Thursday 31 October 2013

Story of a PCOS Women

THERE IS HOPE FOR CHILDLESS COUPLES SUFFERING FROM PCOS (POLY CYSTIC OVARIAN SYNDROME) AND OLIGOSPERMIA (LOW SPERM COUNT)


    Being the first child, Bubbly (named changed) was thoroughly pampered by her parents. While her mother showered her love by feeding her every 2 to 3 hours with ghee and rice, her father would return home with loads of sweets every day. She started growing into a cute and chubby baby.
    However, her problems started when she entered the high school. Bubbly had to struggle with obesity (weight 66kilos). Combined with this, peer pressure and taunts from boys put her under a lot of pressure. To counter this, she found solace in chocolates and ice-creams, also her parents wanted their only child to be happy.
    College was proving to be a nightmare, with her face full of acne and facial hair, but then her studies and entrance classes kept her busy. Though she was getting her periods only once in 2 to 3 months, however, she was not bothered. By that time her weight had jumped to 84 kilos. Joining engineering college meant living in a hostel and consuming canteen food, which was mainly rice, with hardly any protein source or fresh fruits. Long study hours took all the time. So she would hardly find time to undertake any physical activity, let alone play or exercise in the three years. Her weight was 96kilos after the completion of her studies.
    As she hailed from a rich family, marriage was surprisingly an easy matter. She got married to a well positioned engineer from Singapore.
    When she wasn’t able to conceive after one year of marriage, the couple consulted Gift Ivf Centre. After evaluation, it was found that she was having PCOS (Poly cystic Ovaries), while her husband had Oligospermia (low sperm count).
    She was surprised to know that she was malnourished, and was convinced after explaining whatever she was eating was excessive calories without proteins and vitamins. She was informed that she was not ready for the heavy exercise as she might get injured in her present condition. A slow and steady progressive plan for 3-6 months was prepared for her. On her husband’s insistence, she was administered medicines and injections for quick result to achieve the pregnancy, which did not work. As she failed to conceive with that, laparoscopy and ovarian drilling was done to get rid of old unhealthy eggs, but her husband had to go back to Singapore urgently leaving her at home.
Despite all the efforts, she failed to conceive. This resulted in mounting tensions between the families to the extent there were talks about filing for a divorce.
Her husband had been detected with low sperm count condition. A counseling session with him resulted in him agreeing to come down from Singapore and undertake a two-month intensive treatment without any unduepressure from the families.
    Although it had put tremendous pressure, she conceived through the very first cycle of injections and IUI (intra uterine insemination) as the laparoscopy worked well for her. She went on to deliver a healthy baby boy.
    The couple has started living together in Singapore, the baby being bought up on a good diet, as per the advice from paediatrician. As for Bubbly, she is maintaining at a stable weight of 80kilos with regular gym visits,a healthy diet that includes a lot of salads. It’s a happy ending to the story of a couple who faced harrowing time when they were not able to have a baby. The right advice from experts, proper diet and advanced treatment can truly change the course of any troubled couple’s life.


GIFT IVF CENTER
#4, 3R Plaza HAL 2nd Stage,
100 Feet Road,Indiranagar,
 Bangalore India- 560008

Contact:    +91-8050888880


GIFT IVF CENTER
Near Cochin International Airport Jn.
Athani, Ernakulam Dt, Kerala, India-683585

