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Obstetric Programme

pregnancy care by expert sheetal jindal

 

NURTURE HIGHLIGHTS

Highly qualified & experienced team of doctors (obstetricians, fetal medicine experts, geneticists, pediatricians, anesthesiologist) yoga trainers, counselors, US trained birth educators) all under one roof.

1. Lamaze Programme to facilitate vaginal delivery

(a) Scientifically proven method to facilitate in normal vaginal delivery
(b) Improve your chances of vaginal delivery by knowing various pelvic exercises & using them during labour.
(c) It also aim to allay your fears & apprehension regarding labour so as to have a positive birthing experience

2. Yoga and Antenatal exercises

pregnancy yoga

From one of the best experts of the region along with a physical therapist again to increase your chances of normal vaginal delivery and avoid backaches, cramps and other such problems. We shall personalise these exercises in the form of a curriculum depending upon your time schedule and your body and prepare you fully to take care of your child.

3. Special sessions

Special sessions with dietician, skin specialist, pediatrician and anesthesiologist for a wholesome experience and clear all your doubts and apprehensions before your delivery.

4. Child care session

Learn to handle your little one with the help of our experts, special sessions include art of breastfeeding, baby massage, baby bath, how to handle a cry & colicky baby of much more. Know about baby utilities too.

5. Conscious Fathering

fathering

In India, child rearing is still considered a females job. Let’s step out of this and be a role father who are ready to participate and enjoy the fatherhood like never before.

6. Postpartum programme

We do not leave you just after delivery but the programme involves sessions regarding getting back to shape, work and baby adjustments, conscious fathering and preparing for the next pregnancy.

Have questions related to Pregnancy? Ask Our Experts Now!

Read More About :

 

Know Your Pregnancy

 

Ultrasound

 

Second Trimester (14 TO 28 WEEKS)

 

Third Trimester (29 TO 40 WEEKS or Till Delivery)

Infertility Treatments

Infertility Treatments

Infertility affects nearly 10 to 15 % of all married couples planning to start their families. The incidence is increasing. Delay in marriage and childbirth, changing life-style and many such factors have contributed to this increase. New techniques have been now available to counter this menace.

It comprises of:

Intra-uterine-insemination (IUI)

Intrauterine insemination with donor sperm (IUI-D)

Ovulation induction in PCOS

Ovulation induction in hypo-hypo

Gonadotrophin treatment of male hypo-hypo

Treatment of sexual dysfunction

 

Intra-uterine-insemination (IUI)

What it means?

IUI means injecting sperms inside the uterine cavity.

Who are suitable candidates?

Unexplained infertility, mild male factor infertility, sexual dysfunction, mild endometriosis, with ovulation induction donor insemination.

Who should not get IUI?

Women with blocked tubes, severe endometriosis, more than six failed cycles of IUI, severe male factor infertility.

What are its main steps?

Steps:
  Giving appropriate medicines to the female partner to stimulate ovaries to produce one to four follicles
  Preparing semen sample from male partner to obtain an enriched and clean sample containing active spermatozoa
  Injecting this sperm preparation inside the uterus at the time of ovulation as decided by follicular sonography

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Intrauterine insemination with donor sperm (IUI-D)

What it means?

IUI-D means injecting sperms taken from sperm bank inside the uterine cavity.

Who are suitable candidates?

Male partner with nil sperm count, with genetic diseases, very low counts not willing for ICSI, HIV or other serious medical illnesses.

Who should not get IUI-D?

Women with blocked tubes, severe endometriosis, more than six failed cycles of IUI.

What are its main steps?

Steps:
  Giving appropriate medicines to the female partner to stimulate ovaries to produce one to four follicles Natural cycles can also be used.
  Taking sperm from sperm bank. Matched for Blood group, height, color of skin, hair and eyes. These samples are screened for thalassemia trait and common infections e.g. HIV, hepatitis etc. and quarantined for window period.
  Injecting this sperm preparation inside the uterus at the time of ovulation as decided by follicular sonography.

Advantages:

Simple and cost-effective technique in well selected cases with only minor side effects. Overall success rate remains between 10 to 20 % per treatment cycle.

Disadvantage:

The sperm belong to a donor.

Legal status:

  Allowed by Indian Council of Medical Research guidelines, when done with the consent of both partners. The child thus born has all legal rights and obligations.
  Donation from known donor is not allowed.

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Ovulation induction in PCOS

What it means?

PCOS or polycystic ovarian syndrome is a common endocrine disorder characterised by irregular menstrual cycles, infertility and other features like excessive hair growth on body and obesity. It is diagnosed by ultrasound and hormonal tests like LH, FSH and AMH.
Who are suitable candidates?

Patients diagnosed with PCOS, who are not able to conceive after trying for at least 6 months.

What are its main steps?

  Ovulation induction is done with the help of medicines such as clomiphene and injectable drugs like HMG and FSH.
  Various protocols can be followed. Efficacy of the treatment is assessed by serial ultrasound.

Advantages:

Cost effective treatment with good success rate.

Disadvantages:

Occasionally the procedure for ovulation induction may get prolonged.
More chances of multiple pregnancy.

Ovulation induction in hypo-hypo

What it means?

Hypo hypo or hypogonadotrophic hypogonadism is a hormonal disorder in which there is defective production of the hormones FSH and LH from the pituitary resulting in absence of menstrual cycle (amenorrhea) in the female. Therefore, ovulation induction is required for pregnancy.

Who are suitable candidates?

Patients with amenorrhoea diagnosed with hypo hypo after hormonal tests FSH and LH.

What are its main steps?

  Complete workup of the female and male partner is required before starting treatment to rule out any other problem and look for cause of hypo hypo.
  Ovulation induction is done with the help of injectable drugs like HMG. Efficacy of ovulation induction is assessed by serial ultrasound.

Advantages:

Very high success rate:

Disadvantages:

Complications like OHSS and multiple pregnancy can occur.

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Gonadotrophin treatment of male hypo-hypo

What it means?

Hypo hypo or hypogonadotrophic hypogonadism is a hormonal disorder in which there is defective production of the hormones FSH and LH from the pituitary resulting in defective sperm production in the male. If the disorder occurs at an early age, puberty may be delayed.

Who are suitable candidates?

Patients presenting with delayed puberty or infertility, diagnosed with hypo hypo after hormonal tests FSH and LH.

What are its main steps?

  Complete workup of the female and male partner is required before starting treatment to rule out any other problem and look for cause of hypo hypo.
  Injectable drugs HCG and HMG are given on alternate days or twice a week for 3 to 6 months. Efficacy of treatment is assessed by repeating semen analysis.

Advantages:

Good success rate.

