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Infertility Treatments

Infertility is one of the most common problem for many couples. And so there are so many infertility treatments for both men and women to help them. We KARE Centre make sure each and every patient get the best treatment.

Ovulation Induction

Patients are treated with medications that cause the ovary to produce multiple mature eggs. It is used in conditions such as Polycystic ovaries (a hormonal imbalance resulting in lack of ovulation, irregular periods and infertility).

Intrauterine Insemination (IUI):Semen is processed in the laboratory to enhance the proportion of normal active sperm. It is then placed directly into the uterus using one of many various specialized catheters.

  • Treatment of endometriosis
  • Gynecological surgery
  • Laparoscopy
  • Hysteroscopy
  • Microsurgery
  • Reconstruction of the female genital tract
  • Hormone Replacement Therapy

Andrology Services

  • Semen analysis
  • Sperm recovery & survival test
  • Detection of antisperm antibodies
  • Preparation of sperm for intrauterine insemination

Assisted Reproductive Technologies (ART)
In Vitro Fertilization-I.C.S.I Many couples faced with infertility are still unable to become pregnant after first line therapy such as ovulation induction, intrauterine insemination, or reproductive surgery. For these couples, the logical next step is to explore the Assisted Reproductive Technologies (ART). These treatments include In Vitro Fertilization. Intra cytoplasmic sperm injection and other assisted laboratory techniques designed to improve fertilization.

“In Vitro Fertilization is a process whereby eggs are removed from the ovaries with a small needle passed through the top of the vagina and combined with prepared semen in the laboratory.”I.C.S.I involves the injection of a single sperm into a single egg.’
Compared to simpler treatments, ART procedures typically have very high success rates but are more complex as they involve well-coordinated, perfectly timed effort between the medical team, laboratory staff and the patient. The actual IVF treatment consists of suppression and stimulation cycles.

Suppression Cycle
When you start your next menses, you can expect to have an ultrasound to make sure your ovaries contain no cysts that can interfere with proper egg development. Taking into consideration your age, day 3 of cycle FSH (follicle stimulating hormone) level and ultrasound appearance of your ovaries, the doctor can determine how much fertility medication injections you require.

Stimulation Cycle
You will be taking fertility shots for about ten days to stimulate multiple eggs to develop. Women can respond differently to the fertility drug injections and may need adjustment in the amount of medications taken.

HCG Injection
This medication is given when the follicles (eggs) reach about 20 millimeter in size. The egg retrieval is scheduled about 34 to 36 hours after the HCG injection.

Egg Retrieval
The eggs are removed from the ovaries by transvaginal ultrasound technique. This minor surgical procedure is performed in our certified in-office operating room suite. The procedure takes about 15 min. and is performed under intravenous sedation given by our board-certified anesthesiologist. You will be going home about 30 minutes later. You may feel tired afterwards, so plan on taking the rest of the day off.

Now that your eggs have been removed from your ovaries, the next step is for the embryologist to prepare your eggs and your husband’s sperm for fertilization. In cases where the sperm cannot penetrate the egg because of low sperm count, abnormally shaped sperm or low motility, the embryologist will inject one sperm directly into each egg. This procedure is called Intracytoplasmic Sperm Injection or ICSI. Intracytoplasmic sperm injection has been successful in solving problems related to inadequate ejaculations, failure to ejaculate, and azoospermia or the total absence of sperm.

TESE – Testicular Biopsy for males with inadequate sperm from ejaculates Testicular sperm extraction (TESE) is used to retrieve sperm for ICSI when azoospermia (the total absence of sperm in the ejaculate) exists.

Testicular biopsy is a technique used to determine if there is viable sperm production in any area of the testis to be recovered through TESE.

Embryo Culture
Once fertilization occurs, the embryologist will monitor the fertilized eggs for three to five days to make sure that they develop normally.

Stages Of Embryo Development In The Laboratory
Zygote – the fertilized egg, as it appears 16-18 hours as after fertilization, showing the male and female genetic material (pro nuclei) is called a zygote. Sometimes more than one sperm can penetrate the egg resulting in an abnormal zygote which will not be transferred into the uterus.

8 cell stage embryo – as it appears 72-80 hours after fertilization. Generally, 2 embryos will be transferred into the uterine cavitry. If more than 3 such embryos are available, your doctor may choose to allow them to grow two more days in the laboratory to a blastocyst stage.

Blastocyst – the embryo as it appears five days after fertilization. Since implantation rate for blastocysts is significantly higher than day 3 embryos, only 2 blastocysts need to be transferred minimizing the risk of multiple pregnancies.

Embryo Transfer
The doctor will discuss with you the number of embryos to be implanted. At KARE we usually transfer the embryos on day 2 or day 3 and in some cases we do a day 5 or a blastocyst transfer at the blastocyst stage.

The advantage of blastocyst transfer is that only 2 embryos need to be transferred to achieve a very good pregnancy rate, minimizing the risk of multiple pregnancies..

A speculum will be placed in your vagina and the embryos will be gently transferred into a predetermined site within your womb using a very soft catheter. The transfer of the embryos is not painful and takes only a moment to accomplish.

Following the transfer of embryos, you can expect to rest for an hour before leaving the office. We recommend that you continue to relax at home for the next 24 hours.

Pregnancy Test

Your pregnancy test will be scheduled two weeks after your retrieval and you will be notified of the result within 1-2 hours. A positive result indicates that an embryo implanted and you will be scheduled for an ultrasound about 2 weeks later. The ultrasound allows the doctor to document the number of embryos implanted and to check the baby’s heart rate. Assisted Reproductive Techniques offer hope to couples.

who could not otherwise produce a genetically related child. It is effective in treating women with blocked, damaged, or absent tubes and in treating male factor infertility. IVF is often uses in case of unknown causes of infertility.

After the evolution of Intracytoplasmic Sperm Injections (ICSI); severe male factor infertility, once an impenetrable barrier to parenthood, has virtually ceased to exist. ICSI involves the insertion of a single sperm directly into a mature egg obtained from the ovary of a woman undergoing in vitro fertilization. Often, this results in fertilization and the development of a normal embryo. The babies born after ICSI are just as healthy as babies conceived spontaneously.
Egg Donation IVFPremature ovarian failure, poor quality eggs, diminished quantity, menopause or genetic abnormalities lead couples to seek donor eggs. Egg donation is a process where an anonymous or known donor produces and donates eggs to the recipient. The eggs are then fertilized and the resulting embryos are placed in the uterus of the recipient to continue normal fetal development.

Assisted Embryo HatchingHuman eggs are surrounded by an egg shell. Once the egg is fertilized, the early embryo develops within the confines of that shell. When the embryo reaches the uterus, it needs to break out of the shell and make contact with the endometrium. Assisted Embryo Hatching is a technique for thinning the egg shell just before the embryo is placed back in the uterus following IVF. In selected women, helping the embryo to break through its egg shell may improve the chances of an IVF pregnancy.

  • Frozen Embryo Transfer (FET)
  • Embryo Cryopreservation
  • Donor Sperm Insemination

Authored by Dr. Nirmal Krishnan

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