Overview

At SPARSH Fertility Centre, we strive to create bundles of joy & happiness to every person in need of assisted fertility treatment. Our team comprises of highly qualified experienced Gynecologists,Infertility specialists, Embryologists, Laparoscopic surgeons and Anaesthetist, who are extremely committed & passionate to their work and follow high standards of ethical care. SPARSH Fertility Centre houses the best state-of-art equipment & protocols of a Fertility centre.Our patients are thoroughly evaluated and offered tailor made treatments to give the best assisted reproduction with affordable pricing.

SPARSH Fertility Centre

Our approach to fertility solutions is very different. We do not offer a standard package, but personalize our offerings for every couple. We know that every couple has a unique set of issues and we treat them as individuals, not as a package. We offer a comprehensive assessment and an evidence-based solution for infertile couples seeking assistance to overcome infertility. We completely personalize every fertility treatment and we take great care in analyzing every possible issue, before we arrive at an accurate solution. All along, we supported the treatment with counseling, for both husband and wife. Our fertility experts guide the couple through the right treatment, and advise them on whether treatment is required in the first place. The team of specialists also offer support to cope with the stress, because it has been seen that being able to relax is hugely beneficial to people’s attempts at having a baby.

Why is it said infertility

All of the steps during ovulation and fertilization need to happen correctly in order to get pregnant. Sometimes the issues that cause infertility in couples are present at birth, and sometimes they develop later in life. Infertility causes can affect one or both partners. Sometimes, no cause can be found.

When to see a doctor

You probably don’t need to see your doctor about infertility unless you have been trying regularly to get pregnant for at least one year. Women should talk with a obstetrician if they:

• Are age 35 or older and have been trying to conceive for six months or longer
• Are over age 40
• Have irregular or absent periods
• Have very painful periods
• Have known fertility problems
• Have been diagnosed with endometriosis or pelvic inflammatory disease
• Have had multiple miscarriages
• Have undergone treatment for cancer

Men should talk to a health care provider if they have:

• A low sperm count or other problems with sperm
• A history of testicular, prostate or sexual problems
• Undergone treatment for cancer
• Small testicles or swelling in the scrotum
• Others in your family with infertility problems

Causes of male infertility

These may include:

• Abnormal sperm production or function due to undescended testicles, genetic defects, health problems such as diabetes, or infections such as chlamydia, gonorrhea, mumps or HIV. Enlarged veins in the testes (varicocele) also can affect the quality of sperm.
• Problems with the delivery of sperm due to sexual problems, such as premature ejaculation; certain genetic diseases, such as cystic fibrosis; structural problems, such as a blockage in the testicle; or damage or injury to the reproductive organs.
• Overexposure to certain environmental factors, such as pesticides and other chemicals, and radiation. Cigarette smoking, alcohol, marijuana, anabolic steroids, and taking medications to treat bacterial infections, high blood pressure and depression also can affect fertility. Frequent exposure to heat, such as in saunas or hot tubs, can raise body temperature and may affect sperm production.
• Damage related to cancer and its treatment, including radiation or chemotherapy. Treatment for cancer can impair sperm production, sometimes severely.

Causes of female infertility

Causes of female infertility may include:

• Ovulation disorders, which affect the release of eggs from the ovaries. These include hormonal disorders such as polycystic ovary syndrome. Hyperprolactinemia, a condition in which you have too much prolactin — the hormone that stimulates breast milk production — also may interfere with ovulation. Either too much thyroid hormone (hyperthyroidism) or too little (hypothyroidism) can affect the menstrual cycle or cause infertility. Other underlying causes may include too much exercise, eating disorders or tumors.
• Uterine or cervical abnormalities, including abnormalities with the cervix, polyps in the uterus or the shape of the uterus. Noncancerous (benign) tumors in the uterine wall (uterine fibroids) may cause infertility by blocking the fallopian tubes or stopping a fertilized egg from implanting in the uterus.
• Fallopian tube damage or blockage, often caused by inflammation of the fallopian tube (salpingitis). This can result from pelvic inflammatory disease, which is usually caused by a sexually transmitted infection, endometriosis or adhesions.
• Endometriosis, which occurs when endometrial tissue grows outside of the uterus, may affect the function of the ovaries, uterus and fallopian tubes.
• Primary ovarian insufficiency (early menopause), when the ovaries stop working and menstruation ends before age 40. Although the cause is often unknown, certain factors are associated with early menopause, including immune system diseases, certain genetic conditions such as Turner syndrome or carriers of Fragile X syndrome, and radiation or chemotherapy treatment.
• Pelvic adhesions, bands of scar tissue that bind organs that can form after pelvic infection, appendicitis, endometriosis or abdominal or pelvic surgery.
• Cancer and its treatment. Certain cancers — particularly reproductive cancers — often impair female fertility. Both radiation and chemotherapy may affect fertility.

