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Procedure
Down regulation using GnRh will be started on day 21 of the previous phase of the treatment cycle.
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.
Monitoring the follicular growth with trans-vaginal scan is done followed by injection of HCG, 36 hours before egg collection, for maturation of eggs.
Egg collection is then done. This is a day care procedure in which eggs are collected under USG guidance.
Fertilization is the next step. The husband's sperms and the collected eggs are put together in a culture medium (50,000 to 1,00,000 sperms for each egg).
Embryo transfer - fertilized eggs (3-4) are again replaced in the uterine cavity under USG guidance without anaesthesia , 48 hours after egg collection (pregnancy rate per cycle = 32 to 35%).
Advanced Treatment Options
Advanced treatment options are offered if the doctors feel it is essential. These include:
ICSI & ET
These are offered if the patient has
Sperms are recovered from ejaculation or collected by
- TESE (Testicular Sperm Extraction)
- MESA (Microsurgical Epididymal Sperm Aspiration)
- PESA (Percutaneous Epididymal Sperm Aspiration)
Procedure
A single sperm is injected directly into the cytoplasm of the egg by micro-puncture of the egg shell. Fertilization rate is 60-70% and pregnancy rate is 20-40%. Then the embryo is replaced in a procedure similar to IVF/ ET.
Cryopreservation
Usually in IVF/ ICSI cycles more embryos are produced but only 3-4 are transferred into the uterus. The other embryos are frozen and can be used at a later date if the cycle fails.
Assisted Hatching
Hatching of the blastocyst from the egg shell is required for implantation. In assisted hatching the egg shell is artificially thinned / opened with laser or acid tyrode solution. It improves the implantation rate.
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