Thin Endometrium – Successful Pregnancy with Thin Uterine Lining

Thin Endometrium – Successful Pregnancy with Thin Uterine Lining

Thin endometrium – Successful Pregnancy with Thin Uterine Lining

  

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Thin endometrium – Successful Pregnancy with Thin Uterine Lining

Endometrium is the inner lining of uterus which holds the embryo for implantation. Successful pregnancy can not happen with thin uterine lining. Pregnancy chances are low if the endometrium is below 8mm in most cases. You may be wandering about the definition of thin endometrium. Generally, if your endometrium is less than 7 mm it is underdeveloped. In such cases your fertility specialist may advise for cancellation of your embryo transfer.

What is the role of endometrium in fertility?

How endometrium develops?

 Endometrium is one of the main factors in pregnancy. Growing endometrial thickness is measured in infertile women to know the possibility of pregnancy. Women having regular menstrual cycle usually have three phases of endometrium growth. First, immediately after menstrual blood loss the endometrium tries building up. This is the growing (proliferative) phase which last about 14-18 days. This phase coincides your follicular growth and ovulation. At ovulation as the egg is released endometrium also changes its pattern to secretary under the influence of hormones. This change is essential for embryo implantation. At times, during IVF treatment this change is delayed resulting in failure of implantation. Hence your doctor may advise for a frozen embryo transfer in subsequent cycle. So, secretary changes are preparation for pregnancy and this phase lasts typically for 14 days. If pregnancy doesn’t happen then comes the bleeding phase called menstruation. All these changes in endometrium are controlled by female fertility hormones like estrogen and progesterone.

 

What is normal endometrial thickness?

Not all will develop endometrium up to expectation. In some cycles endometrium doesn’t develop even under normal conditions. You can have thick or thin endometrium depending on hormone levels. Usually endometrium growing beyond 8 mm is called receptive for embryo. Some women may conceive with 7mm endometrium also but their percentage is low. Women conceiving with thinner endometrium may lose pregnancy in earlier weeks or go for complications in pregnancy. The normal range of endometrium for pregnancy is 8- 14mm.

 

Endometrium Measurement –

Usually endometrium is measured by ultrasound. Endometrial measurement may not be accurate in uterine fibroids, adenomyosis, polyps. Uterine orientation like retroverted position may not show the correct thickness or pattern. Previous surgeries, uterine contractions also can modify the measurements. Ultrasound machine quality, inter observer and intra-observer variability and patient intolerance are also some of the reasons for variation in measurement.

How endometrial thickness is monitored?

 Ultrasound measurement – The most commonly used method is ultrasound of endometrium. Ultrasound is the ideal harmless tool to evaluate the endometrium. Ultrasound measures thickness of endometrium of endometrium and pattern. Triple line pattern is seen during development of endometrial thickness. At times your doctor may discuss about absence of trilaminar pattern. If you have a backward positioned uterus (retroverted uterus) triple line may not show in ultrasound.

Doppler test- This is another special test done through ultrasound. Doppler measures endometrial blood flow. Your endometrium is directly related to blood flowing to endometrium.

Hysteroscopy – By hysteroscopy your doctor can see the endometrium and find out any defects. But hysteroscopy cannot be done repeatedly because it requires anesthesia.

Hormone Test– Repeated hormone tests like estradiol can indicate growth of endometrium. Estrogen levels correlate with thickness of endometrium. Progesterone levels can indicate receptivity of endometrium.

CT scan – Endometrial volume can be measured by 3D/ 4D CT scan or MRI. Volume measurement is directly related to endometrial thickness.

Thin endometrium in IUI vs IVF pregnancy?

 In IVF treatments, a thin endometrium is associated with lower pregnancy rates. However, if you are under In IUI treatment pregnancy rate may not change. The reason for the reduced pregnancy rates in patients undergoing gonadotrophin-stimulated IVF therapies is not clear. It may be due to higher oxygen concentrations with a thin endometrium. This might be harmful for embryo implantation. Thin endometrium may be hereditary which doesn’t affect fertility. Thin endometrium is a fertility reducing factor but may not cause infertility as such. Receptive endometrium is an essential part of embryo implantation process.

Management of thin endometrium –

How to manage thin endometrium? Endometrial thickness less than 7 mm on ultrasound is generally considered sub-optimal for embryo transfer. Hence your IVF treatment  may not give you success if you have thin lining of uterus. Your fertility specialist may try several treatment modalities to develop endometrium. It includes –

 

  1. Hormone therapies 
  2. Blood thinning agents 
  3. Agents improving blood supply 
  4. Growth factors 
  5. Antioxidants 
  6. Platelet rich plasma 
  7. Neuromuscular electrical stimulation
  8. Stem cell therapy 

Hormone therapy

The best method for developing endometrium thickness is oral or vaginal estrogen hormone therapy. Oral estrogen are also used for endometrium preparation in frozen embryo transfer. HCG injection is also used for development of endometrium at times.

