WHAT IS IUI?

IUI stands for intrauterine insemination. During this procedure men’s semen sample is processed and the obtained sperm sample being placed directly inside the Uterus. IUI is a technique to overcome a variety of mild fertility problems, many of them on the male side. IUI is also often performed in cases of so-called “unexplained” infertility by many fertility specialists.. Male infertility indications for IUI are:

? Low sperm count (there are not enough sperm for a decent chance of natural fertilization)
? Low sperm motility (sperm doesn’t have normal ability to swim up to the egg)
? Cervical factor infertility (cervical mucus inactivates sperm motility)
?Sexual dysfunction

HOW DOES IUI WORK?

IUI is usually combined with ovulation induction, a process in which a woman’s ovaries are mildly stimulated. Mild ovarian stimulation is a good idea in an IUI cycle, because ovarian stimulation encourages the ovaries to produce more than one mature egg. (In a natural menstrual cycle, only one egg matures and gets released from the ovary.) Having more than one mature egg means that the sperm used in IUI have a better chance of “meeting” an egg and fertilizing it. Ovulation induction with IUI, however, also creates a risk for multiple births.

When the ovaries have a good number of mature eggs, a hormonal injection (hCG) is used to trigger ovulation (release of the eggs from the ovaries). This injection determines when the patient ovulates. Inseminations are timed accordingly. At Omja IVF, we inseminate twice every month in most cases, once just before, and a second time just after ovulation on consecutive days.

When the male partner’s sperm count is low, his sperm have a lower chance of fertilizing the egg, simply because there aren’t as many sperm. Similarly, when the male has sperm that has too little “motility” to swim on its own up vagina, uterus and fallopian tube to the egg, sperm is unlikely to reach and fertilize the egg. By placing sperm directly into the uterus by an IUI, the greatest barrier–the mucus in the cervix–is bypassed, and sperm does not have to travel so far to meet the egg in the fallopian tube. Therefore, more sperm reaches the egg, creating a better chance of fertilization for the egg. IUI is also carried out using donor sperm. IUI with donor sperm is called donor insemination. Donor inseminations become necessary when the male does not produce even minimal amounts of sperm, and semen extraction procedures (PESA for example) fail. Contact us to see if IUI is the right treatment for you.

WHAT ARE THE RISKS OF IUI?

The main risk for IUI is the risk of multiple gestations, especially of high-order multiples (triplets or more). This is an inherent risk that is extremely difficult to avoid. The difficulty lies in the fact that the physician does not have good control over how many eggs are released at the time of ovulation, and how many of those eggs are fertilized by the semen from the IUI. Physicians try to strike the right balance between good pregnancy chance and a low risk for multiple gestations, but even in best of hands, high-order multiples will happen.

Fertility practice has come to try to avoid multiple births, especially high-order multiples, because they carry elevated risks, especially of premature delivery. The goal of good infertility treatment is, of course, not only to achieve pregnancy but to achieve pregnancy responsibly, and with as low risk as possible to mother and newborn children.







SHOULD I CHOOSE IUI OR IVF?

IUI is not recommended for women who are over 35, or women with low ovarian reserve. Older women and women whose ovarian function has already started declining should go straight to IVF, because their remaining time of reproduction period with use of their own eggs is likely to be short. IUI’s have lower pregnancy rates, compared to IVF, means that more cycles of IUI will be necessary for conception. If you don’t have the luxury to “wait and see,” your best option is probably IVF. Similarly, if the male partner has severe male-factor infertility, IUI is not the best option. In severe male infertility, sperm may need to be microsurgically injected into the eggs, in a procedure called intracytoplasmic sperm injection (ICSI). Even when there is no sperm in the ejaculate, in about 80-85% of cases, we can extract sperm from the testicles, which can then be used in ICSI (but not in IUI). For couples with severe male-factor infertility, IVF combined with ICSI is often a better (and sometimes the only) option.

IS IUI LESS COSTLY THAN IVF?

