IUI

Intra Uterine Insemination (IUI)

Experience a safe and secure Intrauterine Insemination in Bangalore

One of the most common methods of fertility treatment is Intrauterine Insemination (IUI). IUI treatment is a procedure wherein fast-moving sperm are separated from non-moving or slow-moving sperm and inserted directly into the uterus. At Fortis, we are committed to providing the best IUI treatment in Bangalore.

The female conditions that merit IUI are minimal/ mild endometriosis, ovulatory dysfunction, and cervical factor. IUI is also apt when the male has suboptimal semen parameters, experiences problems with erection and ejaculation, and also if the treatment merits the use of donor sperm.

Among the most sought-after artificial insemination methods, IUI is effective when timed perfectly within the ovulation cycle. It is performed in the periovulatory period. The likelihood of pregnancy is increased because a motile sperm is brought closer to the egg to allow natural fertilization within the body in the fallopian tubes.

Is IUI right for you?

If you are a woman under the age of 35 and are unable to conceive naturally, IUI may be right for you. Couples who have failed ovulation induction (ovulation stimulation by medication) and super ovulation induction cycles (drug-induced production of multiple eggs) can also opt for IUI.

What are the risks?

Normally safe and painless, women opting for IUI may experience mild pain akin to menstrual cramps during the procedure. Certain fertility drugs used during this procedure sometimes cause reactions and complications in pregnancy such as twins or triplets, though this is fairly uncommon.

IUI vs IVF

Another common method of artificial insemination is In Vitro Fertilization (IVF) that involves the mixing of sperm and eggs for fertilization in a laboratory. The fertilized eggs or embryos are then inserted back into the uterus.

As compared to Intrauterine insemination, IVF is a more complicated and expensive procedure. Only around 5- 10% of couples attempt an IVF procedure.

Success Stats

IUI treatment has a success rate of nearly 10-20% among women under 35, 10% for women between 35 and 40, and 5% for those above 40. It is a convenient process that does not take more than 15-20 minutes. While one may not get results the first time around, pregnancy chances are higher if the method is repeated over three to six months.

If pregnancy is not achieved even after four to six attempts of IUI, it may be prudent to resort to IVF +/- ICSI to achieve a successful conception. At Fortis, you can be sure of receiving the latest and the best treatment.

IVF

In-Vitro Fertilization (IVF)

In-Vitro Fertilization (IVF) is a multi-step process in which eggs (Oocytes) are extracted from the woman’s ovary (where the eggs are produced), fertilized by sperm in a laboratory and cultured into early embryos. A portion of these embryos may then be transferred into the woman’s uterus and those not transferred may be cryo-preserved (frozen) for a transfer at a later time. The fallopian tubal damage is the chief indication for anyone to consider IVF. Fortis is one of the best IVF treatment center in Bangalore. We come with a team of successful fertility doctors.

Louise Brown, the first IVF (in vitro fertilization) success, was born in 1978 from a mother whose fallopian tubes were irreparably closed.

Some of the factors to be considered before starting IVF programme for any patients include:

  • Duration of infertility
  • Age of the female partner
  • Previous Infertility Treatment
  • Associated Medical problems in the couple
  • Female – Endometriosis, Blocked tube, fibroids etc.
  • Male – Poor sperm count, mortality, absence of sperm (azoospermia)

In-Vitro Fertilization – Patients Flow Chart:

  • Sub-fertile couple
  • Infertility centre
  • Infertility specialist
  • Assessment of the couple
  • Treatment
  • Ovarian stimulation with hormones
  • Ultrasound monitoring
  • Oocyte retrieval or egg collection
  • Fertilization check
  • Embryo transfer
  • Pregnancy check

ICSI

Intracytoplasmic Sperm Injection: a cure for male infertility

Fortis Fertility Centre is a leading hospital offering Intracytoplasmic Sperm Injection (ICSI) in Bangalore. One of the most common and successful male infertility treatments, ICSI involves injecting the sperm directly into the egg. Every year, Fortis holds out hope for couples wanting to be parents by carrying out the time-tested ICSI in Bangalore.

For fertilisation to take place, the head of the sperm has to penetrate the outer layer of the egg and reach the cytoplasm. When the sperm is unable to do so on its own, ICSI treatment is recommended.

How ICSI works

ICSI is used in nearly 50% of all IVF procedures. Normally in an IVF cycle, fertilisation takes place when the egg is mixed with sperm in a culture dish. If fertilisation doesn’t occur on its own, a single sperm is injected into the mature egg through the ICSI procedure.

Once the sperm is injected, the fertilized egg is allowed to grow in the laboratory for one to five days. The embryo is subsequently transferred into the womb at the correct time.

