વંધ્યત્વ (બિન-ફળદ્રુપતા)

• Sonography scan to diagnosis any uterine, ovarion pathology like pcod,low follicle count, fibroid, endometriosis, polyps etc.
• AMH test: Simple blood test for ovarian reserve.
• Seman analysis: Important male test to measure the number of sperm, motility, morphology.
• Genetic testing : to diagnosis any genetic abnormality which can effect couples fertility.
• Routine blood reports :
• HSG: Using x-ray to confirm the fallopian tube are open anything abnormal in uterine cavity.
• Diagnostic laproscopy & Hysteroscopy:
  1. These tests are invasive.Following fertility tests include like It’s one type of minor surgery.
  2. Laproscopy is performed under general anaesthetic.
     • A scope (laproscope) is passed through a small incision in the umbilicus and one to two accesory probe is inserted through the pubic hairline to view the ovaries, fallopian tubes, uterus and polvic cavity for abnormalities. Tubal patency can also be checked by injecting dye through the uterus and observing its progress.
  3. Hysteroscopy uses a hysteroscope to study the uterine cavity for polyps, fibroids, adhesions and abnormal anatomy.

• By usg, we will inform when ovulation occur & advice ideal time to have sex to live you best chance of conception.we also know about effect of ovulation induction medicine effect ,egg number and quality,endometrium quality and any pelvic infection also.

• Simple oral treatment by medicine or injection to encourage ovulation.

• A technique that involves inserting prepared sperm into the female’s uterus close to the time of ovulation.

The IUI process:

• Step 1: Ovulation induction in which ovulation occur under oral medicine with or without hormones injection.
• Step 2: Seman sample analyzed & washed to concentrate the motile sperm.
• Step 3: Prepared sample used for insemination where it is inserted in to uterine cavity using a speculum and a small catheter.

Not painful but sometimes you might feel mild cramping and/or discomfort.

You should no need to bed rest and You should be able to return to work straight away.

Who is suitable for IUI?

• It is more beneficial in women who are not of an advanced maternal age.
• Unexplained infertility.
• Hostile cervical onucus.
• Minor sperm abnormalities or other male disorders.

IUI by donor sperm :

• Donor sperm may be recommended when male partner with poor quality sperm or if there is high risk of passing on a genetic disease.

• IVF is a procedure, used to overcome a range of fertility issues by which an egg and sperm are joined together outside body in a specialized laboratory.
• The fertilized embryo is allowed to grow in a protected environment for 3-5 days before being transferred into the women’s uterus.
• IVF can be used to solve fertility for many couples give them best chance of having a baby.

IVF process step by step:

Step1: Initial specialist appointment.

• Your fertility specialist will review your medical history and all previous investigations & treatments.
• You and your partner should both attend your first appointment.
• We will advice some investigation reports related to choose treatment plan.

Step 2: Pretreatment counselling

• • You will meet again your fertility specialist.
  • According your report specialist confirm your treatment plan ,solve your any questions answered and  counseling you whole IVF process in details and you can discuss related to results, procedure, charges, diet, physical rest and any social issues.
  • We will give appointment when you have to come to start treatment now.

Step 3: Treatment begins

• • Your fertility specialist examine you and give hormones injection & other medicine to produce more eggs to increase fertilization rate & pregnancy rate.
  • We advice to freeze your husband seman sample.

Step 4: Treatment monitoring

• • Throughout your cycle your specialists measure size and number of your ovarian follicles by sonography.
  • This helps us determine the appropriate.

Step 5: Trigger injection

• • Once you have optimum number and sizes of follicles we plan your egg collection. You’ll have a trigger injection and after 36 to 38 hrs the minor operation for egg collection will occur.

Step 6: Egg collection in day surgery

• • Under light general anaestaesia ,egg collection using needle is under taken by sonography guidance .no need to any cut any part of body to collect egg. You have to stay in hospital from 4 to 6 hrs. You need 1 to 2 days normal rest at home.
  • At time of your egg collection your partner will need to provide a fresh semen(sperm) sample to fertilize your eggs.

