FERTILITY CHECK: Knowing your FERTILITY POTENTIAL will make you understand about your REPRODUCTIVE HEALTH.
A couple ,single men & woman can undergo few tests which will assess your LEVEL OF FERTILITY. FERTILITY POTENTIAL CHECK PACKAGE includes SEMEN ANALYSIS HORMONAL PROFILE TRANSVAGINAL SONOGRAPHY MEDICAL CONSULTATION (60MINUTES).
Intrauterine insemination (IUI) is a relatively low tech approach to fertility treatment. It involves preparing the male partners sperm in the laboratory and then placing only those sperm which move well and are normally formed in the women’s uterus. The sperm are transferred into the uterus at the time of ovulation. IUI can be performed with the sperm of the male partner or with donor sperm. The success of IUI depends on 2 factors :
The indication for IUI (the reason it is being performed)
- Whether performed in a drug stimulated or natural (drug free) cycle
- In general IUI is a good treatment if it is performed to ovecome a problem of lack of sperm . It is also successful if intercourse is not occurring normally such as in cases of ejaculation dysfunction (ED). It is moderately successful when used for cervical mucus hostility when sperm are killed within the cervix. It tends to be less useful if the indication is male factor subfertility. The success rates are higher in a drug stimulated cycle (super-ovulation intrauterine insemination)
Intrauterine insemination is a successful treatment if used in appropriate couples. The chance of pregnancy is reduced in women over the age of 40 years and it is probably not an appropriate treatment for male factor subfertility if less than five million motile sperm are obtained at the end of the sperm preparation technique. For most couples, up to three cycles of intrauterine insemination may be attempted assuming a good response is being maintained
- After that time we would review treatment with you and either consider further IUI treatment or it may be appropriate to move onto other forms of fertility treatment at that stage.
In-vitro fertilisation (IVF)
IVF is probably the most well known of the “Assisted Reproductive Technologies”. It is otherwise known as “test tube baby”, and has helped infertile couples conceive and bear children for over two decades. These days, fertilization actually occurs in a dish, and not a test tube. It was originally developed to help couples overcome tubal factor infertility, but has become useful in treating other factors, such as immunological problems, unexplained infertility and male factor infertility.
IVF is basically a four step process
- First, you take medications to make multiple follicles begin to develop on your ovaries. This step is referred to as ovarian stimulation, or superovulation
- Step two involves monitoring follicular growth by ultrasound, to determine egg growth and uterine lining development. When it is determined that the follicles and the uterine lining are appropriately mature, a final maturation trigger shot of Human Chorionic Gonadotropin is then administered.
- 36 hours after the final maturation trigger shot, the third step begins with retrieval of the eggs by ultrasound-guided-needle aspiration, this process is best done under light anaesthesia. A sperm specimen is then washed and prepared for insemination. The washed sperm is then placed in a dish with the eggs, and they are placed in an incubator for 18 hours. After 18 hours, the incubated eggs are observed for normal fertilization ( penetration of the ovum by the spermatozoa and fusion of their respective genetic materials) , under a microscope, where the pronucleus of egg and sperm can be seen. The fertilized eggs (zygote) are then incubated for further development into multi-cell (6to8) embryos and/or blastocyst
- The fourth and final step involves transferring the embryos or blasocyst into the uterine cavity via a catheter inserted through the cervix. The number returned varies with the desires of the patient, under the guidelines of age categories; under 40 years old, up to two embryos; 40 years and older, up to a maximum of three embryos. Additional embryos and/or blastocyst may be frozen and stored for future use
ICSI is used when the male partners’ sperm is suboptimal, when previous standard IVF treatment has been associated with a low fertilisation rate and occasionally used if only a few eggs are available. With ICSI a single motile sperm is isolated from the male partner’s semen sample and the tail of the sperm is cut to immobilise the sperm. The sperm is aspirated into a very fine glass needle (about one tenth of the diameter of a human hair at its tip). The sperm is then injected directly into the centre of the egg and the needle withdrawn. A very small percentage of eggs can be damaged by the injection procedure but this is more than offset by the increased fertilisation rate.
Blastocyst culture describes the process where embryos are kept in the culture for an extended period till day 5. Blastocyst Transfer maximizes the chances of success as after 8 cell stage embryo’s own genes gets activated.
Follicular study is done to track the follicles(containing oocytes) and their development both naturally or by drugs ( hyperstimulation). This office based procedure is done in OPD itself. Further Retrieval of mature ova and detection of other Pelvic pathologies, USG is carried out on as and when required basis and is an essential clinical tool. We at Sno Condemn Female foeticide and at no stage are inclined to or promote misuse of the technology.
