INFORMATION ON FERTILITY

 


 In reality, there are probably hundreds of “causes” of infertility. What this means is that there are a lot of things that have to happen perfectly in order to conceive and have a baby.

As an overly simplified example of the science involved:
  •  The hormones that stimulate egg development must be made in the brain and pituitary and be released properly.

  •  The egg must be of sufficient quality and be chromosomally normal.

  •  The egg must develop to maturity.

  •  The brain must release a sufficient surge of the LH hormone to stimulate final maturation of the egg.

  •  The follicle (eggs develop in structures called follicles in the ovaries) must rupture and, release the follicular fluid and the egg.

  •  The tube must “pick up” the egg.

  •  The sperm must survive their brief visit in the vagina, enter the cervical mucous, swim to the fallopian tube and “find” the egg.

  •  The sperm must be able to get through the cumulus cells around the egg and bind the shell (zona pellucida) of the egg.

  •  The sperm must undergo a biochemical reaction and release their DNA package (23 chromosomes) into the egg.

  •  The fertilized egg must be able to divide  The early embryo must continue to divide and develop normally

  •  After 3 days, the tube should have transported the embryo down into the uterus.

  •  The embryo must continue to develop and expand into a blastocyst.

  •  The blastocyst must hatch out of its shell.

  •  The endometrial lining of the uterus must be properly developed and receptive.

  •  The hatched blastocyst must attach to the endometrial lining and “implant”.

  •  Many more miracles in early embryonic and fetal development must then follow….

 

 

At Omja IVF, diagnosis begins with your first visit to our IVF center. Infertility is diagnosed through an extensive and comprehensive infertility workup on both partners, when necessary. In the woman, the tests focus on whether or not she is ovulating and any undiagnosed abnormalities in her fallopian tubes or uterus such as pelvic inflammatory disease (PID) endocrine disorders or any other medical conditions. In men, a physical examination, lab work, and ultrasound if required are used to rule out impediments to male fertility, including low sperm count. In case you and your partner have already been seen by a physician about your fertility issues, and you may have had some preliminary lab work done.

 

Bring those results and your complete medical records to your first appointment so one of our fertility specialists can review them and discuss your reproductive history. A crucial part of the diagnosis process for women is a thorough physical exam, including a transvaginal ultrasound and blood test. Other diagnostic tests include hysterosalpingography , hysteroscopic and laparoscopic evaluation. The ovulatory dysfunction can be revealed through hormonal blood tests on Cycle Day2/ 3 and Day 21 testing. With the right diagnosis, A new beginning can be started at Omja IVF. We’re committed to help you out in achieving your dream of pregnancy and parenthood.

Determining fertility treatment options depends on the diagnosis of the cause(s) of the infertility couple is experiencing. There are several treatment options your fertility specialist will discuss with you during your visit.

IUI (INTRA-UTERINE INSEMINATION)

IUI (Intrauterine Insemination) is often a first-step fertility treatment when couples are having trouble getting pregnant through naturally occurring intercourse./p> With intrauterine insemination (IUI), millions of sperms are placed directly into the uterus when the woman is most fertile, immediately prior to and during ovulation. The semen sample is first “washed” with special solutions and concentrated to increase the number of sperms that make it to the fallopian tube where fertilization takes place. This improves the chances for conception. IUI may be performed with or without the use of fertility drugs taken by the woman. When medications are used, the therapy is referred to as controlled ovarian hyperstimulation (COH). IUI with COH generally results in and increased likelihood of pregnancy.

Those who benefit from IUI include:
  • Couples with no known cause of infertilityt.
  • Women with ovulatory disorders who respond well to fertility medication.
  • Women with mild endometriosis.
  • Women using donor sperm.
  • For some patients, IVF (in vitro fertilization) may be advised, including:
  • Women with blocked or severely damaged fallopian tubes.
  • Women with structural problems of the uterus.
  • Women who do not ovulate.
  • Men with low sperm counts, poor morphology, and/or poor motility.

IVF (in vitro fertilization) is a process in which eggs, retrieved from a woman’s ovaries, are fertilized in the Embryology lab with sperm provided by her husband, or sperm from the gamete bank depending on the case and the resulting embryos are grown in the lab for 3-5 days. When fertilization is successful, the resulting embryos(about 2-3) are transferred into the womans uterus and the remaining embryos can be freezed and stored for subsequent cycle use. Follicular stimulation and monitoring Fertility specialist prescribe the medications in order to increase the likelihood of collecting multiple eggs and to control the timing of a patient’s menstrual cycle.

The patient and her partner may administer these medications on a daily basis within the privacy of their home. Omja IVF specialist then monitor the patient’s progress by evaluating the number of ovarian follicles in development through vaginal ultrasound and serial blood samples taken at Omja IVF. A follicle is a sac of fluid in the ovary that may contain an egg (oocyte). Our fertility specialist doctors determine the number and frequency of these tests.Just prior to egg retrieval, a patient takes an additional injectabl medication to complete the maturation of the eggs. The retrieval is scheduled only if there are an adequate number of follicles ready.

