Frequently Asked Question on In Vitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI)

  • Do I need IVF?

IVF is indicated when alternative treatments are either unlikely to achieve a pregnancy or have failed to result in a pregnancy. If you have blocked fallopian tubes or extensive pelvic adhesions preventing the egg from entering the fallopian tubes, IVF is indicated.

Another common indication for IVF is low sperm counts. Because IVF allows us to super concentrate sperm, successful fertilisation can occur even if your partner has low sperm counts.

Infertility is said to be ‘unexplained’ if you are unable to conceive in spite of all tests being normal. In this case, IVF is an option if you have failed to conceive with Intrauterine Insemination (IUI).

IVF may also be advisable if you have Polycystic Ovaries (PCOS) and if ovulation induction with or without IUI has not been successful.

If you have mild to moderate Endometriosis, IUI may be tried before proceeding to IVF, but in the case of severe Endometriosis, IVF is advisable.

 

  • Do I need ICSI?

Intracytoplasmic Sperm Injection (ICSI) has revolutionised the treatment of male infertility. ICSI is advisable if the male partner’s sperm count or a number of motile sperm is very low or the morphology is excessively poor.

Your Fertility Physician at Aster IVF will advise you if ICSI is recommended for you based on the results of the Semen Analysis and other risk factors.

 

  • Is IVF/ ICSI expensive?

IVF/ ICSI involves highly trained professionals with sophisticated laboratories and equipment. The total cost of an IVF/ ICSI cycle largely depends on your age, hormonal test results and the dose of medication required to stimulate the ovaries. It varies from AED 20,000 to AED 25,000 in our facility.

 

  • IS IMSI better than ICSI? Is it a big advance?

IMSI stands for ‘ Intracytoplasmic Morphologically Selected Sperm Injection’. It involves examining the semen sample under an extremely powerful microscope to pick out the best appearing sperm, which is then used in the ICSI protocol. An efficiently performed ICSI carried out by a competent embryologist already ensures that good quality sperms are picked up. Evidence based medicine is yet to conclusively prove the advantages of IMSI over ICSI in terms of pregnancy rates and long term outcomes. We offer IMSI at Aster IVF.

 

  • Are birth defects more common in babies conceived using IVF/ ICSI?

The percentage of birth defects with IVF is roughly the same as in the general population (3-4%). The chances of birth defects after ICSI are rare. Some of the problems that caused the male infertility, however, may be genetic. In these cases, boys conceived with the use of ICSI may have infertility issues as adults.

 

  • What are the health risks for women undergoing IVF/ ICSI cycles?

The drugs used during IVF/ ICSI may on occasion cause side effects. There is a small but significant risk of Multiple Pregnancies, Ectopic Pregnancy, Pelvic Infection and rarely Injury to nearby organs. Controlled Ovarian Hyperstimulation (COH) is associated with a risk of Ovarian Hyperstimulation Syndrome (OHSS). Symptoms of OHSS include the following in varying degrees of severity: nausea, vomiting, diarrhea, extreme bloating, rapid weight gain, difficulty breathing etc.

Aster IVF has put into practice an OHSS-free protocol called IVF LiteTM.

 

  • What do we do if extra Eggs remain after an Egg Retrieval Procedure?

Extra Eggs remaining after the Egg Retrieval Procedure may be frozen by the CryotechTM Vitrification procedure which gives almost 100% survival. This makes future ART cycles simpler, less expensive and less invasive than the initial cycle, since the woman does not require ovarian stimulation or egg retrieval.

 

  • What are the Success Rates?

Our Group success rates are among the best globally. They are the result of years of experience and constant fine-tuning of our stimulation protocols, our laboratory culture conditions and our embryo transfer guidelines.

The most important factors determining the success of a cycle are the woman’s age and the reason for the infertility. We will be pleased to discuss your individual case history with you and provide advice that is tailored for you.

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Laparoscopic Surgery FAQ’s

Is laparoscopy a surgical procedure or diagnostic procedure?

Laparoscopy is a surgical procedure used for diagnosis as well as treatment of disease conditions.

 

What are the advantages and disadvantages of Laparoscopic surgeries?

