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    IVF Infertility Treatment India

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    24x7emarketing
    Rotunda - The Center for Human Reproduction is Ivf Clinic and fertility centre in Mumbai,India,Asia. We are state-of-the-art IVF laboratory which is Mumbai's first ISO 9001-2000 facility. We are Infertility, Fertility & IVF,Surrogacy Clinic for Male & Female in Mumbai,India. Our fertility center provides the best affordable quality infertility,fertility treatments with advanced reproductive technologies like IVF,ART, GIFT, ZIFT, TET, ICSI,donor egg,surrogate and surrogacy services for all nationalities,All couples including lesbian and gay couples and even single men and single women can avail this facility to fulfill their dream of enjoying parenthood. Rotunda -The Center For Human Reproduction offers a comprehensive range of infertility services under one roof, and we are known for our innovation, integrity, medical and technical excellence, personalized service, and consistent willingness to accept patients facing the most difficult medical challenges. Rotunda Clinic offers comprehensive IVF services: IVF, ICSI,GIFT,ZIFT,BET,IUI,ART Donor Egg IVF, Embryo Adoption, Surrogacy Embryo Retrieval through Puncture Overseas IVF Patient Program Gestational Surrogacy and Gestational Carrier ART Program Ovulation Induction and Monitoring Evaluation of male patient Intrauterine insemination Assisted Hatching Surgical Sperm Retrieval. Rotunda-The Center for Human Reproduction http://www.iwannagetpregnant.com [email protected] +91 22 2655 2000

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    IVF Infertility Treatment India

    Uploaded by

    24x7emarketing
    126 views26 pages
    Rotunda - The Center for Human Reproduction is Ivf Clinic and fertility centre in Mumbai,India,Asia. We are state-of-the-art IVF laboratory which is Mumbai's first ISO 9001-2000 facility. We are Infertility, Fertility & IVF,Surrogacy Clinic for Male & Female in Mumbai,India. Our fertility center provides the best affordable quality infertility,fertility treatments with advanced reproductive technologies like IVF,ART, GIFT, ZIFT, TET, ICSI,donor egg,surrogate and surrogacy services for all nationalities,All couples including lesbian and gay couples and even single men and single women can avail this facility to fulfill their dream of enjoying parenthood. Rotunda -The Center For Human Reproduction offers a comprehensive range of infertility services under one roof, and we are known for our innovation, integrity, medical and technical excellence, personalized service, and consistent willingness to accept patients facing the most difficult medical challenges. Rotunda Clinic offers comprehensive IVF services: IVF, ICSI,GIFT,ZIFT,BET,IUI,ART Donor Egg IVF, Embryo Adoption, Surrogacy Embryo Retrieval through Puncture Overseas IVF Patient Program Gestational Surrogacy and Gestational Carrier ART Program Ovulation Induction and Monitoring Evaluation of male patient Intrauterine insemination Assisted Hatching Surgical Sperm Retrieval. Rotunda-The Center for Human Reproduction http://www.iwannagetpregnant.com [email protected] +91 22 2655 2000

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    Rotunda - The Center for Human Reproduction is Ivf Clinic and fertility centre in Mumbai,India,Asia. We are state-of-the-art IVF laboratory which is Mumbai's first ISO 9001-2000 facility. We are Infertility, Fertility & IVF,Surrogacy Clinic for Male & Female in Mumbai,India. Our fertility center provides the best affordable quality infertility,fertility treatments with advanced reproductive technologies like IVF,ART, GIFT, ZIFT, TET, ICSI,donor egg,surrogate and surrogacy services for all nationalities,All couples including lesbian and gay couples and even single men and single women can avail this facility to fulfill their dream of enjoying parenthood. Rotunda -The Center For Human Reproduction offers a comprehensive range of infertility services under one roof, and we are known for our innovation, integrity, medical and technical excellence, personalized service, and consistent willingness to accept patients facing the most difficult medical challenges. Rotunda Clinic offers comprehensive IVF services: IVF, ICSI,GIFT,ZIFT,BET,IUI,ART Donor Egg IVF, Embryo Adoption, Surrogacy Embryo Retrieval through Puncture Overseas IVF Patient Program Gestational Surrogacy and Gestational Carrier ART Program Ovulation Induction and Monitoring Evaluation of male patient Intrauterine insemination Assisted Hatching Surgical Sperm Retrieval. Rotunda-The Center for Human Reproduction http://www.iwannagetpregnant.com [email protected] +91 22 2655 2000

    Copyright:

