IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy

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da.co.in

//www.rotunda.co.in/[12/22/2010 5:36:08 PM]

Welcome to the official website of Rotunda Fertility Clinic and Keyhole Sur

Centre. This clinic is the latest venture of Rotunda-The centre for Hu

Reproduction and one step forwards in creating a chain of well equipped and St

of-the-art IVF centres in the city of Mumbai.

In addition to Infertility treatments, we also have facility for patients to unde

keyhole surgery which is performed by reknowned specialists when indicated.

Facing infertility and undergoing treatment for the same is without doubt one of

most distressing situations that a couple can face. It fosters uncertainities, dou

fears, guilt and apprehensions. We at Rotunda strive towards making the w

process as simple and transparent as possible, providing guidance and counseat every step. We boast of a team sensitised to the needs of our clients and ha

long track record to prove this. Most of all, we respect our clients' need for priv

and offer this and much much more at very reasonable and competitive rates.

Egg donation may offerthe only chance of.....

Success rates at RotundaCentre of Human.....

Please use this form torequest an .......

Home

Programs and Services

Infertility Surgery

All you need to know

Pictures and Videos

About us

Glossary of terms

Our Success rates

Contact us

search...
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Male and FemaleInfertility
http://www.surrogacymumbai.com/http://www.surrogacymumbai.com/http://www.surrogacymumbai.com/http://www.surrogacymumbai.com/


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Goals

Enhance comfort level with workup

Basic Management Strategies

TRICARE

www.rotunda.co.in


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Definition

12 months of unprotected intercourse

Earlier for certain historical factors

Older than 35
http://sixtyminutes.ninemsn.com.au/article.aspx?id=816881http://sixtyminutes.ninemsn.com.au/article.aspx?id=816881http://sixtyminutes.ninemsn.com.au/article.aspx?id=816881


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Infertility Etiology
http://www.iwannagetpregnant.com/surrogacy.asp


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Female Factors


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Male Factors

General Causes

Unknown: 40-50%

1 Hypogonadism: 30-40%

Altered SpermTransport: 10-20%

2 Hypogonadism: 1-2%

Meds

1 or 2Hypogonadism

Common medications

Ketoconazole

Cimetidine

Spironolactone


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The Scenario

Tech: Husband and wife cant get

pregnant.

You: OB rotation was last infertility workup

What now?


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Workup

History is KEY

Focused Physical Exam

Labs and Specialized Tests


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Workup: History

Coital Practices

Gestational History

PMHx/PSHx

Meds

Menstrual History

Substances Recent High Fever


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Our Couple: History

Female

G1 P0010

No hx of STIs

Normal menses

Unprotected sex for15 months

Male

No previous partnerpregnancies

Gonorrhea hx

No meds

Occasional EtOH


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Workup: Physical Exam

Male

Infection

Hernia

Vas deferens

Androgen deficiency

Testicular mass Varicocele

Female Breast Formation

Galactorrhea

Genitalia

Hyperandrogenism?


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Workup: Labs

Female

Ovulation problems

Ovulatory Dysfunction

Ovarian Reserve

Male

CBC

FSH, Testosterone

GC/Chlam, UA

Renal and Liver

Function Semen analysis

Postejaculatoryurinalysis


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WHO Seminal FluidAnalysis (1999)

Volume: >2ml

Sperm concentration: >20 million/ml

Total Sperm Number: >40 million/ejaculate

Sperm Motility:

>50% motile and/or

>25% progressively motile

Sperm Morphology: >14% normal forms


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Workup: Special Tests

Female

TransvaginalUltrasonography(TVUS)

Hysterosalpingography

(HSG)

Hysteroscopy

Laparoscopy

Male

ScrotalUltrasonography

TransrectalUltrasonography(TRUS)


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Our Couple: Exam,Labs & Tests

Normal male exam

Normal initial labs

Oligospermia on 2 separate semenanalyses

TRUS and postejaculatory UA normal


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Management: GeneralConcepts

41 different methods

Fertile window intercourse

E-type vaginal discharge

Avoid lubricants and douches


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Management: Female

Treat underlying cause

Hyperprolactinemia

PCOS

Gonadotropin therapy


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Management: Female

Ovulatory dysfunction (Unknown etiology)

Clomiphene 50mg PO daily x 5 days

Start on days 3-5

Can increase to 100mg daily next cycle

Results

80% will ovulate Hyperstimulation and Twinning

Higher-order multiples rare


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Management: Female

Clomiphene Failure?

IVF

Injectable ovulation-inducing agents


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Management: Female

Tubal/Pelvic/Uterine Issues

Reparative Surgery (low success)

IVF

Endometriosis

Laparoscopic ablation Laparotomy

Ovulation induction +/- IUI and IVF


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Management: Male

Hyperprolactinemia

Surgical repair

Fertility Specialist


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Stress and Infertility

69% Women and 21% Men have

preexisting condition

Greater risk for psychological stress

No significant difference inpsychopathology


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Men have increased stress over time,

same as women

Watch for normal grief vs. psychopathology

Same rates of depression as other chronicdisease


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Bottom line: Not a means to improve

pregnancy rates.
http://www.surrogacymumbai.com/http://www.surrogacymumbai.com/


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Management: Our Couple

Male: Imipramine Mar 08

Pregnant in www.rotunda.co.in June2008!

Separated from USAF in July 2008


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Questions?


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tility treatments

Home Programs and Services Infertility treatments

Infertility treatments

Rotunda offers all services pertinent to infertility under one roof. We are known for our innovation, integrity, med

and technical excellence, personalized service, and consistent willingness to accept patients facing the most diff

medical challenges. We offer the following services:

Intrauterine Insemination

In vitro Fertilisation (IVF)

ICSI

IVF Lite (Mild IVF/Minimal stimulation IVF)

Surgical Sperm retrieval

Donor Egg program

Sperm banking and donor sperm

Embryo freezing

Gestational Surrogacy

Embryo donation

IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy

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Transcript of IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy