What is Infertility and Best Way to get treated?

Infertility is mainly described as the incompetence of the women to get pregnant after even having a year of unprotected intercourse. Male and female are together responsible for infertility problem, which can be treated through proper medical checkup. Now, talking about the infertility in woman is the case when the female is trying to get pregnant but she is still unsuccessful despite having sexual intercourse for more than a year. If you are also facing the same difficulty, it is important that you seek proper medical assistance.

Causes of Infertility

There are many causes of infertility and these are mentioned below:

  • Harm to fallopian tubes: The work of the Fallopian tubes is to carry eggs from the ovaries to the uterus and if it gets damaged, it would prevent the contact between the egg and the sperm.
  • Unsuitable hormonal changes: The next cause can be the hormonal changes, which many women suffer now-a-days.
  • Having Cervical problems: There are women that have cervical condition, where the sperm cannot pass through the cervical canal and as result the area cause blockage and stops from conceiving.
  • Endometriosis: When the endometrial tissue gets implanted and it starts growing outside of the uterus, it leads to pregnancy complications and this is one of the major female infertility causes.

Infertility Treatment

Infertility problem can be treated by using different medical technologies and some of these are mentioned below:

  • In Vito fertilization is one of the comprehensive and highly advanced procedures to treat infertility. It is a technique of artificial insemination, where egg and sperm are combined outside the body and these are placed in the uterus.
  • There are special drugs that are prescribed to the women who are facing the problems with ovulation.
  • Egg donation can also be used to treat infertility, where the fertilized eggs are placed in the uterus of the mother after IVF within 24 hours. With the help of Gamet intrafallopian tube transfer (GIFT), sperm and eggs are mixed before insertion.

If you are facing with the same problem, you can visit Dr Shivani Sachdev Gour, whp is one of the best Infertility Specialists in Delhi. She is an MBBS, MD – Obstetrics & Gynaecology, Gynecologist, Obstetrician and Infertility Specialist with 17 years of experience in this profession. She with her distinguished work has brought both local and international attention to SCI Healthcare IVF and surrogacy programs. With her medical expertise and dedication, she has been able to help hundreds of couples from around the world and treat infertility.

Common Questions On IVF

Here some important questions along with answers which help you to get a solution of most asked question related with IVF

  • What is infertility? When should couples go for IVF?

There are many causes of infertility are due to female and male factors.

Female factors which can be benefited by IVF are:

  • Blocked fallopian tubes
  • Endometriosis
  • PCOS (Polycystic ovarian syndrome)
  • Premature ovarian failure
  • Females over age of 40

Male factors which can be benefited by IVF:

  • Reduced sperm motility
  • Decreased sperm count
  • Abnormal sperm structure
  • Premature ejaculation
  • Retrograde ejaculation

 

  • What is IVF?

The full form of IVF is In Vitro Fertilization which means the fertilization is carried outside the body.  Insemination which means meeting of sperm and the egg is done in a petri dish of a laboratory. For this procedure, eggs from the female are retrieved and at the same time sperms from the male partner are collected. After fertilization of the egg and sperm, the embryo is formed which is transferred in the womb of the female.

  • Is there any age limit for IVF procedure?

The quality of egg decreases with age declines grossly after 35. The maximum age limit for IVF is 42 using her own eggs.

  • What is the time required for an egg retrieval?

The length of egg retrieval process usually depends on the number of follicles matured. Egg retrieval procedure can take about 20-30 minutes.

  • Will I feel any pain when the egg is retrieved?

No, the egg retrieval procedure is carried out under anesthesia. Female patient is asleep due to the heavy sedatives, given to her by anesthetists. You won’t feel any pain during egg retrieval.

  •  Can egg retrieval harm my ovaries?

There is no specific data available implying egg retrieval harms the ovaries. Women who underwent egg retrieval and after that laparoscopic surgery, the ovaries were found to be normal.

  • What is stimulation of ovaries?

