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NU Fertility

Brief History of In Vitro Fertilization

Brief History of IVF

Let’s start at the beginning. In-Vitro Fertilisation, or now more commonly known as IVF treatment saw a flicker of hope as early as the mid-1800s. In the mid-1800s, scientists finally discovered the process of artificial fertilization using a combination of sperm and egg.

History of IVF In the 19th Century

In the 1900s, fresh pieces of research on hormones and how they related to fertility began more fervently. Though around then, IVF-like researches were performed on rabbits..

In 1965, Dr. Jones worked with Dr. Edwards of England and fertilized the first human egg in vitro, all for the world’s first IVF baby.

After three years, in 1968, Dr. Edwards joined Dr. Patrick Steptoe in England, and performed a laparoscopy surgery to retrieve an egg and fertilize it in-vitro (in the lab). The results were published in 1969.

In 1973, the first pregnancy through IVF was reported from Monash university by CarlWood and it was a biochemical pregnancy.

In 1976 an ectopic pregnancy was reported by Patrick Steptoe and Robert Edwards.

First Pregnancy through IVF

Then in 25th July 1978, IVF saw its first birth by Patrick Steptoe and Robert Edwards. It took 102 IVF cycles to achieve this first successful IVF birth. The couple, Lesley and Peter Brown, became the parents to a healthy daughter, Louise Joy Brown, the world’s first test-tube baby.

In this sentinel IVF birth, the mother had a natural menstrual cycle, physicians laparoscopically retrieved a single pre-ovulatory oocyte from her ovary, fertilized it in vitro, and then transferred the resulting eight-cell embryo into her uterus. Even as the birth made headlines around the world, several legal and ethical questions were raised about the future of mankind. However, this one successful birth presented a happy chance for many couples who were battling fertility issues.

When Second IVF baby was born ?

Second IVF baby was born in India – Durga alias Khanupriya Agarwal on October 3rd 1978 . The Pioneer was Dr Subhash Mukopadyay.

Now with reproductive technology booming, the race for test-tube babies was on. After England’s test-tube baby, Australia announced its achievement in 1980. A year later, USA announced the birth of its very own IVF baby, Elizabeth Carr. But many harboured a big concern: the worry that an IVF baby cannot conceive naturally. The concern was put to rest when Louise Joy Brown gave birth to her own baby in 2006, conceived and birthed naturally.

After the 80s, fertility treatments took off like wildfire. Fertility drugs were improved and further researched on; instead of laparoscopic surgeries to retrieve eggs, doctors began taking it out through the vagina; sperm boosting hormones for men facing fertility issues was being prescribed. Embryo freezing and thawing as well as ICSI have revolutionised the IVF treatment and its outcome.Comprehensive Chromosome Screening is now a very important health check for the unborn baby.

How IVF Treatment has been developed in India?

Growth of IVF treatment has been the fastest compared to any other medical field. And keeping up with the achievements in India, one can now secure the best IVF treatment in Bangalore with us. The positive impact of IVF was so great that now World IVF Day is celebrated on the 24th of July, to commemorate the birth of the first IVF baby – Louise Joy Brown.

Laparoscopy Treatment

Ways in Which Laparoscopy Treatment Can Help With Infertility Problems

Laparoscopy is a surgical discipline which primarily involves the doctor making 1 – 3 small cuts (or incisions) on the body through which a laparoscopic tube is inserted. A laparoscopic tube is a surgical instrument fitted with a light and a camera. Laparoscopy typically helps reduce post-operative pain and reduces the risks of open surgery. That being said, the use of laparoscopy for infertility in women is still a topic of debate as those with pelvic pain may be required to undergo surgery. While an ovarian drilling is the most commonly performed operative procedure, a myomectomy will help in the removal of fibroids from the uterus. In addition to pelvic pain and irregular or heavy periods, these fibroids can also cause blockages in the uterus that can make it more difficult for the woman to conceive.

 

When is Laparoscopy recommended?

