Doctor in Indira IVF Udaipur
Patient Review Highlights
My sperm motility Is low. Doctor said I am having grade 1 varicocele. Whether it will affect the fertility? Whether need surgery for that.
What is In vitro fertilization?
In vitro fertilization (IVF) is a process of fertilization where an egg is combined with sperm outside the body. This involves monitoring and stimulating a woman's ovulatory process, removing an ovum or ova (eggs) from the woman's ovaries and then letting sperm fertilize them in a liquid in a laboratory. The fertilized egg (zygote) undergoes embryo culture for 2–6 days.It is then transferred to the same or another woman's uterus, with the intention of establishing a successful pregnancy.
What is the success rate of it?
The success rate depends on factors such as, maternal age, cause of infertility, embryo status, reproductive history and lifestyle factors.
- Maternal age: Younger candidates of IVF are more likely to get pregnant. Women older than 41 are more likely to get pregnant with a donor egg.
- Reproductive history: Women who have been previously pregnant are in many cases more successful with IVF treatments than those who have never been pregnant.
How is it a Blessing?
- Chemotherapy: IVF allows women who are being treated for cancer with chemotherapy to be able to have children. Chemotherapy can destroy or damage the eggs within the ovary. Prior to undergoing chemotherapy treatment, some women may elect to have eggs harvested, frozen, and saved for possible subsequent attempts to have a child after the cancer treatment is completed.
- Absent Uterus: IVF treatment can allow a woman to have a child if she does not have a uterus. The eggs must be harvested from the patient’s ovaries and are then placed inside another woman’s uterus.
- Low Sperm Count: When sperms are defective or counts are extremely low, IVF can be used to become pregnant. IVF can work for these conditions because sperm is placed directly next to the egg, and, in some cases, sperm is injected into the egg (ICSI) to allow the pregnancy to occur.
- Absent Ovaries: IVF can be used for a woman without ovaries. The eggs must be donated from another woman.
- Older Age: IVF can be used for women over the age of 42 to become pregnant. To obtain this reproductive advantage, donated eggs (eggs from another woman younger than 30) must be used
- Unexplained Infertility: Some couples do not have a diagnosed reason for their infertility. This is called unexplained infertility. IVF allows egg and sperm to join together outside of the woman’s body.
- Severe Tubal Disease: Some women have extensively damaged fallopian tubes from pelvic inflammatory disease (PID) or from severe intra-abdominal infections. IVF is designed to bypass the tubes by allowing conception to occur outside the body.The fertilized eggs are then introduced into the uterus in the hope of pregnancy.
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.
Low reserves are caused by
- Production of eggs decreases: Chromosomal abnormalities like Turner syndrome (lack of two X chromosomes) and genetic anomalies like Fragile X can decrease egg production.
- 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.
If a woman has low ovarian reserves, then she will be put on the either of the following protocols:
- 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.
- 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.
- 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).
- Long GnRHa Pituitary Down Regulation Protocol: This is the usual approach to deal with low ovarian reserves.
- Agonist/Antagonist Conversion Protocol: This protocol inhibits FSH production. This protocol generally yields good results.
Infertility is a condition that can be caused due to a variety of reasons, for both males as well as females. Yet, it also comes with plenty of emotional baggage because there is a great deal of social stigma attached to childless parents, especially in the developing countries like India, where we still hold on to traditional thinking which does not really justify modern day realities.
Understanding Infertility in the Developing World: As per medical science, infertility is defined as a problem that is faced by couples who do not manage to conceive even after a year of trying without any birth control measures. In countries like ours, there is a great social stigma that is attached to being childless. As per many studies by the World Health Organization (WHO), about 15% of couples the world over are affected by infertility. Also, such cases go undetected because there is a great social stigma attached to the same. Further, there may be underlying conditions like Tuberculosis which may have been undiagnosed because people do not like to talk to doctors about the symptoms. The main problem in countries like India, and others areas is that people do not open up about such problems and they consider doctors and other medical practitioners as strangers.
Still in the Dark Ages: Even though we have made the transition from an agricultural country where we would pray to the elements and wait for signs for all our everyday activities from harvesting to childbirth, to an industrial country we are still in the dark ages as far as our social setup goes. There are many educated and well-heeled families where being childless is considered as an issue. And many people tend to go to astrologers and temples to change their fate, where a simple visit to a doctor and procedures like IVF, or adoption as the last resort, can also work out.
