| What are the various treatment options for infertility? |
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| The treatment could range from practical lifestyle changes to extended medical procedures - depending on the nature of the problem. As a first step, it could 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 |
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| This is offered when the female counterpart has irregular ovulation. Medication is provided to regularize the ovulation cycle and also to enhance the quality of the egg. |
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| 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. |
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| 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. |
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If IUI (Intra Uterine Insemination) is planned, from day 3 to day 7 Clomiphene Citrate will be prescribed (plus HMG if needed). |
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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. |
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The types of treatment |
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| IUI |
| A procedure where the husband's sperms are prepared and introduced into the uterus by a special catheter. |
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IVF & ET - An option for patients with |
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Tubal disease |
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Male factor infertility |
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Failure of IUI |
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Unexplained infertility |
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| Procedure |
| Down regulation using GnRh will be started on day 21 of the previous phase of the treatment cycle. |
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| Controlled ovarian hyper stimulation is done so that more follicles are recruited by drugs in order to produce more embryos which in turn improves the pregnancy rate. |
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| Monitoring the follicular growth with trans-vaginal scan is done followed by injection of HCG, 36 hours before egg collection, for maturation of eggs. |
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| Egg collection - a day care procedure in which eggs are collected under USG guidance. |
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| Fertilization - husband's sperms and the collected eggs are put together in a culture medium (50,000 to 1,00,000 sperms for each egg). |
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| Embryo transfer - fertilized eggs (3-4) are again replaced in the uterine cavity under USG guidance without anaesthesia , 48 hrs after egg collection (pregnancy rate per cycle = 32 to 35%). |