Best Infertility and IVF/ICSI Treatment in India

Semen cryopreservation

Egg cryopreservation is recommended in:

1. Young girls with cancer before chemotherapy,

2. Aging woman not yet planning pregnancy as still unmarried, or not yet interested in marriage. Embryo Cryopreservation: Married women with cancer, prior to chemotherapy.

It refers to genetic profiling of embryos prior to implantation (as a form of embryo profiling), and sometimes even of oocytes prior to fertilization. Here a genetic material from an Ovum or Embryo is taken and studied before embryo transfer. PGD can potentially be used

1. to select embryos to be without a genetic disorder

2. to have increased chances of successful pregnancy

3. to match a sibling in HLA type in order to be a donor

4. to have less cancer predisposition

5. Various Genetic diseases where it can be used are

Cystic Fibrosis, Beta-Thalassemia, Sickle Cell Disease and Spinal Muscular Atrophy (Type 1) Myotonic Mystrophy, Huntington's Disease and Charcot-Marie-Tooth Disease; Fragile X Syndrome, Haemophilia A and Duchenne Muscular Dystrophy.

• Hysteroscopic Polypectomy
• Hysteroscopic Synechiolysis
• Hysteroscopic Cannulation of Tubes
• Laparoscopic Adhesiolysis
• Laparoscopic Tubal Patency Test
• Laparoscopic Ovarian Drilling
• Laparoscopic Ovarian Cystectomy
• Laparoscopic Varicocoelectomy

Fertilization of both gamates (egg and sperm) occurs in fallopian tube. The surgical repair of the damaged fallopian tubes can be done to treat infertility.

Women suffering from different Pelvic Pathologies can lead to Infertility. Fertility can revert back to natural by correcting Pathologies like Myoma/Fibroids, Endometriosis, Tubal Block, Uterine Septum by performing successful Laparoscopic/ Hysteroscopic surgeries.

It involves stimulation of the female partner to produce more number of eggs at a time. When majority of these eggs mature, ovum-pick-up (OPU) is scheduled. OPU is a day care procedure which is done under sedation. The eggs retrieved are cultured for 3-4 hours before proceeding IVF with washed sperms. Calculated number of sperms are released in the vicinity of the eggs and fertilization occurs naturally with one sperm entering the egg to form an embryo.

ICSI is a highly specialized laboratory procedure developed to help infertile couples with seminal problems. The term 'Intracytoplasmic Sperm Injection" refers to the direct injection of a single sperm into a mature egg of the female. The sperms are magnified 400 times and are then selected based on their normal morphology before injecting in the egg.

When a couple is facing with infertility problems, embryo donation can be an excellent choice.

Issues that typically cause a couple to consider embryo donation include:

• Poor sperm production and count

• Problems with egg development and ovulation

• Attempts at other types of ART have been unsuccessful

• High risk of passing on genetic disorders but are unable to pursue PGD

Other fertility treatments are not financially feasible

Surrogacy can easily be defined as the process whereby another woman carries the child of infertile couple to term. Upon birth, the child is handed over to the couple, with the gestational carrier giving up any legal rights she may have to the child. There are a variety of reasons why a couple may choose to use a surrogate carrier. Women who have absent uterus, diseased uterus or surgically removed for any other cause are advised for surrogacy. Even the women with medical diseases like heart or renal disease or uncontrolled diabetes mellitus who are unable to take the load of pregnancy can go for surrogacy.

Congenital septum or adhesions bands in side the uterine cavity can be removed hysteroscopically.

In ART, Fertilization of gamets (eggs and sperms) is performed either by inseminating sperms around eggs or injecting each eggs with a sperm in the IVF lab. Obviously, one needs excellent in house embryologist and stat-of-the-art laboratory to perform this successfully.

PESA (Percutaneous Epididymal Sperm Aspiration) - This is a non-invasive method of sperm recovery and has excellent potential for patients who have had a vasectomy and do not wish to undergo reversal, or patients who have had an attempted reversal which has failed. In percutaneous epididymal sperm aspiration sperm are aspirated through a fine needle that is placed into the epididymis. TESA (Testicular Sperm Aspiration) - This is a surgical sperm retrieval procedure used in fertility treatment for men who have no sperm in their ejaculate. The extraction of sperm is achieved through a fine needle inserted into the testes. Where this is not successful, then a microsurgical testicular biopsy is done. Testicular Biopsy - The removal of small testicular tissue from men with very poor sperm production and the isolation of sperm for ICSI. Vas Epididymis Exploration - Exploratory surgery to check for blockage of sperm flow.

IMSI is the latest technology in the field of Assisted Reproductive Techniques. 
Ruby Hall IVF & Endoscopy Center, Pune is one of the very few ART centers all over the world to be equipped to perform IMSI. 

Currently, the sperm is magnified only 400 times. IMSI enables us to magnify the sperm as high as 7200 times. This high magnification allows the embryologists to select a morphologically normal sperm. IMSI thereby improves the pregnancy outcomes and reduces abortion rates.