IVF India - Top Rated Centres by Vicky Bhargava

Vol 1 No 4 PublIshING dIreCTor & edITor IN ChIef V. Bhargava editor.ivfindia@gmail.com PublIsher, PrINTer & edITor Ravi Pathak CoNsulTaNT edITor Ratan Mani Lal dePuTy edITor Vikram Gaglash CoNTrIbuTING edITors Kriti Gupta, New Delhi Dipna Kriplani, Ahmedabad Daya Kingston, Chennai Khusboo Singh, Bhubaneshwar edIToral desk Shweta Malviya, Manoj Singh, Sandhya Saurabh, Alok Mahajan arT dIreCTor Raj Bhagat VIsualIsers Ranjit Mongia, Prasoon Pal, Laila K., Arun Masih PhoToGraPhers Aditya Goswami (New Delhi) Nilanshu Khatri (New Delhi) Babar Ali (Mumbai) Ashok Krishnaswamy (Chennai) Prabhu (Pondicherry) Subhamoy S. Roy (Kolkata) Akhil Ranjan (Bhubneshwar) Aakash Jagtap (Pune) Anoop Taneja (Jalandhar) K. Rajnihjawan/Jaipal Bhatia (Chandigarh) Bejoy Viswas (Kochi) Renjith M (Calicut) Gurmeet Singh Sidhu (Kota) Dipna Kirpalani (Ahmedabad) Syed Shakeel Hussain (Hyderababad) Nitin Arora (Lucknow) Bindu (Tirupati) Sanjay Kapur (Nagpur) Utpal Barua (Guwahati/N.E.) Kishore Raj (Raipur/Chattisgarh) Zafar (Kolhapur) Ravi Shankar (Patna)

Contact us: editor@ivfwhois.com www.theivﬁndia.com www.facebook.com/ivﬁndia.info Distributed in India & Nepal by The India Today Group

EDITORIAL

Finding Hope These lines sum up beautifully what a parent feels when their child it born. We are programmed genetically to reproduce like all living species on earth. But with some of us there is a twist which prevents us from doing just this. To fill this void, from centuries, men discarded wives, sought more fertile ones, chose adoption or simply just gave up and resigned themselves to a life without a progeny. A life of loneliness and misery. Till the invention of IVF. Since the birth of the first test tube baby, reproductive science has seen astonishing growth and path breaking scientific advancement. Assisted Reproductive Technology, today, stands at the brink of a technological explosion. Where infertility will be a nightmare of the past. While science is ensuring that childlessness be eraticated from

the world, it is governments who are also moving rapidly to put restrictions in place. While some are needed as safe guards, most are an imposition of pre concieved notions and morality. A case in point is the Indian government’s stand on surrogacy. The bill if passed shall sound the death knell of surrogacy in India. Is it right for any government to decide on who is allowed a child and who is not. On one hand is the science of ART blossoming into newer and newer possibilities and on the other is us trying to contain it’s growth. It is a paradox which needed careful deliberation. However, a ray of hope for the Surrogacy Bill is the recommendations of the Parliamentary Committe which has recommended drastic changes in the bill as it stands today.

Licensed images: Shutterstock/Canstock Printed & Published by Ravi Prakash Pathak for Pugmarks Media, from 63/9A, South Lokpur, Naini, Allahabad 211008 and Printed by him at Bhargava Press, 11/4, Bai ka Bagh, Allahabad 211003. Editor: Ravi Prakash Pathak IVF India does not take the responsibility for returning unsolicited publication material. All disputes are subject to the exclusive jurisdiction of competent courts and forums in Allahabad only. Opinions expressed in the articles are of the authors and do not necessarily reflect those of the editors or publishers. While the editors do their utmost to verify information published they do not accept responsibility for its absolute accuracy.

IVf INdIa - your Guide for a Child

CONTENTS 12 Immunity Boosters

Page 6

Celebrities & Their IVF Kids

Page 8

PCOS - A Complex Fertility Issue Page 18

Page 14

Male Infertility

MYTHS Debunked Page 26

Page 24

Female Infertility Myths

HOPE

SNIPPETS ; SUGGESTIONS ; SUPPORT

UNPLUGGED Do Chinese medicines help? Women trying to conceive have been told that Chinese medicine could help them get pregnant. Scientists have found that combining herbal and acupuncture therapies with fertility treatments can improve a woman's chance of success. Researchers from Tel Aviv University compared the success rates of couples using intrauterine insemination (IUI) both with and without Chinese herbal and acupuncture therapies. Traditional Chinese medicine has long been used to ease pain and treat disease and IUI involves a laboratory procedure to separate fast moving sperm from more sluggish sperm. The fast moving sperm were then placed into the woman's womb close to the time of ovulation when the egg is released from the ovary in the middle of the monthly cycle. The results, which have been published in the Journal of Integrative Medicine, showed a significant increase in fertility when the therapies were administered side-by-side. When combining IUI with traditional treatments,

7 Ways to De-Stress 1. TAKE A WALK Want a break from the office? Does your house feel like an insane asylum? Slip out the door and let your feet take you somewhere. Not only will walking give you the opportunity to clear your head and take a break from that hectic situation, but itâ&#x20AC;&#x2122;s great aerobic exercise, too. 2. CALL A FRIEND We all have someone whose voice alone perks us up. Give them a buzz, even for a few

65.5 per cent of the test group were able to conceive, compared with 39.4 per cent of the control group, who received no herbal or acupuncture therapy. The scientists said the method was as "close to nature" as possible.

Try These Tips When You Feel Stressed

Doctors say women should not delay having children until it is too late Doctors have warned that women should have babies before they are 35 or risk infertility and other health problems. Experts at a recent conference organised by the Indian Society for Assisted Reproduction (ISAR), say the 'optimum age' for childbearing is between 20 and 35 and it would encourage women to consider having families during this time. But that's easier said than done for a lot of women. They say there is an "urgent need" for better public information on the issues surrounding later maternity. Most women are aware that they will find it harder to conceive if they put it off until their late 30s. But when it's so difficult to forge a career, particularly in the current economic climate, and so hard to get on the property ladder, many just don't feel it's an option. The doctors agree there is a growing trend in India for women to put off having children, for many reasons including building a career and achieving financial independence. But, they say, 66% of women aged 30 will conceive naturally and have a baby. After this, it is "increasingly difficult to fall pregnant and the chance of miscarriage rises". Fertility treatment is also much less successful

minutes. Whether with a joke or a funny story, or just by listening, they will likely put a smile on your face and calm you down. Besides, what are friends for? 3. WRITE IN A JOURNAL Expressing our feelings could be the best way to deal with stress. Keeping a journal is a way to capture those feelings at any moment. You don’t have to worry about what others think or say, just let your pen do the work. By the time you’re done, those feelings will be on their way out of your system. 4. PLAY A BOARD GAME Remember these? Maybe there are a dozen stashed in your IVf INdIa - your Guide for a Child

after the age of 35. It works for a third of women under 35 but only 5% of women over 42. Women over 40 are also considered to be at a higher risk of pregnancy complications. There are bigger problems here. There's more pressure on young women to build a career and it's hard to do that if you take a break. It's almost as if career-minded women are expected to wait until the last possible moment and then pop out the perfect family as well.

closet, waiting to be dusted off. Monopoly probably should be saved until you have a few hours to spare, but quick kids’ games like Candy Land, Chutes & Ladders, Connect Four, or even Twister are always good for a smile. 5. WORK UP A SWEAT Have some pent up frustrations? There’s no better way to get rid of them than by exercising. Pop in a workout tape, hop on your bike or grab your jump rope. You’ll be too busy working up a sweat to worry about what’s stressing you out. Picture the stress leaving your body through your pores.

6. PLAN SOMETHING FUN Is there a trip you want to take but never had time to get it together? Or a dinner you’ve always wanted to make? Now’s the time. Not only will you take your mind off things, but you’ll be spending time eagerly anticipating a great getaway or meal later. It’s a win-win situation. 7. TAKE A HOT BATH A hot bath will initially give your body a kick, which in turn will give your mind a kick too – and then it’ll slow both down. Add bubbles and a few candles and you have the ultimate soothing atmosphere. A rubber ducky is optional.

CLEANSE & DETOX

Kicking the soda habit? Want to sip more water? Cleanse & Detox water may be the trick! Also known as spa water, this refreshing and natural infusion of fruit and herbs turns a basic glass of H2O into a deliciously healthy indulgence. Cleanse & Detox waters aren’t just delicious. They’re gorgeous! Shimmering glasses full of bright colors inspire you to stick to your healthy goals because they’re so much prettier than a boring, old candy bar. With millions of color and flavor combinations possible, detox water is a fun way to mix up your healthy eating routine. We’ve pulled together three of our favorite flavor combos. Mix them up or make your own.

IVf INdIa - your Guide for a Child

Rainbow Cleanse & Detox Water This bright combination of fruits and citrus lends a mildly sweet, clean flavor to ice cold water. Perfect for those moments when youâ&#x20AC;&#x2122;re craving dessert but donâ&#x20AC;&#x2122;t want to cave. TO MAKE: In a large mason jar, layer the following in this order: sliced strawberries, sliced oranges, sliced lemons, sliced kiwi fruit, sliced limes, blueberries, blackberries. Top with ice. Fill with water. Serve with a straw and enjoy!

Tropical Cooler Cleanse & Detox Water Zesty kiwi, bright pomegranate seeds, ginger, and slices of lime make for a vivid and cooling cleanser. Perfect for sipping your way through sugar cravings, this cleanse & detox water lends vibrant color and flavor which refreshes your palate and makes it easy to drink your daily water. TO MAKE: Fill a mason jar halfway with ice. Top with sliced limes, sliced kiwi, sliced ginger, and an handful of pomegranate seeds. Top with ice. Fill with water. Serve and enjoy.

Lemon-Cucumber Cleanse & Detox Water Feeling bloated? Try sipping on this refreshing water. Perfect for rehydrating a hangover, delicious for post-workout thirst. This cleanse & detox water is mild and bright. TO MAKE: Fill a large mason jar halfway full with ice. Top with lemon slices, cucumber slices, a slice of fresh ginger, and fresh chopped mint. Fill with water. Enjoy. IVf INdIa - your Guide for a Child

Get pregnant with your smartphone

twelve GINGER

The Natural Cycles app has helped over 5,000 women conceive & the first health app to be regulated as a medical device.

Couples trying to get pregnant may well be able to turn to their smartphones for guidence. Natural Cycles is is a fertility app invented by a husband and wife team from Sweden that's available for free on both iOS and Android. So far, it claims to have helped over 5,000 women in the Scandinavian country conceive a child within three months of using it. The app, is capable of pinpointing the time of ovulation with accuracy usually reserved for clinics and hospitals. It measures a woman's fertility window by tracking her period and temperature. “The success of Natural Cycles depends on its algorithm” explained Dr Elina Berglund, the app's cofounder and a physicist who was part of the Nobel Prize-winning team that discovered the Higgs boson. "It’s unique because it has collected data from hundreds of thousands of cycles. This means Natural Cycles is able to adapt to each individual woman’s body and, with a high degree of precision and accuracy, determine when she is ovulating.”

Maybe you love ginger for the spicy kick it gives food. Or because when you drink it in tea, it can ease nausea and vomiting. This knobby root is also a good source of antioxidants. Add ginger to stir fries or steep it in hot water to make tea. Antioxidants work best in your body when you get them straight from fruits and veggies.

BUTTON MUSHROOMS They give you the mineral selenium and the B vitamins riboflavin and niacin. That helps you in several ways. If you’re low on selenium, you may be more likely to get a more severe flu. Riboflavin and niacin play a role in a healthy immune system. OYSTERS

DID YOU KNOW?! The technology in your smartphone is more powerful than what was in the computers that were used to launch the first space shuttle. They've got zinc in them, which appears to

IVf INdIa - your Guide for a Child

NUTRITION

Immunity Boosters have some virus-fighting powers. That's probably because zinc helps create and activate white blood cells involved in the immune response. It also assists your immune system with tasks such as healing wounds. WATERMELON

Probiotics, found in yogurt and other fermented products, may ease the severity of colds. Look for labels that say "live and active cultures." Also look for added vitamin D. Studies show that people with low vitamin D levels may be more likely to get colds or the flu. SPINACH

which mops up damaging free radicals.This helps bolster the immune system and may even improve the aging process. BROCCOLI

It's not only refreshing. When it's ripe, it's also got plenty of an antioxidant called glutathione. It strengthens the immune system so it can fight infection. To get the most glutathione in your watermelon, eat the red pulpy flesh near the rind. WHEAT GERM

It's the part of a wheat seed that feeds a baby wheat plant, and it's rich in nutrients. It's a great way to get zinc, antioxidants, and B vitamins. Wheat germ delivers a good mix of fiber, protein, and some healthy fat. In recipes, you can substitute some of the regular flour with wheat germ.

You'll find lots of nutrients in this "super food." One of them is folate, which helps your body make new cells and repair DNA. It also boasts fiber, antioxidants such as vitamin C, and more. Eat spinach raw or lightly cooked to get the most benefit.

It's easy to find at the grocery store, and it's an immuneboosting basic. It has vitamins A and C, and the antioxidant glutathione.

TEA

GARLIC

Feel free to choose white, green, or black. Each delivers diseasefighting polyphenols and flavonoids. These antioxidants seek out cell-damaging free radicals and destroy them. Caffeinated and decaf work equally well.

This kitchen staple does more than punch up the flavor of food. Raw garlic can help beat skin infections thanks to its ability to fight bacteria, viruses, and fungi. Garlic may even help lower your cholesterol.

LOW-FAT YOGURT SWEET POTATO Like carrots, sweet potatoes have beta-carotene. In your body that turns into vitamin A,

POMEGRANATE JUICE Pomegranate juice may help your body fight bacteria and several kinds of viruses, including the flu.

HEALTHY LIVING

The Best and Worst Sleeping Positions

Many people wonder whether their sleeping position can contribute to back or neck pain, or even stomach issues. Here we discuss the worst and the best sleeping positions for your body. The Worst Sleeping Position – on Your Stomach This position can be hard on your back and neck and makes it difficult to maintain a natural curve of your spine. Sleeping on your stomach puts pressure on your joints and muscles which can lead to pain, numbness, and tingling. If you can’t sleep any other way, reduce the strain on your back by placing a pillow under your pelvis and lower abdomen. Also place a pillow under your head if it doesn’t place too much strain on your back.

position the weight of the uterus presses on the spine, back muscles, and major blood vessels, which can decrease blood flow around your body and to your baby. If you suffer from backache, it is recommended to place a pillow under your knees and try a small, rolled towel under your lower back for extra support and to help maintain the curve in your back. Also don’t forget to support your neck with a pillow.

Best Sleeping Position – on Your Side In this position, the person sleeps on the side while the back is slightly curled with knees bent and arms folded. Many consider this position to be the healthiest, as it helps to keep your airways open and matches the natural curve of the spine. To make this position even better, you can add a pillow between your knees to reduce stress on the hips. Better Sleeping Position – on Your Back While sleeping on your back is better than sleepIf you tend to suffer from heartburn, then sleeping on your side can also make a difference. ing on your stomach (as your back, head, neck and spine maintain a neutral position), it still has Research has found that sleeping on the left side its drawbacks. can relieve heartburn symptoms, while right-side Sleeping on your back is not recommended if you sleeping makes them worse. The reason for that is not entirely clear, and several theories have are prone to snoring and for those with sleep apnea. Sleeping on your back can also cause your been raised about this issue. tongue to fall inwards which can block the breath- Sleeping on the left side is also recommended ing tube. during pregnancy to improve blood circulation At the later stages of pregnancy, it is recomand to allow your blood an easier way from the mended to avoid lying flat on your back, as in that heart to the placenta to nourish the baby.

IVf INdIa - your Guide for a Child

101-YEAR-OLD WOMAN GIVES BIRTH AFTER SUCCESSFUL OVARY TRANSPLANT

Recently, a 101-years-old Italian woman named Anatolia Vertadella has given a birth to a healthy baby after successful ovary transplant. This procedure has been subjected to harsh critique by medical professionals, given the fact that the woman was in her advanced age. The procedure was actually done in a private clinic in Turkey, as the European laws on ovary transplants don’t apply there. The woman admitted that the procedure was done secretly, but refuses to reveal the name of the clinic where the transplant was conducted. “I am very grateful to all the team of doctors who decided to go on with the operation,” she said in tears. “I am so grateful to have given birth to my 17th child. This is a true blessing and a testament to the power of the creator,” the woman adds. “For so long I have felt useless to God, I could not procreate since I turned 48 years old when I was diagnosed with ovarian cancer. For a long time I believed God was punishing me for only bearing 16 children, but in his godly generosity, he has granted me with fertility once again,” the 101-year old fervent Catholic revealed. The whole procedure is quite controversial and the final decision was left to the patient, according to Dr. Popolicchi.“Who am I to judge if it is the proper thing to do? She has given birth to a beautiful baby and this miraculous birth is definitely a gift from God!” he stated. “The operation was completely legal in Turkey and undertaken by a handful of expert surgeons. The lady is in great health for her age and I predict she has still a IVf INdIa - your Guide for a Child

many good years in front of her to share with her child. So many children are born in this world unwanted or by accident. Is it not a beautiful thing to know this child comes to life in a loving home?” the doctor asked the reporters while giving an interview. Vertadella’s husband died way back in 1998, but the doctor found a sperm donor in order to make the entire procedure possible. The sperm donor was found on the internet. “I met Francesco’s father on the internet while trying to find a father to my child. This 26-year-old man is a Catholic and that is all that is important to me. I wanted my child to be born in a union sanctified by the Catholic church. I know we are not married and that he will not play a part in Francesco’s life, but I have written to the pope to ask his absolution. I have also named my child after the pope in his honor and so I believe he should find a place in his heart to forgive me in this particular situation. I still love my deceased husband and desire to stay a widow until I leave this earth, but I needed the seed of this young fervent Catholic to fulfill God’s will,”- she said. In case you didn’t know, there is yet another similar case of a woman who gave birth to a baby in her advanced age. Malegwale Ramokgopa, a woman born in South Africa in 1839, was believed to be the world`s oldest mother. She gave birth to twins on October 3rd, 1931, after celebrating her 92nd birthday. Source: healthybiofood.com

Dad to a 100 Babies Sperm donor fathers '100 children' in four years by offering his services for free on FACEBOOK

Sperm donor Matt Stone claims he could have fathered up to 100 children in four years by offering his services for free on Facebook. Matt Stone, 37, from Raleigh in North Carolina, USA, has revealed he is contacted "by ten people a day" through the social media site who are seeking his siring service. His first experience in the world of sperm donation came over ten years ago, when he temporarily worked for a sperm bank. Four years ago, he started his own Facebook page - Matt Stone (Shipping Donor) - where he offers his sperm to couples and single women providing they pass his vetting process. In his questionnaire, he asks about their background, income and even checks out how their relationships appear online, all to ensure the children will be born into happy families. He claims to help up to eight people a week and as many as 20 women could currently be carrying the children. To date, he has at least 70 known children but believes there could be well over 100 as many recipients don't report successful pregnancies to them. Matt, who works in IT, said: "With every successful pregnancy it's incredibly rewarding, I've helped couples with fertility issues and those in gay marriages to have the dream they would never otherwise be able to have.â&#x20AC;?

MUST READS

Waiting for Daisy: A Tale of Two Continents, Three Religions, Five Infertility Doctors, an Oscar, an Atomic Bomb, a Romantic Night, and One Woman's Quest to Become a Mother by Peggy Orenstein Waiting for Daisy is about loss, love, anger and redemption. It's about doing all the things you swore you'd never do to get something you hadn't even been sure you wanted. It's about being a woman in a confusing, contradictory time. It's about testing the limits of a loving marriage. And it's about trying (and trying and trying) to have a baby. Silent Sorority: A Barren Woman Gets Busy, Angry, Lost and Found by Pamela Mahoney Tsigdinos From celebrity and news magazines to TV programs to Facebook pages and mommy blogs, family-building successes are routinely and glowingly shared and celebrated. But where are the voices of those who are unable to have children? In relating what happens when nature and science find their limits, Silent Sorority examines a seldom acknowledged outcome and raises provocative, often uncomfortable questions usually reserved for late night reflection or anonymous blogging. Hannah's Hope: Seeking God's Heart in the Midst of Infertility, Miscarriage, and Adoption Loss by Jennifer Saake, Barbara Deane Hannah's Hope is intended as a guide to assist you in making wise decisions as you struggle through your grief of not yet conceiving, losing a child, or struggling through the adoption process. Compiled by: Bhavana Pandey IVf INdIa - your Guide for a Child

RESEARCH

Babies can be conceived from skin cells

Drinking more than a large glass of wine a day can reduce your chances of getting pregnant A new study found fewer pregnancies among women who drank more than 14 servings of alcohol a week, but a small glass or bottle of beer a day does no harm. There is no need for a total booze ban if you are trying to get pregnant. Downing more than one large glass of wine a day can reduce a woman's chances of becoming pregnant , scientists say. But drinking one small serving a day - defined as 120ml of wine or a small bottle of beer - had no impact on fertility. However, researchers warned against drinking while trying to become pregnant due to affects on the foetus if women are unaware they have conceived. The study, published in the BMJ, found women who drink at least 14 servings a week had slightly reduced fertility.

DID YOU KNOW?! â&#x20AC;˘ The Romans used to clean and whiten their teeth with urine. â&#x20AC;˘ The top of the Eiffel Tower can lean up to 7 inches due to the sun expanding the metal it's made out of. â&#x20AC;˘ Our tongue prints are as unique as our fingerprints.

IVf INdIa - your Guide for a Child

A man could even fertilise his own cells to produce offspring containing a mixture of genes inherited from him and his parents, a study reveals. British scientists have conducted a landmark experiment that could one day make it possible for men to have babies with each other. The breakthrough study showed that sperm and skin cells, or any other kind of non-egg cell, might be all that is needed for conception. Such a scenario would mean men could conceive a child without the female side of reproduction. Scientists admitted that the scenario was "speculative and fanciful", but did not rule it out in principle. Working with mice, the team produced healthy offspring while bypassing the normal process of fertilising an egg cell with sperm, and without cloning. The extraordinary result means that sperm could potentially be fused with ordinary cells derived from skin or other tissue to create viable embryos. It also raises the possibility of ethically questionable applications that turn nature on its head by doing away with the female side of reproduction. Gay men, for instance, could have babies with each other, and a man could even fertilise his own cells to produce offspring containing a mixture of genes inherited from him and his parents. More realistically, the technique could allow women whose fertility has been wiped out by cancer drugs or radiotherapy to have their own children. While eggs can be frozen before cancer therapy and later fertilised in an IVF clinic, currently nothing can be done once they have been lost.

Celebrities & their IVF Kids Millions of couples struggle with infertility and the famous people below are no exception. Each one of these entertainment superstars have had trouble conceiving naturally and resorted to undergoing IVF treatment or artificial insemination. Because of their high profile careers and a stigma about artificial pregnancies, celebs often keep their problems with fertility, miscarriages, and IVF treatments a secret. In recent years, however, more and more entertainers are opening up about using various types of treatments and procedures to get pregnant. CELINE DION

ond child Faith Margaret was born in 2010 via a gestational surrogate. MARIAH CAREY

before giving birth to hers and Chris Henchy's daughter Rowan Francis in May 2003. The couple was able to naturally conceive their second daughter, Grier Hammon, three years later. FARAH KHAN AND SHIRISH KUNDER

After six in vitro fertilization attempts, Celine Dion and her husband Rene Angélil gave birth to their son René-Charles in 2000. A decade later, the couple once again used IVF to conceive their twin boys Eddy and Nelson, born in 2010. NICOLE KIDMAN

The chart-topping singer, who had previously suffered a miscarriage, underwent IVF treatments to get pregnant. In 2011, Carey and her husband Nick Cannon welcomed their twins Moroccan and Monroe, which she famously nicknamed "Dem Babies." BROOKE SHIELDS

Nicole Kidman went through various IVF and fertility treatments before the 2008 birth of her and Keith Urban's daughter Sunday Rose. The couple's sec-

Brooke Shields reportedly underwent seven IVF treatments

Bollywood’s ace choreographer and director Farah Khan got married to Shirish Kunder in her 40s. The couple tried two years for a baby. Finally, she decided to go through with IVF. Farah gave birth to triplets, on February 11, 2008. She has even suggested this procedure to many other women who were not able to conceive naturally. According to her: "When the choice is to either go childless or IVF, there is no room for doubts. I was 43 when I had my kids and my biological clock had stopped ticking long time ago." IVf INdIa - your Guide for a Child

third child. Shah Rukh Khan says: "Amidst all the noise that has been going around, the sweetest is the one made by our newborn baby, AbRam. He was born prematurely by several months, but has finally come home". SOHAIL AND SEEMA KHAN

lines; Roohi and Yash. I feel enormously blessed to be a parent to these pieces of my heart who were welcomed into this world with the help of the marvels of medical science." A single father Karan plans to raise his kids with the help of his mother. DIANA HAYDEN

AAMIR KHAN AND KIRAN RAO Aamir Khan, who had two children from his previous marriage, opted for IVF procedure with his second wife, Kiran Rao. The couple was blessed with Azad on December 5, 2011. Aamir was very open about this procedure and has recommended other couples to opt for it, too. On the birth of child, Aamir said" “This baby is especially dear to us because he was born to us after a long wait and some difficulty. We were advised to have a baby through IVF surrogacy, and we feel very grateful to the Almighty that all has gone well."

The ex-Miss India/World went for fertility preservation 8 years ago. She recently delivered a healthy baby girl using her own frozen eggs.