Who can benefit from ICSI treatment?

ICSI is used in nearly 50% of all IVF procedures. Normally in an IVF cycle, fertilisation takes place when the egg is mixed with sperm in a culture dish. If fertilisation doesn’t occur on its own, a single sperm is injected into the mature egg through the ICSI procedure.

Once the sperm is injected, the fertilized egg is allowed to grow in the laboratory for one to five days. The embryo is subsequently transferred into the womb at the correct time.

Who can benefit from ICSI treatment?

ICSI is recommended for the following:

  • Very low sperm count
  • Trouble in ejaculating (either due to injury, disease, or irreversible vasectomy)
  • Abnormally shaped and slow-moving sperms
  • Failure of previous IVF procedures
  • Inability of sperm to attach to the egg on its own
  • Blockage in reproductive tract

How long does ICSI take?

A typical cycle of Intracytoplasmic Sperm Injection takes four to six weeks to complete. After the embryo is transferred, a visit to the fertility clinic for a check up is required within two weeks. Visit Fortis to schedule an appointment for Intracytoplasmic Sperm Injection in Bangalore.

Success rate

After ICSI, the average fertilisation rate lies between 50-80%. Younger men tend to have a higher success rate with ICSI: 32% for men under 35 and 28% for men between 35 and 37.

Risks associated with ICSI

Though ICSI is an effective method, it is important to take note of certain risks associated with the procedure:

  • The fertilised egg may not grow into an embryo
  • The embryo may stop growing even after injection of sperm
  • There is a slight chance that ICSI may damage some of the eggs
  • There is a possibility that the father will pass on genetic infertility to his male progeny born out of ICSI

In a natural pregnancy, the chances of a baby developing major birth defects lie between 1.5% and 5%. For ICSI-treated embryos, the chance of birth defects is in the range of 5-7%.

Embryo Freezing

Fortis Fertility – Embryo Freezing

Fortis hospital is proud to offer the most comprehensive embryo freezing technology in Bangalore. With our team of experienced doctors and latest cryopreservation techniques, Fortis is the preferred destination for embryo freezing in Bangalore.

Embryo freezing is a procedure wherein surplus good quality embryos are frozen for future use. It is a part of the In Vitro Fertilization (IVF) process of fertilizing the egg outside the womb. Embryo freezing is also referred to as Cryopreservation. On an average 15 – 20% of couples will be in a position to freeze the surplus embryos.

Step-by-step

In an average IVF, multiple eggs are formed in the ovary through the use of hormone injections. The eggs are retrieved with the help of an ultrasound guided process. They are then mixed with the sperm for fertilization. Once fertilized, the eggs are left in the petridish in the laboratory to divide and form early embryos. Finally, one or more embryos are inserted back into the uterus.

The leftover embryos, if viable and good quality, can be frozen for use in future conception. This freezing or cryopreservation can be done between the 1st and 5th day after egg retrieval.

Why freeze embryos?

Under cryopreservation, only high-quality embryos are frozen. These can be frozen for up to 10 years. By freezing excess embryos, couples are able to conceive a child in the future using the frozen embryos.

The doctor may advise you to freeze embryos under the following circumstances:

  • If surplus good quality embryos are available after transferring embryos in the fresh IVF/ ICSI cycle
  • If you show symptoms of Ovarian Hyperstimulation Syndrome (OHSS) – this condition necessitates freezing of all embryos and deferring the embryo transfer for a couple of months
  • Embryos may also be frozen if there is fluid in the endometrial cavity around the time of embryo transfer
  • If there is any medical condition that merits only a single embryo transfer (mSET) to avoid risk to the woman’s life
  • If the couple electively choose to have a Single embryo transfer (eSET) to avoid the risk of multiple pregnancy

The benefits of using frozen embryos include:

  • Cumulative increase in pregnancy rate
  • Reduced number of times the ovaries need to be stimulated by fertility drugs
  • Reduced number of hospital visits for egg pick-up procedures
  • Reduced cost of subsequent pregnancy

Frozen Embryo Transfer (FET)

Frozen Embryo Transfer (FET) is a procedure involving the thawing of frozen embryos and their subsequent insertion back into the uterus. Approximately 70 – 75% of frozen embryos survive the thawing process.

Things to remember

Though cryopreservation doesn’t carry any risks per se, a couple of things need to be kept in mind.