Blood thinning agents 

Low dose aspirin, low molecular weight heparin are used to improve endometrial thickness, pattern, and endometrial blood flow. Sildenafil citrate administration can cause  improvement combination with estrogen.

Agents improving blood supply 

 Vasodilators like pentoxiphylline and nitroglycerine are also used by some doctors for improving endometrial thickness. Vitamin E is an antioxidant and also improves blood supply and thickens endometrium.

Growth factors 

Growth factors like G-CSF can improve endometrial thickness and clinical pregnancy rate of the infertile women with thin endometrium. This can be directly infused into uterus.

Platelet-rich plasma (PRP)

PRP is blood plasma prepared from fresh whole blood that has been supplemented with platelets. Endometrial growth and pregnancy  occur in many patients after PRP infusion.

 

Advanced therapies

Neuromuscular electrical stimulation (NMES), 

Stem cell therapy are some of the advanced therapy for endometrial development.

 

Assessment of the endometrium is an essential component in assisted reproduction. Endometrial thickness has been identified as a prognostic factor for success in assisted reproduction.

RBM ONLINE - 2019

Uterine perfusion with G-CSF represents a promising new tool for the currently mostly intractable problem of inadequate, thin endometrium. 

Fertility and Sterility

 

What is Endometrial Array (ERA)?

The endometrial receptivity array (ERA) is a molecular test of endometrium. The test checks genetic information and categorizes endometrium as receptive or non-receptive. Women having repeated implantation failure can go for this investigation.

What are the factors causing thin endometrium?

What are the factors causing thin endometrium?

 Certain situations don’t allow endometrial growth. If you are facing difficulty in endometrial growth your doctor will do certain tests to find out the cause. Infection can lead to the destruction of the basal layer of the endometrium. Tuberculosis is now a day rare but if it affects endometrium doesn’t allow to grow. Some women may have thin endometrium after cleaning of uterus (D&C) or miscarriage. At times women are born with small uterus and thin endometrium. Women who have attained menopause but wishing for a pregnancy with donor egg also may face difficulty in growing endometrium. Some women have high blood pressure and this results in thick blood vessels. In these cases, endometrium doesn’t develop due to lack of blood supply to uterus. Exposure of uterus to radiation during cancer treatment could be another reason. Surgical procedures such as repeated curettage, polypectomy or myomectomy. Drug usage such as clomiphene citrate also can cause thin endometrium.

How thin endometrium affects implantation?

How thin endometrium affects implantation?

Patients having thin endometrium have increased oxygen concentration in the basal layer. High oxygen concentration damages endometrium. A thin endometrium is seen more often in older women probably because of decreased blood flow. Low blodd supply doesn’t allow implantation by harming development of certain molecules.

 

 

Can I get pregnant with thin endometrium?

Can I get pregnant with thin endometrium?

Some of the scientific studies have not found any relation between thickness of endometrium and successful pregnancy. But majority are in the view that thin endometrium is associated with lower pregnancy rate. Hence your doctor will check the thickness of endometrium and provide medications to develop it.

How can I thicken my uterine lining?

Now comes the million-dollar question, “How to thicken endometrium?” Till now scientists have failed to identify a definitive technique to thicken endometrium. There are medications like estrogen tablets, gel which are used in common to thicken endometrium. Others like blood thinning agents, steroids, hormone injections are tried with variable success. Newly evolved methods like platelet derived protein is being extensively used but, results are yet to be verified. Some of the agents like sildenafil G-CSF are in use but no definite result is concluded.

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What is PRP (platelet rich plasma)?

What is PRP (platelet rich plasma)?

PRP is a new approach used for the treatment of thin endometrium. If you have problem in growing endometrium your fertility specialist may suggest PRP infusion. The doctor will take 5ml of blood from your vein and prepare it. Usually it takes 30mins for this process. Then the processed blood is injected into your uterus. This derived protein from blood helps the endometrium to grow because it is rich in growth factors. Since this is taken from patients own body it doesn’t cause any reactions or allergy.

 

Can thin endometrium cause miscarriage?

Can thin endometrium cause miscarriage?

 You must know the mechanism of pregnancy before I answer the question. Endometrium forms a bed for the rolling embryo in the uterus. Now embryo chooses the place for implantation based on the quality of endometrium. Here doesn’t end the responsibility, endometrium has to supply food for growing embryo till three months. After pregnancy happens immediately endometrium changes its structure. It grows to bring in more tissue, blood vessels so that can hold the growing fetus firmly. Thin endometrium doesn’t possess the quality of receiving embryo, so pregnancy may not happen at all. At times if pregnancy succeeds thin endometrium cannot hold it for long. So, the pregnancy ends in miscarriage.

