INDORE

Female Fertility Treatment

Female Fertility Treatment in Yaami Fertility and IVF Indore

Best IVF Center in Indore

Ovulation Induction

  • Ovulation Induction aims at correcting ovulation disorder.
  • First step is correction of any condition causing ovulation problem like thyroid , prolactin or adrenal hormonal issues, extremes of body weight etc.
  • Fertility drugs called ovulogens are given to induce growth of ovarian follicles containing eggs.
  • These medicines are commonly oral tablets (like letrozole, clomiphene citrate & tamoxiphene citrate) or sometimes gonadotrophin hormone injection (Recombinant FSH/urinary FSH)
  • Usually Ovulation Induction treatment is done for 3-4 cycles.

Who can benefit from Ovulation Induction :

  • Women with PCOD -the aim is to induce ovulation of 1 follicle.
  • Woman with unexplained infertility- the aim is to induce growth of 2-3 follicles.
  • Couple who are advised to undergo IUI.

 

What to expect during Ovulation Induction

  • Ultrasound on day 2/3 of period to rule out any ovarian cyst.
  • Fertility medicines are started from day 2-5 of menstrual cycle.
  • Follicular monitoring ultrasounds from day 8 of period in 1st OI cycle .It is repeated once in 2-3 days.
  • Ovulation trigger with injection of HCG( Human chorionic gonadotrophin ) is given once the follicle size is 18-20 mm.
  • Regular sexual intercourse is encouraged during fertile period
  • If IUI was advised , it is done on the day of ovulation
  • Urine pregnancy test with home testing kit 14 days after ovulation.

 

Success rate after OI

  • Usually 8- 16% success after 1 cycle of OI is expected.

  • It depends on many factors like underlying pathology , age of woman , semen quality & duration of infertility , condition of fallopian tubes etc.

Platelet Rich Plasma Therapy

  • PRP is platelet rich plasma extracted from patient’s own blood.
  • Platelets are rich in growth & healing factors.
  • These growth factors promote healing of tissue.
  • There is no risk of getting any viral or bacterial infections as PRP is extracted from patients own blood.

General outline of PRP treatment

  • Approximately 50 ml blood is collected & centrifuged to separate PRP extract.
  • This PRP is injected into ovaries or instilled into uterine cavity to promote the tissue healing & regeneration.

PRP for ovarian rejuvenation

  • PRP can encourage improvement in egg quality, number and response to fertility  
  • PRP is injected into 2 points in each ovaries with help of special long needles.
  • Peak improvement in ovarian function is expected in 1-3 months.

PRP for endometrial rejuvenation

  • Persistently thin endometrium to promote the growth on endometrial lining .
  • RIF cases to improve endometrial receptivity.

Intracytoplasmic Sperm Injection

  • ICSI is advanced modification of IVF  to fertilise egg with sperm .

  • During ICSI each oocyte is held & injected individually with selected sperm by trained embryologist .

  • That is why the term ICSI- Intra Cytoplasmic ( of oocyte here ) Sperm Injection is used .

 

ICSI is preferred over IVF in following cases:

  • Woman with low number of eggs.
  • Men with very low number of sperms.
  • Men with poor sperm quality.
  • Men with poor sperm motility.
  • Men with perm retrieved after TESA / micro TESA in cases of azoospermia.
  • Couple with previous partial or total fertilisation failure.
  • Couple using frozen sperms.

Medical Genetics

Basic outline of genetic testing of the embryo :

1st step -Genetic counselling to determine if the couple needs genetic test of the embryo & which type of test  should be done .

2nd step -IVF /ICSI procedure to get embryos.

3rd step -Blastocyst culture to get embryos with best implantation potential .

4th step -Embryo biopsy  : Collection of 5-7 cells from blastocyst stage embryo using special microsurgical instruments .

- Implantation & future growth potential of the embryo is not compromised when biopsy is done on blastocyst stage embryos. 

5th step - The genetic material , DNA is extracted from these cells & tested for genetic diseases  using specially made  genetic test probes.

6th step - Transfer of normal embryo in womb

-In most cases cryopreservation of embryo is required till the final result of genetic test is available .

 

There are 3 type of embryo genetic testing :

 

(1) Preimplantation Genetic Testing for Aneuploidies ( PGT-A):

  • Earlier it was called Preimplantation Genetic Screening ( PGS ) .
  • The aim is to look for presence of any aneuploidies ( extra or missing chromosome ) of the embryo .
  • It can help to select the embryos with normal chromosomal pattern which will have highest chance of becoming healthy babies .
  • It is done when there’s no known evidence of a genetic abnormality in either parent.

 

Who can benefit from PGT-A ?

  • Female partner age 38 or older.
  • Couples interested in a single embryo transfer.
  • History of repeated pregnancy loss .
  • History of repeated failed IVF .
  • Couple with more number of embryos can choose to select the normal embryo to decrease ‘ time to pregnancy ‘.
  •  

(2) Pre Implantation Genetic Testing for Monogenic Diseases (PGT-M):

  • It was earlier called Preimplantation Genetic Diagnosis( PGD ) .
  • It is recommended when there is known risk of passing down a genetic abnormality to future offspring .
  • Genetic test report of affected family member is analysed in details to plan treatment for the couple .
  •  

Who can benefit from PGT-M ?

  • Personal or family history of single-gene defects—such as cystic fibrosis, haemophilia, sickle cell anaemia, muscular dystrophy , citrullinemia , multiple exostosis etc.

 

 

(3)Pre Implantation Genetic tests for Structural Rearrangement (  PGT- SR )

  • Chromosomal structural rearrangements are translocations , inversions ,duplications or deletions of part of chromosome .
  • Many time carriers of structural rearrangement are apparently healthy individuals .
  • Most of the times structural rearrangements are suspected & detected only when such individual suffer from repeated IVF failure ,  repeated miscarriage  or birth defects in their babies .

 

Who can benefit from PGT-SR ?

  • In known carriers of chromosomal structural rearrangement normal embryos can be selected by PGT SR.

3rd party reproduction & gestational surrogacy

-Third party reproduction involves use of donor sperm, donor egg or  donor embryo to conceive  or taking help of gestational surrogate to carry the pregnancy.

-The couple who will raise the baby after delivery are called ‘Intended Parents’.

-The person who will donate the sperm, egg , embryo or carry the pregnancy is the ‘Third Party ‘.

-Third party reproduction involves teamwork of your fertility physician, psychological counsellor, gamete donor agencies, gestational surrogacy agency, social worker & lawyer .

 

Who may need egg donation ?

  • Ovarian failure in cases of cancer treatment with radiation, chemotherapy or surgical removal of the ovaries.
  • Carrier of serious genetic diseases.
  • Advanced age & menopausal women .
  • Poor quality embryos during previous IVF cycles due to poor quality eggs.

Who may need sperm donation ?

  • Men with azoospermia with failed surgical sperm retrieval.
  • Carrier of serious genetic diseases.
  • Poor quality embryos during previous IVF cycles due to poor sperm quality.

 

Who may need gestational surrogacy ?

  • Woman who does not have a uterus since birth or have undergone surgical removal of uterus.
  • Woman who has a serious health risk in carrying pregnancy.
  • In few selected cases with history of recurrent miscarriage or IVF failure.

 

It’s very important to avoid any conflict in 3rd party reproduction :

  • You should discuss about other possible ways of biological parenthood.
  • Try to gather all information about 3rd party reproduction.
  • Don’t keep your concerns to yourself.
  • Ask the team of professionals involved in your case.
  • Keep all documents.

Ask for transparency in all steps of the treatment.

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