Many patients choose IUI over IVF, thinking that IUI is more cost-effective than IVF. Insurance policies tend to offer more generous coverage for IUI than IVF, for the same (somewhat wrongheaded) reason. Although IUI cycles, indeed, are less costly on a per-cycle basis, IUI cycles aren’t any more cost-effective, because of IUI’s much lower pregnancy rates. Indeed, a number of recent studies concluded that, at least in many patients, going straight to IVF, skipping the interim step of up to four IUI cycles as previously suggested, represents a more cost-effective approach. It certainly represents a more time-efficient approach! The right question, therefore, is not “is IUI less expensive than IVF?” but “is IUI more cost-effective than IVF?” And the answer, sometimes, is a definite “no”.

For many fertility patients, IUI is the gateway to infertility treatment. IUI can be a good starting point if:

? The female partner is young-under age 35.
? Ovarian reserve is normal for your age.
? Cause of infertility is a mild male cause.

This treatment decision, however, does not always make clinical sense, especially if:

? The female partner is over age 35.
? Both the tubes are blocked or damaged.
? Cause of your infertility is a severe male factor.
? You want to avoid multiple gestations.

IS IUI LESS INVASIVE THAN IVF?

There are a lot of fears circulating when it comes to IVF. Many of these fears, if not most, are completely unwarranted. Because of these misconceptions, some patients are hesitant to proceed to IVF for all the wrong reasons, and feel more comfortable with IUI. One important aspect that these patients overlook is that at least once they reach ovarian stimulation with gonadotropins (after the Clomid phase), IUI and IVF cycles are very similar: Both require daily self-injections; both require monitoring with ultrasound and blood testing; both take between 2-4 weeks. The only difference is that the IVF cycle requires egg retrieval under intravenous sedation. Contrary to widely distributed misinformation, egg retrieval is not a surgical procedure, which is performed while the patient is asleep (not with a general anesthetic; just an I.V. sedation, administered by an anesthesiologist), egg retrieval involves no incisions whatsoever! Egg retrieval involves only the aspiration of follicles through the vagina with a long needle under ultrasound guidance. So, yes, because of egg retrieval, IVF has to be considered a little bit more “invasive,” but as most patients who have gone through both kinds of experiences will tell you, the difference is minimal. When deciding on your fertility treatment, we, therefore, recommend that you thoroughly review your options with your fertility doctor, including IUI and IVF, and ask the right questions!







IVF TREATMENT IN LUCKNOW

With the advancement of modern science in the last few decades, assisted reproduction has become a successful and common course of treatment for infertile individuals and couples. In-Vitro Fertilization, IVF, is one such assisted reproductive technique that has been employed successfully as a solution to a range of infertility issues. The IVF process is both safe and effective, and it has been used in the early 1980’s in helping infertile individuals and couples achieve their goal of becoming parents. ivf treatment in lucknow In vitro is Latin, meaning “in glass,” referring to the dish that is used to introduce the sperm to an egg. The term “IVF” includes a whole spectrum of assisted reproductive treatment possibilities that can be used separately or together to increase the chances of success. Whenever possible, IVF is used to fertilize an egg with a sperm, thereby forming an embryo Fertility treatment often includes use of hormone therapy to stimulate the ovaries to produce eggs. Then, IVF begins with retrieval of a woman’s (or her donor’s) eggs. Prior to the retrieval of the eggs, the male partner (or a donor) produces a semen sample, which is processed and washed, and the most motile (active) sperm are selected. Anywhere from three or four, or even up to twenty eggs are retrieved from the woman under general sedation. This procedure requires no surgical incision and is done purely on an outpatient basis in our office. The retrieved eggs are placed in a separate dish under a protective layer of oil and left alone for three to four hours to complete their maturation.

There are two options are available in the lab. The first is routine IVF, where the washed sperm is added in a measured quantity to each dish containing an egg. This method requires numerous amounts of motile sperm from the male. The second is ICSI, which is recommended when either the quality or the quantity of sperm is low. ICSI is also useful when the zona pellucida – the membrane surrounding the egg – is so thick that the sperm cannot penetrate on its own and requires forced injection. Done under a high-powered microscope, ICSI involves selecting one sperm and injecting it into an egg. Both IVF and ICSI procedures are carried out by the well experienced in house embryologist, who is a back bone of an ART center.

