Is this true that people who have conceived successfully before could not have infertility problem later in life?

It is not true, as a fertile couple can develop infertility problem later in life, such type of infertility is called Secondary infertility. Some common causes- endometriosis {one of the most common cause of secondary infertility in women), irregular ovulation, or fallopian tube disease or a man might have decline in concentration or motility of his sperms

What aie the common causes of Infertility in Females and Males?

Causes of Female infertility: For a woman to be fertile, her ovaries must release healthy eggs. Her reproductive tract must allow an egg to pass into her fallopian tubes and allow the sperm to join the egg for fertilization. The fertilized egg must travel on to the uterus and implant in the lining.
Around 40 per cent of fertility problems originate in the woman.

Causes of Female infertility:

  • Fallopian tube damage or blockage
  • Endometriosis
  • Ovulation disorders
  • Age
  • Early menopause
  • Uterine fibroids
  • Health and lifestyle issues
  • Hormonal imbalance like devoted prolactin, Thyroid problem
  • Cancer and its treatment
  • Unexplained infertility where standard fertility tests have not found the cause of the fertility issue.

Causes of Male Infertility:

For a man to be fertile, the testicles must produce enough healthy sperm, and the sperm must be ejaculated effectively into the woman’s vagina and be able to travel to and fertilize the egg.
Around 40 per cent of fertility problems originate in the man. The most common causes of male infertility include: found the cause of the infertility issue.

  • Problem in Sperm production and ejaculation
  • Some health issues like certain genetic diseases, Both radiation and chemotherapy treatment for cancer can impair sperm production.
  • Health and lifestyle, including poor nutrition, obesity, or excessive use of alcohol, tobacco and drugs.
  • Overexposure to certain environmental factors, such as pesticides and other chemicals. This may impair sperm production and lower the sperm count.
  • Age. There is a decrease in fertility as men age and an increased risk of genetic defects.
  • Unexplained infertility

What are the common Investigations carried to diagnose the infertility?

Medical History: The first step in investigating your fertility is a consultation with one of our Fertility Specialist. During this appointment, your medical history and lifestyle may be comprehensively investigated. Birth control use, pregnancy history, frequencyand regularity of menstrual cycles, medications used, surgical history, other health issues, your lifestyle, and your work/living environment may be discussed. After this initial consultation, Fertility Specialist may proceed with further investigations.
Preliminary Test of couple: Blood tests are performed for Infection Screening for patients and their partners for Human Immunodeficiency Virus (HIV), hepatitis B and C and Syphillis. We know that being tested for HIV and Hepatitis is stressful.

We know that being tested for HIV and Hepatitis is stressful. We will support you during this process and you will also be offered the opportunity to have independent, confidential counselling at any stage.

IN FEMALE
You may be asked to have all or some of the following investigations:
1. An ultrasound scan of the pelvis, uterusand ovaries
2. Blood tests to test various hormones and factors responsible to maintain fertility like FSH, LH, AMH, Prolactin Jhyroid, TORCH.
3. SSG/HSG(Hysterosalpingogram) to show whether the fallopian tubesare open or blocked
4. Hysteroscopy (where a small telescope is placed in the womb to checkthat it is normal).This procedure is performed under sedation.
5. Cervical culture:To check occurrence of an infection.

IN MALE
1. Semen analysis: A semen analysis is a common test for determining if there is a male fertility issue. Semen is collected and examined in order to evaluate- the presence of sperm, sperm count, shape, appearance, and mobility of the sperm. Sperm sample may also be checked for signs of problems such as infections.
The semen sample has to be produced by masturbation after two or three days of abstinence from ejaculation. It should not ideally be before or after this time frame. If you feel that producing a sample may be a problem, please talk to the doctor to discuss further
2. Blood test: A blood test can be performed to measure the level of testosterone and other hormones (if there is some abnormality seen in the semen analysis) and also for genetic testing to reveol whether there are change in the Y chromosome (Genetic Abnormality) and to diagnose various congenital or inherited syndromes
3. Testicular biopsy: This is where a small piece of tissue is removed from the tubules in the testes and examined to determine if sperrn production is normal.

How B.P (Hypertension) and Diabetes can affect the chances of conception?

