Month: February 2019

Being diagnosed with infertility can be an extremely painful and challenging experience. It is often talked about that going for an IVF can be a roller coaster ride with a lot of ups and downs of emotions and it is extremely normal for you to feel stressed about it. However, it is important to keep in mind that you are not alone, everyone going through this phase has mixed emotions. Everyone’s reaction to the diagnosis of infertility is different and is extremely normal. It is normal to ask ‘Why Me?’ but it is ‘Not You’, Infertility is Normal and it can be treated with the right treatment and care.

In-vitro Fertilization (IVF) is not a single process but rather a series of steps or hurdles where each stage has to be crossed before tackling the next one. You may find yourself experiencing the following during your IVF journey:

• Your emotions would be more intense. You may feel more vulnerable, angry, sad, anxious, isolated, with a sense of loss, shame than usual.
• You would take less interest in things that you previously enjoyed doing.
• You may react in a very different way to your spouse or friends over little things they’ve said…
• You might pick up on arguments that previously did not matter much.
• You may stay in more and avoid going to social gatherings, especially where you encounter babies or pregnant friends.

Responses to hormonal medication used during stimulation sometimes may have an impact on you or not. Some women do not have any symptoms at all while other women feel more emotional and irritated. Others might feel uncomfortable with bloating, nausea, disturbed bowel movements, tiredness, headaches and mood swings. While you cannot help the way you feel you can definitely find a way to better manage your feelings and reactions.

• Information is the key to power, understanding and preparing yourself for IVF by talking to your doctor or counselor, so as to understand the treatment better.
• Ask Questions to all the people around, nurses, coordinators, counselors, doctors, and clear your doubts.
• Talk to your counselor, who can professionally help you deal with the interpersonal issues that you are facing.
• It is important that you take an adequate amount of rest and do not stress yourself during your process.
• Do not put yourself into extreme situations which can make you feel different or anxious, like moving to a new house, going to a big event, anything which can be emotionally hard for you to take.
• Try to do something meaningful and engage yourself in your favorite activities or spend some quality time with family and friends.
• Be thankful for the positive things in life.
• Communicating more with your spouse by expressing how you feel during this treatment would be extremely helpful.

We know this journey can be hard for you but it will lead you to something beautiful and precious. We at Pristyn Care Ferticity, want to give you that ‘Gift of Life’ by helping you with all your fertility-related issues or queries. Talk to us now, the best IVF centre in Delhi is here to help you!

Compiled By:

Anchita Kapoor

Counselling Psychologist

What is the problem with us, why are we not able to conceive?

The female as well male partners both need to be assessed for the potential problems. First of all, history is taken which focuses on the duration of the marriage and since when the couple was trying to conceive. The menstrual history is taken to assess whether the female is normally forming and releasing one egg per cycle. The past medical/ surgical history or family history such as tuberculosis, diabetes, hypertension is assessed. Also, previous treatment records are reviewed and documented. Some initial blood tests are done to know the general health of the patient. The male partner is advised to take a semen examination which includes sperm count, motility, and percentage of normal-shaped sperms. A baseline ultrasound of the female partner is done in the clinic to assess her ovaries and uterus.

What will be the next step and how are we going to proceed?

Based on the initial history and examination, the problems are identified in both partners. Depending on the problems, thorough counseling is done and step by step treatment plans are made.

When the problem is at the formation of an egg i.e. ovulation, then the drugs for ovulation are given to a woman and timed intercourse or IUI( Intrauterine Insemination ) at the time of egg rupture is offered. Similarly in patients where semen parameters are subnormal then IUI (separating and putting one of the healthiest sperm in the womb) is offered. Before IUI, a sonosalpingogram test is done routinely without anesthesia. It is a test to know whether the tubes are open or not.

4-5 cycles of ovulation induction and IUI can be offered to the patient depending upon the age and other factors. If the number of eggs is less in the ovary then treatment should be at the earliest and thus, IVF is offered. If both the tubes are blocked then, IVF is the only solution.

What is IUI? How is it done?

It is a technique where semen is prepared, concentrated and put inside the womb at the time of egg release. It has the advantage of directly putting sperms that are good in number and highly motile closer to the egg. It is an office procedure and is done without any anesthesia. There is no cut or pain involved. The patient needs to rest for 15 minutes and can carry out her daily routine.

How many cycles can I try for IUI?

The chances of conceiving are maximum within the first 4 cycles of IUI. However, a maximum of 6 cycles can be done depending upon the age and ovarian reserve of the patient.

