FAQ

1. What is Infertility?

For a couple, Infertility is a curable state of failure to be pregnant within a period of one year despite non-contraceptive attempts.

2. What are the causes of infertility?

Men & women are equally vulnerable to infertility

In men the vulnerability might be due to the following;

(a) Semen problems – Low count / No count: Poor/nil motile sperm: Morphologically not good sperm

Various factors like sperm count, motility, morphology and DNA integrity of the sperm are taken into consideration when it comes into sperm parameters.  Scarce health for sperm and raised viscosity levels, that is thick semen, might affect fertility. Infections in genital tracts can also lead to infertility.

(b) Sexual problems

Erectile malfunctioning and more simply a lack of interest in sex are causes of infertility.

A person with a lack of exercise due to sitting jobs, to be more precise sedentary jobs are vulnerable to infertility. Excessively fat people termed as obese might suffer problems with fertility. Alcoholism, smoking and various other kinds of tobacco usage makes a person a candidate for infertility. Persons suffering inordinate stress from their occupation and those who are exposed to petroleum and related products and also those who work in high degrees of temperature can all succumb to infertility.  

(d) Surgery on Testis

A Person who has undergone testicular surgery might be prone to infertility. Past records suggest that 15% of those who have undergone Testicular surgery develop infertility.

In Women 

(a)     Problems in Ovary - PCOD, obesity, hormone problems

Polycystic ovarian disease is a common cause of infertility in woman. Partly happens due to tradition but mostly due to lifestyle and needs strict dieting for cure. 

(b)     Tube Problem - block- due to infections, endometriosis/previous surgeries/ Tubectomy

Fallopian tube problems can be another major reason for infertility.

Endometriosis is a wrong growth of tissue in uterus region. However there are treatments now for us to correct the tradition.

(c)  Uterine Problems - fibroids, polyps, septum

Various growths in Uterus termed fibroid, polyps can be problems against conceiving.

(d)  Unexplained

(e)  Ovarian function may stop before age of 40 years.

Mostly women vulnerabilities to infertility are caused by unfortunate yet genuine medical condition which does not have any cause other than perhaps destiny, which is as distinct from that of the case of men. Hence each of these problems needs detailed evaluation and treatment.  Pregnancy is definitely possible in each of these patients.

3. Do Couple with repeated abortions or fetal death need evaluation and treatment?

Yes, they definitely need detailed evaluation.

Common causes could be:

a) Septa in Uterus/anomalies of Uterus
b) Hormonal Problems - Thyroid....or PCOD
c) Uncontrolled diabetes
d) Antiphospholipid antibody syndrome
e) Poor sperm quality

These have to be diagnosed before the next pregnancy and treatment need to be started.  Healthy Pregnancy is definitely forth coming for these patients.

4. What is IUI?

Intra uterine insemination is collection of Husband's sperm using special laboratory techniques and then healthy sperms are separated and are transferred into the uterus.

5. Who need IUI?

Male

Semen with low count and/ or reduced motility
premature ejaculation
Difficulty in sexual contact
retrograde ejaculation
Genital Problems

Female

Ovulation Problems
Endometriosis
Unexplained Infertility
those receiving injections for improving the ovulation have better success rate with IUI

Success Rate: 10-15/19-25 %, successive IUI's have higher success rate.(Now we are getting 17-23% success rate)

Pre medication before IUI:

After Oral Medication from 3rd day of periods a follow up of follicular growth is conducted using scan. When it is found that the follicle is of right size HCG injection is administered to trigger ovulation. HCG or Human Chorionic Gonadotropin is a hormone considered to augment ovulation.

Do's for Husband before IUI:

Sexual contact (Abstinence) must be avoided for at least 2 days before IUI. Before the semen is collected it needs to be vouchsafed by the husband that genitals are washed clean.

Details of IUI:

According to the timing of the HCG the couples need to be present at the Hospital. There is no diet restriction on the day of the procedure.  Semen is collected for processing and after a specified time which is around 60 to 90 minutes the husband’s semen is placed into wife’s uterus using thin cannula. Cannula is a tube of small size used for insertions into within the body.  Since the procedure is absolutely painless and bloodless anesthesia or sedation is not required. After the process heavy works and long journey need to be avoided. If the next period is missed morning sample of urine has to be checked for pregnancy and then report to the Doctor. 

6. How does pregnancy occur?

During every mid-menstrual period, one of the 2 ovaries releases an ovum. Each Ovum is covered by a membrane called follicle, which is filled with a fluid. This follicle ruptures and releases the ovum which is called ovulation. This ovum travels through the fallopian tube with the help of hair like structures called cilia and reaches the uterus.

A sexual contact induces a millions of sperm to reach the vagina of which about 2000 sperms survive and reach the fallopian tube. Least an ovum, if present in the tube, the process of fertilization ensues. Sperm stays alive for 3 days in the tube and one amongst them penetrates the wall of the ovum leaving the remnant destroyed. Such a fertilized embryo [ovum+sperm] splits into two and becomes 64 cells in 72 hours. The fertilized egg around 5th day reaches the uterus, sticks on to the uterine walls. This process termed nidation or implantation need to succeed for the state of pregnancy.

7. What is IVF?

During normal menstrual cycle instead of one follicle many follicles are stimulated by hormone injections. With the help of scan these follicles are taken out, mixed with husband's sperms and the resulting embryo is kept back into the uterus.

8. What is ICSI?

ICSI is intra cytoplasmic sperm injection. This is an ideal method for those with low sperm counts. Centrifuged and healthy sperm is injected into such ovum using a micromanipulator.