Using the Microscope tubules having sperms are identified and sperms extracted
This is a specialized surgical procedure indicated for Non Obstructive Azoospermia patients, done under general anaesthesia.In this procedure Seminiferous tubules are directly examined under 20X magnification & dilated tubules containing sperms are freezed.Micro-Tese has a very good success rate in cases of AZOOSPERMIA even in patients where testicular biopsy is negative.
PESA/ MESA/ TESA/ TESE
All these treatment options are for male factor infertility in whom there is obstructive azoospermia or defective sperms in semen.
DONOR EGG IVF
DURING FETAL LIFE OVARIES OF A HUMAN FEMALE CONTAINS AROUND 7 MILLION OOCYTES.
AT BIRTH= 1 MILLION AT PUBERTY= 4 00,000.
ONLY SOME 475 WILL OVULATE DURING THE REPRODUCTIVE YEARS. , THIS SHOWS THAT WITH AGE THERE IS A DIP IN FERTILITY
Egg donation is the process by which a woman provides one or several (usually 10-15) eggs (ovum- mature oocytes) for purposes of assisted reproduction . For assisted reproduction purposes, egg donation involves the process of in vitro fertilization as the eggs are fertilized in the laboratory. After the eggs have been obtained, the role of the egg donor is complete. Egg donation is part of the process of third party reproduction as part of ART (Assisted Reproductive Technology).
What Exactly is Donor Egg IVF?
Donor egg IVF is a fertility treatment or Assisted Reproductive Technology (ART) in which the egg from a donor is subjected to IVF. That is, the egg from the donor is mixed with the sperm from the biological father in the laboratory. If embryos are produced, they are grown in a lab dish and then transferred to the recipient’s uterus. If this results in a pregnancy, the baby thus born will have genetic linkage to the donor of the egg.
Who Qualifies to Receive an Egg?
The criteria for women to qualify to receive eggs are:1.WOMAN WITHOUT OVARIES/ OVARIAN FUNCTION :
- Congenital absence of eggs
- Acquired reduced egg quantity / quality
Premature menopause or premature ovarian failure(POF).
- Resistant Ovary Syndrome
- Woman with Ovarian Function
- Ovaries inaccessible for egg retrieval
- Very Low ovarian reserve
- Repeated IVF Failures :-
Due to poor response to COH drugs
Advanced maternal age leads to poor egg quality.
Repeated failure of oocyte recovery
AT Sno we provide anonymous donor oocyte programme.The egg donors are carefully selected,counselled & screened for any diseases like HIV , chlamydia, hepatitis- HBsAg, hepatitis C antibodies, VDRL & Thalassemia testing and other diseases and also Karyotyping for certain genetic predispositions before being accepted on to the Programme. Each egg donor is required to undergo a thorough medical examination, including a pelvic exam, blood draw to check hormone levels and to test for infectious diseases, and an ultrasound to examine her ovaries, uterus and other pelvic organs. In addition, she will be referred to a psychologist who will evaluate if she is mentally prepared to undertake and complete the donation process. These evaluations are necessary to ensure that the donor is fully prepared and capable of completing the donation cycle safely and successfully.
The donor is usually young, not more than 28 years of age, so that the quality of the eggs is high. We prefer parous donors for both psychological reasons & success rates are higher with fertile donors. Once Egg donors are recruited& screened, they give consent prior to participation in the IVF process. The donor must sign the Egg Donor Contract which specifies the rights of the donor with respect to the conceived child and the recipient. In this contract the donor agrees to undergo a thorough medical and psychological screening, genetic testing, and social diseases (i.e. HIV). Also, it specifies that the egg recipient and the father of the child are the legal parents.
Legal documents are signed renouncing rights of ownership and custody on the part of the donor, so that there can be no claims on the part of the donor concerning the offspring.The Recipient woman & her husband will be the Legal Parent for all purposes.
Sno does its best in taking the wishes of the Recipient Couple into account while selecting a donor. we try to match the physical characterstics, nationality & blood group as closely as possible to the Recipient Couple.
Embryo Freezing (Vitrification & cryopreservation)
Eggs are collected per patient resulting in an average of seven embryos per patient. Usually no more than two embryos are transferred at a time. It is possible to freeze some of those embryos, which are not immediately transferred. The decision to freeze the embryos will depend on the number and quality of embryos remaining.