Sohail Khan and Seema decided to have a second baby, ten years after the birth of their first son, TUSSHAR KAPOOR Nirvaan. They, too, decided to consider IVF surrogacy as an option to have their second child. Their second child, Yohan, was born in June, 2011. This much-in love couple had got married in 1998. KARAN JOHAR

Tusshar Kapoor became father to a baby boy. The actor – who is unmarried – fathered the new born through surrogacy using IVF. An elated Tusshar has named the baby Laksshya. It was director Prakash Jha who inspired Tusshar to take this step. “Last year, I went to Tirupati SHAHRUKH AND GAURI KHAN temple. I happened to meet diClearing the air over all the rurector Prakash Jha. We were in mours surrounding the new enthe same flight. He told me trant in Mannat, King Khan and Other than Bollywood Khans, about this procedure (IVF) and his wife, Gauri are the recent ad- Karan Johar was recently blessed how one could be a single parditions to this list. Much after by twins from surrogacy. An ent using the same. I felt inthe birth of their two kids (Aryan overwhelmed Karan said "I am spired and decided to go in for and Suhana), the couple also ecstatic to share with you all the the same.” opted for IVF surrogacy, and two most wonderful additions to have now brought home their my life, my children and life-

IVf INdIa - your Guide for a Child

Planning to conceive after 35? Here is all you need to know!

areer takes precedence over marriage and family for the modern day couples. There has been a sharp increase in the number of women over 40 years of age. There has been an increase of 33% in child births to mothers over the age of 40 in the last 5 years. The older age pregnancies do come with a lot of complications such as infertility and greater chances of chromosomal abnormalities in the child. Also, according to a study conducted by American College of Obstetricians & Gynecologists (ACOG) the rate of miscarriage increases progressively as the women ages, from 13% in women younger than 35 years to 54% in women aged 44 years or older. With advanced maternal age, there are many physiological changes that take place in a

womanâ&#x20AC;&#x2122;s body which can hinder the natural conceiving process or can lead to miscarriages. Not only women, men also experience low sperm count and other impaired sperm parameters which can be associated with older age. Couples in this case often opt for Artificial Reproductive Technologies (ART) such as In- vitro fertilization (IVF). IVF is increasingly gaining popularity especially in couples who are planning their pregnancies in their late 30â&#x20AC;&#x2122;s. In case of both- the male factor infertility and advanced maternal age, the likelihood of miscarriage and chromosomal abnormalities such as Down syndrome also increases. Most embryos with an incorrect number of chromosomes fail to implant in an IVF process or miscarry during the first trimester of pregnancy. In many cases it can IVf INdIa - your Guide for a Child

also led to multiple miscarriages. In women over 38 years old, 79% of embryos have chromosomal abnormalities. These abnormalities can be numeric, with the most common example being that of Down syndrome (three copies of chromosome 21 instead of two), along with Edwards’ and Patau’s syndromes.

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In women over 38 years old, 79% of embryos have chromosomal abnormalities. These abnormalities can be numeric, with the most common example being that of Down syndrome along with Edwards’ and Patau’s syndromes.

age PGS is also recommended in cases of couples who have experienced several spontaneous miscarriages of unknown cause, couples with several failed cycles of IVF, men with low sperm concentration and couples with a previous pregnancy with chromosomal abnormality. PGS test for aneuploidy screening avoids chromosomal abnormalities and it significantly increases the chances of successful pregnancy by 60% in IVFprocedures The quality of the sperm is as important for a healthy embryo which can implant successfully in an IVF process. The Sperm Aneuploidy Test (SAT) is another diagnostic test to male factor infertility. This test enables estimation of the transmission risk of chromosomal abnormalities to the child. It analyzes the chromosomes mostly implicated in spontaneous miscarriages and cases of births with common chromosomal abnormalities such as Down syndrome (also known as trisomy 21). It therefore screens the sperm sample for chromosomes abnormalities related to Trisomy13, 18 and 21 and the sex chromosomes X and Y.

However, even though chances of getting pregnant after the age of 35 decreases it does not certainly mean that it is impossible to conceive or that the intended parents will necessarily have trouble in conceiving. Also, increasingly gaining popularity among urban women is Egg freezing. This is a solution to the age factor so that couples can conceive when they’re ready for it completely. In egg freezing technology, the egg is stored and is frozen, for years. When the woman is ready for pregnancy these eggs are used to form an embryo which is then implanted in her womb through an IVF process. The quality of egg and sperm also decrease with age increasing the chances of chromosomal abThe author is Mr. Francisco Rodriguez Herrera, normalities in natural pregnancies and multiple Business Head of Igenomix India And Middle East. IVF failures if the couple is opting for a pregnancy through IVF. Couples opting for a late pregnancy can rule out possibility of a chromosomal abnormality in their baby and increase their chances of a successful pregnancy through a few reproductive genetics techniques. Non-Invasive prenatal testing (NIPT) analyzes the most frequent chromosomal alterations with a simple blood extraction. It is completely safe for you and your baby. An expecting mother can opt for at 10thweek of pregnancy. NACE (Non-invasive Analysis for chromosomal examination) is one such test by Igenomix. NACE also provides critical fetal fraction data for your specialist. Fetal Fraction refers to the proportion of free DNA in circulation that belongs to the placenta, in relation to the total amount of free DNA in circulation found in the blood sample. If a couple is facing repetitive IVF failures, Preimplantation genetic screening (PGS) and MitoScore is recommended. A study by Igenomix suggests that in the general population, 20% of all clinical pregnancies miscarry and about half of them are chromosomally abnormal. PGS with MitoScore improves reproductive success by helping the specialist to select chromosomally normal embryos which have a greater possibility of resulting in a successful and healthy pregnancy throughIVF. Besides in case of women who are over 35 years of IVf INdIa - your Guide for a Child

PCOS A Complex Infertility Issue

Sometimes medical syndromes are named long before they are fully understood. Take polycystic ovarian syndrome, or PCOS, which affects as many as 10 percent of women of childbearing age, often impairing their fertility. But not all of these women have polycystic ovaries, a fact that can result in misdiagnosis. As it turns out, cysts — sacs of fluid on the ovaries — are just one manifestation of a complex hormonal condition. First described in 1935, PCOS was initially called Stein-Leventhal syndrome, for the two American gynecologists who identified it, Dr. Irving F. Stein Sr. and Dr. Michael L. Leventhal. They recognized that ovarian cysts can interrupt ovulation and cause infertility in significant numbers of women. Irregular menstrual cycles and difficulty conceiving are among the most common symptoms, the

result of ovarian follicles that fail to mature fully and to release eggs. Affected women often have enlarged ovaries and, when menses does occur, prolonged bleeding. Over time more cysts — swollen follicles, really — may form. On anultrasound exam, they resemble a string of pearls stretched over the surface of the ovary. Yet some experts believe cysts are a result, rather than the cause, of the syndrome. “Whether the condition starts in the ovaries is not certain,” Dr. R. Scott Lucidi, an expert on PCOS at Virginia Commonwealth University, said in an interview. Indeed, women with few or no ovarian cysts may be diagnosed with PCOS. According to the so-called Rotterdam criteria, a woman with any two of the following conditions may have the condition: IVf INdIa - your Guide for a Child

Thinning hair

Hair on lip/chin/neck Acne

Hair on back

Hair on chest

Signs & Symptoms

Excess weight around waist Missed periods, ovarian cysts & infertility

Dark discoloured skin & spots

IVf INdIa - your Guide for a Child

Without being extreme, women with PCOS should reduce their carbohydrate intake overall and in particular avoid sugars and refined carbohydrates. They should instead select foods high in fiber made from whole grains, as unprocessed as possible. • Symptoms of elevated levels of androgens, or male sex hormones, which can include acne, excessive hairiness and sometimes male-pattern hair loss. • Irregular menses, with prolonged periods between cycles. • Twelve or more follicular cysts on the ovaries, as seen on an ultrasound. Dr. Lucidi and others have suggested that insulin resistance could be the underlying factor responsible for the disparate symptoms of PCOS. In people resistant to insulin, the hormone does not effectively transfer glucose from blood to body cells to be used for energy. As blood levels of glucose build, more insulin is produced to try to lower it. Excess insulin promotes fat storage and can result in weight gain and obesity. About half of women with PCOS are obese. Insulin also can stimulate the ovaries to produce androgens. But just as some young women with a lot of ovarian cysts do not have PCOS, some women with metabolic syndrome and insulin resistance are thin. PCOS tends to cluster in families, with predisposing genes passed from either parent to both daughters and sons. In affected males, early balding or excessive hairiness can be a sign that the genes have been inherited. In women, symptoms can vary from being very mild to extensive. Some experts believe that the fundamental defect may not be insulin resistance, but hormonal dysregulation by or of the hypothalamus. This small region at the base of the brain produces hormones that stimulate the pituitary gland, which in turn affects organs throughout the body. In most women with PCOS, the pituitary gland produces excessive amounts of luteinizing hormone, which, like insulin, can stimulate the ovaries to secrete androgens, according to a practice guideline written by Dr. Robert L. Barbieri, head of obstetrics and gynecology at Brigham and Women’s Hospital in Boston. When ovarian follicles are enlarging, women with PCOS also produce high levels of estradiol but low levels of progesterone, resulting in a thick uterine

lining and over time an increased risk ofendometrial cancer. There is no cure for PCOS, and the best approach to treatment is individualized, depending on the goals of each patient, Dr. Lucidi said. For women with prolonged intervals between menses or excessive hairiness, or both, contraceptives containing estrogen and progestin are used to regulate the menstrual cycle and suppress the production of androgens. Often, the blood pressure drug spironolactone is also given to counteract androgen-caused acne or hirsutism in adult women. For a woman trying to become pregnant, a different regimen is needed. Two drugs, clomiphene and letrozole, are commonly prescribed to stimulate ovulation. Both these drugs prompt the pituitary to secrete follicle-stimulating hormone (FSH), which enhances the growth of small follicles and thus can trigger ovulation. Dr. Barbieri noted that “most women with PCOS who undergo ovulation induction go on to conceive and bear children.” Perhaps the most challenging therapy involves weight reduction. Losing 10 percent of body weight can result in more regular menstrual cycles and reduced levels of testosterone, Dr. Barbieri wrote. For women with PCOS, the most effective diet for achieving and maintaining weight loss is low in carbohydrates, rather than low in fat. Without being extreme, women with PCOS should reduce their carbohydrate intake overall and in particular avoid sugars and refined carbohydrates (white bread, white rice and anything stripped of its natural fiber or made with refined white flour). They should instead select foods high in fiber made from whole grains, as unprocessed as possible. They are also advised to avoid eating carbohydrate-rich foods by themselves, and space them out during the day to keep insulin levels from spiking. Consuming four or more small meals instead of a few large ones each day is also helpful. Regular moderate or vigorous exercise done five or more times a week is an important part of the regimen. IVf INdIa - your Guide for a Child

PCOS A Complex Infertility Issue

things only you’ll know if you suffer from PCOS

Polycystic ovary syndrome (PCOS) is a condition that affects millions of women in India. It can be diagnosed at a young age, or is sometimes discovered when trying for a baby. It’s one of those syndromes that seems to affect far more that just your ovaries, and as someone who’s been dealing with it for ten years now, I thought it time to talk about all the things us PCOS ladies know to be true. 1. You don’t do embarrassed anymore. You’ve had doctors poking around your nether regions for years. No scan or smear will ever phase you. 2. You develop diabetic paranoia. Because you’ve been being told for years that you’re at ‘high risk’. So you’re obviously convinced that the results from your next blood test will be bad news. 3. You get stuck in a vicious weight circle. Because doctors constantly tell you to shift a kg or two to help your periods regulate. And you’re there like ‘erm, PCOS actually means losing weight is pretty much impossible for me right now’. 4. Contraception is a mine field. What’s the best thing for me? Surely it’s not healthy for me to be on a pill that means I don’t bleed at all? I don’t know what to do! 5. You struggle for answers. Sadly, PCOS is not a topic that GPs and specialists have easy answers for. It’s an evolving learning process and often it’s down to you to determine how to manage it. 6. You feel like a boy. Because all the doctors keep on telling you is that you have high levels of testosterone in you. 7. You fight the constant battle against the fuzz. The increased male hormones running round your body mean that no upper lip, chin or chest area is safe from pesky strands of dark black hair. You get really good at waxing! 8. You wake up in cold sweats at the thought that you’ll struggle to conceive. Your irregular ovulation (or failure to) means it could well be hard work for you to fall pregnant. And it bothers you. 9. However, you hold Victoria Beckham on a pedestal. Because she has it. And has four babies. So there is hope for all. 10. Sometimes, your hair just falls out. Which, if you have thick hair is annoying but manageable.You just leave a trail of hair wherever you go. If it’s thinning because of your PCOS it’s the worst time. 11. You play the ‘period guessing game’. Will I have a period this month? Will it be another four months until I see one? Will it just arrive half way through my holiday when I think I’m safe? Argh! 12. AM I PREGNANT? You spend your life buying both tampons and pregnancy tests because you’re just never sure if your late because of a baby or because of your crazy ovaries. It’s a massive headache. IVf INdIa - your Guide for a Child

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IVf INdIa - your Guide for a Child

Stress as a cause of infertility isn’t warranted. Firstly, stress research is notoriously problematic, since it’s hard to pinpoint what causes what: Was a patient stressed to begin with or did she become stressed after being diagnosed as infertile? Also, it’s hard to objectively assess stress levels, considering that some studies rely on self-reports or don’t take into account how people experience stress differently. In fact, it seems as if for every study supporting an association, another refutes it. A recent study found a connection between stress and lower fertility by measuring a stress biomarker in women’s saliva, yet another article pointed out that the link isn’t so clear, since caffeine, food intake, and exercise can also make that biomarker rise. When Danish researchers reviewed 31 studies on whether stress, anxiety, and depression played a role in whether infertility treatments worked, their conclusion was that the influence of psychological factors appeared to be “somewhat limited.” If the data are so spotty, why does the message persist that stress is bad for fertility? For starters, it’s convenient. Infertility, like autism, remains one of modern medicine’s greatest mysteries. Fertility doctors know why a 45-year-old woman can’t get pregnant, but they don’t know what’s wrong with up to one-third of their patients who are struggling to conceive - causing them to diagnose them with “unexplained fertility.” As a society, we wonder if we’re suffering from lurking environmental toxins or secret sexually transmitted diseases. But stress is an easy explanation. And it fits nicely with the cultural imperative that stress is something that we can - and should - manage at all times. Aside from sex and weight loss it seems to be the next most popular subject in magazines these days. For a woman trying to conceive, the idea that she can do something proactive - practice yoga, meditate, pop fish-oil capsules - is wonderfully appealing. It gives her a sense of control over a process that is frustratingly uncontrollable. The problem, of course, is that no one can control her stress levels all the time. We are going to get annoyed at delayed traffic, inconsiderate partners, and unrealistic bosses. We are going to carry tension in our shoulders and feet. And women who are trying to get pregnant

IVf INdIa - your Guide for a Child

experience a whole other level of misery: Scheduled sex is stressful. The cost of infertility treatment is stressful. “It’s living in the whole fertile world where you don’t fit in. However, all this focus on enforced relaxation often just makes women feel worse. “When women hear things in the press about the causes of infertility, they feel guilty that they’ve done something that prevented them from getting pregnant,” explains Sherlyn Saxena, a psychologist, who reminds patients that many women who have endured severe trauma, such as the riots or rape, still got pregnant. “There is nothing worse than hearing a family member say, ‘You’re way too stressed out’ or ‘You’ve just got to relax.’ It’s not something they can turn on and off.” The message can also set a woman up to be blamed for her infertility. It’s not a far stretch to imagine husbands and partners accusing her of “not really making an effort” if she lets herself get worked up while trying to get knocked up. (Researchers are discovering that stress may harm men’s sperm, too, but that headline doesn’t get as much attention!) More insidiously, society may adopt a standard about how such women should behave. Will we now start the policing even earlier? If we see a friend whom we know is “trying” screaming into her cell phone, should we feel compelled to confront her or quietly slip her some chamomile tea and aromatherapy candles? Women generally feel bad enough about not being able to get pregnant. They already feel enough shame about their malfunctioning bodies and disappointed partners. Adding to a woman’s burden of being told to “chillax” isn’t clearly helpful - to her cause or emotional wellbeing. Stress researchers admit that even if they came up with overwhelming evidence that stress causes infertility, they are at a loss how to design a proven stress therapy that helps women get pregnant. Currently, fertility clinics are increasingly offering “mind body” programs, consisting of stress management and cognitive behavioural therapy exercises, such as breathing or visualization. But administrators say the main goal is simply to help women feel better - not necessarily improve their chances of conception. At the very least, the meditation might be a nice break from thinking about making babies.

For as long as people have been having children, they've been trying to understand the mystery of fertility. We've come a long way, but many misconceptions remain. Here's a look at the top modern infertility myths: MYTH 1: INFERTILITY IS ALMOST ALWAYS A WOMAN'S PROBLEM. FACT: When there's an identifiable cause of infertility, about half the time men contribute to the problem. A male factor is responsible in about 35 percent of infertile couples, and male and female factors together contribute to the problem in another 20 percent. MYTH 2: MANY INFERTILE COUPLES ARE TRYING TOO HARD. IF THEY WOULD JUST RELAX, THEY WOULD CONCEIVE RIGHT AWAY.

FACT: Relaxation alone won't help anyone become a parent. Instead of booking that Puerto Vallarta vacation, infertile couples should schedule a doctor's appointment. One or both partners may have a correctable medical condition that stands in the way of conception. MYTH 3: MOST COUPLES CAN CONCEIVE ANY TIME THEY WANT. FACT: More than 20 million Indians of childbearing age have fertility problems. Even under the best circumstances, conception is tricky. It's not unusual for a perfectly healthy, fertile couple to try for several months or more before achieving a pregnancy. And the longer couples wait to have children, the more difficult it can be: By the time the average woman reaches her early forties, half of her eggs are no longer viable. However, most couples who can afford fertility treatments can IVf INdIa - your Guide for a Child

eventually conceive, if they are open to the use of egg donation. MYTH 4: WOMEN DON'T START TO LOSE THEIR FERTILITY UNTIL THEIR LATE 30S OR EARLY 40S. FACT: According to a report in the journal Human Reproduction, a woman's fertility starts to decline at age 27, although this isn't clinically significant. Most women of this age can still get pregnant, of course, but it might take a few more months of trying. But by the time a woman reaches 35, her chances of getting pregnant during any particular attempt are about half of what they were between the ages of 19 and 26. MYTH 5: CONCEPTION OCCURS ONLY DURING INTERCOURSE. FACT: Believe it or not, a man's sperm can survive for three to five days in a woman's reproductive tract. So, even if you're not ovulating during those moments of passion, his little swimmers can still fertilize an egg if you start ovulating a couple of days later. In fact, a woman's optimal window for fertility starts three to five days before ovulation and ends soon after. And when it comes to getting pregnant, timing really is everything.

Being excessively underweight is linked to nearly five times the risk of infertility

IVf INdIa - your Guide for a Child

leave it up to chance. Instead, buy an at-home fertility monitor and ovulation kit. MYTH 8: TAKING BIRTH CONTROL PILLS CAN RUIN YOUR LONG-TERM FERTILITY. FACT: Though the Pill does suppress ovulation while you're taking it, fears of sustained suppression are unfoundedâ&#x20AC;&#x201D;once a woman stops taking the Pill, it no longer impacts her ability to get pregnant. MYTH 9: INFERTILITY MEANS YOU CAN'T HAVE A CHILD. FACT: Infertility means that you have been unable to have a child naturally after a year of trying. With the proper treatment, many people go on to have children. In addition, there is a possibility of a couple conceiving without treatment if the woman is ovulating and has one open tube, and the male partner has some sperm in his ejaculate. This rate may be lower than you would hope, but it is not zero.

MYTH 8: THE NUMBERS ON THE SCALE HAVE NOTHING TO DO WITH FERTILITY. FACT: How much people weigh can greatly impact their chances of conceiving. Several studies have linked obesity to low sperm count and poor sperm quality in men. MYTH 6: STRESS HAS NOTHING And obesity in women is a risk facTO DO WITH INFERTILITY. tor for anovulation (the absence of FACT: There's stress and then ovulation). On the other hand, acthere's stress. A little is OK, but a lot cording to a study in the journal can wreak havoc on your entire Sterility and Fertility, being excesbody, including your fertility. But sively underweight (a BMI of 17.5 not to worry: A recent study in the or less) is linked to nearly five times journal Fertility and Sterility found the risk of infertility since women mind-body stress-reduction prowith too little body fat can stop grams more than doubled pregovulating and/or menstruating alnancy rates in couples undergoing together. in-vitro fertilization. If you're struggling with infertility, MYTH 7: YOUR BEST CHANCE OF you undoubtedly have many quesGETTING PREGNANT IS ON DAY tions of your own - and maybe even 14 OF YOUR CYCLE. a few misconceptions. Schedule an FACT: While it makes sense in the- appointment with a fertility speory, not everyone has a 28-day cialist and find out where you cycle with ovulation occurring stand. Thanks to modern medicine, smack dab in the middle. To deter- many infertile couples become parmine when you're ovulating, don't ents -and that's no myth.

Through simple lifestyle changes, many men can improve their fertility significantly. For male infertility issues that require fertility treatment, men should be rest assured that these are highly treatable, & with great success.

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Heat created from laptops can affect sperm motility and cause DNA damage. Cell phone emissions can also cause sperm damage, so keep phones in the back pocket and put a fan under your laptop. MYTH: AGE DOES NOT AFFECT MALE FERTILITY A recent study published in the journal Nature has shown that paternal fertility decreases with age. The study found a direct link between paternal age and an increased risk of autism and schizophrenia. The study also shows that fathers pass on as many as four times more genetic mutations when compared to mothers. It is important that men are aware of their age and fertility potential during conception. If you plan to delay fatherhood, preserving fertility by freezing sperm is a relatively inexpensive way to â&#x20AC;&#x153;freezeâ&#x20AC;? your fertility in time. If you are older and looking to conceive, a semen analysis evaluating shape and motility will provide valuable insight to fertility potential. MYTH: ONLY WOMEN NEED TO TAKE SUPPLEMENTS TO IMPROVE FERTILITY It has long been known that IVf INdIa - your Guide for a Child

women should take folic acid while trying to conceive, as well as during pregnancy to prevent certain birth defects, but folic acid is now known to be an important supplement in male fertility. Researchers at the University of California found that men had a higher rate of chromosomal abnormalities in their sperm when their diet was low in folic acid. Coenzyme Q10 has also been found to increase sperm count and sperm motility, while Vitamin E also improves low sperm count. MYTH: SMOKING DOESN’T AFFECT MALE FERTILITY Statistics don’t lie. Smoking increases chances of male infertility by 30 percent. Cutting out cigarettes is an obvious health advantage, but many don’t realize how harmful cigarettes can be to fertility. A report by the British Medical Association showed that smokers may have up to a 10-40 percent lower monthly fecundity (a.k.a. fertility) rate. The American Society for Reproductive Medicine has estimated that up to 13 percent of infertility may be caused by tobacco use. The effect is dose dependent on the number of cigarettes smoked per day. Smoking as few as 5 cigarettes per day has been associated with lower fertility rates in males (and females). MYTH: CELL PHONES, LAPTOPS, HOT TUBS AND BICYCLES DON’T HAVE AN EFFECT ON SEMEN QUALITY. Heat in extreme amounts can damage the testes and decline semen quality. A recent study by Fertility and Sterility found that the heat created from laptops can affect sperm motility and cause DNA damage. Cell phone emissions can also cause sperm damage, so keep phones in the back pocket and put a fan under your laptop. Men should be careful of putting too much time on the bike or lounging too long in a hot tub. Not to worry – semen quality typically declines only in extreme use or regular exposure. Enjoy your life and simply be aware and moderate in your habits. MYTH: ONLY HARD DRUGS CAN AFFECT MALE FERTILITY. Hard drugs affect fertility – and most importantly, pose a threat to your life. But it isn’t just hard drugs that can affect fertility health. Prescription drugs, antibiotics, blood pressure medication and even exposure to lead and mercury can affect the quality and quantity of sperm. MYTH: IN A HEALTHY MALE, ALL SPERM ARE HEALTHY. In an average male, only 14% of sperm by strict morphology have a normal shape, size, and ability IVf INdIa - your Guide for a Child

to move properly. While this may seem low, remember that you only need one sperm to fertilize an egg and become pregnant. MYTH: MALE INFERTILITY IS GENETIC. While male infertility can be genetically passed down, there are several different factors that can cause male infertility. A cancer diagnosis or injury can result in male infertility, while repeated infection or immunity problems can decrease male fertility. A multitude of lifestyle choices such as diet, smoking habits, drug use, exercise habits and body weight can decrease male fertility. MYTH: THERE IS NO COMMON DIAGNOSIS WITH MALE INFERTILITY. While the specific cause of male infertility can vary greatly, the most common diagnosis associated with male infertility is low sperm count. MYTH: SEPARATE HEALTH PROBLEMS DO NOT AFFECT MALE FERTILITY. Chronic conditions such as diabetes and liver cirrhosis can cause abnormal male ejaculation due to nerve damage and retrograde ejaculation. Muscles in the bladder normally close during ejaculation, preventing the entry of semen. During retrograde ejaculation, the semen is redirected into the bladder when these muscles fail to activate. If you are concerned that a chronic condition may be impacting your fertility, reach out to a physician to learn more. MYTH: WEIGHT DOES NOT AFFECT FERTILITY. Extra weight presents a multitude of health issues, and can wreak havoc on male fertility. Obesity causes elevated estrogen and low testosterone levels, which can cause sperm count to decrease. Overweight males also experience a decreased libido. The simple solution is to calculate your Body Mass Index, which provides a healthy numerical range based on height and weight, and work towards it. Exercise will increase energy, decrease weight, and equalize testosterone and libido levels. MYTH: DIET DOES NOT AFFECT MALE FERTILITY. Quite simply, you are what you eat. Men who consume high-fat diets have been found to have a decreased sperm count. Conversely, a mostly plant-based diet has been found to improve fertility and overall health. Fill your refrigerator and pantry with whole grains, fruits, and vegetables while avoiding thick cuts of meat and refined carbohydrates such as white bread and cookies.