9. Who needs ICSI?

Male Factor:

- Unhelathy Sperms
- Obstruction in the track of sperm movement
- Absent sperms & Failure to ejaculate

Female Factor:

- Failure to Ovulate
- Endometriosis 
- Adhesions around uterus -Both Tubes blocked or absent
- Ovaries without follicles/eggs 

10. What are the steps of ICSI?

For this procedure, since more number of follicles will be needed, hormonal injections are given for 12 days prior to the ovum retrieval. Daily Injections with timely scan are done. As per the evidence of follicles growth on scan, the closes of hormone injections are titered. 

Once the follicles are fully matured HCG injection is given. After 36 hrs following, the ovum is taken out transvaginally using using a needle with the help of Ultrasound scan. The patient is discharged after a few hours.

The self same day sperm is collected and healthy sperms are segregated. The healthy sperms thus retrieved are injected into the ovum using advanced high end equipments and the resulting embryo (usually after 2 days) is kept back into uterus. After these progesterone injections are given to support implantation. This is followed by Embryo growth and blood is tested for pregnancy hormone after 13 days. Extra embryos are frozen for future use.

All these steps are out- patient procedures 

Reason for stopping the Treatment:

Despite injections follicles often fail to grow as well as in certain cases Follicles prevail with an absence of ovum. These are sufficient reasons for termination of treatment.

What is the Success Rate?

Even though percentage of Pregnancy is between 60 and 70% take home baby rate can only be determined at 40% because of missed abortion, tubal ectopic etc as like in normal pregnancies.

How is ICSI Pregnancy different from Normal Pregnancy?

Normal Pregnancy is destiny while IVF/ICSI Pregnancy is God’s gift for us. If this can be considered a difference worth considering then it is one. Other than that children born of ICSI Pregnancy and normal pregnancy have not recorded any distinct variations in education, health, behavior etc.

11. Does everyone need IUI/IVF?

No. After in depth evaluation those who have failed in the initial or basic methods or those with severe or extensive diseases are considered for IUI or IVF/ICSI. 

12. Any Difference between IUI/IVF/ICSI pregnancy and normal pregnancy?

No. Once pregnancy is achieved, there is no difference

13.   Can IUI/IVF/ICSI always assure of a pregnancy?

Even though these methods are only alternate they have so far recorded a 45% of chance of achieving pregnancy and delivering a baby. But the important factor is that once a couple have come to the reality that one of them is affected with one of the above mentioned problems which make them infertile and still if they desperately want a child for themselves then as it is there are no better ways than these three that is IUI, IVF, ICSI to achieve it.

IVF/ICSI are the only chances for pregnancy in women - with both tubes blocked- no ovulation/periods- no periods 
Men - with no sperms- with completely immotile sperms 

14. If Periods irregular, is it difficult to have pregnancy?

No. However, obesity/ polycystic ovary, Thyroid imbalance, reasons for irregular periods, may need attention for pregnancy without complication. Still the first step in infertility treatment is correction of hormone imbalance and weight reduction. Each kilogram weight reduction increases pregnancy rate and reduces chances of abortions and future pregnancy complications. 

15. What is the procedure during each appointment?

 After hospital registration, a determining evaluation based on the medical history of the couple is done. Thereafter the couples are subjected to necessary investigations. At West fort LiFE centre we provide particular attention for each and every couple and hence no waitings and moving around since investigations/tests are done under one roof. Only definite cases will be considered for IUI/IVF/ICSI    

16. Do the injections/medicines have side effects or long term effects?

Long term effects are never a complexity to be considered since medicine for couples are antibiotics, hormones, antibodies and   antioxidants. These are only for improvement of health, follicles, sperms and ovum. None of them persist when discontinued.

17. Duration of IVF/ICSI?

Even though there might be variations regarding particular cases generally the procedure is to provide stimulations for a maximum of 12 days. Then the ovum pick-up and after two to three days the embryo transfer. Hence the duration can be determined to 15 days.

18. Is Hospital admission needed during IVF?

No.  All the procedures are as out-patient.  Only if the patient stays too far or wants to avoid travelling following ovum pickup or embryo transfer in-patient care is given.

19. Bed rest after/during IVF - is it needed?

No.  On the day of the embryo transfer and the following day do not exert too much.

20. Freezing, What is it?

Freezing is done regarding an embryo that is ovum and sperm. This is done basically for the next pregnancy. Sperm freezing is done and used if the husband is anticipated as doubtful to be available to provide sperms on day of an ovum pickup.  We have the facility to freeze and store the sperms and embryos for future use. They are frozen in liquid nitrogen after naming each of these in the couple’s name. However fresh samples are always the better option and if possible any difficulty to provide that must be compromised.

21. If my ovaries have stopped functioning at an early age, can I still have pregnancies?

Yes. Still an evaluation, accordingly detailed, will be necessary. Ovaries if determined absolutely negative a donor oocyte programme need to be considered. Oocyte is the female germ cell that relevantly participates in a process of reproduction.  Any couple, should they desire to do so, can arrange someone willing for egg donation and can conceive with donor egg+ husband sperms. Pregnancy as well as growth of the baby all is in wife's uterus. All strict secrecy will be maintained. Oocytes donors can also be arranged at an extra cost.

As the saying goes, "Never think that to have a baby would be a miracle; just remember you yourself were once a miracle." Let’s take those steps together for the "Little Feet" in your arms.