Each egg retrieval takes place under short GA or sedation by a qualified Licensed anaesthesiologist who monitor the patients. While sedated, our fertility doctor use the ultrasound mechine to aspirate the follicular fluid from the ovaries. Not all follicles necessarily contain eggs. Following the retrieval, the patient rests in the recovery room under the care of the Omja IVF Centre doctors and nurses and medical assistants to allow effects of the anesthesia to subside.

Once eggs have been retrieved, the male partner’s sperm is collected and eggs and sperm are brought together for fertilization. The embryologist may choose from a number of techniques including the microdrop method or a microinsemination technique called intracytoplasmic sperm injection known as ICSI (“ik-see”). In ICSI, an embryologist injects a single sperm directly into an egg under a microscope with a tiny needle. Fertilized eggs are then incubated in the embryology laboratory for two to five days prior to embryo transfer.

If the embryos have developed normally after incubation, Omja IVF physician transfers a predetermined number of embryos through the cervix into the uterus via a small catheter (hollow tube). The patient and her physician determine the number of embryos for transfer based on individual circumstances such as age and medical history. No anesthesia is required for this procedure.

 In order to enhance the likelihood of conception, the physician prescribes hormonal therapy following embryo transfer. As in the natural reproduction process, a pregnancy may or may not result. If any excess embryos exist after the initial transfer, the patient may request evaluation for possible freezing and use for a subsequent treatment cycle.

Unused embryos can be cryopreserved (frozen) in liquid nitrogen for possible thawing and later use. Embryos may be frozen anytime after the fertilization stage (pronuclear zygotes, which is one day after egg retrieval up to and including the blastocyst stage, which is 5 days after retrieval. Most commonly, embryos are frozen at either day three or day five. Our embryologist will discuss both options and a decision will be reached as to which is best suited for your particular case.

IVF with donor eggs is a fertility treatment that has been available since the mid 1980’s. Oocytes (eggs) are retrieved from an egg donor and inseminated with the sperm of the intended father. Resulting embryo(s) are then transferred to the uterus of the intended mother. If there are extra eggs or embryos, they can be cryopreserved for future use. IVF with donor eggs is used to treat infertility arising from a woman’s absence of ovaries or the inability of ovaries to produce viable eggs. IVF with donor eggs can also be used to help couples with potential genetic abnormalities that might be carried by the woman..

Both donors and recipients participate in preliminary screening procedures, including review of medical records, physical examination, blood testing, screening for genetic and infectious disease, and a psychological consultation.

Egg donors are healthy women ideally between the ages of 21 and 30. The following are categories of potential egg donors:

Anonymous Donors: Many women opt to undergo the egg donation process as anonymous donors. These individuals donate eggs to an infertile woman or couple whose identity also remains anonymous.

Known Donors: In some instances sisters, friends or others close to the recipient frequently donate eggs. In addition, recipients sometimes opt to recruit an egg donor on their own.

Egg Bank Donors: It is possible to acquire frozen eggs through an egg bank. Medical statistics and physical characteristics of the donors are available in addition to photographs of the donor as a child. This option eliminates the necessity to wait for stimulation and egg retrieval and enables treatment to focus only on the recipient.

The primary benefit to every woman who donates eggs is the aspect of helping another person or couple achieve pregnancy. Anonymous donors receive remuneration for their time, effort, inconvenience, time lost from work and in some cases there are financial benefits to women undergoing their own assisted reproductive treatment cycles who donate their eggs. Guidelines have been set ICMR to assure that donor compensation is not construed as “purchasing” oocytes. Our practice abides by these guidelines.

Achieved a 55% live birth rate for IVF patients using frozen donor eggs. HISTORICAL OVERVIEW Development of technology to effectively cryopreserve (freeze) human oocytes (eggs) began in the mid-1990’s, primarily for the purpose of preserving the fertility potential for cancer patients. (Radiation and certain chemotherapies can negatively impact the reproductive system.) In 2007, Dr. Nagy and his scientific team achieved the most important egg freezing breakthrough based on scientific research initiated in 2004 to explore an alternative way of cryopreservation called “vitrification”.

Utilizing this new rapid-freezing technique with egg donors between the ages of 21 to 30, pregnancy rates equal to fresh donor cycles in traditional IVF centers around the world were achieved. Omja IVF EggBank Lucknow, was established to expand patient access to successful vitrification and thawing protocols. Omja IVF EggBank is an assisted reproduction resource for women with infertility issues affecting egg quantity and/or quality who need IVF using donor eggs to achieve pregnancy. It is also a fertility preservation resource for cancer patients, and for women who choose to delay pregnancy.