Disadvantages:

There is wide variation in response to treatment among the patients. Procedures like IUI and IVF may still be required, but success rate is high.
Treatment is costly and prolonged over 3 to 6 months.

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Treatment of sexual dysfunction

What it means?

Sexual dysfunction means the inability to perform intercourse due to various reasons. The problem may be in female in the form of pain during intercourse or in males in the form of erectile dysfunction. It may occur due to psychological or physical reasons.

Who are suitable candidates?

Couples unable to perform intercourse.

What are its main steps?

Physical factors are to be ruled out such as;

  • Females – endometriosis, trauma, scarring
  • Males – diabetes mellitus, neurological dysfunction, etc.

Most common cause is still psychological for both partners and proper counselling is required for treatment. Medicines are helpful in some situations.

Advantages:

Highly effective treatment if done properly.

Disadvantages:

Psychological counselling require prolonged sessions.

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Standard Assisted reproductive technology ART

Standard ART techniques

Standard Assisted reproductive technology (ART) techniques

Standard Assisted reproductive technology (ART) is the new technology used to achieve pregnancy in procedures such as fertility medication, in vitro fertilization and surrogacy. We have listed below some of the standard Assisted reproductive technology (ART) techniques used at Jindal IVF Chandigarh below:

In-vitro fertilization – embryo transfer (IVF-ET)

Intracytoplasmic sperm injection (ICSI)

ICSI with Testicular sperm (TESA/TESE/Micro TESE/PESA)

IVF with OD

Assisted Hatching

Blastocyst Culture and Transfer

Surrogacy

In-vitro fertilization – embryo transfer (IVF-ET)

What it means?
IVF stands for in-vitro-fertilization and ET for embryo transfer. It actually means fertilization i.e. meeting of eggs and sperms outside the female body in the IVF laboratory. The embryo which is thus formed is put back into the womb. Popularly known as test tube baby.

Who are suitable candidates?
Almost any condition which is leading to infertility can be helped by IVF.

  • 1. Bilateral blocked or absent tubes
  • 2. Endometriosis
  • 3. Unexplained infertility
  • 4. Genital tuberculosis
  • 5. Moderate male factor
  • 6. Failed IUI
  • 7. PCOD failed ovulation induction
  • 8. Prolonged infertility
  • 9. Time short
  • 10. Advancing maternal age

Who should not get IVF-ET?

  • Very short infertility
  • Contraindications to pregnancy
  • Poor endometrial cavity or lining
  • Badly distorted uterus
  • Poor ovarian reserve
  • Big hydrosalpinx
  • Big fibroids
  • Active pelvic infection

What are its main steps?

  • Step-1 Complete workup for general fitness and assessment of ovarian and uterine function
  • Step-2 Giving injections to knock out control of the menstrual cycle by pituitary and higher centres. This can be achieved by two protocols. In long protocol injections known as GnRH-agonists are started few days before menses. In short protocol these are added after the follicles start developing. Both these protocols have their own role, advantages and disadvantages.
  • Step-3 Hormone injections are started with the onset of menses as to achieve 10-12 follicles. The growth is monitored with the help of ultrasound and blood hormone tests. Final maturation trigger is given once at least three lead follicles are more than 16-17 mm diameter.
  • Step-4 Ovum pick-up (OPU) is done 36 hours after final maturation trigger. It is a short procedure done under short general anaesthesia. Eggs are removed from ovaries under ultrasound guidance with the help of a needle mounted on trans-vaginal ultrasound probe. There are no cuts or stitches. There is no intra or post op pain.
  • Step-5 Semen is taken from male partner and processed in laboratory to take out best sperms.
  • Step-6 Eggs are mixed with sperms in culture dish. Sperms enter the eggs with their own power.
  • Step-7 Development of the fertilized eggs (now called embryos) is checked
  • Step-8 Embryo transfer is done at 48-72 hours when embryo is at 4-8 cell stage.
  • Step-9 Medicines are given to support the possible pregnancy
  • Step-10 Blood test for pregnancy is done 12 days after ET to confirm pregnancy.

Advantages:

  • It is a highly effective technique. Success rates per cycle are in the range of 40-45 %. Although costly but this is the most cost effective technique available.

Disadvantages:

  • Cost, time (nearly 6 weeks total) and success rate less than 50%. Generally very safe but serious side effects like OHSS etc. and multiple pregnancy can occur.

Legal status:

  • Allowed by the Indian Council of Medical Research guidelines, when done with the consent of both partners. The child thus born has all legal rights and obligations. The female partner should be above the age of 21 years.

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Intracytoplasmic sperm injection (ICSI)

What it means?
ICSI stands for intracytoplasmic sperm injection. It actually means injecting single sperm in every egg one by one with the help of a very fine equipment called micromanipulator. It is an additional procedure to IVF.
Who are suitable candidates?

  • Primary indication is severe decreased sperm count or motility.
  • Unexplained infertility
  • Almost any condition where IVF is being done ICSI can be done

Who should not get ICSI?
There are no specific contraindications for ICSI in a couple going for IVF-ET.

What are its main steps?
Steps are same as for IVF-ET except that for the lab procedure of insemination of eggs.

  • Step-1 Complete workup for general fitness and assessment of ovarian and uterine function
  • Step-2 Giving injections to knock out control of the menstrual cycle by pituitary and higher centres. This can be achieved by two protocols. In long protocol injections known as GnRH-agonists are started few days before menses. In short protocol these are added after the follicles start developing. Both these protocols have their own role, advantages and disadvantages.
  • Step-3 Hormone injections are started with the onset of menses as to achieve 10-12 follicles. The growth is monitored with the help of ultrasound and blood hormone tests. Final maturation trigger is given once at least three lead follicles are more than 16-17 mm diameter.
  • Step-4 Ovum pick-up (OPU) is done 36 hours after final maturation trigger. It is a short procedure done under short general anaesthesia. Eggs are removed from ovaries under ultrasound guidance with the help of a needle mounted on trans-vaginal ultrasound probe. There are no cuts or stitches. There is no intra or post op pain.
  • Step-5 Semen is taken from male partner and processed in laboratory to take out best sperms.
  • Step-6 Eggs are mixed with sperms in culture dish. Sperms enter the eggs with their own power.
  • Step-7 Development of the fertilized eggs (now called embryos) is checked
  • Step-8 Embryo transfer is done at 48-72 hours when embryo is at 4-8 cell stage.
  • Step-9 medicines are given to support the possible pregnancy
  • Step-10 Blood test for pregnancy is done 12 days after ET to confirm pregnancy.

Advantages:

  • It is a highly effective technique. Success rates per cycle are in the range of 40-45 %. Although costly but this is the most cost effective technique available.

