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It is a very common procedure for women who wish to conceive. Intrauterine insemination (IUI) is an artificial insemination method. The sperm is washed and placed in the uterus during ovulation. This procedure helps the sperm to connect with the egg. Couples experiencing infertility due to medical conditions are recommended this option.Unexplained infertility, low sperm count or quality, endometriosis, are likely issues that need to be treated through this method.

 

IVF is done when female infertility is detected.There was a time when the only way people could have children were through reproduction through sex or by adopting. The need for biological children is natural. Hence, regular medical research has developed in-vitro fertilization. In-vitro literally means ‘in glass’. The dictionary explains it as a process made to occur outside the biological body, in an artificial environment. Thus, in-vitro fertilization is the fertilization process occurring under lab conditions and not inside the mother’s womb. With IVF, conception and pregnancy has a whole new meaning.

A fertility specialist uses this treatment to control the reproductive hormones to get the best results. The sperm and egg are fertilized outside the womb by the experts. The success depends on the age of the woman and seriousness of the problem.

 

This is an infertility treatment for a successful pregnancy. The sperm is injected into the egg to facilitate conception.  ICSI deals with male fertility issues. A number of health problems may be the reason for its occurrence.The pregnancy occurs after the embryo transfer. The live sperm is injected in the lab. But it may not guarantee fertilization.

 

• Hormonal stimulation
• Retrieval of eggs
• Embryo development
• Embryo Transfer
• Clinical Pregnancy

This treatment is ideal for problems like:

• Women having damaged/blocked fallopian tubes
• Ovulation disorders
• Endometriosis or Adenomyosis
• Genetic disorder
• Low sperm count of male
• Unexplained infertility

This is a part of an additional procedure for IVF treatment. The embryo has to ‘hatch’ out of the cell from the outer layer called zona pellucida. With the help of a laser a small crack is made in the shell for implant in the uterus lining. Fresh or frozen eggs can be implanted by this method. The embryo does not get damaged in this process.If a woman has failed IVF cycle, advanced age, high FSH hormone levels earlier then this method is used. There may be a risk of identical twins.

 

A cryopreserved embryo which has been created in the previous cycle is thawed and then put in the uterus. This is done via hormonal support or natural cycles. The former is easy to control and good for ovulation problems.A female body produces progesterone during ovulation. The endometrial lining develops to nurture the fertilized eggs. When this treatment is recommended, women should take complete rest and medication on time. Extreme temperatures in and around the abdomen are not recommended.

 

This is a test with the use of biopsy and is used when the time is right for implantation. It is a way to ascertain why an IVF cycle has failed. Chemical analysis is required to understand the complexities. If a woman has undergone several IVF failures this test is recommended.

This procedure is required to check the embryos for any genetic conditions that may be passed on to the child. They relate to single gene conditions like cystic fibrosis or sickle anemia. In some cases, parental chromosomes are considered. The couple may not be infertile but the families may have a history of abnormal condition which can be transmitted genetically. It helps in having a healthy baby, rather than passing on the condition.

If fertility treatments are unsuccessful,  it is possible to use eggs or sperm donated by a third party or to have another woman carry a fetus.

A couple may be required to preserve their reproductive organs for the future. Healthy babies can be borne with this option. People who have health conditions, age consideration and transgender care opt for this procedure. The reproductive tissues, Embryos, eggs and sperms are protected when a couple wants a delayed pregnancy. This happens due to stability in health conditions or meeting career goals.

This innovative technique involves collection of the immature eggs for fertilization. They are retrieved with a surgical procedure. Eggs are monitored and each one is injected with the sperm through ICSI. The embryos are cultured until they reach the stage of transfer. The best or highest quality are selected for a fresh IVF transfer.Women who have PCOS, cancer patients (sensitive to hormone therapy and risk of OHSS can choose this option. If they are below the age of 30 years’ success rate is good.

 

This is a method wherein a woman agrees to carry a baby in her womb for 9months on behalf of another woman. But the biological parents will stake claim to the child. This is an ‘intended’ option for some couples to become parents. This method is controllable and is very successful. Many couples who go through several broken IVF cycles or other infertility issues opt for it. They can also have a genetically-related child and make a family.

An initial examination is done to find out the problem. A medical history is also jotted to understand if there is a family history. Blood tests are done too.A male reproductive specialist evaluates the reasons before suggesting the line of treatment. A genetic counselor may also examine related issues.

However, the common causes are:

• Low sperm count
• Ejaculation issues
• Abnormal sperm function
• Blockages that stop sperm
• Lump or swelling in testicle area
• Chronic health issues
• Lifestyle choices
• Problem with sexual function
• Respiratory infections
• Inability to smell
• Abnormal breast growth
• Decreased facial and body hair
• Chromosomal or hormonal imbalance
• Partner over the age of 35 years.

It is a low risk procedure for men who have fertility problems. Before the use of IVF the male partner has to provide a semen sample for analysis. Some men have less or no sperm in the semen. In such a case the sperm is collected directly from the testicles, Vas deferens, or epididymis. Due to blockage in the tube carrying the sperm this method is required. If there is no obstruction and yet the sperm is unavailable, then the low sperm production is responsible.The different treatments used are:

• PESA- it is the least invasive method.
• TESE-Biopsies from the testicular region are taken and are invasive.
• Micro-dissection TESE- The microscope points to the tissues that need to be removed.
• TESA- A needle is used to get sperm and tissue samples via suction. When sperms are found they are cultured and frozen for the IVF cycle.