Laparoscopic procedures have a number of advantages, given the fact that they result in cosmetic or negligible scars, less post-operative pain, shorter hospital stay, early mobilization and resumption of daily activities, less internal scarring when the procedure is performed. As this method is minimally invasive, fewer adhesions are made and there is minimal tissue handling. It doesn’t really have too many disadvantages as such. Laparoscopy is a very popular method of diagnosis and surgery these days which it wouldn’t have been if there were disadvantages. Although it is slightly expensive than conventional open surgeries, it also depends on whether it is just diagnostic or the procedure is being used to treat a certain condition. What one should also take into consideration are the advantages it offers when compared to conventional surgical methods. Moreover, Doctors require having special surgical training and expertise in order to conduct a laparoscopic surgery.

 

Is laparoscopy painless or less pain?

Laparoscopic procedures are minimally invasive and the pain it causes is also very minimal. Laparoscopic procedures are performed under General Anesthesia which puts the patient to sleep. These procedures are associated with very less pain and with the advances being made in Laparoscopic procedures it will soon become almost painless.

 

Is it used to diagnose a cause that may lead to a disease?

Diagnostic laparoscopy is used by a doctor to look into the abdomen and pelvic cavity of a patient. It helps identify the cause of pain or a growth in the abdomen and pelvic area. This method is used when patients have some non-specific abdominal pain or in cases when routine diagnostic checks like x-ray or ultrasound results are unclear. Diagnostic laparoscopy is also sometimes used in accident cases to check if any abdominal injury has occurred. Diagnostic laparoscopy is also known as exploratory laparoscopy. This technique of diagnosis is used in cancer patients to check the stage of cancer. In such cases, treatments may differ depending on the diagnosis.

 

Are laparoscopic procedures also used in pregnant women? Please validate if yes or no.

With the acceptance of the procedure, new and improved surgical methods, greater expertise in this field, laparoscopic procedures are used in pregnant women, for the most common indications for surgery during pregnancy include adnexal masses, biliary disease, and appendicitis. Laparoscopy should be performed with the utmost care during pregnancy. It is definitely not advisable beyond 16 weeks of pregnancy.

 

Is there any time or case when laparoscopic procedures can’t be used, i.e. prior abdominal surgery or any such case?

There are definitely some situations when laparoscopic procedures can’t be used, like previous multiple surgeries where extensive bowel adhesions have been anticipated, patients who are in a state of shock and have very large pelvic mass.

What are the cases under Gynecology where laparoscopy is the choice of procedure?

Laparoscopic procedures have become a very common practice in today’s gynecologic field. Almost all gynecological procedures can be done laparoscopically, it is very commonly used in treating Endometriosis, ovarian cysts, removal of fibroids, treatment of ectopic pregnancy, removal of the uterus , investigation of cancer or removal of lymphs for a treatment of cancer and treatment of prolapse with mesh. The most deserving Gynaec procedures that are treated laparoscopically are diagnosis and treatment of endometriosis, female sterilization which is a surgery on the fallopian tubes to prevent further pregnancy, removal of ovaries or womb and removal of adhesions (scar tissue).

 

Can laparoscopic procedures be used to treat women across age groups?

Laparoscopic surgeries are surely used in women across all age groups, the only difference being the technique and size of instruments.

 

Can laparoscopic gynecology use to treat any kind of infertility issues or disabilities?

Most definitely, laparoscopic surgeries are widely used to treat infertility issues. It is considered a standard method in exploring infertility. In fact, most clinicians recommend laparoscopic procedures as it is less invasive and scarring is minimal. Through these procedures, surgeons inspect the pelvic cavity to confirm that the fallopian tubes are fully healthy and open to ensure there is no complication or condition like pelvic adhesion, abnormalities in the uterus, endometriosis, and PCOS.

 

Can emergency operations be performed using this method? Is the time taken to conduct laparoscopic surgeries the same as that of conventional surgeries?

Most surgeries can be performed laparoscopically, including emergency surgeries because what happens during the surgery is the same in both conventional methods and laparoscopic methods, the difference lies in the technique used to operate. In certain cases of emergency like a removal of tubal pregnancies, removal of twisted ovaries with cysts, treatment of ruptured ovarian cysts, twisted fibroids with stalk, laparoscopy is the choice of procedure given the fact that it is minimally invasive, patient experiences less blood loss, the recovery time is rather quick etc.

When compared to conventional surgery, the time was taken to set up the place may be more in Laparoscopic procedures. The time taken to conduct laparoscopic surgeries varies depending on the type of the surgery. Some laparoscopic surgeries may take longer than other laparoscopic surgeries, wholly depending on the procedure.

 

Dr. Caroline Alphine

Specialist Obstetrics & Gynecology, Aster Hospital

News Source – Khaleej Times                                                                Dr. Caroline Article

 

 

 

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