What to Expect During IVF | Eterna IVF & Fertility Clinic

1. The intake interview.

If initial fertility treatments such as fertility drugs or surgery fail and you decide to move forward with IVF, your ob/gyn will refer you to a reproductive endocrinologist. During your initial meeting with the doctor, you'll discuss your medical and fertility history, and that of your partner, to determine which treatment protocols will work best for you, as well as what you can do to improve the odds of a healthy birth.

2. Preliminary tests and talks.

You'll undergo ultrasound and blood tests to determine the number and quality of your eggs. You'll also meet with a nurse to learn how to self administer fertility drugs, a financial counselor to work out payment, and a psychologist to discuss coping with any stress that might arise.

3. Drugs to induce egg growth.

To stimulate your follicles to grow as many eggs as possible during your cycle, for about two weeks you'll give yourself one to three daily injections of fertility medications (such as GonalF, a folliclestimulating hormone, and Repronex, a luteinizing hormone) in your thigh or stomach. Either before your cycle or midway through, you'll also inject a gonadotropinreleasing hormone (GnRH) drug such as Lupron, which prevents you from ovulating too early. Around day 12, you'll inject the drug human chorionic gonadotropin (hCG) to stimulate ovulation and precisely time the final burst of egg growth. During these two weeks, you'll visit the clinic about five times for blood and ultrasound tests to monitor your progress.

4. Egg harvesting.

In a carefully targeted window of time — shortly before doctors calculate that your eggs will be released through the fallopian tubes during ovulation — you'll be heavily sedated and, using ultrasound as a guide, your doctor will pull eggs out of your ovaries with a hollow needle inserted through the wall of the vagina. In the meantime, your partner, in a nearby room, will ejaculate into a cup to obtain sperm, which the lab will then quickly process to extract the most robust ones. The sperm and eggs are then mixed together in an incubator so insemination can occur. If necessary — for instance, when sperm count is low or the sperm are having difficulty penetrating the egg — the lab embryologist might also perform intracytoplasmic sperm injection (ICSI), a procedure in which sperm are injected directly into an egg. If you are over 40 or a previous IVF attempt failed, he might also puncture the outer shell of a resulting embryo shortly before transferring it into the uterus so it can implant itself more easily, a process called assisted hatching.

5. Embryo transfer.

Three days after harvesting your eggs, your doctor will use a thin catheter to insert two or three embryos into your uterus via the vagina. "This is a painless procedure that feels like a Pap smear," explains Sarita Sukhija, medical director at Eterna IVF in Delhi. If genetic diseases are a concern, this step might occur on day five, after lab biopsies have been performed to select the healthiest embryos.

6. The outcome.

Your partner (or a friend or a family member) will give you daily injections of progesterone, a hormone that aids implantation, in the buttocks. In two weeks, you'll take a pregnancy test at the clinic; someone there will call to give you the results.

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Infertility and Men | Eterna IVF and Fertility Clinic

Although some people still think of fertility as a "woman's problem," a third of all cases of infertility involve problems solely with the male partner. Infertility in a man may be the sole reason that a couple can't conceive, or it may simply add to the difficulties caused by infertility in his partner.

So it's crucial that men get tested for fertility as well as women. It's also important that men do it early. Though some guys may want to put off being tested -- possibly to avoid embarrassment -- early testing can spare their partners a great deal of unnecessary discomfort and expense. It's also a good way to quickly narrow down potential problems.

Getting Tested for Infertility

The first thing to do for fertility issues is to go to the doctor, typically a urologist. After a physical exam, your doctor will probably order a semen analysis, which will check the quality and quantity of the sperm in the semen. And yes, your doctor will want you to give the sample there, or at least someplace nearby, because it's important that the analysis take place quickly. Just remember, as sheepish as you might feel, a semen analysis is a common test, and the results could save you months of worry and stress.