  • The live birth rate from frozen embryos is slightly less than that from fresh embryos
  • Unused frozen embryos may be donated to another couple or may be used for laboratory research to further scientific knowledge, if no further pregnancy is desired
  • Unused frozen embryos may also be discarded in certain cases

Cryopreservation

Cryopreservation

Cryopreservation of embryos maximizes the chance of successful pregnancy with any IVF treatment cycle. Prior to the availability of embryo cryopreservation, IVF centers had to deal with “excess eggs (oocytes) and embryos” without the ability to save, or preserve them. They were forced to “selectively” fertilize only a few eggs to avoid “excess” embryos, but would run the risk of wasting normal eggs that were not fertilized. Alternatively, if all eggs obtained from an IVF cycle were exposed to sperm, an excess number of embryos might have resulted with pressure of transferring more embryos than recommended, resulting in multiple pregnancies (i.e. twins, triplets, or greater). If the embryos could not be cryopreserved, couples may have been forced to discard excess embryos, creating some potential ethical or religious conflicts.

Embryo cryopreservation during IVF treatment, allows for all of one’s eggs recovered that cycle, to be exposed to sperm. Because all oocytes can look ‘normal’ after retrieval, exposing all of the oocytes to sperm increases the chance of having higher quality embryos available for transfer. Not only does embryo cryopreservation maximize the chance of being able to transfer embryos of the highest quality through the process of selection after fertilization, but it also gives a couple the opportunity to freeze extra embryos for use in the future, if they are of good quality. Use of cryopreserved embryos in the future avoids the need to repeat stimulation of the ovaries with injectable medications, since the embryos have already been created. Success rates with frozen embryos have been near, or equal to fresh IVF treatment cycles at many IVF centers in recent years.

Cryopreservation of embryos can be done at nearly any stage of development.

The most common stages are:

  • Pronuclear freezing
  • Day 3 embryo freezing
  • Day 5 blastocyst freezing
  • Oocyte or egg freezing can also be done

Blastocyst transfer

Fortis Fertility Centre is a part of the Fortis Hospitals, a reputed centre that specializes in enabling successful blastocyst transfer in Bangalore.

Blastocyst transfer is a breakthrough complementary In Vitro Fertilization (IVF) procedure involving the transfer of an embryo back into the womb five to six days after fertilization. This embryo or blastocyst is a rapidly dividing ball of cells. The inner group of cells turn into the embryo, while the outer group nourishes and protects it.

How blastocyst transfer is performed

In a regular IVF procedure, eggs removed from the ovaries are mixed with sperm in a laboratory, where fertilization occurs. After two to three days, the embryo is transferred back into the womb. However, in blastocyst transfer, the embryos are allowed to incubate until the blastocyst stage before being implanted into the uterus.

Usually, one to two of the best blastocysts are chosen and implanted. This increases the chances of pregnancy.

Why blastocyst transfer works

Blastocyst transfer enhances chances of pregnancy. An alternative to IVF or Intracytoplasmic Sperm Injection (ICSI), it is more effective because only the best embryos develop into blastocysts and one or two of these are implanted.

The procedure is more akin to the natural process, where an embryo enters the uterus only after five to six days of fertilization. In traditional IVF, the transfer happens at a time when the embryo ideally should still be in the fallopian tubes.

Blastocyst transfer also significantly brings down the chances of a multiple pregnancy as only one or two blastocysts are implanted. This further cut down health risks and costs associated with multiple births.

Who can opt for blastocyst transfer?

Blastocyst transfer is recommended for those who have undergone previous failed attempts of IVF or ICSI. A safe procedure, it is especially effective for younger women who have a good prognosis from IVF. Women over 40 too can avail of blastocyst treatment if their embryos are viable.

Donor gametes

Gametes Donation – sperm, egg and embryo donation

The use of donor gametes (eggs, sperm and embryos) is designed to help recipients have a child when one or both partners have a form of infertility and are unable to conceive on their own.

Who can become a sperm donor?

Any healthy male aged between 21 and 40 years may be considered as a possible donor if he has normal semen analysis and has been tested for Hepatitis ( B and C) , HIV (1 and 2) and Syphilis.

Who can become an egg donor?

Any healthy female between 21 and 35 years, who has had children of her own, may be considered as a possible donor and has been tested for Hepatitis ( B and C), HIV (1 and 2) and Syphilis.

Who can become an embryo donor?

Extra embryos may result from completed IVF treatment. If extra good quality embryos have been frozen from couples and the couple wish to donate them then these embryos may be considered suitable for donation.

How are donors screened?

Each potential donor is thoroughly screened in order to minimize the risks of transmitting infectious diseases or inherited disorders. All donors are assessed medically and donors and their partners (if applicable) are counselled regarding the future implications of donation.

Confidentiality and the access of identifying information.

Donations can be made anonymously but a donor must consent to having identifying details accessible to any donor conceived child at the age of 18, upon request.

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