Normal Pregnancy- How it Actually happens ? explained by Dr. Sarabjeet Singh, Ridge IVF Delhi

Pregnancy is the fertilization and development of one or more offspring, known as an embryo or fetus, in a woman's uterus. It is the common name for gestation in humans. A multiple pregnancy involves more than one embryo or fetus in a single pregnancy, such as with twins. Childbirth usually occurs about 38 weeks after conception; in women who have a menstrual cycle length of four weeks, this is approximately 40 weeks from the start of the last normal menstrual period (LNMP).

IVF- In Vitro Fertilisation, Ridge IVF Delhi

Q1. What is In Vitro Fertilisation (IVF)? 

For patients with irreparably damaged fallopian tubes profound oligospermia (Low Sperm counts )or failure to conceive after adequate attempts of intrauterine insemmination, In Vitro Fertilasationhas become the treatment of choice. 

The technology involves incubating the oocytes(eggs) & sperm in the laboratory & allowing the resulting embryo (s) to develop for a number of days prior to transferring them into the endometrial cavity (uterus). 

Q2. What is the success rate of IVF? 

In the 1980's pregnancy rates for IVF were relatively low, approx 15%. As the nutrition requirements for the embryo growth within the Laboratory became better understood, conception rates began to increase. As we head into the new millenium, anticipated pregnancy rates for many patients may exceed 50 percent. 

Q 3. Any risks involved in IVF? 

Increased emotional stress because of high cost & time consuming with success rate of 40%. Risks of multiple pregnancies & hyperstimulationsyndrome are all increased. 

Q4. How long does it take for one attempt of IVF & is hospitalisation essential during any stage of treatment? 

Patient needs to be in constant touch with the IVF center for about one and a half month from starting medication upto the result of IVF. Out of this period active treatment takes ten to fifteen days during which patient has to visit the IVF Lab. No hospitalizations essential during the treatment cycle. 

Q5. How are eggs collected? 

Prior to collection of eggs, patient is given medication in the form of daily injections starting fromday 2 of menstrual cycle & response to these injections is monitored with frequent blood tests & Vaginal ultrasound. Eggs are retrieved from the ovaries by a needle with the help of transvaginal sonography guidance. It is done under mild anaesthesia & is a day care procedure. It is done 32-36 hours after final hormone injection. 

Treatments For Infertility

MALE INFERTILITY

We provide comprehensive management and treatment for Azoospermia, Oligospermia, Impotency, Erectile dysfunction and premature ejaculation.

Treatment of Male Factor

Obstructive causes

Surgical Procedures such as Vaso-epidydimo-anastamosis might improve the sperm count in 40% of cases. If sperm count in low then IVF-ICSI is the only solution if the couple is keen on their own genetic child. Another options is donor insemination.

Non Obstructive causes

• In case of genetic defects like KLINE FELTERS syndrome, Micro deletion in Y chromosome etc. donor insemination is the option. Adoption another alternative in case the couple is averse to treatment.
• If the testes are atrophic due to infections again donor insemination is the option.
• Varicocelectomy (Ligation of veins or embolisation) might improve sperm count.
• Erectile dysfunction: medications like Sidnaphyll and counseling can help. If the sperm count is good then IUI is an option. In case of very low sperm count IVF-ICSI is the option. For impotency, penile prosthesis are available which can couples have normal sex.
• Azospermia can be managed through the following procedures.

Sperm Aspiration

This is a procedure to obtain viable sperms from the male reproductive tract. The following methods are used to extract the sperms for use in ICSI.

• Microsurgical Epidydimal Sperm Aspiration (MESA): To obtain sperms from the epididymus using an operating microscope.
• Percutaneous Epididymal Sperm Aspiration (MESA): To retrieve sperms, epididymus is punctured with a needle & sperms are aspirated with a syringe. This is a simpler technique.
• Testicular Sperm Aspiration (TESA): This involves sucking out the testicular tissue &sperms are isolated from it.
• Testicular Sperm Extraction (TESE): It is an open procedure where a small portion of testicular tissue is removed through an incision. This tissue is placed in culture media &sperms are extracted from it.

Some Common Terminology

Hypospermia : low semen volume

Normozoospermia : Normal ejaculate (WHO Criteria)

Oligozoospermia : Sperm concentration fewer than 15 x 106/ml

Asthenozoospermia : Fewer than 50% of motile sperm

Teratozoospermia : Fewer than 4% with normal morphology

Oligoasthenoteratozoospermia : Signifies disturbance of all three variables

Azoospermia : No spermatozoa in the ejaculate

Aspermia : No ejaculate (absence of semen)

Necrozoospermia  : All spermatozoa are dead as defined by vital staining