10 Tips to Cope with Infertility Stress / How to Cope with Stress during Infertility Treatmen

Feeling stressed during infertility diagnosis and treatment is a natural response to a challenging life situation. The anxiety, however, can take a toll on a couple’s mental and physical health, causing further challenges to fertility treatment and outcomes.

In a previous post we discussed how stress can hinder fertility in both men and women. Furthermore, there is some evidence that extreme stress may negatively affect outcomes of ART (assisted reproductive therapies) in some individuals. Therefore, helping couples cope with stress is an indispensable aspect of fertility treatment at all Gaudium IVF centres.

In this article, the counsellors at MANTRANA - Gaudium’s unique counselling programme for couples undergoing infertility treatment - have compiled 10 useful tips to help you cope with infertility related stress. 

1. Acknowledge that you are stressed

The foremost step to relieving infertility stress is to stop evading the need for emotional support. When a couple is going through infertility problems, feeling stressed or frustrated is natural and should not be considered a sign of weakness. Apart from your own personal desire to have a baby, family expectations and societal pressure can take a toll on your mental well being.

Only when you take a moment to admit to yourself that stress may be affecting your physical and emotional health, will you be able to take concrete steps to do something about it.

2. be supportive of your partner

Because of the misplaced perceptions people have regarding infertility, it is often the female partner who receives brick bats for not being able to conceive. Ironically it is also the female who receives abundant support and empathy from loved ones.

Perhaps because men are conditioned to put up a brave front, they seldom seek emotional support or acknowledge the need for counselling.In reality, being diagnosed with infertility can cause extreme stress to the male partner. His self- esteem can take a hit and he may become withdrawn and distant in trying to deal with the situation. This is the time when both partners need to understand each other’s state of mind, be supportive of each other and not let infertility take a toll on the relationship.

3. Be receptive to help and support

Being diagnosed with infertility is emotionally taxing for a couple. While it is a time when you expect your partner to be your greatest emotional anchor, at times they may be too overwhelmed to offer you the love and support you need.

Confiding in a friend or a loved one can help you gain a new perspective and release some of the distress you may be feeling. Remember, you cannot deal with infertility in isolation. You may feel the urge to cut everyone out, but the love and support of those who care for you can make the journey a lot easier.

4. Look out for yourself

Infertility treatment can be a long and exhausting process. It needs your time and commitment. More importantly, it needs you to be in the right frame of mind, and you have every right to safeguard your mental and physical health. Allow yourself to disagree with insensitive remarks or unpleasant questions by inquisitive relatives and acquaintances.If being with children upsets you, avoid it for the time being, instead of beating yourself up for having such feelings. There will be days when, despite having an optimistic outlook, you can’t help feeling sad. Delegate responsibilities and claim your time and space to deal with the roller coaster of emotions you may be experiencing. Make your emotional well being a priority and be kind to yourself.

5. Releasing is empowering

While most times you may be concealing your emotions to protect your partner, do know that it is not abnormal for a person struggling with infertility to feel angry, hurtful, or scared. Allow yourself to release these feelings. Confront emotions instead of suppressing them.Cry if it makes you feel better; meditate if it makes you calmer. Do physical exercise to release physical and mental tension.

Share your feelings with your partner and encourage them to do the same. Don’t let simmering negative emotions keep you from giving your best to your fertility treatment.

6. Find ways to help yourself

Going through cycles of infertility treatment, waiting for results, and keeping your hopes up through it all can be strenuous. Find ways to help yourself cope better. If music makes you happy, make it a part of your every-day life. If its meeting with friends that has pulled you through rough times in the past, don’t avoid it now. Walking, meditation, yoga, reading, learning a new skill – the things that you never found the time for earlier – take practical steps to cope with stress.

Pull yourself up and it is sure to have a positive impact on other aspects of your life.

7. Learn about your condition

Global statistics indicate that one in every six couples worldwide faces some form of infertility. Ask your fertility doctor questions that can help you learn more about your condition and the treatment options available to you. Read up on infertility treatments and the possible outcomes. Learn about the lifestyle changes that can make a positive difference to your treatment. To assure yourself further, learn more about your fertility doctor and the infrastructure and services at your fertility clinic.