It is the first step in IVF. Fertility medications are given in the form of injections in the female which stimulates the ovaries to develop many follicles. Only one egg is released from ovaries normally. Fertility medicines induce the ovaries to produce many eggs.

  • Is there any vaginal bleeding after egg retrieval procedure?

There is very slight bleeding similar to menstrual bleeding or less than that. The bleeding results due to the puncture site in the vagina. It is minor and need not be worried about.

  • How many eggs are retrieved?

Eggs are retrieved from the most matured follicles. After ovulation induction, many follicles increase in size, but all of them may not carry eggs; some might have immature or post mature eggs.

  • Will I have pain during embryo transfer?

It is not painful. The doctor will use a speculum to visualize the cervix; you will only feel the speculum.  

  • What is ICSI?

ICSI stands for Intracytoplasmic sperm injection. When the sperm is directly injected into the female egg, it is called as ICSI. This process is done to increase the success of fertilization.

  • Do I need complete bed rest after embryo is transferred?

Embryo swims in the womb for few days before actual implantation. Only prophylactic rest is advised which means avoid any kind of vigorous activities.

  • Are all the embryos transferred in the womb?

All the embryos are not transferred .Usually 2-3 embryos are transferred. If the couple wishes them to be preserved for future use, they are cryopreserved.

  • When should I do a pregnancy test after IVF?

A pregnancy test will be positive after the hormone hCG which finalizes egg maturation comes in the urine and blood which in itself takes about 9 to 10 days. Hence between 12 to 14 days the pregnancy test will be positive.

  • What are the restrictions during an IVF procedure?

Stop smoking and drinking alcohol at least 3 months before an IVF procedure. Smoking during pregnancy is hazardous for the growing fetus. It may result in low birth weight baby and congenital disabilities. Smoking also affects the pregnancy rate.

Inform your physician about all the medications you are taking. Over-the-counter medicines affect the fertility medications. Few of them are not safe during ovulation or implantation.

Rigorous exercises or any activities are prohibited during the entire procedure.

Stress is inevitable during IVF cycle. Couples must seek advice from psychologist/personnel counselor or talk with friends and family members for support.  

  • If I become pregnant, what are the steps to take?

Your doctor will advise few blood tests, ultrasound to keep a check on successful pregnancy. An obstetrician will guide you further once the fetal heartbeat is confirmed.

  • Does IVF increase the chance of abortion?

The abortion rate is same when compared to females conceived naturally. Although elder females undergone IVF have high risk of miscarriage.

  • What affects sperm quality?

Sperm development takes about 3 months. Hence the health during the 3 months has to be monitored.

Sperm quality is affected by following conditions:

  • High-grade fever hinders in the fertilization process. Immediate help from the physician must be taken to lower the temperature.
  • Alcohol and smoking.
  • Any prescription drugs apart from advised by IVF specialist.
  • Sitting in hot spas, Jacuzzis, tubs or saunas
  • Vigorous workout routine
  • Supplements containing testosterone, DHEA usually given in gym.
  • Genital herpes

 

  • What is the success rate of IVF?

There are various factors which influence successful IVF:

  • Age of woman- Increasing age decreases the success rate.
  • Quality of sperm
  • Response to the fertility medicines
  • Number of embryos implanted in the womb.

Usually success rates are 60 % depending on center to centre .

  • What are the side-effects of IVF?

The minor side-effects during the egg retrieval procedure are an infection, bleeding, and pain. These are usually mild and are resolve with appropriate care and treatment.

Hormonal injections give to female may cause ovarian hyper stimulation syndrome. There might be pain associated with bloating and uncomfortable feeling. These are self-limiting symptoms and go away with time.

The major risk of IVF are an ectopic pregnancy (implantation occurs in fallopian tubes), blood pressure disturbances, gestational diabetes and multiple pregnancies.

Multiple pregnancies may lead to abortion, premature delivery and affect the health of mother or child.

 

In Vitro Fertilization (IVF)

Infertility is a dark, lonely situation which is hard to experience. It is difficult to live with the reality which comes with the countless trying, investigations and failure to conceive even after the various procedures. Medical science with its increasing advances has created a reproductive assistance to the infertile couples. In Vitro Fertilization or popularly known as IVF wherein the egg and sperm are fertilized in a laboratory dish and then transferred to the uterus.