I made my life’s biggest pain, my life’s greatest MY INFERTILITY passion Journey

”

I am a regular middle class girl from Lucknow who succumbed to her parent’s timeline and got married early in life despite having studied in JNU with dreams of doing a PhD. Well, life had other plans for me – I had to do PhD in REAL LIFE. After customary one year of marriage, we were flooded with the quintessential question, “Any good news?” After trying for one year with no luck the jitters started to seep in. I took some Ayurvedic medicines and soon conceived. Everyone around was elated. I was confused though. Not sure of how to react. I followed all the protocols of pregnancy as taught by the elder women of my family. At my fourth month ultrasound, I was up for the biggest shock of my life. “The foetus is not growing. It stopped growing somewhere at 6-8 weeks. We will have to abort it immediately.” I was totally devastated, jolted out of a dream into real life. The word “miscarriage” was introduced. Soon thereafter, new and heavy words like “DNC”, “Infertility”, “IVF”, “Molar Pregnancy”, “Tubal Blockage” etc gradually kept on being added to my new found dictionary of life. For 10 long years I fought with infertility. I went through everything possible during this journey. 5 miscarriages, one failed IVF, tryst with ovarian cancer, complications of molar pregnancy, myriad of tests, treatments, wrong diagnosis, confusion over doctors, emotional rollercoaster, mood swings, frustration with family, frequent marital discord with husband, the feeling to flee away, complete loss of self-esteem, becoming reticent and overtly sensitive. It was one hell of a journey. I kept asking, “Why Me?” I had a love-hate relationship with God. After the first IVF failure, I was so despondent that I actually ran away from everything and everyone. I worked for an NGO in a remote and far-off location to clear my head. My MIL remarked “Are you getting divorced?” So evident was the desperation of our lives. However, my husband understood and let me go. He stood there rock-solid with me. Though, he was my scapegoat for everything – I blamed him for almost everything going wrong in my life. He was dignified enough to take it all in his stride. I even suggested him to marry someone else for I couldn’t bear him a child, “How Filmy?” was his reaction.

We dropped all treatments and started filing for adoption. But, I wasn’t getting any closure. “What’s wrong with me?” I couldn’t find the answer and Gitanjali Banerjee Founder infertilitydost.com wasn’t able to accept it lying down. I decided to go for second round of IVF with an open mind and a Plan B. Finally, patience and the will to upturn fate paid off. Second IVF succeeded and I was blessed with a baby. Meanwhile, I was also practicing to become a writer. Well, mostly out of that need to vent out, I wrote. I had left my job and career. But, my writing career was building up innately and entered into a flourishing domain in ecommerce called – Content Management. Somehow, it attuned with my innate skills of expressing and connecting with people through the online medium. Soon, I excelled in content marketing and was hired by big companies like Make My Trip and Policy Bazaar as their Manager for Content, Blog and Marketing. My career went on, unplanned. I just went with the flow. The Infertility journey is very challenging emotionally and physically but there is no one to hold your hand. Your parents are just anxious, surrender themselves to God and aren’t of much help with new medical terminologies like IVF or ICSI. Can’t blame them. Also they had normal pregnancies. So, they can’t help you much. Husband is equally or more confused. Firstly, it is not his body which is on the firing line and he is supposed to behave stoic but he is also shattered from inside. He grew up thinking he can handle everything but not what is happening now and has no way to express his vulnerability, for society won’t let men to be vulnerable. Friends can empathize but that seems shallow at that point of time. You not only need support but want answers for so many questions that keep hammering your head, “ Is this happening with me only?” “Should I believe this doctor or should I go for a second IVf INdIa - your Guide for a Child

opinion?” “I have PCOD, can I ever conceive?” “Should I leave my job and concentrate on making a child full-time?” There are lots of questions but no one to reach out to for answers. I faced all this, first-hand during my journey and I always felt the need to reach out to women and guide them. The thought of having a one-stop platform for Indian couples to facilitate all their needs during an infertility or IVF journey found genesis. There were many foreign ladies who had recounted their tales of IVF or surrogacy journey and many websites that explained the processes in medical terminology but none by an Indian woman. No Indian woman had come out to speak about her journey and no platform that was conducive to Indian sentiments and socio-cultural needs. It is startling that there is no neutral platform and especially no woman who comes up and says, “Yes, I have gone through it, I know it is not easy but you got to keep going”. One in every 4 couples in India is fighting some or the other form of infertility. There was a need to come out of the infertility closet. Thus, I overcame my personal fears and started InfertilityDost to reach out to women who suffer in silence. Introducing InfertilityDost I found my life’s calling and started building Infertility Dost – India’s first website that facilities couples undergoing infertility with support and knowledge. Overwhelming response started to pour in. Not only women but men too vented their true feelings and experiences. Couples mirrored their deepest fear and anxieties through our support group. Found good doctors in their vicinity based upon reviews given by other people who went through the treatment. Hope and inspiration started to flow from joining of hand. At InfertilityDost, we hold hand, facilitate right guidance so that couples can take good decisions and stay away from misleading advertisements and fraud clinics, answer their queries by connecting them to experts, keep them motivated throughout this tough phase of life, reinforcing their strength and hope, helping them #StandUp and fight society’s stereotypes and prejudices, and simply reassuring them that everything is gonna be all right.

IVf INdIa - your Guide for a Child

What Infertility Dost Offers? • A one stop solution for all infertility and IVF information. • Accurate information on various aspects of infertility through blogs– emotional, social, psychological, financial, physical and medical. • Expert panel to cut through myths and guide couples. We have naturopathy, acupuncture, nutrition, psychologists onboard. • Collates and shares real life journey of not only women but men too, to provide hope and inspiration. • Find and review doctors to ensure that couples reach the right doctor and avoid being misguided. • Discussion forum to find support, create bonds and discuss almost everything related to the subject of infertility • Comfort of anonymity – On our website a person can login and choose a pen name to stay anonymous because the subject of infertility is so personal that a lot of people might not be comfortable being seen especially when everything is linked to social media. • Conducts talks and workshops at various cities to spread awareness and break social taboo and humiliation around the subject of infertility. • Helping women acknowledge that help is available and they are not alone.

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Our Thailand and Cambodia clinics can offer you a complete range of fertility services, with high success rates and at affordable prices.

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JEWELS OF THE CROWN

MR. ALFRED SIU Mr Siu graduated from the Stanford University in the USA, and was previously awarded the Young Entrepreneur award sponsored by DHL/SCMP in Hong Kong. Mr Siu founded of The Eden Group in 2006 as Hong Kongspecializes in Fertility Tourism, and soon expanded its services into Bangkok launching its First Fertility Group in Thailand operations in 2013 and the latest Center in Phnom Penh, Cambodia in 2015. “Inside our Center you will be meet by our friendly and multilingual team ready to begin your journey into one of the most stress free IVF programs in the world. Our doctors have over 10 years’ experience in the field of IVF and claim the highest success rates in IVF today. Coupled with our expertise in IVF technology and our experienced doctors, our clinic offers a high chance of success.” His concept of the Center are luxury and one-stop service. Luxury meaning is not about expensive, it is about the patient experience in the treatment with the Center by having personal assistant to help the patient in one stop service, what patient would like to know his personal assistant will provide information with honesty in accommodation, travelling, treatment and result.

Ms. Piraporn Jindasri Embryologist Supervisor With more than 8 years of experience as an embryology supervisor for our laboratory team, her devotion to work and professionalism brings happiness to many couples around the world.

DR. SANTHA SRISUPARP M. D. As the Medical Director of First Fertility Clinic, Dr.Santha is a highly trained and experienced IVF specialist in Thailand who dedicates his time and energy to each individua fluent Thai and English, Dr Santha is friendly, approachable and generous to all his patients from around the world who come to visitour clinic for medical advice and guidance.

Dr. Nipawan A. Medical Doctor Dr. Nipawan specializes in all aspects of Assisted Reproductive Technology treatments including IVF, pre-implantation genetic diagnosis (PGD) & fertility surgery professional training. Fluently in both Thai and English, Dr. Nipawan takes time to lisDR. DU XIAOPING ten to patients Dr. Du Xiaoping is a professional member of the concerns and discuss Jiangsu Society for Reproductive Medicine. With over the range of treatment 30 yearsâ&#x20AC;&#x2122; experience, he is proficient in gynecology and has mastered a variety of reproductive technology options to improve sucprocedures. In mainland China, Dr. Du was responsi- cess rates and to give patients the best possible for setting up two centers for Reproductive Medible results. Come and cine and is one of China's early pioneer in human visit our clinic or drop assisted reproductive technology specialists. by to our clinic for medical advice and guidance.

Dr. Tanut J. Medical Doctor Beside from normal Obstetrician and Gynecology Dr.Tanut professional specialist Assisted Reproductive Technology Treatment together with his laboratory professional training who dedicates his time and effort to each individual patient to find the best suitable treatment to help his patients dream come true. Fluent in Thai and English both, Dr. Tanut is friendly, approachable and generous to all his patients from around the world. Come and visit our clinic or drop by to our clinic for medical advice and guidance.

TEAM: FIRST FERTILITY

Team: Admin

Team: OR

Team: Lab

Team: OPD

ABOUT US Make your journey with us Simple & Enjoyable Design your affordable and reasonable treatment with us.

FIRST FERTILITY CENTER GROUP

First Fertility Center Limited launched a popular and luxury one-stop service for IVF treatment in Thailand and Cambodia providing a highly successful step by step IVF program that incorporates modern technology, proven IVF techniques and an astute focus on helping mums completely unwind and relax throughout their journey. Our Center is one of Asia's leading infertility treatment clinics. We specialize in providing the most advanced level of care while maintaining a commitment to a patient friendly environment. Our Doctors Team are one of Thailand's most renowned fertility specialists and has helped many international patients achieve their dream of having a family of their own. The team at First Fertility Center Group continuously looks to partner with and work with experts on the field of IVF in order to expand our knowledge and understanding in order to achieve the best results for our patientsOur successful pregnancy rate of more than 60% and increasing higher, is our primary focus and our compassion, personal attention and medical expertise is what makes us the most respected fertility clinic in Bangkok, Thailand.Our team consists of highly trained and experienced IVF doctors, embryologists, nurses and personal assistants that can assist and guide patients through the IVF process. The teams in Bangkok and Phnom Penh work together to provide patients seamless service and excitement in bringing a healthy baby into each family. Both centers also offer couples an enjoyable and relaxing vacation during their treatment for a rare, exciting and unique IVF program. Our service has been designed to be as convenient as possible for our patients. In addition, First Fertility Center Group stands out from other IVF clinics or hospital because of the personlised care and advanced clinical conditions. We are one of the few IVF clinics in the world to collect, create, culture and store embryos in a

At First Fertility Center we pride ourselves on personalised patient care before, during, and after IVF treatment. You will be treated like a family by our customer service team from the moment you contact us. At First Fertility Clinic our personal assistants will provide patients with both excitement in bringing a healthy baby into their family; while at the same time providing couples with an enjoyable and seamless IVF treatment vacation to Thailand that oďŹ&#x20AC;ers a rare, exciting and unique IVF program.

clean room environment; an operational and technological asset that has time and again proven to increase the success rate of IVF.

WHY US? Our IVF procedure introduces to our patients an entirely unique approach. FFC’s role in the field of medical science is dedicated solely to IVF treatment; therefore, we are one of the very few specialist IVF

clinics in the industry. We are not a hospital where busy wards, difficult access or lack of financing can be a problem, and with our unique IVF methodology, we have been able to confidently increase IVF success rates helping many of our patients who have failed IVF on previous attempts.

bacteria coming into contact with the eggs. In modern IVF practices doctors are now able to help the couple or individual involved in the IVF process inIn vitro fertilization crease the success rate. Also, the technological advance(IVF), is practiced ments in IVF have meant that we can tell you the gender worldwide to assist of the embryo for medical reasons and avoid other couples with fertility problems such as the risk of Down syndrome. problems to have a Once the specific embryo(s) has been identified as havbaby. Good IVF practice in- ing the best success rate, transfer back to woman’s womb where the embryo will develop into a healthy volves: baby. • Detailed patient Bangkok is one of the most experienced and best medical history and pre-treatment investi- equipped infertility centers in Asia which has help thousands of coupled achieve their dream of having baby. gations WHAT IS EMBRYO TRANSFER? • Preparation of both Embryo Transfer is the female and male the final step in the to optimize gamete (egg and sperm) quality process of an IVF • Stimulation of the female to grow more follicles in treatment cycle in order to collect eggs from the ovary which the embryo(s) • Insemination of the eggs with specifically prepared are transferred into and selected sperm (ICSI) the uterus of the fe• Culture of the embryos to the blastocyst stage of develmale patient with the opment intent to form a preg• Embryo transfer of developmentally competent emnancy. bryos back to the female Embryos can be • Embryo freezing for all competent embryos transferred “fresh” • Embryo biopsy – where indicated – for genetic testing from the IVF stimulaof embryos tion cycle or “frozen” First Fertility Clinic Group looks to optimize all steps in where the embryos have undergone embryo cryopreserthe IVF process in order to achieve the best results. The procedure involves surgically removing several eggs vation and are thawed just prior to the transfer. from a woman’s ovaries for fertilization with sperm that Advantage of Frozen Embryo Transfer have been specifically selected due to showing high per- • Your body has had time to recover back to its normal state after all medication injections from the stimulated formance. At First Fertility Center we use a clean room IVF cycle. to carry this procedure in order to avoid any foreign

FACILITIES

IVF / ICSI

• This provides a more natural environment for the embryo implantation conditions. • Instead of stimulation medication, patients use estrogen and progesterone to thicken the lining of the uterus in preparation for the embryo transfer. • Fewer potential side effects. • Less demanding of your body. • Less emotional stress since the egg production has already been taken care of and the issue of usable embryo resolved. • You can plan the available date of frozen embryo transfer to suit your needs • The frozen embryos can be stored indefinitely in their frozen state. • Stimulation medication may cause an over response or “hyperstimulation” which means the females hormone levels may rise above expected. These patients cannot undergo fresh embryo transfer as any resulting pregnancy may be harmful to the female. • Stimulation medications also alter the state of the endometrium lining of the uterus making it a less than ideal environment for embryo implantation. • Patients who wish to assess the chromosomal status of their embryos will also need to freeze all their embryos for transfer in a frozen-thawed embryo transfer cycle. COMPREHENSIVE CHROMOSOME SCREENING Comprehensive Chromosome Screening is a technique used in parallel with IVF treatment to select embryos with the right number of chromosomes. After in vitro fertilization, a small number of cells from each embryo are biopsied and sent to the genetics lab for testing. The purpose of chromosome screening is to analyze, select and transfer only embryos that have the normal number of chromosomes. It is known that aneuploidy any embryo with too many or too few chromosomes - is the cause of over 60% of miscarriages and a most likely reason for failure to achieve pregnancy during an IVF cycle. Preimplantation Genetic Screening (PGS), also known as aneuploidy screening, using Next Generation Sequencing (NGS) is widely used to select competent embryos, free of chromosome abnormalities, for embryo transfer. This embryo selection improves clinical outcomes by achieving a higher implantation rate and a reduction in miscarriage rates. Who is suitable for Comprehensive Chromosome Screening? • Women 35 years of age or older • Women with a history of repeated miscarriage • Women with a previous pregnancy involving a chromosome abnormality • Woman who have had multiple failed IVF cycles or implantation failure What methods are available?

• FISH (Fluorescent in situ hybridization) requires removal a single cell on Day 3 or several cells on day 5 or 6 of embryo development. The FISH test is done using fluorescent probes that bind to certain specific chromosomes. The 5 probe FISH method screens for the five important chromosome which includes X,Y,13,18 and 21. • Next-Generation Sequencing (NGS) is the latest technology in genetic testing all 23 pairs chromosomes and sex chromosome at a more comprehensive level and with high resolution. NGS provides the ability to screen embryos from chromosomes errors such as Down syndrome and other similar aneuploidy conditions. PGD What is PDG? The procedure has been designed and tested to help couples reduce the risk of conceiving a child in situations where there is a high risk of a chromosome or genetic disorder. • Preimplantation Genetic Diagnosis (PGD) is the technique of checking the genes or chromosomes for a specific genetic condition. • Like PGS testing, PGD is also used in parallel with an IVF treatment cycle. A small number of cells are removed from the blastocyst embryo and sent to the genetic lab for testing. • There are over 100 known genetic disorders that can be tested. For some couples with a less common genetic disorder, the genetics lab can perform feasibility testing to ascertain if a test can be developed for their specific disorder. Who is suitable for PGD testing? • Carriers of sex-linked genetic disorders • Carriers of single gene disorders • Carriers of translocations Preimplantation genetic diagnosis involves using assisted reproductive technology also known as ART, a system also used to assist couples with fertility problems. ART is a very delicate and complicated procedure that considerably increases successful problem free child development during and after pregnancy. The procedure is used six days subsequent to egg collection. New embryos are given six days to develop at which point several cells are selected and removed from each embryo for testing. During these tests doctors will carry out investigations into the chromosomes or DNA in order to determine whether or not there are any chromosome or genetic abnormalities evident. Once tests have revealed the strongest embryos with no chromosome or genetic abnormalities, these embryos will be transferred to the uterus. At this stage of the procedure the desired outcome is for the embryos to implant and as a result of implantation pregnancy follows. Using this procedure the baby will be free of all disorders tested for subsequent to day six of fertilization.

WHY IVF TREATMENT IN THAILAND?

CONTACT US First Fertility PGS Center Limited (Thailand) Tel: (+66)2 652 0150-4 Mobile/Whatsapp: (+66)61 465 5098 Wechat: ffcclinc E-mail: ipcc.ffc@gmail.com Website: http://firstfertility.co.th First Fertility Phnom Penh Limited (Cambodia) Tel: (+855) 23 963 222 Whatsapp: (+855)9 863 5293 Wechat: ivfsolutation99 E-mail: ipcc.ffpp@gmail.com Website: http://firstfertilityphnompenh.com

Much of our success has been courtesy of our exclusive methodologies that focus on helping our new mums to be relax throughout the procedure. While undergoing IVF treatment in Bangkok (keyword), our mums are fully relaxed. They are able to enjoy luxury accommodation located in one of the most affluent areas of Bangkok all prearranged by our team before arrival. In addition, they have the opportunity to indulge in fine Thai and international cuisines in any of the city’s high end dining establishments, they can spoil themselves by visiting one of Bangkok’s many modern shopping complexes, and in the last stages of their treatment they even have the chance to unwind on a tropical beach getaway. With all this in mind, we can confidently say that there is no other IVF treatment program out there that can match our approach to IVF in order to ensure our mum’s enjoy an unnerving and satisfying experience with FFC. We use state-of-the-art IVF technology proven in medical science to increase IVF success Our doctors have over 10 years’ experience, and they already claim high IVF success rates We use mental phycology to help mums relax in every step of the IVF process to increase success Physical research into successful IVF patients has shown a well-planned diet, tender love, care and attention increases IVF success rates Enjoy our spacious doctors’ offices, comfortable waiting areas with entertainment, healthy food and refreshments in our IVF clinic designed to create a tranquil, harmonious and relaxing environment putting our mums relaxation and physical wellbeing first. We also use acupuncture to increase blood flow as well as other additional relaxation techniques that help with the body and mind Our service provides a nanny to babysit your children, and we provide wheelchair escorts to and from your room Last and most importantly, we take care of our patients’ every need. We’ll book flights and accommodation, take care of transfers to and from the airport, arrange excursions, and we provide a 24/7 team to assist our mums every step of the way Looking after your mental and physical health We help you feel free of the worries involved with injections and embryo success Gain expert advice and answers to all your dietary questions by using our clinic’s dedicated dietary and health experts Go through the IVF process at a relaxing pace in a relaxing environment combined with activities to keep you always refreshed. Sit back and enjoy the journey into creating new life. Post IVF Support: You never have to worry about going home because we are always here to support you. We’ll also make sure the transition back home is as comfortable as possible for you: We’ll legally ship all medicines and vitamins to your home You will have a hotline available 24 hours a day for advice from our staff while you are at home

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SRISHTI INFERTILITY CLINIC, Kolkata

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HELPING YOU CHANGE HOW YOUR IVF STORY ENDS

DR SUDIP BASU MBBS, MS, DNB, FRCOG (UK), MRCPI (IRELAND), CCT (UK) PG Certified in Ultrasound (Cardiff University, UK) Special Skills Certificate (RCOG) in Ultrasound & Assisted Reproduction. Consultant Gynaecologist & Infertility Specialist (Ex Clinical Lecturer and Senior Registrar, University Hospital of Wales, Cardiff, UK)

Meet Dr Sudip Basu

At Srishti we have one aim - to oďŹ&#x20AC;er the highest standards of patient care and comfort for couples and individuals seeking fertility treatment.

Can you tell us about your educational qualifications? I have done my MBBS from Calcutta Medical College. In the year1991, I did my postgraduation (MS) from Motilal Nehru Medical College, Allahabad and in the same year completed DNB from National Board of Education, New Delhi. Then I went to UK in 1995 for higher studies and completed my membership examination (MRCOG,1996) from The Royal College of Obstetricians & Gynaecologists and thereafter MRCPI from The Royal College of Physicians, Ireland (1998). In the year 2007 I did a certificate course in Gynaecological Ultrasound from Cardiff University. I completed my specialist training in Obstetrics and Gynaecology (CCST) in 2007, which would allow me to work at a capacity of Consultant in Europe, Australia and New Zealand. When & how did you enter the field of infertility management? When I went to UK, I worked as Registrar in prestigious institutions like The Royal London Hospital, Whitechappel, St Thomas’ Hospital, Guy’s Hospital and St Bartholomew’s Hospital. At that time I had initial exposure in infertility albeit for a brief tenure. I became interested in this complex subject and wanted to pursue career as Infertility Specialist. In 2001 I started working as a research fellow at University Hospital of Wales, Cardiff which was the tertiary referral center for all infertility patients for the Country of Wales. I worked there from 20012007, initially as a research fellow then at senior registrar level and finally as clinical lecturer in Cardiff University. My real exposure to infertility was during that time when I started doing all the invasive procedures related to infertility in a center with more than 600 IVF cycles per year. Now I have more than 17 years of experience in Infertility. What motivates you in this field? Before my decade stint in UK, I had a brief exposure in private practice in and around Kolkata though for a short duration. At that time I used to see quite a few patients suffering from simple or complex infertility problems, were coming from all sorts of background. Many of them used to get misguided and then abandoned by relatives for not being able to bear a child. Then I was not knowledgble enough to treat those kind of patients and there were only one superspeciality centres offering advanced infertility treatment.It was that time, I decided that if I get proper training I would help these people in bearing a child which would change their lives forever. There are a lot of myths associated with infertility. Can you shed some light on some of them? Yes there are lots of myths associated with infertility. Common misconception is that once pregnant after IVF treatment, one need to take complete bed rest for nine months which is absolutely untrue. A patient can continue normal day to day activities and it has not got any bearings on the success.The second myth, people suspect that babies born through IVF treatment is going to be abnormal or of less intelligence which is also not the fact. So far many researches have been done and none of them could confirm this. The third most common myth is that

IVF treatment is costly and need to be done repeatedly to get success. Now a days IVF treatment can be done within one lakh rupees and fifty percent patients may get positive result on their first attempt. In recent times the treatment price has gone down significantly with the availability of good quality medicines and culture media. What are the risks associated with ART? There is no great risk associated with ART as such. The one risk that we infertility specialists try to avoid is, Ovarian Hyper Stimulation Syndrome. Patients having too many follicles need to be carefully monitored otherwise they lose fluid in the abdominal and thoracic cavities and become very sick. However with the inventions of new Medicines and change in protocols the risk of Ovarian Hyper Stimulation Syndrome has been mitigated, but we are still very cautious about it. How do you explain ‘Unexplained Infertility’ to your patients? Unexplained Infertility is difficult to define. When we cannot find any obvious cause for infertility then we call it Unexplained Infertility. But with the advancement of knowledgs, skill and help of sophisticated instruments, very few patients are left behind as truly unexplained. Many Patients stamped as unexplained infertility elsewhere, when they come to me for treatment, problem sometimes is easily identified with the help of Ultrasound or Lparoscopy. So the stress should be to consult right person at right time, which will save both money and time. Few genuine cases remain unsolved till the time we do IVF. We find very poor quality eggs leading to poor quality embryos. That could explain why they were suffering from infertility despite having all investigations within normal limits. However in some cases as we have seen, in spite of having normal uterus, good quality eggs, good quality sperm and also good quality embryo the patient still does not get pregnant. Problem lies at cellular level which is not easy to diagnose.This is because when the embryo tries to get implanted in the endometrium, lots of biomolecular activities takes place which cannot be manipulated from outside. There are some cells which try to help the embryo to get implanted (Helper Cells) and on the other hand there are some cells which prevent the embryo from getting implanted (Killer Cell). So it is the fight between these two which will determine the ultimate outcome along with some other biochemical markers. The implantaion window is itself very small and complicates the matter further. Many puzzles at implantation level still remain unsolved. What makes you different from other IVF centers? I see all patients myself. At most of the IVF centers you will find that history is taken by a junior doctor, followed by ultrasound being done by somebody else. Egg collection is done by different person and medicines are explained by nurses. So there is lack of continuity and many a times there is a communication gap between the patient and the consultant. As a result if something goes wrong in the beginning, it becomes a chain reaction which adversely affects the outcome. Patients struggle to figure out

Meet Dr Sudip Basu

what exactly went wrong. I deal my patients differently. First I consult them, try to understand their problems and worries, do the scan my-self and then explain it to them. That helps to build a rapport and confidence between patient and myself, which goes a long way in getting result. I have been able to introduce western ethics and work culture in my clinic. We ensure continuity of care and patient satisfaction at every step of treatment. What treatment can a patient expect at your center? We provide Fertility consultation, Ultrasound, Controlled Ovarian Stimulation , Folliculometry, IUI, IVF, ICSI, Oocyte donation, embryo donation program, embryo and oocyte freezing and surrogacy. How do you address the emotional needs of a patient? Initial counselling is done by me but for unusual cases, we do get professional help from Psychologists who are experts in this field. From time to time we organise patients group meeting where we discuss different cases anonymously which is a good platform for exchange of ideas and worries. Many of my patients go through difficult time in their life for irrational behaviour of their relatives and neighbours and it is very important to bring back their confidence. Most of them gone through many unsuccessful infertility procedures and faced many difficulties in life and as a result they are depressed. When they come to know about other patients who have gone through similar situations and gone home with a baby, then their confidence goes up. We believe firmly, “A good doctor treats diseases but great doctors treat patients” When should one consult an infertility expert? The initial workup should to be done by the gynaecologist. For a couple who do not have any obvious problem, if practice intercourse at time of ovulation, their chance of getting pregnant is nearly seventy percent which rises to almost ninety percent. It means a couple needs thorough investigation if fail to get pregnant within two years. For high risk patient early intervention is necessary. If general gynaecologist fails to understand the root cause for their infertility, patients should be referred to infertility consultants. If significant problem is found regarding sperm, ovary, tube blockage then early referral will be helpful. How difficult is ART from a patient’s perspective? Unfortunately most of the patients don’t get proper guidance. We see many infertile patients from both rural and urban areas are consulting gynaecologists for many years but still do not understand why they could not get pregnant. Systematic scientific approach is missing so many of them get misguided very easily. It cause significant frustration and irritability and gradually a sense of helplessness overshadows everything. What kind of dedication is required from a patient? Patients have a tendency to switch from one consultant to another very frequentlly. They wait for 3 to 6 months and if they don’t get desired results, they change consultant and as a result, they have to go through the entire process again. Sometimes they have to repeat the tests which costs money and time. Another major drawback is

that they are amenable to every little suggestion by their relatives and friends. They need to understand that every patient is unique so one patient’s success story does not ensure success for the next patient. What should a patient look for before choosing an IVF Clinic? At present there are thirty IVF centres in the metro city of Kolkata and many of them spend a lot of of money on advertisements in popular newspapers and try to glorify their unit. Consequently many people get lured by them. At present there is no government or private organization in India which can check accountability of the inefertility Units on a regular basis. Few IVF centers take the advantage of this situation and claim to have more than 90% success rate which is completely untrue. The average positive pregnancy rate of my clinic is around 40-50% and take home baby rate is close to 40% which is at par with the International standards. Patients should do the background work before approaching the infertility units. Not only the success rate but also the professional approach along with empathy matters. Can you share some cases which were a challenge to you? There was a NRI patient who had undergone failed IVF treatment at one of the best IVF Center in USA and then came to me through a friend’s reference . Fortunately she conceived on the first IVF treatment under my supervision. Since then She had delivered a healthy baby girl and now living in USA. I had a patient who was infertile due to a a foreign body impacted in the uterine cavity. I had to remove it with great difficulty and then try IVF treatment due to blocked Tubes. She conceived on second attempt and delivered a baby. Another patient lost her ovaries due to Ovarian cancer and then conceived with donor oocyte treatment under my care. The list is endless for such inspiring stories. What are the special clinics are offered by Srishti? Polycystic Ovaries Club is one of the special clinics we offer. Fifteen to twenty percent women of reproductive age group suffer from Polycystic disease. Here we offer a multidisciplinary treatment at a yearly membership fees. Patients can see endocrinologist, Fertility specialist, Dietician, Physiotherapy, Psychologist and dermatologists. Investigations like hormonal test and ultrasound is offered with fifteen percent discount. Apart from that we also run Recurrent Miscarriage Clinic, Well Woman Clinic, Menopause Clinic, Well Baby clinic and Early Pregnancy assessment Clinic. How do you relax after helping patients? I usually start my day around 8 am in the morning and finish my clinic by 6.30 pm in the evening. I live in South City Residency which provides service of an ultramodern club. Here I play some indoor games or spend time in the gymnasium. I like listening to old Bengali and Hindi songs or watch movies during my leisure time. My daughter is in UK and pursuing a career in MicroBiology. I help my son, a student of South City International School, with his homework and project. I like writing blogs and small stories. Very recently a movie has been made from my story on surrogacy.