Fertility Preservation for Cancer Patients Our team is ready to provide an immediate response for patients who are seeking information and/or services for fertility preservation due to a cancer diagnosis in which treatment will impact a woman’s future ability to conceive and carry a pregnancy. Oncologist Referrals: We agree that the possibility of fertility preservation should be discussed with women of child-bearing age who are diagnosed with cancer and about to undergo treatment protocols that pose a risk to future fertility. Fertility Preservation Services at RSC New England include: Freezing and thawing for therapeutic use: Fertilized eggs (zygotes) Eggs (oocytes)

State-of-the-Art Technology

Cryopreservation/Vitrification

Expertise

Accredited embryology lab with state of ART Equipments

Egg freezing experience

Continuous quality improvement

Collaborative, Patient-Centered Care

Working collaboratively with referring Oncologists to identify and apply appropriate hormonal stimulation

Patient-Centered Price Plans

Omja IVF offers compassionate-care price plans.

Women at optimal fertility age — 21 to 30 and a few years beyond — have the option to take advantage of advanced technology and delay pregnancy through egg freezing. Many women are choosing to start their families much later than their mothers. Surveys indicate, for example, that while 7 out of 10 women plan to become pregnant, 30% plan to wait until their 30s to do so. There are numerous reasons for this. The changing roles for women in the 21st century find many choosing to pursue advanced educational degrees and to focus on establishing professional careers before starting a family.

And, it can take many years to find the right partner which can lead to women getting married at an older age in which she many not have the ovarian reserves or egg quality that she would in her 20s or early 30s. Unlike years past, women at optimal child-bearing age — 21 to 30 and a few years beyond — have the option to take advantage of advanced technology resulting in egg freezing. And, there is evidence that, vitrification, a new rapid-freezing technique, can result in pregnancy rates equal to IVF (in-vitro fertilization) using a 21 to 30 year old’s fresh oocytes (eggs) Starting with a fertility doctor consultation is the first step when considering egg freezing for delaying pregnancy. and find out if this is a realistic option for you.

Naturally, it is difficult to realize that getting pregnant is not going to be as easy as you always imagined it would be. Infertility is challenging. It’s important to remember that you’re not alone and there is help available.. Emotional counseling and help coping with infertility is available at our centre.

Coping with the emotional challenges of infertility can be difficult for couples. Infertility can create feelings of anxiety, sadness, self-doubt, anger, resentment, and helplessness. Infertility can affect many aspects of life, including friendships, work, and even your primary relationship. Making the infertility treatment decision can be stressful when couples agree. If you and your partner are not on the same page or timetable, the impact of differences can feel overwhelming. 

Couples consist of two individuals with different personalities and coping styles. It is not surprising that each person may feel and express themselves differently since the family backgrounds and life experiences are not the same. Each person has different priorities, needs, and timeline. It is important to be realistic about the possibility that you will experience some disagreement and tension around these important decisions. Just because you disagree now, does not mean you will always disagree. Remind yourself that this is a process and that couples ultimately find common ground. Women tend to talk and express their feelings and look for support from significant others. Men, on the other hand, tend to be less inclined to share their innermost feelings, while using a more logical approach to problem-solving. While these differences may lead one partner to feel the other is uncaring or overreacting.

It is important to know that infertility is common. One out of every 8 couples is infertile. Upon evaluation, 30% will discover a female factor, 30% a male factor, 30% will find a contribution from both partners, and 10% will have unknown causes for their infertility(unexplained infertility). One or both members of a couple may hesitate to move forward with a fertility evaluation due to a fear that she or he is responsible for their infertility. One or the other person may be anxious about what they are going to find. For many people, even acknowledging that there might be a problem is overwhelming and scary. Acknowledging that you are in this together can defuse the issue of blame and enable a couple to move forward. And, each person can certainly take responsibility for how he or she will handle the challenge.

Information gathering is the first step in making any thoughtful, educated decision. When it comes to infertility treatment, this can be done through reading, attending workshops, consultation with professionals, and talking to other couples who have faced similar challenges. Becoming well informed should help you to make decisions and advocate for yourselves. However, you may consider seeking professional help if you and your partner remain “stuck” or if the tension between you is causing additional stress. A mental health professional can help you improve your communication skills and understand your attitudes and feelings, so that you can ultimately reach important decisions together.

Friends and relatives provide emotional support for couples dealing with infertility!

If you have a friend or relative who is challenged by infertility, considering or already in treatment, following these suggestions is likely to be received as helpful infertility support: Don’t minimize infertility by mentioning the hassles of parenting or say there are worse things that could happen. Coping with infertility is painful and only those experiencing it understand how difficult it can be. Don’t tell a couple challenged by infertility to “relax” and if they are meant to become pregnant, it will happen.

While stress often appears to be a contributor to infertility, the human reproductive system is complex and affected by a number of biological and physical factors. Women under 34 years of age who have tried unsuccessfully to conceive for a year need to consult a fertility specialist for an evaluation and information about their options. If a woman is 35 years or older, she should consult a fertility specialist after trying for 6 months to become pregnant without success 39 or older, after 3 months of trying.