IUI – Intrauterine Insemination
Intrauterine insemination (IUI) is the process of preparing a sperm specimen to concentrate it for the most active motile sperm and placing the washed sperm into the uterus as close as possible to the tubal opening. Intrauterine insemination is often recommended because studies have shown that pregnancy is more likely to occur if timing of exposure to sperm is controlled, and if sperm is placed in higher numbers closer to the egg or eggs.
Who are the candidates for IUI ?
» have unexplained infertility;
» have failed other treatments;
» have mild male factor infertility;
» are single women who are using donor sperm;
» have ovulation problems and are undergoing ovulation induction;
» are unable to have normal intercourse with ejaculation into the
vagina at appropriate times
IUI (Intrauterine Insemination) Process :
There are many techniques available for preparing the sperm, most of which are derived from in-vitro fertilization laboratory techniques, or from study of sperm behavior in the laboratory. The goal in sperm processing is to separate the sperm cells from the seminal fluid, fluid that can be irritating to the uterine lining. In the process, the most active, motile sperm are concentrated and separated from dead sperm, cellular debris and bacteria.
The sperm can be collected at home and brought within one hour to the office or can be produced in a clinic’s sperm collection room. The laboratory will then perform a sperm count and motility evaluation and prepare the sperm. The usual preparation procedure takes about two hours. After preparation, the sperm concentrate is placed into the uterus, through the cervix, using a small catheter.
Some of the sperm will also be placed directly into the cervix. The actual insemination process takes approximately 5 to 10 minutes.
IVF – In Vitro Fertilization
About IVF :
IVF or In Vitro Fertilization involves retrieving eggs from the female and fertilizing them in the laboratory by placing them with the sperms. This means that the sperm must have the capacity to fertilize the egg on its own in IVF. In contrast, ICSI involves injecting a single sperm in the egg, and is therefore used in extreme cases when the sperm have no motility of their own.
Life Line Hospital is one of the best IVF center in Bhopal.
ICSI – Intracytoplasmic Sperm Injection
Intracytoplasmic sperm injection (ICSI) is a new procedure that allows couples with sperm problems to have IVF treatment. Developed in Belgium in 1992, ICSI is the process of injecting a single sperm into an egg.
FET – Transfer Frozen Embryo
Freezing extra embryos increases the opportunity to achieve a pregnancy as a result of a single egg retrieval procedure. If a pregnancy does not occur in “fresh” IVF cycle, the patient can return at a later time for transfer of the remaining embryos. An ultrasound assessment of the uterine lining is performed before the embryos are thawed, to make sure an adequate uterine environment is present. Usually about 75% of the frozen embryos survive the thawing process, but it can vary depending on the stage at which the embryos are frozen.
In the past several decades the technology of cryopreservation, or maintaining life in a frozen state, has advanced considerably. With the use of modern techniques, cryopreservation of sperm to preserve an individual’s ability to reproduce has become successful, safe, and widely available.
High Risk Pregnancy Care
Pregnancy, Hypertension, Diabetes, Asthma Animia, Twins, Low Birth Weight Babies, Premature Delivery Recurrent Abortions, Previous Surgeries, Thyroid Problems.
Probability of Success with ART Treatments
The probability of success with ART treatments depends upon a number of factors like the age of the woman, the cause of infertility, additional pathology of uterus, genetic and epi genetic factors, endometrium receptivity, the quality of eggs retrieved and the quality of the sperm.