Step 7: Egg fertilization

• • Collected eggs are taken to laboratory & prepare for fertilization.
  • In IVF prepared sperm and eggs are placed together in a dish when fertilization occurs.
  • In ICSI, an individual sperm is selected by a our highly experienced embryologist and under very delicate microscopic control, the egg is injected with this single sperm.

Step 8: Embryo development

• • Embryologist will examine the embyo to determine if fertilization has occurred or not.if fertilization occur recheck embyo to know about  development of embryos after 5-7 days.

Step 9: Freezing embryo

Step 10: Embryo transfer

• • After collection of eggs within 10 to 15 days you have to visit your doctor on 2nd or 3rd day of menses.
  • From 2nd/3rd menses. we start medicine related growth of uterus lining.
  • we transfer embryo around 14-17 days after menses.
  • After Embryo transfer , your specialist prescribe you other medicine to growth and nourish your embryo.

Step 11: Pregnancy test

• • Your nurse will organize an appointment for you to collect your blood at home side after embryo transfer.
  • If your pregnancy test is positive, we will arrange on ultrasound scan after a week.

• ICSI means Intracytoplasmic sperm injection.ICSI is recommened for couples who have been diagnosed with male infertility issues like low sperm count,low sperm morphology or motility and positive anti sperm antibody.
• Also used for couples who have experienced poor or no fertilisation rates using standard IVF.

We have the following donor facility :

1. Donor sperm:
   • Donor sperm is required in case of male partner has azoospermia or severe azoospermia or severe oligoastner spernia, ejaculatory dysfunction, and pt do not went to do IVF-ICSI ,significant genetic defect, in HIV infection.
   • We can use donor sperm for IUI or IVF-ICSI treatment.
2. Donor oocyte:
   • Donor oocyte is required in case of female partner has premature ovarian failure OR poor quality oocytes.
   • Latrogenic ovarian failure.
   • Menopause – Poor responders.
   • Risk of inheritable disease.
     • For using donor oocyte/donor female egg. we have to do IVF/IVF-ICSI treatment.
   • In which we extract donor oocyte/female egg from a donor female which fertilized by a male partner and transfer embryo in infertile female partner.
3. Donor embryo:
   • In some couples, a male has problems so we need to use donor sperm, and the female has problems so we need to use donor oocyte so we advise using donor embryo to couples.
   • We transfer Frozen donor embryo in infertile female uterus.

• Absent of uterus.
• Repeated miscarriages.
• Repeated implantation failure.
• Untreatable asherman syndrome.
• Medical condition which makes pregnancy life-threatening

In surrogacy, by doing IVF we use husband sperm to fertile wife oocyte and a frozen embryo is  transfer in surrogate female (third party)’s uterus who delivered the baby. This baby handover to the infertile couple legally.

1. Gonadotropin hormones injection therapy:
   • In a male, the case of hypogonadotropic hypogonadism is generally associated with low hormone(LH, testosterone).
   • In such a patient, the injection of hormone induces sperm production in the testis.
2. Reanastomosis surgery:
   • In a male, around 15% of all infertility has obstruction of the male genital tract tube system. So sperm production present in testis but no sperm are seen in semen.
   • In reanastomosis surgery, excision of obstruction & re-join tube each other.
   • Patient can conceive by ovulation induction or IUI treatment also.
3. Surgery for varicocele:
   • In which ligation of a blood vessel to prevent extra blood collection around testis so sperm motility increases.
4. Sperm extraction techniques:
   • In which sperm aspirated or extract from epididymis or testis by using a thin needle.
   • There is a different method for it like
     1. Microsurgical epididymal sperm aspiration(MESA)
     2. Percutaneous epididymal sperm aspiration(PESA)
     3. Testicular sperm aspiration(TESA)
     4. Testicular biopsy
   • This technique used in the case of azoospermia(ZERO sperm) to get a few motile sperm to do IVF-ICSI.

• Matulya IVF offers a fertility preservation service to protect and preserve your fertility for the future.
• This facility required who has a serious illness like cancer that will potentially risk damage to your eggs or sperm.
• Infertility preservation, we preserve oocyte (female egg), sperm, or embryo which can be used when pt wants by IVF treatments.