Fertility NEWS LETTER

Ideal fertility : ICSI / IVF & Genetic Center India

Dear Colleges
Hello

Hope the newsletter find you in good health and spirits.

The newsletter discusses success story in the field of assisted conception for reproduction technology. In earlier days there was no training available. We started the work on oocytes and animal sperm obtained from slaughter.

Today by grace of the almighty many singles and twins are born using test tube baby techniques at the clinic.

We are try to avoid to get multiple pregnancies, but as the IVF procedures are not funded by any agencies, the aim of pregnancy is of utmost importance. The transfer of multiple embryos is frequent occurrence.

The culture media are now state of art technology based and with fertility expertise it leads to better implantation rate.

I wish state that Azoospermia is not untreatable.

With warm regards
Dr. D’Pankar Banerji

1. Our first IVF triplet and 25th Twins delivery by IVF and ICSI method

We wish to share our joy to achieve the First IVF/ICSI triplet babies and 25th twin delivery .

First about the triplets:

This couple from Narsingpur was married 9 yrs back, and trying for pregnancy since then. The female partner is having distorted fallopian tubes and husband is having moderate oligoastheno zoospermia.
Female is 31 yrs old and having regular periods with good ovarian reserve.

She was down regulated and the her ovaries were stimulated in controlled fashion. After oocyte retrieval ,all the oocytes were denuded and then intracytoplasmic single sperm injection (ICSI)was done by Dr .Mrs. Rinku Banerji, center’s embryologist and pathologist on the same day.

On day three post fertilization, two good quality( Grade I) and two moderate quality embryos (Grade II) were transferred under ultrasound guidance on 30th September 2007 Pregnancy test was positive after 14 days of embryo transfer.

Sonography scan was done after 10 days and found three sacs in the uterine cavity.
Regular antenatal check up were done .

On 16th July 2008 ,patient delivered two male and one female child by cesarean section. Female child weighing 1600 gms, boys weighing 1750 and 2000 gms respectively ,cry immediate and with good Apgar score
After one month all the kids are doing well.

Regarding 25th Twins: This couple is from Durg and had 6ys of infertility , Female is 29yrs and male is 35 yrs. Indication of IVF was tubal damage.

2. Azoospermia : Couple get twin pregnancy by PESA-ICSI-IVF

Azoopsepermia are of three types ,pretesticular,testicular and post testicular. In these variety the testicular is difficult to get any sperms while doing the aspiration. Post testicular Azoospermia is usually due to blockage in the vas deference or total absence of vas ,a congenital defect.

A couple attended our center ,husband with azoopsermia. The azoopspermia was worked out and found to be post testicular .

Wife ,Vineeta age 28 yrs, the periods were regular. Injection Luprolide acetate 1 mg s/c per day started in the midluteal phase. The injection continued till she gets the next period. After finishing the period, she was examined to assess the down regulation. Down regulation was confirmed by ultrasound alone . The criteria were, endometrium less than 2 mm and there is no follicle more than 2mm in size.

Ovarian stimulation was started along with Inj luprofact with urinary highly purified FSH 300 IU per day for three days. From day4 Injection HMG started 300 IU per day.
Injection HCG 10000 IU injected when lead follicles reached 17 mm diameter.
After 36 hours oocyte retrieval was done under inj.propophol. 9 good quality oocytes retrieved .

After egg pickup, husband(Deepak age 32Yrs.) was taken for sperm aspiration. Local anesthestheic injected in spermatic cord. 17 gauge needle inserted in the epididymis and suction with 10 ml syringe applied . Small amount of fluid came out and examined under inverted microscope . There were 3-4 motile sperms present per high power field.

All the oocytes were denuded with hylase and 6 were in MII stage . ICSI was done after 2 hours of denudation .
On next day all the six oocyte shows 2 PN . Out of this 4 were of ZP1.

On Day 3, good 8-10 cell embryos developed from the 4 ZP1 fertilized oocytes.

Embryo transfer was done under ultrasound guide with Cook ET catheter. Four embryos were transferred.
Luteal support was give as usual .

Urine pregnancy test was done after 14 days of transfer and was positive.

After 15 days ( 27th May 2008)we did an ultrasound and there was three sacs present with fetal pole .
27th June : Three alive fetuses

After one month : repeat USG revealed that one baby was absorbed and without any heart activity

Conclusion : Azoospermia is treatable condition most of the time and especially the obstructive one where the chances are good to retrieve sperms and get a pregnancy too.

Services and there rates at Ideal Fertility :

ICSI –IVF one cycle ------------------------------------------ Rs. 80,000

IVF, one cycle---------------------------------------------------Rs. 70,000

Couples with female’s age less than 30 yrs and with regular cycles :
IVF : Rs. 50,000 and ICSI : Rs. 60,000

Females who has a good ovarian reserve and wish to share her eggs :
IVF : Rs. 40,000 and ICSI : Rs. 50,000

These rate are inclusive of all ,no hidden charges
Combined fetal monitoring with color Doppler and non stress test ( NST) : Rs. 2,000.

Figure 2 : First IVF triplets