Do Milder IVF stimulation techniques mark the end of conventional IVF procedures?

Introduction and improvement in IVF techniques have increased the chances of women with infertility issues to conceive. Milder Stimulation protocols in IVF are now gaining increasing popularity, given the belief that they are safer and have more chances of success than conventional IVF methods in selected patient groups.

Aster IVF & Women Clinic is the only fertility clinic in UAE to efficiently perform both conventional and minimal stimulation IVF techniques. Mild stimulation IVF or Aster’s IVF Lite is a new and improved technique that can be used to help women get pregnant with minimal risks. Conventional IVF and IVF Lite are forms of ART (Assisted reproductive technology).

IVF is a procedure in which the egg and sperm are fertilised outside the body in a laboratory dish and the embryo is later transferred into the uterus. With IVF a woman is stimulated with fertility injections or hormone treatments to control egg production. These fertility injections are usually high dosage injections and are high stimulants which cause the woman to produce multiple eggs. Conventional IVF techniques have certain side-effects, the major ones being the risk of causing OHSS (Ovarian Hyper Stimulation Syndrome) and risk of multiple births. Multiple births is a pregnancy problem that causes certain complications like increased chances of pre-term births, chances of having a C-section, miscarriages, baby being born with birth defects/ genetic disorders etc. Multiple pregnancies conceived by assisted reproductive technology poses a greater risk of pregnancy problems.

OHSS occurs in certain susceptible women taking hormonal injections to stimulate the production of eggs, where the ovaries over react and produce an excess number of eggs. Mild cases of OHSS can be managed with conservative measures but extreme cases may even lead to the death of the patient. These complications occur in very few woman and there are ways of preventing them.

Conventional IVF methods have been used for a long period of time and have had success rates as well. Now with the presence of an improved technique of ART called IVF Lite, more and more couples tend to prefer this technique over the conventional one.

IVF Lite or minimal stimulation technique is a simpler treatment method that Aster IVF & Women Clinic provides to make the process of ART less invasive for women. IVF Lite involves oral fertility medications instead of fertility injections leading to milder stimulation with better quality eggs. It is often said that the older a woman, lesser are her chances of conceiving which is true because, with age, a woman’s ovarian reserve becomes less. This belief holds true in today’s time and age where couples wish to grow professionally and are completely financially sound before having a baby. Even IVF success rates drop after women cross the age of 40. IVF Lite is a technique that helps couples increase their chances of getting pregnant even after a designated age. IVF Lite technique can be used to treat women who wish to get pregnant even after the age of 40 and Aster IVF & Women Clinic has been successfully treating women over 40 with the low ovarian reserve with this method. IVF Lite technique can be used to treat women who have had failed prior IVF attempts, poor and hyper responders and women with endometriosis.

Dr. Gautam Allahbadia, IVF Consultant and Head of Aster IVF & Women Clinic states that “Infertility is a major issue in this region and the number of women seeking infertility treatment only seems to be increasing. A common issue faced here is that couples delay their pregnancy due to various reasons and also delay in seeking medical help. They consult a specialist only years after unsuccessful attempts at being pregnant. Age, health complications like PCOS, obesity are all reasons of infertility and IVF success rates drop drastically after a certain point. Age is surely a reason to cause infertility, but it is a misconception that this issue is seen only in older women. At Aster IVF & Women Clinic we have seen patients below the age of 25 with fertility issues. Of late easier and less expensive fertility treatment techniques have greater demand because of its advantages. IVF Lite is one technique of ART, which was originally introduced to treat women with low ovarian reserve but in the recent past, it has shown to have positive results in women over 40 as well, which a great advantage in today’s age is given the changing ideologies and lifestyle preferences.”

Mild ovarian stimulation method or IVF Lite has a great number of advantages over conventional IVF techniques including fewer medications, safer and with quality eggs. IVF Lite is also a feasible choice for couples who chose the cost-effective technique. IVF Lite also presents very favourable pregnancies in women who are over the age of 40 and those who have had previous unsuccessful IVF attempts.

Experts recommend IVF Lite as a new approach for women who are poor or hyper responders, suffer from endometriosis, have previous unexplained IVF failures or are over 37 years old. Aster IVF & Women Clinic offers IVF Lite as a safer and patient friendly alternative to conventional IVF treatments.

 

 

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Frequently Asked Questions About IVF Lite

Did you know? In IVT treatments, gonadotropin injections are used to stimulate the ovaries to increase the number of available eggs. But unfortunately, conventional IVF protocols can be expensive, inconvenient and are often associated with uncomfortable side effects.

That’s why at Aster IVF, we’re offering IVF Lite, a.k.a. Minimal Stimulation IVF, which has regained favour due to the realisation that it is associated with fewer side effects, incurs a lower risk of ovarian hyperstimulation syndrome (OHSS), has a lower cost and good success rates! Aster IVF offers IVF Lite as a cost-effective and safer alternative to the standard IVF program.

