Intrauterine Insemination (IUI) is a fertility treatment that involves placing sperm inside a woman’s uterus to facilitate fertilization. The goal of IUI is to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilization. It provides the sperm with an advantage by giving it a head start but still requires a sperm to reach and fertilize the egg on its own.
IUI is recommended when there is Ejaculatory dysfunction, Male subfertility, Unexplained infertility, Cervical factors or Immunological factors.
This is an assisted reproductive technique in which the sperm and egg are fertilized outside the body. The ovaries are stimulated to produce multiple eggs with the help of drugs and medications, or the doctor goes in accordance with the woman’s natural ovulation cycle. Once mature, these eggs are removed with the help of a needle under ultrasound guidance. Next, they are incubated along with sperms in the IVF lab for 3 to 5 days during which time they get fertilized and start dividing to form embryos. These embryos are then transferred into the uterus.
IVF is recommended for those with unexplained male or female infertility, blocked fallopian tube or vas deferens, ovarian failure or low egg reserve and also in patients with endometriosis.
ICSI or Intra Cytoplasmic Sperm Injection is a procedure wherein a single sperm is injected into each egg with a very fine needle under high magnification. This is required in severe male infertility where conventional IVF is not likely to work and also if the egg quality is poor or very few numbers of eggs are available.
These sperm retrieval procedures are performed in men who are azoospermic, i.e., they do not have sperms in the semen. Sperms are directly removed from the testes and used for fertilizing the eggs by ICSI. PESA & TESA are performed in men with obstructive azoospermia. mTESE is performed in men who have no obstruction in the passage of sperms but are infertile due to extremely low sperm production.
PESA or Percutaneous Epididymal Sperm Aspiration, does not require a surgical incision. A small needle is passed directly into the head of the epididymis through the scrotal skin and fluid is aspirated. The embryologist retrieves the sperm cells from the fluid and prepares them for ICSI & also cryopreserves any extra sperms available.
TESA or testicular sperm aspiration is performed by inserting a needle in the testis and aspirating fluid and tissue with negative pressure. The aspirated tissue is then processed in the embryology laboratory and the sperm cells extracted are used for ICSI.
This procedure is performed by making a small cut in the testicle and removing seminiferous tubules under magnification by looking through a surgical microscope. These tubules are then dissected under a microscope in the IVF lab to look for sperm. If found, the sperm can be used right away to fertilize an egg, or the sperm cells can be frozen, stored, and thawed at a later time to be used for infertility treatment.
There is hope for couples with a severe abnormality in sperms or eggs in the form of donated sperms and eggs. The centre has a donor semen bank where samples matched with blood group, height, skin colour, eye colour, etc. are available. These samples are procured from government authorized semen banks where donors have been screened for thalassemia as well as sexually transmitted infections. These samples are then quarantined for six months & dispatched for use only after running a repeat screen for infections.
Donor eggs are also made available from healthy young women matched for blood group and physical appearance as far as possible. These women are similarly screened for thalassemia, sexually transmitted infections, diabetes, hypothyroidism, etc. They can also be put through advanced tests for carrier screening for genetic diseases on request.
This involves running a genetic test on the embryo to check for genetic anomalies. With the help of a laser, a few cells are removed from the embryo (embryo biopsy) which are subjected to genetic testing. In PGS (Preimplantation Genetic Screening) aneuploidy screening is done to look for numerical abnormalities in all 23 chromosomes; whereas in PGD (Preimplantation Genetic Diagnosis), testing is done for specific diseases which may be present in one or both partners in manifest or carrier form. In the meanwhile, the embryos are frozen, and only embryos which are normal are later transferred into the uterus.
Cryopreservation is a term used to indicate the freezing of embryos, eggs or sperm, in order to preserve them for future use. Embryos are routinely cryopreserved during IVF when extra embryos are available. These embryos can be transferred later on if the first IVF cycle fails or ends in a miscarriage or the couple wants to have another baby. Some couples who want to defer a pregnancy due to personal reasons also opt for freezing of all their embryos for future use.
For men with low sperm counts, ejaculatory problems or for those who need surgical sperm retrieval, sperm can be frozen prior to IVF treatment. Sperms can also be frozen for couples not living together regularly, and these sperms can be used for IUI or IVF even when the husband is away.
Cancer treatments are now highly effective, and cancer survivors lead long & meaningful lives after conquering the disease. However, cancer treatments (including surgery, chemotherapy & radiotherapy) may damage the eggs & sperms temporarily or permanently, and it is advisable to preserve sperms/eggs/embryos before subjecting cancer patients to gonadotoxic treatments.
Women who want to get married or plan pregnancies later are at risk of infertility due to increasing age. These women can opt for freezing their eggs or embryos. Though this is not a sure-shot method to preserve fertility, it is a good option in unavoidable circumstances.
Laparoscopy, also known as ‘key-hole surgery’, is a way of doing the surgery using small incisions (cuts). It is different from ‘open’ surgery where the incision on the skin can be several inches long. Laparoscopy is done in cases where there is a need to diagnose or treat conditions in the abdomen or pelvis area, e.g. to diagnose or treat blocked tubes or endometriosis, take a biopsy for testing, etc. or removal of tumours, cysts or even removal of the uterus, tubes &/or ovaries. Opting for laparoscopy has many benefits. There is less pain after laparoscopic surgery than after open abdominal surgery, shorter hospital stay, and faster recovery. The smaller incisions that are used to heal faster and leave smaller scars. The risk of infection is also lower than with open surgery.
Hysteroscopy is the inspection of the uterine cavity by endoscopy with access through the cervix, i.e. through the natural opening of the uterus and therefore does not require any cutting or stitches. It is done to investigate and treat various gynaecological problems such as heavy periods, abnormal vaginal bleeding, post-menopausal bleeding, repeated miscarriages, difficulty in getting pregnant, etc. It is done with the help of a hysteroscope, a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus. Conditions inside the uterine cavity such as fibroids, polyps (non-cancerous growths in the womb), septum, adhesions, etc. can be diagnosed and removed at the same time. Tubal cannulation can be done to open tubes which are blocked just at their origin from the uterus. The procedure is not painful because some sort of sedation or anaesthesia will be given. The extent of anaesthesia you need will depend on the purpose of your hysteroscopy.
A lot of women may not be able to achieve motherhood due to repeated miscarriages. These women require a lot of specialized care and compassion. Our team has a lot of experience in handling these highly precious pregnancies. We are proud to be a part of the success stories of so many couples whom we helped to conquer this problem.
For any concerns related to reproductive organs and female complications, you can get your appointment by contacting our number: 8146677366/8146677363/0172-2218044. For any queries, you can also visit Dr Sodhi’s Health Care Multispecialty Hospital & IVF Centre at 1524, S.A.S Nagar, Sector-69 Mohali, Punjab, without any hesitation.
Our other centre: “Dr Sodhi's Health Care Diagnostic Cardiology Centre”