HEALTH SERVICES

INVITRO FERTILIZATION

Description

This is one of the main procedures in Assisted Reproductive Technologies(ART) where the fertilization of oocyte is done outside the female body. This procedure can be done by either a client’s own oocyte and sperm or by donated oocytes and sperm.

Why Choose IVF?

Opting for an IVF procedure increases chances of getting pregnant than using normal cycle and Interuterine insemination.

What to expect during IVF

IVF may be an option in the following conditions:

• Fallopian tube damage or blockage. Fallopian tube damage or blockage makes it difficult for an egg to be fertilized or for an embryo to travel to the uterus for implantation. Without a healthy fallopian tube, fertilization and implantation are affected which are very crucial steps in conception. The reason for this happening include; scar tissues, infections or pelvic adhesions.

• The symptoms of blocked fallopian tubes. Most often the fallopian tube blockage is asymptomatic. Many women only realise it when they have difficulties getting pregnant. In some cases blocked fallopian tubes can lead to mild, regular pain on the side of the abdomen. This occurs when fluid fills and enlarges a blocked fallopian tube. Conditions that can lead to a blocked fallopian tube can casue their own symptoms. Eg. Endometriosis often causes very painful and heavy periods and pelvic pain which can increase fallopian tube blockage.

• Ovulation disorders. If ovulation is infrequent or absent, fewer eggs are available for fertilization.

• Endometriosis. Endometriosis occurs when tissue similar to the lining of the uterus implants and grows outside of the uterus — often affecting the function of the ovaries, uterus and fallopian tubes.

• Uterine fibroids. Fibroids are benign tumors in the uterus. They are common in women in their 30s and 40s. Fibroids can interfere with implantation of the fertilized egg.

• Previous tubal sterilization or removal. Tubal ligation is a type of sterilization in which the fallopian tubes are cut or blocked to permanently prevent pregnancy. If you wish to conceive after tubal ligation, IVF may be an alternative to tubal ligation reversal surgery.

• Impaired sperm production or function. Below-average sperm concentration, weak movement of sperm (poor mobility), or abnormalities in sperm size and shape can make it difficult for sperm to fertilize an egg. If semen abnormalities are found, a visit to an infertility specialist might be needed to see if there are correctable problems or underlying health concerns.

• Unexplained infertility. Unexplained infertility means no cause of infertility has been found despite evaluation for common causes.

• A genetic disorder. If you or your partner is at risk of passing on a genetic disorder to your child, you may be candidates for preimplantation genetic testing — a procedure that involves IVF. After the eggs are harvested and fertilized, they're screened for certain genetic problems, although not all genetic problems can be found. Embryos that don't contain identified problems can be transferred to the uterus.

• Fertility preservation for cancer or other health conditions. If you're about to start cancer treatment — such as radiation or chemotherapy — that could harm your fertility, IVF for fertility preservation may be an option. Women can have eggs harvested from their ovaries and frozen in an unfertilized state for later use. Or the eggs can be fertilized and frozen as embryos for future use.
  Women who don't have a functional uterus or for whom pregnancy poses a serious health risk might choose IVF using another person to carry(surrogate).

COUNSELLING

Infertility can bring an emotional toll upon any person who finds out they are incapable of bearing a child. The emotional support from family and friends may not always be professional hence it is highly recommended for couples to have counselling services from our counselling experts.

Among the advantages of getting professional counselling is:

• 1. Understand the psychosocial and ethical implications of treatment, client rights and responsibilities and any legal considerations

• 2. Explore areas of potential stress and discuss strategies for managing them

• 3. Having a non-judgmental platform where couples/ individuals can open up about their feelings and be clearer about their decisions and solutions

• 4. Receive encouragement to find answers to the questions in their minds without interfering with their decisions

• 5. Get an understanding of what they are about to do and understand how to cope with the effects or implications of their treatment in different aspects of their life.

Stress can have negative implications on the well-being of the woman who is expected to conceive. The rollercoaster of emotions such as despair, hope, anger, anxiety and isolation can interfere with the treatments hence it is important to address these feelings.

Most women blame themselves for not conceiving and this leads to negative emotions such as anxiety, depression or distress.

With the help of our counselling services, we wish a peaceful and stress-free IVF journey full of positive emotions and a healthy mental state.

SEMEN ANALYSIS

Description

Semen is the fluid containing sperm (plus other sugar and protein substances) that’s released during ejaculation. A semen analysis is typically the first test performed to determine if there is male factor infertility and measures the number and quality of sperm in the semen, as well as other parameters.

This test checks the quantity and quality of sperms in the ejaculate. This includes volume of the semen sample, sperm count, sperm motility, sperm vitality and sperm morphology. We examine to determine the root cause of infertility.

According to the American Society for Reproductive Medicine (ASRM), 20% of infertility cases are due solely the male factor infertility and another 20% are caused by a combination of male infertility and another factor. One of the main causes of male infertility is abnormalities in the sperm.