“The single most consistent variable affecting ovarian reserve is the woman’s age. This is because a woman is born with all the eggs she will ever have. In most women in their 20s about 2/3 of the eggs are genetically normal or balanced. However, there will be some that are genetically abnormal or unbalanced. It appears that the best eggs are ovulated first. The older a woman is, the fewer genetically balanced eggs she has left to respond to fertility drugs. This age relationship holds true even in the fertile population. At age 35 about 40-50% of eggs are chromosomally normal, at age 40 about 10-20% and then much fewer after that. Therefore, in older women fewer normal embryos are available for implantation into the uterus. Hence, healthy women over 35 are less fertile than their younger counterparts. Women 40 and over may have only a 20% live birth rate with IVF treatment using their own eggs, even though several embryos are replaced into the uterus.” Read more – Gail F. Whitman-Elia, MD, MPH, HCLD
The world meta-analysis (2012) shows the following probabilities:
||Live birth rate per retrieval
The success rate for having a baby depends a great deal upon the type of treatment e.g. IVF treatment or donor egg etc.
Laparoscopy Tubal Patency Cyst & Ovarian
How Does Pregnancy Occur ?
The female reproduce system involves the uterus, ovaries, fallopian tubes, cervix and vagina. Yhe female hormones, oestrogen and progesterone produced by the ovaries, rise and fall during the month and cause the menstrual cycle.
In the first half menstrual cycle after the menstrual period, the oestrogen produced by the ovaries repairs the lining of tge uterus. At the same time, an egg (ovum) in one of the ovaries matures. At about day 14 of a typical 28-day cycle, the egg leaves the ovary. This is called ovalution.
In the second half of the menstrual cycle, the egg begins to travel through the fallopian tube towards the uterus. Progesterone levels rise and thiken the uterine lining to prepare for pregnancy. If a woman has had a sexual intercourse at around the time the egg is released, the sperm travels from the vagina to fallopian tube where it fertilizes the egg; this is called fertilization.
The male & female gametes (sperm and egg respectively) fuse multiply and after approximately 6 days of fertilization these from a cluster of cells which gets attached in the uterus; that’s when the woman is said to be pregnant. There is continuous release of progesterone which helps maintain pregnancy. thus giving a temporary break to the monthly periods.
Pain Less Delivery – What is an Epidural?
An epidural is an injection given into the lower back. It is the most effective way to relieve labour pains. The feeling of pain is carried to the brain via the nerves in the spinal cord. An epidural injection obstructs this message of pain and you go through a painless labour.
Will an Epidural Injection Hurt?
The area where the epidural injection is to be inserted will be numbed prior to performing the procedure, so you will not feel any pain. But you will feel some sensation, and these will be fully explained to you.
Is it Safe to Take an Epidural?
Epidurals have an excellent worldwide safety record. As with any procedure, however, some patients may experience some minor side effects like shivering; decreased blood pressure; mild itching in labour; headache; persistent pain in some areas, etc. other complications like epidural or spinal hematoma are rare. Please discuss with our team members if more information is required.
How common is Headache after Epidural? How Do You Treat?
Headache after epidural is uncommon. At this institute, it is usually seen in 1 – 2 per 1000 epidurals. Most headaches respond to conservative management using simple analgesics like paracetamol. Small percentage of women may need epidural blood patch. Do not hesitate to ask our team member to know more about blood patch.
Does an Epidural Cause Backache?
No. Minor back problems are common during pregnancy and childbirth, with or without an epidural.
Do Epidurals Result in C. sections?
The chances of a normal delivery before or after the procedure are the same. There is sufficient data to prove that an epidural will not lead to an increased rate of C. section but some times when patient is uncooperative while bearing doon then instrumental delivery may be ……
If Ihave to subsequently undergo a C. section, will the epidural catheter be removed?
No. The same catheter will be used to administer anaesthesia. However, the concentration of the drug used will be higher to minimise discomfort during surgery. The same catheter will be retained for 48 hours after your surgery to administer pain-relieving medications, thus reducing your pain and discomfort even in the post-operative period.
Will the Epidural Harm my Baby?
No, not at all. A properly administered epidural improves blood supply to your baby and is especially helpful to mothers who have small babies or those with preterm labour. Another benefit is that when the mother is pain-free, she can cooperate with the obstetrician and help make the birth process quicker.
Is an Epidural Procedure Safe for Mothers with Hypertension/Heart/Lung Disease?
