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IVF Treatment in India

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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.

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Myths about infertility

Myths about Infertility

Myth 01: Infertility is rare.

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Does the collection of eggs increase the chance of pregnancy?

Does the collection of eggs increase the chance of pregnancy from IVF?

The process of IVF(In-Vitro-Fertilization) involves the ovarian stimulation with hormones with the intention of retrieving more eggs. The whole idea is to have enough eggs to produce an optimum number of good embryos to transfer and to freeze a few in case the fresh transfer fails. The question here is how many do we actually need? What is the optimum number of eggs needed to achieve a live birth, which in turn is the ultimate aim of IVF?

Does the collection of eggs increase the chance of pregnancy?

The higher number of eggs retrieved is associated with a probability of more chromosomally normal (euploid) embryos which can implant and give rise to a living birth. Chromosomally abnormal embryos (“aneuploid”) are unlikely to develop as pregnancies, and, if they do, frequently result in miscarriage. The frequency of chromosomally abnormal embryos increases with age and thus the pregnancy rates decrease with age. To produce one and two euploid embryos respectively, five and 14 oocytes would be required at age 34, while 10 and 24 oocytes would be required at age 38. Thus it makes sense to retrieve more eggs.

But this comes at a cost .. To retrieve more eggs often we have to use a higher dose of hormones increasing the cost as well as the side effects. It also leads to a potentially serious complication of ovarian hyperstimulation where they collect fluid in the abdomen, lungs and also susceptible to hypotension, increased clotting tendency and at times renal shutdown. The excessive ovarian response can also cause the enlarged ovaries to twist on its pedicle, cutting off its blood supply – what we call as ovarian torsion. This is an acutely painful condition which requires immediate medical and surgical attention. Another reason for concern is the compromised egg quality for unknown reasons when there is an excessive ovarian response. The raised estradiol hormone in case of excessive ovarian response advances the implantation window, thereby causing an asynchrony between the embryo and the endometrium (uterine lining), ultimately decreasing the implantation rates.

Frozen Embryo Transfer

So our aim in IVF cycle is to retrieve anywhere between 8 to 15 oocytes, so as to consider a fresh embryo transfer and also to expect a reasonably good pregnancy rate. Studies have proven that pregnancy rates steadily increase till 15 oocytes and thereby it decreases. When there is hyperresponse we may have to defer embryo transfer and freeze all embryos to avoid potential complications of ovarian hyperstimulation. They can be transferred at a later date after preparing the endometrium – Frozen Embryo transfer.