MONITOR GROWTH

The fertilized eggs – embryos – are monitored in the lab as they begin the process of division. Within the next 24 hours a single embryo divides one or two times into a two-celled or four-celled embryo.In some indicated patient our doctors would consider to do the embryo transfer on day two of embryo growth..

CHECK FOR FERTILIZATION

About 16-18 hours later, the embryologist inspects the eggs under a microscope to ascertain whether they have been fertilized – whether the sperm has successfully penetrated the egg to create an embryo. The embryologist does so by looking for specific formed signs or genetic (pro-nuclear) changes: when a sperm enters an egg, it “wakes up” the condensed genetic material of the egg, activating or “opening” it and beginning the process of growth. The number of eggs fertilized is thereby noted. This is the earliest stage at which embryos can be frozen. Elective freezing enables the preservation of a woman’s potential fertility well past the time when her body could hypothetically stop producing viable eggs.

MONITORING OF EMBRYO DEVELOPMENT

Over the following 24 hours, the embryo, which has divided further into either four or eight cells, can now be transferred to the uterus. Alternatively, the divided embryos can be frozen at this stage for the preservation of future fertility. Also, the divided embryos can grow for a further 48 hours to the blastocyst stage, where either a transfer or freeze cycle can be accomplished (blastocyst transfer is explained below).

ASSISTED HATCHING

Another technique used at our centre to increase a woman’s chances of implantation is assisted hatching. To successfully implant in the womb, the outer layer or “shell” of the embryo, called the zona pellucida, must break, allowing the embryo to “hatch out” and attach to the endometrial lining. However, as a woman ages, her eggs may develop thicker shells, making it more difficult for the egg to hatch naturally; or, the embryologist may have Identifiedas a poor embryos from a previous IVF cycle. In these scenarios, the Embryologist may choose to employ assisted hatching, which is the process by which a hole is created in the shell of the developing embryo, using mechanical or chemical means, to facilitate the natural process of hatching and improve the chances of implantation with embryo-transfer.

PREIMPLANTATION GENETIC DIAGNOSIS

Day 3 is also the time when advanced techniques such as preimplantation genetic diagnosis are carried out. This technique employs molecular genetic methods to enable the identification of genetically normal embryo.







SPERM BANK

We at Omja IVF is serving with sincere care. We welcome visitors to come forward and have a counseling session with us before considering donor sperm programe. We would like to provide much information for the benefit of visitors. Centre is equiped with best counseler to carry out couselling session. Omja IVF in Lucknow is organization with multidisciplinary skills. It is known for the best organization in reproductive medicine. We at Omja IVF are engaged in best counseling, diagnosing and providing solution to childless parents with our advanced reproductive practice being followed at Omja IVF.

ICSI & IMSI SPERM INJECTION

ICSI Treatment which stands for Intracytoplasmic Sperm Injection involves the direct injection of a single sperm into each egg under direct microscopic vision. The introduction of ICSI has made it possible to fertilize eggs with sperm derived from men with the severest degrees of male infertility and in the process IMSI Treatment or Intracytoplasmic Morphologically Selected Sperm Injection is a relatively new technique used by our fertility doctors to treat male infertility. IMSI is recommended for patients who had two or more unsuccessful ICSI attempts and for males with abnormally shaped sperm. Our service are appreciated by many childless couples, please visit our website for detailed information.

ICSI TREATMENT

In centers of excellence, when ICSI is employed, the IVF birth rate is unaffected by the presence and severity of male infertility. In such cases, the birth rate is usually no different than when IVF is performed for indications other than male infertility.

ICSI SUCCESS RATES

The success rate varies depending on the cause and ranges between 35-50% per cycle. No major differences in birth, behavior problems, or parental stress were found between the children conceived with infertility treatments and those conceived naturally.