To avoid being misled, do make sure to consult only reliable and authentic sources of information.

8. Watch your diet

What we eat affects our mood.

It is possible that in dealing with the challenge at hand, you may be neglecting your general health. Poor eating and unhealthy binging can deplete you of energy and cause unwanted weight gain. While comfort foods may appear to ease your tension a little, they cause multiple health problems. Also, the chemicals in processed foods are best avoided particularly during this phase of your life.

Seek nutrition advice from your fertility clinic and follow your doctor’s instructions on healthy eating.
Mindful eating was never as important as it is now!

9. Plan ahead for the two-week wait

The two-week period between embryo transfer and pregnancy test results often tends to be the most difficult time for couples as they wait in anticipation for positive news. While it is normal to feel anxious or worried during this time, try and distract yourself and keep yourself busy.

10.Stay realistic

Last but not the least, expect the best but prepare yourself for all possible outcomes. Discuss the way forward with your partner and make genuine effort to not let infertility consume the other aspects of your life. Having a realistic approach and accepting that some things may be beyond your control helps. Understand that infertility is just one part of your life and not your entire life.

Developing the mind set to fight stress and anxiety is easier said than done. The support of family and friends can make the journey easier so don’t hesitate to reach out to those who care for you.

Need further guidance? Feel free to get in touch with our counsellors at MANTRANA, the country’s first ever comprehensive counselling programme to help couples cope with infertility related stress.

Email id.: info@gaudiumivfcentre.com Contact No. : 08527858585, 011-69413434

Male Infertility: Misconceptions, Causes and Solutions

In the last few decades, male infertility in India has been on a steady rise. At the international conference on Challenges in Infertility Management (CIIM) in 2014, experts observed that male infertility now contributes to 6 in 10 of all infertility cases in the country. In most cases, low sperm count is the underlying cause.

Being diagnosed with infertility can be particularly hard for a man to cope with. The ability to father a child is still believed to be a man’s greatest virtue, and failure to do so can leave him feeling heartbroken, even depressed.

Since a large number of men avoid discussing the issue openly, male infertility is often confused with impotence. While impotence means the inability to attain or sustain an erection during sexual activity, infertility is the inability to have a child, often caused by problems with sperm production. Thus, a man can be sexually active and yet be infertile.

Unlike impotence, male infertility may present no physical symptoms, and therefore can go undiagnosed for a long time.

Causes of Male Infertility

Sperm related problems are identified as the main cause of male infertility worldwide, and may be classified as follows:

-          Oligospermia: The number of healthy sperm produced is abnormally low (less than 20 million/ml).

-          Azoospermia: No sperm is produced at all.

-          Asthenospermia: Poor sperm motility. Motility is the ability of the sperm to swim and move forward in a straight line through the female reproductive system to reach the oocyte (the egg).

-          Abnormal sperm morphology: When a sperm has abnormal shape, size or structure, it cannot fertilize the egg.

These anomalies are detected through a detailed semen analysis, which is the first step in the treatment of male infertility. Semen analysis is preceded by a thorough physical examination of the male partner and complete medical history of both partners.

Based on the findings of the semen analysis, further investigation is undertaken to determine the root cause of the problem.

Factors which may inhibit sperm production and healthy functioning of the male reproductive system include:

·         Varicocele, a condition marked by enlargement of veins present in the scrotum, the sac that holds the testicles.

·         STDs (sexually transmitted diseases) can cause scarring of the male reproductive organs and obstruct sperm production and movement.

·         Viral infections such as smallpox and mumps and diseases such as tuberculosis, prostatitis, liver disease and renal disease also impact sperm production.

·         Alcohol, smoking and drug abuse are known causes of male infertility.

·         Genetic disorders, structural abnormalities or birth defects in the male reproductive organs can impair reproduction.

·         Hormonal imbalance such as low levels of testosterone may alter sperm production.

·         Exposure to heavy metals, toxins, chemicals or medications can affect sperm function.

·         Aging affects sperm production, motility and quality.

·         Excessive stress. In a recent article, we discussed how stress can impact the natural reproduction process click here

·         Some studies link poor sperm production to non-medical factors such as poor lifestyle, unhealthy diet, increased consumption of processed foods, and the burgeoning trend of late marriage. For example, obesity is known to alter hormonal levels, which in turn affects sperm production.