Disadvantages:

  • Cost, time (nearly 6 weeks total) and success rate less than 50%. Generally very safe but serious side effects like OHSS etc. and multiple pregnancy can occur.

Legal status:

  • Allowed by Indian Council of Medical Research guidelines, when done with the consent of both partners.
  • The child thus born has all legal rights and obligations. The female partner should be above the age of 21 years.

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ICSI with Testicular sperm (TESA/TESE/Micro TESE/PESA)

What it means?
ICSI stands for intracytoplasmic sperm injection. It actually means injecting single sperm in every egg one by one with the help of a very fine equipment called micromanipulator. It is an additional procedure to IVF. When ICSI is done with sperms taken directly from testis it is called ICSI with testicular sperm. TESA/TESE/Micro TESE/PESA are various techniques for obtaining sperms from testis. The choice depends upon the indication of obtaining testicular sperms directly from the testis. PESA and micro TESE are the most commonly performed techniques.
TESA – testicular sperm aspiration
TESE – testicular sperm extraction
Micro-TESE – retrieval of best sperms from healthy tubules of testes under operating microscope
PESA – percutaneous epididymal sperm aspiration

Who are suitable candidates?

  • Primary indication is azoospermia or absent sperm in semen
  • Severe decreased sperm count or motility, sometimes testicular sperm give better result
  • Blockage of vas or ejaculatory ducts (the male ducts)
  • Spinal injury, severe sexual dysfunction, retrograde ejaculation. Anejaculation
  • High DNA fragmentation in semen

Who should not get ICSI –with testicular sperm?

  • Very High FSH
  • High surgical risk, e.g. very high BP, uncontrolled diabetes heart disease etc.
  • Men with genetic abnormalities

Is FNAC required to decide?

    • No. Spermatogenesis in testes can be patchy and FNAC can give information on the area sampled
    • Can Patients with Sertoli cell only, or testicular atrophy on FNAC try testicular sperm?
    • Yes, there is nearly 50 % chance of getting functional sperms even in these cases

How much rest is required?

      • Not much. Only cases of micro-TESE may require a few days’ rest.

What are its main steps?
Steps are same as for IVF-ET and ICSI. In addition procedures for sperm retrieval and isolation are required.

      • Step-1 Complete workup for both partners for general fitness and assessment of ovarian and uterine function. The male partner needs to be thoroughly examined and counselled for selection of procedure and anaesthesia.
      • Step-2 Giving injections to knock out the control of menstrual cycle by pituitary and higher centres. This can be achieved by two protocols. In long protocol injections known as GnRH-agonists are started few days before menses. In short protocol these are added after the follicles start developing. Both these protocols have their own role, advantages and disadvantages.
      • Step-3 Hormone injections are started with the onset of menses as to achieve 10-12 follicles. The growth is monitored with the help of ultrasound and blood hormone tests. Final maturation trigger is given once at least three lead follicles are more than 16-17 mm diameter.
      • Step-4 Ovum pick-up (OPU) is done 36 hours after final maturation trigger. It is a short procedure done under short general anaesthesia. Eggs are removed from ovaries under ultrasound guidance with the help of a needle mounted on trans-vaginal ultrasound probe. There are no cuts or stitches. There is no intra or post op pain.
      • Step-5 Spermatozoa are taken out from testes by the surgeon and isolated in the IVF laboratory to take out the best sperms. Except for micro-TESE all other procedures can be done under local anaesthesia. For micro-TESE spinal or general anaesthesia is required.
      • Step-6Eggs are injected with sperms isolated from testicular aspirate. Isolation of sperms is a highly technical and specialized procedure and takes almost 2-3 hours.
      • Step-7 Development of the fertilized eggs now called embryos is checked every day.
      • Step-8 Embryo transfer is done when at 48-72 hours when embryo is at 4-8 cell stage.
      • Step-9 Medicines are given to support the possible pregnancy.
      • Step-10 Blood test for pregnancy is done 12 days after ET to confirm pregnancy.

Advantages:

      • It is a highly effective technique. Success rates per cycle are in the range of 40-45 %. In young couples success is even higher. Although costly but this is the only technique which gives the men suffering from azoospermia or very poor sperm counts a chance to get their own biological child. The only other option is adoption.

Disadvantages:

      • The procedure costs nearly 35 to 40 thousand rupees over and above the cost of IVF. Generally there are no complications but rare cases of bleeding and pain may be there.

Legal status:

      • Since the child is genetically linked to the male partner there are no legal issues involved.

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IVF with OD

What it means?
IVF stands for in-vitro-fertilization and ET for embryo transfer. It actually means fertilization i.e. meeting of eggs and sperms outside the female body in the IVF laboratory. The embryo which is thus formed is put back into the womb. Popularly known as test tube baby. When eggs are taken from another women it is called IVF withovum donation or briefly IVF with OD.

Who are suitable candidates?
When the women’s ability to produce good quality eggs ovum donation is required.

      • Age related decline in fertility. Nearly 10-13 years before menopause ( stoppage of menses) ovaries get weak. They keep on ovulating and bringing hormonal changes adequate for menstruation. But the quantity and quality of eggs is severely compromised.
      • Postmenopausal women
      • premature ovarian failure
      • ovaries absent by birth
      • unexplained fertilization failure or implantation failure.
      • Carriers of genetic diseases especially sex linked inherited diseases.
      • serious medical illness contraindicating egg retrieval
      • unapproachable ovaries due to previous surgeries, endometriosis etc
      • surgically removed ovaries
      • Gay couples

Who should not get IVF-ET with OD?

      • Poor endometrial cavity or lining
      • Badly distorted uterus
      • Big hydrosalpinx
      • Big fibroids
      • Active pelvic infection

What are its main steps?

      • Step-1 complete workup for both partners for general fitness and assessment of ovarian and uterine function
      • Step-2 selection and detailed assessment of donor
      • Step-3 synchronization of menstruation of donor and recipient
      • Step-4 stimulation of ovaries of donors. This involves giving injections to knock out the control of menstrual cycle by pituitary and higher centres. This can be achieved by two protocols. In long protocol injections known as GnRH-agonists are started few days before menses. In short protocol these are added after the follicles start developing. Both these protocols have their own role, advantages and disadvantages.
        The recipient is also given Medicines to control her cycle.
      • Step-5 the donor is started with hormone injections with the onset of menses as to achieve 10-12 follicles. The growth is monitored with the help of ultrasound and blood hormone tests. Final maturation trigger is given once at least three lead follicles are more than 16-17 mm diameter.
        Simultaneously recipient is also given hormones to build the lining of uterus or endometrium.
      • Step-6 Ovum pick-up (OPU) of donor is done 36 hours after final maturation trigger. It is a short procedure done under short general anaesthesia . Eggs are removed from ovaries under ultrasound guidance with the help of a needle mounted on trans-vaginal ultrasound probe. There are no cuts or stitches.There is no intra or post op pain.
      • Step-7 Semen is taken from male partner and processed in laboratory to take out best sperms.
      • Step-8 Eggs are inseminated with sperms in culture dish.
      • Step-9 Development of the fertilized eggs now called embryos are checked
      • Step-10 Embryo transfer is done when at 48-72 hours when embryo is at 4-8 cell stage.
      • Step-11 medicines are given to support the possible pregnancy to recipient. No more medicines are given to donor.
      • Step-12 Blood test for pregnancy is done 12 days after ET to confirm pregnancy.