ABOUT US One Stop Solution for All Kinds Fertility Problems Srishti Infertility Clinic is a premier infertility treatment centre in Kolkata. Consultant Gynaecologist & Infertility Specialist Dr. Sudip Basu is at the helm of its affairs. Current statistics shows there are approximately 15 million childless couples waiting for treatment and it is increasing by 1 million new cases every year. Infertility has become a grave problem in India and Kolkata is no exception. Srishti Infertility Clinic was established in 2014 in Kolkata with the motto of offering quality advice and treatment at an affordable price. Since its inception Srishti Clinic doctors have seen more than ten thousand infertile couples. More than one thousand couples gone home with a baby. Till date more than four hundred IVF babies were born under our care. We are proud to say that Srishti clinic has been able to replicate the success achieved in overseas centres. Deployment of state-of-the-art technology and equipments enables Srishti Infertility Clinic deliver a wide range of treatment facilities. Srishtiâ&#x20AC;&#x2122;s bouquet of services includes laparoscopic and hysteroscopic corrections, In-Vitro Fertilisation (IVF), Intra-Uterine Insemination (IUI), Intra-Cytoplasmic Sperm Injection (ICSI), Folliculometry and many more. Srishti hopes to continue with its success rate and grow its services in the years to come.

ART SERVICES OVULATION-INDUCTION: Stimulation of ovulation by medication. Strictly, ovulation induction would specifically refer only to the induced ovulation of already mature follicles in the ovaries. However, the term is usually used for stimulation of the development of ovarian follicles to reverse anovulation or oligoovulation. In any case, ovarian stimulation (in the sense of stimulating the development of oocytes) is often used in conjunction with ("strict") ovulation induction. Also, a few definitions also include ovarian hyperstimulation (stimulating the development of multiple follicles of the ovaries in one single cycle) in the definition of ovarian stimulation. Otherwise, ovarian hyperstimulation may still be a side effect of ovulation induction.

(Folliculometry) and hormonal blood tests. Once there are sufficient follicles of the decent size (usually 18/19 mm), an injection of Human Chorionic Gonadotrophin (HCG) is given for egg maturation. Eggs are then removed approximately 36 hours later after the HCG injection. This is usually done using a fine needle through the vagina under ultrasound guidance and performed with the help of intra venous sedation. Then the eggs are fertilized with sperm in a special laboratory. After a few days, when fertilization is confirmed, the fertilized egg (embryo) is re-turned to the womb. The chance of a positive pregnancy test after a fresh cy IVF cycle varies, but is approximately 30 to 50 per cent. To maximize the chances of a pregnancy, two embryos are usually returned at the same time, but it then increases chance of twin pregnancies. Surplus good quality embryos kept frozen for future use (FET) which increases cumulative success rate to sixty percent. If embryos are frozen using newer techniques INTRA-UTERINE-INSEMNITION: (vitrification), then the success of a frozen embryo This procedure relies on the natural ability of sperm to transfer is slightly more than that of a fresh cycle. fertilize an egg within the reproductive tract. It is useful in cases where infertility is caused by Cervical ICSI: Mucus Incompatibility, elevated anti sperm antibodIntracytoplasmic Sperm Injection or ICSI is a novel ies, Low Sperm Survival, High Seminal Viscosity, Poor technique used mainly for severe male infertility or for Sperm Morphology, Unexplained Infertility, Impothose patients where poor or no fertilization has been tence or Premature Ejaculation. achieved after a cycle of IVF. The procedure is very The aim is to introduce a quantity of sperm into the similar to IVF. However, with ICSI a single sperm is inuterus in order to encourage fertilization. The procejected into a solitary egg with the help of very sophisdure is simple. We induce ovulation in the female part- cated microscope (Micromanipulator). The success ner by fertility drugs. Patient undergoes ultrasound to rate is similar to that of IVF. Normally sperm is obmonitor the development of follicles (Folliculometry). tained by masturbation. Under certain circumstances At time of ovulation, prepared semen sample is placed sperm may be obtained directly from the testis by a high in the uterine cavity through a fine catheter. It is minor operation (Testicular sperm extraction). needless to mention that at least one of the fallopian tubes of the female partner needs to be functioning. EGG DONATION & EGG SHARING: It is considered for women who is a poor responder to IN-VITRO-FERTILIZATION: ovulation induction drugs or has reduced ovarian rePopularly known as Test tube baby is actually a serve, or is a carrier of a genetic condition. Here the process where the egg (Oocyte) is fertilized outside the egg donor undergoes stimulation, monitored, and body and then the embryo is placed in the uterine then the oocytes are retrieved. Once the eggs are recavity. It is also known as In Vitro (in glass) Fertilizatrieved, they are fertilized with the partner’s sperms. tion (IVF). It can be done by two methods. Long down Legal, medical and Psycho logic counselling are reregulation (Agonist) protocol where clinicians supquired. press the function of the ovary by using special injection or a nasal spray and then start stimulation with PESA / TESA: gonadotrophins. The whole process takes approxiPESA (Percutaneous Epidydimal Sperm Aspiration) mately one month to complete. This tradinional proand TESA (Testicular Sperm Aspiration) procedure tocol is gradually being replaced by a newer method should be used when there is no sperm in ejaculate “Antagonist protocol” where ovarian stimulation starts (so called "azoospermia") confirmed in two independfrom day2/3 of menstrual cycle and then the second ent semen assessments. injection (antagonist) is added from day five to preThe procedure can be done under local anaesthesia or vent premature ovulation. This method is very patient short intravenous sedation. For both the procedure, friendly and success rate is comparable. For the paspecial fine needles are used to make the precedure tients suffering from poly cystic ovaries, Antagonist less painful. Sperm collected by this method are usumethod offeres an added advantage of low risk of hyally cyropreserved and used for ICSI (Intracytoplasmic perstimulation syndrome (OHSS). Patients are reguSperm Injection) on the day of the egg collection. larly followed by ultrasound monitoring of follicle

Our LittLE MirAcLES

At Srishti Fertility we have one aim - to offer the highest standards of patient care and comfort for couples and individuals seeking fertility treatment.

362 Sanipally, Block-BE, Plot-3, (Behind Geetanjali Stadium), Kolkata Email: sbasu@shrishiivf.com Phone: 033 4066 4321 Website: www.srishtiivf.com Facebook: facebook.com/srishticlinic Twitter: twitter.com/srishticlinic

FIRM HOSPITALS, Chennai

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let us help you conceive hope

DR MALA RAJ MBBS, DGO, Dip Adv Lap Surgery (Germany), Dip Reproductive Medicine (Germany)

My method in practice is quite different from other IVF centers because I provide a comprehensive package to my patients which is individualized. I give individual attention to all my patients and provide personalized care.

MEET DR MALA RAJ Can you tell us about your educational journey? I did my MBBS from Kilpauk Medical College, Chennai. Then I did my post-graduation diploma from Sri Ramchandra Medical College. After completing my post-graduation I went to Germany where I did my diploma in endoscopic surgery and diploma in reproductive medicine from the University Of Kiel, Germany.

It is a very sensitive issue so we have to handle these individuals very carefully. My team is very particular when it comes to personalized care and assistance and we address to the emotional needs of our patients gently.

There are a lot of myths associated with infertility. Can you shed some light on some of them? There are some myths associated with infertility. Some people think that going for infertility treatment is a taboo and if they eat certain food items they will not be able to conceive. There are women who think that they will not be able to conceive once they go for infertility treatment. But slowly things are changing positively now and people are becoming more aware about infertility treatment.

What kind of dedication is required from a patient? A patient must follow the advice of an infertility consultant and take the medicines on time.

When should one consult an infertility expert? Age and duration of marriage is not a criterion. The initial workup has to be done by the gynecologist but When & how did you enter the field of infertility? after 6 months to one year of having unprotected sex if I have been in practice for last 20 years and started my the women is not able to conceive then they should career as gynecologist. Almost 20% of my patients refer the patient to an infertility consultant. In addiwhom I treated had infertility problems and I used to tion to that if there is a significant problem with the take them to fertility centers and treat them. Later on I sperm, ovulation, tube blockage and the gynecologist decided to have my own center and currently I am is not confident enough to address these issues then providing complete women care package with adthey should refer the patient to infertility expert. vanced laparoscopic surgeries and infertility management all under one roof. How difficult is ART from a patientâ&#x20AC;&#x2122;s perspective? It is not easy to counsel a patient for ART because they What motivates you in this field? have lots of misconceptions and we have to clear them As I mentioned earlier that most of my patients had first. Nowadays patients who come to our clinic are problems related to infertility and the agony which well educated and once we explain them about every they were going through motivated me to have my perspective of the treatment and the alternate options own center where I can treat them myself. that are available they understand that and accept it.

What should a patient look for before choosing an IVF Clinic? They need to see whether the center is well equipped and they follow the guidelines that are laid for performing the ART procedure. In addition to that it is important to find out whether they would be having any complications. Apart from that I would like to What are the risks associated with ART? mention that ART procedures and laparoscopic proceThe most common risk is that women may have hyper dures go hand in hand so it is important to get all such stimulation syndrome during the procedure but treatments under one roof. They should also check if nowadays we are able to overcome the risk by modify- the doctors can guide them and help them in conceiving the protocol i.e, we use only antagonist protocol ing naturally before opting for IVF treatment. and we freeze the embryo when we feel that the women is going to have hyper stimulation syndrome. Can you share some cases which were a challenge to you? What makes you different from other IVF centers? There was a lady from Malaysia, who was having only My method in practice is quite different from other one egg and we were about to cancel the cycle but as IVF centers because I provide a comprehensive pack- she had taken all the medications and she knew that age to my patients which is individualized. I give indi- this was going to be her last attempt she insisted on vidual attention to all my patients and provide making one last attempt. Therefore, we picked up one personalized care. Apart from that as I mentioned ear- egg and arranged for a donor and created an embryo lier my plus point is that I am also an advanced lafrom it and transferred it to the next cycle and luckily paroscopic surgeon so patients who come to my she got pregnant. We have got many such success stocenter for treatment know that they will be able to ries like that. There has also been cases when the paachieve pregnancy naturally through laparoscopic tients have conceived even after five failed attempts as procedures. When Laparoscopy is not able to reap re- they were having having fibroids . sults then only we advise them to go for IVF treatment. How do you relax after helping patients? How do you address the emotional needs of a patient? I like reading and listening to music.

ABOUT FIRM HOSPITALS We understand how important this is for you. For us, nothing is more important than “YOU” Firm Hospitals was conceptualized with the purpose of providing excellent, affordable, international quality health care for women. The hospital has been designed to meet the international standards, providing utmost professional and personal care. It recently received the NABH Accreditation – Pre-accreditation Entry Level Certification by the National Accreditation Board for Hospitals and Healthcare Providers (NABH), a constituent Board of Quality Council of India. The organization is now a part of the select group of institutions in the country. This group consists of fewer than 350 hospitals and healthcare providers that adhere to the stringent healthcare standards for patient safety in India. The NABH board has designed an exhaustive healthcare standard for hospitals with a stringent 600 plus objective elements for the hospital to achieve in order to get the NABH Accreditation. To comply with these standards, the hospital will need to have a process driven approach in all aspects of the hospital activities – from registration, admission, pre-surgery, perisurgery and post – surgery protocols, discharge from the hospital to follow up with the hospital after discharge. In a nutshell, NABH aims at streamlining the entire operations of the hospital. Its standards have been accredited by IsQua, the apex body accrediting the accreditors, hence making NABH at par with the world’s most leading hospital accreditations. Firm Hospitals is situated in a tranquil neighbourhood ence with state-of-the-art upgraded facility to provide at Anna Nagar, Chennai. It provides a soothing ambithe best in Women’s health care.

TEAM FIRM HOSPITALS

OUR SPECIALITIES FIRM FERTILITY CENTER Firm Hospitals, rated as the best fertility centre in Chennai, we have created a private, comforting & compassionate treatment facility where patients receive individualized care from the best fertility doctors in Chennai and can feel at ease. The inability to conceive is a difficult time for any couple. However, standing apart from other fertility hospitals in Chennai, in Firm Fertility Center we have come up with spectacular IVF & ICSI techniques, which could fulfill your heartfelt desire to have a baby of your own. Rated as one of the best fertility hospitals in Chennai, we understand the pain infertility can cause and we ensure that every treatment and our support are personalized to your needs. Dr. Mala raj one among the best fertility doctors in Chennai offers personal care for everyone. Patients come to us with a hope for their infertility treatments and get the best treatment that works for them with proven success rates. The main resource in Firm’s Fertility Centre is our chief doctor Dr. Mala Raj. Being an advanced laparoscopic surgeon and fertility specialist, she is able to resolve all your minor problems by laparoscopy itself, so that you can get pregnant naturally. If any advanced fertility treatments are needed, we are equipped with latest fertility options likely improving your chances of conceiving. At the first visit to the doctor, we expect both the husband

and wife to be available, as we need to evaluate the cause of infertility by evaluating both the partners.

The various treatment options available are • Controlled Ovarian Stimulation • Intrauterine Insemination (IUI) • In Vitro Fertilization (IVF) • Intracytoplasmic Sperm Injection (ICSI) • Laser Assisted Hatching • Surrogacy

LAPAROSCOPIC CENTER Firm Hospitals’ Laparoscopic centre is committed to providing excellent and compassionate health care ranging from simple to advanced laparoscopic surgeries. It is well equipped with state of the art technology gadgets to make the procedure simple and safe. Even the complex surgeries like Laparoscopic Surgery for Myomectomy and Laparoscopic Surgery for Fibroid are simplified with the skill and expertise of Dr. Mala Raj. It is to be mentioned that Laparoscopic surgery for myomectomy and the removal of fibroids with laparoscopic surgery for fibroid are the best treatment option for fibroids. The patient can be discharged the very next day even after major surgeries like removal of uterus and removal of fibroids laparoscopically. Laparoscopy is a type of surgical procedure that allows a doctor to observe a woman’s uterus, ovaries and a fallopian tube. It is often used to detect ovarian cysts, fibroids, scar tissue, and diagnose pelvic or abdominal pain, endometriosis, ectopic pregnancy or blocked fallopian tubes. Laparoscopic surgeries are usually done as a day care procedure under general anaesthesia. The viewing tube (called the laparoscope) is equipped with a small camera on the eyepiece and is inserted through a small incision in the naval. The doctor can then examine the abdominal and pelvic organs on a video monitor connected to the tube. Other small incisions can be made to insert instruments to perform a variety of procedures. Laparoscopy is less invasive than regular open abdominal surgery (laparotomy). Dr. Mala is an expert in Total Laparoscopic Hysterectomy which requires great skill and expertise as entire uterus is removed laparoscopically along with suturing which is also done laparoscopically. There are tremendous benefits to the patient by doing an entire surgery laparoscopically compared to hybrid surgery, laparoscopic assisted vaginal hysterectomy where half the surgery is done laparoscopically and remaining half is done vaginally. Procedures Offered • Diagnostic Hystero Laparoscopy • Laparoscopic PCOD Drilling • Laparoscopic Myomectomy • Laparoscopic Cystectomy • Laparoscopic Ectopic Pregancy Removal • Laparoscopic Tubal Recanalisation • Laparoscopic Pelvic Floor Repair

MATERNITY CARE Antenatal care means how your health, and the health of your baby is monitored before your baby’s delivery.Once you realize or suspect your pregnancy, you should make an appointment with your Doctor to discuss your antenatal care. Firm Hospitals Labour room is furnished with world class multiposition birthing bed,with all latest gadgets for a safe and comfortable delivery. For those who don’t want to experience any pain, epidural analgesia is offered. Apart from all the ultra modern facilities, the regular antenatal check up includes, counseling the right diet and exercise, antenatal classes and postnatal classes which are being offered. At Firm Hospitals,the whole journey into motherhood is an experience, giving you the feel of home away from home.

UROGYNECOLOGY Urogynecology stands as a surgical sub-specialty of urology and gynecology. An Urogynecologist deals with the clinical problems associated with dysfunction of the pelvic floor and bladder. This includes the assessment and treatment of a variety of health conditions affecting women, including cystitis, stress incontinence and pelvic organ prolapse. We focus on a minimally invasive treatment option to create a stress-free future for you. Introducing the revolutionary ThermiVa present in our armamentarium plays a vital role in our Urogynecology procedures. Conditions & Treatments • Stress Incontinence • Urgency/Overactive Bladder • Pelvic Organ Prolapse (POP) • Recurrent UTI • Vaginal Vault Prolapse (VVP) COSMETIC GYNAECOLOGY More than 30 lakh Indian women suffer from symptoms of pelvic relaxation and urinary incontinence. There is a rapid increase in terms of the prolapse of the pelvic organs such as the bladder, rectum, bowel and uterus making the traumas of childbearing apparent. Many women are either too shy or too embarrassed to even bring up the problem with their physicians. Cosmetic Gynecology or Intimate Aesthetic Surgery is a set of procedures performed either to improve the function of female sensitive parts, for appearance, or for both. They are sometimes just cosmetic in nature and not medically necessary. Our Services • Labiaplasty: Labiaplasty is a cosmetic procedure to sculpt and remove excess and usually even out the labia minora (inner lips) • Hymenoplasty Hymenoplasty is a discreet and tactful procedure to create a pseudo hymenal membrane from either existing hymenal tissue or nonhymenal soft tissue. • Perineoplasty/Perineorrhphy Perineoplasty or Perineorrhaphy procedure takes care of the area between the rectum and the floor of the vagina. It repairs and restores. • Vaginal Rejuvenation/Vaginal Tightening Vaginoplasty refers to any procedure targeted at reducing the width of the vagina. These include tightening of the perineum muscles and repairing the rear vaginal wall.

WHY US The hospital is run by the able hands of its Managing Director and Chief Doctor, Dr. Mala Raj, Obstetrician and Gynecologist, Laparoscopy and Infertility Specialist and Aesthetic Gynecologist. The hospital is a 20 bedded centre, providing advanced treatment options in Laparoscopy, Fertility, Maternity and its latest, Aesthetic Gynecology. The hospital is equipped with international standard rooms with an aesthetic touch to give the patient a soothing and ‘home-like’ feel. It comes with 2 operating rooms that are equipped with advanced state of the art technology to provide the best possible care to its patients. Some of the laparoscopic treatments offered include Laparoscopic PCOD Drilling, Total Laparoscopic Hysterectomy, Laparoscopic Cystectomy, Laparoscopic Pelvic Floor Repair, Laparoscopic Tubal Recanalisation, Laparoscopic Myomectomy. Firm Hospitals recently provides an advanced option of laparoscopic tissue removal which involves removal of an entire fibroid or uterus in a bag through laparoscopy by a method called Laparoscopic In-bag Morcellation performed by Dr. Mala Raj herself. This procedure prevents contamination, spread, spillage and damage to nearby organs. Firm Hospitals, apart from treating gynecological concerns in women also provide relief to women who fail to conceive naturally. The hospital is equipped with an advanced centre for Assisted Reproductive Technology to help couples struggling to conceive. The advanced centre offers IUI, IVF, ICSI, Laser Assisted Hatching and Surrogacy. The hospitals advanced maternity unit provides patients with a chance to experience a smooth delivery under the best possible expertise. It is all encompassed with a multipositioning birthing suite and has a well trained team to handle high-risk pregnancies as well as provides patients with an option of painless delivery (epidural). Besides this, the hospital also provides various value added services including free antenatal classes, physiotherapy, antenatal and post natal care etc.

FiRM hospitAls No.65, R-Block, 12th Street, Anna Nagar, Chennai – 600 040, call: +91 44 2626 2666/ +91 99529 92618/ +91 96772 22618 email: drmalaraj@ﬁrmhospitals.com Website: www.ﬁrmhospitals.com

DR BABITA PANDA, Bhubneshwar

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HELPING YOU CHANGE HOW YOUR IVF STORY ENDS

DR BABITA PANDA MBBS, MD (Gynaec)

MEET DR BABITA PANDA ACCREDITATION Life Member, Indian Society for Assisted Reproduction (ISAR). Life Member, Federation of Obstetric and Gynaecological Societies of India (FOGSI). RECOGNITION Young Scientist of the Year Award. Federation of Obstetric and Gynaecological Societies of India. 1998 Winner. All India Perinatology Quiz, Jamshedpur. 1998

Can you tell us about your educational qualifications? I completed my MD in Obstetrics & Gynaecology in the year 1999. Thereafter I went to pursue higher course in Infertility & reproductive medicine at Christian Medical College (CMC), Vellore. I worked as a consultant in the IVF Centre of CMC, Vellore from 2003-07. After that I came back to Orissa and Headed the IVF Unit ( Centre for Human Reproduction) of IMS & SUM Hospital.

ity ethical practice in medical scienceâ&#x20AC;? can draw patients from far off places. Language was a barrier and travel was lengthy, but still their immense faith brought them to Vellore. This was a major inspiration for me. If we could set up an exclusive infertility unit in a medical college setup, we can cater to such patients in Odisha.

What motivates you in this field? The infertile couple is already into lot of psychological stress and there is evidence that stress levels influWhen & how did you enter the field of infertility ences the outcome of infertility treatment. An exclusive infertility unit where a lot of time is spent to listen management? to these couples and counsel them was always my In the year 2003 when I joined CMC, Vellore, I saw many infertility patients coming from North Eastern & dream. Eastern India for IVF treatment. This meant that â&#x20AC;&#x153;qual-

There are a lot of myths associated with infertility. Can you shed some light on some of them? The most common myth that exists in our society is that people still blame only women for their inability to conceive, but the reality is that in almost 50% male infertility is the contributing factor. Apart from that people think that infertility treatment is a highly costly affair and only few people can afford which is not true. And to clarify their doubts let me explain that treatment does not mean only IVF. IVF is the ultimate treatment that is needed in only a small percentage of the patients. What are the risks associated with ART? ART or Assisted Reproductive Technologies, is done with proper supervision and monitoring and there is very minimal risk involved in such procedures. In IVF procedure, Ovarian Hyper Stimulation Syndrome was considered to be a dreaded complication. But, nowadays with the change in protocols (minimal stimulation IVF, use of antagonists and use of embryo freezing technologies) have minimised the complications. The risk of multiple pregnancies has been avoided by doing single or two embryo transfer. How do you explain â&#x20AC;&#x2DC;Unexplained Infertilityâ&#x20AC;&#x2122; to your patients? There are three important processes involved in having a normal pregnancy. First is regular ovulation which means that the lady should have normal regular cycles . Secondly, the husband should have normal semen parameters.

Thirdly the lady should have healthy and patent fallopian tubes (here the process of fertilization occurs). If on routine examination it is found that all the above three are normal but the couple fail to conceive, it is termed unexplained infertility. What makes your centre different from other IVF centres ? The inability to conceive apart from being an emotionally draining experience is also a financial burden for low-income families. Our IVF centre, being a medical college and hospital, the intention was to cater to a larger population by making the treatment very affordable. At the same time, quality has not been compromised in providing all kinds of infertility treatment under one roof. What level of treatment can a patient expect at your centre? In our centre we are doing routine investigations and treatment for basic infertility workup. Procedures such as fertility enhancing surgeries, IUI , IVF , ICSI, Semen freezing , embryo freezing & frozen embryo transfer. How do you address the emotional needs of a patient? As I have mentioned before, the first visit is mostly centred on listening to the problems, couple counselling and formulating the treatment plan that is individually tailored to give the best result. Our transparency helps us in addressing the emotional & psychological aspects.