Challenges in treating Male Factor Infertility in India

Social Challenges

•        Social stigma attached to male infertility discourages men from confronting the problem and seeking treatment.

•        Most people believe that infertility clinics treat only female infertility.

•        Impotence is often mistaken for infertility, leading men to resort to alternative treatments such as herbal products to improve sexual performance.

•        Most couples delay treatment assuming the problem would resolve itself over time, which only worsens the situation.

Medical Challenges

•        Delayed treatment of male infertility reduces the chances of successful conception.

•        As male infertility is still largely misunderstood, many infertility treatment centres still rely on conventional treatment via medicines and injectables. In severe male infertility, such treatments often prove futile.

•        Driven by the desperation to conceive, patients tend to pressurise the fertility doctor to prescribe magic pills to improve sperm count. Unnecessary medication causes delay in appropriate treatment of the root cause.

Male Infertility Treatments Gaudium

Gaudium IVF centre employs advanced technologies to treat both male and female infertility. Whenever necessary, treatment for male factor infertility is combined with women’s infertility treatments such as IUI (intra-uterine insemination), IVF (in vitro fertilization), ICSI (intracytoplasmic sperm injection) and GIFT (gamete intra-fallopian transfer).

In such cases, both partners undergo simultaneous procedures where high quality sperm are selected, prepared and combined with the female egg for fertilization. Fertilization may occur in a lab dish (IVF/ICSI) or in the womb (IUI).

IUI (Intrauterine Insemination)

IUI is a simple and cost-effective treatment beneficial for men with mild male factor infertility. In IUI, the semen obtained from the male is ‘washed’ to remove seminal fluid and any dead sperm. The healthy sperm thus obtained are placed into the woman’s uterus using a thin tube called a catheter. The procedure is timed to coincide with the woman’s ovulation.

For IUI to be successful, it is first ensured that the woman’s fallopian tubes are free of blockage.

TESA (Testicular Sperm Aspiration)

In case of nil sperm, TESA-ICSI is known to be the one of the most effective treatments in helping couples conceive. As no sperm is present in the ejaculated semen, a small needle is used to collect a small piece of tissue from the testes.

The sperm retrieved from the tissue is ‘prepared’ and injected directly into the egg retrieved from the female’s ovary. This procedure is known as ICSI which is an advanced form of the conventional IVF treatment.

ICSI is particularly beneficial for men with low sperm count as injecting high quality sperm directly into the egg maximizes the chances of successful fertilization.

Learn more about ICSI

A noteworthy example is of a 31-year-old Gaudium patient who reported to us with nil sperm in the semen sample. The couple had been married for more than nine years and were trying to have a baby for the past five years. Gaudium fertility specialists counselled the couple about TESA-ICSI. The wife underwent IVF and on the day of the egg-retrieval, TESA was done for the husband. After successful fertilization in the lab, embryo transfer was performed through ICSI. The patient conceived and delivered a healthy baby in the very first attempt.

PESA (Percutaneous Epididymal Sperm Aspiration)

This is a simple technique often combined with ICSI. PESA is performed for men who have a blockage in the vas deferens (the tube that transports sperm from the testicle to the urethra).

The procedure of sperm aspiration is similar to that of TESA; the only difference is that the seminal fluid is collected from the vas deferens instead of the testes. This is followed by ICSI procedure as explained above.

Medication

Sperm production is affected by the levels of the hormones testosterone and estrogenin the body. In such cases where hormonal imbalance is detected, medication may be prescribed to restore normal hormone levels.

Surgery

Some men require surgery to remove a blockage that may be affecting production or release of the sperm.  Common surgeries for this purpose include varicocelectomy, epididymovasostomy and vasovasostomy (vasectomy reversal).

Donor Sperm

In a rare case when male infertility is found to be incurable, couples may choose to use donor sperm to achieve pregnancy.  As the sperm is in frozen state, it is first thawed and then implanted into the uterus using IUI.

Today several treatment alternatives are available for men diagnosed with male infertility. Gaudium infertility specialists have successfully treated mild-to-severe male factor infertility for thousands of couples. Since 2009, Gaudium Infertility Clinic has assisted more than 6,000 couples have a child of their own.