Advantages:

      • It is a highly effective technique. Success rates per cycle are in the range of 40-45 %. Although additional cost of arranging donor is there but this is the only method with which a women can carry her husband’s sperm in her own uterus. Only other option is adoption.

Disadvantages:

      • Additional cost. Waiting list because of shortage of donors.Generally very safe. In older women especially who have medical problems hormones and pregnancy have higher risks.

Legal status:

      • Allowed by Indian Council of medical research guidelines when done with the consent of both partners. The child thus born has all legal rights and obligations. Donation from known donors or relations is not allowed.

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Assisted Hatching

What it means?
There is a protective shell outside the egg and embryo. The embryo comes out of it before implantation. This process is called hatching. When this procedure is done artificially it is called assisted hatching. Basically means making a hole in zonapellucida.
Who are suitable candidates?

      • Recurrent implantation failure
      • After cryofreezing
      • before trophoectoderm biopsy (blastocyst biopsy)
      • thick zona
      • highly fragmented embryos

Who should not get embryo-cryofreezing?
There is no role of routine assisted hatching in all cases . It improves implantation only in selected cases.

What are its main steps?

      • Step-1 Embryos are selected
      • Step-2 Consent from both partners is taken
      • Step-3 A hole is made in the zona with the help of laser, sharp needle or acid tyrode.
      • Step-4 Embryos are further cultured or transferred to uterus.

Advantages:

      • It is a moderately effective technique. In well selected cases it improves implantation.

Disadvantages:

      • Additional cost.

Legal status:

      • It is a laboratory procedure and there are no restrictions.

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Blastocyst Culture and Transfer

Blastocyst Culture and Transfer is a technique in which an embryo is developed in the laboratory for 4-6 days after fertilization before being placed in womb. The embryo gains many cells as a result of being developed for so many days. The embryos developed for 4-6 days are much more advanced than the ones developed for just three days. These Embryos are called blastocysts.

The embryos which survive for 4-6 days are more likely to produce the fruitful results. This enables embryologists to select from the more advanced embryos with better potential for implantation.

The biggest advantage of Blastocyst Culture and Transfer method is that it significantly reduces the risk of multiple pregnancies. Also, the pregnancy and implantation success rate is higher in this technique because it is easy to determine the robust embryos after developing for 4-6 days hence only the competent embryo are transferred to uterus.

With the advent of cutting-edge technology, it has become a feasible option to perform ‘minimally invasive’ surgeries with precision and finesse. Laparoscopy and Hysteroscopy are two such surgeries used to diagnose and cure certain female infertility conditions.

Laparoscopy: It is done using a small but significant telescope named ‘Laparoscope’ to which a light source and camera are attached. It enables doctors to see ovaries, outside of uterus and fallopian tubes inside the abdomen. The doctors can perform surgeries while looking inside the abdomen. Laparoscopy is done to determine the causes of infertility, symptoms like pelvic pain & abdominal pain and to check if there are any scar tissues or blockage in the fallopian tubes. The doctors use this technique to treat cysts, endometriosis and fibroids.


Embryo transfer

What it means?
ET or embryo transfer means the transfer of fertilized and cultured embryo into the woman’s uterus under ultrasound guidance.

Who are suitable candidates?

  • Any patient who has undergone IVF for formation of embryos (fresh cycle) or has cryopreserved embryos from previous cycle (frozen embryo transfer).
  • Patient may also undergo embryo transfer of donor embryo in case the couple’s gametes (both sperm and egg) are defective. These donor embryos may be frozen or from fresh cycle.

Who should not get ET?

  • Women who do not have suitable uterus for implantation eg thin endometrium, uterine adhesions etc.

What are its main steps?

  • Development of the embryos is checked
  • Embryo transfer is done 48-72 hours after OPU when embryo is at 4-8 cell stage, under ultrasound guidance
  • Medicines are given to support the possible pregnancy
  • Blood test for pregnancy is done 12 days after ET to confirm pregnancy

Advantages:

  • It is a highly effective technique. Success rates per cycle are in the range of 40-45 %.

Disadvantages:

  • high cost, being part of IVF cycle

Legal status:

  • Allowed by Indian Council of medical research guidelines when done with the consent of both partners. The child thus born has all legal rights and obligations. The female partner should be above the age of 21 years.

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Surrogacy

What it means?
IVF stands for in-vitro-fertilization and ET for embryo transfer. It actually means fertilization i.e. meeting of eggs and sperms outside the female body in the IVF laboratory. The embryo which is thus formed is put back into the womb. Popularly known as test tube baby. When embryos are implanted in another women’s uterus (womb) then it is called surrogacy. The baby grows for nine months in surrogate’s uterus but it is genetically linked to the couple who commissioned the surrogate.

Who are suitable candidates?
When the women’s uterus is absent, badly damaged or women has risk carrying pregnancy to term then surrogacy is required.

  • women after hysterectomy who have functioning ovaries
  • women have absent uterus by birth but have ovaries
  • Badly damaged uterus due to TB, adenomyosisetc
  • Repeated abortions due to weak uterus or cervical incompetence.
  • Serious medical illness in female partner where carrying pregnancy may be dangerous for her or baby.
  • unexplained recurrent implantation failure.
  • Gay couples and transsexuals

Who should not get IVF-ET with surrogacy?

  • implantation failure due to poor eggs
  • women demanding surrogacy for social reasonsPoor endometrial cavity or lining

What are its main steps?