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IUI Treatment Cost In Chennai – Cost Vs Success

IUI Treatment Cost In Chennai – Cost Vs Success

IUI Treatment Cost In Chennai – Cost Vs Success

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IUI Treatment Cost In Chennai – Cost Vs Success

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Can I get pregnant with thin endometrium?

     Some of the scientific studies have not found any relation between thickness of endometrium and successful pregnancy. But majority are in the view that thin endometrium is associated with lower pregnancy rate. Hence your doctor will

– Femelife Fertility

IUI is the simple and most common fertility treatment used worldwide. Often patients ask for IUI treatment as it is less costly and simple to perform. However, it is not suitable for all infertile couples. It has some prerequisites or conditions. Functioning fallopian tubes, good sperm count and healthy sperms are essential for IUI success. You have to undergo basic tests like semen analysis, hormone tests and HSG test before undergoing IUI treatment.

IUI Treatment – Factors for Success:

Before starting IUI procedure your fertility specialist will explain about success rate and limitations. IUI is a simple procedure with low success.

Healthy Fallopian Tube

Sperm Health 

Fertility Hormones

Andrology Laboratory

 

Sperm Bank

 

   

 

 

HSG/ Laparoscopy

Healthy fallopian tubes are essential for transport of sperm to the site of fertilisation. Your doctor will check the tubes either by HSG or through laparoscope.

Sperm motility and morphology

 

 

WHO has given guidelines for assessing sperm health though semen analysis. You must go through the detailed semen analysis report before proceeding for IUI.

Done on 2nd/3rd day of cycle

 

 

Fertility hormones like FSH and LH are checked before ovulation induction. FSH hormone is a measure of egg quantity whereas, LH tells us about quality of eggs

A clean and well maintained andrology laboratory gives good success for IUI. Infection in the laboratory can reduce motility and kill the sperms.

Ethical Sperm Bank

If you are choosing for donor sperm IUI you will be provided a sample matching to your partner’s profile. Usually the identity of the donor is kept anonymous.

Good Andrologist

Sperm sample preparation is an important part of IUI. A good andrology specialist separates sperm sample from other cells and the fluid in semen.

How much does IUI cost in Chennai?

How much does IUI cost in Chennai?

IUI treatment cost varies from clinic to clinic. It depends on the type of medications used. Your doctor may not use any medicines if you are young and visiting for the first time. Natural cycle IUI will cost less for you. If you are using Recombinant injections then cost goes up. Cost of IUI treatment includes the cost of medications, IUI preparation and supportive medications after the procedure. Cost breakup for IUI treatment will depend on Type of ovulation induction, procedure of IUI and supportive medicines used. IUI treatment cost may vary between 5000 INR to 40000 INR per cycle

IUI Process

IUI Process

At times your doctor may conduct IUI procedure for consecutive days to improve success rate. This will add to your cost. Donor sperm IUI will also cost more.

Ovulation Induction

Ovulation induction is the process of using medications to stimulate ovulation in women who have irregular or absent ovulation

IUI for PCOS

IUI for PCOS

If you are having PCOS then your doctor may advise for down regulated cycle. This will escalate your package cost as it requires lot of injections.

Luteal Support

You will be advised to take some medications after the IUI procedure. These medicines will help you protect the pregnancy.

What is the success rate of IUI?

 

IUI Treatment – What You must Know

Common queries of Infertility

 

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How many follicles need for IUI?

Ovulation induction is used in IUI treatment to grow the follicles. Follicle in the ovary contain eggs and release by ovulation after maturity. Naturally the ovaries ovulate in alternative calendar months thus making one mature egg available each month.

Ovulation induction you may grow more eggs in contrast to natural cycle. For better success 2 or 3 follicles of size 18 mm or beyond is suggested.

What is the success rate of IUI?

IUI is a simple treatment and its success rate is slightly higher than natural pregnancy. If you and your partner are healthy and have good fertility score than your chances of falling pregnant naturally in one month is around 5- 10 %.

In IUI success rate depends on the fertility parameters. On an average success of IUI is 9-15% per cycle. You may be advised 3 to 4 cycles of IUI procedure by your doctor. This will increase your cumulative pregnancy rate to 25- 30%.

W

What are the types of IUI treatment used?

hat are the types of IUI treatment used?

Various type of protocols are used in IUI treatment depending on the fertility parameters of couple. If you are young your doctor may try natural cycle IUI. Ovulation induction is used in patients who fail in natural cycle IUI or have been trying for few years.

IUI can be done after down regulation of hormones. PCOS patients are advised this type of IUI treatment. Your doctor may do the IUI procedure after confirmation of ovulation by ultrasound. Some doctors prefer to do IUI before ovulation. They may conduct a second IUI procedure after ovulation.