If the first semen analysis is normal, your doctor may order a second test to confirm the results. Two normal tests usually are interpreted to mean that the man doesn't have any significant infertility problems. If something in the results looks irregular, your doctor might order further tests to pinpoint the problem. At this point, if you aren't already seeing a urologist, you should considering seeing a specialist.

What a Semen Analysis Can Detect

Azoospermia. No sperm are produced, or the sperm aren't appearing in the semen.

• Oligospermia. Few sperm are produced.
• Problems with sperm motility. If sperm aren't moving normally, they are less likely to be capable of fertilizing an egg.
• Problems with sperm morphology. Problems with the form and structure -- or morphology -- of the sperm may cause infertility.

But while these conditions may be the direct reason that you can't conceive, they themselves may be caused by an underlying medical condition. Your doctor will probably want to investigate the issue further by ordering blood and urine tests or other procedures.

Reasons for Male Infertility

There are a wide number of reasons for male infertility. Some are caused by physical problems that prevent the sperm from being ejaculated normally in semen. Others affect the quality and production of the sperm itself.

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Myths and Facts about Men's Infertility | Eterna IVF and Fertility Clinic

When a couple is diagnosed infertile, first thoughts often run to the woman. She's barren. She can't conceive. She's not a "complete" woman because she can't get pregnant. As nature would have it, problems with infertility are equally due to male and female conditions.

Infertility is the inability to get pregnant after one year of unprotected sexual intercourse. Statistics suggest that 35 to 40 percent of the problems are caused by male conditions, another 35 to 40 percent by female conditions, and the last 20 to 30 percent a combination of the two, plus a small percentage of unknown causes.

Men's part in fertilization is quite amazing. About 200 million sperm are mixed with semen to form ejaculate. In most men, 15 to 45 million of these sperm are healthy enough to fertilize an egg, although only 400 survive after a man ejaculates. Only 40 of those 400 reach the vicinity of the egg, surviving the toxic environment of the semen and the hostile environment of the vagina. After another process called capacitation (an explosion that allows the remaining sperm to drill a hole through the tough outer layer of the egg), only one lone sperm reaches the egg for fertilization and conception.

Top Causes of Male Infertility

• Low sperm count
• Slow sperm motility (movement)
• Abnormal morphology (shape and size of sperm)
• Problems with semen

Even though specialists know the causes of male infertility, what's not always known is the cause behind the cause. There are many factors -- lifestyle, genetics, physiology -- that might explain low sperm count, slow sperm mobility, abnormal sperm shape, and so on.

Recent developments in treatment have made fertility possible for many men. But before undergoing any complicated procedures, there are some simple lifestyle changes that can better the odds of a successful conception. (These tips are helpful for any couple trying to conceive, whether or not infertility has been diagnosed.)

Stop smoking cigarettes or marijuana. Smoking tobacco has been linked to low sperm counts and sluggish motility. Long-term use of marijuana can result in low sperm count and abnormally developed sperm.

• Decrease your drinking. Alcohol can reduce the production of normally formed sperm needed for a successful pregnancy.
• Watch your weight. Both overweight and underweight men can have fertility problems. With too much weight, there can be hormonal disturbances, and when a man's too lean, he can have decreased sperm count and functionality.
• Exercise in moderation. Excessive exercise could lower your sperm count indirectly by lowering the amount of testosterone in your body. And as you might have guessed, stay off the steroids -- they can cause testicular shrinkage, resulting in infertility.
• Value your vitamins. Low levels of vitamin C and zinc can cause sperm to clump together, so keep your numbers up. Vitamin E can counteract excess free-oxygen radicals, which can also affect sperm quality.
• Turn your back on toxins. Landscapers, contractors, manufacturing workers, and men who have regular contact with environmental toxins or poisons (pesticides, insecticides, lead, radiation, or heavy metals) are all at risk of infertility.

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How to Choose a Fertility Clinic | Eterna IVF and Fertility Clinic

Before you take the next step in your journey to become pregnant, it's worth seeking out a good fertility clinic.

