Treatments available at Swamini fertility center are:
Medical Treatment of female and male partners either with tablets and/or injections if necessary.
Laparohysteroscopy- This is a very important modality of investigation and at the same time
treatment of the infertile couple.
With the help of laparoscopy we can detect any abnormalities of uterus, ovaries and tubes.
The advantage of laparoscopy is that we can treat some abnormalities at the same time, for eg. polycystic ovarian drilling is done. Any tumours - fibroids most commonly fibroid in the uterus are removed.Ovarian cysts are aspirated.
Endometriotic cysts are removed and endometriotic spots are cauterized.
Tubal patency is tested and if there is any tubal block, we can try to remove it at the same time
With the help of hysteroscopy we examine the uterus.
If there is any mass or polyp or septum in the uterus we can remove it.
Assisted Reproductive Technologies (ART) - Many disorders in reproduction can be treated by means of medication or by way of operative interventions (Laparohysteroscopy), so that subsequently an undisturbed reproductive process becomes possible.
But, if the patient does not conceive with these treatments, assisted reproductive technologies help a lot in such patients. They are:
- IUI - Intrauterine insemination
- Invitrofertilization (IVF)and Intracytoplasmic Sperm Injection (ICSI)
- TESA and PESA
1. IUI - Intrauterine Insemination
IUI is of two types:a. Husbands Sperm Insemination: Inseminations of husbands sperms in the uterus under all aspetic precautions.In this procedure washed, concentrated and capacitated normal sperms are inseminated in the uterus with the help of a small catheter. The procedure does not need anesthesia. IUI is done at the time of ovulation.
Patients who are helped with IUI treatments are:
1. Patients with unexplained infertility.
2. Patients who do not conceive with medication and injections.
3. Husbands sperm count slightly less than normal.
4. Patients whose postcoital test is positive
Post coital test:- The wife's cervical mucous is checked 1-2 days before ovulation. It is done within 2-8 hours after intercourse. Cervical mucous is examined and the presence of mobile sperm is observed. Patients who do not have motile sperms in post coital test but have otherwise normal sperm count are helped by IUI.
b. Artificial insemination of donor sample (AID): This treatment is useful in patients who do not have sperms in their semen.This treatment is useful in patients with testicular failure.Sperms from semen bank are inseminated in the uterus of female partner. This procedure does not need anaesthesia.
In this mode of treatment of infertility, fertilization ( union of sperm and ovum) is carried out outside the body. It is of two types:
2. ICSI-Intracytoplasmic Sperm Injection
In IVF or ICSI the ova are collected outside with the help of a procedure called Ovum Pickup.
Ovum Pickup is done under general anaesthesia.
In IVF, sperms and ova are coincubated and embryos are formed.
In ICSI, the sperm is injected in the ovum with the help of ICSI microscope and micromanipulator. Then they are kept in the incubator. The embryos formed in these procedures are transferred to the uterus.
Indications for IVF and ICSI treatment:
Both the fallopian tubes are blocked and not accessible for operative treatment or the operative treatment has failed.
Endometriosis present in the female.
IUI has failed to achieve pregnancy.
Hormonal disturbances- at the level of Hypothalmus, hypophyses or ovaries and subsequent disturbances in the oocytes.
The sperm count and motility is very much less than normal
In case of tubal blockage or absent vas , sperms are present in testes but not in semen.
TESA or PESA treatment with ICSI is useful in such patients where sperms are aspirated from epididymis or testes and wife's sperms are inseminated with those sperms with ICSI treatment and fertilization is achieved.