  • Step-1 complete workup for both partners for general fitness and assessment of ovarian and uterine function
  • Step-2 selection and detailed assessment of surrogate
  • Step-3 detailed contracts and consents according to ICMR guidelines
  • Step-4 synchronization of menstruation of donor and recipient
  • Step-5 stimulation of ovaries of female partner. This involves giving injections to knock out the control of menstrual cycle by pituitary and higher centres. This can be achieved by two protocols. In long protocol injections known as GnRH-agonists are started few days before menses. In short protocol these are added after the follicles start developing. Both these protocols have their own role, advantages and disadvantages.
    The surrogate is also given Medicines to control her cycle.
  • Step-6 the female partner is started with hormone injections with the onset of menses as to achieve 10-12 follicles. The growth is monitored with the help of ultrasound and blood hormone tests. Final maturation trigger is given once at least three lead follicles are more than 16-17 mm diameter.
    Simultaneously surrogate is also given hormones to build the lining of uterus or endometrium.
  • Step-7 Ovum pick-up (OPU) of female partner is done 36 hours after final maturation trigger. It is a short procedure done under short general anaesthesia . Eggs are removed from ovaries under ultrasound guidance with the help of a needle mounted on trans-vaginal ultrasound probe. There are no cuts or stitches.There is no intra or post op pain.
  • Step-8 Semen is taken from male partner and processed in laboratory to take out best sperms.
  • Step-9 Eggs are inseminated with husbands sperms in culture dish.
  • Step-10 Development of the fertilized eggs now called embryos are checked
  • Step-11 Embryo transfer is done when at 48-72 hours when embryo is at 4-8 cell stage in surrogates uterus
  • Step-12 medicines are given to support the possible pregnancy to surrogate. No more medicines are given to female partner.
  • Step-13 Blood test for pregnancy is done 12 days after ET on surrogate to confirm pregnancy

Advantages:

  • It is a highly effective technique. Success rates per cycle are in the range of 40-45 %. Although additional cost of arranging surrogate is there but this is the only method with which a couple can have their own genetic baby even in the absence of uterus. Only other option is adoption.

Disadvantages:

  • Very high additional cost. Waiting list because of shortage of surrogates. Generally very safe.

Legal status:

  • Allowed by Indian Council of medical research guidelines when done with the consent of both partners. The child thus born has all legal rights and obligations. Surrogacy is allowed only for Indian couples married for at least two years.

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Advanced IVF or Advanced ART

Advanced IVF or Advanced ART

It combines of:

Fertility Preservation

Recurrent Implantation Failure

Advanced Andrology

PGD/PGS

Embryoscope

Fertility preservation

What it means?
The treatment for cancer is becoming better day by day leading to higher life expectncy and even cure in some cases. However, the medicines given for this affect the fertility potential of the person by destroying the sperm and ova producing cells of the human body. This is an important consideration for young people affected by the disease who are still to complete their families or even get married. Therefore, few procedures may be done to preserve their reproductive cells so that they are able to become genetic parents in future.

Who are suitable candidates?
Young men and women likely to undergo chemo or radiotherapy, but have not yet become parents.

What are its main steps?
Counselling is important for these patients especially if the disease is in early stge.

  • Males – fertility preservation in males who have reached puberty is easy as it requires semen cryopreservation. 2 or 3 samples (given by masturbation) may be preserved before starting chemo or radiotherapy
  • Preservation in children is difficult and still under research
  • Females – it is more difficult than in males and varies according to situation.
  • Children – requires ovarian tissue preservation which is still under research
  • Unmarried women who have attained puberty – patient can be stimulated with the help of hormonal injections, followed by oocyte retrieval. Oocytes thus obtained can be cryopreserved for future use.
  • Married women who have not completed their families – an IVF cycle is performed for the patient, wherein ovaries are stimulated by hormonal injections to retrieve eggs. These eggs are fertilized with the husband’s sperm. Embryos thus formed are cryopreserved till the patient completes chemo or radiotherapy after which these can be implanted in the woman’s uterus.

Advantages:

  • Effective method for fertility preservation
  • Easy and cost effective method in males

Disadvantages:

  • For females the method is difficult, time consuming and expensive

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Recurrent implantation failure

What it means?
The term recurrent implantation failure is used for patients who have had previous two or three filed IVF attempts.

Who are suitable candidates?
Women who have had 2 or 3 failed IVF attempts.

What are its main steps?
RIF may be due to various causes which need to be corrected-

  • Improving endometrial receptivity
    • Hysteroscopic correction of cavity pathology – myomectomy, polypectomy, septectomy, adhesiolysis
    • Myomectomy
    • Treatment of thin endometrium – sildenfil, high dose estrogen
    • Endometrial stimulation (biopsy)
    • G-CSF
  • Immunotherapy (intravenous immunoglobulin, steroids, aspirin and heparin)
  • Treatment of the embryos
    • Preimplantation genetic screening
    • Assisted hatching
    • Zygote intra-Fallopian transfer
    • Co-culture
    • Blastocyst transfer
    • Improving ET technique
  • Male factor
    • Assessment of DNA fragmentation
    • IMSI
  • Multifactorial treatment options
    • Treating endometriosis
    • Salpingectomy in case of hydrosalpinges
    • Tailoring the stimulation protocols
    • Use of donor gametes

Advantages:

  • May be successful if proper investigation and treatment done

Disadvantages:

  • Expensive and time consuming procedures

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Advanced Andrology

What it means?
Advanced andrology means specialized tests for the male partner in order to diagnose conditions responsible for male infertility not diagnosed by routine semen examination

Who are suitable candidates?

  • Cases recurrent IUI , IVF ,Fertilization failure.
  • Before IVF
  • Older age men
  • Men with life style and chronic diseases
  • Men with high proportion of dead sperms
  • Men with persistent pus cells.
  • Who should not get advanced andrology tests?
  • First semen examination

What are its main steps?

  • Semen collection by masturbation
  • Special tests in laboratory
  • Reporting

Advantages:

  • Male infertility can be accurately diagnosed.
  • Appropriate treatment can be proposed
  • Monitoring of treatment can be done

Disadvantages:

  • Cost

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PGD/PGS

What it means?
Pre-implantation genetic diagnosis (PGD) or screening (PGS) is a process by which few cells are taken from the blastocyst formed after IVF procedure and chromosomal analysis is done on them to check for any genetic diseases

Who are suitable candidates?
Patients with-

  • Recurrent abortions
  • Recurrent implantation failure
  • History of genetic disease in family

What are its main steps?

  • patient is stimulated according to an IVF cycle and embryos are formed
  • the embryos formed are grown upto the blastocyst stage (needs 4 to 5 days of culture)
  • few cells are removed from the embryo after penetrating the wall and sent for chromosomal analysis
  • the embryos are cryopreserved pending report of chromosomal analysis
  • embryos with normal report are transferred into the patient’s uterus at a later date in frozen embryo transfer cycle.

Advantages:

  • Useful procedure for patients with history of genetic disease in family with good success rate.

