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The term ICSI denotes Intra Cytoplasmic Sperm Injection.The advent of ICSI has revolutionized the field of Assisted Reproduction, as it offers hope of a successful pregnancy in severe male factor infertility. As the name denotes; after the oocytes from the female partner are aspirated by ultrasound guidance, spermatozoa are selected from the processed semen sample of the male partner, and one spermatozoa is injected into each oocyte using micro manipulators, under high magnification. This ensures a higher percentage of fertilization and subsequently a higher rate of implantation. After the procedure, the embryos will be placed in an incubator, to ensure a controlled temperature and atmosphere favorable for their growth. Good quality embryos will be transferred to the Mother’s uterus on either day 3 or day 5 of the procedure.

 

At KARE, oocyte aspiration is carried out under short general anaesthesia, thus ensuring that the patient is comfortable and the procedure painless. The embryos are returned to the Mother’s womb on usually Day 3 or Day 5 of the procedure, this Embryo transfer is also a painless procedure.

 

At KARE, all these procedures are carried out as Out- Patient procedures, hence no hospital admission will be necessary. We do however, advise our patients to avoid traveling on the day of Embryo Transfer, and so it would be better if you could stay near the clinic on the day of Embryo Transfer. Details regarding accomodation will be made available by contacting the office staff

 

When Assisted Reproductive techniques are being used, a higher incidence of Multiple pregnancy has been reported.

This can be explained by the fact that drugs are given to increase the number of follicles developing, which may result in a multiple pregnancy if a procedure like IUI is being done.

In IVF or ICSI, a higher number of embryos being positioned in the uterus, may lead to the implantation of a higher number of embryos and thus result in a multiple pregnancy.

In order to minimize the occurance of Multiple pregnancy; at KARE, we introduce only 2 embryos or a maximum of 3 embryos, if the patient is elderly. At our centre, Blastocyst transfer is also being done, where the implantation rates are higher than with a day 3 transfer, thus minimizing the number of embryos transferred and thereby reducing the chance of a multiple pregnancy.

In higher order pregnancies, fetal reduction is also an option, by which we can reduce the number of fetuses in the womb, and this can also be resorted to, if there is an abnormal fetus; in which case the abnormal fetus can be selectively reduced, such that there is no interference in the growth of the normal baby.

This is when an embryo develops in your fallopian tube rather than in the womb, and can happen in a natural pregnancy or when you have become pregnant through fertility treatment. The chances of having an ectopic pregnancy seem to be slightly higher in women having fertility treatment, especially if you have existing problems that affect your fallopian tubes. Symptoms include vaginal bleeding and low pregnancy hormone levels. If the pregnancy continues, there is a risk of miscarriage and the fallopian tube bursting.Report any vaginal bleeding or stomach pain to your clinic. They can do a blood test to check your hormone levels. You should have a scan at six weeks to check for the baby’s heartbeat and to make sure it is growing properly in the womb. Ectopic pregnancy can be managed medically or surgically, depending on factors like when the patient presented, the site and size of the ectopic etc.

 

In cases of repeated abortions or repeated IVF failures, where you suspect a rejection phenomenon, the best available treatment is HLT. Here we separate lymphocyte, a special white blood cell from the husband’s blood. This is the memory cells in the blood. Its then concentrated and injected into wife’s lymphatics, by a simple method. Its done in 5 times, either at weekly or monthly intervals. After 2 months waiting period, your body will be sensitized. Then you can try for spontaneous conception or try IVF.

Now we are celebrating 500 successful deliveries following HLT. Many of them had several abortions ranging from 4 to 10 abortions, where they had lost their hopes, could get healthy babies after HLT. Many among these had gone through repeated IVF-ICSI cases ranging from 3 to 9 IVF failed cases. Some of them got twins after HLT.

Ideally an IUI should be performed within 6 hours either side of ovulation — for male factor infertility some doctors believe after ovulation is better, otherwise chances of success are higher with insemination before ovulation with the sperm waiting for the egg. When timing is based on an hCG injection, the IUIs are usually done between 24 and 48 hours later. Typical timing would be to have a single IUI at about 36 hours post-hCG, though some do it at 24 hours, and some clinics are reporting better results when doing the IUI at 40-42 hours post-hCG. If two IUIs are scheduled, they are usually spaced at least 12 hours apart between 24 and 48 hours after the hCG. Some reports show no increase in success rates with two IUIs, but others suggest it may increase success as much as 6 percent.

Some doctors will base timing of IUI on a natural LH surgery. In that case, a single IUI at 36 hours is the norm, but doing them at 24 hours is also pretty common since ovulation may be a bit earlier. When two inseminations are planned, they are usually timed between 12 and 48 hours after the surge is detected. The egg is only viable for a maximum of 24 hours after it is released.

 

This depends on your individual situation, but it usually should not be more than than 72 hours since his last ejaculation in order to ensure the best motility and morphology. Where low sperm count is the reason for IUI, it is generally best to wait 48 hours between ejaculation and collecting sperm for the IUI. With no sperm count issues, it makes sense to wait at least 24 hours. Some suggest trying for about 36 hours to cover the most territory with the highest counts — a common suggestion is to have intercourse around the time of HCG injection.

 

The luteal phase, also referred to as ‘days past ovulation’ or ‘DPO’, is the part of the cycle that starts at ovulation and ends the day before your next period. It usually lasts about 14 days and does not vary by more than a day in each person. The luteal phase is named after the corpus luteum (Latin: “yellow body”), a structure that grows on the surface of the ovary where a mature egg was released at ovulation. The corpus luteum produces progesterone in preparing the body for pregnancy. Your luteal phase must be at least 10 days long to support pregnancy.

The importance of the luteal phase

The length of the luteal phase determines the time of ovulation within your menstrual cycle. Ovulation can be delayed by a number of factors, such as stress, increased activity or medication, but the length of the luteal phase is usually constant. Taking this into account, you can calculate the time of ovulation within your cycle by subtracting the length of your luteal phase from the length of your cycle. For example, if your cycle is 28 days long and your luteal phase is 12 days long, the ovulation will occur on day 16 of your cycle (28-12=16). Ovulation Calendar uses this formula to calculate your time of ovulation.

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