ICSI, IMSI

ICSI which stands for Intracytoplasmic Sperm Injection involves the direct injection of a single sperm into each egg under direct microscopic vision. The introduction of ICSI has made it possible to fertilize eggs with sperm derived from men with the severest degrees of male infertility and in the process, to achieve pregnancy rates as high, if not higher than those that can be achieved through conventional IVF in non-male-factor cases. With ICSI, all that is needed is a single sperm of reasonable morphologic quality. Motility is no longer a major factor in fertilization, since the sperm is carried to the egg and injected directly into it. In fact, even when there is an absence of sperm in the ejaculate such as occurs in cases of congenital absence of the Vas deferens (when a man is born without these major sperm collecting ducts), in cases where the vasa deferentia (ducts that carry the sperm from the testicles to the urethra for ejaculation) are obstructed (such as following vasectomy or trauma), , or where the man has impotency, ICSI can be performed with sperm obtained throughTesticular Sperm Extraction (TESE), or aspiration (TESA). In such cases, the birth rate is usually no different than when IVF is performed for indications other than male infertility. The successful performance of ICSI requires a high level of technical expertise by the embryology lab. As a general principle, if the male factor cannot be reversed in the man’s body by simple medical or surgical treatment, then IVF with ICSI represents the only rational approach. Results are so high, some couples even choose this treatment mode instead of other medical or surgical treatments even in those who are good candidates for these other treatments. There is no evidence of any significant increase in the incidence of serious birth defects attributable to the ICSI procedure itself. More relevant is the fact that when ICSI is performed for indications other than male infertility there is NO reported increase in the risk of subsequent embryo chromosome deletions, miscarriages or in the incidence of subsequent male factor infertility in the offspring.







GENETIC TESTING

Genetic testing (PGD) is done to determine if one or both parents may have abnormal genes that may increase the chance that their child will have a specific genetic disease. If the abnormal gene is passed to the child, the child will usually not be affected with that genetic disease but will also be a carrier for that genetic disease. If both parents are carriers of the abnormal gene for the same genetic disease, there is a 25% chance that their child will inherit one abnormal gene from each parent and be affected with that genetic disease. Genetic screening is typically done on one parent first, and if the first parent tests positive, then the other parent is tested. The American College of Obstetricians and Gynecologists (ACOG) recommends screening for certain genetic diseases when indicated due to ethnicity, family history, or other known risk factors. There are other genetic diseases which are transmitted directly from parent to child, so that if the parent is determined to have the gene causing that genetic disease, there is a 50% risk of the child being affected by the same genetic disease. Certain genetic diseases that are carried on the sex-determining (X & Y) chromosomes may cause disease primarily in male children but only rarely in female children. During the course of your evaluation and treatment at Omja IVF, our experts may recommend screening for specific genetic disease(s) which may be indicated based on your medical history and/or family history, to determine whether or not you are a carrier for the specified genetic disease(s). Genetic testing is a valuable tool but there are limitations:.

Negative result – The genetic testing laboratory usually tests for the most common mutations (change in gene structure) and may not identify the less common mutations. So it is possible to have a negative test result but still have a genetic mutation that was not or could not be identified by the testing laboratory due to limitations of current technology.

Positive result – A positive test result indicates that you are a carrier for a genetic mutation that can cause a specific genetic disease or can put you and/or your child at risk for developing a disease. If you are determined to be a carrier, your reproductive partner will then be advised to undergo genetic carrier testing.

Inconclusive result – Sometimes it is not possible for the testing laboratory to determine genetic mutations. In this case, the genetic carrier test may need to be performed again at the same or different testing laboratory.