It is known that embryos that are not of good quality (as shown by their physical appearance under the microscope) will be unlikely to survive the freezing and thawing procedure. However, if there are a sufficient number of good quality embryos available, these can be frozen and preserved in this state for up to ten years. The frozen embryos can be thawed out and transferred back into your uterus in a subsequent cycle or cycles. The chances of pregnancy resulting from frozen embryos are not as good as that from fresh embryos but, nevertheless, this does offer a supplementary chance compared to if freezing was not available.
Laparoscopy & Hysteroscopy (Diagnostic + Operative)
Our clinic is dedicated to providing gynecological care for women of all ages. Our goal is to provide personalized, high quality, accessible care from adolescent until after menopause. We focus on care for the well-women (preventive care) as well as cutting edge treatment for known reproductive and gynaecological disorders. These include abdominal, laparoscopic, vaginal and hysteroscopic procedures
Laparoscopic Surgery (key-hole surgery) involves the direct visualization of abdominal and pelvic organs via the introduction of a small fiber optic lens 5-10 mm in size (with a built in light source) into the abdominal cavity. Entry to the abdominal cavity is achieved by making a small incision at the level of the umbilicus (navel), inserting a multipurpose access port, and passing the fiber optic lens through the port into the abdomen. Additional access ports may be placed in strategic places along the abdominal wall in order to facilitate the passage of multiple specialized surgical instruments. The net effect is to permit the surgeon to perform intra-abdominal/pelvic surgery without the need of a large surgical incision. Again, post operative pain is substantially decreased and post operative recovery time is minimized.
Procedures traditionally performed through “open” incisions are now routinely handled through laparoscopic interventions. Examples of these procedures are diagnostic procedures, destruction of endometriosis lesions, hysterectomies, surgeries for subfertility, removal or drainage of ovarian cysts
Our full range of Gynaecology services
- General Gynaecology
- Women’s Health Screening – FIT AT 40
- Abnormal Pap Smear evaluation and treatment Contraception including Mirena® LNG-IUS
- Hormonal issues from adolescence through menopause
- Pelvic pain management
- Vaginal discharge and infection
- Menopause and hormone replacement
- Urinary incontinence and genital prolapse
- Uterine fibroid management and treatment
- Laparoscopic Surgery (key-hole surgery)
Preivf – Hysteroscopy is the Gold Standard Method for Uterine Cavity Evaluation.
The patients with Bad obstertic History ( multiple pregnancy losses in terms of miscarriage, malformed, still born) are thoroughly investigated and diagnosed.Appropriate line of treatment is initialted as required and as per guidelines
It is an office procedure carried out to diagnose pathology of testes in persons where there is qualitative or quantitative( complete absence of sperms – NON OBSTRUCTIVE AZOOSPERMIA ) anomaly of sperms..
Embryo donation is seen as an alternative route to pregnancy. It helps couples that would otherwise be unable to conceive, carry a pregnancy to term. A relatively new procedure, embryo donation involves using another couple’s embryos in order to conceive. These donated embryos are then transferred into the uterus using frozen embryo transfer.
Embryo donation is chosen by many couples who are unable to afford conventional reproductive treatments or who have been unsuccessful with IVF treatments. This procedure is similar to egg donation. However, instead of borrowing the egg and using the recipient’s husband’s sperm for fertilization, both the egg and the sperms are derived from donors. Types of Embryo Donation: There are two types of embryo donation
Embryo Sonation : Frozen embryo donation involves using frozen embryos donated by another infertile couple. Many couples go through IVF treatments in order to get pregnant. With each embryo transfer only 2 to 3 embryos are ever implanted .usually a couple get some extra embryos at each ivf cycle & therefore many couples choose to donate their remaining frozen embryos to couples who are having trouble conceiving.
Embryo Creation : This involves using a donated sperm & donated egg to create an Embryo.This resulting embryo is then transferred into your uterus.
There are many young patients who need IVF/ICSI procedure but who cannot afford it.These patients produce lot of eggs & hence many embryos.After taking proper informed consent of these patients (Embryo Donors) , some of their extra embryos are used for the recipients.In return, the costs of drugs of the younger patient are born by the receipient
At Sno clinic Embryo Donation is totally an anonymous process. There is absolutely no contact between the donor couple and the recipients, who never see each other. Unlike traditional adoption, the couple does not have to go through a legal process to adopt, but do so through medical treatment. This means that the couple ‘biologically adopts’ the embryo. There are many reasons why couples may prefer embryo adoption to adopting a child. For infertile couples, embryo adoption offers the unique opportunity to be pregnant, to bond with their child prior to birth, and to give birth. Embryo adoption also offers couples privacy and secrecy, so that they do not need to worry about societal acceptance of their adopted child. Embryo adoption is an alternative for infertile couples who need egg or sperm donation.
