Queries We Often Come across In Mind Of Childless Couples



1). What is infertility ?
Infertility in women refers to the condition in which a woman is not able to conceive or contribute in the conception of a child due to some health issues. In some cases of infertility, a woman may conceive, but might not be able to carry a child until its birth.
2).Causes of infertility –
· Male factor-sperm issues
· Female factors- egg related, tube relate or womb related issues
· Combined factors
· Unexplained
3). What all we need to go through as patients?
· As patients first thing is right approach and proper guidance
· Baseline workup of couple to see- status of eggs , sperms,tubes and uterus
· Pointing out the causative factor underlying
· Treatment plan is advised as per clinical situation
4) .Do all childless couples need IVF ?
No.Each couple is different so needs individualized treatment and stratification.There can be alternate options as per clinical decision based on a panel of tests
5) .What are the various options a couple can access ?(Services Offered)
· Timed intercourse(window period)
· IUI(intrauterine insemination)
· IVF(Invitrofertilization)
· Sperm/egg donation
· Embryo donation
· Semen Freezing
· Surrogacy
· Azoospermia treatment/options
· Laparoscopy/Hysteroscopy
6) .Various health tips we can follow while in process ?
Common deficiencies-
· Iron - iron deficiency can inhibit women from ovulating. Good food sources are red meat, eggs and leafy green vegetables.
· Iodine - iodine deficiency can impair the health of the thyroid gland, a major cause of infertility. About 50 per cent of patients are deficient in iodine .A supplement should only be taken if a blood test shows a deficiency.
· Omega-3 – This is essential fatty acid inspires the production of the hormone progesterone for ovulation to take place. 
· Vitamin d - vitamin D deficiency can inhibit ovulation, and women with polycystic syndrome are particularly likely to be deficient.
7).What to avoid?
· Bad fats - like Trans fats found in processed, packaged and fried foods, biscuits and cakes can keep a woman from ovulating. Consume the good fats found in extra virgin olive oil, avocados and nuts and seeds instead.
· Cigarettes – it will stringently reduce sperm count and sperm motility.
· Alcohol – it moderates the creation of progesterone, can stop ovulation in women and lessens sperm count & motility.
· Coffee - Women who drink more than 300ml of coffee a day are twice as likely to experience infertility for a year or more.
8.  Intrauterine insemination(IUI)-
IUI Treatment  is a procedure in which washed and processed semen sample is put inside the woman’s womb around the time of egg release(ovulation), thereby increasing the chances of conception in that particular cycle.
9.In Vitro Fertilisation (IVF) & associated treatments-
In Vitro Fertilisation, in simple language, is growing, collecting and combining eggs with sperm in the laboratory to create embryos to be transferred to a woman’s womb.
· Medications(Gonadotrophins) are given over 10-14 days to stimulate egg production and prepare the womb to receive embryos .
· Eggs are collected by a minor surgical procedure under ultrasound guidance.
· Eggs are inseminated with sperm and then embryos are cultured in the  laboratory, of which one or two are transferred to a woman’s womb. Any  remaining embryos will be frozen for possible use in later treatment cycles.
Associated treatments
·  ICSI is when a single sperm is injected into a single egg to achieve fertilization, specially indicated in cases where sperm count is substantially low or the quality is poor.
·  Blastocyst culture is when the embryos are grown and cultured till 5 days in the laboratory, where they undergo critical developmental changes before  being returned to the womb.
·  Assisted hatching is weakening the embryo shell to help them hatch before being transferred to the womb.
·  Surgical sperm retrieval is a minor surgical procedure to harvest sperm from the testicles.
·  Electro-ejaculation is a minor theatre procedure to overcome problems of erection and ejaculation.
10. Donor Egg IVF/Oocyte Donation-
· As you go through your own treatment with us, you might be surprised by the number of couples who are in the same situation as yourself−the same frustration, the same anxiety, the same dream of success that you have. Every situation is different in detail. Many people are able to use their own gametes (sperm and eggs) and embryos in their treatment, but there are some who need to use donor sperm or donor eggs  to help them achieve that dream.
· If you meet our donation or sharing criteria, you might want to consider others less  fortunate than yourself, and donate some of your eggs or sperm for their treatment. If you have been successful in your own treatment and have extra embryos in storage, you might consider donating those embryos to other patients. The gratitude of recipients of eggs, sperm and embryos is difficult to describe, and you can forever be proud of your own generosity.