A healthcare professional may suggest to opt for laparoscopic surgery for infertility only after infertility has been tested, and furthermore, if the symptoms warrant it. The conditions for which laparoscopy treatment may be recommended include:

  • Menstrual cramps / pelvic pain
  • Suspected endometriosis
  • Any inflammatory disease / pelvic adhesions
  • Suspected hydrosalpinx: This is a case of a blocked fallopian tube that hinders IVF success rates.
  • Endometrial deposits that are detrimental to fertility
  • Suspected ovarian cyst that may / may not cause pain and / or distortion in the uterine cavity.
  • Fibroids that cause pain

 

Why is it important?

Although the use of laparoscopy treatment on women for infertility is still a topic under debate, there are certain cases of infertility where laparoscopy is the only viable surgical method as it allows the doctor to see the inside of the abdomen and diagnose any suspicious growth of cysts. Laparoscopy can also be employed to eliminate any scar tissue, fibroid, and / or endometrial deposits.

 

How is it done?

Laparoscopic surgery requires a hospital environment while employing the use of general anaesthesia. A laparoscopic surgery can be conducted inside a fertility clinic, however, it is not recommended as it requires trained and seasoned professionals who can guide the patient on the necessary preparations. The patient might be advised to avoid eating and drinking at least 6-8 hours prior to the laparoscopy surgery and might even be instructed to take antibiotics during that period.

The anaesthesiologist will place a mask over your face, and after breathing a sweet-smelling gas for a few minutes, you’ll fall asleep. Once the anaesthesia has taken effect, the doctor will make a small cut around your belly button. Through this cut, a needle will be used to fill your abdomen with carbon dioxide gas. This provides room for your doctor to see the organs and move the surgical instruments in the right directions.

Once the abdomen is sufficiently filled with gas, the doctor will then insert the tube through the incision made to analyse the pelvic organs. The surgeon may also employ a biopsy for testing. It all starts with the surgeon visually examining the pelvic organs and the surrounding abdominal organs for any presence of cysts, scar tissues, adhesions, fibroids, and / or endometrial growths. A dye can be injected through the cervix, so the surgeon can evaluate if the fallopian tubes are open.

If ectopic pregnancy is suspected, the surgeon will evaluate the fallopian tubes for an abnormal pregnancy.

 

Post-operative scenario: 

  • The patient, during the surgery, will be under the effect of anaesthesia and will not feel any pain
  • The patient may / may not wake up with a sore throat
  • The area around the incisions may feel sore which is completely normal
  • The patient may also feel bloated due to the excess of CO2 gas inside
  • It will take you 2-3 days to recover from the strenuous effect of the laparoscopy treatment and you can resume most of your activities in 2-3 days’ time depending on nature of the surgery.
  • The doctor may prescribe additional medicines and antibiotics to help you recover from the effects of minimally invasive laparoscopic surgery 

 

 

Sperm Donation

It’s All About Sperm Donation

Why is sperm donation done?

Sperm donation is a process where a healthy donor donates his sperms after undergoing few screening tests to help women attain pregnancy in cases where the male partner is infertile or in the absence of a male partner. The process involves a sperm donor who is usually kept anonymous. Direct sexual contact between the donor and recipient is not done, and the donor’s sperms are placed inside the woman’s body through artificial means. However, the nature of pregnancy stays similar and the sperm donor becomes the biological father of the offspring, thus getting an opportunity to father a child as a part of third-party reproduction. The process is usually carried out at a sperm donation centre.

 

What is the process of sperm donation?

The process of sperm donation majorly involves donor-preparation and a number of tests to analyse the quality and fertility of the sample. Below are the steps involved in the process of sperm donation –

  • Usually, the sperm donor is asked to refrain from ejaculating 2 – 3 days prior to the donation.
  • Once the sample is collected, the sperm bank washes the semen to extract the sperm as unwashed semen may be used only for intra-cervical inseminations to avoid cramping.
  • If the sperm is to be stored in the freezer in liquid nitrogen, a chemical known as cryo-protectant semen extender is added to it.
  • Following the required quarantine, the samples are inseminated into the women’s body.

