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1.
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Why
am I childless? What is infertility/subfertility?
Infertility/Subfertility is a condition when a woman
after one year of unprotected sexual intercourse not being able to conceive on her
own. Both the partners need to be investigated together to treat this problem.
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2.
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Who needs to visit an Infertility Specialist?
When there is no conception after one year of unprotected
intercourse in women of < 35 years, the couple should seek advice from Infertility
specialist. When the woman is >38 years, they should seek advice after 6 months
of unprotected intercourse. |
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3.
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How common is infertility/subfertility?
It is known that 84% of women would conceive within
one year of marriage; 92% in two years and 93% in after three years. It means some
5-15% of the married couples are facing this problem at any given time in a society.
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4.
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Is infertility becoming more common nowadays?
Though it may appear to be so, nevertheless, as
people have become knowledgeable, more and more patients start approaching specialists
to find out the cause of their subfertility status sooner than before. Notwithstanding
that, there seems to be subtle decrease in our fertility rates as a society, thanks
to our changed lifestyle, career needs and economic factors.
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5.
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What is a normal semen analysis?
Normally a man has about 40 to 100 million sperms
in semen per ml. WHO has reported that 20 million sperms per ml with 50% motility
as the requirement for natural conception to occur. Anybody whose count is consistently
lower than this may require ART procedures.
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6.
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What are the pre-screening tests a couple with infertility
problem need to undergo and why so many?
In order to investigate and analyze your infertility
problem, we need to know the underlying medical problem which will help you to choose
the correct option of treatment. for eg a semen analysis showing very few sperms
will obviously direct the couple to ICSI without wasting any time. We accept reports
from any reputed clinical laboratory for tests done within 6 months to one year.
We generally prefer to do a simple semen analysis in our laboratory. One Semen analysis
may not give the real status. If a person had a fever of more than 101’F for some
days, he might expect to have a worse semen report for the next 3 months.
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7. |
Female Screening Requirements:
Blood Tests Day 2-4 (of un-medicated cycle) FSH,
LH and estradiol levels
Rubella Antibody titre
HIV I and II
Chlamydia IgM/IgG status
Hepatitis B surface antigen HBsAg
Hemoglobin
Testosterone in some women
DHEASO4 in some women
Day 21 Progesterone to know the luteal functioning
Pelvic ultrasound to rule out ovarian cysts, fibroids, polyps and hydrosalpinges
(fluid filled tubes)
Hysterosalpingogram (HSG) or hysteroscopy to evaluate uterine cavity and tubal patency
Male Screening Requirements:
Semen Analysis
HIV I and II
Hepatitis B surface antigen
VDRL
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8. |
What is a day 2 FSH and estradiol level and why should it be done only at that time?
These tests measure the level of follicle stimulating
hormone (FSH) and estrogen on the second day of your menses period. The test values
give us an indication of ‘ovarian reserve', in other words, how hard your pituitary
gland in your brain has to work to stimulate your ovaries to ovulate. These values
give us a rough idea to determine what IVF protocol to choose, how much hormone
injection (FSH dose) may be required for stimulation and an insight into the potential success rates of IVF. Some centres may not accept a woman if her blood FSH level
is > 11 mIU/mL.
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Why does this IVF treatment take so long?
As you may be aware, certain part of your brain
(pituitary gland) controls your ovaries. If we have
to bring your ovaries into our
control for controlled stimulation, we need to delink your brain-ovary control axis
and this is called down-regulation or ovarian suppression. You don’t panic, once
you are off the medication, your brain will take over and your cycles will be restored
as before.
This takes about 8 to 10 days in the cycle before the start of ovarian stimulation
drugs. Soon after you get your proper menses, ovarian stimulation in the form of
daily FSH injections is initiated and this lasts for about 9 to 14 days. Egg Collection
is fixed in the next 2 days after giving you a shot of hCG injection for final maturation
of your eggs. Embryo Transfer is fixed in the next 2 days following your
egg collection.
Basically the IVF treatment gets over by the time of Embryo Transfer. One has to
wait for the result of pregnancy in the next 14 days. Actual treatment commences
from the 21 st of the preceding menses cycle and lasts till about 14 to 16 day of
IVF treatment cycle. Refer to our Typical IVF Calendar in Genesis.
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10. |
Is it possible for a woman without getting menses to conceive on her own?
Yes, in certain circumstances like polycystic ovarian
disease where the anovulation is occurring due to hormonal imbalance. If we can
make these ovulate with treatment, they have good chances of conceiving. If the
problem is of premature menopause, she could get pregnant with donated eggs.
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