Proper coun­sel­ing is key to suc­cess

IVF India - - Jaipur, Rajasthan -


• In­fer­til­ity work up with ad­e­quate coun­sel­ing.

• Di­ag­nos­tic Transvagi­nal Sonog­ra­phy (TVS)

• In­ter­ven­tional TVS

• Fol­lic­u­lar Study / Ovu­la­tion pro­file

• Video con­trolled di­ag­nos­tic and op­er­a­tive hys­teroscopy and la­paroscopy.

• Fal­lop­ian tubal re­canal­iza­tion

• VEA (Va­soe­pi­didy­mal Anas­to­mo­sis)

• In­trauter­ine in­sem­i­na­tion

• IVF-ET ( Test tube baby)

• IVF-ICSI (Poor sperm func­tions or re­peated IVF fail­ure)

• TESA/PESA (Ob­struc­tive azoosper­mia)

• Se­men freez­ing

• Cry­op­reser­va­tion of Em­bryos

• Man­age­ment of Nor­mal and high risk preg­nan­cies and De­liv­er­ies

(a) What is IVF? In Vitro Fer­til­iza­tion and Em­bryo Trans­fer (IVF-ET) is a pro­ce­dure that en­hances the chances of con­cep­tion in those cou­ples when other fer­til­ity ther­a­pies have been un­suc­cess­ful or are not pos­si­ble.

(b) When is IVF in­di­cated? 1. Fe­male fac­tors • Blocked fal­lop­ian tubes • Anovu­la­tion not re­spond­ing to med­i­cal treat­ment • En­dometrio­sis • Al­tered tubo-ovar­ian re­la­tions due to ad­he­sions and or pre­vi­ous ab­dom­i­nal surgery • Sex­ual dys­func­tion e.g. vagin­is­mus 2. Male fac­tors • Mild to mod­er­ate oligoas­thenosper­mia not re­spond­ing to med­i­cal ther­apy • Se­vere oligoas­thenosper­mia (ICSI is ad­vised) • Ob­struc­tive azoosper­mia ( TESA/PESA with ICSI is ad­vised) 3. Un­ex­plained In­fer­til­ity

(c) What are the steps in­volved in in­fer­til­ity? • Su­per­ovu­la­tion - stim­u­lates egg de­vel­op­ment • Oocyte (egg) Re­trieval - Done un­der IV se­da­tion by transvagi­nal guided ul­tra­sound. • Col­lect­ing and pre­par­ing se­men - Done on the day of egg re­trieval. • In­sem­i­na­tion of eggs and em­bryo cul­ture • Trans­fer­ring em­bryos to the uterus • Done on Day 2, 3 or day five of de­vel­op­ment and two to three em­bryos are trans­ferred • Ex­tra em­bryos are frozen af­ter tak­ing in­formed con­sent. • Blood for Beta HCG is done 2 weeks af­ter em­bryo trans­fer

(d) What are risk or con­cerns in­volved in IVF-ET • Risk of Ovar­ian Hy­per­stim­u­la­tion Syn­drome (OHSS) • There may be a fail­ure to re­cover an egg • Eggs re­cov­ered may not be nor­mal • Some­times male part­ners may not be able to pro­duce se­men spec­i­men but this prob­lem is treated by se­men freez­ing as "back up" • Fer­til­iza­tion fail­ure in­spite of nor­mal eggs • Ab­nor­mal de­vel­op­ment of em­bryos which are then not trans­ferred. • Em­bryos trans­fer may be dif­fi­cult or there may be im­plan­ta­tion fail­ure • Any step in IVF-ET process may be com­pli­cated due to un­fore­seen equip­ment fail­ure, lab­o­ra­tory con­di­tion etc. • Con­gen­i­tal mal­for­ma­tion, ge­netic ab­nor­mal­i­ties, men­tal and other birth de­fects oc­cur in 3% of spon­ta­neously con­ceived chil­dren, may also oc­cur IVF ba­bies • Adop­tion till date, is still an al­ter­na­tive to IVF-ET.

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