When should one consult an infertility expert? An infertility specialist can be consulted if the woman is not able to conceive (without any contraception) for one year in young patients and six months is those above 35 years. How difficult is ART from a patientâ&#x20AC;&#x2122;s perspective? ART procedures are little expensive and the success rate is approximately 50% at the best centres of the world. Female age is a major factor .The previous trend was that patients came to our centre in their late 30s, having already tried some irregular and un-monitored treatment and some unnecessary investigations. For example, a simple test such as semen analysis of the husband could have avoided lots of investigations on the female. But, things are changing. In last 10 years of my practice I have seen people becoming more aware about the existence of an exclusive infertility unit and they been coming to our unit early. What kind of dedication is required from a patient? Sticking to one treatment protocol is very important. A simple step such as strictly following a weight losing protocol helps in many obese females in regaining their ovulation capability. Here the faith of the patient on the treating specialist is of utmost importance.

who have already been treated for infertility related issues. Their first hand experience with the chief consultant and the support staff of the IVF unit will help. Whether there is accreditation by NABH and registration under ICMR will speak about the quality of the IVF laboratory. Can you share some cases which were a challenge to you? There have been many stories of success and God has been very kind to the Unit. There was a lady who had come from Delhi and she had two boys and both them had died of drowning. At the age of 39 she came to me and there were very few eggs left in her ovary. She had only three eggs out of which two fertilized and one good embryo developed and with that she was able to conceive and give birth. We had a male patient, an IT professional, who had very low sperm count. He took six months of hormonal treatment and finally his wife conceived.

How do you relax after helping patients? Its six days of untiring effort per week and at the end of each day one has to be fresh enough to give a little quality time to your family. It is important for me to maintain balance. Hence I start early. I go for morning walk by 5:15 AM followed by Surya namaskar and breathing exercises. This gives me enormous strength What should a patient look for before choosing an IVF to carry on throughout the day. The last patient of the Clinic? day is as important and needs equivalent effort from The easiest and the most reliable way to choose an IVF my side as compared to any other patient in the day. clinic is by taking opinion of close friend and relatives

UNDERSTANDING INFERTILITY Infertility refers to a couple having failed to conceive after 12 months of regular sexual intercourse with-

out the use of contraception. Studies indicate that slightly over half of all cases of infertility are a result of female conditions, while the rest are caused by either sperm

disorders or unidentified factors. World Averages of natural conception are as follows: • 20% will conceive within one month • 70% will conceive within six months • 85% will conceive within 12 months • 90% will conceive within 18 months • 95% will conceive within 24 months RISK FACTORS OF INFERTILITY In medicine, a risk factor is something that raises the risk of developing a condition, disease or symptom. Age - a woman's fertility starts to drop after she is about 32 years old, and continues doing so. Male fertility progressively drops after the age of 40. Smoking & tobacco chewing - significantly increases the risk of infertility in both men and women. Obesity and a sedentary lifestyle - are often found to be the principal causes

of female infertility due to ovulatory dysfunction. An overweight man has a higher risk of having abnormal sperm. Being vegan - if you are a strict vegan you must make sure your intake of iron, folic acid, zinc and vitamin B-12 are adequate Sexually transmitted infections (STIs) - some STIs may cause infertility. Exposure to some chemicals – some pesticides, herbicides, metals (lead) and solvents have been linked to fertility problems in both men and women. Mental stress - studies indicate that female ovulation and sperm production may be affected by mental stress. CAUSES OF INFERTILITY IN WOMEN There are many possible causes of infertility. Ovulation disorders • Ovulation disorders can be due to: • Premature ovarian failure • PCOS (polycystic ovary syndrome) • Hyperprolactinemia • Poor egg quality • Overactive thyroid gland • Underactive thyroid gland • Some chronic conditions, such as AIDS or cancer. Problems in the uterus or fallopian tubes This may be due to:

• Surgery • Submucosal fibroids • Endometriosis • Medications CAUSES OF INFERTILITY IN MEN The following are common causes of infertility in men. Semen

Abnormal semen is responsible for about 75% of all cases of male infertility. The following problems are possible: • Low sperm count • No sperm • Low sperm mobility (motility) • Abnormal sperm Causes of abnormal semen

• Testicular infection • Testicular cancer • Testicular surgery • Overheating the testicles • Varicocele • Undescended testicle • Hypogonadism • Genetic abnormality • Mumps • Hypospadias

• Cystic fibrosis • Radiotherapy • Medications INFERTILITY TESTS FOR MEN • General physical exam • Semen analysis • Blood test • Ultrasound test • Chlamydia test

INFERTILITY TESTS FOR WOMEN • General physical exam • Blood test • Hysterosalpingography • Laparoscopy • Genetic testing • Chlamydia test • Thyroid function test

ASSISTED REPRODUCTIVE TECHNOLOGY (ART) Laboratory based technologies to enhance the success of fertility treatment. Intrauterine insemination (IUI)

In this procedure, husband’s semen is processed to take out the actively motile sperms, which is injected into the woman’s uterus around the time of ovulation.

male factor infertility.

Intracytoplasmic Sperm Injection (ICSI) is often used for couples in which means ferthere is tilization very low outside of sperm the body. count, IVF is the azoospermost effecmia ( no tive ART. It sperm) is indicated in bilateral fallopian tube damage, dense Testicular sperm aspiration (TESA) - Sperm is extracted adhesion from the testes and a single sperm is injected into a mature due to enegg. dometriosis, pelvic inflammatory disease & in severe In Vitro Fertilization (IVF)

COntACt US: Dr Babita Panda Email: drpandababita@rediﬀmail.com, chrimsivf@gmail.com For Appointments : 7609950211, 9438519453 WhatsApp only : 9938027580 Website: www.drbabitapanda.com

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we care for your dreams

FIRST STEP IVF, New Delhi

DR MANU GUPTA

DR PRITI GUPTA

MS, MCh (Urology) Urological Surgeon and Andrologist

MD, Gold Medalist Infertility Specialist

Can you tell us about your educational qualifications? My father always wanted me to become a doctor. I pursued my graduation from Maulana Azad Medical College where I topped almost all the semesters and got the best students award at the end of my M.B.B.S. I did my post graduation from AIIMS I wanted to be in a teaching institute as I was inclined towards teaching. I spent time at SGPGIMS, Lucknow and started practicing in 2010. When & how did you enter the field of infertility? In 2010 after completing my senior residency I decided to get into infertility management. The queries related to patients who are unable to conceive had always intrigued me. What motivates you in this field? It’s a challenge for me to give a baby to my patients. The joy that I get to see once the treatment is successful is the greater purpose of my life. There are a lot of myths associated with infertility. Can you shed some light on some of them? Lack of awareness amongst patients and doctors have created lot of issues. Most of the patients I have seen have been under tremendous pressure of their families and society. Lot of people still believe that women are responsible entirely if she is unable to bear a child. Infact male factor is 50% cause for infertility. At the same time I would like to point out that now a days there are many supportive husbands who understands their wives and the mental pressure that they both have to encounter. What are the risks associated with ART? Due to advancement in technology and medicines the risk associated with ART has reduced to a remarkable extent. The drugs used for stimulating the ovaries can cause ovarian hyper-stimulation system when the dose is given in high quantity, but under an expert’s guidance it can also be controlled. How do you explain ‘Unexplained Infertility’ to your patients? I check for four factors i.e, The eggs, the fallopian tubes, the uterus and the male partners quality of sperm. If these factors are normal then there is not much problem in conceiving. But when we see that despite everything being normal a couple is not being able to have a baby then we counsel them and explain them that due to some unknown factor the fertilization is not happening. What makes you different from other IVF centres? I am very honest in my approach to patients. I have treated patients even free of cost. I try to solve issues without using IVF. I try to make them conceive naturally. My effort is always there to keep my center updated with the state-of art facilities.

What level of treatment can a patient expect at First Step? We have all the latest technology for ART at our clinic to give the best treatment possible. How do you address the emotional needs of a patient? We try to counsel and tell our patients about the possibilities and also about the limitations of IVF. It’s a long process. Every patient is different from the other and I along with my entire team ensure that the patients don’t feel that they are alone in the process. We also talk to the family members as and when required to support the patient. When should one consult an infertility expert? After 2 years of having unprotected intercourse if a couple is not able to conceive then they should consult an infertility expert. People who are chronic smokers or the one who is addicted to any drugs might face issues. How difficult is ART from a patient’s perspective? The lady has to undergo daily injection. There is lot of mental pressure and societal pressure on the couple. They also need to be financially stable due to the cost involved in ART. What kind of dedication is required from a patient? They should be positive about the doctors and the treatment they are undergoing.The trust and belief that everything that is being done for them is going to reap good results is very crucial from a patient’s perspective. I have witnessed cases that patients who are optimistic about their treatment, somehow sooner or later they conceive. What should a patient look for before choosing an IVF Clinic? They should check for transparency maintained by the clinic. They should analyze whether the doctor is being able to understand the changes that their body is undergoing. They should also check for the success rate of the clinic and feedback from other patients. Can you share some cases which were a challenge to you? A 35 year old lady came to our clinic and said that she never had periods. She only menstruated when she had contraceptive pills. She got to know from other doctors that her uterus size is small. This was one of the most challenging condition. I gave her a proper trial of donor eggs along with medicines and injections. We just transferred one embryo and she conceived. How do you relax after helping patients? Treating people and giving them relief makes me happy. I have two kids who keep me on my toes.

MEET DR PRITI GUPTA

ABOUT US First Step IVF is a sincere effort to help couples struggling with fertility and reproductive health related issues. It is one of the best and leading test tube baby center in vikaspuri, West Delhi with treatment for infetility in men and women. The infertility specialists here are highly experienced and knowlegdeable. The essential values of medicine- honesty, integrity and competence is their core philosophy. There are no corporate pressures, no targets to meet, no false promises in terms of treatment at our centre. Transparency is total and complete. Dr. Priti Gupta and Dr. Manu Gupta both have been trained and worked at the best centres in the world. Dr. (Mrs.) Santosh Gupta is the most famous Obstetrician and Gynaecologist in West Delhi, helping deliver more than 7,000 babies in her long and illustrious career.

DR. (MRS.) SANTOSH GUPTA, MBBS, CGO Obstetrics & Gynaecology Dr.(Mrs.) Santosh Gupta She has been practicing Obstetrics & Gynaecology for 40 years. She has helped to deliver more than 7,000 babies in her long and illustrious career. She has been instrumental in guiding many doctors in Delhi and inculcating the value of honesty and hard work in them. She is an inspiration for many who have interacted with her, whether doctors or patients.

DR. MANU GUPTA, MS, MCh Urological Surgeon and Andrologist Dr. Manu Gupta is a Consultant Urological Surgeon and Andrologist, practicing in Sir Ganga Ram Hospital, Delhi. He has been trained in Delhi, Lucknow, London and New York. He is also an Associate Professor in Urology center at GRIPMER (Ganga Ram Institute of Post Graduate Medical Education And Research). He deals with the surgical aspects of diseases of the kidney, prostate and bladder. He also deals with male sexual disorders and infertility. He is an expert in laparoscopic surgery and has recently trained at Roswell Park Cancer Institute, Buffalo, New York in Robotic Surgery. He is a member of Medecins Sans Frontieres (MSF) (Doctors without Borders) and is actively involved in his old college (Maulana Azad Medical College) and school(Mount St. Maryâ&#x20AC;&#x2122;s, Delhi Cantt.) alumni associations. He is an avid musician and can play five instruments. He is the bass guitarist of Stringstrasse (Street of Strings), a rock band with five Urologists and does regular shows across India.

TREATMENTS We provide state of the art infertility treatments in a well-maintained, cleanand patient-focused environment. We provide complete Infertility Health care and guidance to the infertile couples and our advanced techniques and treatments rangefrom the simplest test to latest technical procedures. Offering top-of-the-line services and treatments,our Clinic provides IUI (Intrauterine insemination), IVF (Invitro Fertilization), ICSI (Intra cytoplasmic sperm injection), Frozen Embryo Transfer, Surrogacy Programs and Donor IUI programs. IUI or Intrauterine Insemination IUI or Intrauterine insemination is a treatment wherein sperms are instilled inside a womenâ&#x20AC;&#x2122;s uterus to facilitate fertilization. IUI is the most common fertility procedure done in our clinic. Sperms are first â&#x20AC;&#x153;washedâ&#x20AC;? before insemination. Washing involves removal of the seminal fluid attached to the sperm and any other chemicals that may affect fertilization. The washed sperms are then inserted during the 12th-15th day of the menstrual cycle. IUI is very affordable compared to IVF, with excellent results. If you think IUI is what you need, take your first step to our clinic. Donor Insemination (DI) Donor Insemination is required in couples when the male partner has low quality semen parameters. Hence, IUI is carried out with the help from a donor who is ready to donate his sperms.

At First Step IVF, a dedicated team of Doctors, Embryologists and Fertility Nurses make sincere efforts to make IVF procedures as comfortable as possible. ICSI The intra cytoplasmic sperm injection or the ICSI treatment is generally suggested to couples where the male partner has severe oligo astheno-teratozoospermia (decrease in count, mobility or abnormal morphology). It is also indicated in women with unexplained infertility and in women with previous fertilization failures. It is also helpful in cases with previous recurrent pregnancies when combined with PGD (Pre - Implantation Genetic Diagnosis). In the procedure, the egg is fertilized by the direct injection of a solitary sperm into the egg with the assistance of a very thin needle. The purpose for doing so is that the egg membrane can be fertilized directly by the spermatozoa. Before the procedure is started several eggs are collected from the female via medications. If the process of fertilization is successful, then the embryos are formed and the healthy embryos are then transplanted into the uterus of the female to develop. First Step IVF is equipped with the latest equipment and expertise for ICSI procedures, with an excellent success rate.

Egg Donation Egg donation is used when the patient is unable to produce her own eggs. This type of infertility is often associated with older maternal age, when the ovary's store of follicles is beginning to run out. The tell-tale signs are irregular - and even absent - periods, which IVF IVF or In vitro Fertilization is a good option to treat in- are often a prelude to the menopause. In normally fertility due to ovulation disorders, poor sperm quality 'fertile' women this can happen in their late 30s and or quantity, cervical disorders, and damaged Fallopian early 40s, but there are also unfortunate younger women who are found to have a 'premature' tubes. menopause. This can happen in women as young as In this procedure, daily injections of gonadotrophins 20 or 30. are given to the lady and the procedure is called conAt First Step IVF, we arrange for good quality donor trolled ovarian hyper stimulation. The aim is to proeggs, when required. Treatment can take place within duce multiple eggs (ideally 7-15) in both the ovaries. Transvaginal ultrasound is done periodically, to moni- three months with a high success rate. tor the number and size of the eggs. Once the eggs are mature (on the basis of size and some blood tests) ma- Surrogacy Surrogacy is required by those couples where the feture eggs are collected from the female and are then fertilized in laboratories with the sperm coming from male is capable of producing good quality eggs but is the male partner. The embryo developing out of fertil- not able to bear a child in her womb. This often happens due to uterine problems like abnormally shaped ization is then inserted into the uterus of the female. Although the process can be carried out with the eggs uterus, the poor lining of the uterus or adhesions and sperm of the concerned couple, yet there may be within the uterine cavity. Surrogacy at First Step IVF is guided by expert councases where the eggs or the sperm or both are taken from a donor. A gestational carrier may also be used if sellors and we ensure a smooth and transparent process necessary. The total IVF cycle is about 2 weeks.

Our Happy Families What is PGD? PGD is a technique that enables couples with a particular inherited condition in their family to avoid passing it on to their children. The process helps potential parents prevent the birth of a child with a serious genetic condition. PGD is used when one or both parents has a known genetic abnormality and diagnostic testing is performed on an embryo to determine if it has also inherited the abnormality. PGD involves the use of Assisted Reproductive Technology (ART). Eggs are obtained and fertilized through In Vitro Fertilisation (IVF). Once fertilized, the embryo develops for 2-3 days and then one or two cells are removed from each embryo. The genetic material (DNA or chromosomes) within each cell is then tested for the genetic or chromosomal abnormality. Up to two unaffected embryos are then transferred to the womanâ&#x20AC;&#x2122;s uterus to implant. If successful, the procedure will result in pregnancy and the child should not be affected by the condition for which it was tested. Frozen Embryo Transfer (FET) A frozen embryo transfer (FET) is a cycle in which the frozen embryos from a previous fresh IVF or donor egg cycle are thawed and then transferred back into the woman's uterus.

first step iVf A-149, Vikas Puri, New Delhi - 18 call: +(91)- 8595 223 355 Dr Manu Gupta 98719 00299 e-mail: ďŹ rststepivf@gmail.com website: www.ďŹ rststepivf.com

SREE FERTILITY CENTRE, Hyderabad

[

delivering the joy of parenthood

SRILATA SHINDE

DR PRAVIN SHINDE

Msc ( Micro- Biology) Embryologist

MSc, M.Tech, PhD Embryologist

MEET DR PRAVIN SHINDE Can you tell us about your educational qualifications? I have completed my Ms in Microbiology, M.Tech in Bio- Technology and PhD from Gulbarga University Karnataka. When & how did you enter the field of infertility management? I started my career in 1999 as a junior embryologist and then I worked as a inhouse embryologist in Kiran Infertility Center for 7 years. Since 2007 I have started my own centre called Shree Fertility Center, and we have two branches in Hyderabad. We have advanced level of infertility treatment. What motivates you in this field? Giving parenthood to infertile couple is the major motivating factor. A couple feels incomplete when they don’t have a child and they come to us with lot of hope. With god’s grace and our consistent effort we have been able to bring smile on their faces since the last one decade. There are a lot of myths associated with infertility. Can you shed some light on some of them? There are lots of myths about infertility. It is crucial to separate facts from fiction because believing some of these myths could prevent you from getting the treatment you need. Myth: infertility is rare. I cannot be infertile. Fact: 10-15 per cent married couples in India face infertility. There is no way of knowing about this before you try to conceive. Myth: men don’t have infertility problems Fact: 35 percent of all infertility cases are due to a female problem. But 35 percent (an equal number!) can be traced to a male problem, 20 percent to a problem in both partners, and 10 percent to unknown causes. There is no correction between virility and fertility for men and some men with a normal sex drive may have no sperm at all. Myth: you need to try harder or more Fact: most of the couples who pursue treatment will achieve a successful pregnancy. On the other hand, it's im-

portant to remember that infertility is a medical disease and that problems sometimes remain untreatable - no matter how hard a couple "works" at solving them. Myth: I am fit and physically active. How can I be infertile? Fact: infertility is completely unrelated to physical fitness. Myth: a person can wait for a long period to become pregnant Fact: a healthy 30-year-old woman has about a 20 percent chance of getting pregnant each month; while by age 40, her chances drop to about 5 percent a month. But, infertility can affect women of any age, and from any background. Myth: we will need daily visits to doctor during treatment Fact: most treatment modalities require few visits to the doctor, and most visits are short, enabling you to continue your lives relatively uninterrupted. What are the risks associated with ART? The main risk factor is Ovarian hyper stimulation, the female partner is stimulated and due to over stimulation the ovaries tends to grow in size. With advanced technology we have been able to reduce the risks to a large extent.

process involved in getting pregnant, the couple’s problem, the meaning and impact of infertility and their treatment options. Lending a sympathetic ear sometimes makes all the difference. Counseling the family as a whole and explaining that infertility is a medical problem which can be treated with proper medical help and family support reduces the marital discord and stress. How difficult is ART from a patient’s perspective? Many couples find that dealing with infertility and its treatment is physically, emotionally and financially demanding. While they are very grateful for their treatment, many feel frustrated, sad and feel that it is a real blow to their self confidence. Most difficult part of the treatment is the waiting. Particularly, the 2 week wait after IUI/embryo transfer to find out whether the treatment has worked or not. Physical demand of IVF range from daily injections, frequent scans, blood tests, egg retrieval procedure for the woman and the need for man to produce semen sample on demand. These add on to the emotional stress Support from the partner and family will go a long way in easing the process and reducing the stress.

What kind of dedication is required from a patient? They need to make required lifestyle changes like quitHow do you explain ‘Unexplained Fertility’ to your pa- ting smoking and drinking alcohol. tients? Compliance should be maintained with treatment It occurs when the reason is unknown despite the nor- schedule and visits. They have to take their vitamins mal count of sperm in the male partner and the feand supplements daily, eat healthy food and be physimale is also fit. We do detailed investigation for those cally active. Keeping yourself busy is the best way to patients. The causes of “unexplained Infertility is still reduce stress. I advice workouts, starting new hobbies, not discovered and research is still going on. meeting new people to stay busy Most importantly – Baby steps... take one day at a What makes you different from other IVF centers? time. Thinking too far and getting all worked up won’t Most of the other Infertility clinics are run by gynecol- help. ogist by Shree Infertility clinic is being run by an Embryologist. We have a scientific infertility team and Can you share some cases which were a challenge to expert ART specialist. The infrastructure is at par with you? the international standards. There are a couple of cases. It once happened when a 24 year old lady was unable to conceive even after 5 What level of treatment can a patient expect at your years of her marriage. She came to our infertility cencentre? ter four years back. It was a difficult as she underwent In our Infertility clinic we have from basic to advanced Ovarian hyper stimulation. We retrieved all the emlevel of treatment. From normal ovulation Induction bryos and she conceived. to PGD,PGS we do everything under one roof at our We have helped a 48 years old in conceiving and decenter. livering a baby even after her menopause. Her husband was 51. How do you address the emotional needs of a patient? For many seeking medical reproductive help, it’s a How do you relax after helping patients? very distressing experience and they go through a Spending time with family and friends has always roller coaster of emotions. Not knowing the actual been my stress buster. My family is my constant problem builds up extra stress source of love and happiness. Watching & playing The first step towards change is awareness and the cricket, and last but not least HCG positive of IVF pasecond step is acceptance tients gives me great boast of relaxation. So, my counseling starts with explaining the actual

infertility SpecialiSt DR. ARADHYA ACHURI Dr Aradhya Achuri is a consultant gynecologist and infertility specialist at Sree fertility centre, Kondapur. She has completed her MBBS and MS OBG from Dr.NTR University of health sciences. She pursued a fellowship in reproductive medicine at Srusti fertility centre, Chennai one of the pioneers of infertility in South India. She has also done fellowship in assisted reproductive technology and fellowship in minimal access surgery from Delhi She brings her expertise to Sree Fertility Centre in all aspects of reproductive medicine which include transvaginal ultrasonography, timed intercourse, IUI, IVF/ICSI, FET, third party/donor assisted reproduction, andrology, hysteroscopy and fertility enhancing laparoscopic surgeries.

ABOUT - SREE FERTILITY

WHY SREE FERTILITY ?

At SREE Fertility Centre, We bring hope to childless couples. Our goal is to provide affordable and quality care in a world class ambience. A dedicated team of IVF specialists is committed to delivering the highest standards of infertility treatment under complete privacy and confidentiality. Research and innovation are cornerstones of the culture at SREE IVF Centre, with a focus on the development and practice of newer methods including Oocyte Banking, In Vitro Maturation, Minimal Stimulation IVF and Pre-implantation Genetic Diagnosis. We specialize in each and every aspect of infertility and provide comprehensive services in IUI, IVF, IVFICSI, Assisted Hatching, egg donation, embryo donation, surrogate motherhood, male infertility, natural infertility treatments, semen banking, embryo freezing, sexual and psychological problem and try to give moral and emotional support to our infertility patients. Our team consisting of gynaecologists, fertility specialists, embryologists and andrologists gives you personalized attention at each step. Your treatment is started with a thorough medical and physical examination. You can be assured of receiving a comprehensive treatment plan tailored to suit your requirements. Our goal is to improve your chances of successfully carrying a baby to term.

• One of the 12 people in India to have got recognition by central board to start fellowship program in IVF Almost every alternate person undergoing IVF in our unit gets pregnant. • We are in the field of ART since 15 years in India (first established in 1999). • We have four high quality IVF labs in Hyderabad. • Our clinical pregnancy rate is 40-50% per started cycle in women less than 35 years. • Our labs are heap filtered using class 10,000 air handling units which are run 24/7. • We offer ICSI - IMSI. • Our vitrification results: embryo thaw recovery: 90% & pregnancy rate of 40 to 45%. • We have an Oocyte freezing and ovarian tissue freezing program for patients with cancer. • Our egg donors and surrogates are rigorously screened as per international guidelines. • We can provide egg donation for Asians. • We are two high quality IVF labs in Hyderabad, (Srinagar Colony & Miyapur)

ADVANTAGES OF SREE FERTILITY At the SREE Fertility Centre, we diagnose and treat infertility with the latest in technology and training. We offer a gamut of medical and surgical options ranging from simple treatment by laparoscopic correction of tubal block, and laparotomy repair, to Intra Uterine Insemination, and In Vitro Fertilization and Cryopreservation. • Quality care • Qualified and experienced doctors and scientists • State-of-the-art facilities with advanced techniques • Individualized protocols The SREE Fertility Centre is keeping pace with time and technology. Medical facilities/technology in practice in Europe, America and Australia, is now available at the SREE Fertility Centre at a fraction of the cost.

Emotional Toll of Infertility The emotional toll of infertility can be extremely difficult on a couple's relationship, and may affect each partner differently. It’s an exciting time when you decide to start a family. But this can shift into disappointment and worry if pregnancy doesn’t happen right away. Some couples decide to try fertility treatment. You may wonder how to support your partner through this challenging process. Fortunately, there’s plenty you can do. The experience can even strengthen your relationship. The last few years have seen a prevalent rise in infertility amongst the population across the world. This rise in infertility is due to the precarious lifestyle choices we are making, inclusive of all the junk, frozen food we eat as opposed to the fresh, organic foods we should be eating. The partner that has been diagnosed with infertility may feel guilty and carry a sense of denial. The practice of infertility counselling delivered by mental health and medical professionals has become more sophisticated and widespread over the past decade making it a viable and sensible option for those undergoing stress due to fertility problems. Before infertility takes a toll on your marriage and your relationships, it best to address the negative feelings and get help. Infertility can be tackled with new age fertility treatments but before you go for tests and treatments it is important that you go for counselling. Counselling helps in dealing with feelings of grief and sadness and preps you and your partner for the journey with fertility medicine. Counselling can curb feelings of fear and help you address the problem with an open mind. It enables you and your partner to understand each other as well as the treatment options available better. It is important to keep the channels of communication open as fertility treatments. Counselling instills hope and happiness. It important to feel positive about tests and treatments. It also helps to understand the need and nature of treatments. Counselling helps to cope and bring back normalcy and hope in one’s life.