For a consultation with Dr. Manika Khanna, India’s leading infertility specialist, please click here.

Infertility Treatment: Are You Being Taken for a Ride?

With infertility in both men and women on the rise, there has been an influx of infertility treatment centres and IVF clinics all over the country.

In the past decade, ART (assisted reproductive technology) has witnessed several breakthroughs which make infertility treatments such as IVF more patient-friendly and also greatly affect success rates.Unfortunately, not all fertility clinics have the resources or the expertise to pass on the benefits of these latest advances to their patients.As a result, thousands of unsuspecting childless couples pay for sub-par treatment at mediocre infertility clinics that still use conventional equipment and/or procedures.

The purpose of this blog post is to help safeguard the best interests of childless individuals contemplating fertility treatment.

How to choose your fertility clinic

Choosing your fertility clinic can be a daunting task, and many people tend to go by recommendations from family and friends. Referrals are good, however choosing where you go for treatment should be a decision based on information rather than just plain recommendation. Do thorough research; learn more about the doctors on panel, the infrastructure, services offered and the facilities provided at the clinic.  Look for an experienced fertility specialist with a credible track record.

Once you have shortlisted a clinic, enquire if they are equipped to provide the latest infertility treatments. For example, many IVF clinics in India still use the conventional IVF treatment methods which involve prolonged treatment with injectables. The latest advances in IVF have made the treatment mush less painful for patients. This technology, adopted by Gaudium IVF many years back, involves only 8-9 days of injectables with minimal risk of hyper-stimulation of the ovaries.

To be sure of your decision, here is a list of questions to consider when selecting your fertility clinic:

• Is the clinic registered with the relevant Government body?
• What are the procedures offered at the clinic?
• What is the fertility specialist’s qualification and experience?
• Does the clinic treat male infertility?
• What are the treatments available for male infertility?
• What is the clinic’s cumulative success rate?
• What is the success rate of the treatment suggested for you?
• What is the number of live births or take-home baby rate?
• What is their success rate with previously failed IVF?
• Does the clinic perform blastocyst-stage transfer (embryo transfer on day 5 or 6 of fertilization, which is known to improve chances of pregnancy)?
• Is the centre equipped with the latest state-of-the-art lab and equipment?
• Does the clinic perform oocyte freezing and embryo freezing? If yes, do they follow the conventional slow-freezing method or the new Vitrification method?
• Are there provisions to provide psychological counselling if required?
• What is the estimated cost of your treatment plan and what will it include?
• Is the clinic known to provide personalised patient care?

Once you are satisfied that you have made the right choice, schedule an appointment with the fertility specialist.  Expect to be asked a range of questions surrounding your general health and detailed medical history. This would be likely accompanied by a physical examination, and an ultrasound of the uterus and the ovaries. A semen analysis may be ordered for the male partner.

Steer clear of a clinic where elaborate treatment plans are suggested without first obtaining your medical history. Ask why the recommended treatment is best suited for you and what other alternatives are available. [Here we must add that it is the patient’s duty to share all pertinent information necessary for the doctor to make an accurate diagnosis.]

Following this, your doctor may advise further tests to confirm the preliminary diagnosis. At this point, you may find yourself wondering, “Why has the good doctor prescribed so many tests?”. The best way to resolve your concerns is to not feel intimidated by the complex medical jargon, and ask your doctor to explain what each test means and why it is needed.

Doctors understand your concerns, and in most cases, you will get these answers without asking.

Once your doctor recommends a line of treatment, seek to learn more about it. Knowing what you are getting into brings a sense of control, reduces anxiety and boosts patient-doctor trust

Avoid miracle cures

Avoid infertility treatment ‘centres’ offering miracle cures and 100 percent success with pregnancy. Infertility is not something you can treat or cure with pills from the local pharmacist, or by trying remedies suggested by the local quack.It needs proper diagnosis and timely treatment by an experienced fertility doctor. Men, in particular, should not resort to ‘miracle cures’ to increase sperm count or to treat erectile dysfunction.

