Showing posts with label infertility treatment. Show all posts
Showing posts with label infertility treatment. Show all posts
Saturday, May 21, 2016
Friday, May 20, 2016
Treatment & Services of IVF Department at indraprastha Apollo Hospitals Delhi, India
Treatment
Options Available:
·
Complete Assessment of male and female subfertility
·
Ovulatory induction / controlled ovarian stimulation
·
Intrauterine Insemination (IUI) – Husband / Donor
·
In Vitro Fertilization (IVF)
·
Intra Cytoplasmic Sperm Injection (ICSI)
·
Semen Bank
·
Donor Oocyte Program
·
Donor Embryo Program
·
Sperm retrieval techniques
·
TESA - Testicular Sperm Aspiration
·
TESE - Testicular Sperm Extraction
·
MESA - Micro Surgical Epididymal
Sperm Aspiratio
·
PESA - Percutaneous Epididymal Sperm
Aspiration
·
Cryopreservation Services (for Gametes and Embryos) (Fertility
Preservation)
·
Blastocyst Culture
·
Assisted Hatching
Assisted Reproductive
Technologies (ART):
Any
medical technique that attempts to obtain a pregnancy by means other than by
intercourse is defined as ART. These techniques involve the manipulation of
sperm or Oocyte or both, and the gametes or the embryos are transferred into
the uterus or fallopian tubes. ART includes Intrauterine Insemination (IUI), In
Vitro Fertilization-Embryo Transfer (IVF-ET), Intra-Cytoplasmic Sperm Injection
(ICSI). Assisted Hatching (AH) etc. We at ARRU provide you the full ranges of
ART services to aid your infertility treatment and help you to bear a child.
Successful outcome with minimum invasion is always our priority.
Intra
Uterine Insemination (IUI):
This
is the method by which processed semen is placed directly in the uterus with
the help of a catheter. IUI can be done in a natural cycle, however, to get
better results, it is usually preceded by ovulation induction / ovarian
stimulation using appropriate fertility enhancing drugs. With a policy of
initial treatment by 1UL approximately 20 % couples (cumulative pregnancy
chances) would achieve pregnancy. However, there is not much benefit by
continuing same treatment repeatedly and after 3-4 unsuccessful cycles of IUI;
couple should consider IVF or ICSI treatment. Advanced female age, poor post
wash semen quality and a history of tubal factor or previous pelvic surgery are
significant risk factors for poor IUI success rates. In Vitro
fertilization (IVF) and Embryo Transfer (ET)Commonly known as “Test Tube
Baby". IVF means fertilization of an ovum outside the body
and consequently transfer of the fertilized ovum (embryo) into the uterus of
the woman. IVF is probably the most widely practiced ART procedure in the
world. The procedure does not need overnight admission at any step and the
complete treatment is conducted on outpatient basis.
Steps
involved in IVF procedure:
·
Ovarian stimulation by hormonal
injections to produce multiple eggs (some patients require ‘down regulation’ of
their natural hormones by medicines starting on Day 21 of their previous cycle,
before starting their ovarian stimulation)
·
Monitoring of the response by
ultrasound scans and blood tests.
·
Egg retrieval with the help of a
needle under local /general anesthesia.
·
Collection and adequate preparation
of sperm from male partner on same day.
·
Fertilization of the eggs in the
laboratory.
·
Transfer of the resulting embryo(s)
into the uterus of the woman.
·
Hormonal treatment to support Embryo
Implantation over next two weeks.
·
Blood test is performed 15 days after
ET to access the establishment of pregnancy.
If the treatment
procedure is successful, one or more embryos will implant in the uterus and the
pregnancy will result, just as it happens in the natural process of conception. Indications for IVF:
IVF is helpful in a variety of infertility cases involving: -
·
Bilateral tubal blockage or
abnormality
·
Male factor infertility
·
Unexplained infertility
·
Where ovulation induction/stimulation
(OI / OS) & IUI has failed
·
Endometriosis
Ejaculatory disorders
·
CBAV - congenital bilateral absence
of the vas deferens
·
Obstruction of both ejaculatory
ducts.