Contact:    +91-974 5494804

Email:     info@giftivf.com
Web site: www.giftivf.com

New Techniques In IVF - Endometrial Receptivity Test

There are several instances when IVF fails, even when the embryo might be good. It is not uncommon to see patients who have undergone 3, 5 or even 8 cycles of IVF/ICSI.
In such circumstances, it is very important to evaluate to find out the reason. Of course, the quality of egg/sperm is important and if those are bad, the only option is to go for donor egg or donor sperm accordingly.
In case gamates and embryo are good, the reason could be failure of implantation. Implantation is the process by which communication happens between the embryo and the inner lining of the uterus. It happens through some chemicals which results in adherence of embryo and subsequent growth in the lining.
 Endometrial Receptivity Test, now introduced in India can diagnose if the uterine lining is ready for the embryo implantation to take place. This occurs around days 19-21 in each menstrual cycle of a fertile woman
This is a crucial step for pregnancy.  No matter how good embryo is, if the test is negative, it will not result in pregnancy. Thus, it helps in finding the cause in repeated ART failures. By changing the dates of the test, one may be able to find a different time frame when the uterus will be receptive to the embryo. This helps in changing the embryo transfer date.
The method for the test is quite simple and is done in an outpatient setting by collecting a small sample of the endometrium and sending it for analysis. It is cost effective as it will avoid unnecessary repetition of IVF.

Endometrial receptivity assay ERA - success story 


She came to me for donor egg , at 37 yrs ,  she had 5 failed IVF cycles , history of PCOD and teratozoospermia (husband) . After a scientific analysis, we felt she needed to have hysterolaparoscopy, which was surprisingly never suggested . Flimsy tubal adhesions were released and ovarian drilling was done. We also performed endometrial receptivity test ( ERA ). The test was positive and she was very much reassured by the fact that she can conceive.
 

While they were waiting for an IVF with donor egg next cycle , I suggested IUI. To our great surprise she conceived, had a smooth pregnancy and Caesarian at term. The mother’s joy knew no bounds when she held her beautiful  baby girl. All it took was scratching the uterus !! Psychology may also play an important role, which we ignore most of the time ....

Dr. Anita Mani
Infertility Specialist at Gift IVF Centre
anitadane@gmail.com




GIFT IVF CENTER
#4, 3R Plaza HAL 2nd Stage,
100 Feet Road,Indiranagar,
 Bangalore India- 560008

Contact:    +91-8050888880


GIFT IVF CENTER
Near Cochin International Airport Jn.
Athani, Ernakulam Dt, Kerala, India-683585

Contact:    +91-974 5494804

Email:     info@giftivf.com
Web site: www.giftivf.com

Laparoscopy The gold standard in infertility investigation

                                 Laparoscopy - The gold standard in infertility investigation

 The present generation is so busy, no one has time, even to make babies !!!  Infertility rate  is going up on an alarming rate!! Unless, there is a proper scientific approach to this problem, the treatment for infertility gets prolonged unnecessarily.
    Laparoscopy is very helpful in countering infertility. But if  the treatment is delayed  that, by the time a laparoscopy is finally done, the surgeon finds that damage to pelvic structures like fallopian tube blocks have became chronic and in-correctable. Only   the option of IVF is left  in such cases. The success rate is low, when the age of the women is advanced , so much that, they may even have to go for egg donation.
    In western developed countries,  they follow strict protocols and  medicines and injections followed by IUI (intrauterine insemination) is done only for maximum of 3 to 6 cycles . If pregnancy does not occur, diagnostic Hystero- laparoscopy is done to make a proper diagnosis and to correct problems.
    Laparoscopy is a surgical procedure in which a camera is passed through the belly button and the pelvic organs like uterus, tubes and ovaries are seen (magnified ) directly on the screen. This enables the surgeon to make direct diagnosis of  problems of uterus like fibroid and remove it, to find tubal block and correct it, to check ovaries to see if they have PCOS (Polycystic Ovaries) and judge the severity and do drilling procedure. Ovarian drilling helps in opening up of old, unruptured follicles (which have abnormal eggs) helping the ovary to release fresh eggs and normalize the hormone profile.
    The diagnosis of early endometriosis can be made only through laparoscopy and can be corrected by cauterization of lesions. Endometriosis is one of the main cause for infertility and  is found in 40-60% of laparoscopies done in women with infertility. This can go undetected without laparoscopy.

  Laparoscopy is done as a day case,  the patient doesn't have to be admitted and  is able to go home by evening and do all the normal work from next day. It is painless as it is done under GA ( General anaesthesia) .Generally 80% of women conceive within 6 months after laparoscopy , if there are no major problems found. This  makes it highly cost effective, as most of the other prolonged treatments are expensive.
    The main drawback is the lack of proper laparoscopic  training, so the procedure is not widely available. The dexterity, hand eye co –ordinations and fine surgical skills are very important aspects of a laparoscopy surgeon which will affect the outcome.