High blood pressure, or hypertension, is a chronic condition that can lead to many medical complications. In females. having high blood pressure does not directly make it more difficult to become pregnant. Although high blood pressure might affect the lining of the uterus, which could interfere with an embryo’s healthy implantation. In males, high blood pressure & diabetes can cause problems with erection and ejaculation, either directly or as a side effect of medication.

Does age affect fertility in females?

As women grow older the likelihood of getting pregnant falls so fertility starts to decline for women from about the age of 30, dropping down more steeply 35 onwards. Higher age group females have an option of getting pregnant by undergoing donoregg programme.

What are the Infertility Treatment options?

It depends on your clinical profile and personal preferences, but may include:
To treat Female infertility
1. Fertility drugs and hormonal balance
2. Tubal and Uterine Surgery
3. Intrauterine Insemination (“IUI”)
4. Assisted reproductive treatment, for example, In Vitro Fertillization (“IVF”)
To treat Male infertility
1. Fertility drugs or hormonal treatment
2. Intrauterine Insemination (IUI)
3. In Vitro Fertilisation (IVF) and Intra cytoplasmic Sperm Injection (ICSI)
4. Testicular Sperm Aspiration or Micro surgical Sperm Retrieval
5. Donor Sperm – If none of the above treatment can be opted

What is Artificial Inseminatiun/IUl (Intra uterine insemination)?

IUI is a common procedure that has been used for many years to help deliver male sperms closer to the female egg. It is usually one of the first techniques used to assist couple who is having difficulty becoming parents. In this procedure, processed and concentrated sperms introduced into the woman’s uterus through a tube. Sperms can be provided by woman’s husband or a donor. The procedure is done around time of ovulation to give the best chance of conception. Hormonal medications might be used in conjunction with the treatment to enhance conditions for pregnancy.
WHEN IUI IS NOT SUITABLE
 A blocked damaged fallopian tube
 Ovarian failure
 Severe male infertility, very low sperm count, poor sperm motility,
sperm defects
 Severe endometriosis
 A female partner over the age of 40

What is IVF or Test Tube Baby?

IVF- in vitro fertilization (literally means “fertilization in glass”) and 1CSI-intracytoplasmic sperm injection involves the fertilization of the egg by the sperm outside the body, and transfer of the embryo back into the uterus.

WHEN IS IVF/ICSI USED?

IVF was originally developed for women with blocked fallopian tubes or missing tubes and is still used to treat those conditions. It is also used when fertility cannot be explained and with following ovulatory or structural causes:
 Problems with ovulation
 Endometriosis
 Fibroids
 Polycystic ovarian syndrome (PCOS)
 Cervical problems ICSI is usually offered to couples who have had poor or no fertilization during standard IVF. It is mainly used to overcome male infertility. It was first used in 1992 and offers an alternate to donor sperm for those who have severe male infertility which includes
 Poor sperm morphology

 Poor sperm motility
 A low sperm count
 Sperms retrieved by surgical procedure (TESA/MESA/PESA/TESE)
 An obstruction which prevents sperm release
 Anti Sperm Antibodies

How does ICSI differ from IVF?

IVF and ICSI are two most popular assisted reproductive technologies used for successful fertilization. The only difference between the two is the way the egg is fertilized, IVF allows sperm to penetrate the egg of its own accord whereas ICSI directly inserts sperm into the egg. ICSI is done under microscope by qualified technicians using very fine tools (known as micromanipulation). The technique is used when the sperm count is very low or the sperm is unable to penetrate the egg wall. If the egg is fertilized the embryo is transferred into the uterus the same way as for IVF.

Who is a SURROGATE?

For some people, carrying their own baby through pregnancy is impossible and a surrogate offers their only hope of having a child. A surrogate is a woman who carries a pregnancy for the intended parents. In surrogacy, an embryo is created using an egg and sperm produced by the intending parent(s) (or donors), and is transferred into the surrogate’s uterus. The surrogate has no genetic link to the child. Her eggs cannot be used to conceive the child in surrogacy, there is clear legal understanding between two parties. The two parties sign a legal contract.

What is fertility preservation and why to Store Your Eggs, Sperms or Embryos?