    Attribution Non-Commercial (BY-NC)
    126 views26 pages

    IVF Infertility Treatment India

    Uploaded by

    24x7emarketing
    Rotunda - The Center for Human Reproduction is Ivf Clinic and fertility centre in Mumbai,India,Asia. We are state-of-the-art IVF laboratory which is Mumbai's first ISO 9001-2000 facility. We are Infertility, Fertility & IVF,Surrogacy Clinic for Male & Female in Mumbai,India. Our fertility center provides the best affordable quality infertility,fertility treatments with advanced reproductive technologies like IVF,ART, GIFT, ZIFT, TET, ICSI,donor egg,surrogate and surrogacy services for all nationalities,All couples including lesbian and gay couples and even single men and single women can avail this facility to fulfill their dream of enjoying parenthood. Rotunda -The Center For Human Reproduction offers a comprehensive range of infertility services under one roof, and we are known for our innovation, integrity, medical and technical excellence, personalized service, and consistent willingness to accept patients facing the most difficult medical challenges. Rotunda Clinic offers comprehensive IVF services: IVF, ICSI,GIFT,ZIFT,BET,IUI,ART Donor Egg IVF, Embryo Adoption, Surrogacy Embryo Retrieval through Puncture Overseas IVF Patient Program Gestational Surrogacy and Gestational Carrier ART Program Ovulation Induction and Monitoring Evaluation of male patient Intrauterine insemination Assisted Hatching Surgical Sperm Retrieval. Rotunda-The Center for Human Reproduction http://www.iwannagetpregnant.com [email protected] +91 22 2655 2000

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    of 26

    Male and Female

    Infertility
    Goals

     Enhance comfort level with workup

     Basic Management Strategies

     TRICARE
    Coveragehttp://www.rotundaivf.com/
    Definition
     12 months of unprotected intercourse

     Earlier for certain historical factors

     Older than 35
    Infertility Etiology
    Female Factors
    Male Factors
    General Causes Meds
     Unknown: 40-50%  1° or 2°
    Hypogonadism
     1° Hypogonadism: 30-
    40%  Common medications
     Ketoconazole
     Altered Sperm Transport:
     Cimetidine
    10-20%
     Spironolactone
     2° Hypogonadism: 1-2%
    The Scenario
     Tech: “Husband and wife can’t get
    pregnant.”

     You: OB rotation was last infertility workup

     What now?
    Workup

     History is KEY

     Focused Physical Exam

     Labs and Specialized Tests


    Workup: History
     Coital Practices
     Gestational History
     PMHx/PSHx
     Meds
     Menstrual History
     Substances
     Recent High Fever
    Our Couple: History
    Female Male
     G1 P0010  No previous partner
    pregnancies
     No hx of STIs
     Gonorrhea hx
     Normal menses
     No meds
     Unprotected sex for 15
    months  Occasional EtOH
    Workup: Physical Exam
    Female Male
     Breast Formation  Infection
     Hernia
     Galactorrhea  Vas deferens
     Androgen deficiency
     Genitalia  Testicular mass
     Varicocele
     Hyperandrogenism?
    Workup: Labs
    Female Male
     Ovulation problems  CBC
     FSH, Testosterone
     Ovulatory Dysfunction  GC/Chlam, UA
     Renal and Liver
     Ovarian Reserve Function
     Semen analysis
     Postejaculatory
    urinalysis
    WHO Seminal Fluid
    Analysis (1999)
     Volume: >2ml
     Sperm concentration: >20 million/ml
     Total Sperm Number: >40 million/ejaculate
     Sperm Motility:
     >50% motile and/or
     >25% progressively motile

     Sperm Morphology: >14% normal forms


    Workup: Special Tests
    Female Male
     Transvaginal  Scrotal
    Ultrasonography (TVUS) Ultrasonography

     Hysterosalpingography
    (HSG)
     Transrectal
     Hysteroscopy Ultrasonography
    (TRUS)
     Laparoscopy
    Our Couple: Exam,
    Labs & Tests
     Normal male exam

     Normal initial labs

     Oligospermia on 2 separate semen


    analyses

     TRUS and postejaculatory UA normal


    Management: General
    Concepts
     41 different methods

     “Fertile window” intercourse

     “E-type” vaginal discharge

     Avoid lubricants and douches


    Management: Female
     Treat underlying cause

     Hyperprolactinemia

     PCOS

     Gonadotropin therapy
    Management: Female
     Ovulatory dysfunction (Unknown etiology)
     Clomiphene 50mg PO daily x 5 days
     Start on days 3-5

     Can increase to 100mg daily next cycle

     Results
     80% will ovulate
     Hyperstimulation and Twinning

     Higher-order multiples rare


    Management: Female
     Clomiphene Failure?

     IVF

     Injectable ovulation-inducing agents


    Management: Female
     Tubal/Pelvic/Uterine Issues
     Reparative Surgery (low success)
     IVF

     Endometriosis
     Laparoscopic ablation
     Laparotomy

     Ovulation induction +/- IUI and IVF


    Management: Male

     Hyperprolactinemia

     Surgical repair

     Fertility Specialist
    Stress and Infertility
     69% Women and 21% Men have
    preexisting condition

     Greater risk for psychological stress

     No significant difference in
    psychopathology
    Stress and Infertility
     Men have increased stress over time,
    same as women

     Watch for normal grief vs. psychopathology

     Same rates of depression as other chronic


    disease
    Stress and Infertility
     Bottom line: Not a means to improve
    pregnancy rates.
    Management: Our Couple

     Male: Imipramine Mar 08

     Pregnant inhttp://www.rotundaivf.com/
    June 2008!

     Separated from USAF in July 2008


    Questions?

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