Treatment Options Available

The treatment will be initiated after careful review of the investigation results and diagnosis of the exact cause of infertility. Assisted Reproductive Technology (ART) is the term used for infertility treatments. These treatments are designed to increase the number of eggs or sperm, and to bring them together, thus improving the likelihood of pregnancy.

Infertility treatment can range from practical lifestyle changes to extended medical procedures - depending on the nature of the problem. As a first step, it may just be a few simple measures, like awareness of fertile period and psycho social interventions (Quit Smoking / Alcohol, Relaxation Therapy).

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Ovulation induction

This is offered when the female has irregular ovulation. Medication is provided to regularize the ovulation cycle and also to enhance the quality of the egg. Drugs commonly used are Clomiphene Citrate, HMG, purified and recombinant FSH. Usually HMG, FSH are used for recruiting more follicles - which is necessary in IVF/ ICSI procedures.

Clomiphene Citrate is used from day 3 to day 7 of the cycle with alternate day relationship from day 8 to day 20. Progesterone supplementation is provided from day 15. Follicular tracking can be started from day 10/11. If IUI (Intra Uterine Insemination) is planned, from day 3 to day 7 Clomiphene Citrate will be prescribed (plus HMG if needed).From Day 10, follicular study will start. When the dominant follicular size is 18 to 20 mm, an injection is given to release the egg which is evident in the scan. IUI is done 40 hours after the injection.

Procedures

• IUI (Intra Uterine Insemination): This is the method by which processed semen is placed directly in the uterus with the help of a catheter. On an average, 20-30 IUI are done every month.

• IVF (In Vitro Fertilization): IVF means fertilization of an ovum outside the body and consequently, the transfer of the fertilized ovum (embryo) into the uterus of the woman.

• ICSI (Intra Cytoplasmic Sperm Injection): ICSI is the technological breakthrough in the field of IVF which is used to overcome the inability of sperm to fertilize an egg (which may be either due to sub-optimal sperm parameters, oocyte defects or other reasons). In this technique, a single sperm is directly injected into the cytoplasm of an egg in order to achieve fertilization.

• TESA (Testicular Sperm Aspiration): Apollo Hospitals carries out on an average 8-10 TESA every month.

• Embryo Freezing Excess (Surplus): Embryos can be Cryo-preserved at ultra low temperatures for many years. These frozen embryos can be used subsequently, without the need for ovarian stimulation and egg retrieval.

• Assisted Hatching: The procedure is based on the fact that an alteration in zona pellucida (outer covering of egg) either by drilling a hole through it or by thinning it, will promote hatching or implantation of embryos that are otherwise unable to escape intact from the zona pellucida.

• Semen/Sperm freezing: Semen/Sperm can be stored frozen at ultra low temperatures for long duration which could be helpful in a variety of circumstances - semen freezing prior to chemotherapy, inability of the male partner to be present or to deliver the semen on the day of procedure, testicular biopsy/sperm freezing to avoid repeated biopsies, donor semen, etc.