What is IVF Lite?
IVF Lite involves a soft stimulation protocol with the lesser amount of fertility drugs. When combined with Egg Accumulation using the Cryotech Vitrification Technology (ACCU-VIT), it provides a very efficient and cost-effective alternative to conventional IVF.  It is designed to retrieve only a few eggs in each ovarian stimulation cycle. Stimulation in this manner has been associated with better quality eggs and hence better quality embryos. In other words, it is a simpler treatment schedule with lower doses of drugs, fewer risks (from Multiple Pregnancy and Over-stimulation) and consequently reduced cost.

IVF Lite goes easy on your ovaries and easier on your finances.

What is Cryotech Vitrification and can you tell me more about ACCU-VIT?
Cryotech Vitrification technique has overtaken the conventional slow freezing technique. The eggs to be frozen are placed in a very small volume of vitrification medium, which is then cooled at an extreme rate so that the eggs are flash frozen and preserved intact. Survival rates after vitrification & thawing and subsequent pregnancy rates are much better than they were with conventional slow freezing.

In the IVF Lite protocol, one or more Minimal Stimulation IVF cycles are carried out and all the resulting eggs are frozen using the Cryotech Vitrification technique to accumulate a sufficient number of eggs (ACCU-VIT) for a remote PGS (if indicated) and frozen thawed embryo transfer. In cost-conscious environments, IVF Lite is the only type of IVF that is going to be the future.

What does the Minimal Stimulation IVF procedure involve?
Instead of the high doses of fertility injections used in conventional IVF cycles, Clomiphene Citrate tablets, a low dose of fertility injections (Gonadotropins) and GnRH Antagonist injections are used in the softer IVF Lite stimulation protocol. Egg retrieval is planned 34-36 hours after the hCG trigger. All retrieved eggs are frozen and in a subsequently chosen month, the endometrium is prepared using estrogen tablets to increase implantation rates. In this month the eggs are thawed and fertilised with husband’s sperm and an Embryo Transfer is planned in this remote cycle.

Am I a suitable candidate for IVF Lite?
Today we can offer IVF Lite to almost everyone requiring IVF. The groups which traditionally benefitted from minimal stimulation IVF are Poor Responders, Older Patients (above age 40), women with multiple previous conventional IVF Failures and Hyper-responders (like patients with PCOS who go repeatedly into Ovarian Hyperstimulation). Today, because of the cost advantages & much higher success rates,  we have extended the indications of IVF Lite to all patients requiring IVF/ ICSI. If IVF LiteTM sounds appealing to you, discuss with your Fertility Physician at Aster IVF whether it is suitable for you.

What are the Advantages?
With IVF Lite, painful and expensive injections of conventional IVF in the initial part of the cycle are substituted by inexpensive oral medications. Lesser injections improve patient compliance. IVF Lite decreases the number of visits to the clinic so that there is very little interference with work schedules and other regular commitments.

IVF Lite gives rise to more number of Euploid eggs and Embryos on PGS leading to higher pregnancy rates in women with low AMH.

IVF Lite gives Pregnancy Rates (PRs) comparable to conventional IVF in patients with a normal Ovarian Reserve and PRs better than conventional IVF in Older Patients, patients with previous conventional IVF Failures, Poor Responders & Hyper-responders.

IVF Lite means a simpler treatment schedule, a lower drug dose, a good outcome, fewer risks (from Multiple Pregnancy & Ovarian Hyperstimulation Syndrome) and a lower cost. By all accounts, this is patient-friendly IVF.

What are the Disadvantages?


With the IVF Lite protocol, fewer eggs are formed per cycle, necessitating the need for multiple cycles in order to accumulate an optimum number of good quality eggs. This form of IVF needs proper counselling so that patients are aware and are mentally prepared for multiple attempts. IVF Lite can occasionally result in poor or no response at all, necessitating cycle cancellation.

A well-equipped laboratory capable of successfully vitrifying and thawing eggs is absolutely mandatory for this form of IVF.

What are the Success Rates?
At Aster IVF, our success rates with Minimal Stimulation IVF Lite are similar to conventional IVF for women with a normal Ovarian Reserve. For Poor Responders, our success rates are as high as 40%. 

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The truth about sugar

Love it or hate it, sugar is an unavoidable part of our daily diets. We consume it every single day, be it with that innocent cup of tea we have every morning or thanks to a large can of sauce that’s more savoury than sweet. Sugar can be found in ubiquitous stuff, like your morning coffee, cakes, chocolates, cookies, diet sodas, white bread, salad dressings or cereals boasting about their ‘low fat’ contents. And then, there are sugars that simply sneak into your diet without you noticing – through fruits, honey and even milk. But as you may have actually guessed, not all sugars are the same. So, is there a ‘right’ kind, and if so, how do we ensure we have it?