What are the steps of IUI treatment?

IUI treatment starts with basic investigations of couple. If your fertility tests are normal then your fertility specialist will advise you for IUI. Steps followed in IUI treatment are –

1) Ovulation induction to grow follicles. Follicular growth is monitored by ultrasound and hormone tests. Follicles are tracked until they grow more than 18 mm.

2) Release of egg is done by administering HCG injection.

3) IUI preparation and insemination to the uterus.

4) Luteal support and guide for pregnancy check.

What are the limitations of IUI treatment?

Before starting IUI procedure your fertility specialist will explain about success rate and limitations. IUI is a simple procedure with low success. Hence your doctor prepares for 3- 4 cycles of IUI to increase chances of pregnancy. With each cycle of ovulation induction you will loose few good eggs.

Women have limited eggs in their ovary and it is not advisable to waste by repeated ovulation induction. After 3 to 4 failed IUI cycles you can take a break or opt for IVF treatment. After few cycles IUI treatment cost amounts to IVF treatment. At times infertility in couples are unexplained and IUI treatment fails for them.

Why follicular monitoring is required in IUI?

 Ovulation induction is the process of using medications to stimulate ovulation in women who have irregular or absent ovulation.

It works in a condition where follicles in a woman’s ovary do not mature and release eggs. Ovulation induction is typically achieved with a variety of medications that stimulate the ovary to produce and release eggs.  Follicular monitoring tells us about the time of follicular growth and release of egg. This helps in administering medications in time.

 

 
 

Thin Endometrium – Successful Pregnancy with Thin Uterine Lining

Receptive endometrium is essential for pregnancy.

IUI Treatment Cost In Chennai – Cost Vs Success

IUI treatment starts with basic investigations of couple. If your fertility tests are normal then your fertility specialist will advise you for IUI.

IVF Failure What Next – Options After Failed IVF Treatment

Options after failed IVF treatment

Egg Freezing Cost in India – Fertility Preservation

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How is ICSI treatment different from IVF

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Your Satisfaction Is Our Priority

VISION – FEMELIFE is the vision of Dr.S.K.Sahu the visionary founder-Director & Chairman of FEMELIFE Group and Dr. Nabaneeta Padhy Founder Director & Medical Director of FEMELIFE GROUP. 
PATIENT CARE IS STILL OUR 1ST PRIORITY.

CHAIRMAN    

PROMISE – The Founder-Director & Medical Director of FEMELIFE Fertility Foundation. Furthermore we started with an aim to reach people at an affordable cost . IT IS A FAMILY : MEET US ….. TO KNOW US.

MEDICAL DIRECTOR    

Contact Us

Talk with Us!

Complete Fertility Care. IVF / ICSI / IUI

Email Address
Call Me

+91 9941551661

 

Visit Me

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IVF Failure What Next – Options After Failed IVF Treatment

IVF Failure What Next – Options After Failed IVF Treatment

IVF Failure What Next?

 

  

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OPTIONS AFTER  IVF FAILURE

IVF Failure What Next?

 

IVF failure is heartbreaking and shocking to the couple undergoing fertility treatment. Since it is a costly treatment, often causes financial and psychological stress on the couple. But once a failed IVF doesn’t mean always a failure. There are ways to get out of it. You must not lose hope and discuss further options with your IVF specialist, IVF failure what next.

What are the chances of getting pregnant with IVF?

Even with the best of embryo and endometrium the success rate of IVF treatment is limited to 35% on an average worldwide. It may be due to the restricted natural fertility in human being. However, the following causes can be discussed for future treatment.

Why does IVF fail the first time?

Embryo quality –

It may be due to low embryo quality. Remember to discuss with your specialist about the quality of embryo before embryo transfer. Again, this embryo quality may be due to poor eggs or sperm in the couple. Usually blastocyst culture chooses the best quality embryo and predict better success.

 

Egg quality –

     Some women may yield poor quality eggs in IVF process. Women with PCOS, poor ovarian reserve or endometriosis are at risk of low quality eggs. Your embryologist can disclose the quality of eggs after oocyte retrieval. Further IVF process can be stopped at this point. IVF protocol also affects the quality of eggs. Hence your IVF specialist may suggest different injections and protocol next time.  Poor egg quality is caused by diminished ovarian reserve and is one of a common cause of infertility, especially in women over 35. Poor egg quality is closely associated with chromosomal abnormalities in embryos.

 

Endometrium –

 The endometrium is the layer in which the implantation (nesting) takes place. This layer experiences several changes that are closely associated with the cyclic release of female reproductive hormones. Endometrium and its receptivity is one of the causes leading to IVF failure.