DONOR EGG IVF

Our egg donation program locates and screens egg donors who can provide healthy eggs for women who are unable to conceive due to advanced ovarian age, elevated FSH, multiple failed IVF attempts, or premature ovarian failure. Deciding to be a recipient of egg donation is an extremely rewarding and effective method of conception that allows you to be fully involved in the development of a child from the moment of his or her conception. Egg donation allows you to choose the egg donor you feel most comfortable with and gives the opportunity for both intended parents to be completely engaged in the entire process of bringing a child into this world together. One of our expert staff members will plan the entire process with you and your spouse in order to help you manage the required procedure so that you will have the most positive and exciting experience that every mother deserves. As a recipient of egg donation, you will be giving yourself the opportunity to experience all the wonders of motherhood from the very beginning that will allow you to create a lasting bond with your child. Egg donation is a unique method because it allows you and your spouse to carefully choose the characteristics of the donor, which may allow you to find an egg donor whose attributes are very similar to yours. As a recipient, you will be giving the fetus an environment that you know and trust for its growth and nurture – your own body! And with the statistically positive rate per retrieval (over 50% delivery rate!) you can be confident that your initial procedure will result in a healthy newborn that will enter your family like a shining beacon of light. Last but not least, egg donation often results in multiple embryos that can be used in the future if you decide to have another child, which makes the entire process a lot shorter and easier for you and your family. We know the decision to use donor eggs can be an emotionally difficult decision to make. Omja IVF understands how to work closely with you and your donor to prepare you for a successfull pregnancy.

HOW DOES THE PROCESS WORK?(EGG DONATION)

Your initial consultation will include a meeting with the medical director to review your medical history and may include a physical exam, blood testing, ultrasound, Pap test and cultures. Once you are accepted into the Donor Egg program, you will be scheduled to meet with a nurse coordinator and/or Medical Director to review the program in detail, discuss the required testing for you and your partner and to schedule your consultation with our Counseller.







GESTATIONAL SURROGACY

When a woman is unable to carry a baby due to physiological restrictions, she may use a gestational surrogate (GS). Thesurrogate functions just as the embryo recipient in the above egg donation example. Many times, the intended mother provides the eggs. In other cases, a couple may use an egg donor in conjunction with the surrogate. The intended parents may use an outside agency to find a surrogate, or may find a known surrogate within their circle of family and friends. Typically, there is a legal agreement drafted and signed by the surrogate and the intended parents. Again, since there is a large amount of coordination to be done, the IVF clinic needs to be intimately involved and familiar with the process in order to manage a donor/surrogate cycle effectively. We work closely with a number of established egg donor/surrogacy agencies and can provide referrals. With gestational surrogacy, one or more embryos derived from the patient’s eggs and her partner’s sperm is transferred into the uterus of a surrogate. The surrogate in effect provides a host womb but does not contribute genetically. In spite of original ethical, moral, and medical legal reservations, gestational surrogacy has now gained widespread social acceptance.

Candidates for IVF surrogacy can be divided into two groups:

(1) women that do not have a uterus capable of carrying a pregnancy to term and.
(2) women who cannot safely undertake a pregnancy because of medical conditions or illnesses.

PROCESS – HOW IT WORKS?

The process involves the genetic parents undergoing a thorough clinical, psychological, and laboratory assessment prior to selecting a surrogate. This is to exclude sexually transmitted diseases that might be carried to the surrogate at the time of embryo transfer. They are also counseled on the many issues confronting all IVF candidates such as the possibility of multiple births, ectopic pregnancy, and miscarriage. All legal issues pertaining to custody and the rights of the biological parents as well as the surrogate are discussed in detail and the appropriate consent forms are completed. It is advisable for the surrogate and the genetic parents to obtain separate legal counsel, in order to avoid a conflict of interest that would arise were one attorney to counsel both parties.

