- Infertility is a problem through out and increasing rates noticed. - The successful birth of a “Test Tube Baby”, Louise Brown occurred in 1978 in Oldham General Hospital, U.K. - Roberts G. Edwards; the physiologist who developed the treatment was awarded the noble prize in Medicine in 2010.

1. Email : ms@jjmedicalinstitute.com ; Website : http://jjmedicalinstitute.com,

2.  Infertility is a problem through
out and increasing rates noticed.
 The successful birth of a “Test
Tube Baby”, Louise Brown
occurred in 1978 in Oldham
General Hospital, U.K.
 Roberts G. Edwards; the
physiologist who developed the
treatment was awarded the
nobel prize in Medicine in 2010.

3. What is Infertility & when
should a married couple
consult the fertility
specialist?

4.  Inability to conceive after unprotected sexual
exposure for one year, if female age is less
than 35 yrs.
 If the female age is more than 35 yrs ,then
treatment should be started after 6 months.

5. What are the main causes
of Infertility?

6.  It is estimated that infertility affects 1 in
7 heterosexual couples in UK
 In about 40% of cases disorders are found
in both the man and the woman
Hysteroscopy

7. What are the
investigations done in a
female suffering from
infertility?

8. Routine Investigations
 Hormonal Test:
 D2: FSH, LH,
 TSH,
 Prolactin
 AMH
 HSG
 USG Pelvis & (TVS)
 Hysteroscopy and Laparoscopy
Hysteroscopy

10. Laparoscopy
Hysteroscopy

12. What are the
investigations done in a
male partner suffering
from infertility?

13. Semen
Analysis
 USG &
Doppler
Other Tests
 FSH
 LH
 PL
 TSH
 Testosterone
 HB, Bl Sugar,
KFT, LFT, HIV,
VDRL,HBS,
HCV
 Sperm
Function
Tests

14. What are the possible
treatment options
available?

15.  Intrauterine Insemination is defined as the
deposition of specially prepared sperm in the
uterine cavity above the internal os.

16. Indications
 Abnormal Semen Profile
 Oligospermia, Mild Asthenospermia, combination of both
 Cervical Factors
 Immunological factors
 Unilateral Tubal defect
 Ovulatory Dysfunction
 Unexplained Infertility, Mild Endometriosis
 Other ejaculatory problems, erectile dysfunction
Donor Insemination
 Never use fresh donor sample.
 Never use samples from relatives or known person.
 Always use cryopreserved semen from a Semen bank
which is tested for HIV,HBS,HCV .

17.  Both tubes should be patent and functional
 Both Ovaries capable of responding to
ovulation inducing agents.
 Endometrial cavity capable of Implantation.

18. Semen Prepration
Semen prepration helps to remove dead sperms,
leucocytes, Infectious agents and Prostaglandins from
the semen
 It helps in capacitation of spermatozoa
 Sperm washing media provides nutritional support
and keeps them active for longer .
Controlled Ovarian Stimulation
 Corrects subtle ovulation defects
 Better control over timing of ovulation
Intrauterine Insemination
 By passes cervical mucous barrier which may be
hostile to sperm
 Increases sperm density in upper genital tract.
 Overcomes coital difficulties

19.  Ovarian Stimulation
 Monitoring IUI cycle by USG
 Ovulation Trigger
 Semen Prepration
 swim up,single density gradient,double
density gradient
 Insemination

20.  Factors that determine the success are;
 Age of female Partner
 Stimulation Protocol
 Cause of Infertility
 Recovery of motile sperm fraction.
 Results vary from 5 to 30%

21. Popularly IVF is a process by
which an egg is fertilized by
sperm outside the body in vitro
termed “Test Tube Baby”
First IVF Pregnancy in 1977-
Louise …….

22.  Tests
 Down Regulation
 Ovarian Stimulation
 Collection of sperms
 Insemination
 Embryo Transfer

23.  Ovarian stimulation is done to produce multiple eggs-
rather than single egg with Injection-Gonadotropin
 Multiple follicles are stimulated as some eggs will not be
fertilized
 USG monitoring is done to assess growth of follicle.
 When Follicle reach 17-18 mm a final injection (Hcg) for
oocyte maturion is given.
 Egg retrieval is done 36 hours after hcg injection under
short GA.
 Eggs are identified & collected by embryologist in a Petri
dish containing IVF culture media.
 These eggs are then inseminated with the washed semen.
 Incubation is done in CO2 incubators.
 Fertilization is checked next day after about 18 hours.

24.  Embryo are Transferred on D3/D5
 Embryo suspended in drops of culture media
is drawn into ET Cathetor.
 The Cathetor is carefully inserted into uterine
cavity US guidance.

25. Is there any relation
between age and succes in
ART?

26.  <35 yrs: 40-43%
 35-37 33-35%
 38-40 23-27%
 >41 13-18%

27.  Tubal disease, Blockage.
 Pelvic factors…Endometriosis,adnexal
adhesions
 Ovulatory Factors, PCOD,POF
 Uterine Factors….Infections,cong
malformations,Synaechiae
 Age related
 Male Factor Infertility
 Unexplained Infertility

28. Is there any gurantee of success
with ART procedures?
The success of ART varies from
10-40% depending on age &
cause. There is no 100% gurantee.

29. Is there any maximum number
of attempts in IUI & IVF?
In IUI, 3-6 attempts are
normally adviced,though best
results are availed in first three.
In IVF also 4-5 chances can be
taken.

30. Is there structural/mental
difference between
naturally conceived &
ART conceived babies?
No

31. Is there treatment possible
in couples where the male
partner has nil sperm count
(Azoospermia)?
Tese/mesa with icsi can help
father these couples.

32. My wife underwent
hysterectomy due to
certain complications.
Can she have a baby?
Surrogacy can help her.

33. I suffered a tubal
pregnancy and my tube had
to be removed.Can I
become pregnant?
Yes,the other tube can
definitely help in getting