SPARSH FERTILITY CENTRE

At SPARSH Fertility Centre, we strive to create bundles of joy & happiness to every person in need of assisted fertility treatment. Our team comprises highly qualified experienced Gynecologists ,Infertility specialists, Embryologists, Laparoscopic surgeons and Anaesthetist, who are extremely committed & passionate to their work and follow high standards of ethical care. SPARSH Fertility Centre houses the best state-of-art equipment & protocols of a Fertility center Our patients are thoroughly evaluated and offered tailor made treatments to give the best assisted reproduction with affordable pricing.

Services & Treatments

HSG Test or Hysterosalpingography HSG Test or Hysterosalpingography, or uterosalpingography is a medical test performed by a trained professional expert to evaluate the condition of your uterus and fallopian tubes. A contrast medium is injected into your uterus, and an X-ray is taken to determine if the cavity is normal and ensure that the fluid spills out of your fallopian tubes. This fluid usually contains a chromatic dye which accounts for easy detection. As such, X-ray contrast is a process in which a substance like air or metal like barium is used to obtain the contrast of an image through radiography. A positive contrast medium absorbs X-rays more strongly than the tissue being examined. On the other hand, a negative contrast medium absorbs X-rays less strongly. Usually, the HSG technique uses a radio-opaque material and fluoroscopy involving image intensification. Usually, in case of studying tubal rupture, the spilling of material into the peritoneal cavity is observed. Hysterosalpingography helps to determine shape of uterine cavity and shape and patency of fallopian tubes. Usually, it’s done during the follicular phase of the menstrual cycle when the follicles are most proliferated. Having the HSG test done during day one to day fourteen of the menstrual cycle is most advantageous as this is the period which has the least chances of pregnancy. A HSG test, as such, doesn’t take more than 5 minutes. However, you should try to be at the hospital around 30 minutes earlier than your scheduled time to prepare for the test.The health care expert might suggest you an over-the-counter pain reliever (analgesic) or antibiotic with regards to the fact that you may not feel very well after the test. The test is a bit painful to do, so you would want to discuss the antibiotics that are being prescribed to you with your health care expert. Why is Hysterosalpingography Test Performed? With the HSG test, your doctor will be able to confirm whether a woman’s fallopian tubes are open and uterus has a normal shape or not. It also makes sure the cavity is not affected by fibroids, polyps or scar tissue. In simple words, Hysterosalpingography is a histological test used to diagnose the internal organs related to the female reproductive system. Through this test, the doctor can easily detect the various causes of infertility and other problems related to pregnancy. HSG is also done after a few months of tubal sterilization, i.e., tubectomy to check whether the fallopian tubes have been fully blocked or not. HSG test also helps to highlight symptoms of common fertility or reproductive tract disorders, including uterine malformations, Asherman’s syndrome, tubal occlusion and even PID (Pelvic Inflammatory Disease). In simple words, the HSG test is done mostly to determine a woman’s true reproductive potential. Since it’s a radio test, it’s usually performed in the radiological department of the hospital or any outpatient radiology facility. It might also be done in a clinic or a health care giver’s office.

In Vitro Fertilization (IVF)

In Vitro Fertilization (IVF) Treatment is an assisted reproductive technique in which eggs are collected from your ovaries and fertilized with the sperm in a specialized laboratory. The fertilized egg (embryo) is allowed to grow in a protected environment for some days before being transferred into the woman’s uterus increasing the chance that a pregnancy will occur. The process of fertilization takes place over a few hours and a number of embryos can form. The embryos are grown in the laboratory until Day 5, known as the Blastocyst stage because there is strong evidence that these embryos are more likely to implant into the uterus. Fertilized embryos are transferred to the woman’s uterus in a simple procedure call an embryo transfer. If more than two embryos develop, the surplus can be frozen for use in subsequent cycles. If there are issues around sperm quality, the process of fertilization is carried out by Intracytoplasmic Sperm Injection (ICSI). This is where one sperm is inserted into each egg.

What are the Steps Involved In IVF Treatment?