We provide counseling related to this medical procedure. It helps the pregnant patients to understand risks and medical issues which can be transferred from the parent to the child. Gene mutations may affect the infant at birth or afterwards. Any patient undergoing genetic testing could be a potential carrier of a disease. This is a reason for infertility in couples. Patients have to decide if this service is required with prior consultation with the doctor.You may need this service if:

• Multiple carriages
• Still born child
• Unknown cause of infertility (even if test results are normal)
• A family history of cystic fibrosis which is a genetic condition
• A child with sickle anaemia previously)
• Women aged above 40 years (chromosomal abnormalities are risky) like Down Syndrome
• Pregnancies with high pre-natal screen results for Down Syndrome
• Ultrasound showing a baby with a cleft lip, hole in the heart. Both are genetic disorders.

 

These are now common health issues many women face in India. It can derail the emotion and physical condition of the woman undergoing this problem. In the case of Endometriosis, the uterine tissue grows outside the uterus and changes its size. Fertility issues are also common at this stage.Fibroids give severe pain and heavy bleeding is common.  When the problem is frequent and not subsiding with medication the patient is advised to remove the uterus.

PCOS results in hormonal imbalance. A woman cannot ovulate, has irregular periods and shows high androgen symptoms. Such patients can have infertility issues too. Diagnostic hystero- laparoscopy with ovarian drilling may be  required for infertility PCOS patients.

Hysterectomy /vaginal/Abdominal/laparoscopic

With the help of surgery, the uterus is removed. Once done, a woman cannot become pregnant nor have a menstruation cycle. This is done when bleeding is heavy, fibroids develop, uterine prolapse is detected and/or cancer appears. Depending on the patient, the surrounding organs, tissues, ovaries or fallopian tubes

are also removed.

 

This is minimally invasive surgery. It is a surgical procedure in which a thin camera- equipped device is used to examine the abdomen or pelvic region via a camera. A small incision (one or two) is made. It allows the surgeon to get a real-time video of the internal organs.The major advantages are:

• Risks of infections are reduced compared to open surgery.
• There is less blood loss in this method.
• The recovery is faster without prolonged bed rest.
• The patient can go home earlier.

Laparoscopic procedures conducted at Womb include:
When all other imaging tests have failed, this procedure is most useful for accurate diagnosis.

• Diagnostic laparoscopy
• laparoscopic ovarian drilling
• laparoscopic ovarian cystectomy
• laparoscopic myomectomy
• laparoscopic endometrial resection
• laparoscopic hysterectomy
• laparoscopic salpingectomy
• laparoscopic ectopic resection
• laparoscopic tubal recanalization

 

It is a simple procedure that lets the doctor check the uterus with a tool. It is thin and has a light. It is inserted through the vagina to check for abnormalities. It will detect abnormal uterine bleeding, issues of infertility, foreign bodes like polyp or fibroma.Surgery is required once the doctor determines the problem. It is done within 15 minutes to about an hour depending on the patient’s problem.

There are different types of Hysteroscopy done.

• Diagnostic procedure-recurrent abortion and infertility
• Therapeutic (operative)- It concerns with uterine cavity, fallopian tube ostia and cervix
• Pre – IVF procedure -Determine the endometrial lining, uterine cavity abnormalities and to increase pregnancy rates in IVF and ICSI cycles.
• Menstrual cycle is not disturbed
• Recovery time is early

When a woman is over 35 years of age, it could be a high risk pregnancy. Such a patient needs prenatal care for a normal delivery. Other reasons include:

• Women who smoke and consume alcohol or drugs.
• High BP, Cholesterol, epilepsy, thyroid disorders, obesity and diabetes.
• Pregnancy complications
• Less fetal growth
• Unusual placenta position
• Rh sensitization
• Multiple pregnancy (more than one fetus)
• Pregnancy history with problems

A mother may not be able to bear the pain when she is in labor. She has a choice of painless delivery. An epidural injection is given to numb the pain. It is given in the lower spine. The mother does not have to push the baby out. A forceps and vacuum pump are used to deliver the baby. There are no risks involved as expert doctors do the procedure.Mother and baby are happy soon after the delivery.

 

With advancement there are many ways childbirth can be experienced by a mother. They are:

• Natural and unassisted
• Assisted and delivery via cesarean
• Vaginal birth without medication to reduce the pain. It involves breathing techniques with the partner.

The mother can decide which is the best option for her. She can reduce the intensity of pain and enjoy the delivery process.

WOMB clinic employs the best doctors in the medical field. We have considerable experience in dealing with all the above treatments with patience and sensitivity.

 

Sometimes a baby is born sick and needs to be cared for if it is healthy. It is put in a neonatal intensive care unit. They require continuous cardiorespiratory monitoring. It is a pediatric sub-specialty of the clinic. The baby may not have a life threatening risk but will require monitoring. Special nurses are a part of our team to look after these tiny human beings waiting to see the world outside.