1) What is the relation between irregular mense & infertility ?
Ans : Those females not having timely egg formation (Day 11-18 Ovulation), Obese & having hormonal imbalance suffer from irregular menses. Drugs for ovulation induction (egg production) will help them regularise their cycle thus increasing the possibility of pregnancy.
2) Does Obesity having any effect on Fertility?
Ans: Yes, Obesity has negative effect on fertility. It reduces the quantity & quality of egg, imbalances your hormone status, increases the chance of abortion & foetal death. During the infertility management, weight reduction by diet changes & exercise is a must.
3) Extra hairs on face, hands, lower abdomen has any significance in fertility treatment?
Ans : Extra hairs on face, hands, lower abdomen is called HIRSUITISM. Such Women have an increased production of testosterone and androstenedione (male hormone). The most commonly seen clinical problem is polycystic ovarian disease (PCOD ) with hirsuitism, irregular menstrual cycles (anovulation) & obesity. Ovulation induction with weight loss is the answer.
4) Sir, I am a patient of Poly Cystic Ovaries, what should I do?
Ans: Polycystic ovary syndrome (PCOS) is the most common hormonal disorder among infertile women. Polycystic means "many cysts". Common findings are obesity, extra hairs, irregular menses; but thin women may have PCOS.
PCOS management starts with a proper diagnosis by Sonography and Blood test. Treatment for PCOS may include: Birth control pills to regulate menstruation for unmarried girls and Ovulation induction with medicine or injection to treat infertility.
5) My both fallopian tubes are blocked, can I be mother or not in future ?
Ans: Yes, you may conceive with treatment. There are two options: as fallopian tube blockage prevents successful passage of the egg to the sperm, or the fertilized egg to the uterus. i) Surgery can be done to open the tubes. ii) Advanced reproductive Technology like IVF & ICSI will help you if the tubes cannot be repaired by surgery or when a tube has developed a buildup of fluid called Hydrosalpinx.
6) My one tube is removed due to ectopic pregnancy, Can I have a normal pregnancy ?
Ans : Yes, you may still be able to get pregnant with only one tube, if your remaining fallopian tube is healthy. However there is risk of a repeat tubal pregnancy (15%), hence do sonography early to detect ectopic pregnancy. Or you may have opt for IVF which has a very low risk for ectopic.
7) My uterus having fibroid tumors, should I remove them before pregnancy treatment?
Ans: If fibroid are smaller we need not to remove. If fibroid inside uterine cavity or larger than 3cm, should be removed before pregnancy treatment.
8) Doctor told me I am suffering from Endometriosis/ Chocolate Cyst, what should I do ?
Ans: The treatment plans depend on severity of Endometriosis.
In early endometriosis medical management, laparoscopic cauterization and later on IUI (3-6 cycles) should be done.
In advance endometriosis laparoscopic adhesiolysis and removal of chocolate cyst is done then three trials of IUI should be considered, if failed IVF / ICSI to be done.
9) My menses are already stopped, Can I be pregnant ?
Ans : Yes, even after menopause pregnancy can be done. The uterus is prepared with Estrogen drugs & then Embryo Transfer is done. If you have Diabetes, High Blood Pressure & Hypothyroid diseases, to be treated as well.
10) My age is around 40, can I be mother ?
Ans : Yes, you can be a mother. Now a days age is not a factor, but we have to take Egg from a younger ovum donor, because advance age has detrimental effect on egg/ embryo quality. But embryo will be transferred in your uterus.
11) Why Laparoscopy & Hysteroscopy are done, are these necessary ?
Ans : Yes, these are very important investigations. Laparoscopy & Hysteroscopy help determine the cause of your infertility. Problems that cannot be discovered by an external physical examination can be discovered by this invasive test. While Hysteroscopy lets the doctor see inside the uterine cavity, Laparoscopy shows the outside of the uterus, the ovaries, and fallopian tubes, adhesions, endometriosis, tuberculosis etc. If an abnormal condition is detected during the diagnostic procedure, operative laparoscopy or operative hysteroscopy can often be performed to correct it at the same time, avoiding the need for a second surgery.