Sir Robert Edwards and Patrick Steptoe are the pioneers of IVF in 1978. Louise Brown is the first test tube baby born by IVF. Infertility can be due to both male and female factors which needs to be assessed carefully.

Which are the couples who can go for In Vitro Fertilization?

IVF can be useful in the patients with following conditions:

  • Women with blocked fallopian tubes
  • Male having low sperm count or abnormal structure and motility of sperms
  • Women with Endometriosis , ovarian failure, and ovulation disorders
  • Couples having genetic diseases in which conceiving is difficult
  • Unexplained infertility

What are the procedures of In Vitro Fertilization?

A couple has to undergo five steps  in IVF:

  1. Stimulation of ovaries for egg production:

Fertility drugs are given to stimulate the ovaries for ovulation or known as egg production. Normally, only one egg is released from ovaries.  Fertility drugs cause the ovaries to produce many eggs. Follicular studies are done to monitor the follicular growth and development through transvaginal ultrasounds.  Blood tests are also done to check levels of hormones.

  1. Retrieving of  eggs

A small outpatient procedure is carried out to retrieve the eggs/follicular fluid aspiration from woman’s ovaries .The woman is put under anaesthesia. There is continuous monitoring of the woman’s reproductive system by ultrasound imaging. The doctor inserts a needle connected to a suction device into the vagina and then in the follicles of ovary. The device pulls the eggs from the follicles one by one. This step is repeated with the other ovary

In cases where a woman cannot produce their own eggs, they are taken  from egg donors from ART banks

  1. Combining and fertilization:

The combining of the sperm and the egg is known as insemination. This is stored in a controlled temperature in the laboratory. Fertilization occurs when the sperm enters an egg which happens within few hours.

Intracytoplasmic sperm injection (ICSI) is the process where the sperm is directly injected into the egg. This is carried out when the chances of fertilization might be low.

  1. Embryo culture:

Division of the fertilized egg results into an embryo. A constant check is done on the growth of the embryo. A normal and healthy embryo is which divides actively. If there are chances of a strong genetic disorder transferring to the child, a pre-implantation genetic diagnosis (PGD) is done 3-4 days after fertilization. Genetic material from the embryo is screened for the disorders.

  1. Embryo transfer:

The final and important step in IVF is placing the embryos in the uterus after about 3 to 5 days from fertilization.
A catheter (thin tube) containing the embryos is inserted through the vagina, then cervix and up into the uterus. The woman is awake during this procedure.
When the embryo gets implanted in the uterine lining and grows,  woman gets pregnant.
Chances of twins, triplets increase when more than one embryo is transferred into the uterus. Doctors can store the unused extra embryos in frozen form . If first embryo transfer fails , frozen embryos can later be used in next attempt .

What are the benefits of In Vitro Fertilization and why should couples consider IVF?

  1.   When couples  who are trying to conceive are tired with the various failed infertility treatments, IVF techniques offers them their best chances for success. Due to everincreasing developments and new technology in the field  of this  procedure,  IVF success rates are now even better.
  2.  IVF is also used during surrogacy especially for  woman who is physically unfit to carry a full-term pregnancy .
  3. IVF is carried out in couples who have a low ovarian reserve or low or nil sperm count. In such cases donated eggs/sperms are used for IVF and the pregnancy chances increase with donor gametes
  4. Couples who are much focused on careers can store (cryopreservation) their eggs and sperms to carry out IVF in future.
  5. IVF decreases the chances of genetic disorders (Down’s syndrome, sickle cell anemia to name a few) due to PGD carried out during the procedure. Hence the possibility of healthy baby increases.
  6. IVF has reduced the number of abortions which occurs most often due to genetic abnormality.
  7. PCOS is the most common cause of hormonal imbalance and irregular ovulation in females. IVF has been successful in such cases where the ovulation is facilitated by giving fertility drugs.
  8. Women aged more than 40 years having low ovarian reserve are the suitable patients for in vitro fertilization.

