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"Santhathi" offers full rangeof modern
diagnostic tests directed at finding the causes of infertility.
The tests are as follows:
- Comprehensive Semen Analysis.
- Hormone Assays
- Doppler and Transvaginal Ultrasound.
- Hystero-salpingogram
- Hysteroscopy & Laparoscopy
- Chromosome Analysis
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1. Comprehensive Semen Analysis:
The examination of Semen sample of the male partners under
a microscope gives valuable information regarding the
presence of any male factor that may be responsible for
the subfertility. A simple evaluation is first carried
on and if any problems are discovered detail examination
such as Sperm function tests are done.
If Semen parameters are normal,no more tests are needed
for the male partner.
If abnormal, other tests such as Hormonal Assay, Testicular
Ultrasound and Doppler Examination are performed. |
2. Hormone Assays:
A sample of the blood is analyzed to check reproductive
as well as other endocrine systems. This is a useful test
both in male and female partners. |
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3. Doppler and Transvaginal Ultrasound:
Ultrasound scanning of various parts of the body is
a Revolutionary test in medicine. In the female partner
the recently introduced method of Transvaginal Ultrasound
scan gives valuable information about the uterus, ovaries
and ovulation. In the male partner, testicular ultrasound
and Doppler examination are done to find out any problems
in the testicular environment.
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4. Hystero-salpingogram (H.S.G):
This is a time proven simple out-patient x-ray test to
check the uterus and its fallopian tubes. It is also enhanced
by Hysteroscopy and Laparoscopy which give additional
information. |
5. Hysteroscopy and Laparoscopy:
These are the so called "keyhole" surgeries which have
become very common in the evaluation of the female reproductive
organs. They give near total information about the health
of these organs.
Laparoscopy involves a minor operation where in a telescope
is used to check the abdomen and pelvic organs. This is
the best method of checking whether the uterine tubes
are normal
Hysteroscopy is a similar telescopic viewing of the inside
of the uterus. It is now possible to perform this in an
out patient setup. |
| 6. Chromosome Analysis: Genetic make-up
of an individual has effects on certain illnesses. A small
percentage of infertility cases, especially male infertility,
may be caused by genetic abnormalities. This can be found
out by Chromosome Anaysis from a blood sample of the individual
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1st Step
Both Partners
History Clinical Examination.
Male Partner
Semen analysis.
Female Partner
Ultrasound Examination . |
2nd Step
Male Partner
If the semen analysis is normal no further tests are necessary.
If there is a problem in the semen, Hormone assays, ultrasound(
Doppler ) of testes and more detailed tests on the semen
are performed.
Female Partner
If ultrasound examination shows normal anatomy and ovulation,
fallopian tubal patency test is done by X ray ( Hystero
- salpingogram) or Laparoscopy and Hysteroscopy. |
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:: Treatment
Facilities /Methods :: |
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"Santhathi" is equipped to provide all types
of modern treatments for couple with infertility.
Counselling
Ovulation Induction
Sperm Bank
Endoscopic Surgery
Assisted Reproductive Techniques (ART's). |
a) Counselling:
Fertility Genetic Pre pregnancy Counseling, where in the
patient is given explanation about the tests, treatment
and their implication, is an important part of modern
health-care. It is especially important in infertility
management where unawareness is a major factor. It is
stated that up to one fourth of couples achieve pregnancy
with counseling only. Our centre also offers counseling
for genetic problems, sexual health and pre-conceptional
advice. |
b) Ovulation Induction:
This is done when ovulation is defective or as a part
of an "ART"(Assisted Reproductive Techniques) treatment.
It involves giving medicines and hormones under Transvaginal
ultrasound guidance to achieve the desired number of eggs
to grow and get released. It is very important that this
treatment is carried out under the guidance of an experienced
clinician. |
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c) Sperm Bank:
Semen can be frozen and stored in a special environment
for a long duration. The semen from fully screened individuals
is used in the sperm bank. This is used for the donor
insemination treatment after complete matching of the
donor with recipient This is necessary when there is
no possibility of finding any sperms in the male partner.