Producing a healthy sperm is a complex process, involving several elements that need to work together. The testicles must function properly and in sequence with the pituitary and hypothalamus glands that trigger sperm production. The sperm then has to be transported from the testicles and mixed with semen for ejaculation. Problems in this system can result in sperm of poor quality.

A semen analysis can provide information about the sperm and semen that have an effect on male fertility. A study published by the National Institutes of Health shows that a semen analysis can detect 9 out of 10 men with infertility problems.

This test can also help identify if there is an infection in the reproductive system. The results can help determine the appropriate infertility treatments.

What to expect

The semen can be collected through masturbation, without the use of lubricants, including water-based ones, into a sterile container. Alternatively, a special condom can be used during intercourse to collect the semen. A physician may recommend the male not to release sperm, or ejaculate, for a few days before providing a sample.
Because sperm levels can fluctuate between tests, the individual may be required to give more than one sample. The same individual giving a sample two weeks apart can expect differences in the semen analysis.

Cryopreservation

Is the process of preserving gametes(eggs, embryos and sperm) for future use. The gametes are stored in liquid nitrogen at a temperature of – 196 degrees centigrade.
Cryopreservation is a relatively safe, advanced procedure and can often lead to a successful pregnancy at a later time. Research has shown that the process of freezing and thawing embryos does not harm babies and children born from frozen embryos.

INTRA UTERINE INSEMINATION

Description

In this procedure a sperm sample is collected, processed and then transferred into a woman’s uterus. This helps the sperm to reach where it’s suppose to.

What to expect during IUI

The male partner will be directed to collect semen sample, once collected, the semen sample is then “washed” in the laboratory to concentrate the sperm and remove the seminal fluid (seminal fluid can cause severe cramping in the woman). This process can take up to 2 hours to complete.

IUI is performed near the time that the woman is ovulating. The IUI procedure is relatively simple and only takes a few minutes once the semen sample is ready. The woman lies on an examining table and the clinician inserts a speculum into her vagina to see her cervix. A catheter (narrow tube) is inserted through the cervix into the uterus and the washed semen sample is slowly injected. Usually this procedure is painless, but some women have mild cramps. Some women may experience spotting for a day or two after the IUI.

Does it work?

The success will vary depending on the underlying cause of the infertility. IUI works best in patients with unexplained infertility, women with a cervix that limits the passage of sperm, and men who are unable to ejaculate effectively. IUI does not work as well for men who produce few sperm or have severe abnormalities with their sperm and does not help women who have severe fallopian tube disease, moderate to severe endometriosis, or a history of pelvic (lower belly) infections. Other fertility treatments are better for these patients.

Are there risks?

If a woman is taking fertility medications to increase the number of eggs when she has an IUI, her chance of getting pregnant with twins, triplets, or more is greater than if she were not taking fertility medications. Having an IUI does not increase the risk of birth defects. The chance of birth defects in all children is 2% to 4% whether conceived naturally or from IUI. The risk of developing an infection after an IUI is small.

Intra-cytoplasmic sperm injection

Description

Will ICSI work?

ICSI fertilizes 50% to 80% of eggs. But the following problems may occur during or after the ICSI process:

• Some or all of the eggs may be damaged.
• The egg might not grow into an embryo even after it is injected with sperm.
• The embryo may stop growing.

Once fertilization takes place, a couple’s chance of giving birth to a single baby, twins, or triplets is the same if they have IVF with or without ICSI.

Can ICSI affect a baby’s development?

If a woman gets pregnant naturally, there is a 1.5% to 3% chance that the baby will have a major birth defect. The chance of birth defects associated with ICSI is similar to IVF, but slightly higher than in natural conception.
The slightly higher risk of birth defects may actually be due to the infertility and not the treatments used to overcome the infertility. 

Certain conditions have been associated with the use of ICSI, such as Beckwith-Wiedemann syndrome, Angelman syndrome, hypospadias, or sex chromosome abnormalities. They are thought to occur in far less than 1% of children conceived using this technique. Some of the problems that cause infertility may be genetic. For example, male children conceived with the use of ICSI may have the same infertility issues as their fathers.

SPERM EXTRACTION

Description

Testicular Sperm Extraction (TESE)

This procedure is done to collect sperm directly from the testes when there are no sperm found in semen. The procedure is done when:

• Testes aren’t making enough sperm in the semen.
• blockage is preventing the sperm from passing out of the penis

Samples of tissue are taken from the testicles and sent to a sperm bank. If sperm is detected in the sample tissue, it will be frozen and stored.