Disadvantages:

  • Additional cost
  • Risk of abortion not completely eliminated
  • Legal status
  • No prohibition

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Embryoscope

What it means?
Embryoscope is an advanced equipment for the purpose of embryo culture. It allows for continuous culture of embryos without any interference from outside so that embryos may grow under ideal conditions. It has-

  • Tri-gas Incubator with advanced temperature control
  • Build-in microscope for acquisition of time-lapse images
  • 6 patients with 12 embryos each = 72 samples
  • Automatic startup and un-attended operation
  • External workstation for monitoring, evaluation and image analysis

Who are suitable candidates?
Can be used in all patients going for IVF-ICSI

Advantages:

  • Reduced handling of embryos as observations made from inside incubator
  • Direct heat transfer allows for uniform distribution
  • Active carbon and HEPA filter
  • UV disinfection of circulated Air
  • Tri-gas mixer fro optimal growth environment
  • Time-lapse imaging allows for better choice between embryos
  • Embryos are undisturbed and can be assessed without opening the incubator again and again

Disadvantages:

  • High cost of equipment

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male infertility

Male Infertility

Andros Diagnostics

Infertility has always been a sensitive and straining issue for couples. With many studies conducted, they’ve shown that 15 to 20 percent of people within reproductive age have some level of infertility. Furthermore with infertility in men, that is actually to blame 30 to 40 percent of the time.

It’s surprising since a lot of us think infertility is primarily due to women being infertile, but that’s not always the case. The only real difference in detecting male infertility is that it’s harder than female infertility.

Male fertility is a complex process. To get your partner pregnant, the following must occur:

      • You must produce healthy sperm. Initially, this involves the growth and formation of the male reproductive organs during puberty. At least one of your testicles must be functioning correctly, and your body must produce testosterone and other hormones to trigger and maintain sperm production.

     

      • Sperm have to be carried into the semen. Once sperm are produced in the testicles, delicate tubes transport them until they mix with semen and are ejaculated out of the penis.

     

      • There needs to be enough sperm in the semen. If the number of sperm in your semen (sperm count) is low, it decreases the odds that one of your sperm will fertilize your partner’s egg. A low sperm count is fewer than 15 million sperm per milliliter of semen or fewer than 39 million per ejaculate.

     

      • Sperm must be functional and able to move. If the movement (motility) or function of your sperm is abnormal, the sperm may not be able to reach or penetrate your partner’s egg.

     

In those kinds of situations you want to be conducting male fertility tests to test male fertility. All you need to do is go to a fertility clinic. But there can be some other signs that lead up to male infertility and from those we can understand how to detect early signs of infertility.

Difficulties with Ejaculation & Orgasms

Known as “ejaculation disorder” in the medical world, this issue at the core is suggesting ejaculation isn’t normal. This means that the volume is low or happens rarely or can be hampered through erectile dysfunction.

This disorder can stem from a variety of things, but it does contribute to infertility in men. In the end,
if you do suffer from an ejaculation disorder, check with your local physician or fertility specialist .

Varicocele of the Testicles

These are the veins that appear in your testicles and serve to obstruct drainage. They also serve to lower sperm count as well and affect about 10 to 15% of men within the reproductive age range. How it is caused is really up for debate, however what’s important is the signs of this. Those signs being lumps on the testicles, dull pains, swelling, and being able to see large inflamed veins on them. Thankfully this condition can be corrected through surgery in most situations, but you still want to check for swelling and lumps on the regular.

Lower Sperm Count

With this one, it’s hard to tell at home and you’ll need to go to a male fertility clinic for a male fertility test. The reason being is you’ll need to measure how many sperm are present is your semen and only doctors have the equipment to measure it properly. When it comes to male infertility, their sperm count falls below 15 million sperm for every milliliter of semen. That’s quite a lot, but before you panic, in healthy fertile men, the sperm count of that amount ranges between 20 million and 150 million.

Dropped Libido & Other Hormones

Popular culture has men portrayed as individuals who indulge in sex more than women. Men produce a naturally large amount of testosterone which is a hormone linked to libido (aka the sex drive). It’s for this particular reason why if you should be concerned if men have a change in their sex drive and isn’t related to external events (like stress from tragic events or longer working hours). In those situations it could be a sign of male infertility.

Risk factors

Risk factors linked to male infertility include:

  • Smoking tobacco
  • Using alcohol
  • Using certain illicit drugs
  • Being overweight
  • Having certain past or present infections
  • Being exposed to toxins
  • Overheating the testicles
  • Having experienced trauma to the testicles
  • Having a prior vasectomy or major abdominal or pelvic surgery
  • Having a history of undescended testicles
  • Other causes

Andros Diagnostics

Andros Diagnostics is a dedicated, state of the art, male infertility lab. With the latest WHO approved equipment and complete semen analysis by CASA or computer assisted semen analysis, we provide complete diagnostic information. We are the one and only center in North India to be providing such advanced information about male infertility and semen analysis. Details like DNA fragmentation, ROS, etc. are not provided in routine semen testing, while you can get the complete package here at Andros Diagnostics.

Cryofreezing

Cryopreservation Frozen Embryo Transfer Embryo Freezing

 

Get deep insights about frozen embryo transfer, embryo freezing, embryo cryopreservation, sperm cryofreezing techniques at Jindal IVF Chandigarh

Cryofreezing combines following three categories:

Embryo Cryo Preservation

Sperm Cryopreservation

Frozen Embryo transfer

 

 

Embryo Cryo Preservation

What does Embryo Cryo Preservation means?
In IVF procedures ovaries are stimulated to produce 10-15 eggs. All these eggs can lead to healthy embryos after fertilization. Only one or two embryos are transferred. Remaining spare embryos can be preserved for future use by freezing these embryos.

Who are suitable candidates for Embryo Cryo Preservation?

  • All IVF cycles which have spare good quality embryos can be benefitted by cryofreezing of embryos.
  • When embryo transfer is cancelled in same cycle due to various indications and unavoidable circumstances all embryos can be frozen
  • Now there is a movement for elective freezing of all embryos because results are equal or even better in frozen cycles
  • For fertility preservation when immediate pregnancy is not possible due to medical or social reasons like chemotherapy for cancers or carrier choice.

Who should not get embryo-cryofreezing?
There are no contraindications for embryo-cryofreezing. Couples with infections like hepatitis may be denied freezing by the hospital because risk of cross contamination.

What are the main steps of Embryo Cryo Preservation?

  • Step-1 After embryo transfer spare good quality embryos are separated.
  • Step-2 Consent from both partners is taken.
  • Step-3 Embryos are mixed with protecting solutions.
  • Step-4 Embryos are loaded in freezing straws.
  • Step-5 Then these devises are slowly cooled in a programmed freezer to -80 degree C and then plunged and stored at -180 degrees C in liquid nitrogen. An alternate method is called vitrification in which embryos are directly plunged in liquid nitogen at -180 degrees. Both method are highly successful.
  • Step-6 A detailed log is kept for identification.