“Type 1 diabetes occurs in a genetically susceptible individual when unknown environmental factors trigger the condition,” explains Dr Ajith Kumar, specialist endocrinologist, Aster Clinic, Al Qusais. “Type 2 diabetes, on the other hand, is caused by genetic factors as well as lifestyle habits.”

Type 2 is the more common of the two, accounting for about 85-90 percent of all cases diagnosed, and is caused due to a variety of reasons including a sedentary lifestyle, high blood pressure or even a history of diabetes in the family. While it’s important to know that reaching for that second doughnut won’t directly give you diabetes, weight gain and obesity, on the other hand, are actual concerns.

 

DIABETES: WHAT’S TRUE AND WHAT’S NOT
The most dangerous belief about diabetes is the idea that the condition can be easily dealt with using minimal attention and care. In fact, diabetes is a serious, chronic disease. Two out of three people with diabetes die from cardiovascular-related episodes, such as a heart attack or stroke. However, diabetes can be controlled with proper medications and lifestyle changes.

A lot of people believe that if someone is overweight, he/she will automatically get Type 2 diabetes. This is not true for every individual. In fact, most overweight people never develop Type 2 diabetes, and many people with Type 2 diabetes have an average weight or are only moderately overweight.
Diabetics cannot eat sweets at all. There is no reason people with Type 2 diabetes cannot eat sweets, as long as they fit it into a normal meal plan, or make sure the intake is combined with exercise. Eating small portions and including them with other foods can help slow down digestion, stopping them from wreaking havoc on your blood sugar levels. The key is to have a very small portion and save sweets for special occasions.
It’s not true that everyone who has diabetes needs to have insulin shots. Diabetes can be controlled with many oral and injectable medications, of which, insulin is the most effective. But not all people suffering from diabetes need to take it. The oral medications are safe and effective, but they are to be carefully chosen to suit the needs of the patient.
Many patients claim that they know when their blood sugar is high or low, leading to the myth that regular testing is not needed. In fact, you cannot rely on how you are feeling when it comes to your blood sugar level. You may feel shaky, lightheaded, and dizzy because you’re coming down with a cold or the flu. The longer you have diabetes, the less reliable those feelings become. The only way to know for sure is to check your blood sugar regularly.

 
Dr. Ajith Kumar

Specialist Endocrinologist 

Aster Clinic, Al Qusais 

 

News Source – http://www.khaleejtimes.com/lifestyle/the-truth-about-sugar

Sugar 3 Sugar 2 Sugar 1

 

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Increasing Number of Patients with GERD being detected, say experts from Aster Hospital and Clinic

Local experts urge early detection of GERD symptoms – a chronic digestive disease and encourage seeking appropriate medical attention to improve quality of life

  • On the occasion of Gastroesophageal Reflux Disease (GERD) Awareness Week, Aster Hospital and Clinic initiates a nationwide programme to increase awareness of symptoms and treatment in order to alleviate discomfort for people suffering from the disease.
  • Specialists at Aster Hospital and Clinic are receiving an increasing number of patients with this condition, with symptoms persisting for months. They often receive 2 to 3 patients a day with GERD. In the last 1.8 years, they have treated around 320 patients with the condition.
  • According to a 2014 report, by Emirates Gastroenterology Society, around 30% of the population in the UAE suffers from GERD .

Gastroesophageal Reflux Disease or GERD is a chronic digestive disease that occurs when acid from the stomach flows backwards into the esophagus, causing a burning, acidic feel in the throat and chest. On account of GERD Awareness Week, observed from November 20-26, Aster Hospital and Clinic has initiated a “GERD Awareness Campaign” to educate the residents of UAE on alarm symptoms or critical symptoms associated with the disease, which if noted, should prompt medical attention. Through dedicated programmes for the general population, Aster aims to encourage early diagnosis and proper treatment that can improve the quality of life of people suffering from the condition.

“Increasingly sedentary lifestyles, consumption of oily and spicy food, obesity coupled with a lack of regular exercise are the risk factors contributing to the rise of GERD. Therefore, it is essential to equip UAE residents with the necessary information to avoid such a condition. Our awareness programme which will run throughout GERD Awareness week across our Hospital and Clinic in UAE aims to help people suffering from GERD to consult a healthcare professional and seek medical assistance” said Dr. Amal Upadhyay, Consultant Gastroenterology, Aster Hospital Mankhool.