Sno with its state-of-the-art artificial reproductive technology (IVF, Surrogacy etc) and advanced facilities, is dedicated to bring Bundle of joy to the couple who are incapable of having their own child by means of Gestational Surrogacy. Gestational surrogacy is done through In Vitro Fertilization (IVF). The recipient mother or an egg donor provides the eggs which are fertilized with the sperm of the recipient father or a sperm donor.
The resulting embryo is transferred into the uterus of the surrogate (host). It is the only method by which an infertile couple can have the advantage of having their own genetic child without compromising the baby’s health and intended mother’s health.
Since surrogate has no genetic link to the baby she is carrying, the child is the genetic property of the couples & the surrogacy contract is legally recognized & enforceable. Unlike adoption, there is no risk of the genetic mother changing her mind about taking the baby. Gestational Surrogacy Procedure at Sno : Requirements for Gestational Surrogacy Keeping in view the need & importance of surrogacy and to avoid the misuse of surrogacy , certain guidelines have been laid down. A contract is drafted specifying that the baby becomes the legitimate adopted child of the genetic couple. The genetic parents, the surrogate mother and her spouse will sign this document. Requirements of the sperm donor and the Oocyte (egg) Donor are – they should be free of HIV, hepatitis B and C infections, sexually transmitted diseases, hypertension and other medical conditions. The blood group, Rh status, age, height, weight, etc. are also determined and stored for future references
Screening the surrogate (HOST):
Sno services begin with finding an Indian surrogate, who is sourced by means of advertisements in local newspapers given by the Gamete Bank on your behalf. The clinic ensures that surrogate mothers taken into their program are qualified for the job. Sno makes sure they are in the age bracket of 21-35 years, and their pregnancy history mentions normal deliveries and healthy babies. She is tested for HIV beforehand, and tested again, just before embryo transfer. At Sno the surrogate (host) has to go through basic serological screening tests, and investigated for infectious diseases, and thalassemia.
The Sno gestational surrogacy program process begins with Estrogen tablets that are given to the surrogate to prepare her endometrium (lining of the uterus) from the first day of her menses. Alongside, the genetic mother will be given Gonadotropin injections from day 1 of her menses, which will continue daily for approximately 10 days. Within that time period, mature eggs will have developed in both ovaries of the genetic mother.
The egg pick-up will be around Day#13. On the day of the egg pick-up, the genetic father provides his semen sample. On Day#15 Sno experts start the embryo transfer, into the surrogate, guided by an ultrasound. The surrogate is then put onto certain injections and tablets for luteal support. After 15 days of this, a pregnancy test is done to confirm the pregnancy.
Delivery and Birth Certificate
Genetic parents need to be present in the fertility clinic in the beginning stage (as explained above) and during the delivery of the baby. Once the embryo transfer has taken place, the surrogate is placed under the care of sno efficient obstetricians till term (9 months). Genetic parents will be provided with regular updates about the surrogate mother’s progress through e-mail. The baby will be delivered in a hospital set up and handed over to the genetic parents immediately following the birth.
The Government of India issues a birth certificate in the name of the Intended parents / Genetic parents. Sno requests genetic parents to educate themselves about the prevailing laws in their country. This helps in speedy facilitation of the formalities required to carry their baby back to their country. Sno also provides the genetic parents with services of a lawyer to expedite the paperwork.
Fertility Preservation is a boon for Cancer patients who are starting with the treatment of cancer, he can consider the option of freezing his own sperm, as the treatment for cancer may affect his fertility drastically. Female patients who are starting with chemotherapy for breast cancer, she can consider minidose IVF stimulation followed by oocyte retrieval & freezing the fertilized eggs.These fertilized eggs can be used for future pregnancies.With these fertility preservation programme one can get one’s own biological child.
We understands that fertility treatment can be an extremely stressful & an emotional experience.Under the supervision of specialized counsellors, we strive to make your treatment more comfortable & easy with genuine care & warmth.
We at Sno provides State of the art IVF treatment at par with international standards to our overseas patient. For Surrogacy we at Sno requests genetic parents to educate themselves about the prevailing laws in their country. This helps in speedy facilitation of the formalities required to carry their baby back to their country.
Various country consulates in New delhi (Capital of India) also help find out about the laws and formalities that are prevalent in the country of the intended parents. Sno also arranges the services of a lawyer for the genetic parents to expedite the paperwork. AT Sno we provide ANONYMOUS donor oocyte programme for overseas Patients. Legal documents are signed renouncing rights of ownership and custody on the part of the donor, so that there can be no claims on the part of the donor concerning the offspring.The Recipient woman & her husband will be the legal parent for all purposes.