Treatment options: Laparoscopy:

Diagnostic Laparoscopy: This is the gold standard diagnostic method to find out the cause of infertility. Through laparoscopy, it is possible to assess the reproductive system by looking at the ovaries, uterus and tubes and determine the reason/cause for infertility. Most of the causes can be simultaneously treated with the diagnostic laparoscopy.

Operative endoscopy:

We specialize in treating the causes of the infertility with the help of endoscopic surgery.

PCOD Drilling:

Most of the cases of PCOS can be treated with the help of laparoscopic ovarian drilling, which is one of our specialties.

Laparoscopic Myomectomy:

Large fibroids in uterus are removed laparoscopically, using this technique.

Endoscopic tubal cannulation:

This technique is used to open blocked tubes. Success rate depends upon the length of the blockage in the tubes.

Laparo-surgery for endometriosis:

This is a highly successful method to tackle endometriosis in medicine failure cases.

Laparo- ovarian cystectomy:

The ovarian cysts are removed laparoscopically.

Laparoscopic adhesionolysis:

Cases of adhesions are managed with laparoscopic adhesionolysis.

Art-Assisted Reproductive Technology:
 
This includes:

A technique used for couples having sexual problems. Simply the sperms are injected into the vagina.

IUI- Intrauterine insemination (IUI) is a process in which the semen sample is processed and concentrated. This preparation is placed in the uterus with the help of very thin tubing. It is a treatment option for patients having minor semen abnormalities & in patients having antisperm antibodies ( -ve Post coital test) and in couples having sexual dysfunctions

IVF-ET- This is mainly done for blocked tubes, unexplained infertility, PCOD, endometriosis grade 3-4, mild oligospermia in males. Hormonal injections are given to the woman to induce super ovulation, serial Transvaginal sonographies done to monitor follicles, HCG injections given to induce the egg release, Ovum pick up is done , eggs are inseminated with processed sperms of the husband. Fertilization of eggs takes place within a day followed by cleavage & the embryos thus formed are replaced into uterus on day 2, 3 or 5 (Blastocyst). 

Step One - Ovulation Induction  

Hormone injections are given to stimulate multiple egg production rather than the single egg normally produced by the body each month. This stimulation process usually requires the initial use of Lupron to suppress the ovary to prevent ovulation until the desired time. Daily gonadotropin injections are then added to stimulate the development of the eggs. These are usually given subcutaneously (under the skin) and are much less uncomfortable than the previous generations of medication. We then monitor the progress of ovulation induction with ultrasounds and blood estrogen levels over several days. 

Step Two - Egg Retrieval

An egg retrieval is performed with the help of transvaginal sonography placing a special needle into the ovarian follicle and removing the fluid that contains the egg.A needle is directed alongside the probe, through the vaginal wall, and into the ovary. To avoid any discomfort, strong, short acting intravenous sedation is provided.

Step Three- Fertilization

The eggs are transferred to a laboratory dish where they are fertilized by sperm from the male partner.  

Day - 5 embryo at Blastocyst Stage

Step Four - Embryo Transfer

Embryos may be transferred on day 3, 5, or 6 after egg retrieval. Transfers on day 5 or 6 are called blastocyst transfers. They are placed through the cervix into the uterine cavity using a small, soft catheter. This procedure usually requires no anesthesia. It is similar to the Mock Embryo Transfer which will be performed prior to the actual IVF cycle. 

 
Intracytoplasmic Sperm Injection (ICSI):

It is a process in which a single sperm is injected into the cytoplasm (center) of each egg by an embryologist (a specialist in egg fertilization). After the egg has been injected with the sperm, the embryologist will observe the egg over the next day or so. If fertilization occurs and the embryo matures properly, it will be transferred into your uterine cavity. This is the treatment of choice for cases in which the sperm count is less than 5 millions/ml, sperm defects, dead, immotile, abnormal sperms, unexplained infertility and failed IVF. Super ovulation, follicular monitoring, ovum pick up is done as in IVF. This technique may provide men who have very small amounts of weak sperm (too small for routine IVF) a chance to fertilize individual eggs. If the egg is fertilized, the embryo is inserted into the uterus in the same way as in IVF.

PESA and TESE (Pecutaneous Epidydimal Sperm Aspiration and Testicular Sperm Extraction)                 

Some men have no sperm in the ejaculate but still produce them in the testes. This may occur due to a vasectomy, to a congenital obstruction of the sperm ducts leaving the testes, or to inadequate development of the sperm such that they cannot leave the testes. Usually performed as an outpatient procedure, Epididymal sperms are usually not fully motile and, therefore, cannot be inseminated into the uterus or cervix directly without sophisticated techniques that place the egg and sperm in direct contact so fertilization can occur. If MESA is done in conjunction with an IVF cycle, it will be performed around the same time as egg retrieval from the female partner. Sperms obtained from the epididymis are usually placed directly into the egg (ICSI).

Zygote Intrafallopian Transfer (ZIFT)  

(ZIFT) combines the principle of both IVF and the GIFT. Protocols for ovarian stimulation are similar to those used for IVF and GIFT. Eggs are collected and fertilized by sperm in the laboratory. ZIFT is different from IVF in the sense that the embryo is placed into the woman's fallopian tube laparoscopically rather than through the cervix into the uterus. 

Gamete Intrafallopian Transfer (GIFT)

This is a treatment of choice in unexplained infertility and patients having cervical factors and immunological factors. In this procedure mixture of sperm and eggs is placed directly into one of the woman's fallopian tubes during laparoscopy. Conception occurs in the fallopian tube. Once fertilized, the embryo then travels into the uterus, just as in a natural cycle. As with other ART procedures, GIFT requires that the woman's ovaries first be stimulated with hormonal medication to encourage the development of multiple follicles. This enhances the chances of fertilization. With GIFT, fertilization takes place inside the woman's body. However, GIFT can only be used in patients with healthy fallopian tubes (at least one).   

Assisted-Hatching

(AH) is a procedure performed prior to transfer in selected cases. An embryo needs to escape or "hatch" from it's protein shell, called the Zona Pellucida, before it can implant in the uterus. In AH, a chemical or a laser can be used to dissolve part of the zona, to facilitate the hatching process later. This technique is often used with prior failed IVF cycles, female age over 38, and with abnormally thick zonae.

EMBRYO FREEZING

The embryos which are not used in an IVF/ICSI cycle can be stored by freezing. Embryos which are not used in a particular ART cycle are preserved for future use. Once frozen, they remain viable for long periods of time. This procedure called Cryopreservation enables the stored embryos to be used in the ART cycle and some to be stored for future use in a natural cycle (a cycle without hormonal stimulation). This also lowers the cost of subsequent ART procedures because the first few stages (ovarian stimulation, egg retrieval) do not have to be repeated when the frozen embryos are used.