Eggs, sperm and embryos can all be frozen and stored, in case you need them in the future. It is a relatively straight forward procedure that has helped many men and women on their path to a family. You might choose to use storage if:
1. You’re about to be treated for cancer- This is called onco-fertility. It allows you to undergo treatment without the constant worry of infertility after cancer treatments.
2. You’re going through In Vitro Fertilisation (“IVF”) – Sperm can also be Stored for IVF, which is very helpful for men who find it difficult to ejaculate demand or are unavailable on the day of egg collection.
3. Before vasectomy
4. Extra embryos during IVF treatment can be freezed.
We can store your sperms and embryos for up to 10 years or more; however, we require an additional consent after one year.

Is this true that rate of abnormalities or birth defects is higher in case of frozen sperms or embryos are used?

Research has shown no difference in the rates of abnormalities or birth defects among children conceived with fresh versus frozen sperm and embryos.

How change in normal diet plan and lifestyle can boost fertility?

While it may seem hard to believe, but improving fertility can be influenced by lifestyle adjustments. Following are some of the recommendation that can help you:
1. Avoid alcohol and cigarette smoking
2. Avoid plastics from your diet e.g. food packed or heated in plastics, plastic utensils, etc as they leech out harmful chemicals that can affect your hormonal system and sperm production in males.
3. Avoid frequent exposure to environmental toxins as much as possible.
4. Avoid sedentary lifestyle, Get regular exercise.
5. Avoid high intake of food rich in Fats/Junk Food
6. Make managing your stress a priority
7. Maintain Personal Hygiene
8. Intake of foods rich in Zinc, Vitamin C, B & E and Selenium as they have strong antioxidant properties.

How consumption of alcohol and cigarette smoking affects the fertility in men and women?

Alcohol and cigarette smoking has been directly associated with low sperm count, motility and even impotency. Exposure to recreational drugs appears to accelerate the loss of eggs and reproductive function in females. It may also advances the time of menopause by several years.

What should be the first step?

First step is the most difficult step when the couple decides that they need an infertility treatment. Here the timely taken decision plays a very crucial role in successful infertility treatment. So contact the infertility clinic and talk with the infertility specialist to know the treatment options.

Guidelines for the Patient who want to continue their treatment at their hometown after achieving successful pregnancy at SJS IVF

It is not necessary* to stay with us after achieving pregnancy. We’ll provide a copy of your medical record for your local supervising physician detailing the treatment undertaken. Medication will be provided to you that you have to carry for advised period. We continue to provide you ongoing support and care.

General Information

Clinic Delays
At times there may be delays whilst you are waiting for an appointment.

These are unavoidable and are due to the nature of treatment. We aim to avoid any delays or inconvenience in commencing treatment, but at times this may occur.
Privacy and Confidentiality
All SJS IVF staff have a professional responsibility and duty of care to protect your personal information.
Accommodation Arrangements
Couples who need to make arrangements for accommodation should let us know so that we can help make things run smoothly for them. We have accommodation facility for the patients.
IVF Costs
The cost is variable for each patient and is calculated by the type of treatments performed. At SJS IVF, we aim to make this complex area as simple as possible to ensure you are able to carefully plan the financial impact that infertility treatment will have, prior to your infertility treatment commencing.

Patient Responsibilities

At SJS IVF we are committed to providing the highest level of professional care and treatment for men and women using contemporary Assisted Reproductive Technologies. Patient shave certain responsibilities, Privacy and confidentiality of information and communications provided
 Give feedback and make complaints and have this information addressed.
 To treat staff and other patients courteously and with respect
 To respect the rights and privacy of staff and other people using the service
 To provide accurate information regarding personal circumstances, hearth and medical history
 Understand your treatment and ask questions if you do not
 To keep personal details up-to-date, including changes to personal details after treatment, if you have stored gametes or embryos
 Provide notification of any alteration in treatment choice and conditions
 Attend your appointment and inform staff if you need to change your appointment.

What Is Infertility?

Infertility refers to an inability to conceive after having regular unprotected sex. Infertility can also refer to the biological inability of an individual to contribute to conception, or to a female who cannot carry a pregnancy to full term.

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