallopian tube.  The cells in the fertilized egg divide and grow into an embryo as it moves to the uterus, and it implants in the uterus to continue growing.  In an IVF cycle, fertilization and embryo development takes place in the embryology lab.  The eggs and sperm are combined, and the fertilized eggs begin the process of dividing and growing.

Embryos that have grown for three days in the lab are called cleavage stage embryos.  Sometimes embryos are allowed to grow for five days before transfer and are called blastocysts.  When the embryos are ready, a reproductive endocrinologist will transfer the best quality embryo(s) to your uterus.  You will agree on the number to be transferred, usually no more than two embryos, before the procedure takes place.  Then, if all goes well, one of the embryos will implant in your uterus and grow into a baby.

Embryo Grading

The embryologists monitor the embryos and, prior to choosing which ones to transfer at the cleavage or blastocyst stage, grade them to determine which ones have the best chance of being healthy and resulting in a successful pregnancy.  Grading of embryos is a non-invasive method of selecting the best embryos for transfer. In addition, the embryologists look at the embryo growth rate as too fast or too slow can indicate the presence of chromosomal problems.

Embryo grading may be done at the cleavage stage or blastocyst stage.  Embryo grading at the cleavage stage includes the number and appearance of the cells and the degree of fragmentation, which is the presence of small pieces of cellular material which have broken off during division of the cells.

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