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  1. What is infertility ?
    Failure to conceive after one year of regular unprotected intercourse is called infertility.
  2. Is it related to the time period after marriage ?
    Yes, during first year after marriage, the frequency of intercourse is more, so there are more chances of pregnancy. More is the time since marriage more are the chances of unexplained infertility.
  3. Is it related to womenís age?
    Yes, the women is most fertile between the age of 18 to 25 years. ( 80%). The fertility goes down gradually as the age increases and it reaches as low as 15-20% above the age of 40.
  4. When should a couple see an infertility specialist?
    If a couple is unable to conceive even after one year of unprotected regular intercourse, they should see an infertility specialist.
  5. What are the causes of infertility?
    In 30-40% of cases the female factors are present like tubal block, PCOs, Endometriosis, ovarian failure, fibroids, septate uterus, bicornuate uterus etc. In 30-40% of cases the male factor is present like low sperm count due to various conditions like varicocele, hydrocele, tobacco and alcohol consumption, undescended testis etc. Patient may have azoospermia ( obstructive / non obstructive ). Some patients have both the male and female factor. Around 15-20% of patients have unexplained infertility.
  6. What are the various treatments available?
    If the tubes are open and the sperm count is good, superovulation IUI (Intra uterine Insemination) should be done. If there is a tubal block, PCO and the sperm count is good, IVF ( Invitro fertilization) is the treatment of choice. If there is a male factor infertility, ICSI (Intra cytoplasmic sperm injection) is the treatment.
  7. What is super ovulation?
    The female is given medicines like clomiphene citrate, letrozole, Injections like FSH, Urinary FSH, Recominant FSH, HMG etc. This will help to get more than one follicles in both the ovaries. Patient is given hcg injection to rupture the follicles when they reach adequate size. This process increases the chances of pregnancy by 30-40%. This is to be done with caution and should be done with an expert as there are chances of OHSS (Ovarian hyperstimulation syndrome) and multiple pregnancies.
  8. What is IUI?
    In this process the patient is stimulated with hormones and when the follicles reach 18 to 20 mm in size they are ruptured using hCG. The semen of husband is processed by either swim up or density gradient method and these processed capacitated sperms are inseminated in to the uterus just below the fundus. It gives 30-40% chance of pregnancy to the patient.
  9. What are the results of IUI at Gynotech Associates in the last two years.
    Around 960 IUI cycles were done in the last two years and around 332 patients got pregnant through this treatment, with success rate of 34.58%.
  10. What is IVF and ICSI?
    IVF is in vitro fertilization. In this technique patient is stimulated with hormones and when they reach size of 18-20mm, they are given Inj. hCG. Around 35 hours after hCG injection, follicles are aspirated transvaginally under USG guidance. The OCCs ( Oocyte cumulus complexes ) are then inseminated with husbandís processed and capacitated sperms for fertilization. The resultant embryos are then transferred back to uterus on day 2 or day-3. In ICSI instead of inseminating OCCs with sperms, each oocyte is cleaned of cumulus cells and is injected with single sperm with the use of micromanipulator. The rest is same as IVF.
  11. What is diagnostic hysteroscopy and laparoscopy?
    We donít take any patient without doing hysteroscopy, because by doing so we can easily find out some treatable causes of infertility and can see the endometrial status. In Diagsnostic hysteroscopy we check the cavity of uterus through hysteroscope to find out any abnormality. Ashermanís syndrome, fibroid, polyp and septum etc can be treated at the same time. In diagnostic laparoscopy we can check ovaries for cysts, dermoids, the fallopian tubes for patency, uterus for adhesions and submucous fibroids. In PCO patient, drilling of cysts, removal of submucous myoma, adhesions etc can be done at the same time doing laparoscopy.
  12. What are the results of IVF ICSI at gynotech associates?
    We expect three to four patients out of ten to get pregnant and usually we do get it.
  13. What is PESA, TESA , MESA ? When is it required?
    These are all sperm retrieval techniques. In patients of obstructive azoospermia ejaculate doesnít contain sperms but we can aspirate sperms from epidydimis. It is called Percutaneous Epidydimal Sperm Aspiration (PESA), MESA is micro epidydimal sperm aspiration. Testicular sperm extraction (TESE) , Testicular sperm aspiration( TESA ) and testicular biopsies are done to get sperms from testis in case we donít get it through PESA,MESA and in cases of testicular atrophy.
  14. What is Ovum donation ?
    The menopausal women, women with ovarian failure, with recurrent abortions, are donated oocytes from a healthy donor who is screened for all infectious diseases like HIV HbsAg and VDRL. The donor takes the hormones to prepare good follicles and so good occytes while the recipient takes estrogen to prepare her endometrium which has to be receptive for the embryos.
  15. What is surrogacy and who requires it?
    When embryos developed through infertile couple is implanted in the other fertile womenís uterus for further development, it is called surrogacy and the fertile women who carries the pregnancy and nurtures the child for nine months is called surrogate mother. The woman who has undergone hysterectomy, who has the history of recurrent abortions, who is at very high risk if she gets pregnant, are the potential patients opting for surrogacy.
  16. Who needs sperm donation?
    All azoospermic males and those with severe oligoasthenospermia patients with genetically abnormal sperms require sperm donation. Frozen and quarantined sperms which are free of HIV and hepatitis B can be used for insemination. Male factor patients who requires ART and who are not affording can also opt for this treatment.
  17. What is cryopreservation?
    Cryopreservation is the technique to store sperms and embryos for long period of time in liquid Nitrogen. The temperature of liquid nitrogen is -196 degree celcius.
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