State-of-the-art facilities make Shree Fertility the

REASONS TO CHOOSE SREE FERTILITY CENTRE • Collective experience of more than 16 years • Clinical Expertise with over 16 years of experience available for you 24/7

Fertility Hospitals in Hyderabad • All Under One Roof All infertility treatments ranging from conventional IUI to advanced PGD/ PGS under one roof- A choice of treatments to choose what is right for you • Class 5,000 SFT. State-of-theArt IVF Lab We have highly equipped advanced IVF lab, which helps optimize the results of Assisted Reproductive Techniques (ART) • Happy Couples At SREE IVF We have High Success rates and ever increasing happy couples. • Our Priority is You We tailor individual treatment plans based on your needs. • Our Approach Transparency, Ethics and Values • Evidence Based Practice Quality Systems And Evidence based practice • Family Friendly Center Sree IVF is a family friendly center addressing all infertility needs and offering medical and psycho-social support throughout the journey.

ART SERVICES:

fertilization can take place. In vitro fertilization (IVF) In vitro fertilization treatments help patients conceive by taking Intrauterine insemination (IUI) Intrauterine insemination is a the female partner’s egg, or a commonly used procedure that in- donor egg, and joining it with volves processing or “washing” of a sperm in an embryology laboratory. After the embryo has reached semen sample to help to concentrate the live, motile sperm and the optimal development, it can place it into the uterine cavity, then be transferred into the woman’s uterus where it may imthereby bypassing the cervical mucus and getting the sperm plant and grow. closer to the fallopian tubes where ICSI

best choice in Hyderabad For males with significant male factor infertility, Intracytoplasmic sperm injection (ICSI) may be used to fertilize an egg in the embryology lab via in vitro fertilization. ICSI may be an option for those who have low sperm concentrations or motility, or abnormal sperm anatomy (morphology) ICSI is an assisted fertilization technique that can increase the likelihood of fertilization and therefore possible eventual pregnancy. During the procedure, an embryologist will use a glass needle to pick up a single sperm cell for injection into a mature egg. IMSI Intracytoplasmic Morphological Sperm Injection (IMSI) is a technique in which sperm samples are examined under a microscope that is almost 6000 times more powerful than normal ICSI microscopes. This technique enables the fertility experts to choose the best quality sperm, without any defects, to inject into the egg, thereby improving the prospects of implantation and pregnancy. IMSI is indicated when the sperm sample is severely abnormal, when at least 2 previous ICSI treatments have failed or there is recurrent first trimester pregnancy loss after ICSI. Blastocyst Culture & Transfer Most embryo transfers are performed on Day 3 of IVF. When an embryo is cultured

in the lab for 5 to 6 days it forms a blastocyst. Blastocyst culture allows for the better selection of the embryos to be transferred and only requires a smaller number of embryos transfers to achieve a pregnancy. This helps to lower the risk of a multiple pregnancy. LASER Assisted Hatching Before an embryo can attach to the walls of the womb, it has to break out or hatch from its outer layer called the zona pellucida. Assisted hatching is performed while the embryo is in the laboratory. Before being transferred back to the womb a hole is made in the outer layer of the embryo or it is thinned, using a laser. This helps the embryo hatch and increases the chances of successful implantation which increases pregnancy rates. In safe and experienced hands, this procedure keeps the embryo safe as the outer layer is operated on. Freezing Services Clinically described as cryopreservation, freezing is a process in which cells or whole tissues are preserved by cooling to sub-zero temperatures (-196 Degree Celsius). When fast frozen in liquid nitrogen, the process is called as (Vitrification). Vitrification is ideal for embryos as it minimizes damage to the cells due to ice crystal formation. Sperm and eggs can also be frozen to achieve a higher chance of success. Cocoon Fertility, with its state-of-the-art facilities, has a well-managed freezing mechanism. Embryo Freezing & Frozen Embryo Transfer Cycle In IVF, the ovaries are stimulated to obtain eggs - all of these, if mature, will be fertilized, thus creating embryos in excess of those that can be transferred to the womb at one time. If these (spare) embryos are

of sufficiently good quality, they can be frozen and placed in storage for future use. This provides another possibility of pregnancy, without having to go through the process of ovarian stimulation multiple times. These frozen embryos can be replaced in, either a natural cycle (no drugs involved) or in a cycle, in which the lining of the womb is stimulated with hormones (if there are concerns about the endometrial quality). We will be happy to discuss both options with you so that you can make an informed decision. Frozen Eggs Egg freezing, as a fertility preservation technique, has been around for many years. With the advent of newer cryopreservation techniques, egg freezing is now a viable option using the Egg Vitrification Egg Storage (EVES) Technique. Frozen eggs extracted from a woman at a younger age will give her a better chance of getting pregnant later in life, rather than with eggs collected when she is older. Over 85% of eggs undergoing the EVES will survive the freeze-thaw process. Frozen Sperm Age does not have the same effect on sperm as it has on eggs, which is why men can produce healthy sperm even after the age of 60. Men who need to have a vasectomy, but would like to be able to father a child can opt for sperm freezing. Men who have to undergo cancer treatments can also opt for sperm freezing, as chemotherapy and radiotherapy are known to adversely affect fertility levels.

PARTNER WITH US We will get in fertility treatments in India; we have devised 4 partnership models which may interest

you as partner. 1. Physicians Referrals We work with a network of trusted doctors that refers complex cases to us. Or if you are a gynaecologist, looking to refer regular fertility treatment patients to us, you are at a right stop. Each patient is special and we from a treatment plan with crucial detailing for unmatched success. 2. Shared association As a clinic, hospital, healthcare institute or medical tourism company, you can easily refer your fertility treatment patients to us. You can be rest assured that your patients will have the best chance of success on arriving at Sree IVF. If you are a gynaecologist yourself, you can also counsel the patients, dispense the medicine and stimulate the patients at your own centre or hospital, under our supervision. The actual IVF procedure will be done at Sree IVF Centre. The patient follow-up and subsequent delivery will be done by you. 3. Affiliation If you are looking for SREE IVF to perform the technical work pertaining to IVF cases at your own centre or hospital, we have our visiting team of doctors and embryologists for it. 4. Ventures / Franchise With immense growth in the sector, were looking to expand SREE IVF Group with full-fledged IVF and fertility centres across India. We will be happy to assist you if you are interested to develop into Sree partners in your city wherein all services are provided as a single Unit in your own Hospital.

SREE FERTILITY CENTRE

Kondapur

Sri Nagar Colony 8-3-1109/1/6, Plot # 3, 1st & 2nd Floor, Hari Priya Villa, Opp SBI bank, Keshava nagar, Sri Nagar Colony, Hyderabad - 500073. Email: psdiksha@rediffmail.com

2nd Floor, Kothari K1 Primo Complex, Above Ratnadeep Super Market, Kondapur X Roads, Kondapur, Hyderabad - 500084. Mobile: +91 98492 14655 Website: www.sreefertility.com

GENESIS FERTILITY RESEARCH CENTRE, Erode

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25 years of excellence

DR. NIRMALA SADASIVAM MD, DGO, MNAMS, Ph.D

Can you tell us about your educational qualifications? I have done my Master Degree (MD) in Obstetrics & Gynecology and D.G.O from Madras Medical College, Chennai. I am member of National Academy of Medical Sciences (MNAMS), New Delhi and Ph.D. in IVF Science (CCMB, Hyderabad).

ovum in the fallopian tubes. Sometimes the union of sperms and ovum are not good enough and sperms will not able to enter inside because of embryological imbalance. The eggs will develop antibodies to the sperm and vice versa. Almost 30% of patients who come for infertility treatment are patients of “Unexplained Infertility”.

When & how did you enter the field of infertility management? In the year 1978 when I had applied for my Master’s Degree (MD) at Madras Medical College at that time the first IVF baby was born in London. I was inspired by this news in The Hindu Newspaper and at that time I decided to become an infertility specialist.

What makes you different from other IVF centers? We feel proud of running our center for past 25 years. In 1996 when there were no IVF centers out of Chennai we are the first ones to open a center outside the capital and at that time Erode was a small town. I started this center with all the facilities after completing my training from Australia, UK & Singapore. In 1996 when other centers were culturing embryos for Day 2 which means What motivates you in this field? they were culturing two days embryo outside the body The field of infertility management is a passion for me. at that time we had imported the culture medium from When I was doing my MD In the field of Obstetrics & Denmark and started culturing the embryos for Day 3. Gynecology we had to choose our specialization in eiWe were gaining around 50% of success rate at that ther medical termination of pregnancies , deliveries and time. Afterwards in May 2000 I had an opportunity to caesarians or scientific method of producing babies i.e., work with Prof. Ariff Bongso who had trained me for infertility management so I chose infertility manageculturing the embryo for Day 5 that means culturing the ment as my specialization. embryo until it gains life after 120 hours. We have started doing this technique from the year 2000 when it There are a lot of myths associated with infertility. Can was not known to most of the doctors or IVF specialists. you shed some light on some of them? On 25th of June 2001 the first blastocyst baby (Day 5 Due to unawareness during the 1980s people had a mis- embryo is called Blastocyst) of Tamil Nadu was born in conception that test tube babies were born out of body our center and since then we are doing only Blastocyst and were extraterrestrial beings. The second most com- transfer and the success rate is between 70-80%. This mon myth was that the doctors intermingle the gametes makes our center different from other IVF centers. i.e., they use somebody else’s sperm and else’s ovum for IVF treatment which is not true. They also didn’t believe What level of treatment can a patient expect at your in the cryopreservation .But, nowadays people have be- center? come aware about the treatment through media, adver- Our center provides the highest level of treatment availtisements, daily soaps etc. It has now become easier for able in the world. We do Day 5 Transfer, Laser Assisted us to counsel the patients. Hatching, IUI, IVF, and BAPC & Surrogacy. What are the risks associated with ART? Assisted Reproduction Technique (ART) is a procedure which has to be done very carefully. There is almost 0% risk for a male because he provides only the semen for the procedure. The real challenge is faced by the woman. When the females behave differently for different hormones we need to standardize with one or two type and there is a risk of treatment failure. Therefore one of the risk of ART treatment is losing money because the pregnancy test result may be negative in that particular cycle. The risk as such is Ovarian Hyper stimulation Syndrome in some patients but from last 15 years with the introduction of antagonist protocol the risk of ovarian hyper stimulation syndrome is almost nil.

How do you address the emotional needs of a patient? First of all when couples come to our clinic we treat them as individuals without any disease and not patients. We counsel them about the treatment options that are available after going through their case history. It is important to gain their confidence once they come to us for treatment. We have to be clear and transparent to them so that they can understand that some good things can happen here.

When should one consult an infertility expert? It depends upon the age of the patient. For example if a 21 year old woman married to a 30 year old man has failed to conceive after one or one and half years then it is important for the couples to consult an infertility expert provided they had stayed together and had expoHow do you explain ‘Unexplained Infertility’ to your pa- sure to sex. tients? Firstly I explain them the Science behind a woman get- How difficult is ART from a patient’s perspective? ting pregnant naturally. Pregnancy occurs in the womb This is a good question you have asked. We counsel our of a woman by introduction of sperms and it fuses with patients about the facilities and the treatment options

that are available in our clinic and they understand properly after one or two seatingâ&#x20AC;&#x2122;s but affordability is a challenge to some of them. So we provide all categories of treatment under one roof like Day 2 treatment, Day 3 Treatment and Day 5 treatment but we prefer them to undergo Day 5 treatment. We are considerate to their economical background by giving them fees waiver and asking them to buy the medicines and in this way almost 30% of the patients are treated free of cost at our clinic since our inception. What kind of dedication is required from a patient? Patients need to understand their problem and need trust on us once they come for treatment. Almost 50% of the couples take the test results from one center and go another center to verify. Hence it is important for the patients to do a thorough study about a center and check it credentials before choosing it for treatment. If a patient is illiterate then she should take advice of the family doctor before choosing an IVF clinic. What should a patient look for before choosing an IVF Clinic? A patient should verify the track record and the credentials of a clinic before choosing it and in order to do that they should take help from their family doctor and must go through the website of the center. In addition to that they can also go through the search results of websites like Google. They must personally visit a center once for counselling and after that they can decide whether to continue with that institute or not. Sometimes word of mouth also plays an important role in decision making for people who are looking for IVF treatment as it is considered more reliable when compared to Google Ads and newspaper advertisements. People should also know about the forums who have accederated the center. Can you share some cases which were a challenge to you? Our center was inaugurated on 15th day of September 1995 and every year on that day we organize free counselling camp where we also do evaluation. In the year 2003 when we had organized the camp on 15th of September a 64 year old lady and her 73 year old husband came to us and they had gone through IVF treatment 12 times all over India but had failed. When I examined her I found that her Uterus was good but I told her that her age she would develop all age related complications once she conceives. After few weeks she came to me with a local politician who was transport minister of Tamil Nadu at that time for recommendation. We had to do ovum donation for IVF treatment and that too we did it with Blastocysct Culture (Day 5 Culture) and she was able to conceive. In the month of February 2004 she delivered an eight month old baby. The live relay was done by BBC and the news was covered by several newspapers and TV Channels all over the world. How do you relax after helping patients? I work from 8.00 am in the morning to 6.00 pm in the evening and after that I go back home and I spend time with my family. This is how I relax after helping my patients.

ABOUT US GFRC is an extremely distinguished medical centre for Infertility with all facilities under one roof. It has come a long way since its inception as a pioneering institute in ERODE, Tamil Nadu since 1996. It has taken giant steps to become a center of excellence in all facets of infertility and IVF treatment options, which are offered at affordable cost for the public. This center has been a leader in Blastocyst Culture, an Extended embryo Culture Technology and other novel Male Infertility treatment modalities like Surgical Sperm Retrievals – TESA, MESA, PESA, TESE, etc., with ICSI facility and genetic studies too. This research center is a unit of Maaruthi Medical Center and Hospitals, which is a well known 300 bed corporate hospital situated in the centre of Erode city. The success story of GFRC & MMCH in infertility treatment is largely due to the support of an extremely dedicated and experienced IVF team led by Dr. Nirmala Sadasivam, who has invaluable experience due to trainings she had at various world class institutes overseas, since 1991, and has pioneered in Blastocyst Culture technique since 1998. She was recognized by National Academy of Medical science and offered MNAMS – membership. With the vast knowledge and experience in Blastocyst culture technique she has utilized the data of more than 4000 infertile couples treated in her center, she could do PhD in the same speciality. This institution was endorsed in its nascent stage at the National “Art” Registry of India, and is now

a prestigious senior member of ISAR, India. Another feather in their cap is the inclusion of the center as one among the esteem early participants at ASPIRE – Asia Pacific Initiation of Reproductive Endocrinology, Hong Kong, in their academic events. This institute is accredited to ICMR through the Indian Society for Assisted Reproduction. MEDICAL MIRACLE The world level recognition for this center , came largely due to the “Medical Miracle” where 64 year old Mrs. Pappathi Subramaniam gave birth to a healthy baby which was flashed in all medias worldwide. This news has gained importance and it is occupying a page in BBC web site till today. This enduring success has a strong base of stupendous extended embryo culture technology (Blastocyst Technology) which conquered all obstacles of implantation in this old woman.

Why us GFRC, is a dedicated Center of Excellence for several key facilities in Infertility treatment. They are unique and state of the art facilities in the center and this Department stands out as a citadel of excellence for the whole Institute – Maaruthi Medical Centre and Hospitals, Erode. HIGHLIGHTS State of the art and Best in class Infrastructure. Excellent clinical team and dedicated and committed Human Resources. Credentialing and Privileging of-all clinical staff Clinical Pathways usage for best possible outcomes Excellence in Allied Sciences and Specialties Focus on Research Emphasis on Quality Management. Excellence in academics benchmarking against the world’s best centers. Collaboration with world class institutes for research & clinical study. Tracking and standardization of best practices Accreditation with best forums of the world in this specialty. Periodical up gradation of IVF laboratory and instrumentations for the best outcome. Maintenance of standard operating protocols – with the guidance of ethical committee Periodical clinical – CME s for updating the knowledge of other doctors in Infertility.

TREATMENTS • IUI Treatment • IVF Treatment-In Vitro Fertilisation • ICSI • IMSI • Surrogacy • Capsule Test Tube Baby • Blastocyst • Hystero Laparoscopy • Laser Assisted Hatching • Preimplantation Genetics • Embryo Glue • Embryo Culture • Embryo Transfer • IVF Egg Pick up Procedure • Egg Donation • Cryopreservation • Stimulation of Ovaries • Semen Banking • Live 3d/4d Scan System

FACILITIES BASIC FACILITIES: The Genesis Fertility Research Center houses state-of-the-art range of infertility equipments and treatments. Our IVF lab is one of the most modern, completely equipped labs in India. We pioneered the use of Trigas incubator system since 1998 which is the first one of its kinds in India in addition to the routine CO2 incubators. In that, we utilize 5% O2, 6 % CO2 and 89% N2 which gives the embryos an ideal environment, as it finds in the mother’s Fallopian tubes. OUR OTHER FACILITIES INCLUDE: • Stage specific, Sequential Culture Medias are being used as per the need of growing embryos, depending on the day of culture. • Integrated vertical laminar flow work stations, positive pressure ventilation and the latest Nikon stereozoom & Inverted Microscopes with motorized Micromanipulators, aid our genuine Embryo Culture System to lead with the best “Take home Baby rates”. • We adopt Sequential Embryo Transfer technique wherein, third day embryos are transferred to the uterus as FIRST ET, followed by fifth day Embryo transfer called BLASTOCYST – transfer. • We also help couples by providing complete investigation modes for infertility under one roof in the specified manner, like Operative video hysterolaparoscopy which corrects tubal blocks, endometriotic lesions and intrauterine lesions & septums. • Male infertility couples are also benefited since we have facilities and specialists for Surgical Sperm Retrieval procedures like TESA, MESA, PESA & TESE etc to use ICSI procedures as per their sperm counts in the ejaculate or extracted secretions from testes or epididymis. This procedure really helps the couple who have no sperm at all in the ejaculate, a condition called AZOOSPERMIA. Our Genetic Department takes care of Pre Implantation Genetics study of the Embryos in families with Hereditary / Familial Diseases, or in couples with repeated miscarriages and Bad Obstetric History. • Third party reproduction is another boon for aged needy infertile couples with defective uterus or gametes (eggs & sperms). Our first case of ovum donation yielded a fruitful pregnancy for 48 years old woman in 1999 and the first surrogate mother had delivered of a term child in 2000. A medical miracle could be made in our prestigious institution in 2004 ( Feb 24th ) through egg donation, with which 64 years old Mrs. Pappathy delivered of a male child by caesarian section.

MAARUTHI MEDICAL CENTRE AND HOSPITALS 300 Bed Multi – Speciality Hospital (ISO 9002 – 2000 – AUSTRALIA)

GenesIs ferTIlITy researcH cenTre #564, Perundurai Road, ERODE – 638 011. Tamil Nadu. e-mail: nirmalasadasivam1963@gmail.com Websites: www.ivfgenesis.com/www.1testtubebaby.com www.best-hospital-infertility.com Phone: 9865196660/9362766660

LIFELINE INFERTILITY & IVF CENTRE, Panvel

DR. JAYSHREE PATIL MEDICAL DIRECTOR, LIFELINE HOSPITAL

DR. PRAKASH PATIL CONSULTING GYNAECOLOGIST, ART CONSULTANT AND ENDOSCOPIC SURGEON. CHAIRMAN & MANAGING DIRECTOR OF LIFELINE MULTISPECIALITY HOSPITAL, PANVEL. DIRECTOR OF LIFELINE INFERTILITY & IVF CENTRES (PANVEL, VASHI - NAVI MUMBAI, THANE, DOMBIVALI, PUNE)

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AffordAble IVf for All

Meet dr. PrAkAsh PAtIl consulting gynaecologist, aRt consultant & endoscopic suRgeon

Lifeline Hospital received "Among best Multi Speciality Hospitals in Mumbai" Award in Global healthcare Excellence Award function at Delhi, received from Renowned Politician Mr. Amar Singh and Sport and Youth welfare Minister Mr. Chetan Chauhan. When and how did you start your IVF facility? I started my infertility work about 25 years back as a laparoscopic surgeon. This was in 1985. I was operating in Raigarh district and some other districts of Konkan. I used to hold camps and have done more than 40,000 tubal procedures till date. I was also awarded for three years by the Maharastra government for my work in Konkan. During that period I realized that just doing diagnostic laparoscopy was not efficient. In 1994, I got the opportunity to go abroad and there I took my training with Dr. Semm of Germany, Dr. Clermont Ferrand of France and Dr. Bruhat & Dr. Adam Magosh of UK. For six months I trained in endoscopy and IVF. I was also doing preliminary work like IUI and started our infertility centre in Panvel in 1997. We got our first IVF baby of Navi Mumbai and Konkan in 1998. Since then we have had many firsts of this region at our infertility centre. Till date we have have achieved more than 7000 live births of IVF-ICSI procedures and have performed more than 12000 fertility enhancing laparoscopies. When did you start Lifeline? We started in 1997 with 50 beds and the first CT scan in Panvel. Since then we have not looked back. How is the Lifeline IVF different from other centers of the region? We are the pioneers in economy IVF. We get a lot of patients from the rural areas who cannot otherwise afford the cost of ART procedures. Our programs are designed so as to cut down the cost of IVF by nearly half. As you must be aware the cost of IVF is its biggest hurdle, but we are trying to make a difference by doing low cost IVF. How low is Low Cost IVF? We are not just doing Low Cost IVF but also low cost endoscopic surgeries so that this technique is affordable to the rural population as well.

should be complete transparency which unfortunately is not practiced by some centers. The patient should be told what injections they would be getting, when and why. Then during pick up; how many eggs were retrieved, how many embryos we got and how many were transferred. It is all these details which boost patient confidence. We at Lifeline even take the patients companion in the OT for pickups. We show them the number of eggs retrieved, photograph them and give them a copy of the picture. So that they feel assured that the proper treatment is being done. Later if the patient gets pregnant, well and good, otherwise she is assured that at least the treatment was done properly. In case of failure, counseling is equally important so that they retain the confidence to try again. Can you tell us briefly about a case which was your biggest challenge? One patient I remember. She was 43 and both her ovaries had been removed. We put her on HRT (hormone replacement therapy) and egg donation program. We could achieve pregnancy and she carried the child for the full term till delivery. In another case the patientâ&#x20AC;&#x2122;s uterus and ovaries were very small. Other gynecologists had told her that she will not be able to carry a child because of her condition. We did a hysteroscopy and could access her uterine cavity which was also very small. We used an egg donation program and she carried twin pregnancies. It was a miracle. You start working early and work till late in the night, how and when do you find time for yourself? We start working at eight in the morning and relax at 11.30 in the night. Ours is a multi specialty hospital so the issues are numerous every day. We sometimes catch a late night movie. I am also a Rotarian so there are some club activities. We also prefer to go abroad at least three to four times in a year. My daughter is gynaecologist and trained in field of IVF at OXFORD University, London and in Ireland. She stays in Ireland with her husband who is an Orthopaedic Surgeon. Currently she is working in the field of IVF in Ireland and very soon she will be joining our Panvel IVF set up. My son is MS, Surgery and currently pursuing MCH Urology. He is very keen in Andrology & Sexual medicine.

What is your vision for Lifeline? At present IVF is accessible only for the higher income bracket group and not to the lower income and the rural population. They are scared to going in for IVF because of the cost involved. We want to make it accessible to the lower income and rural populations also. I am myself a Is Mrs. Patil also involved? farmers son and I try to do ART procedures to a farmer or She is the backbone of the hospital. She is the administrasomeone from the lower income bracket at a very, very low tor. She is my boss! (laughs) cost. I feel that anyone should not be deprived of a child because of lack of money. This is our aim and vision. We have Dr. Ketki Patil - Mhaske also set up a 100 bed multi specialty hospital in Pune. MBBS, MS(OBGY), DGO, MSc. What is most important in achieving patient confidence and comfort? Whenever I appear on TV shows, I try and convey the message that the couples undergoing IVF should have complete faith in the IVF team treating them. At the same time the IVF team should counsel the patients continuously so that this confidence is developed. Secondly there

Consulting Gynaecologist, IVF & Infertility Specialist Dip. in Obstetrics & Gynaecology (DGO) Ireland M.Sc. Clinical Embryology (Oxford) UK Advanced Training in Laparoscopy and Hysteroscopy Surgery (France)

Welcome to LIFELINE Hospital Life Line Superspecialty Hospital, a 250-bed hospital located on Panvel, Navi Mumbai, has earned a reputation for outstanding patient care and innovative medical and surgical treatments. The hospital is particularly well known for excellence in internal medicine, cardiovascular disease, orthopedics, sports medicine, otolaryngology/head and neck surgery, and maternal/child health. The Hospital is also a recognized leader in public health education and community outreach. Life Line Hospital is committed to providing a high standard of patient care to a socio-economically and ethnically diverse patient population, with multi-lingual translators available 24 hours a day. Life Line Hospital, established in 1997, has proven to be an innovative leader in many fields.

LIFELINE IVF LIFELINE IVF is a treatment center for married couples not having child. Here at LIFELINE IVF Center married couples are provides IVF (in vitro fertilization) treatment through which they can have babies. Lifeline IVF is proud to announce the success of more than 7000 live births through IVF treatment. Now with the help of IVF any married couple can have a baby. LIFELINE IVF is a sister concern of LIFELINE PANVEL.

MISSION AND VISION MOTTO "Healthcare with Human Touch" MISSION â&#x20AC;˘ To provide quality health services and facilities for the community, to promote wellness, to relieve suffering, and to restore health as swiftly, safely, and

humanely â&#x20AC;˘ To provide competent, innovative, and accessible emergency and acute care services for the poor and needy. VISION To participate in the creation of healthier lives within the community

UNDERSTANDING INFERTILITY Infertility primarily refers to the biological inability of a person to contribute to conception. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term. There are many biological causes of infertility, some which may be bypassed with medical intervention. Women who are fertile experience a natural period of fertility before and during ovulation, and they are naturally infertile during the rest of the menstrual cycle. Fertility awareness methods are used to discern when these changes occur by tracking changes in cervical mucus or basal body temperature. Prevalence: • Generally, worldwide it is esti-

mated that one in seven couples have problems conceiving, with the incidence similar in most countries independent of the level of the country's development. • Women become less fertile as they get older. For women aged 35, about 94 out of every 100 who have regular unprotected sexual intercourse will get pregnant after 3 years of trying. For women aged 38, however, only 77 out of every 100 will do so. The effect of age upon men's fertility is less clear. Causes Factors that can cause male as well as female infertility are:Genetic factors • A Robertsonian translocation in either partner may cause recurrent

spontaneous abortions or complete infertility. General factors • Diabetes mellitus, thyroid disorders, adrenal disease Hypothalamic-pituitary factors • Hyperprolactinemia • Hypopituitarism • The presence of anti-thyroid antibodies is associated with an increased risk of unexplained subfertility with an odds ratio of 1.5 and 95% confidence interval of 1.1– 2.0.[11] Environmental factors • Toxins such as glues, volatile organic solvents or silicones, physical agents, chemical dusts, and pesticides. Tobacco smokers are 60% more likely to be infertile than nonsmokers.