Even though with many benefits of in vitro fertilization, there are few complications which can occur. Fertility medicines may give rise to abdominal pain, headaches, acidity, mood swings and bloating. Over-response to these medicines in rare circumstances can cause ovarian hyper-stimulation syndrome (OHSS ).

Success rate of IVF:

IVF has been noted to have a high success rate over other assisted reproductive technology. However, IVF may not be successful in each and every case.

Risks associated with IVF procedure:

There is a chance of bleeding, rupture of bowel or bladder and infection during egg retrieval step.

IVF carries a risk of multiple pregnancy when many embryos are transferred which in turn may give rise to low birth weight baby and premature delivery.

The major impact of in vitro fertilization on patients is on their finances due to its high cost. Emotionally couples are drained in case of In Vitro Fertilization failure.

Egg Freezing – Female Fertility Preservation Option

Female infertility is a condition that explains when a woman experiences trouble in getting pregnant. Approximately, it is stated that 1 out of every 6 couple faces this problem. Talking about the infertility, it is not just the female that gets affected; males can also have the fertility issue. It is studied that female infertility factor contributes approximately 50% of all the infertility cases. There are number of cases that can cause female infertility and these are mentioned below:
• Damage of fallopian tube
• Unusual hormonal Change
• Cervical Issue
• Trouble in Uterine

Solution to Female Infertility
One of the best solutions to female infertility is Egg Freezing. It is a method of storing a woman’s unfertilized eggs. In order to obtain eggs for freezing, a woman should usually have hormonal stimulation for at least 10 – 12 days. In this concern, when a woman is ready to use her eggs, they are firstly warmed, and then fertilized with sperm. While the unfertilized eggs that are freeze would allow the woman to conceive at a later dates. The frozen eggs are stored for years so that it can be used afterwards.
• Egg freezing process includes hormone stimulation, where you would find that the stimulation medications are self-administered by pushing a daily injection using a pen device with a small needle.
• The next is the egg collection, where the eggs are collected from the ovaries inserting in to the vagina. The needle is passed through the vaginal wall thereby sending into the ovaries thereby allowing the doctor to aspirate eggs easily.
• The final is Vitrification, where the eggs undergo the freezing process and the liquid from the eggs are separated.

Benefits of Egg Freezing
• Egg freezing would allow you to easily maintain the personal goals and maintain the dream of motherhood. It ultimately takes the control of your life and provides you a choice to get pregnant when the time is right.
• Egg freezing would allow you to currently protect the health of your eggs and at the same time increase your chances of conception through the IVF if needed in the future.
• It keeps you biologically strong and let you take control of your life thereby providing a choice to get pregnant when it is the right time.
• It also helps you ensure the possibility to conceive and become pregnant by using your own eggs in the future and have biological child.

So, it is one of the best practiced solutions that would help you experience fertility.

Dr Shivani Sachdev Gour – IVF Doctor in Delhi, Fertility Treatment Doctor

10 Important Questions to Ask your Gynecologist

People those who stay sexually active might have visits to gynecologist at least once in life time. For those who haven’t, so visit because they are the one who can help you get all your answers related to sexual issues. You don’t need to uncomfortable or awkward in asking Gynecologist the questions that you want to.

1. What kind of Birth control measures can be taken?
No matter if you are using birth control measures or if you are thinking about changing your Birth Control method, you should discuss it with you doctor. They can let you know which would be the best way for the birth control.

2. Why is my period so heavy?
Every woman’s period is different and you won’t be able to know what is normal and what is abnormal. If you experience heavy bleeding, which lasts more than a week hours is called menorrhagia. It totally depends on your age, heavy bleeding that you can experience for menopause. Besides, if anyone feels tired of dealing with heavy bleeding, it may be due to the cause of health problem. In this concern, you need to talk to your doctor as soon as possible and get treated.