Infertility Stigma for Males and Females: For an infertile couple, the problem may stem from the male, or the female or both partners. There are still many social stigmas that are attached to this and many people in countries like India tend to call the woman barren, if she is unable to bear a child. In many cases, the male partner does not even go in for a check up as it is not even considered as an option that the problem might lie with him. Male erectile dysfunction, ejaculation problems, and general infertility can cause a range of issues for the couple when it comes to conception. So it is imperative to have the same checked by the doctor so that a sperm test can also be conducted and the treatment can carry on accordingly with the help of IUI or IVF.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Are you aware of the condition known as oligohydramnios during pregnancy, in which there is too less amniotic fluid? The amniotic fluid is an important part of your baby’s support system. It helps in protecting your baby and in the development of lungs, muscles, limbs, and the digestive system. The amount of this fluid can be measured via several methods. amniotic fluid index (AFI) evaluation is commonly used for measurement. When the results show a fluid level less than five centimeters, you need to diagnose yourself for oligohydramnios.
There are several causes, which may lead to low amniotic fluid levels in your body. They are as follows:
- Birth defects: Issues in proper development of the urinary tract or the kidneys lead to decreased urine production, which in turn results in decreased amniotic fluid levels.
- Placental problems: When your placenta does not provide sufficient supply of blood and nutrients to the baby, it may not recycle the fluid anymore.
- Leaking of membranes: A tear in the membrane may cause a slow trickling of fluid, or a rapid gush of fluid. The premature rupture of membranes (PROM) also leads to low levels of amniotic fluid.
- Post date pregnancy: Low amniotic fluid levels may occur during a post date pregnancy. It is a form of pregnancy that lasts for 42 weeks.
- Maternal complications: Several factors like hypertension, maternal dehydration, diabetes, and chronic hypoxia may lead to decreased levels of amniotic fluid levels during pregnancy.
The treatment for low amniotic fluid level depends on your gestational age. In case you are not full term, you will be closely monitored and your fluid levels will be observed. Non-stress and contraction stress tests may be conducted for monitoring the activities of your baby. If you are almost near full term, delivery is recommended by most health practitioners, in case of low amniotic fluid levels.
Other treatment methods that are used include the following:
- Amino infusion during labor via an intrauterine catheter is carried out. The added fluids help with the umbilical cord padding during delivery. It also helps in lowering the chances of a Cesarean delivery.
- The injection of amniotic fluid before delivery via amniocentesis is also undertaken. It is likely for the oligohydramnios to reoccur within one week after this treatment procedure, but it helps doctors to visualize your fetal anatomy and diagnose the condition.
Maternal rehydration using oral fluids and IV fluids also helps in increasing the amniotic fluid levels. It is important for you to consult a doctor for proper diagnosis so that the most ideal treatment can be prescribed to you.
It is no hidden fact that miscarriages hurt you deeply. The trauma that comes with it is unbearable, but you will have to get through it. Don’t blame yourself for the situation, you may not know it but miscarriages are quite common. Doctors have said that one out of four pregnancies ends up in a miscarriage. If you have experienced more than two consecutive miscarriages then you are suffering from a recurrent miscarriage. If you are going through recurrent miscarriages then there are some medical conditions to blame.
Is miscarriage the end?
A recurrent miscarriage may sometimes complicate things a little, but don’t think that it is the end. As the medical research has progressed, there are several ways for you to get pregnant or have a child. There is in vitro fertilization or IVF which is one of the best ways to cope with a miscarriage. Even if you are having some problem with your fallopian tube IVF can solve your problems and fertilization will be done in the lab and the embryo will be implanted.
How to cope with the emotional stress?
Miscarriages are hard in itself, and you need to deal with the post-miscarriage situation with the utmost maturity to keep your psychological and physical state under complete care. Emotionally good health will go a long way and let you think clearly about your options. If the stress and sadness of the miscarriage have brought you down, then seek the counseling of psychiatrist. Don’t feel ashamed to share your feeling and never suppress them. Talk about them and if needed join a support group that will help you to get through the tough situation.