OUR FACILITIES: Our IVF lab is equipped with state of the art equipments like laminar flows, Stereozoom & Binocular microscopes, Inverted Microscopes, Micro manipulators for ICSI, Co2 incubators for embryo cultures, a separate infertility operations theater, Cryofreezer for freezing of sperms & embryos. It is manned with an organized team of consultants as Gynecologists, Andrologists, Reproduction Biologists, Sonologist, Genetics study consultants and other well trained operation theater staff.

Facilities

ALL FACILITIES UNDER ONE ROOF Fertility Evaluation & Counseling: The couples are counseled to undergo the investigations & treatment by showing them slides, pictures, video clips. For Male Partner: Investigations like Andrology work up for oligo, Astheno, Terato, & Necrospermias as well as counseling for sexual dysfunction. Colour Doppler for Scrotum, Surgical procedures by andrologist like VVA, VEA, Varicocelectomy, TESA, PESA, Testicular Biopsies. For Female Partner: Counseling for sexual dysfunction, Trans Vaginal Sonography. Hormonal assays, Color Doppler studies, HSB (Hysterosalpingo graphy), SSG (Sono Salpingo Graphy) Follicular studies, karyotyping (Centre for Genetic studies), Intervetional TV sonographies.

Imaging Facilities: Colour Doppler & 3D sonography help to know the perfect & early diagnosis & helpful in the IVF procedues, like oocyte retrieval (removing eggs from Female ovary). Obstetric colour Doppler, Embryo reduction in multiple pregnancies. Video laparo hysteroscopy Facility: Video laparo hysteroscopy helps in diagnosis of the cause of infertility in female partner & any pathology in the uterus (myomas), tubes (hydrosalpinx or tubal adhesions & ovaries PCOD or ovarian cyst endometriomas & other pathologies can be diagnosed & rectified at the very same time being a day care procedure. Operative Videolaparoscopy & hysteroscopy: Dr. Prakash Patil was trained for Video laparoscopy & hysteroscopy at Keil, (Germany) under Dr. Semm, Cler-

OUR PROUD ACHIEVEMENTS More than 100000 infertile couples counselled At Lifeline IVF, Including all infertility treatments imparted, more than 10000 families are blessed with parenthood. ■ More than 12000 fertility enhancing video Laparo Hysteroscopies Done. ■ First IVF Baby of Raigad, Konkan and Navi Mumbai. She is in 3rd year of engineering now. ■ First ICSI baby of Raigad, Konkan and Navi Mumbai ■ First IVF twins of Raigad, Konkan and Navi Mumbai ■ First Laser Assisted Hatching centre of Raigad, Konkan and Navi Mumbai. ■ ■

mont Ferrand (France) under Dr. Bruhat & Dr. Adam Magosh in U.K. He has performed more than 5000 video laparo hysteroscopies till date. IUI: (Intra Uterine Insemination) Done in loligo & Asthenospermic males (sperms count & motility very low) couples with unexplained infertility & other specific indications. IVF-ET: (Test Tube Baby procedure) For couples with husband having normal sperms count & motility, but the female partner having tubal pathology. ICSI-ET Procedure: (Intra Cycoplasmic Sperm Injection & Embryo Trans-

fer) - ICSI have proven a gold standard particularly in patients with, Azoospermia (zero sperm count with spermatogenesis), low sperm count unexplained infertility & many other special indications.

eConoMY IVf: the cost of iVF/icsi creates a phobia about this treatment but we have tried to bring the cost of iVF down to almost half of the normal.

Blastocyst Culture: In this procedure the embryo is cultured & grown for five days to attain the stage of Blastocyst & then transfeffred in to the uterine cavity. This procedure gives better pregnancy rate & possibility of multiple pregnancy is minimized. Laser Assisted Hatching (LAH): After Embryo transfer two things occur in the uterine cavity: Hatching: Embryo breaks the outer cover (Zona) & hatches out in the cavity. Implantation: Occurs in to the internal lining (endometrium) of the uterus. Hatching is less in aged patient (age 35 to 40) as well in patients with the thick zona,. Such thick zona is drilled with the help of a laser beam & weakened to achieve easy hatching & optimize the pregnancy rate by 10% of the normal. Cryofreezing of Sperms & Embryos: In this method the sperms, oocytes & embryos are stored in liquid nitrogen at-169C & whenever required can be brought to normal (Thawing) & transferred to the uterine cavity of the recipient. Pre Genetic Diagnosis: PGD involves the creation of several embryos in vitro from the eggs and sperm of an interested couple. The embryos are permitted to develop till 6 to 10 cell stage, at which point one of the embryonic cells is removed from each embryo and the cellular DNA is analysed for chromosomal abnormalities or genetic mutations either by polymerase chain reaction [PCR] or Fluorescence Insitu Hybridization [FISH]. An embryo or embryos found to be free of genetic abnormalities are subsequently transferred to the womanâ&#x20AC;&#x2122;s uterus. Karyotyping and Chromosomal Disorders Screening: With the state of art Genetic Lab for culture systems and Olympus BX 53 Fluoroscent Microscope and CYTOVISION software for Karyotyping we have a fully equipped setup for all sorts of Chromosomal disorder screening. Surrogacy: In surrogacy, the eggs retrieved from either you or egg

donor are fertilized in lab conditions (by IVF or ICSI) with sperms retrieved from either your partner or sperm donor and incubated for 2-5 days. When the fertilized embryos are at the proper stage, they are inseminated into the uterus of the surrogate. The surrogate mother is not genetically/biologically related to your child and thus, acts only as a carrier. TESE - Testicular Sperm Extraction: Sperm extracted from testicles can be used for fertilization for men who have no sperm in their semen but want to conceive with their own gametes. PESA - Per Epididymal Sperm Aspiration: PESA has many advantages and is much more acceptable to patients who usually return to work the next day and who generally have no anxiety about its repetition. If sperm cannot be found in the epididymis we then proceed to a Testicular Sperm Aspiration (TESA). The surgical technique is very similar - the needle is simply inserted into the testis itself. Ovulation Induction: Ovulation induction is the stimulation of the ovaries to produce multiple follicles, each containing an egg. Ovarian stimulation involves the use of fertility medications that promote the simultaneous maturation of multiple follicles. During the ovarian stimulation stage, the woman's progress is monitored with hormone testing and ultrasound.

lIfelIne InfertIlItY & IVf Centre opp. s.t. stand, nH 4, panvel, district: Raigad, Maharashtra - 410206, india helpline: 022-61567000 / 01 / 02 / 03 +919769112233 email: drprakashpatil.ivf@gmail.com Website: www.lifelineivf.com www.lifelinepanvel.com

PRASHANTH FERTILITY RESEARCH CENTRE, Chennai

DR. GEETHA HARIPRIYA

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MD. DGO.,FRCOG(London) Obstetrician, Gynaecologist and Specialist in Assisted Reproduction

we assisT in miracles

reduced as people are more open minded about this whole concept. However, the financial aspect still keeps many couples away, as the cost of the procedure is on the higher side. While IVF was designed originally for women with tubal diseases, now IVF has been extended with equal success to infertility due to endometriosis, and unexplained factors. It is also largely due to male factors, which was a taboo to even talk about in the earlier days.. What is your idea of good patient care? Patients should feel that they are in experienced hands and they must get prompt response to their problems.

When did you start the Prashant Fertility Research Centre (PFRC)? This centre was started in 2001. How did you choose this particular branch of medicine? I had always been interested in the subject of infertility and used to read a lot about it to find out the latest developments in this area. More than anything else , my personal experience was a strong motivating factor as I had my baby 14 years after marriage. How far do you think you have succeeded in your endeavour? I believe I have achieved about 75 per cent success in my endeavour of making families complete with a baby. However, the efforts are still on to ensure more success in this field. What was the status of ART centres in India when you started as compared to now? In the initial years when ART made its presence felt in India , the facilities offered were very basic and very limited. In fact I can proudly say that our Centre is among the top 100 in the world offering all the latest and hi-tech facilities. What motivates you in this field? I am always reminded of my personal problem in this regard and that keeps me going ! And this is definitely a motivating factor for achieving still better results. I remember when I had to go to Singapore and other place for my treatment, I made up my mind that one day I would certainly bring this technology to my own hometown and our country. Is IVF difficult to go through from a patient’s perspective? The social stigma once attached to this is now much

What care can a patient expect at PFRC? Personalised Care • We have a “Care Team” deploying patient-care approach. • We believe that knowing our patients allow us to develop individualized treatment plans. • We believe that this familiarity and consistency of care, contributes to each patient’s well being, and ultimately, to the success of their treatment. • This “Care Team” approach shows the individualized experience we provide each patient. We also look into the comfort of the patient while in the hospital. And for this very reason, we have made a wide range of rooms available depending on the patient’s choice. The rooms are equipped with all facilities required for a comfortable stay. The ambience is exclusive and appreciated by all. Every bed is provided with an attendant couch, side cupboard and a footstool. The private rooms are airconditioned with an attached washroom, a telephone and a television with Cable TV connection. Then there are Deluxe Rooms comprising of a larger individual air-conditioned room with a telephone, television, refrigerator, microwave and a sofa. The Suite Rooms comprise of a double large air-conditioned room with an attached washroom and a fully-furnished attendant room. The Royal Suite gives the ambience of a five star hotel . We also have facilities for water birthing. What are your memories of the first IVF Baby you helped conceive? The pleasure it gave me is something beyond comprehension. As I had earlier said, it was my personal experience that was in the forefront, and therefore the joy I felt was no less than that of the beneficiary couple. Incidentally, the first IVF baby born under my care was not one but triplets, in November 2002. You have seen the birth of thousands of IVF babies so far. Can you share a few memorable cases? The most memorable case is that of a woman who was

Dr Geetha Haripriya is a renowned obstetrician and gynaecologist and a specialist in reproductive medicine and laparoscopic surgery. She has performed more than 50,000 procedures in assisted reproduction, delivered more than 36,000 from Assisted Reproductive Techniques (ART). She received the “Blue ring” award by the International Diabetes Federation along with Dr Nallaperumal for her excellent work in fertility and diabetes. . She also received the ‘Best Doctor’ from Dr M.G.R. Medical University, a Certificate of Honour in Forensic Medicine and also represented India in the international Shape-in-Clinic meetings and Educational Series 2010 at Melbourne, Australia She has been awarded the “Life Time Achievement Award 2010” by GOAL Committee 2010 in collaboration with Harvard University, USA. She was also the recipient of an Award from the State Government of Tamil Nadu for meritorious service in the field of Medicine in 2014. paralyzed below the hip. With a successful procedure, she underwent IVF and gave birth to a healthy baby in 2003. Medical research has taken great strides in the last three decades and there has been a tremendous and remarkable change in the technology that is used. Should patients be reassured by these developments? Yes indeed. New techniques have made it possible for couples of all ages to experience the joy of becoming parents. Various techniques that were only available in advanced countries are now available in India also. What are the most important latest technology in the last few years? IMSI A new computer Assisted technique to identify morphologically normal sperms for patients with abnormal sperms. IMSI is based on selecting the best sperm under a magnification of more than 6000x. Using this magnification, morphological defects, even small vacuoles become apparent. The technique is harmless and safe and leads to better embryo development, higher pregnancy rates and lower miscarriage rates. This is a real boon for patients with repeated IVF failures and those with recurrent miscarriages. Embryoscope Do you want a second to second display of what your embryos are doing when you are sleeping? • Embryoscope is the newest innovation in reproductive technology. • We are one of the top 700 centres in the world using the Embryo scope. It is the Hi-tech way to view your embryos. • Embryoscope allows dynamic continuous viewing of embryos from conception to embryo transfer. • Embryos grow in an atmosphere similar to the human fallopian tube. • Abnormalities are identified during early development. • Embryo quality is better • Embryo scope allows selection of top quality embryos for transfer into the uterus. • Gives remarkable pregnancy rates and decreases miscarriage rates. • Choose the smartest most active dynamic baby by using the Embryo scope. Embryo glue

• Embryo glue is a chemical substance which is used to coat embryos before transfer into the uterus. • It increases the stickiness of the embryo to be transferred into the uterus and therefore helps the embryos to implant with ease… and fix onto the lining of the uterus Do you believe the success rate would improve in view of such changes? Yes, without doubt ! The success rate of infertility treatment will improve tremendously by using the hitech techniques. What are the biggest hurdles of making ART available for the masses? I believe the financial aspect of the treatment is the one which keeps the masses away from it, as much as they would like to avail the same facilities. Do you think the government should help infertile couples? Since infertility is not a disease, the treatment is not covered under the health or medical insurance. This is one area that could be explored so that every family can atleast have one child to complete their family. What special facilities do you offer patients seeking ART procedures at PFRC? Prashanth Hospitals and Prashanth Fertility Research Centre offer excellent facilities and well equipped infrastructure for various procedures such as Intrauterine Insemination (IUI), In-Vitro Fertilization (IVF), Intra Cytoplasmic Sperm Injection, (ICSI), Assisted Hatching (AH), Blastocyst Transfer, Sperm and Embryo Cryopreservation, with a well equipped Andrology Laboratory for diagnostic and therapeutic purposes. Our Adult Intensive Care Unit and Neonatal Intensive Care Unit also cater to specific needs. The best thing is we keep updating ourselves with the latest technology from time to time. After helping so many distressed couples, how do you unwind to take on another challenging day? I have a beach house in Chennai and I go there whenever I feel like unwinding. Besides, I have great interest in music and designing. I have two hospitals and I have done the designing of both the exterior and interior myself.

ABOUT US The Center offers excellent facilities and well equipped infrastructure for advanced fertility treatments to tackle male and female infertility challenges, mastering in various procedures such as Intrauterine Insemination (IUI), In-Vitro Fertilization (IVF), Intra Cytoplasmic Sperm Injection (ICSI), Assisted Hatching (AH), Blastocyst Transfer, Sperm and Embryo Cryopreservation, PGD , Endometrosis and others. PFRC has a well equipped Andrology Laboratory for diagnostic and therapeutic purposes. A fully equipped laparoscopic setup for minimally invasive surgery is also available. PFRC is the first centre with a 3D laparoscopy with state of the art facilities for Hysteroscopy and Laparoscopy. PFRC also has a male fertility center called Alpha Male Health Clinic which comprises of expert and dedicated Andrologists to tackle male health challenges specially male infertility. Patients come from all over the world to PFRC and undergo advanced fertility treatments under the guidance of one of the best Assisted Reproductive specialists in India and the best in south India, Chennai, Dr. Geetha Haripriya and her team. The Donor Egg” and “Surrogacy” programme is one of our highlights. This Centre has also acquired the Diode Laser for assisted embryo hatching, facilities for genetic studies such as “Pre-Implantation Genetic Diagnosis and Pre-Natal Testing” for chromosomal and genetic disorders are also available. We have delivered 380 babies through

the Surrogacy Programme. We deliver effective and comprehensive care in assisted reproduction at affordable pricing to our patients.

VISION To be the preferred comprehensive care provider for Women, children and male & female infertility. Specializing in ObGyn, Pregnancy Care & Delivery, Pediatrics and most importantly Assisted reproductive care at a global level. To promote a cutting edge and pioneering scientific approach to help individuals with successful outcomes. MISSION Achieve best results with tender care. To set the standard of excellence in ART in India and Asia to continuously innovate to deliver superior patient satisfaction beyond expectations. We are committed to the care and improvement of human life.

We act in ways that respect dignity, uniqueness and intrinsic worth of every individual. VALUES We treat all those we serve with the utmost compassion and confidentiality. We act with honesty, integrity and fairness and aim to inspire trust in the way we conduct our treatment. This is OUR “TRIIC” Team Playing, Responsiveness, Integrity, Innovation & Confidentiality. GOALS At PFRC IVF, we have two goals for infertility treatment. The first is to help you get pregnant . The second is to help you experience an uncomplicated pregnancy and deliver a healthy baby.

WHY US? Prashanth Fertility Research Center , PFRCIVF was established by renowned fertility expert, Dr. Geetha Haripriya & Dr. G. Gopalaswamy ,to provide the latest and most advanced assisted reproductive services for treatment of male and female infertility and related issues. Over the years, we’ve helped hundreds of couples to overcome their infertility challenges; many of whom had previously almost given up hope of having their own babies. Since its establishment in 2001, Prashanth Fertility Research Center, PFRC IVF, Chennai has become a national destination for patients seeking fertility care. RECENT ADVANCES Advances in the treatment of infertility are almost a daily news story. We are at the forefront of these technological advancements in infertility treatment.In addition to deploying cutting edge facilities and equipment, Prashanth Fertility Research Centre – PFRC houses ultra modern facilities and state of the art equipments. We thrive to provide the finest reproductive endocrine care. CYTOPLASMIC TRANSFER Prashanth Super specialty hospital once again pioneers a revolutionary technique in Chennai, giving new hope to many infertile couples. Cytoplasmic transfer is the donation of healthy cytoplasm from fertile donors to patients eggs. This intricate technique is most beneficial in older patients whose eggs have lost the ability to function normally as well as younger patients with unexplained infertility and recurrent implantation failure. It is also beneficial to patients suffering from mitochondrial disorders. The procedure itself involves the use of cytoplasm of young, fertile egg donors to rejuvenate the eggs of patients. This donated, fertile cytoplasm is rich in factors that are necessary for sustained embryo growth and implantation. This injection of “Fertile” cytoplasm into the patient’s eggs gives the embryo an energy boost which is often all that is needed for better embryo development and later implantation. The egg donors are carefully selected and their eggs harvested for donation. Simultaneously, the recipient’s eggs are also harvested and prepared for sperm injection with her husband’s sperm. During the sperm injection, an enucleate volume of the egg donor’s cytoplasm is injected along with the sperm into the recipient’s eggs. The donated cytoplasm is a rich source of mitochondria and other factors that can be deficient in infertile couple’s eggs. Cytoplasmic analysis of the donor’s remaining eggs is then done to ensure that the donor’s chromosomes

have not been accidentally transferred into the recipient’s eggs. The resulting embryo is checked for fertilization, embryo cleavage and blastulation. The resulting baby is genetically that of the treated couple. There have been over thirty babies born around the world from this technique. Previous studies have shown that many patients whose embryos have previously failed to implant become pregnant after using this ground-breaking new technique. The developing embryo is often of better quality due to the restoring factors in the donated cytoplasm. In addition, women of advance age who previously had poor pregnancy outcomes with their own eggs alone have delivered healthy babies from this technique. In February this year, the use of cytoplasmic transfers was approved in the United Kingdom in consultation with the Human Fertilization and Embryology Authority. Prashanth Super Specialty hospital is now offering this state of the art procedure overseen by their Australian collaboration. Couples suffering from unexplained infertility, recurrent implantation failure, highly fragmented embryos, advance aged patients and those with mitochondrial disorders are the best candidates for theirs new treatment method. Cytoplasmic transfer is a fresh new hope for infertile couples in India. Women who previously had to use donor eggs because of poor or absent eggs due to endometriosis, previous surgeries for ovarian cysts and those in the over 38 to 40 age group, can now have babies with this new technique. Use of donor eggs are unacceptable to some women who cannot accept a baby with genes that are not theirs and this is particularly so in the educated and higher socio economic group. Young patients who have had repeated IVF failures or recurrent miscarriages because of poor egg quality will also benefit by this technique. Cytoplasmic transfer is a boon for infertile couples. ENDOMETRIAL RECEPTIVITY ARRAY • The Endometrial receptivity genome analysis (ERA) involves assessing a woman’s endometrial receptivity status from a molecular viewpoint. This molecular tool allows us to diagnose whether the endometrium is receptive or not, by analyzing the expression of a group of genes responsible for this function. This diagnostic method patented by iGenomix focuses on women who visit the clinic for their fertility problems. • With the endometrial gene expression diagnosis, problems that may affect the embryo implantation before starting the fertility treatment can be detected. As a result, corresponding measures can be taken to carry out the fertility treatment successfully. It also enables an early diagnosis of diseases originating in the endometrium. • This is advised for women who do not conceive despite all tests being normal.

OVARIAN REJUVENTION PROCEDURE (ORP) PLATELET RICH PLASMA (PRP ) Ovarian rejuvenation is a procedure that may create new eggs in the ovaries of women who are unable to conceive because of early menopause, advanced maternal age or low oocyte (egg) reserve, yet who wish to have their own biological child. These individuals are either unable or unwilling, for their own personal reasons, to use donor eggs or to adopt a child. New eggs do not develop in the ovaries under normal circumstances, and, according to the current scientific understanding of ovarian physiology, a woman is born with all the eggs that will be available for conception during her reproductive life. Furthermore, it is a scientifically undisputed fact that a womanâ&#x20AC;&#x2122;s supply of eggs diminishes both in number and genetic quality as she ages. In women who do not get periods, the procedure can be performed at any time. In women who do get periods, either regularly or irregularly, the procedure is best performed during the menstrual period or early in the cycle, prior to the development of an egg follicle. The procedure can be performed as early as the day of the initial evaluation. Prior to undergoing the procedure, you must not eat or drink anything for a period of 8 hours prior to the procedure, since an anesthetic is used. On the day of the procedure your blood will be drawn for the preparation of your PRP. The anesthesiologist will insert an intravenous line and you will be an asleep for approximately 10 minutes while the procedure is performed. Transvaginal ultrasound guided technique is used to inject a small amount of fluid containing your white blood cells and platelets into each ovary. MICROSCOPIC TESTICULAR MAPPING FOR AZOOSPERMIA Azoospermia is a condition in which there are no sperm seen in semen analysis even after pellet preparation. Some of these patients undergo testicular biopsy for diagnostic and therapeutic purposes. Until now biopsy was done only in a single site however recently it has been shown that even if the majority of the testis does not have spermatogenisis there can be focal areas of sperm production which can be missed with single site biopsy technique. Now we have started doing tes-

ticular mapping which is taking biopsy from multiple sites to enable us to identify these focal areas of sperm production. As the technique of assisted reproduction is advanced even a few sperms can be utilized for ICSI/IMSI. At Prashanth fertility centre we have started doing testicular mapping with the aid of an operating microscope. The advantage of this is the trauma to the testis is minimised and the incisions on the testis are small. With this technique we will be able to map the testis more extensively thus increasing the chance of finding these focal areas of sperm production. EXPERT MALE AND FEMALE INFERTILITY CARE PFRC specializes in Female infertility and houses all the advanced care and treatments under the PFRC banner and has dedicated MOM & ME and Prashanth Women Hospital to address the comprehensive needs of women health . It also has a male fertility center called Alpha Male Health Clinic which comprises of expert and dedicated Andrologists and Gynecologists t to tackle male health challenges especially male infertility.

ASSISTED REPRODUCTION LABORATORY The laboratory is fully equipped with the latest technology with duplication of all laboratory equipments, so that there is an effective back up system. Our clinical team includes inhouse embryologists trained by SIVF Scientists, who will be involved in all procedures. We also have consultant Embryologists from Australia. We perform routine quality control assays to ensure high performance.

TREATMENT OPTIONS • INTRAUTERINE INSEMINATION (IUI) • IVF • INTRA CYTOPLASMIC SPERM (ICSI) • LASER ASSISTED HATCHING • BLASTOCYST CULTURE • DONOR OOCYTE PROGRAMME • DONOR INSEMINATION • EMBRYO CRYOPRESERVATION • DONOR EMBRYO PROGRAMME • SURROGACY PROGRAMME

• CYTOPLASMIC TRANSFER

MALE FERTILITY CLINIC AT PFRC To keep our body physically and mentally fit, sexual health plays a key role and it deserves an important part in everyone’s life. Emotionally,it’s a pleasurable activity that can help cement the bonding between two people. Sexual health is influenced by physical, psychological ,interpersonal and social factors. Sexual health involves the sexual desire (libido) and the ability to get and sustain an erection. Any disturbance like hormonal imbalance, stress, depression, relationship issues, cholesterol – clogged arteries can affect the libido and erection (erectile dysfunction). In fact, it is an early warning sign for heart disease. Male sexual health also covers the prevention and treatment of sexually transmitted diseases and the assessment and treatment of male infertility. We understand that it can be difficult and embarrassing to discuss sexual dysfunction. But,

have the courage to take the first step to reactivate your sex life. Not only will you and your partner feel more satisfied by taking control of your sexual health, but you will also be able to take control of other, more serious health problems, giving you the chance to improve your overall health.

HIGH RISK PREGNANCY CARE AT PFRC A High-risk pregnancy is one that threatens the health or life of the mother or her fetus. For most women, early and regular prenatal care promotes a healthy pregnancy and delivery without complications. But some women are at an increased risk for complications even before they get pregnant for a variety of reasons. Women with high-risk pregnancies receive care from a special team of PFRC to ensure that their pregnancies are healthy and that they can carry their infant or infants to term.

THE MANAGEMENT DESK DR. GEETHA HARIPRIYA, MD. DGO., FRCOG (London) - A renowned Obstetrician & Gynaecologist and specialist in reproductive medicine and laparoscopic surgery. She has performed more than 50,000 procedures in assisted reproduction, delivered more than 36,000 babies from Assisted Reproductive techniques. DR. G. GOPALASWAMY, MS., FRCS. - A surgical Gastroenterologist and a Laparoscopic surgeon who runs an efficient gastroenterologist unit and an Andrology service for Prashanth Fertility Research Centre. He takes care of counselling the male partner assessing them and treating them medically and surgically if necessary.

