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All Posts in Category: Blog

Role of Prolactin in IVF Treatment

IVF

Prolactin is a chemical that is secreted by pituitary gland. This is the pea-sized gland found in the middle of brain and is responsible for triggering many body’s processes. It is found in both men and women and is released at various times throughout the day and night. Prolactin is generally released in order to stimulate milk production in pregnant women. It also enlarges a woman’s mammary glands in order to allow her to prepare for breast feeding. On the other hand, it also affects ovulation and menstrual cycles. This is why it is nearly impossible to become pregnant when a woman is breastfeeding. Prolactin inhibits two hormones: follicle stimulating hormone (FSH) and gonadotropin releasing hormone (GnRH). Both of these hormones are responsible for eggs maturation and development in the ovaries, so that they can be released during ovulation. Thus when a woman have excess prolactin level, ovulation is not triggered rendering a women infertile.

 

By -Dr. Ayesha Maqbool

ACIMC Lahore, Coordinator (MBBS)

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Infertility: A Stigma of Life

IVF

Infertility is a major life event that brings about social and psychological problems.

Main themes include:

  1. Cognitive reactions of infertility (mental engagement; psychological turmoil).
  2. Emotional-affective reactions of infertility (fear, anxiety and worry; loneliness and guilt).

In Pakistan parenthood is almost an obsession. According to a report of Express tribune in year 2017, about 21.7 per cent of all couples in Pakistan are unable to have children and most of these couples unfortunately are faced with an extreme social stigma. But every dark cloud has a silver lining and in this ray of despair ICSI is like a miracle. It is an appropriate treatment for couples suffering from infertility. This treatment involves injecting a single sperm directly into an egg. The fertilized egg (embryo) is then transferred in to womb (uterus).It gives a chance of conceiving genetic child when other fertility treatments options are unlikely to do so.

 

By -Dr. Ayesha Maqbool

ACIMC Lahore, Coordinator (MBBS)

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Ovarian Reserve Test AMH

IVF

Women are born with their lifetime supply of eggs, and these gradually decrease in both quality and quantity with age. Anti-Mullerian Hormone (AMH) is a hormone secreted by cells in developing egg sacs (follicles). The level of AMH in a woman’s blood is generally a good indicator of her ovarian reserve.  AMH does not change during your menstrual cycle, so the blood sample can be taken at any time of the month – even while you are using oral contraception. An AMH test gives us some insight into the remaining quantity of eggs and number of fertile years you may have, but it cannot tell us much about the quality of those eggs.

By -Dr. Rushda Akram

ACIMC Lahore, Coordinator (MBBS)

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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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