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IVF

Difference Between Gynecologist and Infertility Specialist

Progress and development is an integral part of human nature. As scientists and physicians began to push the frontiers in the study of human body it became clear that a single physician is not able to fully understand the intricate details of all areas of medicine. This gave rise to formation of specialties like cardiology, nephrology, urology, gynecology and many others. However, in recent years as a result of further researches done in the field of medicine the generalized studies have become insufficient leading to formation of sub specialties

Gynecologists are doctors who deal with the general health of female reproductive system as a whole and the doctors who have studied and worked in infertility treatment specially are considered infertility specialists. These are the doctors who have spent years studying and practicing new treatments for couples unable to conceive naturally.

Just like a patient suffering from heart issue prefers to get treatment from a cardiologist and would not visit a gastroenterologist to treat his heart issue similarly couples suffering from infertility should visit infertility specialist to ensure that they get proper treatment individualized to their condition. Gynecologist although are knowledgeable about female reproductive system but sometimes treatment of infertility needs a combined approach addressing issues related to field of urology and endocrinology also. An infertility specialist can more accurately assess the conditions of such patients and provide necessary intervention increasing their chances to conceive.

 

By -Dr. Saira Afzal

ACIMC Lahore, ART Coordinator (MBBS)

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IVF

Dual Stimulation in In Vitro Fertilization

In vitro fertilization, IVF is a set of procedures that includes combining eggs of a female and sperm of a male outside the mother’s womb. Once the embryos are formed they are placed inside the uterus.
Ovarian stimulation is done during IVF in order to retrieve multiple mature eggs from the female ovaries. Multiple eggs maximize the chances of increased number of fertilized eggs that can be implanted back in the uterus, thus increasing the chances of pregnancy leading to a healthy baby.
Ovarian stimulation in IVF involves injection of medication consisting mainly hormones for 8-14 days starting from the second day of periods. These injections cause the ovaries to stimulate and mature multiple eggs. Frequent ultrasounds are done to monitor the increasing sizes of the follicles encircling the eggs. Once the follicles have reached a favorable size, egg retrieval is done. These eggs are then injected with the male sperm and eventually fertilization occurs.

Dual Stimulation or double stimulation is done in patients who show a poor response to hormonal injections usually due to a poor ovarian reserve. Poor response usually corresponds to retrieval of fewer mature eggs.
As the name suggests, dual stimulation has 2 rounds of stimulation done in order to retrieve as many mature eggs as possible. The 1st stimulation starts from 2nd day of periods till the 1st retrieval and second stimulation begins from the next day. This stimulation is also done with injections that again stimulate the ovaries to mature a few more eggs. When the ultrasound shows an increase in the follicle size, a second egg retrieval is done. These 2 stimulation and retrievals yield a good number of eggs that can be fertilized leading to a greater chance of a successful pregnancy after implantation.

 

By -Dr. Sundus Saeed Gill

ACIMC Lahore, Coordinator (MBBS)

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IVF

Poor Responders in IVF/ ICSI Treatment

“Poor Responder” is a term used for female who have decreased response to stimulation during test tube baby treatment.  According to The Bologna ESHRE criteria  “Poor Ovarian Responders” should be considered in patients having at least two of the following criteria:

  1. A previous episode of poor ovarian response with a standard dose of medication.
  2. An abnormal ovarian reserve with Antral Follicle Count (AFC) <5–7 follicles or AMH <0.5–1.1 ng/mL.
  3. Women above 40 years of age or presenting other risk factors for poor response such as previous ovarian surgery, genetic defects, chemotherapy, radiotherapy, and autoimmune disorders.

Low ovarian reserve is normally the cause of poor response. with increased age the ovarian reserve declines but however few women may suffer from premature ovarian failure resulting in decreased response before the expected age. Ovarian response can be analyzed before starting the IVF/ICSI treatment by performing tests like FSH, AMH and Antral follicle count. In some cases clomiphene challenge test can also help to make a diagnosis.

Pre determination of the ovarian reserve by conducting these tests allow the consultant doctor to adjust the dosage for IVF/ ICSI treatment individualized to the patients needs resulting in a more effective treatment. Addition of androgens and medication to increase blood flow to the ovary can also be beneficial in some cases.

 

By -Dr. Saira Afzal

ACIMC Lahore, Coordinator (MBBS)

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IVF

Treatment of Swollen Fallopian Tubes via IVF

Sexually transmitted diseases may cause bacterial infection leading to swollen fallopian tubes obstructing natural conception can be treated well by IVF Specialists.

Up to 50% reduction in rates of IVF pregnancy may be due to immobile fluid inside the tubes required for polluting the natural pregnancy environment.

IVF specialist will discuss regarding various selections such as opening of the Fallopian tubes through laparoscopic ally, clipping various factors affecting the pregnancy to improve your probabilities of pregnancy significantly.