Let's say you've been getting advice from your gynecologist, who's run a blood test for hormones or had you record your basal body temperature for a couple of months. At the same time, your husband has had his plumbing checked out by a urologist. When it comes time to diagnose where the problem may be and suggest solutions, you may wish there were a single doctor you both could see. That's where the infertility specialist comes in, providing big-picture advice. Women over age 35 or who have a history of three or more miscarriages; men with a poor semen analysis; and couples who have tried for at least two years to get pregnant, should plan on seeing a specialist, recommends Resolve, an infertility support group. 

However, you need to do some homework first. Before you step foot into the fertility clinic, find out what kind of invasive tests or procedures might lie in wait for you. And give some thought ahead of time to how far you're willing to go with this process. Advanced reproductive technology can cost many thousands of dollars, can involve strong drugs or hormones, and can be an emotional roller coaster. Knowing your limits will keep you from being talked into some nifty new procedure that you really don't want and can't afford.

When it comes to choosing a clinic, do thorough research ahead of time. One useful resource is a federal database kept by the national Centers for Disease Control and Prevention that contains the success rates of fertility centers around the country. The statistics are updated every few years, so check the date. Keep in mind that some fertility centers that looked great several years ago may have had high staff turnover and declined in quality. But the numbers give you a place to start. Also, ask a lot of questions of every fertility clinic you're considering.

"You shouldn't look at the report and say 'Center A has the highest success rate, I'm going there,'" says Arthur Gautam Chhabra, GM, an infertility specialist in Delhi, India., and author. "Just be sure they have a success rate that's at least above the national average."

We've all heard the scary stories about embryos ending up in the wrong womb or ugly legal disputes over someone's frozen eggs. To be sure you don't become the next reproductive-technology headline, check that the clinic has good quality control and strong ethics.

Questions to Ask of a Fertility Clinic

How long has the fertility clinic's medical director been there?

• How long have the doctors and technicians been there? High staff turnover can be a sign of bad management and can contribute to mistakes.
• Which procedures do you do, and how often? Be sure the clinic has a wide range of infertility remedies available and is familiar with the latest technology, such as something called blastocyst transfer.
• Do you have age limits for treatment? If so, it's a good sign that the clinic is concerned about ethical issues.
• When you do an advanced procedure that involves fertilizing the eggs outside the woman and then planting them inside her, who decides how many eggs go back in -- the doctor or patient? Gautam recommends steering away from a clinic that gives complete control to the doctor. This is important because the more eggs planted, the greater the chance for multiple births.
• How many cycles per year do you do? Gautam notes that some clinics handle so many patients -- each of whom may be treated for multiple menstrual cycles -- that patients end up feeling like a number.
• What does treatment cost? While you don't want to choose strictly on price, it's good to know costs ahead of time so you know what you're getting into. Beware of clinics that offer a money-back guarantee if you don't get pregnant -- the doctor may have a financial incentive to treat you more aggressively than you want.

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How Do Exercise, Weight, and Age Affect Fertility and Home Treatment

Exercise

Exercise should be encouraged for both women and men who are gearing up to try to conceive. However, excessive, strenuous exercise in women may result in disruption of the ovulation cycle, thereby affecting her periods. Normal exercise has not been linked to miscarriages (loss of pregnancy), but certain forms of exercise (for example, high-impact or contact sports or scuba diving) should be avoided in pregnancy. In men, too much exercise may cause a low sperm count.

Weight and Fertility

A healthy diet is very important for women who are trying for a baby. Being overweight can affect a woman's fertility and can cause complications during pregnancy. A woman who is overweight and who is planning a pregnancy would be advised to lose weight before she conceives.
Weight loss with anorexia or bulimia can disrupt a woman's menstrual cycle and thereby reduce her chances of becoming pregnant.

Age and Fertility

A woman's peak fertility is in her early 20s. At age 35 and beyond (and particularly after 40), the likelihood of becoming pregnant reduces. As men age, levels of testosterone fall, and the volume and concentration of sperm change.
Healthy couples younger than 30 years who have regular sexual intercourse and use no contraception have a 25% to 30% chance of achieving pregnancy each month.