     During a woman’s reproductive years, the lining of uterus, the endometrium, changes through cycles of growth, maturation and shedding. All of these changes are dependent upon a normal hormone balance by the functioning ovary. The endometrium thickens in the early phase succeeding menstruation and show a trilaminar pattern. Absence of this patter can indicate lower receptivity. Your IVF specialist may cancer embryo transfer if your endometrium doesn’t not reach 8mm in thickness or trilaminar pattern. In PCOS women often endometrium is thick and show effect of androgens. Frozen embryo transfer under down regulation can be tried for them.

 The endometrium is one of the most dynamic organs in the body. Physiologically, the endometrial thickness has a wide range. It can respond to an endocrine environment by an increase in thickness in preparation for implantation or by sloughing its lining in preparation for a new cycle. Endometrial pattern and thickness are dependent on blood flow. Hence your doctor may do endometrial Doppler study for checking optimum receptive endometrium.

 The endometrium is the layer in which the implantation (nesting) takes place. This layer experiences several changes that are closely associated with the cyclic release of female reproductive hormones. Endometrium and its receptivity is one of the causes leading to IVF failure.

     During a woman’s reproductive years, the lining of uterus, the endometrium, changes through cycles of growth, maturation and shedding. All of these changes are dependent upon a normal hormone balance by the functioning ovary. The endometrium thickens in the early phase succeeding menstruation and show a trilaminar pattern. Absence of this patter can indicate lower receptivity. Your IVF specialist may cancer embryo transfer if your endometrium doesn’t not reach 8mm in thickness or trilaminar pattern. In PCOS women often endometrium is thick and show effect of androgens. Frozen embryo transfer under down regulation can be tried for them.

 The endometrium is one of the most dynamic organs in the body. Physiologically, the endometrial thickness has a wide range. It can respond to an endocrine environment by an increase in thickness in preparation for implantation or by sloughing its lining in preparation for a new cycle. Endometrial pattern and thickness are dependent on blood flow. Hence your doctor may do endometrial Doppler study for checking optimum receptive endometrium.

 Hormone status –

      When a woman is undergoing a fertility work-up, Cycle Day 3 is the day she has blood work performed to check the levels of three important hormones: follicle stimulating hormone (FSH), luteinising hormone (LH) and estradiol (E2).

The FSH blood test is used to help diagnose problems with sexual development, menstruation, and fertility. It can be used to diagnose or evaluate polycystic ovary disease, ovarian cysts, irregular vaginal bleeding and infertility.

The LH blood test measures the amount of luteinising hormone, which is also secreted by the pituitary gland. In women, LH levels rise at mid-cycle; within 24 to 36 hours, ovulation occurs. Higher-than-normal levels of LH indicate several disorders, including ovarian failure and polycystic ovary disease.

Estradiol is the most important form of oestrogen. It is primarily made in and released from the ovaries, adrenal cortex and the placenta, and it is responsible for the growth of the breasts, outer genitals, uterus, fallopian tubes and vagina.

 The natural levels of prolactin in the body change throughout the day. Levels gradually rise overnight and are at their highest in the morning. High levels of prolactin in the blood can stop the ovaries from making the hormone oestrogen and may cause infertility. Thyroid hormones are important in preventing miscarriage and aiding foetal brain development. Low levels of thyroid hormone can interfere with the release of an egg from your ovary (ovulation), which impairs fertility.

 

Anti-Müllerian hormone (AMH), a marker of ovarian reserve, declines over a woman’s reproductive lifespan. AMH is highly correlated with a woman’s age and number of primordial ovarian follicles. AMH concentrations slowly decrease with increasing age until becoming undetectable ∼5 years before menopause.

AMH serum concentration does accurately reflect the size of the pool of antral follicles, representing the quantity of the remaining primordial follicles.

Sperm quality-

     Human fertilisation starts from entry of a healthy sperm into a human egg followed by mixing and division of genetic material. Fertilisation usually occurs in the ampulla of the fallopian tube. The result of this union is the production of a zygote cell, or fertilised egg, initiating development of an embryo which grows into a baby.

This process requires a healthy tube, motile and healthy sperm in good numbers and a good quality egg.

Fertilisation can fail due to low sperm production, abnormal sperm function or blockages that prevent the delivery of sperm. ICSI refers to the laboratory procedure which overcomes hindrance in fertilisation failure due to male infertility. Through ICSI a single sperm is picked up with a fine glass needle and is injected directly into each egg. ICSI can also be done with frozen sperms. It is offered in cases of male infertility.

What causes recurrent implantation failure or IVF failure?


Implantation is referred to the stage of pregnancy at which the embryo adheres to the wall of the uterus. It helps the embryo to grow by receiving nutrients from the mother.

In humans, implantation of a fertilised ovum is most likely to occur around 6 – 9 days after ovulation. The reception-ready phase of the endometrium of the uterus is usually termed the “implantation window” and lasts about 4 days.