The most common symptom of GERD is a burning chest pain beginning from behind the breastbone, moving upwards to the neck and throat, leaving an acidic or bitter taste in the mouth. Difficulty in swallowing, a dry cough, hoarseness of voice and sore throat are also possible symptoms of GERD. Given the atypical symptoms of GERD, they are often mistaken for a heart condition or throat infection, leading to a delayed diagnosis. Other symptoms include regurgitation of food or sour liquid (acid reflux) as well as a sensation of a lump in one’s throat. GERD could also remain asymptomatic in some individuals. Although many people experience acid reflux every now and then, those who experience frequent and intractable symptoms should seek prompt medical attention. Rarely but importantly, in some patients, untreated GERD can lead to complications including cancer. Any such complications if diagnosed early can be controlled and treated.

A series of corporate and community talks under the GERD Connect Programs will focus on healthy eating habits, while radio talks organised by Aster will reach out to a wider audience across the UAE, educating residents about changes in lifestyle that can prevent GERD. In addition, Aster will distribute information booklets at Aster Hospital in Mankhool and all Aster Clinics across Dubai; create informative and educative articles and blog posts about GERD; and circulate live videos of specialist gastroenterologists, in order to spread awareness of the causes, myths, prevention, diagnosis and treatment available for GERD. The programmes also aim to motivate patients to adopt lifestyle changes that could help reduce the risk of suffering from GERD.

To further spread the message of awareness, Aster Hospital and Clinic will also be launching a risk assessment questionnaire targeting around 10,000 people across various corporates. The questions will allow participants to better assess themselves on the alarm symptoms of GERD and other symptoms which are usually disregarded.

Aster specialists follow best practices to decrease pain and alleviate the suffering of GERD patients. Although GERD symptoms are generally controlled with drugs, specialists recommend addressing the underlying cause of the disease. Doctors also encourage patients to adopt lifestyle changes that can help in managing the disease, including maintaining a healthy body weight, avoiding food and drinks that can trigger heartburn, quitting smoking, eating smaller meals and allowing enough time for meals and sleep. Other treatments available at Aster Hospital include endoscopic intervention, STRETTA procedure (FDA approved), and treatment of obesity. Aster also offers specialised tests as well as laparoscopic surgery for GERD (anti-reflux surgery) where required.

 

Dr. Amal Upadhyay,

Consultant Gastroenterology

Aster Hospital Mankhool.

 

News Source : www.godubai.com

 

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The Link between PCOS and Diabetes

Polycystic ovarian syndrome, commonly known as PCOS is an endocrinal disorder caused due to hormonal imbalance in the body. 8 in 10 women suffer from the condition but most of the time women are left undiagnosed. Women with PCOS have no periods or have very irregular periods, which ties back to the fact that PCOS is a major cause of infertility. PCOS is not curable but early diagnosis and treatment can help control symptoms and prevent long-term consequences.

Symptoms of PCOS tend to develop gradually although it may become rather an evident post weight gain. Other symptoms of the condition include very few or no menstruation with irregular bleeding, male pattern of balding, acne or oily skin, excessive hair growth etc. PCOS, if left undiagnosed and untreated may lead to serious consequences like infertility and Type 2 diabetes. Insulin resistance is also a major cause of PCOS.

Insulin resistance is a condition in which the body cells fail to respond to insulin and the cells are unable to effectively utilize the insulin. When the body becomes insulin resistant the muscles, fat and liver cells do not respond to insulin the way they should and become unable to absorb glucose from the bloodstream. The sugar is then retained in the blood, hence leading to excess blood sugar. For a brief period of time, the pancreas produces more insulin to keep up with the increased need. Over time the pancreas fails to keep up with the increased need for insulin, leading to Type 2 diabetes. Excess buildup of blood glucose leads to pre-diabetes, type 2 diabetes, and various other health complications. As stated by research, understanding the link between insulin resistance and PCOS is rather crucial in the UAE because 1 in 5 women here suffer from type 2 diabetes.

In other cases, women with PCOS are also at the risk of gestational diabetes, a condition when pregnant women who have never had diabetes, have high sugar levels during pregnancy. If diagnosed with PCOS, complications of developing Type 2 diabetes and gestational diabetes increases drastically.

Another factor linked to both PCOS and diabetes is obesity. Half of the population of women in the UAE is clinically obese. According to the 2015 World Health Statistics report, UAE’s female residents are overweight as compared to men. This data is clearly worrying because of the health complications obese women face, the most common ones being heart diseases and type 2 diabetes.

Experts suggest that PCOS may be linked to hereditary factors but the definitive cause is still unknown. Changing lifestyle habits, early diagnosis to control symptoms and prevent complications, maintaining a healthy body weight, exercising regularly, having a balanced diet etc. will help in controlling symptoms. PCOS and diabetes have a well-established link and creating awareness about the same are extremely necessary.

 

Dr. Jayacy C Jayankar

Specialist Obstetrician & Gynaecologist

Aster Hospital Mankhol

 

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