Dr. Anita Mani
Infertility Specialist at Gift IVF Centre
anitadane@gmail.com


GIFT IVF CENTER
#4, 3R Plaza HAL 2nd Stage,
100 Feet Road,Indiranagar,
 Bangalore India- 560008

Contact:    +91-8050888880


GIFT IVF CENTER
Near Cochin International Airport Jn.
Athani, Ernakulam Dt, Kerala, India-683585

Contact:    +91-974 5494804

Email:     info@giftivf.com
Web site: www.giftivf.com

Common problems related to infertility






                                                       How to tackle Infertility


The moment of becoming a mother is a celebration for women. It not only brings a bundle of joy in the couple’s life, but also brings in more responsibility from the father. Many women silently suffer, just because they do not conceive within a short span after marriage as expected by the relatives, in laws and the society in general. Men are not exempted, but generally are in a better position, but this causes a strain in the married life.

The invent of ART (Artificial reproductive techniques) has made the life of  those women easier, who are denied the luxury of early marriage or early motherhood. 

Understanding the problems by an infertility specialist is the first step towards addressing the issue of infertility. A simple test of semen analysis, where the number and motility of sperm is analysed can be used as a basic test in men. For women, a good evaluation can be made by internal scanning , which will pick up most of the problems related to uterus and ovary. Ideally the initial scan should be done by the fertility specialist and laparoscopic surgeon, because they will be able to pick up subtle problems like adhesions between the organs.

If there are any medical conditions which is preventing pregnancy, couple would be educated  with the latest techniques available for achieving successful pregnancy. Dietary modifications, lifestyle changes, exercises and  stress reduction techniques are advised to the couple to improve fertility. 

Erectile dysfunction (ED) is very commonly seen in the younger generation due to several factors, but working under stress is the main cause. Men often suffer psychologically due to erectile dysfunction without taking medical help, as they are not aware that it is a treatable medical condition. 

PCOS (polycystic ovarian syndrome) has become very common in the girls (even as young as 11year old), due to improper dietary habits and lack of active life. This will make them prone to infertility in addition to the risk of obesity, acne and hirsuitism (excess hair growth). Time is precious, and PCOS should be treated as early as possible with life style modification. If they become sub fertile, medicines can help, but can result in repeated miscarriages, if egg quality is bad. A laparoscopic drilling of ovaries,  a non invasive surgery can be done to get rid of old unruptured eggs which will also stimulate ovaries to release fresh eggs and help in having a healthy baby. Proper evaluation for tubal blockage should be done to check for pelvic infections if any. 


Couples who cannot conceive even after IUI (intra uterine Insemination) may have to go for ART ( artificial reproductive techniques) . They can try IVF or ICSI (done for men with reduced sperm count)  and there is even hope for men  without  sperm (azoospermia), in whose cases TESA/PESA   ( testicular aspiration) can be be performed. Last but not the least.

Subfertility is something which needs a good evaluation and counseling and is not a disease which should be  treated at a regular hospital. Stress free environment, good ambiance, a caring and sensitive expert team of specialists , along with modern technology  will go a long way in helping to heal their wounds and for achieving a successful pregnancy. 



Dr. Anita Mani
Infertility Specialist at Gift IVF Centre
anitadane@gmail.com
www.giftivf.com
bangaloreivf.blogspot.in


GIFT IVF CENTER
#4, 3R Plaza HAL 2nd Stage,
100 Feet Road,Indiranagar,
 Bangalore India- 560008

Contact:    +91-8050888880


GIFT IVF CENTER
Near Cochin International Airport Jn.
Athani, Ernakulam Dt, Kerala, India-683585

Contact:    +91-974 5494804

Email:     info@giftivf.com
Web site: www.giftivf.com


Advanced treatment for infertility



     

Advanced treatment for infertility 



                   When a  young couple gets married  and want to start a family, they don’t  expect that  things can go wrong with the joyous experience of becoming a parent. Only those who have experienced infertility can understand the anguish and pain of coming to terms with the fact that they cannot have children.
   
                   Complex reasons leave some of these couples with no other option except to totally abandon the idea of parenthood. But progress in technology has given a ray of hope to them with several medical treatments that could give such couples a better chance for realizing their dream.
  
                  The advent of laparoscopic surgery has been a blessing for women suffering from painful periods due to endometriosis, absence of ovulation due to PCOS, ovarian cysts and uterine fibroids. Advances in laparoscopic surgery has made it  possible that today a large cyst is removed and tomorrow patient can go back to work and resume the normal life, completely pain free.

                 Sexual disorders in men are now easily treatable with modern medicines and procedures. Problems like Azoospermia, (no measurable level of sperm in semen) can be remedied and a man can become father through ICSI after Testicular Aspiration of Sperms (TESA). IVF or In Vitro Fertilization has meant that even women without ovaries are able to conceive with donated eggs through this procedure. All the options listed above are offered at Gift IVF Centre (Cochin, Bangalore). 

             
 Dr. Anitha Mani and Dr. S. Mani, along with a competent team work diligently to make every story have a happy ending.  Our motto is to bring happiness and  joy of being a parent into the life of infertile couples . 

GIFT IVF CENTER

GIFT IVF CENTER
#4, 3R Plaza HAL 2nd Stage,
100 Feet Road,Indiranagar,
 Bangalore India- 560008

Contact:    +91-8050888880

GIFT IVF CENTER
Near Cochin International Airport Jn.
Athani, Ernakulam Dt, Kerala, India-683585
Contact:    +91-974 5494804

Email:     info@giftivf.com

Web site: www.giftivf.com 

Rare Case of IVF Success

“ A Ray of Hope”


Thirty-eight-year-old Mary Joseph(name changed) had a  surgery to remove her pituitary gland tumor (seated deep inside the brain)in 2002. She had a condition called Panhypopituatarism, wherein  hormones  like LH,FSH,E2 are absent in the body and need to be replaced. In such a scenario, pregnancy and child birth were thought to be impossible for her. When she came to me for treatment, I did not want to give her any false hopes and told her clearly that there is only a slim chance for a successful child birth. 


The couple did not lose heart and  resorted to in-vitro fertilization (IVF) - the assisted reproductive technology and it was nothing less of a miracle that she conceived in the first attempt. Our joy knew no bounds. She had to be admitted for all the 9 months and was treated on a daily basis as it was high risk pregnancy case because of her medical problem. Every single hormone had to be administrated daily and monitored closely by blood test. It was a marvel that she conceived in the very first cycle of the treatment with IVF, The professor at the medical college where she was initially referred to, could not believe that she conceived and continued till the term. In fact, they made a case study of this rare case. 


I often fondly reminisces the day when the Joseph couple visited me along with their baby, during  X’mas season. Giggling and smiling without teeth, the baby was sitting on my consultation table fiddling with my stethoscope. The baby smiled at me after hearing my voice, as if  my voice was recognised. This was one of the precious moments in my career, now I believe in Santa Claus and I got my X’mas present as well :) 



Dr. Anita Mani
Infertility Specialist at Gift IVF Centre
anitadane@gmail.com

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Dr. Anita Mani is a renowned infertility specialist in south India with 15 years experience in ART (Assisted Reproductive Technology). Dr. Anita has successfully set up ART hospitals in Cochin and Bangalore,  along with her spouse  Dr. S Mani. She completed MRCOG, from Royal College of Obstetrician and Gynaecologist  London, DFFP from  ART Warwick university and  worked in UK for 5 years. Dr. Anitha believes in scientific and ethical practice and is currently the director of Gift Gyno IVF centre Cochin and  Bangalore.  Apart from advanced laparoscopic surgeries, she is also an expert in various ART techniques including IVF, IUI, ICSI , donor egg / sperm. Her proficiency is in genetic abnormalities and high risk pregnancies.