One of the biggest breakthroughs in treating infertility came in 1978 when the first test tube baby was born with the help of In Vitro fertilization (IVF).
One of the biggest breakthroughs in treating infertility came in 1978 when the first test tube baby was born with the help of In Vitro fertilization (IVF). Recently, Dr Robert Edwards was given the 2010 Nobel Prize in medicine for his momentous innovation. But lVF failed in patients with low sperm count.
Sparking innovation
This was overcome in 1992 with the introduction of a new technique called Intra Cytoplasmic Sperm Injection (ICSI).
The technique of ICSI was introduced in India by the Bloom IVF group in 1996. In 1998, the group started an advanced centre at the Lilavati Hospital, Bandra.
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First, we do an ultrasound to see whether the patients are suffering from pathologies such as fibroids, hydrosalpinx, endometriosis or polycystic disease.
These are treated before IVF. Most of them are subjected to an internal endoscopic examination of the womb called hysteroscopy. If there's any abnormality, it is promptly treated by hysteroscopy in the same sitting.
The right setting
Their lab at Lilavati Hospital is state-of-the-art with environment controlled withu00a0 a device called Air Handling Unit (AHU). The lab temperature at around 24 to 26 C.
This device runs 24X7 for 365 days of the year. There are eight incubators. As the number of incubators rise, the opening and closing of incubators reduces. This significantly contributes to improved embryo quality and thus pregnancy rates.
Some extra steps
There are new methods of Intracytoplasmic Morphologically Selected Sperm Injection (IMSI). In initial experience, they've found a dramatic increase in pregnancy rates with males with severe low sperm count, low sperm motility and abnormal sperms.
However, more research is needed. They've been using the technique of Assisted Laser Hatching since 1998. Here, the cover of embryo is cut with help of laser before putting embryos back into womb.
It's effective for older women (>38years), patients with recurrent IVF failures and in those undergoing transfer with frozen embryos.
Precise and easy
We also do the embryo transfer using an ultrasound machine. It helps us correctly place the embryos in the uterine cavity.
We also give special relaxation medicine to reduce uterine contractions at time of transfer to prevent expulsion of embryos. A patient can go home 20 minutes later. Recently, they have introduced the metabolomics machine that helps select best embryos for the first time in Asia.
Another highlight is the ability to successfully freeze extra embryos, using vitrification. Their pregnancy rate using frozen embryos is the same as pregnancy rate using fresh embryos: in the region of 40-50 per cent in women less than 35.
A second chance
Despite all this, few patients are unable to become pregnant. They can either opt for surrogacy or adoption. In surrogacy, the couple undergoes IVF using her own egg and sperm, and resultant embryo is placed into the womb of another woman called a surrogate, who bears the child.
You can also adopt a child. Please note that prenatal sex selection and detection is a crime, and banned in India. It is not advocated or practised.
Bloom IVF group has units all over India. Its flagship units are at Lilavati Hospital IVF Centre, Bandra (Tel: 022-26438280; 26751000 ext 8226; bloomivf@gmaiI.com; 09833600644) and Fort is La Femme IVF Centre, Delhi. (Tel: 011-29220125; 40579493; 09350887858; fortisbloom@gmail .com)
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