To decrease your risk of fertility problems and increase your chances of becoming pregnant, use the following guidelines.

Track ovulation at home

Estimate when you are ovulating by practicing fertility awareness. This means:

• Tracking your cervical mucus changes.
• Tracking your basal body temperature on a monthly Fahrenheit temperature chart or Celsius temperature chart.
• Tracking your luteinizing hormone (LH) levels with a home ovulation predictor test. Many doctors now recommend these home tests as the best way to track ovulation at home.
• Try this interactive tool to calculate your peak fertility calculator.gif.
• Try having sex every day or every other day during a woman's fertile period. This can improve the chance of pregnancy.
• If you exercise strenuously most days of the week, reduce your level of activity. Very strenuous exercise can cause women to ovulate less often.

Protect sperm count and quality

• If you use a vaginal lubricant during sex, select one that doesn't kill or damage sperm.
• If you exercise strenuously most days of the week, reduce your level of activity. Very strenuous exercise may be a cause of lower sperm counts in some men.
• Avoid hot tubs and saunas. High scrotal temperatures may decrease sperm count and quality.3
• Try to control fever when you are ill. High fever has been known to have a harmful effect on sperm for 2 to 3 months afterward. (Sperm take this long to grow from germ cells to mature sperm.)

General measures

Women who are trying to get pregnant should avoid using alcohol and medicines, including nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin.

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In Vitro Fertilization (IVF) Introduction and Factors to Consider

Infertility, known as principal infertility, could be the incapacity of few for being pregnant (regardless associated with cause) right after twelve months associated with unprotected intercourse employing not any contraception techniques. This is unlike supplementary infertility, which often means the shortcoming to maintain the being pregnant right up until delivery.

Major infertility has effects on about 6.1 mil individuals in the united states, about 10% involving women and men involving reproductive era. Assisted reproductive technological know-how (ARTs) are usually ways to assist a lady get pregnant, as well as in vitro fertilization (IVF), intracytoplasmic ejaculation injection (ICSI), along with comparable methods.

IVF had been utilized properly for the first time in America inside 1981. A lot more than 4 trillion babies have been blessed worldwide because of when using the inside vitro fertilization method. IVF gives infertile lovers an opportunity to use a baby who is biologically linked to them. Nowadays, over 1% associated with infants blessed in the usa are usually due to a new maternity put together by made it easier for reproductive technological know-how.

Having IVF, a method associated with made it easier for imitation, a new guy's orgasm and also the woman's egg are usually combined in a laboratory dish, wherever fertilization occurs. The particular caused embryo or maybe embryos is/are subsequently used in the girl uterus (womb) for you to implant and create effortlessly. Usually, a couple of for you to four embryos they fit in the woman's uterus at one time. Every single effort is called a new never-ending cycle.

The phrase examination tube child may be used during the past to reference young children created with this technique. The 1st so-called examination tube child, Louise Dark brown, gotten to age group 20 years with 2003. Your lover was born with Great Britain.

Under 5% involving infertile newlyweds in fact utilize IVF. IVF is normally the management of choice for the female using plugged, severely ruined, or no Fallopian pipes. IVF is additionally used to conquer infertility a result of endometriosis or problems with the actual guy's semen (such as reduced semen count). Couples exactly who just are not able to consider and also have attempted additional infertility approaches (such as intrauterine insemination) that have not necessarily did wonders for him or her also can attempt IVF.

Age: Any kind of lady who's however ovulating may look at IVF, though good results charges decline like a lady age range. Females under grow older 30 possess the best probability of good results with this process.

Multiple births: Commonly, in women who use IVF to determine a live birth, about 63% are single babies, 32% are twins babies, and 5% are triplets or even more.

Cost: IVF is really a pricey course of action that will, in many cases, seriously isn't covered by health care insurance programs.