By -Dr. Sajjad

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IVF

Treatment of Blocked Fallopian Tubes via IVF

IVF specialist can perform laparoscopic surgery on a female patient having blockage of her Fallopian tubes at whichever end of the tubes, in order to open the spider mesh like adhesion easing your way for natural conception.

Surgery may not be suitable in case of extensively blocked Fallopian tubes. Luckily blocked Fallopian tubes can bypass through IVF permitting pregnancy to rise.

 

By -Dr. Sajjad

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IVF

How Does IVF Improve Fertility

Inefficient human reproduction can be efficiently increased by possible way of IVF Technology.

Multiple eggs are removed from female partner in IVF and then carefully cultured for 3-5 days until the eggs fertilized, after fertilization, healthy embryos may be one or more are placed back into the uterus. With IVF fertility is improved in many couples that have sperm issues or any female issues, via straight transferring of fertilized embryo(s) into the uterine cavity.

IVF also have a benefit that freezing of remaining embryos is possible for future use.

 

By -Dr. Sajjad

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IVF

When to Opt for IVF – In Vitro Fertilization

Couples suffering from infertility due to following reasons may undergo IVF Treatment :

  • Female with Fallopian Tube Damage/Tubal Factor
  • Endometriosis concerned sterility
  • Less than 15-20 million per milliliter of Sperm concentrations
  • Less than 35% sperm motility
  • Male having poor Sperm morphology can go for IVF Treatment
  • Unexplained Infertility can be cured with IVF

 

By -Dr. Sajjad

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Are Test Tube Baby or IVF (In-Vitro Fertilization) Procedures Legal in Islam?

It is absolutely fine to ask the question whether Test Tube Baby or IVF In-Vitro Fertilization procedures are legal. The Good News is that it has been officially declared legal by competent authorities around the world an in Pakistan.

Jamia Al-Azhar was established under the Fatimid Caliphate in 975 C.E. and is recognized as the oldest Islamic university and the second oldest university in worldwide.

Al-Azhar University or Jamia Al-Azhar’s FATWA Committee is the leading International Authority for Muslims around the world. In 1980, Al Azhar issued FATWA declaring that Test Tube Baby, IVF and similar technologies are permissible as long as they do not involve any form of third-party donation (of sperm, eggs, embryos, or uteruses).

In addition, The Federal Shariah Court of Pakistan in February 2017, declared Test Tube Baby, IVF legal in Pakistan. For Details visit https://tribune.com.pk/story/1334709/federal-shariat-court-declares-test-tube-babies-legal/

When you are planning to visit us for treatment you can be rest assured that your treatment will be conducted in the best professional, ethical and in accordance with Islamic guidelines.

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IVF

TEST TUBE BABY

WHAT IS TEST TUBE BABY ?

“Test tube baby “is defined as a baby resulting from fertilization occurring outside a woman’s body. This is also called In Vitro Fertilization.

Normal pregnancy occurs when a female ovulates releasing a mature egg which is penetrated by the male sperm resulting in formation of an embryo (fertilized egg). This embryo travels through the Fallopian tube and gets implanted in the uterus (womb) of the female.

However, if any of the above mentioned components of natural conception have a problem a couple might not be able to conceive naturally and for such patients Assisted Reproductive techniques (ART) can be used. Test tube baby (IVF/ICSI) is considered as the most effective among such assisted techniques.

In this procedure, the female is first stimulated to produce more follicles and eggs then normally produced. The eggs are then retrieved through a minor operative procedure and placed together with the male sperm in an environmentally controlled chamber in the laboratory. The sperm enters the egg (IVF) or can be injected directly into the egg (ICSI). This results in the formation of embryo outside the female’s body. This embryo is then placed into the female uterus where it gets attached resulting in a positive pregnancy. ACIMC is offering Test-Tube technology in Pakistan since 1998.

 

By -Dr. Saira Afzal

ACIMC Lahore, Coordinator (MBBS)

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IVF

Importance of Diagnostic Hysteroscopy before IVF ‚ ICSI & Test Tube Procedures

The outpatient hysteroscopy failure rate is less than half (2%) with the mini-hysteroscopy compared with the traditional 5 mm hysteroscopy (5%).

Hysteroscopy done at the time of Laparoscopy, has low complication rate, high requirement and adds little equipment & cost.

Positive hysteroscopy findings are found in many cases (15 %) despite having normal HSG and no suggestive history of uterine lesions.

In IVF program patients with normal historiography but abnormal hysteroscopy findings had a significantly lower clinical PR, demonstrating the importance of performing hysteroscopy before IVF.

Therefore it is recommended that Diagnostic Hysteroscopy should be performed on all patients before they undergo IVF.

 

By -Dr. Safia Munir

Consultant

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