Taking a second opinion

Infertility treatment can be a long and exhausting process for couples, and you may reach a juncture when you or your partner feels the need to get a second opinion. If you strongly feel that you could use another expert viewpoint, consult a reputed fertility specialist to get a fresh perspective of things.

In the end, it’s important that the clinic you have chosen is a reputable organization known to function with integrity and transparency, and a team of doctors who have your best interests at heart.

Have a question? Consult Dr.Manika Khanna for a Free Second Opinion.

Modern advance treatment to conceive a baby

IVF, IUI and ICSI: What is the Difference?

IVF, IUI and ICSI are various forms of infertility treatments or assisted reproductive techniques (ART). Unlike IVF, IUI does not always involve administration of fertility medication, hence considered a more ‘natural’ fertility treatment. ICSI is a modification of the standard IVF procedure undertaken in cases of severe male infertility.

This article provides simplified information which will help you understand the basic differences between the three:

IUI (Intrauterine Insemination)

IUI is a cost-effective fertility treatment in which healthy sperm retrieved from the male partner is manually planted inside a woman’s uterine cavity around the time of ovulation. For many patients seeking infertility treatment, non-medicated or natural cycle IUI is often the first recourse recommended by doctors. Placing the sperm directly into the uterus helps increase the chances of fertilization and may benefit a couple in cases where:

• the woman has problems with ovulation or has polycystic ovaries
• the woman has cervical mucus hostility – when the mucus or fluid produced by the woman’s cervix is thick and sticky, making it difficult for the sperm to reach the egg for fertilization
• there is mild male-factor infertility
• the male partner has problems with ejaculation
• there is unexplained infertility – when the cause of infertility cannot be determined despite detailed investigation
• for same-sex couples or single women who wish to use donor sperm to get pregnant

Performing IUI requires that the woman’s Fallopian tubes are healthy and free of any blockage which may be confirmed through a laparoscopy.  Some patients, for example women who have ovulation problems, may need to be given fertility medication to stimulate the ovaries. This is known as stimulated cycle IUI.

During an IUI, the menstrual cycle is closely monitored to ascertain the time of ovulation as the insemination must be done within 36-40 hours of ovulation. On the day of the IUI procedure, the male partner provides a semen sample from which motile or fast-moving sperm is extracted and prepared for insemination. The process of sperm injection takes about 10 minutes and is usually painless.

Thus, a standard IUI cycle, from ovulation induction to sperm implantation, involves the following steps:

• Ovulation induction (only in Stimulated Cycle IUI)
• Sperm retrieval and preparation
• Insemination of sperm into the womb
• Pregnancy test after two weeks

IVF (In vitro Fertilization)

IVF is essentially the process of facilitating fertilization of a female egg by a male sperm outside of the human body. Most IVF cycles involve fertilization of multiple eggs to improve chances of success.

A complete IVF cycle takes up to 4-6 weeks, beginning with ovarian stimulation wherein the female is given medication to promote the growth of egg containing follicles. Just like in an IUI cycle, the entire process – from ovarian stimulation to egg release – is closely supervised by the fertility doctor through ultrasounds, blood tests and medication.

Once ready for retrieval, mature eggs are removed from the ovaries and simultaneously a sperm sample is obtained from the male partner. This is followed by selection and preparation of the better quality egg and sperm for fertilization in a glass dish.

The dish is then placed in an incubator which provides an environment conducive to fertilization. Once fertilized, the embryo is allowed to grow for another 2-5 days. The embryo selected for transfer is then planted into the female’s uterus or Fallopian tube with the help of a thin tube called a catheter. Embryo transfer may be done either three or five days after fertilization. The extra embryos, if any, may be frozen for future use.

To summarize, a standard IVF cycle involves the following steps:

• Ovarian stimulation
• Egg retrieval and selection
• Sperm retrieval and preparation
• Fertilization
• Embryo culture (embryo development)
• Embryo transfer
• Pregnancy test after two weeks of ET

ICSI (Intracytoplasmic Sperm Injection)

ICSI is a specialized form of in vitro fertilization and is one of the most frequently practiced treatments for severe male-factor infertility.

Unlike in IVF where the oocyte and the sperm are allowed to fertilize on their own, ICSI goes a step further wherein your embryologist injects a single high quality sperm into a mature female egg (oocyte). The procedure, also known as insemination, is usually performed for more than one oocyte.