·
Failed vasectomy reversal.
·
The steps involved in ICSI procedure
are exactly the same as for IVF, except that fertilization is achieved with the
help of a micromanipulator.
In many cases when there is a complete absence of sperm in
the ejaculate (Azoospermia), normal sperm can be retrieved from the testis /
epididymidesand used for ICSI.
The
Testicular / Epididymal sperm retrieval techniques are:
·
PESA - Percutaneous Epididymal Sperm
Aspiration
·
MESA - Microsurgical Epididymal Sperm
Aspiration
·
TESA - Testicular Sperm Aspiration
·
TESE - Testicular Sperm Extraction
Cryo Preservation of Embryos (Embryo freezing):
Excess (Surplus) embryos can be Cryo-preserved at ultralow
temperatures for many years. These frozen embryos can be used subsequently
without the need for ovarian stimulation and egg retrieval. However the
pregnancy rate following transfer of frozen embryos is lower than that with
fresh embryos.
Assisted Hatching (AH):
The procedure is based on the fact that an alteration in
zona pellucida (outer covering of egg) either by drilling a hole through it or
by thinning it, will promote hatching or implantation of embryos that are
otherwise unable to escape intact from the zona pellucida.
IVF Using Donor Oocyte
(Eggs):
Women who are unable to produce their own eggs or their eggs
failed to fertilize during an IVF cycle due to poor Oocyte quality can be
helped by using other women's egg (Donor Oocyte). Replacement of donor embryos
and surrogacy are other available options to the infertile couple.
Semen
/Sperm freezing:
Semen /Sperm can be stored frozen at ultra-low temperatures
for long duration which could be helpful in a variety of circumstances such as:
·
Semen freezing prior to chemotherapy.
·
Inability of the male partner to be
present or to deliver the semen on the day of procedure (however, the frozen
semen is used as a standby and fresh sample is always preferable)
·
Testicular biopsy / sperm freezing to
avoid repeated biopsies.
·
Donor semen, until getting a repeated
investigation done for the infectious diseases.
Semen Bank:
We are having a semen bank at ARRU. The bank contains frozen
sperm from voluntary donors with various backgrounds and physical
characteristics to match with the individual needs. Donors are screened
thoroughly to rule out transmission of any infectious or genetic diseases.
Investigations
Required For Subfertility Evaluation or an ART Procedure:
For
successful conduction of the ART procedure(s) the couple has to undergo certain
investigations:
Investigations
for female partner:
·
General Health Check Tests
·
Tubal patency tests: This
test detects blockages or pelvic adhesions in your fallopian tubes. It includes
procedures like gas insufflation, hysterosalpingography (HSG), laparoscopy,
etc.
·
Pelvic ultrasound: It
checks the status of your uterus, fallopian tubes, endometrium and ovaries to
identify fibroid tumors, endometriosis, pelvic infections, ovarian cysts,
hydrosalpinx etc.
·
Follicular monitoring: This
involves a series of ultrasonic monitoring of the ovarian follicles to identify
when the egg is mature.
·
Ovulation testing and Hormonal Assay: These tests measure your hormone levels to determine
whether you are ovulating or not.The testsmeasure the levels of Estradiol,
Follicular Stimulating Hormone (FSH), Luteinizing Hormone (LH), Progesterone,
Prolactin and Thyroid Stimulating Hormone and thyroxin (T3/T4) hormones.
·
Hysteroscopy and laparoscopy: These procedures provide exact condition of your pelvic
organs and are helpful in diagnosing abnormal uterine conditions such as
fibroids, scar tissue, polyps and congenital malformations.