Thawing:
Thawing is done only when embryos are to be transferred back to the uterus. During thawing also these are slowly brought to room temperature and passed through solutions to bring to normal. The embryos are further grown in laboratory for evidence of further development. Then embryos are transferred to uterus.

Advantages:

  • It is a highly effective technique. Success rates per cycle are in the range of 40-45 % and almost equal to fresh cycles.
  • This is a highly cost effective technique. In good cases one can get the benefit of 2 or 3 ETs with one OPU with at much less cost. Moreover same embryos can be used for second child.

Disadvantages:

  • Additional cost.
  • Legal status.
  • Allowed by Indian Council of medical research guidelines when done with the consent of both partners. The child thus born has all legal rights and obligations. Custody issues may arise in the event of divorce or death of one or both partners.

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Sperm Cryopreservation

What does Sperm Cryopreservation means?
Sperm cryofreezing means freezing the semen for storage for future use.

Who are suitable candidates for Sperm Cryopreservation?

  • Donated semen
  • Backup for IVF and IUI cases.
  • Long term storage for fertility preservation e.g. before chemotherapy.

Who should not get sperm cryofreezing?
There are no contraindications for sperm-cryofreezing. Couples with infections like hepatitis may be denied freezing by the hospital because risk of cross contamination.

What are main steps of Sperm Cryopreservation?

  • Step-1 Appropriate consent is taken.
  • Step-2 Male partner is investigated to exclude common illnesses and infections.
  • Step-3 Semen is collected after masturbation.
  • Step-4 Semen is mixed with protecting solutions.
  • Step-5 Mixed mixture loaded in freezing straws.
  • Step-6 Then these straws are slowly cooled in a programmed freezer to -80 degree C and then plunged and stored at -180 degrees C in liquid nitrogen. An alternate method is called vitrification in which semen is directly plunged in liquid nitrogen at -180 degrees. Both method are highly successful.
  • Step-7 A detailed log is kept for identification.

Thawing:
Thawing is done only when semen is to be used. During thawing also these are slowly brought to room temperature and passed through solutions to bring to normal. The semen is checked for sperm count and motility before using for IVF or IUI.

Advantages:
It is a highly effective and relatively low cost technique. The sperm banks store different samples which can be used on demand. Semen is quarantined before releasing for use . This time is generally equal to the window period of HIV infections . This time gap ensures safety of samples.

Disadvantages:

  • Sperm survival is reduced. Success rate with IUI with frozen samples is reduced as compared to fresh samples.
  • Legal status.
  • Allowed by Indian Council of medical research guidelines when done with the consent of both partners. The child thus born has all legal rights and obligations. Custody issues may arise in the event of divorce or death of male partner when semen was collected for self-use.

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Frozen Embryo transfer

What does Frozen Embryo transfer means?
The cryopreserved embryos are transferred to woman’s uterus at some date after IVF cycle.

Who are suitable candidates for Frozen Embryo transfer?

  • patients for whom spare embryos have been frozen after fresh IVF cycle
  • When embryo transfer is cancelled in same cycle due to various indications and unavoidable circumstances all embryos can be frozen
  • If patient is planning for next pregnancy after having conceived in previous IVF cycle
  • Embryos were frozen for fertility preservation when immediate pregnancy not possible due to medical or social reasons like chemotherapy for cancers or carrier choice.

What are main steps for Frozen Embryo transfer?

  • Patient is given hormonal medicines for development of good endometrium; or transfer can be done in natural cycle also.
  • Serial ultrasound is done to assess quality of endometrium and day of transfer decided accordingly
  • Frozen embrys are thawed on day of transfer and quality of embryos assessed
  • Good quality embryos are transferred to the uterus under ultrasound guidance

Advantages:

  • Very good success rate (40-50%), even higher than fresh cycle according to few studies
  • no need to undergo fresh cycle.

Disadvantages:

  • Patient has to bear cost of cryopreservation

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Obstetrics

Obstetrics including High Risk Pregnancies

 

Pregnant women can get best advice for Obstetrics, Ob Gyn & gynecology treatments from obstetricians at IVF Jindal Chandigarh to ensure safe pregnancy & delivery.

What Obstetrics means? 

Obstetrics means caring for pregnant women to ensure safe pregnancy and delivery to ensure a healthy mother and baby. It is the dream of every woman to experience the joy of motherhood and we at Jindal IVF are committed to providing the best experience to aspiring mothers and fathers! We firmly believe that more information about a process leads to better understanding and enjoyment; we have tried to provide a small amount of knowledge here.

Obstetrics is divided into:

1. The antenatal period – This is the period from conception to delivery of the baby. The standard duration is 9 months and 7 days or 40 weeks. In this time the mother’s body gradually adapts to the growing baby inside and gears up for the tough stress of delivery.

2. The intranatal period – This is the time of delivery of the baby to the outside world. It is the shortest of all three periods but is the most stressful to the mother and baby. There is a sudden change in environmental conditions for mother and baby and both need care and support in this time.

3. The postnatal period – After delivery. This period, also known as the puerperium, is the time when the mother’s body returns to its non-pregnant condition, while the baby becomes strong enough to face the outside world. It is a time of rest and contemplation and of mother-baby bonding.

One would hope that a process as natural as pregnancy and delivery should be free from diseases and complications. Alas, as we all know, this is not so. Diabetes, hypertension, anemia, infections, to name a few, all may affect pregnancy. This has given rise to the term ‘High risk pregnancy’.

Both normal and high risk pregnancies need to be suitably monitored to prevent and control any problems. Moreover, the Janani Suraksha Yojna of the Government of India envisages 100% institutional deliveries for all mothers, just for the reason mentioned above. Sometimes these patients require assistance during delivery too in form of forceps, ventouse application or even Caesarian section.

The basic procedure for antenatal care is as follows:

  • There should be at least 10 to 12 visits during antenatal period spread over 9 months and more for some high risk pregnancies.
  • Blood tests are done to ensure that mother is in best of health to carry safe pregnancy. These include Hb, sugars, infection screen, thyroid screen, etc.
  • Ultrasounds at specific intervals to monitor wellbeing and growth of baby.
  • Ultrasound and blood tests to exclude genetic diseases and malformations in the baby.
  • Appropriate immunizations, supplements
  • Diet and other general advise
  • Treatment of inter-current problems like urine infection fever etc.
  • Surgical intervention for surgical diseases if required
  • Timely decision of mode and timing of delivery

To know more book an appointment at 0172-4911000, or visit our centre at Jindal Clinics, SCO 21, Sector 20D, Chandigarh, 160020.

Endoscopy

Best Gynecological Endoscopy Laparoscopy

 

Endoscopy is the science of looking inside the human body without opening it up. It was telescopic instruments to view the interior of the body, which are inserted either through natural openings or through small artificial ones.