The egg retrieval from the female and sperm collection from the male partner are usually done on the day of the procedure. If the male partner is unable to provide a fresh semen sample, sperm may be retrieved surgically from a testicle. Your embryologist then separates high-quality sperm, ‘washes’ or treats them for insemination and injects a single sperm into each egg. This is followed by embryo culture and embryo implantation as previously explained under IVF.

A complete ICSI cycle takes between 4 and 6 weeks. ICSI is particularly beneficial in the following situations:

• severe male-factor infertility indicated by very low sperm count or nil sperm
• when the male is producing healthy sperm but is unable to ejaculate due to a physical obstruction or erectile dysfunction
• if the couple is unable to have sexual intercourse for biological or medical reasons, or
• for couples using donor sperm

A typical ICSI cycle involves the following stages:

• Ovarian stimulation
• Egg retrieval and selection
• Sperm retrieval and preparation
• Sperm injection
• Fertilization
• Embryo culture
• Embryo transfer
• Pregnancy test after two weeks of ET

The success rates of ICSI are similar to those of IVF. ICSI is usually recommended to couples with severe male infertility; however some clinics prefer doing ICSI even when the male’s sperm count is normal. Selection of a fertility treatment method depends on a number of factors such as the age of the female partner, cause of female infertility, level and cause of male infertility, past ART history etc. Only when your fertility specialist has done a detailed analysis of your condition should they be able to recommend treatment options best suited for your case.

If you have more questions or need further guidance regarding selection of fertility treatment, feel free to consult Dr. Manika Khanna for a free second opinion.

Couples going through infertility treatment may sometimes feel overwhelmed with having to go through a number of tests, particularly at the time of diagnosis. Given that some clinics do mislead unsuspecting patients and advise unnecessary tests, it is not unusual for a patient to be apprehensive about the necessity of all the tests recommended by their doctor.

Diagnosing infertility can be a complex process. Once your fertility doctor has learned your in-depth medical history, the next step is to prescribe diagnostic tests to determine the root cause of infertility.

At Gaudium Fertility Clinic, we encourage our patients to ask questions and discuss every concern they might have regarding the diagnosis and treatment process. Having dealt with thousands of patients from all walks of life, our experts believe that the best way to calm patients’ anxiety is by maintaining transparency and by providing patients with information which makes them feel informed and in control.

As a general protocol, for most infertility patients the less invasive and less expensive tests are recommended first, and not every patient needs to undergo extensive testing.A credible fertility specialist would not recommend lab tests without an in-depth evaluation of your condition. If your doctor appears eager to prescribe tests or medication in the very first meeting without obtaining your detailed medical, sexual and reproductive history, it is not a good sign.

To give you a fair idea of what to expect, shared below is a list of tests your doctor may suggest during infertility assessment.

Infertility Diagnosis and Testing for Women

Expect your doctor to ask questions regarding your menstrual cycle, history of past pregnancies, sexual health, past illness, surgery, medication etc. This would be followed by further testing to ascertain the cause of infertility:

Stage I

• Physical examination including pelvic examination to rule out genital infections
• Ovulation test to check any problems with the monthly egg release (ovulation)
• Blood tests to check estrogen and testosterone levels
• Ultrasound to check for ovarian cysts and fibroids
• Blood tests for thyroid, hepatitis, HIV and any chronic illness
• FSH level test to detect blood levels of the follicle stimulating hormone secreted by the pituitary gland. This hormone regulates the production of estrogen and progesterone, and is responsible for the growth of eggs in the ovaries. The test is carried out on the third day of your period.

Based on the results of preliminary testing, your fertility doctor may recommend one or more of the following tests to confirm the diagnosis made so far.

Stage II

• Laparoscopy: Helps detect endometriosis, a condition where the tissue lining the uterus develops outside the uterus causing heavy periods and problems with fertility.
• HSG (Hysterosalpingogram): X-ray to check uterine health and detect any blockage in the fallopian tubes.
• Hysteroscopy: Conducted if the HSG indicates abnormalities in the uterus or fallopian tubes. Allows your doctor to take photos of the damaged areas.
• Endometrial biopsy: A small amount of tissue is taken from the uterine lining (endometrium) to detect abnormalities which could affect implantation of a fertilized egg.