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d) Endoscopic Surgery:
The laparoscope and Hysteroscope can be used to perform
various operations on the uterus, Tubes and ovaries. This
has many advantages over conventional surgery especially
in the treatment of Infertility. |
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e) Assisted Reproductive Techniques(ART's):
These are procedures aimed at "Assisting" conception.
These range from simple treatments such as IUI ( Intra
Uterine Insemination) to highly sophisticated ' Test
Tube Baby'(IVF-ET) techniques and ICSI(Intra Cytoplasmic
Sperm Injection) etc.
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IUI(Intra Uterine Insemination):
This is a simple procedure where in a small amount of
' washed 'sperms are kept in the patients womb at the
time of ovulation.
GIFT(Gamete Intra Fallopian Transfer): This involves
a minor operation where in eggs collected from the ovary
are mixed with sperms and placed in the uterine tube by
Laparoscopy.
IVF & ET (In Vitro Fertilization & embryo Transfer):
This is so called 'Test Tube Baby' treatment. This was
pioneered by Streptoe and Edwards and the first IVF baby
( In Vitro Fertilization ) - Louise Brown - was born in
1978 since then hundreds of thousands of babies have been
born, all over the world, from this technique. Medicine
is given to the women to grow many eggs which are then
collected by a minor operation. They are then mixed with
sperms in a'Test Tube' in a highly specialized laboratory.
The fertilized eggs( Embryos ) are placed in the womb
2 - 5 days later.
ICSI (Intra Cytoplasmic Sperm Injection):
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(Fig .Inverted Microscope with MicroManipulator) |
This is a variant of 'Test Tube Baby' treatment. It is
useful when the number of sperms available from the male
partner are too few to perform IVF(In Vitro Fertilization).
This revolutionary method of fertility treatment was pioneered
in Belgium in 1993. Here each egg is injected with a sperm
using micro-injection techniques to achieve an Embryo
and placed in the womb as in IVF.
Stages of ICSI (Test Tube baby):
| ICSI stage1 |
ICSI stage2 |
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| Zygote stage3 |
Embryo stage4 |
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Sperm Aspiration Techniques: When no sperms are
found in the semen(Azoospermia) but sperms are being produced
in the Testes they are collected by a small operation
& Sperms are used for ICSI( Intra Cytoplasmic Sperm Injection).
The various techniques are as follows:-
TESE(Testicular Spermextraction/Aspiration)
PESA(Percutaneous Epidydimal Sperm Aspiration)
MESA(Microsurgical Epidydimal Sperm Aspiration)
Embryo and egg sharing: In women with low response
to ovulation induction drugs, the egg or Embryo sharing
with another women is recommended to have viable and compatible
Embryo to achieve a pregnancy.
Egg and Embryo Donation: This is another means
of helping couple who do not have the capacity to produce
eggs or sperms. A donor offers her/his eggs/sperms to
the couple after complete matching.
Surrogacy: In women who do not have a uterus that
can hold a pregnancy, another woman's womb can be used
to carry the pregnancy. In simple terms, the Embryo formed
from the egg and sperm of one couple develops in another
woman's womb.
Assisted Hatching: In this technology the embryo
is treated with chemical or laser to make a small hole
on the Zona pellucida to enhance the implantation potential
to help achieve pregnancy.
P.G.D(Pre-implanation Genetic Diagnosis): This
technique can diagnose any genetic or cytogenetic defect
at the Embryonic stage itself. Till 8-16 cell stage, each
blastomere ( cell ) is totipotent and carries total genome(
chromosomes). These cells can be separated by " embryo
biopsy " and used to reveal the genetic make up of the
embryo. The defective embryos will not be transferred
to the uterus, thus avoiding the birth of any genetically
defective child.
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f) Adoption:
When all the above techniques fail, the last alternative
is adoption. A child can be adopted according to
the legal formalities of the Institution and the
country. |
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Cost :: |
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| The myth all over the world is that infertility
treatment is expensive. However, the fact is that though
high-tech treatment is not cheap(up to Rs.50,000) most
couple achieve pregnancy with minor treatment which may
cost Rs.2,000 - Rs.5,000). For further details Contact.
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