Endoscopy can be used to look at any part of the body.

We, at Jindal IVF, have been doing endoscopy for all sorts of gynaecological and infertility related problem for many years now.

Gynae endoscopy is of three main types :-

1) Laparoscopy

2) Hysteroscopy

3) Advanced Gynae Endoscopy

Laparoscopy

What it means?

Laparoscopy is a procedure by which a telescope is introduced into the abdominal cavity to assess the pelvic organs and perform any required surgery. It is done as a day care procedure most of the time but may require admission to the hospital for complicated cases. It may be diagnostic or operative.

Who are suitable candidates?

  • Patients with unexplained infertility – diagnostic laparoscopy to rule out peritoneal endometriosis, etc.
  • To check for tubal patency in case of blocked tubes
  • Operative –
    –  Myomectomy – removal of fibroids
    – Cystectomy – removal of endometriotic or other ovarian cysts
    – Adhesiolysis – means removal of intraabdominal bands on the uterus
    – Salpingectomy for ectopic pregnancy, hydrosalpinx
    – Tubal surgery – recanalization
    – Ovarian drilling
    – Hysterectomy – removal of uterus

What are its main steps?

  • Complete workup of patient is done to assess preoperative status and suitability for anaesthesia
  • Patient is kept under overnight fasting
  • Surgery performed under general anaesthesia
  • Telescope and instruments introduced from small puncture sites on the abdomen
  • Patient kept under observation for 4-5 hours post-operative

laprascopy process at laprascopy clinic

Blausen.com staff (2014). “Medical gallery of Blausen Medical 2014“. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. – Own work

Advantages

  • Short hospital stay
  • Faster recovery
  • Small scar

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Hysteroscopy

What it means?

Hysteroscopy is a procedure by which a telescope is introduced into the uterine cavity to assess the uterus and perform any required surgery. Depending upon the type of procedure local or general anaesthesia may be used. It may be diagnostic or operative.

Who are suitable candidates?

Diagnostic –

  • Before undergoing embryo transfer. In addition to finding abnormalities it stimulates the endometrium for implantation
  • In case of abnormal uterine bleeding or postmenopausal bleeding
  • Thin endometrium

Operative –

  • Myomectomy – removal of fibroid
  • Polypectomy removal of endometrial polyp
  • Adhesiolysis
  • Septum resection
  • Correction of uterine anomalies

What are its main steps?

  • Complete workup of patient is done to assess preoperative status and suitability for anaesthesia
  • Patient is kept under overnight fasting
  • Surgery performed under general anaesthesia
  • Telescope and instruments introduced from cervical canal
  • Patient kept under observation for 4-5 hours post-operative

hysteroscopy procedure

By BruceBlaus [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], from Wikimedia Commons

Advantages

  • Short hospital stay – OPD procedure
  • No cut made in abdomen

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Advanced Gynae Endoscopy

Jindal IVF has started a specialised advanced gynae endoscopy unit to cater to the need for advanced endoscopic procedures, which were available only in select hospitals in the region previously.

Advanced endoscopic procedures avoid the need for open surgery, thus reducing cost, time spent in anesthesia, recovery time and discomfort. Some of the procedures done here include:

a. Laparoscopic cervical cerclage – for incompetent os
b. Laparoscopic sacropexy – for prolapse uterus
c. Laparoscopic TLH (hysterectomy) – removal of uterus
d. Laparoscopic myomectomy – removal of large fibroids, difficult cases of fibroids and endometriosis
e.  And others

If you have any need of these kind of procedures, Jindal IVF provides a comfortable and affordable place to get operated. Our motto is ‘where excellence and ethics meet’ and we try to live up to it.

To know more book an appointment at 0172-4911000, or visit our centre at Jindal Clinics, SCO 21, Sector 20 – D, Chandigarh, 160020.

Fetal Medicine

Fetal Medicine

 

Best maternal fetal medicine specialist treatment from specialized Doctors at IVF Jindal fetal medicine clinic Chandigarh to avoid birth of abnormal children.

What it means?
Fetal medicine is a new upcoming field in the care of pregnant women. This aims at detecting problems in the fetus. Treating them in utero if possible or abort in time to avoid the birth of abnormal or handicapped children.

Who are suitable candidates?

  • All pregnant females
  • Older age women
  • Women with history of previous abnormal baby
  • Women with genetic diseases in family on either maternal or paternal side
  • Rh -ve isoimmunised women

 

Who should not get fetal medicine check-up and advice?
No pregnancy should be devoid of the benefits.

 

What are its main procedures?

  • Biochemical screening for Down’s syndrome
  • Detailed ultrasound for malformations and other genetic abnormalities
  • Amniocentesis
  • Chorionic villous biopsy
  • Cordocentesis
  • Intrauterine transfusion
  • Vessel ablation
  • Multi-fetal pregnancy reduction
  • Genetic testing on various materials

 

Advantages:

  • Timely Detection and abortion of abnormal babies
  • Treatment of Rh -ve isoimmunised babies
  • Confirmatory diagnostic tests
  • Multifetal pregnancy reduction

 

Disadvantages:

  • Cost and non-availability of experts

Amniocentesis

Amniocentesis

Get Amniocentesis, amniotic test done at IVF Jindal Chandigarh. It is a procedure to diagnose down syndrome in baby or abnormal pregnancy using amniotic fluid test

What it means?
It means taking out amniotic fluid from the pockets of fluid surrounding the baby and submitting this fluid to a genetic laboratory for various tests.

Who are suitable candidates?
Various indications for amniocentesis are:-

  • Abnormal triple test
  • Suspicion of genetic abnormalities on ultrasound
  • Known genetic disease in family e.g. Thalassaemia, DMD, etc.
  • Older women
  • Previously affected baby

Who should not get amniocentesis?

  • History of recurrent abortions
  • Normal NIPT
  • Confirmed abnormality on ultrasound
  • Vaginal bleeding

What are its main steps?

  • Counselling and consent
  • Aspiration of amniotic fluid under local anaesthesia and ultrasound guidance
  • Dispatch the sample to genetic laboratory FISH test or karyotype
  • Receipt of report
  • Reassurance and counselling if normal
  • MTP if abnormal

Advantages:

  • Highly reliable and confirmatory test
  • Simple and safe day care procedure
  • No after care required

Disadvantages:

  • Abortion risk > 5 to 1%
  • Cost
  • Rarely failure of lab to give a report
  • Delay of 2-3 weeks in getting the report
  • Not all diseases can be diagnosed
  • Limited genetic labs

Legal issues:

  • Amniocentesis can only be done in authorized centres and authorized laboratories only can test the samples.
  • MTP can only be done before 20 weeks.
  • Appropriate forms and records need to be filled and saved.