Remember one thing that if you are emotionally aggrieved and suppress your feelings then that will take a toll on your relationship with your partner. With IVF becoming so developed, there is no need to lament about miscarriage.
How can I improve my fertility?
You may be suffering from recurrent miscarriages, but you should not lose your hope. Keep on trying and you may succeed. You never know. Visit the specialists and let them know your medical history. With special care, IVF can solve all your problems.
But only IVF would never work. Opt for a healthy lifestyle by doing exercises, eating healthy foods, quit smoking, and reduce your alcohol and caffeine intake. You should take a multivitamin rich in folic acid every day. You should also restrict your exposure to environmental chemicals and toxins. It is advisable that you leave behind any kind of heavy lifting, strenuous physical exercises, and any dangerous contact sports. Try not to take stress by taking up yoga or tai chi. And most importantly, try to maintain a healthy sexual relationship with your partner and contact your doctor to know when can you get pregnant again.
Childbirth comes within an age bracket. Women feel this more so than men. Career demands or other personal choices can delay the time to get pregnant. Thus, freezing your eggs can prove to be beneficial, if you delay childbirth to focus on your career or education, or if you have certain medical conditions such as cancer.
- Egg Retrieval: Before the eggs are harvested, there is a lot you have to do. The first month is spent taking blood tests and ultrasounds. In the second month, you will have to take medicines before your procedure for egg retrieval. Ultrasounds and blood tests are also conducted at this stage to monitor the growth of the eggs. Around the time of your ovulation, the eggs will be harvested. You will be lightly sedated during the procedure. After the procedure, you might feel bloated and experience cramping. At least 15 eggs are retrieved for optimum chances. The medicines prescribed are all hormone injections which you can self-administer.
- Freezing and Storage: The largest human cell is the egg. It is comprised mainly of water. When the eggs are frozen, crystals can form which can destroy it. So an anti-freeze replaces the water after the eggs are dehydrated. This prevents crystal formation. Eggs are frozen using vitrification. In this process, the eggs are either slowly or flash frozen. Eggs can be frozen for as long as 10 years. This does not hamper the quality.
- Risks: There is no guarantee that freezing eggs will lead to having a baby. Sometimes, eggs do not survive the freezing or the thaw.
- Advantages: For women who are suffering from cancer, freezing their eggs might be the best option. They might want to preserve their fertility before their cancer treatment starts. This is useful since radiation and chemotherapy can harm your chances of getting pregnant.
The obvious advantage of freezing your eggs would be the fact that it gives you time. It lets you decide and keeps you one step ahead of your biological clock.
In case you have a concern or query you can always consult an expert & get answers to your questions!
In vitro fertilization or IVF is deemed as one of the wonder treatments for couples who are facing infertility issues. Whether it is due to poor sperm quality of blocked fallopian tubes, IVF has proven to be a safe and effective solution. However, like with all new techniques, IVF also has some myths which need to be understood before signing up for the procedure. With so much at stake in terms of finances and time, understanding the process will help set realistic expectations and improve the success rate of IVF.
Myth 1: High success rate. While IVF has very high success rates, some women just fail to get pregnant. This could be about 5% of the women and may not be attributable to any particular cause. Each woman responds differently, and failure to conceive through IVF could be due to no explainable cause. What is interesting is that though the first attempt failed, subsequent attempts may be successful. Failing the first cycle does not mean failure in subsequent cycles. Also, success rate differs from clinic to clinic, and so choose one which has a proven track record and good success rates. It should not just have good doctors but also the essential technology and infrastructure to support the IVF technique.
Myth #2: IVF leads to multiple births. While achieving multiple births is easier through IVF, it always does not lead to multiple births. Multiple embryos are implanted, only to improve the chances of success. It does not necessarily translate into multiple births. In women over 38 years of age, it is mandatory to only transfer a single embryo as multiple births are very likely to be complicated.
Myth #3: Rest and time off work. It is believed that IVF has a higher success rate with proper rest and time off work. Rest is definitely required the first few days after embryo transplant but it definitely later assumes a normal course of things. It is not that too much time off work is required, just because you had an IVF. Your body might be different and require more rest, but that could have been the case even with a normal pregnancy.