We offer comprehensive freezing programmes for eggs, sperm and embryos, which can be an appropriate option for some people, for example those starting cancer treatment or the ones who wish to make it a lifestyle choice. This is a complex subject and we would be happy to discuss this further with you. Please contact us for further information, advice and support.
12. Frozen Embryo Transfer-
 . Frozen Embryo Transfer means replacing thawed frozen embryos in the  womb at the optimum time for implantation.
· FET drugs are used to prepare the womb to receive embryos at the  appropriate time.
· This helps the woman avoid undergoing injections for growth of eggs again.
13.What is Egg Donation?
Egg donation is a process in which a woman offers to provide several eggs during a cycle to couples unable to conceive. Egg donation can provide a lifeline for intended parents, whether the intended mother carries the pregnancy to term or seeks a surrogate, also known as a Gestational Carriers (GC), to do so.
From the moment a doctor harvests donated eggs from donor’s ovaries, the eggs belong solely to the intended parents; the donor has no claim or control over the eggs or resulting embryos, regardless of whether they will be fertilised with the sperm of the intended father or donor sperm – and regardless of whether the  resulting embryos will be transferred to the uterus of the intended mother or GC.
A good number of egg donors are women who are themselves going through IVF and have produced sufficient eggs for these to be shared with another patient. In these situations, the egg sharer has free treatment and the substantial reward of helping another couple create a family – an emotional process the donor will, having gone undertaken IVF treatment, fully appreciate. All donors are also offered free counselling. 
14).Intracytoplasmic Sperm Injection (ICSI) : 
It is a technique sometimes used with in-vitrofertilisation (IVF) in which one sperm is injected directly into one egg to achieve fertilisation. This is especially useful for men with very low sperm counts as ICSI ensures that the sperm reaches the egg directly rather than waiting for the sperm to naturally fertilise the egg.
ICSI is also used as a treatment method for male infertility. ICSI is currently the most successful treatment for male infertility, with fertilisation rates of 60%-70% depending on quality of the sperm used. However, once the egg is fertilised, the success rates of ICSI in conjunction with IVF remain the same as conventional IVF.
Micro-TESE stands for Microsurgical Sperm Retrieval from the Testicle. This involves an operation performed through a small midline incision in the scrotum, through which one or both testicles can be seen.
The surgeon examines the testicle(s) under the microscope, which provides up to 20x magnification, in search of areas where the seminiferous tubules – small areas of testicular tissue – are dilated and therefore more likely to contain sperm. The surgeon then removes these areas, and we examine them in our laboratory for the presence of sperm.
We continue examining different areas of the testicle(s) until we find sperm, or until we’ve examined and biopsied all sites of the testicle(s) without seeing any sperm.
Who needs Micro-TESE?
This procedure is usually applicable if other SSR techniques(PESA or TESA) have been unsuccessful, or if you don’t have any sperm within the ejaculate due to defective sperm production. In this latter case, it may be the result of previous testicular surgery, previous medical treatment or a genetic problem.
The Consultant will be able to recommend if this procedure is the most likely to succeed in obtaining sperm in your particular case.
16).Pre conceptual Care-
The months leading up to conception can have a significant impact on the health and development of your future family. If you are thinking about starting a family there are a number of physical and lifestyle factors that you and your partner can adapt in order to improve your chances of conception and give your child the best start in life.
Whether you are trying to conceive naturally, or wanting to get the best out of your fertility treatment, the consultations with our experts will include practical advice and support, as well as health checks, to ensure you are fully prepared as you embark on your journey towards parenthood.
A preconception visit will also help you determine any individual risk factors meaning you may need additional care during pregnancy.
Every preconception consultation is personally tailored to you. We will start by conducting a health and lifestyle audit, taking into account any fertility issues and/or existing health conditions. Depending on your needs the suite of services offered will include:
· Health checks e.g. BMI, blood pressure, blood tests & genetic screens
· Nutritional advice to enhance fertility
· Vitamin and supplement guide
· Ovulation calendar & fertility charts
· Relaxation techniques and managing stress
· What to expect during your pregnancy
17).Fertility and Health-
Before proceeding with IVF treatment, there are many things you can do to improve your chances of conceiving. Being aware of these, and demonstrating which you have acted on, will help your gynaecologist suggest the next steps of your journey. surrogacy doctor best ivf dr in mumbai