Reduced need for surgery: In case a woman provides IVF, the lady may not ought to experience surgical procedures on her Fallopian hoses. Approximately this IVF approach provides lowered this kind of operations through 1 / 2.

Safety: Scientific tests claim that within vitro fertilization can be risk-free. Research insured nearly 1, 000 young children developed by way of these kind of procedures within several Countries in europe and discovered the young children supervised via start to be able to get older 5 a long time, were being because balanced because young children developed normally. On the other hand, additional scientific tests have found a a little bit greater chance involving hereditary problems within young children developed by way of assisted reproductive technology. On the other hand, damaging outcomes while in maternity along with the perinatal time usually are increased within pregnancy that come via IVF. A few or maybe most of this kind of greater chance can be because of the fact that a higher amount involving IVF pregnancy contain many gestations. On the other hand, there's a minor greater chance involving troubles within singleton pregnancy caused by IVF, maybe relevant to the age of this moms and dads in order to this main problems which in turn resulted in this infertility and dependence on IVF.

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Surrogacy - How does surrogacy work?

Surrogacy, simply, is a procedure in which the pregnancy is carried by someone else, and not the mother herself. The woman, who carries the baby for the couple, is known as the surrogate mother.

When Is Surrogacy Needed?

Surrogacy

It is usually done in a situation where the mother’s body does not have a hospitable environment for the baby. This can be due to different reasons like a malformed or a totally absent womb, and repeated failure in the in-vitro fertilisation treatment. Surrogacy, in normal cases, is never recommended because of issues other than medical ones. Some women prefer to have a baby through surrogacy because of their professions, but it should be realised that surrogacy should be taken up only if there is an actual need for it, medically.

The Different surrogacies

Surrogacy

There are two types of surrogacies: Full (or Gestational) surrogacy and Half (or Partial) Surrogacy.

In a Gestational Surrogacy, there are three possibilities. 

1. The egg and the sperm, both from the parents, are implanted in the surrogate.

2. The sperm of the father is implanted with a donor egg.

3. Both the egg and the sperm are donated, and the baby is carried by the surrogate.

Basically, in this kind of surrogacy, the surrogate mother does not have any genetic impact on the baby. 

The second kind, the Half or Partial Surrogacy, involves the fertilisation of the egg from the surrogate mother, by the sperm from the father. In this kind, the baby will, obviously, have the surrogate mother’s traits. There are two methods of carrying out fertilisation in this procedure- Artificial Insemination or Intra-Uterine Insemination (IUI). 

Choosing a Surrogate

Surrogate

If you have been advised to take up surrogacy, by a doctor, the next step is to choose a suitable carrier. The agency, through which you are planning to do this, will help you make the right choice. The time taken for this depends of various factors. Once a suitable carrier is chosen, based on the forms of different carriers, you will be made to meet her in person. It is recommended for the couple to choose a surrogate mother who doesn’t put up too far.

How Does It Happen?

Surrogacy

In case of a gestational surrogacy, the first step is the retrieval of the egg from the donor, or the actual mother. Ovulation is triggered using drugs and usually more than one egg is retrieved, to increase chances of fertilisation. After that, the sperms from the father or the donor are used to fertilise the eggs. The implantation in the surrogate takes place at the embryo level. 

In case of a partial surrogacy, the surrogate is given fertility drugs and monitored for healthy eggs. The sperm from the father is then introduced, using artificial insemination or IUI. 

Factors That Affect Surrogacy

Surrogacy Factors

There are many factors that affect the rate of success in a surrogacy.

1. Firstly, the surrogate should be able to get pregnant, and have a good environment for the growth of the baby. This will depend upon her age, too.

2. Secondly, if the egg is taken from a donor, her age would also affect the fertilisation process.

3. Thirdly, all the medical procedures, like IVF and IUI, done as a part of the surrogacy, should also be done with great care to ensure their success. Failure at one step would mean failure at all of them.

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