The complete procedure of IVF cycle may last from four to six weeks. The step-by-step procedure of IVF includes: Step 1- Ovulation Stimulation During the stimulation phase of an IVF cycle, patients self-administer hormones. The length of the stimulation phase depends on the response to the medication regimen. Monitoring with blood tests and ultrasound of the ovaries tracks this response. Step 2- Egg retrieval You will be put under mild sedation and the eggs are collected with a hollow needle that is attached to the ultrasound probe. After egg retrieval, you are asked to use the medication that prepares the lining of the womb for embryo transfer. Eggs can sometimes be stored if you want to delay the process of becoming pregnant. Step 3- Sperm retrieval Your partner is asked to produce a semen sample. The specimen is washed thoroughly, and the sperms that show maximum motility are selected. Such sperms can be used fresh for fertilizing the egg or frozen and used later on. Step 4- Fertilizing the eggs Retrieved eggs are fertilized either by conventional insemination, the placement of eggs and sperm in a culture-containing dish or by intracytoplasmic sperm injection (ICSI). The eggs are regularly monitored to confirm the fertilization. Step 5- Embryo transfer into the uterus Embryologists monitor the embryos’ growth and viability to determine whether a day 3 or day 5 transfer should be done. Embryo transfers three days after retrieval when the embryo contains four-to-eight cells) may be done or embryos are often transferred five days after retrieval and fertilization (Day 5 transfer or blastocyst transfer). A small catheter is inserted through which the embryo is placed in your uterus. If the procedure is successful, it takes about six to ten days for the implantation to occur.

Embryo Cryopreservation

The embryologist evaluates any remaining embryos for cryopreservation (freezing). Embryo cryopreservation gives patients who wish to have another child the option to have an embryo transferred at a later date without having to complete another In Vitro Fertilization (IVF) cycle. After Transfer Two weeks after retrieval, a pregnancy blood test is performed. If this test is positive, the patient is considered four weeks pregnant. Are there any Risks with In Vitro Fertilization (IVF) Treatment? Though IVF treatment is a safe procedure, some women may develop minor problems.

• While you are on fertility drugs you may experience the side effects of headache, mood swings, and abdominal pain.
• While collecting your egg, you may have a little bleeding, damage to the bladder or infection.
• Use of fertility medications may also cause ovarian hyper-stimulation syndrome which is a very rare condition.

Intrauterine Insemination Treatment (IUI) Intrauterine insemination treatment (IUI Treatment) is one of the commonly used assisted reproductive procedures. Normally, the sperms swim through the female reproductive organs (cervix and uterus and fallopian tube) to reach the egg. Once the sperm fuses with the egg an embryo develops and grows during pregnancy into a fetus. Intrauterine insemination i.e., IUI Procedure is a fertility treatment that involves placing sperm inside a woman’s uterus to facilitate fertilization. The goal of IUI technique is to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilization. When is IUI Technique used? The most common reasons for doing IUI Procedure are a low sperm count or decreased sperm mobility. However it may be a treatment option in the following conditions as well:

• Unexplained infertility
• When there is a cervical condition preventing pregnancy including a cervical mucus problem
• Cervical scar tissue from past procedures which may hinder the sperms’ ability to enter the uterus
• Ejaculation dysfunction with ovulation induction

What is an IUI procedure? Before intrauterine insemination, ovulation-stimulating medications may be used and you will be monitored to determine when the eggs are mature.

• The IUI procedure will be performed around the time of ovulation.
• A semen sample will be washed by the lab to separate the semen from the seminal fluid.
• A catheter will then be used to insert the sperm directly into the uterus. This process maximizes the number of sperm cells that are placed in the uterus, thus increasing the possibility of conception.

The entire procedure takes only a few minutes and you may feel little pain. Ovulation induction Sperm retrieval Artificial insemination Common risks involved with IUI Treatment? With ovulation induction, the chances of becoming pregnant with multiples is increased. There is also a small risk of infection after IUI. Success score of IUI procedure? The success of IUI Treatment depends on several factors. If a couple has the IUI procedure performed each month, success rates may reach as high as 20% per cycle depending on variables such as female age, the reason for infertility, and whether they were used, among other variables. The success also depends on your age, the cause of infertility, and the type of fertility drugs used. A success rate of IUI Procedure by age:

• If your age is less than 35 years, you have 10 to 20 % chance of becoming pregnant
• If your age is between 35 and 40 years, there is 10 % chance of you becoming pregnant
• If your age is 40 years and more, you have 2 to 5 % chance of becoming pregnant