The initial phase of the implantation process is attachment of embryo to maternal tissue. This first phase requires the newly hatched blastocyst to loosely adhere to the endometrial epithelium, often “rolling” to the eventual site of implantation where it is firmly adhered. This process requires both the blastocyst adhesion interaction with the endometrium during the “receptive window”.

The term “implantation” is used to describe process of attachment and invasion of the uterus endometrium by the blastocyst (conceptus).

Implantation is a highly-coordinated event that involves both embryonic and maternal active participation.

Initially the newly hatched blastocyst loosely adheres to the endometrial epithelium. Then it rolls over the endometrium to find a suitable place for implantation where it gets attached firmly.

Various structural problems in endometrium can lead to IVF failure. Polyps (small growth), presence of septum (partition dividing endometrial cavity), fibroid uterus also can lead to recurrent Implantation failure.

 What happens when IVF doesn’t work?

Extreme stress may affect fertility, women with high levels of alpha-amylase, an enzyme that correlates with stress, have difficulty in getting pregnant. Stress can affect the functioning of the hypothalamus and the hormones that controls ovaries to release eggs. Physical stress or emotional stress does interfere with menstrual cycle and alters the release of eggs. Stress and depression can lead to miscarriages.

The risk of depression, anxiety, and distress is high for infertile patients. However, the impact of distress on treatment outcome is less definitive. More depressed infertile woman, are less likely to start infertility treatment and the more likely to drop out after only one cycle. Psychological interventions for women with infertility have the potential to decrease anxiety and depression. This may well lead to significantly higher pregnancy rates.

What are the options after failed IVF treatment?

Blastocyst culture

       Blastocyst is an embryo which has developed to day 5 stage with different cell components and a fluid cavity. Once IVF fails you can opt for blastocyst culture and transfer.

The advantage of blastocyst cultures is the selection of best embryo because only the embryos with high potential for development reach the blastocyst stage.  Pregnancy chances are high when using a blastocyst then with an embryo of day 2 or 3 development. Frozen embryo transfer is more successful with blastocysts as they survive the freezing and thawing process well. Blastocysts are also used for embryo diagnosis in PGD. Blastocyst cultures are particularly useful when a good yield of eggs is obtained. With lower number of eggs there is risk of failure of development into blastocyst. After IVF failure with eight cell embryos you can choose for blastocyst culture and transfer.

Assisted hatching 

 

Assisted hatching is a laboratory procedure that is sometimes done along with in vitro fertilization (IVF) treatment. During assisted hatching, the outer shell of the embryo is artificially weakened by making a small hole in the outer covering called zona pellucida. Assisted hatching may help the embryo to implant into the uterine wall, and   lead to a pregnancy. 

Experts do not recommend the use of assisted hatching in all patients undergoing IVF treatments. Rarely, assisted hatching can damage the embryo, making it unusable. The risk for identical twins might be slightly increased when assisted hatching is applied. Medical complications are higher in identical twin pregnancies than in normal, singleton pregnancies. However assisted hatching may be an option for patients having repeated IVF failure.

Frozen embryo transfer

 

 Embryo cryopreservation is useful for surplus embryos during in vitro fertilisation. Patients who fail to conceive may become pregnant using frozen embryos in subsequent cycles. Successful patients in IVF treatment may come back later for frozen embryo transfer to achieve a sibling pregnancy. Cryopreservation was applied to humans beginning in 1954 with three pregnancies resulting from the insemination of previously frozen sperm. Clinical pregnancy and live birth rates of fresh and frozen embryo transfers are not significantly different. Patients having IVF failure with fresh embryo transfer can go for frozen embryo transfer.

Donor egg programme after failed IVF

  

Egg donor IVF is a fertility treatment option for those who can’t use their own eggs due to various reasons. The egg donation process involves retrieving eggs from a woman who has normally functioning ovaries. Following egg retrieval, the eggs are fertilised in the in vitro fertilisation (IVF) lab using sperm from the receiving couple’s partner, or in certain situations with donor sperm. You can choose for donor egg if quality of eggs are not good.

 Female infertility is defined as a failure to achieve a successful pregnancy after 12 months. The quality of oocytes plays an important role in determining fertility outcomes. It is well known that increasing maternal age has a negative impact on the ability of an oocyte. Donor eggs and embryos can bypass the problem, but not everyone accepts third-party genetic involvement.

Donor sperm IVF 

 

     At present among all infertility cases, approximately 40–50% is due to “male factor” infertility. Many men as exhibit suboptimal sperm parameters due to increasing pollution and lifestyle diseases. In these conditions fertility has dropped down and cases of male infertility are increasing. If there is decrease in sperm count or number of healthy sperms then the couple face difficulty in achieving a healthy pregnancy. If your male partner is having low count you doctor may advise for ICSI treatment. But in some cases, ICSI may not be possible due to poor quality of sperm. In such cases chances of fertilisation failure is high and pregnancy if happens may end in miscarriages. To avoid such a situation your doctor may offer you use of an anonymous donor matching to the profile of your male partner.

