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Infertility Treatment in Bangalore

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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.

Intrauterine Insemination - IUI

Intrauterine Insemination(IUI)

  • What is IUI?

Intrauterine insemination (IUI) is a type of artificial insemination in which there is a transfer of many motile (actively swimming) sperm, through the cervix and directly into the uterus.

  • Why is IUI performed?

IUI can be performed depending on the age and reproductive health of the woman.

  • Lack of conception after a woman has been on ovulation enhancing agents. This can be particularly important when taking Clomiphene since it can cause decreased cervical mucus
  • Cervical factor
  • Mild to moderately abnormal semen parameters can be an indication for IUI
  • Unexplained infertility
  • Minimal – mild endometriosis
  • Advancing maternal age
  • Male ejaculatory dysfunction
  • Use of frozen sperm
  • When donor sperm needs to be used
  • How is an IUI performed?

An IUI is performed by threading a very thin flexible catheter through the cervix and injecting washed sperm directly into the uterus. It usually requires the insertion of a speculum and then the catheter. The whole process takes only a few minutes.

  • When is the best time to do an IUI?

Ideally, an IUI should be performed around the time of ovulation. When timing is based on an hCG (human chorionic gonadotropin) injection, the IUI’s are usually done between 24 and 48 hours later. If two IUI’s are scheduled, they are usually spaced at least 24 hours apart.

  • Where is the sperm collected? How long before the IUI?

Intrauterine insemination (IUI)Usually, the sample is collected through ejaculation into a sterile collection cup. Most clinics want the semen to be delivered within a half-hour of ejaculation, around the time of liquefaction, so if one lives close enough the sample can be collected at home.

There will delay between when the semen sample is given for washing and when it will be inseminated. The amount of time depends on the washing technique used, which takes 30 minutes to two hours. Most will perform the IUI as soon after washing is completed as possible.

  • How long does washed sperm live?

Current research indicates that washed sperm can live 24-72 hours; however, it does lose potency (ability to fertilize the egg) after 24 hours. Another issue with Intrauterine insemination (IUI) is that the sperm can keep on swimming beyond the fallopian tube, so the ideal window is really within 6-12 hours of the egg being released, with a larger margin before ovulation than after since the egg’s viability is shorter. Sperm can live up to 5 days in fertile mucus, 2-3 days being pretty common, so combining IUI with intercourse may provide better coverage.

  • How long do I have to lie down after an IUI?

It is advisable to lie down for 30 minutes after the procedure.

  • Do I need to rest after an IUI?

Most people don’t need to, but if you had cramping or don’t feel well afterward it makes sense to take rest for a while. Some people reduce their aerobic activity and lifting heavy weights during the luteal phase, in the hope that it will increase the chance of implantation.

  • How long before an IUI should the male abstain from intercourse/ejaculating and store up sperm?

This depends on your individual situation, but it usually should not be more than 72 hours since his last ejaculation in order to ensure the best motility and morphology. Where low sperm count is the reason for IUI, it is generally best to wait 48 hours between ejaculation and collecting sperm for the IUI. With no sperm count issues, it makes sense to wait at least 24 hours.

  • How soon after an IUI can I have intercourse?

Usually, you can have intercourse anytime after an IUI. In fact, most doctors suggest having intercourse, when that is an option, soon after the last IUI to help make sure ovulation is covered. The best fertility doctors may suggest waiting 48 hours to resume relations if you had any bleeding during the IUI.

  • What are the risks involved in IUI?

The main risks are some discomfort such as cramping, a minor injury to the cervix that leads to bleeding or spotting, or the introduction of infection. There are also risks of hyperstimulation associated with the use of ovulation induction medications such as clomiphene citrate (low risk) and gonadotropin therapy (higher risk). Proper technique and adequate monitoring reduce risks.

  • When will I have to test for pregnancy after an IUI?

The pregnancy test should be done 2 weeks after an IUI.

Reference

https://www.asrm.org/FACTSHEET_Intrauterine_Insemination_IUI/

Impacts of infertility on the couples Relationships?

Impacts of Infertility on the couples Relationships?

Men and women are affected by infertility in different ways.

Most couples experience the struggle in much the same way. This is related to the traditional ways men and women have been trained to think, feel and act. Women are typically seen, by others as well as themselves, as the emotional caretakers or providers of the relationship.

Women typically feel responsible not only for everyone’s bad feelings but also for anything bad that happens. When women try to repress feelings, their emotions can become more ominous until they finally feel out of control. Their emotions can become a monster about to swallow them whole.

Women in infertile couples often protect their husbands from their own pain and feelings of failure by taking much of the responsibility for the treatments upon themselves. When it is suggested that men accompany their wives for appointments, couples get concerned about issues like income loss, use of time, etc. While these concerns are usually relevant and important, they also serve the purpose of protecting husbands from their own responsibility in the conception process and from their own feelings, which could easily be intensified by so much contact with the medical process.

Men are traditionally seen as the financial providers of the relationship and are responsible for protecting the family from real or imagined dangers. Men usually feel more threatened expressing themselves since they have often been conditioned to repress their emotions. They are trained to be more instructional to take charge, to make decisions and to think without being sidetracked by emotions.

Males in infertile couples often feel overwhelmed by the intensity of their partner’s emotions as well as an inability to access their own. They tend to focus their energy back into their work, a place where they feel they can have more success.

Impact of Infertility in Women

As a result of taking responsibility for the emotional impact of infertility, the woman experiences intense feelings, such as pain, anger, fear, etc., which, combined with the messages that her way of dealing with things is in some way dysfunctional or “crazy”, causes her to feel an anxious depression. As feelings spill out, she feels out of control and doesn’t really know how to ask for what she needs, especially from the husband she is struggling so hard to protect. She may yearn for an emotional connection/interaction at one moment and in the next withdraw emotionally from her husband when she fears she has disappointed him.

Men find themselves in a position where, regardless of how well they’ve been trained to solve problems, they are helpless to make this situation better for the woman and, as a result, may give off messages that she is “too” emotional or sensitive, hoping that this will calm her down. The wife hears this as a criticism of her coping and caretaking skills rather than as an expression of her husband’s fears.

This is the time when couples cling together for dear life, feeling that they’ve failed in the most basic of all roles: reproduction. Couples are hesitant to admit problems in their marriage, feeling that having difficulty coping would mean that their marriage is also a failure.

Luckily, there are ways that men and women can help each other balance thinking and feeling as they struggle side by side on their journey toward parenthood.

Seeing an Infertility doctor does not mean you have to do an IVF 

The questions then arise:

  • How do I get what I need from my partner?
  • How can I support my partner during this difficult time?

Here are some suggestions to help both partners during the infertility process:

  • Communicate openly with each other.
  • Realize there’s no right or wrong way to feel. Getting in touch with your feelings will help you know what you need. Once needs are identified, clearly and specifically tell your partner how to help you.
  • Ask your partner what she/he needs rather than assuming that you can/cannot give it.
  • Recognize the psychological and emotional differences between men and women.
  • See if you can teach each other some of the skills you’ve learned from your own life experiences as a man or woman.
  • Share more in the process of treatment. Share both the burdens and joys of your different perceptions/experiences of infertility. It will help to balance the intensity and bring you closer with a deeper respect for each other.

The Easiest Way to get rid of Infertility