IntraCytoplasmic Sperm Injection (ICSI) Treatment The technique of injecting the sperm cell into the cytoplasm of the egg is known as Intra Cytoplasmic Sperm Injection (ICSI) Treatment. ICSI treatment is a specialized form of In Vitro Fertilisation (IVF) that is used for the treatment of severe cases of male-factor infertility. ICSI treatment involves the injection of a single sperm directly into a mature egg. This treatment is performed in parallel with IVF where after suitable stimulation the retrieved eggs from a woman are mixed with the partner’s sperm. When is ICSI Treatment Beneficial? During ICSI treatment the sperm doesn’t have to travel to the egg or penetrate the outer layers of the egg. Your doctor may recommend ICSI if there is any difficulty in achieving fertilization due to male infertility factors. The factors include:

• Low sperm count
• Poor sperm motility
• Decreased ability of sperm to penetrate into the egg
• Previous unsuccessful IVF procedure

When is ICSI Treatment Performed?

As with standard IVF, you will be given fertility drugs to stimulate your ovaries to develop several mature eggs for fertilization. When your eggs are ready for a collection they will be retrieved through a short outpatient procedure. The collected eggs are used immediately or frozen and used later on. Meanwhile, the sperms are collected from the semen sample of the male partner. These sperm are washed and a single best sperm is chosen. This sperm is injected carefully into the cytoplasm of the egg by using very fine needles. The entire procedure of fertilization is carried out under a very powerful microscope. This fertilized egg is then placed in the incubator. Such an egg begins to show signs of fertilization after 24 hrs. The egg continues to divide and form an embryo. When the embryo is 3 days old having 8 cells, it is ready to be transferred to the uterus. Or the transfer may be done on day 5 and is called a Blastocyst transfer. If you’re just having one embryo transferred (called elective single embryo transfer, or eSET), having a blastocyst transfer can improve your chances of a successful, healthy, single baby. If all goes well, an embryo will attach to your uterus wall and continue to grow to become your baby. After about two weeks, you will be able to take a pregnancy test. What are the risks associated with ICSI? You may have a higher risk of congenital conditions in your baby. During natural conception, only the hardiest sperm manage to break through the membrane of an egg to fertilize it. Weaker sperm doesn’t make it. But because ICSI treatment bypasses this natural selection process, there’s an increased risk of rare genetic problems carried by the sperm being passed on to the child. Some but not all genetic problems can be tested for before you have the treatment. PGS & PGD Preimplantation genetic diagnosis (PGD) allows those with an inheritable condition in their family to avoid passing it on to their children. It involves checking the genes and/or chromosomes of embryos created through IVF. Preimplantation genetic screening (PGS) involves checking the chromosomes of embryos conceived by ICSI for common abnormalities. Chromosomal abnormalities are a major cause of the failure of embryos to implant, and of miscarriages. They can also cause conditions such as Down’s syndrome. PGD can be used to test for virtually any genetic condition where a specific gene is known to cause that condition. Who would benefit from PGD and PGS screening?

• Patients who have repeated IVF failures
• Patients who had a history of recurrent miscarriages
• Patients who have ended previous pregnancies because of a serious genetic condition
• Patients who already have a child with a serious genetic condition
• Patients who are the carriers of abnormal chromosomes or have a family history of serious genetic disorders or chromosomal problems.
• Patients who are 38 years and above who are undergoing IVF cycles

These tests may help identify the problems that are causing infertility. Once diagnosed, the problems can be treated by our doctors. Cryopreservation is the term used to describe the process of freezing and storing sperm, eggs or surplus embryos from an in vitro fertilization cycle. There are 2 methods currently used for freezing in IVF labs-slow freezing and vitrification (ultra-rapid freezing) Vitrification is the process of converting something into a solid without any crystal formation. This is done by adding a cryo-protectant. This is important because ice crystal formation can be very damaging to frozen embryos. Embryos can be frozen at the pronuclear stage (one cell), or at any stage after that up to and including the blastocyst stage (5-7 days after fertilization). Different cryoprotectants and freezing solutions and protocols are used for different stages of embryo development. Many IVF clinics freeze their embryos at the blastocyst stage Sperm Freezing Sperm freezing is also known as cryopreservation or semen banking is a technique of preserving sperms by freezing and storing in liquid nitrogen at the temperature of -196⁰C that is used on a later date for fertilizing an egg. Sperm freezing is useful because :