Follow-up tests are performed to check the success/failure of the insemination.

 

What is the basic screening criteria for potential donors?

Doctors / Sperm Banks usually screen potential donors for any prevalent conditions such as sexually-transmitted infections. There is, however, a quarantine period during which the sample will be collected and stored in the freezer for 6 months and will then again be tested for any STDs or any new infections that may have accumulated over time. Provided all tests result in negative, the samples can then be transferred and used for treatments / insemination.

 

What can you expect after the procedure?

Once the insemination is done, the recipient can expect pregnancy. Although medical science has taken leaps in terms of risk reduction and healthy insemination, some threats still persist. However, no sperm donation centre can guarantee a 100% pure sperm because there are certain hereditary conditions which still don’t come under the scope of standard testing procedures.

Sperm donors, more often than not, are also asked to sign a legal agreement with the bank about concerns that involve the rights of the future child.

ivf or tube reversal _nu fertility

Tube Reversal vs IVF Treatment : Which is the better Choice?

Attaining Motherhood and having children is one of the very important stages in life which a woman comes across. Though Pregnancy and Childbirth can get challenging at times, it is looked forward to as stage of immense significance, by every woman. While on one hand, birth control has become a topic for global discussion, on the other hand, there are many enthusiastic women, in their middle ages, who are looking at exploring options to extend their family, even after undergoing procedures towards achieving permanent birth control.

With life throwing up so many surprises at us at all times, circumstances change, relationships change and this might bring in a change in family building goals too. Recent studies indicate that in spite of having chosen the path to permanent sterilization, up to 14.3% of sterilized women request information about possible fertility options within a few years of having undergone the tubal sterilization procedure.

What are the possible options women can explore to achieve their dream of having children, following tubular sterilization?

Available Options

More widely suggested options for patients, in this case, is a surgical reversal of sterilization which is also referred as Tube Reversal or the process of In Vitro Fertilization or IVF, which is gaining global identity at a very rapid pace.

However, out of these two,

  1. which is the most preferred?
  2. Which process is cost-effective?
  3. Which is safer, easy and less risky based on female age? And most importantly,
  4. which process is more likely to yield the desired results?

To answer all these questions, which are on expected lines, let’s get straight into the options involved and study them independently.

Tube (block) Reversal

For simple understanding, Tube (block) Reversal is a short stay procedure, performed as an outpatient, to restore contact between tubal segments. This is a small procedure, performed using microsurgical techniques. Basically, this procedure is aimed at supporting women, who wish to become pregnant without more complex medical attention.

Process Involved during Tube Reversal,

  1. The blocked sections of the fallopian tubes are reconnected with the remainder of the Fallopian tubes, which subsequently facilitate the eggs to move up the tubes smoothly and interact with the sperm.
  2. Your doctor will take a closer look at your medical parameters before suggesting a Tube Reversal procedure. Age, body weight and fertility factors such as the (egg count, sperm quality) are taken into consideration.
  3. Furthermore, one must consider the post-operative recovery period and time off from work, usually relatively minimal but, could be possibly prolonged. Your doctors will also look into possible complexities for ectopic pregnancy as well.
  4. However, it is interesting to note that not every type of tubal sterilizations is reversible. If the earlier fallopian tube segments are either short or subjected to damage due to surgery or infection earlier, the Tube Reversal might not be the best option. Therefore, your doctor would clearly ascertain these factors to come to a conclusion.
  5. An in-depth study of the male partner’s semen sample is also conducted as a part of the pre-surgical tests required.
  6. The time taken to confirm that the Tube Reversal surgery was a success or not is usually 3 months after the surgery was performed.

In addition, it might take close to 2 years for the patient to become pregnant, after the success of the surgery.