Epidural is the technique of choice and is highly recommended for mothers with this problem. Good pain relief will not only reduce the stress on the heart but will also improve oxygenation of both mother and baby, thus reducing stress on the heart and lungs.
Can IWalk after an Epidural?
Yes. All epidurals at this hospital are given using low dose mixtures of local anaesthetics and narcotics which preserve the motor power of your legs. In fact, if there is no maternal or fetal contraindication, the labour ward nurse will encourage you to walk after an epidural.
Are there any Contraindications?
Yes, there are a few. Epidurals and spinals are contraindicated in mothers who have clotting problems or infection at the insertion site. If necessary, your anaesthetist will do certain blood tests before performing the procedure.Such cases, however, will be given some other form of pain relief.
OTHER Methods of Pain Relief
Although an epidural injection is the most popular mode of labour analgesia, there are other forms of pain relief which may be used under various clinical conditions.
In this method, women are given medications either by intramuscular or intravenous route to produce relief of pain. The dosage used is quite safe for
mother and baby, but occasionally some mothers may be drowsy and may have shallow respiration. Some babies may have similar problems too, but these can be easily diagnosed and treated. Other side effects are nausea and vomiting, which can also be easily treated.
Post-Operative Pain Relief
We believe that it is not enough to keep you pain-free only while the procedure is in progress. It is equally important to keep you as comfortable as possible afterwards as well. With this in mind, the anaesthetists at Fernandez Hospital runs an acute pain management service. Good pain control enables you to recover quickly, even after major surgery, thereby reducing your stay in hospital. There are several ways of providing pain relief.
Patient Controlled Anaesthesia (PCA)
The PCA machine allows you to give yourself small doses of pain-relieving medications whenever you need it to minimise your pain/discomfort. This
means that you are independent and in control of your own pain relief. The anaesthetist will programme the machine and make it safe for you.
This is controlled by a doctor or a nurse. Your pain level is assessed and pain relieving medication is given continuously, either through an IV or epidural route.
What is Gestational Diabetes ?
Pregnant women who have never had diabetes before but who have high blood glucose (sugar) levels during pregnancy are said to have gestational diabetes. According to a 2014 analysis by the Centers for Disease Control and Prevention, the prevalence of gestational diabetes is as high as 9.2%.
We don’t know what causes gestational diabetes, but we have some clues. The placenta supports the baby as it grows. Hormones from the placenta help the baby develop. But these hormones also block the action of the mother’s insulin in her body. This problem is called insulin resistance. Insulin resistance makes it hard for the mother’s body to use insulin. She may need up to three times as much insulin.
Gestational diabetes starts when your body is not able to make and use all the insulin it needs for pregnancy. Without enough insulin, glucose cannot leave the blood and be changed to energy. Glucose builds up in the blood to high levels. This is called hyperglycemia.
How Gestational Diabetes Can Affect Your Baby
Gestational diabetes affects the mother in late pregnancy, after the baby’s body has been formed, but while the baby is busy growing. Because of this, gestational diabetes does not cause the kinds of birth defects sometimes seen in babies whose mothers had diabetes before pregnancy.
However, untreated or poorly controlled gestational diabetes can hurt your baby. When you have gestational diabetes, your pancreas works overtime to produce insulin, but the insulin does not lower your blood glucose levels. Although insulin does not cross the placenta, glucose and other nutrients do. So extra blood glucose goes through the placenta, giving the baby high blood glucose levels. This causes the baby’s pancreas to make extra insulin to get rid of the blood glucose. Since the baby is getting more energy than it needs to grow and develop, the extra energy is stored as fat.
This can lead to macrosomia, or a “fat” baby. Babies with macrosomia face health problems of their own, including damage to their shoulders during birth. Because of the extra insulin made by the baby’s pancreas, newborns may have very low blood glucose levels at birth and are also at higher risk for breathing problems. Babies with excess insulin become children who are at risk for obesity and adults who are at risk for type 2 diabetes.