• you have a condition or are facing medical treatment for a condition, that may affect your fertility
• you are about to have a vasectomy
• you have a low sperm count or the quality of your sperm is deteriorating
• you have difficulty producing a sample on the day of fertility treatment
• you are at risk of injury or death (eg: you’re a member of the Armed Forces who is being deployed to a war zone)

Procedure before you store sperm

• You need to go through careful screening for HIV, HBV, HCV, etc. to avoid chances of infection.
• You need to give a written consent regarding what will happen to your sperm if you cannot make decisions for yourself or die, whether anybody can use your sperm such as your partner or for research or if it can be donated for somebody else’s treatment and for how long you want to store your sperm

The standard time for storing a sperm is 10 years, but you can extend the storage time up to 55 years. Before doing that your Andrologist will check the condition of the sperm in one of the vials and help you decide on the fate of the frozen sperms. Oocyte vitrification , also known as egg freezing, is a technique used to preserve a woman’s eggs for future use. The process involves extracting a woman’s eggs and freezing them using a special solution that prevents ice crystals from forming and damaging the cells. The eggs can then be stored for years until they are needed for in vitro fertilization (IVF) or other assisted reproductive techniques. Oocyte vitrification has become an increasingly popular option for women who wish to delay childbearing for personal or medical reasons, such as pursuing education, career goals, or undergoing medical treatments that may affect fertility. The procedure is typically done in an outpatient setting under sedation or anesthesia, and recovery time is minimal. One potential advantage of oocyte vitrification is that it allows women to preserve their fertility while their eggs are still healthy and of good quality, typically in their 20s and 30s. This may increase the chances of success in future fertility treatments compared to waiting until later in life when fertility declines. However, it’s important to note that oocyte vitrification does not guarantee future pregnancy success and may not be appropriate for all women. The procedure can be costly and requires careful planning and monitoring by a fertility specialist. Additionally, success rates may vary depending on a woman’s age at the time of freezing and other factors, such as the quality of the eggs and the skill of the laboratory performing the procedure. Sperm / Semen preservation Cryopreservation is the term used to describe the process of freezing and storing sperm, eggs or surplus embryos from an in vitro fertilization cycle. There are 2 methods currently used for freezing in IVF labs-slow freezing and vitrification (ultra-rapid freezing) Vitrification is the process of converting something into a solid without any crystal formation. This is done by adding a cryo-protectant. This is important because ice crystal formation can be very damaging to frozen embryos. Embryos can be frozen at the pronuclear stage (one cell), or at any stage after that up to and including the blastocyst stage (5-7 days after fertilization). Different cryoprotectants and freezing solutions and protocols are used for different stages of embryo development. Many IVF clinics freeze their embryos at the blastocyst stage Sperm Freezing Sperm freezing is also known as cryopreservation or semen banking is a technique of preserving sperms by freezing and storing in liquid nitrogen at the temperature of -196⁰C that is used on a later date for fertilizing an egg. Sperm freezing is useful if:

• you have a condition or are facing medical treatment for a condition, that may affect your fertility
• you are about to have a vasectomy
• you have a low sperm count or the quality of your sperm is deteriorating
• you have difficulty producing a sample on the day of fertility treatment
• you are at risk of injury or death (eg: you’re a member of the Armed Forces who is being deployed to a war zone)

Procedure before you store sperm

• You need to go through careful screening for HIV, HBV, HCV, etc. to avoid chances of infection.
• You need to give a written consent regarding what will happen to your sperm if you cannot make decisions for yourself or die, whether anybody can use your sperm such as your partner or for research or if it can be donated for somebody else’s treatment and for how long you want to store your sperm

The standard time for storing a sperm is 10 years, but you can extend the storage time up to 55 years. Before doing that your Andrologist will check the condition of the sperm in one of the vials and help you decide on the fate of the frozen sperms.

Services offered at SPARSH FERTILITY CENTRE

• Complete infertility Evaluation
• Psychological Support and Counselling Ovarian stimulation
• Intra Uterine Insemination (IUI)
• In Vitro Fertilization (IVF) Intracytoplasmic Sperm Injection (ICSI)
• Sperm, Embryo Freezing (Vitrification)
• Frozen Embryo Donation
• Surrogacy
• Testicular Sperm Aspiration (TESA)
• Percutaneous Epididymal Sperm Aspiration (PESA)
• Genetic Screening
• Endometrial Receptivity Array (ERA)
• Non-invasive prenatal Analysis for Chromosomal
• Examination (NACE)