Many patients tend to term this waiting period as pretty long as they continue to remain anxious about the results.

Misconceptions about IVF 

In Vitro Fertilization (IVF)

IVF or In-vitro fertilization continues to gain prominence as a very effective alternative to Tube Reversal. Since its inception in 1970, this technique has been refined and continues to make immense progress with very high success rates.

To put in in easy words, IVF is a procedure by which an egg is fertilized in the lab and then transferred to a woman’s uterus. This facilitates the process of pregnancy to occur by completely bypassing the Fallopian tubes. So, the events which ordinarily occur in the fallopian tubes thus occur in the laboratory, providing a sort of tubal bypass.

The process of IVF allows the choice of the strongest and healthiest embryos.

Compared to a Tube Reversal process, IVF can be thought about as an effective solution, even for problems like advanced age, tube damages beyond repair and male factor infertility. The post-procedure downtime in IVF is rather minimal. However, with the sensitivity involved with the procedure, it is always important to choose a best IVF clinic with care.

This question has been very effectively answered by best Fertility Hospital in Bengaluru, which has proven experience in offering high standard IVF services, to the fullest satisfaction of its patients. The experience and techniques employed by the IVF physicians at NU fertility is a combination of the very latest in technology and subject expertise.

Which then is the best choice: IVF or Tubal Reversal?

One of the best things about IVF is that the time taken for pregnancy is much shorter as it takes only two months for the process to be completed. The age of the woman in question is also important as the choice of whether to go for Tube Reversal of IVF depends largely on this factor. The number of children, a couple would desire also influences the decision. It is well understood that with advance in age, the chances of a woman to conceive is lesser and hence for those women who are above 35 years of age, IVF perhaps be a better choice.

Though women below the age of 35, who would want to attain parenthood again after having undergone Tube Ligation, might look into Tube Reversal, published reports for all age groups truly indicate that the success-per-cycle rates in IVF are better than those for tubal reversal.

Conclusion

Doctors connected with leading medical institutions suggest IVF over Tube Reversal, but that is surely not without a reason. Though there is not much of a difference with respect to cost in both the procedures, IVF enjoys less risk factors and more success rates, than Tube Reversal. Findings have suggested that the chances of ectopic pregnancy with Tube Reversals are as high as 20% while that with IVF is almost legible, as low as (3) %. (The pregnancy rates with IVF in tubal factor infertility are 65%; the highest among all causes of infertility while the pregnancy rates with tubal surgery vary between 20-60% depending on multiple factors.) Compared to a Tube Reversal procedure, IVF does not require a prolonged hospital stay.

Above all, it’s the quality of your medical service provider and the comfort level they offer from the basic stages of discussions that matters and NU Hospitals sees that you are comfortable, both before and after your treatment is completed to your fullest satisfaction.

Male Infertility

Male Infertility – What You Need To Know

When a couple is ready to get pregnant, it should be the happiest and easiest thing in the world. However, for a large majority of couples, getting pregnant is not so easy. There are a number of complications that can arise, either in the man or woman, that can make getting pregnant extremely problematic.
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ivf misconceptions

Misconceptions about IVF

IVF is one of the most fascinating discoveries of the 20th century. Nobel prize in medicine was awarded to Sir Robert G Edwards in 2010 for this amazing discovery. It has been about 40 years since the birth of the first child through IVF. Over 4 million people owe their existence to IVF. Despite this, many people are not convinced by this concept.

 Popular Misconceptions about IVF

  • IVF injections cause cancer.

All the injections which are given are eliminated from the body within one month. There have been numerous studies till date which have proven that the gonadotropin injections do not cause cancer. However, a small risk of borderline ovarian tumours is noted, which have an excellent prognosis with preservation of fertility. An oocyte donor can donate eggs for up to 6 cycles safely!

  • The medications take away all eggs and result in early menopause.