3. Why I sometimes feel pressure in my vagina& pelvis?
This can be the reason of possible pelvic organ prolapsed. You might feel the problem only when an organ in the pelvis comes aside from its normal location and it starts pressing against the walls of the vagina.

4. What is that comes out from vaginal discharge?
If you find milky-looking discharge from your vagina it is completely normal. The discharge can be explained as your body’s regular “housekeeping” mechanism that perfectly helps in flushing old cells from your system.

5. Why does sex sometimes painful?
Not every woman would experience pain during intercourse, but if you feel the pain during intercourse, you should directly talk to your gynecologist and seek his/her advice on it.

6. Why does Vagina Smells?
Vaginal odor is common in every woman and you need not have to worry about it. But, if you find something different and uncomfortable related to vaginal odor, your gynecologist should know about it. This can be due to excessive discharge or even burning and itching as well.

7. Why do I leak Urine Sometimes?
This can be the sign of urinary incontinence, which you might experience due to stress incontinence. If you are facing this, you would lose few drops of urine or even sometimes small stream of urine when straining. You need to ask your doctor for this UI treatment.

8. Why it itches down there?
Itching in Vagina can be embarrassing and troubling and you might be facing this because of infection. This can also be a sign of sexually transmissible infection and even can a bacterial infection. So, if you are facing such itching for long do not hide it from your doctor. Let you doctor treat it.

9. Is possible that I can get pregnant during period sex?
It’s not that true, but to get the correct answer, you can check it with your gynecologist.

10. When can I be Sure not be pregnant?
It is complicated, but you can use protections. The best thing would be to discuss it with your doctor.

Ask you gynecologist all the issues that you are facing and you want to know. Never hide anything from your doctor as it is they who can treat your issues easily.

Dr. Shivani Sachdev Gour, a famous name of IVF expert in Delhi.

Dr. Shivani Sachdev Gour: A Trustworthy Obstetrician and Gynecologist in Delhi

You might have met many couples who don’t have any offspring even after 2 to 3 years of marriage. The reason is infertility which is explained as not getting pregnant even after having carefully timed and unprotected sex for one year. Any issue related to such issues can be resolved because nowadays there are many clinical ways that can help you get pregnant and let you enjoy the phase of parenthood.

 

You can meet with infertility specialists namely Dr. Shivani Sachdev Gour, who is one of the prominent Obstetrician and Gynecologist in Delhi. She has practiced as an Obstetrician & Gynecologist and even as Infertility Specialist for the past 16 years. She has completed her medical and Obstetrical qualifications from Mumbai in the year 2000. She was also involved with the treating of the first cases of legal surrogacy in India. Talking about her expertise; she has spent four years in the United Kingdom and worked as an IVF clinical research fellow at the prestigious Hammersmith Hospital.

 

She has also practiced as a Gynecologist and Obstetrician at Royal Infirmary of Edinburgh, where she has gained membership of the Royal College of Obstetricians and Gynaecologists (UK) in May 2005. After this, she has returned to Delhi in the year 2007 in order to consult with an IVF specialist with Delhi’s premier Infertility treatment centers. With all her dexterous and expertise, she now leads the SCI Healthcare and SCIIVF Hospital surrogacy and IVF programs.

 

Benefits of IVF

IVF is very beneficial as it can help conceive and let you enjoy the time of parenthood. The ultimate advantage of IVF is to achieve a successful pregnancy and a healthy baby. IVF can help in making the reality for those people who were unable to have a baby for a long time.

  • IVF can bring up the best opportunity of having a child by using their own eggs
  • Through IVF the chance of older patients conceiving can also be increased. Moreover, the process focuses on using quality of eggs as well.
  • IVF also proved to very successful in patients with PCOS
  • IVF treatment can also be done by using donor egg

 

If a patient would require advanced technological assistance in IVF, the cost would be a bit higher. For ICSI treatment it will require an additional Rs. 1,50,000 to Rs. 2,50,000 and for FET (Frozen Embryo Transfer) procedure will cost about Rs. 1,20,000, apart from the IVF cost in India.