 

 Embryo donation 

             For some couple embryo donation may the last resort. The IVF specialist offers embryo donation if both egg and sperm quality is not good and pregnancy doesn’t happen instead of trying multiple times. Good quality embryos in eight cell stage or blastocyst can help to achieve pregnancy in such cases. Repeated implantation failure or recurrent miscarriage can be treated in this way.

 

Surrogacy 

        People require surrogacy treatment when pregnancy is medically impossible or risky for the would be mother. Surrogacy is a legal agreement, whereby another woman not related to the child genetically carries the pregnancy and delivers for the biological parents. Receiving money for the arrangement is known as commercial surrogacy, which is right now under radar in India. In some countries, surrogacy is only legal if money does not exchange hands.  Surrogacy may be traditional or gestational, depending on the genetic origin of the egg.

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PGD/PGS after IVF failure

  PGD is a genetic test on cells removed from embryos, to help select the best embryo. PGD may be advised to couples at increased risk for chromosome abnormalities or specific genetic disorders or women who have had several miscarriages. This is also done in women who have had a prior pregnancy with a chromosome abnormality or women over 38 years of age and men with some types of sperm abnormalities. Most IVF failures can be accounted for by embryonic aneuploidy. Recurrent IVF failure (RIF) is usually defined as 3 or more failed IVF attempts involving high-quality embryos

Low sperm count, poor morphology, and poor motility in men with severe infertility has been linked to the generation of embryos with an increased incidence of inherited chromosomal abnormalities. Genetic defects found to be associated with male factor infertility includes aneuploidy, most commonly Klinefelter syndrome, Robertsonian translocations, Y chromosome microdeletions, androgen receptor mutations, and other autosomal gene mutations.

The use of PGS/PGD in couples with severe male factor infertility may decrease pregnancy rates but also limits the prevalence of chromosome abnormalities.

Mitochondrial transfer and other assisted reproductive technologies have aroused biological, ethical, and legal concerns. But for infertile couples looking a solution they throw a ray of hope. In a world where designer babies could be just around the corner IVF failure can be overcome. Science is developing rapidly so is reproductive technology. Human reproduction is better understood in this era and is being applied to treat infertility. IVF failure what next question is being answered at all stages. Don’t worry if IVF fails, there are alternative methods.

 

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    Egg Freezing Cost in India – Fertility Preservation

    Egg Freezing Cost in India – Fertility Preservation

    Egg Freezing Cost in India–

                     Egg freezing cost in India is cheaper than other countries. It is a process of cryofreezing for fertility preservation. Women wishing to preserve fertility for future use have a new era in age related fertility decline. Egg freezing cost in India is affordable and attracts patients from abroad as well. Anyone who wants to delay pregnancy or cannot avoid a delayed marriage benefits from this procedure. Childless women with diseases of tube or low fertility in male partner are offered IVF treatment. You may choose to delay the family way due to financial constraints or till you get a right partner. Egg freezing doesn’t require sperm because the eggs aren’t fertilised before they’re frozen. You will have to use fertility drugs and go through IVF process before freezing eggs.

     Why egg freezing is done?

    You may choose to go for egg freezing in the following conditions:

    1. If you are above 35 years and still searching for the right partner you may opt for egg freezing. Quality of eggs deteriorate with age and decrease in numbers. This procedure will enable you to procure your biological child in future.
    2. If you are going for cancer treatment your doctor will advise for fertility preservation. Cancer chemotherapy can harm the eggs and lead to infertility. In such a situation, you can freeze eggs for future fertility.
    3. Excess eggs during IVF process may be frozen instead of embryo freezing if good sperms are not available. Sperm quality can be improved over time and later used for embryo generation.
    4. If you are suffering from a progressive medical illness you may choose to freeze eggs before your disease becomes severe.
    5. Donor eggs are at times frozen for future use.
    6. Transgender patients may opt for freezing of eggs before a gender change surgery.

    Why egg freezing is advised in elderly women delaying pregnancy?

            In today’s world infertility is becoming more common due to advanced age because many women wait until their 30s to begin their families. Even though you are healthier and taking better care of yourself you can’t prevent ageing of eggs. Improved health in later life does not offset the natural age-related decline in fertility. A woman’s cycles will remain regular, 26 to 35 days, until her late 30s to early 40s when her cycles become shorter. As time passes, her periods become increasingly infrequent until they cease completely. When a woman has not had a menstrual period for 1 full year, she is said to be in menopause.