Normally a group of follicles containing eggs begins to grow at the beginning of a menstrual cycle. Only 1 egg matures enough and is released from the ovary. Remaining degenerate. In IVF, these injections rescue the degenerating eggs and stimulate them to reach maturity. As a result, the age of menopause is not affected.

  • Babies born through IVF are not normal physically and mentally.

2% of the babies conceived naturally are born with some malformation. Similarly, about 2-3% of babies born through IVF are with malformations. Most of the abnormal embryos do not implant in the uterus and grow.

  • IVF results in twins and higher-order pregnancies

We can limit the number of embryos transferred into the uterus and hence prevent multiple pregnancies. In other treatment options such as ovarian stimulation and Intrauterine insemination IUI, all the eggs that are released are capable of being fertilized. Hence, we have no control over the rate of multiple pregnancies.

  • After IVF treatment, complete bed rest is required.

Both the egg retrieval and embryo transfer are daycare procedures, requiring an admission of 3-4 hours. It is advisable to avoid the strenuous physical activity of any sort; however, there is no evidence that complete bed rest favours embryo implantation. Routine activities can very well be carried out without affecting pregnancy rates.

fertility-treatment-bangalore

How does being overweight affect fertility?

what is Obesity?

Obesity, in simpler terms well-understood as overweight, is a common term, heard everywhere these days. It has become a global endemic or a wide-ranging problem, so to say and millions around the world continue to face the challenges that obesity continues to throw at them.

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The easiest way to get rid of Infertility

Tips to get rid of infertility

Infertility is the inability to get pregnant after 12 months of regular unprotected intercourse. About 50 million couple worldwide experience infertility. The numbers are rising as years pass by due to various factors.

It is frustrating when you realize that you need to take help for such a basic human function, reproduction. However, you are definitely not alone. There are thousands of couples who want to get over the phase from childlessness to parenthood as quickly as possible. This path may be easy for some and not so easy for some.

Here are some tips to get rid of infertility

1. Adopt a healthy lifestyle

All the choices you make in life have a bearing on your health. Maintain appropriate weight, follow a healthy diet and exercise at least 5 times a week. Avoid smoking, drinking alcohol and limit caffeine intake to no more than 2 cups a day. Stress also contributes to infertility and miscarriages. Everybody has different stressors in life, it is important to find ways of dealing with it.

2. Understand the basic functioning of the reproductive system

The egg needs to be fertilized by a sperm to form an embryo and result in a pregnancy. The release of the egg from the ovary is called ovulation. This happens on day 13-15 of the cycle in women with a regular 28-day cycle. It is important to have intercourse around the time of ovulation. There are several ways to know when you are ovulating. You can use Urinary LH kits from day 12 of your cycle to detect the day of ovulation. Your fertility specialist can help you find out the most probable day of ovulation by the scan.

3. Visit a fertility specialist before it is too late

A fertility specialist is a doctor with special training in treating infertile couple. Not all Obstetrician & Gynaecologist have this training. It could be a fellowship or a Masters degree in Reproductive Medicine. If you have had 1 year of regular unprotected intercourse and not able to conceive, it is time to visit your fertility specialist.

4. Find the reason for infertility

About 30% of infertility is due to the female factor, 30% due to male factor, 30% due to a combination of male and female factors and 10% remain unexplained. So it is very important for the male and female partner to get evaluated simultaneously for infertility. Do not be afraid to get yourself evaluated. There is a solution to every problem, once the cause of the problem is identified.

5. Personalized fertility treatment

There are several treatment options available for subfertility. The most commonly offered fertility treatments include:

a. Ovulation Induction is medications used to induce ovulation

b. Intrauterine Insemination is the injection of processed sperms directly into the uterine cavity at the time of ovulation

c. IVF/ test tube baby where embryos are created in the lab from your egg and sperm and injected into the uterine cavity

It is not “one size fits all”. Everyone is unique. The treatment you may require is decided after thoroughly evaluating you and your partner and personalized treatment is offered.

To fix an appointment with our fertility specialist call +91 80-42489999