FERTILITY PRESERVATION

Fertility Preservation: Preserving a woman’s fertility by banking her eggs or embryos for later use. Fertilization: The fusion of the sperm and egg to form a zygote. Fertility Screening and Preservation – Planning for the Future There are few individuals – male or female – that don’t think at some point in their lives about having children and raising a family. It is hardwired in the human genetic code. However, it has become increasingly more common to get “distracted” in life from these thoughts of procreation and family, pushing them out of our minds while we occupy ourselves with career and other various activities. Invariably, however, the idea of childbearing comes back. The problem is that nature does not get distracted from its incessant negative effects on reproductive potential. The “Biological Clock” does not stop ticking for anyone, and for some individuals, it ticks much faster than they would hope or expect. This sounds horribly ominous! Nevertheless, it is true. The good news is that there are ways to pre-emptively address this reproductive aging process. Here is the background for women: Even before birth, you are losing eggs from your ovaries. At birth, a woman has about 2 million eggs. By the time the first menses occurs at around age 11, she has about 400,000. In the mid-thirties, the rate of loss increases, such that by around age 50, there are none left. This is the onset of menopause. Egg quality also declines as a woman ages. That is, the chance that any one egg will make a baby decreases as “the Clock” ticks. So with age come fewer eggs, and poorer quality ones at that. Though most people instinctively understand the concept of age-related fertility decline, very few of them understand that the decline starts a lot younger than is commonly thought – on average around age 27. In the field of Reproductive Medicine, there are viable emerging techniques and technologies for egg freezing or “cryopreservation” (sperm cryopreservation has been available for decades). These technologies have recently undergone significant advances that dramatically improve live birth rates. We can now cryopreserve eggs for patients that are undergoing potentially damaging ovarian surgery and provide egg freezing for cancer patients prior to undergoing chemotherapy (both of which can negatively impact ovarian reserve and thus fertility future). These techniques also make it possible to freeze and store eggs for those that wish to preserve fertility or postpone childbearing for other personal reasons.

EMBRYO BANKING

The introduction of Vitrification has opened up new possibilities for IVF treatment and fertility preservation. One dilemma that women face when considering IVF at a later age is the fact that they generally have fewer eggs available, and of those, a higher percentage are chromosomally abnormal. A new option that has great promise for halting the biological clock and aiding these women in conception is Embryo Banking. The basic premise is as follows: a woman undergoes 2-3 consecutive IVF stimulation and egg retrieval cycles without an embryo transfer. After each retrieval, the eggs/embryos are biopsied and frozen and the “competent” eggs/embryos are identified, the woman then schedules her embryo transfer using 1 or 2 of the competent embryos. This optimizes her chances of success, while minimizing the cost of testing and treatment. Freeze the Biological Clock Multiple Egg Retrievals to Increase Yield Competent Embryos Identified by CGH Testing Schedule Embryo Transfer to Suit You.

EGG FREEZING

Women who want to preserve their fertility for reasons of cancer treatment, career, or other personal choice, have faced a difficult barrier due to the poor success rates for egg freezing. Pregnancy rates for women using frozen/thawed eggs have been less than 4% for each individual egg frozen. This is due to the fact that; 1) at least 60% of eggs frozen are chromosomally abnormal from the outset and therefore cannot produce a normal embryo and; 2) traditional (slow) egg freezing techniques commonly cause ice crystal formation within the cell structure, reducing viability or destroying the cells in the process.

ENDOSCOPY-DIAGNOSTIC & OPERATIVE HYSTEROSCOPIC & LAPAROSCOPIC SURGERIES

Endoscopic surgery is by definition performed by accessing the site of intervention, either an organ or cavity, through natural or artificial orifices by using an optical system with camera and light that allows us to see what is going to be performed on a television monitor. Surgical manipulation is also done in these orifices or “ports” of entry. It is now without a doubt, the surgery of choice for Reproductive Gynecology. We only consider traditional or open surgery in specific cases after evaluating their indication. There are basically two types of gynecological endoscopy: Hysteroscopy.

EMBRYO ADOPTION

The fact that hundreds of thousands of embryos are currently cryopreserved worldwide has been the subject of many articles in the press and a slew of television programs. Our world-class specialists use cutting edge technology to boost your fertility odds.

Our clinic is one of only a dozen clinics in the country that has embryo monitoring technology (time-lapse-photography system for watching embryonic development) and include a camera that can be set to capture images at set intervals. The time-lapse photography system allows embryologists to monitor developing embryos in a whole new way. Previously, In the lab embryologist use to remove the embryos from the incubator regularly in order to check their progress. This new technology offers more data to embryologists as they consider which embryo will be best for implantation. As a result, some believe this technology will contribute to higher IVF treatment success rates.

We believe that higher success rates are a result of experience and technology. New technology is important and EmbryoScopes are great tools but our advantage will always be our experienced team of doctors as nothing can replace an experienced embryologist’s eye. We believe it’s our doctors that make the difference. New Hope is committed to your success.

Contact us for any emergency

  • 8090402001
  • 9919273571
  • 7565002200
  • 7235888877