    Women and fertility decline

            As women age, fertility declines due to normal, age-related changes that occur in the ovaries. However, men continue to produce sperm throughout their lives, a man’s decrease in sperm characteristics occurs much later. Sperm quality deteriorates somewhat as men get older, but it generally does not become a problem before a man is in his 60s.  A woman’s best reproductive years are in her 20s. Fertility gradually declines in the 30s, particularly after age 35. If you are healthy and you are around 30 years, each month you try, you have a 20% chance of getting pregnant. That means that for every 100 fertile 30-year-old women trying to get pregnant in 1 cycle, 20 will be successful and the other 80 will have to try again. By age 40, a woman’s chance is less than 5% per cycle, so fewer than 5 out of every 100 women are expected to be successful each month.

    Women do not remain fertile until menopause. The average age for menopause is 51. The age-related loss of female fertility happens because both the quality and the quantity of eggs gradually decline. 

    Egg Quality

    A woman’s age is the most accurate test of egg quality, because egg quality decreases as the woman approaches menopause. An important change in egg quality is the frequency of genetic abnormalities which make the aging woman less likely to become pregnant and more likely to have miscarriages. As a woman gets older, more and more of her eggs have either too few or too many chromosomes. That means that if fertilization occurs, the embryo also will have too many or too few chromosomes. 

    Egg Quantity

      Ageing women begin to lose ovarian reserve before they become infertile and before they stop having regular periods. As ovarian reserve declines, the follicles become less and less sensitive to FSH stimulation, so that they require more stimulation for an egg to mature and ovulate. However, young women may have reduced ovarian reserve due to smoking, family history of premature menopause, and prior ovarian surgery. Young women may have diminished ovarian reserve even if they have no known risk factors.

    How Infertility Evaluation is done in Advanced Maternal Age?

    If a woman is 35 or older, infertility evaluation should begin earlier than younger women, usually after 6 months of trying to conceive. Fertility tests may include ovulation detection and evaluation of the fallopian tubes, cervix, and uterus. The male partner will have a semen analysis. Most testing can be completed within 6 months, and appropriate treatment can be started immediately after the evaluation is completed. Older women are more likely to have a medical disorder, such as high blood pressure or diabetes, which should be evaluated before fertility treatment. Children born to women over age 35 have a higher risk of chromosomal problems. Women can choose to discuss these risks with their clinical care provider or a genetic counsellor prior to attempting pregnancy. 

    What are the risks of egg freezing?

               Risks of cryofreezing are also applied to egg freezing. If you have decided for egg freezing you must consider few points.

    1. Egg freezing doesn’t guarantee a future pregnancy. You may have to go for donor egg programme if the frozen eggs fail to give pregnancy.
    2. Frozen eggs carry the risk of damage during the process of cryofreezing. In this case, you have go again for IVF or opt for alternative treatment as suggested by your fertility specialist.
    3. Your frozen eggs also carry the risk of contamination or infection. Infection is a rare phenomenon in cryofreezing but can happen at rare instances.  

    What is the egg freezing cost in India?

                      Egg freezing cost in India is around 150000 – 170000 INR. It includes the cost of IVF protocol and egg retrieval. In this package cost of ICSI and embryo transfer is not included. IVF protocol cost includes the medications and injections used to stimulate the ovaries. Egg collection, anaesthesia for the procedure, egg screening and denudation are the costs included in the package. Egg freezing cost in India depends on the time period opted by the patient. Longer the time costlier is the procedure as freezing requires periodic adding of liquid nitrogen into the frozen sample.  

    Where egg freezing is done in India?

    India is a hub for fertility treatment in South Asia and attracts childless couples from Malaysia, Singapore, Dubai, UK and USA. NRI patients prefer India because of its low-cost fertility services. Egg freezing and IVF protocol in India costs around 150000 – 170000 INR.

                       As egg freezing cost in India is affordable it attracts patients world wide. You must choose a Centre in India where cryopreservation of eggs is done regularly. Expert embryologists can give good success with frozen eggs. Femelife Fertility is such an IVF Centre in Chennai which has achieved milestone success in IVF/ICSI and advanced fertility treatment.

    Egg freezing cost in India

    How long can you freeze your eggs?

          Human eggs can be for a long time but is guarded by laws of different countries. In India, frozen eggs and their records are maintained for 10 years. Extension of freezing is done by request to the Centre. It can be done at an extra cost.

    What is social egg freezing?

         Healthy and fertile women seeking egg freezing for own convenience is called social egg freezing. At times women delay child bearing for better career or in search of suitable partner. This decision puts them into age related fertility issues. Fertility preservation in terms of egg freezing helps them for procuring biological child in future. Social egg freezing means to preserve and store a woman’s oocytes for non-medical purposes. However, this creates a controversy in the society as gays, lesbians and single mothers take advantage of it. Social egg freezing may set a trend towards delayed childbearing.

    Also Read –

    Embryo Freezing