The collective results of the above tests would help your doctor determine the line of treatment best suited for you.

Infertility Diagnosis and Testing for Men

Stage I

• Initial assessment through detailed medicaland reproductive history
• Physical examination to detect genital abnormalities and infections
• Complete Semen Analysis to detect problems with sperm count (number of live sperm cells per milliliter of semen), sperm movement (motility) or abnormalities in sperm shape (morphology)

If the results of semen analysis are normal, your doctor may order more tests for the female partner.If, however,the semen analysis report indicates problems with semen production and/or quality, the male would be required to undergo further investigation.

Stage II

• Blood tests to check hormone levels (testosterone and other hormones which affect fertility)
• Scrotal ultrasound to detect blockage in the testicles and surrounding area which could be obstructing semen flow
• Transrectal Ultrasound to check prostate health and detect any blockage in the ejaculatory ducts
• Extensive sperm function tests which may be undertaken if, after unfavorable sperm analysis, your doctor needs to further investigate the behavior of your sperm post- ejaculation
• Testicular biopsy wherein a small sample of testicular tissue is removed and tested to check any problems with sperm production

In certain cases where the above testing fails to indicate the underlying cause of male infertility, genetic testing may be recommended to test for genetic disorders.

Unnecessary testing by some (mediocre)fertility clinics leads to mistrust and frustration in patients, and gives a bad name to the noble vocation of a fertility doctor. At Gaudium IVF Centre we believe it the patients’ right and the doctor’s duty to explain why a particular test or procedure may be indispensable to a particular treatment protocol.

If you have an unanswered question about your infertility diagnosis, feel free to consult Dr. Manika Khanna for a free second opinion

.

Email id.:  info@gaudiumivfcentre.com   Contact No. : 08527858585, 011-69413434

All You Need to Know about Embryo Freezing – 10 Frequently Asked Questions

When a woman undergoes an IVF cycle, she is given fertility medication to induce her ovaries to release multiple eggs at a time. This is done with the objective of developing more than one embryo so that the best ones may be selected for transfer to her uterus to facilitate pregnancy.

Since not all embryos cultivated during an IVF cycle get utilized, some couples may have surplus embryos which may be frozen and stored for future use.The number of good quality embryos available for freezing varies from patient to patient and largely depends on the female’s age at the time of IVF.

Many IVF patients today opt for embryo freezing for various reasons – to avoid going through another cycle of super ovulation and embryo culture in case the first one is unsuccessful, or to be able to have a second child later in life. Some couples opt for embryo freezing in their fertile years to get pregnant in the later years when their natural fertility would have declined due to age.

With state-of-the-art infrastructure in infertility solutions and sophisticated embryo freezing facilities,Gaudium Infertility and Surrogacy Clinic has emerged as a pioneer in embryo freezing in India. With best IVF centre of India acclamation from last two years in a row made Gaudium IVF centre as a leader in ART techniques.

In this blog post, we have compiled a list of ten questions about Embryo Freezing frequently asked by our patients, along with responses from our fertility specialists.

What is Embryo Freezing?

An embryo is created when an egg (oocyte) from the female is fertilized by sperm from the male partner. In IVF this fertilization takes place in a laboratory under the careful supervision of an embryologist who selects high quality eggs and sperm for best results.

Once embryo culture is complete, your fertility doctor selects the best quality embryos to be placed in the uterus through a process known as embryo transfer (ET). The patient may then decide to preserve the surplus embryos through embryo freezing.

Embryo freezing, also known as Cryopreservation, is a process where the unused embryos are frozen and preserved in liquid nitrogen for future use. Only the strongest embryos are selected for freezing.

What does the process entail?

The embryos are cooled to very low temperature (-196°C) using sophisticated freezing apparatus. The frozen embryos are then safely stored in liquid nitrogen. There are two methods of embryo freezing:

• Slow freezing method – a cumbersome technique being phased out slowly as it results in the formation of ice crystals that can severely damage the embryo.
• Vitrification or ultra-rapid freezing

Gaudium uses the Vitrification method to freeze embryos and oocytes (eggs). This process enables your embryologist to freeze embryos at such a fast speed that there is no time for ice crystals to form.  The entire process takes only about ten minutes.