Testicular sperm aspiration (TESA)

This is performed by inserting a needle in the testis and aspirating tissue with no pressure. In percutaneous epidydimal sperm aspiration (PESA), a small needle is passed directly into the head of the epididymis and fluid is aspirated. It does not require surgical incision and fertility treatments like Intracytoplasmic Sperm Injection (ICSI) use these extracted sperm cells.
The sperms obtained are then used in ICSI.

Sperm Bank

Description

Our facility offers sperm banking services, where we collect sperm samples from different donors. The sperm samples are processed and cryopreserved in cryo cans. For clients looking to opt for sperm donor, our sperm bank is will offer the donor sperm. Donor sperm can also be purchased by other fertility clinic whenever they are inneed of donor sperm.

Sperm bank is a facility which purchases, stores and sells human semen. Our clinic runs this facility and provides this service to individual patients or other fertility clinics. It provides the opportunity for individuals to have a child who otherwise would not be able to conceive naturally.

Sperm Freezing

Description

This is the process of collecting, analyzing, freezing and storing a man’s sperm. The samples are later used for fertility treatments or donated to other couples or individuals who do not have means to get sperms.
Sperm (the reproductive cells found in a man’s semen) is typically collected through masturbation. A man can choose to collect his sample at home or in our clinic, but should only use an approved, sterile container that doesn’t harm the sample quality.

Men are also asked to abstain from sexual activity for approximately two days prior to the appointment to allow for the best possible specimen. Once a semen sample is provided it is tested for sperm quantity, shape, and movement within each specimen.
If sperm are not present in the sample or if the man is unable to ejaculate, a surgical retrieval to remove sperm directly from the testicle is another option.

Next, the samples are separated into multiple vials to be frozen. Lab scientists will use specialized cryoprotectant (“anti-freeze”) agents to help preserve and protect sperm cells. The frozen sperm is then stored in the lab until needed. When the time comes, the sperm is thawed, washed, and tested for mobility prior to use in IUI or IVF.

Common reasons to choose to freeze sperm:

• Advancing age
• Deteriorating sperm quality or low quantity
• Cancer or other medical reasons
• Pre-vasectomy patients
• Career and lifestyle choices, such as those with high-risk occupations or who spend a lot of time away from their partners.

Egg Freezing

Description

is a relatively new method of fertility preservation where a mature, unfertilized egg is retrieved from a woman, frozen, and stored for future use. Egg freezing allows patients to extend their fertility. Thawed eggs retain their ability to become fertilized from the time of freezing, giving the patient peace of mind by knowing pregnancy may be possible in the future.

For women who have to go through aggressive and potentially fertility-harming treatments such as chemotherapy, egg freezing may allow them to preserve their fertility and build a family after treatment. Some women choose to freeze and bank their eggs for social reasons, such as waiting for the right partner or not wanting to take a leave from work. The frozen eggs can be thawed, fertilized and implanted for pregnancy at a later time.

Embryo Freezing

Description

Embryo that are unused undergo a freezing process and stored in liquid nitrogen. The frozen embryos can later be thawed, as needed, for future use in IVF. This allows patients currently undergoing IVF to save time and money on future cycles because a woman will not need to undergo additional egg retrievals and take as many medications.

Hysteroscopy

Description

During a hysteroscopy procedure, your uterus is examined using a thin, lighted telescope-like device that is inserted through your vagina. The hysteroscope transmits images of your uterus to a screen. Other instruments may also be used.

Why should Hysteroscopy be done?

A hysteroscopy before IVF treatment is necessary. A hysteroscopy is the best way to ensure that your uterus is healthy and ready to carry a baby.

Laparoscopy

Description

The laparoscopic procedure for infertility involves inserting a laparoscope (a fiber-optic tube with light and camera) through two or more small incisions in the belly button. The surgeon can then visualize the reproductive organs inside the pelvis. This procedure can also be used to remove any blockage that is present in the tubes.

This procedure can also be used to remove any blockage that is present in the tubes.

HSG(Hysterosalpingography)

Description

The HSG is performed to examine your fallopian tubes, uterus, and adjacent areas. A dye, usually water-based (or sometimes oil-based), is injected into your uterus via your vagina, quickly filling it with dye and – usually showing all of the attached tubes.

An HSG is performed to identify problems like uterine fibroids, scarring, myomas, tubal blockages, and irregularities that may be interfering with fertility or, in some cases, preventing conception and pregnancy.

HORMONAL ANALYSIS

Description

Monitoring of different hormones at various stages during the woman’s cycle is important to give the idea of the number of eggs available, the ovarian reserve, and to monitor any imbalance.

Some of the conditions may require a balancing of the hormones and this will be enough for the couple to conceive and have a baby. This means there would be no need to go through stimulations and subject the woman to a series of medications.

The level of AMH, which is important to measure before performing an IVF/ICSI procedure, can be used as a prognostic factor in older patients. However, this test does not predict pregnancy outcomes in younger patients.

The blood sample will be collected and hormone analysis will be performed depending on the history of the client.