Myth #4: The medications with IVF are going to have lots of side effects. While the hormones given to promote egg release do have their side effects of making you feel moody and emotional, it is only transient. Once the egg release happens, fertilization is done, and embryo transplant is done, then things should settle down. The effects should wear down once the embryo is implanted and then things should settle down. Of course, pregnancy brings its own hormonal changes, which will run their course through pregnancy.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Doctors believe that all women are born with a certain quantity of eggs as well as chances of conception. Also, all bodies are unique with individual strengths and weaknesses. Fertility tests can help in unravelling a number of issues as well as the health of your reproductive system as a whole. It is important to address various lifestyle issues in order to retain your fertility and ensure that you have a hassle free conception. Read on to know more about the ways in which you can preserve your fertility.
- Oral health: There are a number of medical studies that go as far as suggesting that the state of the woman’s oral health is a significant factor when it comes to the proper functioning of her reproductive system. Many women who have required treatment for infertility are said to have suffered from oral health problems like inflammation and gum disease. One needs to avoid these issues so as to have more reproductive success. So, it is important to brush and floss on a regular basis in order to have better oral and reproductive health.
- Food: When we are talking about oral health, how can food intake be too far behind? In order to maintain good oral health, it is important to take care of your eating habits. One should steer clear of excessive sugary food intake as well as junk food intake which end up harming the gums as well as the overall system of the patient. Also, you must avoid eating processed carbohydrates like white bread and white rice. It is also a good idea to get your proteins from plant sources rather than animal sources. Furthermore, it is also a good option to strike trans fat off the list and to pick unsaturated fats instead. This kind of a diet is known as low glycemic diet which keeps the sugar levels stable. This helps in boosting all body functions in general, including one’s fertility.
- Smoking: As per a number of medical studies, about 13 per cent of the infertility cases are linked with excessive smoking. Tobacco has an adverse effect on the state of your fertility, and it usually makes the eggs deteriorate at a much faster rate. It can also cause early miscarriage and ectopic pregnancy, which is a dangerous condition where the egg gets lodged in the fallopian tube. Smoking can also bring about early menopause.
- Vitamin supplements: Many doctors suggest that once a woman has entered her child bearing years, it is important to start taking multivitamins as these contain folic acid. Folic acid is an important nutrient that helps in foetal growth and stimulates ovulation.
The concept of egg quality of a woman is derived from the belief that the embryo implantation probability is powerfully related to the age and ovarian reserve of the woman. Thus, it is regarded that the quality of the egg is almost synonymous with the chances of embryo implantation. Its quality cannot be assessed merely by looking at the egg or measuring its ability to receive the fertilization by sperm or simply observing the initial embryo division.
There are a few important factors that contribute to the success or failure of the embryo implantation and some of them are:
- Diminished ovarian reserve: A woman with an increased FSH level on the third day of the menses is regarded as having diminished reserve of ovary. This implies that her ovary is not competent in sending feedback signals to the pituitary gland and the body responds by producing an increased amount of FSH for stimulating the ovary. For more than 10 years, it has been found that in over thousands of fertility treatment cycles, women with an increased FSH level have a lower egg quality.
- Advanced age of maternity: Even though the FSH level is normal, the age of the mother who provides the eggs plays an important role to determine the quality of the egg. Quite like women with increased FSH levels, eggs obtained from women aged more than 40 years can have some problems at a later stage of fertilization. Normal FSH levels are not considered a reassuring factor, owing to the lower implantation rate in females aged over 45 years.
- Diminished quality of egg: With an increase in age, the capacity of the mitochondria in producing energy slowly decreases. The egg is linked to the circulation before ovulation, and it is linked again after the embryo implantation. But during the one week time ranging from ovulation to implantation, the egg and the resulting embryo are contained in the zona pellucida and function on the basis of mitochondrial energy supply. The older age of the woman doesn’t cause any problem at the initial stage of ovulation. Its fertilization and embryonic development are also normal. But soon, it runs out of energy and stops dividing before reaching the stage of implantation.
Therefore, it is important to have the eggs tested to find out any sort of chromosomal abnormality. In case the mother is deficient of producing high quality eggs, the best option is to have donor eggs.