Investigations for male partner:
·
General physical examination
·
Semen analysis
·
Semen culture &sensitivity
·
Transrectal and scrotal
ultrasound
Investigations for both the
partners
·
HIV
·
Hepatitis B
·
VDRL
·
Blood grouping
Hepatitis CTreatments & Services of Gynecologist & Obstetricians at Indraprastha Apollo Hospitals Delhi, India
At Indraprastha Apollo Hospitals various services
provided by the department of obstetrics and gynaecology includes:
Apollo’s Assisted Reproduction
Unit (IVF Unit)
It is our aim to provide the latest scientific
developments in infertility
treatment, in a friendly and informal environment. We aim
to set standard for the treatment of the infertile. Our state-of-the-art IVF
lab is backed up by highly experienced doctors, who have been involved in the
field of infertility and assisted Reproductive technologies (ART) for many
years in India and abroad with extensive firsthand experience and very
respectable success rates. A full range of diagnostic and treatment procedures
are available for the infertile couple in Apollo’s Assisted Reproduction Unit
(“AARU”). We provide consistent 24*7*52 Service (No waiting for the batches)
with full time in-house embryologists and supportive laboratory services.
Individualized patient care by our internationally trained and experienced
professional team ensures maximum success rates possible.
Infertility Treatment Options
Available
·
Ovulation
induction/ Controlled ovarian stimulation
·
Intrauterine
insemination (IUI) – husband/donor
·
In
Vitro Fertilization (IVF)
·
Intra
Cytoplasmic sperm injection (ICSI)
·
Sperm
retrieval techniques – TESA (Testicular sperm aspiration), TESE (Testicular
Sperm Extraction), MESA(Microsurgical epididymal sperm aspiration), PESA
(Percutaneous epididymal sperm aspiration)
·
Semen
Bank
·
Donor
Oocyte Program
·
Donor
Embryo program
·
Cryopreservation
of gametes and embryos/ Vitrification
·
All
other advanced technologies
Laparoscopic and Hysteroscopic
surgeries
Well trained Hysteroscopic and laparoscopic gynaecologists with
years of experience in India and abroad individually tailor almost all
gynaecological operations to needs using modern modality of surgery. Some of
the common laparoscopic surgeries performed are for:
·
Laparoscopy
·
Ectopic
pregnancies
·
Ovarian
cysts
·
Hysterectomies
(laparoscopic assisted vaginal hysterectomy)
·
Myomectomy
for fibroid
·
Laparoscopic
treatment for infertility
·
Endometriosis
etc.
·
Chronic
pelvic pain
·
Hysteroscopy
·
Fibroid
removal
·
Removal
of Polyps
·
Menstrual
problems
·
Infertility
·
Uterine
septum
Shortly
we shall be introducing Robotic surgery
Natural Access Scar less Surgery
This implies vaginal surgery operations like:
·
Hysterectomy
·
Prolapse
·
Myomectomy
·
Polypectomy
Post
operative recovery is maximum with this approach and results in less pain since
it is a totally scarless method much like a normal vaginal delivery.
Urogynaecology
We offer complete evaluation, assessment,
management (medical & surgical) of female urinary incontinence, urgency,
urge incontinence, recurrent urinary infection, voiding problems, anal
incontinence as well as pelvic floor dysfunction including Urogenital Prolapse,
post hysterectomy vault Prolapse and sexual dysfunction. Women are offered a
variety of treatment options including non-surgical such as pelvic floor
exercises, biofeedback, medical management and surgical procedures as
appropriate. The surgical options include minimally invasive techniques such as
TVT, TVT-O and other meshes and the conventional surgeries for incontinence and
Prolapse.We have a dedicated lab for urodynamics and uroflowmetry. Urinary
problems of urgency, urge incontinence and stress urinary incontinence are
assessed and managed medically and surgically as well.
Fetal Medicine
Problem pregnancies, both because of genetic and
structural growth defects in the fetus or because of maternal complications are
seen by specialists. The availability of high resolution ultrasound machines, a
genetic lab and intrauterine procedures such as amniocentesis, fetal blood
sampling and fetal transfusion, help in carrying the pregnancy forward safely.
Neonatology
·
Specialized
care of sick term and tiny preterm babies is provided at our hospital
Availability of advanced
life support equipment and transport facilities is also ensured
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