Thus, compared to the conventional slow freezing method, Vitrification allows for higher embryo survival and implantation rates as it protects the embryos against damage by ice crystals.

Furthermore, Gaudium IVF Centre prefers to freeze blastocyst stage embryos. Blastocysts are embryos that have developed for five or six days, andfrozen blastocysts have displayed better post-thaw survival and pregnancy rates.

What is the purpose of Embryo Freezing?

Embryo freezing may be done to preserve surplus embryos for a future pregnancy.

The process also makes the pregnancy ‘age-proof’ to an extent. For example, a couple in their late 20s or early 30s may opt for embryo freezing to facilitate conception in the later years.

How is a frozen embryo used?

The embryo is first thawed to reach a temperature optimal forembryo transfer (ET).  The process of frozen embryo transfer (FET) remains the same as in the case of a fresh embryo transfer.

In fact, for many patients FET turns out to be a more ‘natural’ procedure since the embryo transfer is made to coincide with the woman’s natural cycle, eliminating the need for fertility medication.

However,women with irregular periods may need to be given estrogens and progesterone to prepare the uterus for implantation.

What is the success rate of pregnancy through frozen embryo transfer?

Pregnancy rates from frozen embryos are similar to those achieved from non-frozen embryos.  About 70% of frozen embryos are known to survive the thawing process, and FET is more cost effective than going through a new IVF cycle.

Frozen embryos are suspended in time, i.e. they do not age. Thus it is the woman’s age at the time of embryo freezing that impacts the quality of the embryos created, and not her age at the time of frozen embryo transfer (FET).

What are the benefits of a Frozen Embryo Transfer compared to a fresh IVF cycle?

For couples who have had a previously failed IVF cycle or those who want to have a second child, frozen embryo transfer offers the following advantages over a fresh treatment cycle:

-          Lower costs as there is no need for ovulation induction, egg retrieval and fertilization

-          Fewer medicines as the patient need only take hormonal medication to prepare the uterus for implantation

-          A viable solution for couples who want to be safeguarded against age-related fertility problems.

Are there any risks associated with Embryo Freezing?

In the conventional embryo freezing method used in some clinics, there is a risk of the formation of ice crystals which can damage the embryo. If you are considering embryo freezing, do check with your fertility clinic about the freezing methods they use, their frozen embryo transfer success rates, and the associated costs.

Patients also need to know that not all frozen embryos may survive the process of thawing, even if everything is done procedurally as the process requires skill and experience.

What if my embryos get mixed up with another’s during storage?

This is a common apprehension in patients due to the lack of information and discussion about how embryo freezing and storage really works.

Embryo storage is a highly specialized procedure carried out by experienced professionals. The frozen embryos are stored in a state-of-the-art computerized storage facility with round-the-clock surveillance.

The freezing procedure itself is done by an experienced senior embryologist in the presence of a medical team comprising of another embryologist, a laboratory staff and a nurse. The frozen embryos are carefully labelled with patient details (full name, date of birth, date of freezing) and catalogued, and the entire process involves multiple checks by the witnessing team to eliminate human error. The storage records are maintained at two locations for future cross reference.

Every procedure at a reputable fertility clinic is performed under strict adherence to protocol and double-checked at every step. At Gaudium, your embryos are in safe hands and there is absolutely no risk of them getting mixed up with another patient’s.

Do frozen embryos have a use-by date?

If stored properly, frozen embryos remain usable for an infinite amount of time. This means they can be used even 10, 15 or 20 years later.

Also, frozen embryos can be transported cross-country and even from overseas using specialized equipment. At Gaudium, we accept frozen embryos from other locations, including from overseas patients who wish to have a child through an Indian surrogate.

What if I decide later that I do not wish to ever use my frozen embryo(s)?

Storage of frozen embryos entails a yearly fee. You can at any time choose to terminate the storage. Disposing the unused embryos can be a difficult decision and may be taken after due consideration by both partners.

Have more questions about embryo freezing? Our fertility team would be happy to assist you.

Phone no. -08527858585, 011-69413434, Email id-info@gaudiumivfcentre.com