PrasHanTH FerTiliTY researcH cenTre No.76 & 77, Harrington Road, Chetpet,Chennai – 600 031, Tamilnadu, India. Phone: 93 8066 8066 , 044 4227 7777 Fax: + 91 44 28363516

PrasHanTH sUPer sPecialiTY HOsPiTal No.36 & 36A, Velachery Main Road, Velachery, Chennai – 600 042. Phone: 93 8099 8099 ,044 22439494 website: www.pfrcivf.com email: info@pfrcivf.com

MEDICAL DIRECTOR: Dr. C. Geetha Haripriya, MD., DGO., FRCOG (London ) INTERNATIONAL SCIENTIFIC CONSULTANTS: Mrs Irena Lila Mrs Natalie Van Gramberg SCIENTIFIC DIRECTOR: Dr. Chandrika, MBBS., DCP ANDROLOGIST: Dr. G. Gopalaswamy, MS.,FRCS. CONSULTANTS: Dr.Kalpana Subramani, MBBS DGO, DMAS Dr. UshaTodhadhri, MBBS., DNB Dr.Saroja, MBBS., DGO Dr.S. Sailaja, MBBS, DNB Dr. Kalpanadevi, MS(Gen Surgeon), DGO Dr. Lakshmi.S, DGO, DNB SONOLOGISTS: Dr. Anita Chelliah, MBBS Dr. Murali Dr. Raji Venkatachelam ANAESTHETISTS: Dr. Murali Rengarajan, MBBS, DA, DNB Dr. Rajkumar Palanichamy, MBBS., MD.,FCCP Dr. Haribabu, MD EMBRYOLOGISTS: Mrs. Shanthi Mr. Radhakrishnan Mr. Praveenkumar Mrs. Silambarasi Mr. Amjad Khan LEGAL ADVISOR: Mrs. G. Kamala TECHNICAL COORDINATOR: Mr. Thiruvengadam LABORATORY CONSULTANT: Mr. Sathyamoorthy IVF COORDINATOR: Mrs.Shyamaladevi PROCEDURE COORDINATOR: Mrs. Sunanda, Mrs. Manju, Mrs. Rajini, Ms. Rama CHIEF COORDINATOR OF DONOR & SURROGACY PROGRAM: Ms. Sasi Duraivelu

PRAVI IVF & FERTILITY CENTRE, Kanpur

Dr Monica Sachdeva

Dr Rit Shukla

Obstetrician, Gynaecologist and Specialist in Assisted Reproduction

Scientific Director

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where motherhood is a blessing...

DR. MONICA SACHDEVA is a seasoned Infertility Specialist and skilled Obstetrician & Gynaecologist with more than 15 years of clinical experience. She is an infertility and IVF specialist with extensive training from Dr.U.N.Jindal (a renowned name in IVF in India) and from university of Kiel,Germany.For more than 2 years, she was associated with Bourn Hall Clinic (Cambridge,UK),Gurgaon as Sr. IVF Consultant and gained expertise in IVF protocols practiced at international level. She is currently the Medical director and Senior IVF consultant in PRAVI IVF & Fertility Centre,Kanpur (U.P.) She has done more than 2500 IVF cycles so far and specialises in repeated IVF failures, donor and surrogacy cycles and is expert in different IVF protocols of Bourn Hall, Cambridge, UK for treating infertile couples. Dr.Monica Sachdevahas done her MBBS from Madurai Medical College,Madurai (through AIIPMT) and DNB(Obstetrics &Gynaecology) from Hindu Rao Medical College &Hospital, Delhi (first attempt).She has pursued fellowship in infertility from Dr Umesh Jindal Hospital, pioneer in field of IVF and Infertility Treatment, in Chandigarh. She has been acknowledge by Bourn Hall UK Medical Director, Dr Thomas Matthews, for her excellence in treating infertile couples.Dr Monica is a life member of FOGSI, AOGD,Indian Fertility Society, ISAR and Indian Medical Association. She has been known for her pleasant demeanour and devoted nature for which she has been awarded with many recognitions from IVF Pioneers like Bourn Hall IVF clinic.Her friendly nature eases out the tension of distressed patients and makes their journey through IVF easy.She has been consistently giving excellent results with compassionate care. This is evident from the testimonial given to her from hundreds of couples who are blessed with joy of parenthood through her expert clinical hands. She is always updating herself with latest academic developments by attending national and international conferences.She is instrumental in training postgraduate doctors in field of IVF. Her motto is to serve childless couple with full compassion and transparency and eventually help with utmost zeal to achieve their long cherished dreams.

DR RIT SHUKLA, Scientific Director of PRAVI IVF & Fertility Centre, is committed to provide world class IVF services especially in embryology. With the vision of Dr Rit, this is happening first time in Kanpur that he has established Exclusive IVF hospitalwhich will serves only to childless couple to bring joy of parenthood in their life. He has gained his embryology skills from esteemed IIRRH (International Institute for Training & Research in Reproductive Health) by pioneers in field of IVF, Dr.Kamini Raoâ&#x20AC;&#x2122;s facility in BACC (Banglore Assisted Conception Centre). Dr Rit has rich clinical experience of more than 14 years and is practising embryologist for almost 3 years in Delhi & NCR region. During this period he has developed his expertise in Blastocyst culturing &transferring, IVF, ICSI, Vitrification, Thawing, Andrology and IUI. In addition to above after MBBS and he has completed his post-graduation in Health & Hospital administration and is known for many recognition in this domain as he has provided medical consultancies to multinational Health care organization and has managed various international and national level health care projects. He has come up with the concept of exclusive IVF centre for the first time in Kanpur and has ensure that PRAVI IVF & Fertility Centre has all the facilities required by childless couples for their infertility related treatment to provide them the joy of being parent. Dr Rit is available all the time for your any IVF/ Test tube baby related queries.

ABOUT US

"PRAVI word is explained in almost each language of world as genuine, proper, real, sheer, simon-pure, stark, sterling, thorough, true, honest, loyal and above all it is as Eeswar who wants to create and originate life, relations, peace and happiness forever..." In PRAVI IVF & Fertility Center, we are creating relations....of motherhood....of parenthood... by applying adPASSION, ENTHUSIASM, HONESTY, INTEGRITY, TRANSPARENCY AND TEAMvanced IVF techniques in paWORK • Passion - Passionately helping infertile couples in realizing their dream of hav- tient friendly and empathetic manner... ing their own child with indiscriminate approach and confidentiality. Pravi IVF is committed to • Enthusiasm - We believe in stepping along with patient in the extraordinary achieve excellence in adjourney of parenthood with equal enthusiasm. vanced infertility treatment • Honesty - We are caring and honest with our patient by providing them best under expert guidance from chance to enjoy parenthood. Dr. Monica Sachdeva and Dr. • Commitment - We are committed to focused patient care with highest standard of quality treatment and cost effective approach. Rit Shukla, who has over a • Integrity and Transparency - We aim to deliver result based integrated fertility decade of experience in treatpractice with honesty, transparency and confidentiality. ing infertile couples with ut• Teamwork - Our key to success is a strong teamwork with highest level of acmost care and excellent care. countability to our patients, General Practioners, Gynaecological Specialists and to other stakeholder in the community. Welcome to the Pravi IVF & Fertility Center - IVF Centre In Kanpur. PIFC is committed to provide world class fertility services to infertile couples with empathy and commitment. As a close knit, dedicated and professional team, we not only achieve consistently high results but also provide a positive and uplifting environment in which our patients undergo their treatment cycle. Over the past 35 years, In Vitro Fertilization (IVF) treatment has helped thousands of couples worldwide overcome a wide variety of infertility diagnoses enabling them to realize their dreams of becoming parents. IVF helps infertile couples become pregnant by joining the egg and sperm together in an embryology laboratory where embryos are created that can later be transferred back into the woman's uterus. While most of us have heard about IVF, not many people know exactly how the process works.

MISSION

WHY US?

"Pravi IVF is committed to provide individualized and empathetic fertility care with most advanced scientific techniques in field of reproductive medicine...."

Pravi IVF and Fertility Centre is giving care with utmost sincerity and devotion solely for the management of childnessness. We offer economical services with world class standards.We know that transparency is an important aspect to bulid trust in every relationship so we passionately work towards it. Here are some salient feature which make Pravi IVF and Fertility Centre trustworthy.

VISION "To excel in field of IVF by continuously gifting parenthood to infertile couples with highest level of patient focused fertility care...."

1.Educating the infertile couple so that they can take informed decision. 2.Entire treatment under one Roof. 3.Dealing with patient with empathy and care. 4.Indiviualized treatment . 5.Team approach with core being the patient. 6.IVF Lab strictly as per international standards. 7.In house embryologist. 8.Availability and accessibility to clinician. 9.A perfect amicable atmosphere brimming with positivity. 10.Honest opinions unbiased by materialistic gains.

OUR FACILITIES • Intrauterine Innsemination(IUI) • In Vitro Fertilization(IVF) • Intra Cytoplasmic Sperm Injection(ICSI) • Surgical Sperm Retrieval(TESA/PESA) • Frozen Embryo Transfer(FET) • Blastocyst (D-5) Transfer • Assisted Hatching Donor & Surrogacy : • Donor Egg/Oocyte • Donor Sperm • Embryo Donation • Surrogacy Vitrification : • Embryo Freezing • Sperm freezing • Egg/Oocyte Freezing Start up Female Infertility Treatment : • Pelvic Ultra Sonography • Tube Patency Test • Follicular Monitoring • Hormonal Test Start up Male Infertility Treatment : • Semen Analysis • Hormonal Assay • Sub Fertility Treatment

MYTHS & FACTS

ples to hear. First it suggests that adoption is only a means to an end, not an happy and successful end in itself. Second, it is simply not true. Studies reveal that the rate for achieving pregnancy after adopting is the same as for those who do not adopt. Myth: I shouldn’t take a month off from infertility treatment for any reason… I just know that this next month will be THE one. Fact: It is important periodically to reassess your treatment and your parenting goal. Continuity in treatment is important, but sometimes a break can provide needed rest and renewal for the next steps.

Myth: I’ll be labeled a ‘trouble maker’ if I ask too many questions Fact: The physician/patient team is important. You Myth: IVF is a costly treatment and for rich people Fact: False. Though it is expensive, the cost of IVF has need to be informed about what treatments are available. What is right for one couple may not be not increased much over the years. It is less than right for another, either physically, financially, or some other major procedures like heart surgery or emotionally. Don’t be afraid to ask questions of your joint replacement. doctor. A second opinion can be helpful. If needed, discuss this option with your physician. Myth: IVF is successful in all cases Fact: False, IVF is successful in up to 40% of cases. Success depends on a number of other factors like age of the female, cause of infertility, centre of expertise, biological and hormonal reasons, etc. Myth: IVF requires admission in the hospital Fact: False, it does not require overnight admission. It is, by and large, an out-patient treatment. Only the egg-collection procedure requires day-care admission. Myth: IVF always result in multiple pregnancies like twins or triplets Fact: Not true, the chances of twin pregnancies are there.But multiple embryo transfers are avoided to reduce risk ofhigh order pregnancies.

Myth: If I have taken oral contraceptive pills before, I will find it difficult to get pregnant later Fact: The use of oral contraceptive pills in the past to avoid pregnancy does not reduce the chance of getting pregnant in the future when the couple desires, as is commonly believed. Myth: Is IVF is my last option, if I don’t get pregnant in this cycle I will never get pregnant Fact: Is IVF the last option? is one of the effective ways of getting pregnant, however it is not the last option. Many couples get pregnant after an IVF attempt even spontaneously. Is IVF Myth: Undergoing a Laproscopy surgery will further worsen my infertility problems Fact: Laproscopy in infertility is a skilled procedure. It is very useful to diagnose and treat female infertility problems. There is spontaneous pregnancy rates upto 60 % in some cases.

Myth: IVFand ICSI babies have a high risk of birth defects and malformations Fact: Not true. Absolute risk of congenital malformations in babies of Assisted reproductive technique are very low. Generally in India IVF is decided at later Myth: I must confine myself to a certain fixed diet age of women,so age related risk of congenital malformations are there but it is nowhere related to IVF. plan to get pregnant and stay pregnant. Fact: There is too much emphasis given to dietary do’s and dont’s. People from all over the world, right Myth: IVF results are superior in winter than sumfrom Africa, Mongolia, Europe and Asia are getting mer. pregnant! They all have varied dietary patterns. It is Fact: Not true. IVF results depend on lab condiimportant to have a balanced nutritious diet. tions,age of women,quality of embryos and en-

dometrium.Nowadays the superior air purification system in lab make it unaffected by outside tempera- Myth: Bed rest is essential to get pregnant after IVF Fact: A woman should not undergo excessive physiture conditions and thus results are not affected. cal or mental stress after the procedure. Strict bed rest is not associated with increased pregnancy rates. Myth: If you adopt a baby you’ll get pregnant!! Fact: This is one of the most painful myths for cou-

YOUR JOURNEY AT PRAVI Every patient is given personal care and attention and treatment pattern varies from individual to individual . Enlisted below is a standard course of treatment in PRAVI . 1st visit : Initial consultation with or without USG and investigations and /or semen analysis. 2nd visit : Transvaginal Scan and initation of hormonal injections.(Day22 of menstrual cycle or day2/3 of menstrual cycle) 3rd visit : Assessment of follicular growth by Transvaginal Scan and Blood hormones and hormonal injections 4th visit : Assessment of follicular growth by Transvaginal Scan and +/blood hormones and hormonal injections plus a preanaesthetic check up by anaesthetist. 5th visit : Assessment of follicular growth by TVS USG and hormonal injections +/-semen freezing depending upon semen parameters . 6th visit : Transvaginal USG to assess follicular growth and blood hormones and give final hormonal injections. 7th visit : Egg collection under General Anesthesia.(patient to come fasting) 8th visit : Embryo transfer under Tansabdominal USG guidance after discussion with embryologist about quality of embryos to be transferred and/or to be frozen. 9th visit : Pregnancy test. 10th visit : Pregnancy scan. Follow up consultation or early pregnancy care.

Pravi iVF & Fertility Centre 113/121, Near Raj Ratan Saree, In Front of Chhatrapati Shivaji Dwar, Nadri Corner, Swaroop Nagar, Kanpur - 208 002. dr. rit shukla ScientiďŹ c Director +91 - 9990134194 new Patient enquiry +91 - 8417084446 +91 - 8417084447 website: www.praviivf.in

Follow uP Patient +91 - 8826027898 +91 - 9990134194 0512- 2555333 e-mail ritshukla@gmail.com, info@praviivf.in

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we care for your dreams

XENITH ADVANCED FERTILITY CENTRE, Pune

DR MAMTA DIGHE MD, DNB, FCPS, DGO, FNB Infertility Specialist

MEET DR MAMTA DIGHE MD, DNB, FCPS, DGO, FNB

What level of treatment can a patient expect at Xenith? It is a tertiary IVF center so provide all types of infertility treatment. Apart from IVF we provide IUI, ICSI, egg donation, Embryo Donation, Gestational Carriers & Surrogacy, Blastocyst Transfer, Fertility Enhancing Surgeries, Sperm & Embryo Freezing & Nutrition Program. We do quality control and maintenance of our lab at every six months.

Can you tell us about your educational qualifications? I did my MD in Obstetrics & Gynecology from S.G.S Medical College in K.E.M Hospital, Mumbai in 1996 and my DNB , FCPS , DGO the same year. I also finished my fellowship in reproductive medicine by Delhi National Board and was among two or three candidates in India who completed this course, which is equivalent to the board certification required to practice reproductive medicine in USA or UK. After working in K.E.M Hospital and some other hospitals, I entered the field of infertility in 1999, when I started working with Dr Kamini Rao in Bangalore, who is one of the pioneers of IVF treatment in India. When & how did you enter the field of infertility? When I started working with Dr Rao in 1999, there were hardly any centers in India and very few doctors specialising in infertility. As a result people from all over India would come to our center for treatment. I saw the pain women go through when they are unable to conceive and that motivated me to enter this field. What are the risks associated with ART? At present there are only two risks - one is Ovarian Hyper stimulation Syndrome (OHSS) and the second is multiple pregnancies. But nowadays, with the change in protocol and availability of new drugs most of the clinics are OHSS free. Secondly, we shouldn’t transfer more than two embryos to prevent the risk of multiple pregnancies. Multiple pregnancies are always considered high risk.

sorting to more advanced treatments. Nowadays, we come across several patients who walk into our clinic just to know their fertility status. How difficult is ART from a patient’s perspective? I think the difficulty in ART is coping with the uncertainty of the result. Otherwise, I do not think ART is difficult because it doesn’t involve any major surgical procedures. With the introduction of newer injections, the patient can take these injections themselves. With introduction of patient friendly protocols all the procedures have become much easier. We have embryo preservation and with the help of that a patient doesn’t have to go through the stimulation cycles over and over again. What kind of dedication is required from a patient? Dedication is a two way thing. It is required from both doctor and patient. The connect between the two is crucial for getting favorable results. The patient has to follows directions diligently and have full faith on the doctor.

Can you share some cases which were a challenge to you? We have come across several challenging cases at our clinic. Recently, a woman came to us for treatment with very low ovarian reserve. She had gone through three IVF cycles at another clinic and every time they were unable to develop more than one embryo. After IVF treatment at our clinic, we were able to develop six excellent embryos which we transferred and she conWhat makes you different from other IVF centers? ceived. It was a challenge because it is not easy to get We are an exclusive and dedicated IVF center. Since I patients with low ovarian reserve pregnant. There was started my practice, I have focused only on fertility. We another patient who had undergone infertility treatare very focused in our approach and we evaluate ment for 8 years and even a surgery for correction of every patient very carefully. Secondly, we have special- her uterine septum. After the surgery, she had underized sub divisions for all categories of infertility. For ex- gone two IUIs and one IVF but failed to conceive. ample, if it is a male factor infertility we have an When she came to us, we found that the surgical corandrologist who will examine the male. We have a full rection of her uterine septum was not done properly. time embryologist and a well maintained IVF lab and We did the surgery again and made sure that the lining we provide personalised care to each patient. of the uterus developed well. After that we did an IUI and she conceived. When should one consult an infertility expert? It advisable for couples not to delay consulting an inHow do you relax after helping patients? fertility expert the moment they start thinking in terms After going home the feeling of work satisfaction helps of fertility. A specialist, who can give the best possible me in de-stressing myself. I like reading books, listenresults with the least possible intervention and, if reing to music, singing, meditation and am a trained quired, can provide advanced treatment in the best classical dancer, so I like dancing. Apart from that I like possible way. So, the earlier a couple consults an infer- spending time with my family. tility expert, faster they would get results without re-

Xenith Advanced Fertility Centre and Dr. Mamta Dighe, Medical Director of Xenith, Pune, India, has been honoured as the World's Greatest Brands and Leaders 20162017-chosen by Consumers and Industry during the 2017 Indo-UAE Business and Council forum, which was held at the Meydan Hotel in Dubai. She was recognised with the " World's Greatest Leaders" and the centre as "World's Greatest Brands". Over 100 brands and leaders were felicitated during the World's Greatest Brands and Leaders 2016-2017 Chosen by Consumers and Industry, which were reviewed by PricewaterhouseCooper PL. Following an intense research in the 15 categories, iconic, powerful and emerg-

ing brands and leaders were selected across Asia and the GCC along with an exclusive list of 'AsiaOne 50 Most Inﬂuential Indians Under 50'. On receiving the accolade, Dr. Mamta Dighe said:" I want to thank every person who has been along with me in this journey and helped our centre- Xenith reach the position it has today. Special thanks to my entire team, as it is the success of the team as a whole that helped us reach here. Thanks to all my family and friends, teachers and colleagues. Last but not the least a big thank you to all, my patients, for all the love and aﬀection showered back on us. As a team, we are committed to excellence and giving the best success rates in ART" A TEAM AND INFRASTRUCTURE TO ASSIST YOU AT EVERY STEP We provide an excellent infrastructure, robust experience, relevant procedures and treatments at our IVF centre. We cater complete infertility treatments under one roof and are definitely the best infertility specialist in Pune. The team of experts is always there for you at Xenith IVF clinic. This team is closely associated with IVF Pune, a specialized associated reproductive unit.

INFERTILITY...NOT A CONCERN ANY MORE In today's world, conceiving a baby has moved beyond just being nature’s phenomenon. Busy schedules and growing stress ratios have affected many aspiring couples, making this natural process feel more complex and intense. Being an advanced fertility centre in Pune we understand your concerns, your feelings and also have the expertise and solutions to fulfill your dreams. We partner with you in your journey to parenthood, with our core expertise clubbed with utmost care. PHILOSOPHY & GOALS Our mission is to resolve fertility problems in the right way for each individual patient. We believe in a conservative clinical approach that aims to minimize medical & surgical intervention & maximize the chance of pregnancy, by offering optimum infertility treatment & options. We support couples in creating their families.

WHY XENITH? At XENITH we are here for you and are aware that every couple desires children and we ensure that when a couple visits our infertility clinic we serve them the best and continue completing our odyssey under the guidance of one of the best infertility doctor in Pune. XENITH is well established and equipped with the latest diagnostic and therapeutic equipmentâ&#x20AC;&#x2122;s. We endeavor to provide a great experience and best treatment to each couple who comes to us with an expectation, to acquire the bliss of parenthood. We are eternally dedicated in helping couples from the various parts of India facing the issue of infertility and Xenith has been conceived of this with the goal of being best IVF centre in Pune.

Q&A What is ‘Unexplained Infertility’ ? A couple is given the diagnosis of unexplained infertility when they suffer from infertility but the diagnostic workup fails to find any reasonable cause of the condition. Unexplained infertility is essentially a negative diagnosis; in other words, the clinical team knows there is a problem but the cause remains unknown. Even with the availability of a number of fertility diagnostics, unexplained infertility is very common. Upwards of 30% of couples seeking fertility care are labeled with unexplained infertility.

UNDERSTANDING INFERTILITY INFERTILITY is the inability to conceive after one year of unprotected intercourse. Women who are able to get pregnant but then have repeated miscarriages are also said to be sub fertile. Infertility is classified as primary or secondary, depending on previous history of pregnancy. Primary Infertility: Primary infertility is defined as a couple who has never been pregnant. Secondary Infertility: Describes a couple who are having trouble conceiving again, even though they have previously achieved pregnancy. Traditionally, couples sought evaluation after trying to conceive for one year. However, many couples are now postponing parenthood until they are older, so it is suggested that couples seek evaluation earlier if they have any concerns about their fertility. In fact at Xenith we believe that every couple desirous of fertility should have a preconception counselling and evaluation to ascertain their individual fertility potential. There are various factors which may decrease fertility independent of age. Knowing about them early and treating them will give a much better fertility outcome. TESTING & DIAGNOSIS There are a number of diagnostic tools available to help pinpoint the cause of infertility. After a couple has undergone evaluation through a comprehensive physical exam and medical history, a fertility doctor

will recommend specific diagnostic tests.Before having infertility testing, be aware of the commitment that's required. Your doctor or clinic will need to determine what your sexual habits are and may make recommendations about changing them. Tests and treatment trial periods may extend over several months. In some infertile couples, no specific cause is found (unexplained infertility).Evaluation can be expensive and in some cases involves uncomfortable procedures. Many medical plans may not reimburse the cost of fertility treatment. Finally, there's no guarantee — even after all the testing and counselling — that conception will occur The fertility specialists at Xenith Advanced Fertility center perform both male and female infertility diagnosis and testing. In very broad terms, fertility diagnosis starts with attempting to determine the impact of several major factors for the male and female partners with testing and diagnosis.

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WE USE OUR PROFICIENCY TO CARVE YOUR TREATMENTS Often the couples are shocked and into the mode of disbelief when detected with infertility. At the beginning of this phase they are presented with the information that they were unaware of before. They get introduced to new medical terms, recommendations for different tests and treatments that are completely unfamiliar to them. At XENITH, known as one of the best IVF centre in Pune, we focus on building a strong relationship with patients. We understand this can be made possible only when patients are well aware of the situation and treatments that are planned ahead. We believe in providing patients with a homely atmosphere which supports trust and mutual respect and where maintaining open and transparent relationship gets a higher priority. Being a dedicated fertility centre we guide patients carefully and precisely with infertility treatment, taking into account the individual need of patients. SERVICES • IUI • IVF • ICSI • Blastocyst Transfer • Egg Donation • Embryo Donation • Donor Sperm Program • Gestational Carriers & Surrogacy • Sperm & Embryo Freezing • Fertility Preservation/Egg Freezing • Counseling

• Fertility Enhancing Surgeries • Male Infertility Treatment • Nutrition Program

How does age affect a woman's ability to have children? More and more women are waiting until their 30s and 40s to have children. So age is an increasingly common cause of fertility problems. About one-third of couples in which the woman is over 35 have fertility problems. Aging decreases a woman's chances of having a baby in the following ways: • The ability of a woman's ovaries to release eggs ready for fertilization declines with age. • The health of a woman's eggs declines with age. • As a woman ages she is more likely to have health problems that can interfere with fertility. • As a women ages, her risk of having a miscarriage increases. What increases a man's risk of infertility? The number and quality of a man's sperm can be affected by his overall health and lifestyle. Some things that may reduce sperm number and/or quality include: • Alcohol • Drugs • Environmental toxins, including pesticides and lead • Smoking cigarettes • Health problems • Medicines • Radiation treatment and chemotherapy for cancer • Age

OUR EXPERTS MENTOR YOU TOWARDS WELLNESS At XENITH a fertility clinic in Pune, we consider the necessity of healthcare needs by women of all ages, whether it is at the beginning of her bloom or at very old age. We intend to provide solutions with precision for each and every dilemma or problem under one roof. A variety of counseling and accurate treatments are served to the patients by the experts with deep ingenuity in the field of Gynaecology, as apart from being an infertility centre we also specialize all reproductive problems of woman. • Hormone Problems • Breast Clinic • Premarital Counseling • Fertility Counseling • Menstrual Problems • Well Woman Check Up • Contraception Advice • Cervical Cancer Vaccination • Multiload / CUT / Mirena Insertion • Pap Smear & Cervical Cancer Screening • Adolescent Clinic

OUR PRICELESS ATTRIBUTES • 14 + Years of Success • Personalized Solutions • Patient Support workshops • Priceless Parenthood • Advanced IVF Laborotary • Unmatched Excellence • Complete Fertility Care

Dr Dighe received an award at the hands of Amar Singh, MP and Cricketer Sandip Patil in Delhi as a part of Global Excellence Health Care Awards 2016. Our centre was awarded ' The Most Emerging IVF Centre in Maharashtra.' Global Excellence Healthcare Awards are given nationally by Prime Time which is a partner channel of NDTV."

Xenith Advanced Fertility Centre Oﬃce nos. 307,8,9, 3rd ﬂoor, Wing B, GO Square, Kaspte Chowk, Wakad, Pune- 411057 Phone: 020-65001220 / +91-9130037780 email: info@xenith.clinic website: www.xenith.clinic