What are the chances of us getting a baby?

In IUI chances are between 10-15% per cycle. In IVF, there is a chance of 40-45% per cycle .

What is IVF & ICSI? How is it done?

IVF is the technique where drugs are given to the female partner to produce many eggs. The eggs are then collected through the vagina. The procedure is called ovum pick up and it is done under general anesthesia. This procedure requires no cuts or stitches. The eggs are then mixed with the sperm to make babies. When the eggs are incubated with semen in a Petri dish then fertilization takes on its own, this procedure is known as IVF( In vitro fertilization). However, when one sperm is injected inside each egg then it is known as ICSI ( Intracytoplasmic Sperm Injection). The embryos are kept in an incubator and transferred into the womb on day 3 or day 5 depending upon the number and quality of the embryos.

What is the duration of the treatment?

The stimulation of the female takes 9-10 days. It starts from day 1 or day 2 of the cycle. Then the ovum pick-up occurs 34-36 hours after which the final injection is given to mature the eggs. The embryo transfer occurs from day 2 to day 5 after the pick-up. So the whole process takes around 12-15 days. Sometimes, when the female produces a large number of eggs, especially in the case of polycystic ovaries, then the embryos are frozen and transferred into another cycle, and it is known as the Frozen embryo transfer cycle.

What precautions do we need to take before starting the treatment?

The female is advised to take a healthy diet with regular exercise. Good sleep, yoga/meditation helps to relax oneself. Smoking and alcohol should be avoided.

How is the embryo transfer done?

It is a simple procedure without anesthesia. The woman is asked to come with a full bladder and with the help of abdominal scan guidance, the embryos are placed inside the uterine cavity in the right place. It is a painless procedure and one can go home or work after the procedure.

What are precautions after the embryo transfer?

Constipation should be avoided by drinking plenty of fluids and having a good diet rich in roughage. Rigorous exercises like lifting heavy weights should be avoided. The medicines and injections on the prescription should be taken diligently.

If you have any questions don’t hesitate to reach out to us, our fertility experts at Pristyn Care Ferticity Fertility Clinics will be glad to help you.

We are one of the best IVF centres in South Delhi and have helped thousands of couples to build a happy family. You can be the next!

FSH stands for follicle stimulating hormone. It is produced by the pituitary gland in the brain. As the name suggests, it stimulates the growth of the follicle inside the ovary. Its level in the blood are in turn regulated by the estradiol and inhibin produced by the growing follicle inside the ovary.

FSH levels are measured along with antimullerian levels( AMH) and antral follicle count( AFC) to assess the ovarian reserve of the patient. As the FSH levels vary throughout the menstrual cycle, it should be done on day2/3 of the cycle and preferably along with estradiol levels for correct interpretation.

As the age advances, the number of follicles decline in the ovary resulting in low AMH and High FSH levels. However in around 10% of the patients accelerated ovarian ageing occur and they present with low AMH and high FSH levels at a younger age. Certain autoimmune disorders , prior radiation , chemotherapy , as well as certain viral infections may cause ovaries to fail prematurely which is defined by FSH levels > 40 mIU/ml .

High FSH and low AMH entails need for aggressive fertility treatment. IVF remains cornerstone therapy in these patients.

The success rate of IVF using self eggs varies from 6% to 30% depending upon the age of the patient and cause of the decreased ovarian reserve. A young patient with decreased ovarian reserve or high FSH has a better prognosis than a old patient with high FSH. The challenge for fertility specialist in such patients is at many levels. Poor response to stimulation requiring high dose of gonadotropins, obtaining less number of poor quality oocytes which in turn form poor quality of embryos with chromosomal abnormalities. This result in poor implantation rate and high miscarriage rates . Prestimulation with DHEA , and aggressive individualised stimulation protocols may help in some patients

The success rate of IVF using donor eggs is upto the tune of 60% to 70%. Since donors are typically of a young age, the chances of miscarriage are of a young woman with normal ovarian reserve. Donor egg is also treatment of choice for patients with premature ovarian failure.

Every couple should be thoroughly counselled so that they are able to take an informed, individualized decision.

It is in research that patients at risk of developing decreased ovarian reserve may be identified through screening of FMR1 gene premutations. These patients may be offered fertility preservation through ovum or embryo preservation. Patients undergoing chemotherapy or radiation therapy may be offered ovarian cortex cryopreservation.

Therefore treatment options for patients with high FSH are highly individualised and need thorough discussions and counselling with the fertility specialist.