12) How many times IUI should be done, what is the percentage of pregnancy ?
Ans : Maximum 3-4 time IUI should be done. Success rate 10-15% per cycle.
13) I had suffered from Abdominal Tuberculosis, should I do IUI or IVF ?
Ans: If the fallopian tubes are open 3 cycles of IUI should be done first, otherwise IVF/ ICSI is the answer. Sometimes the inner lining of uterus are destroyed completely in TB then surrogacy is the only choice.
14) My first IVF cycle is failed, what is next ?
Ans : According to books IVF success rate is 30-40%, so unfortunately many couples will not have successful first cycle IVF results and need to consider a 2nd or even 3rd cycle. With repeated IVF success may go upto 90%. All IVF centre are not equal. Some give a much higher chance of success than others.
15) What is wrong with my uterus. It’s not accepting the embryos. Do I need the surrogate to carry the embryos ?
Ans: When IVF does not work after numerous attempts; switching the uterus is not likely to result in success. However you may go for Egg Donation; sometimes the problem may be the Egg quality, switching to Eggs from a Young Egg Donor may lead to success.
16) What is the difference between IVF & ICSI, which give best result ?
Ans : Both IVF (in vitro fertilisation) and ICSI ( intracytoplasmic sperm injection) are types of assisted reproductive techniques, ICSI is a modification of the basic IVF technique. The only difference is, in IVF the sperms fertilise the eggs on their own in a culture dish & in ICSI, a single sperm is injected directly into an egg with the help of a micromanipulator under high resolution microscope. All other steps of IVF & ICSI are same.
For male factor infertility (men with very low sperm counts or those with azoospermia) & when the outer wall of egg is thick, ICSI is the only option, however, for men with normal sperm counts IVF should be done. The embryo implantation rate for both IVF and ICSI is the same.
17) Please tell me the percentage of success in IUI, IVF & ICSI at your centre.
Ans : In most of the centres success rate is 30-40% per cycle, but in our centre it is 50-60% per cycle, with repeated ET the pregnancy success rate is 90-100% in our centre.
IUI success rate is only 10-15% per cycle at our centre
18) What is the difference between fresh & frozen embryo transfer, which gives better result?
Ans : Embryo means BHRUNA (fertilized egg). In Fresh ET embryo is formed & transfer in same cycle; in Frozen ET embryo are freezed in luquid nitrogen (-1960 C) and after 1-2 months embryos are taken out to normal temperature and then transfer inside uterus. Result in Frozen ET is much better.
19) My husband not staying with me, he is in job at a different place, how IUI or IVF can be done ?
Ans : Husband has to come at least once to the centre to preserve his semen. Later on IUI / IVF procedure can be done with his frozen sperm.
20) If semen report shows no sperm at all, is pregnancy possible ?
Ans : This condition is called as Azoospermia. If it is obstructive variety then surgery may help. If testis size is smaller and your LH FSH hormones are high then you have to take donor sperm (AID) for insemination. If testis size and your hormone reports are normal, you can have a baby with your own sperm by technique called TESA or MESA with ICSI.
21) My Semen quantity & quality is low, what to do ?
Ans : A low sperm count or poor sperm quality is the cause of infertility in about 45% of couples with fertility problems. Low sperm count may be caused by many factors, for details……..
Treatments for low sperm count include:
- Lifestyle changes and diet advice to be followed.
- Hormone treatments and medications. It may take three months before you'll notice any effects on your semen analysis. Majority of patient does not get benefit of medicines.
- You may opt for IUI (Artificial Semen Injection) for 3-6 cycle.
- If IUI fails ICSI should be done.
22) My uterus is small, do I need Surrogacy?
Ans : First we shall prescribe medicine to increase the size of uterus and embryo transfer will done in your own uterus, if repeated failure occurs then you need surrogacy.