It is inability to conceive after 1 year of unprotected intercourse.

If you are trying to conceive for an year or more you should see a doctor to evaluate the problem.

If you are 35 yrs or older ,the infertility evaluation should begin after 6 months of unprotected intercourse, Even in cases of known or suspected underlying problem earlier guidance ,care & treatment may be required.

History of irregular cycles, excessive bleeding ,presence of cysts or myomas on ultrasonography ,presence of cysts or myomas on ultrasonography, or history of any pelvic surgery in past.

First of all, one should   not   hesitate   to see a doctor or centre where you are comfortable. The first should be with your partner mandatorily because subfertility is to be dealt as a couple.

Yes, you can eat and drink prior to the embryo transfer procedure. In fact, you are asked to drink at least 1 litre of water before arriving at Centre and to keep your bladder full to enable a better view of the uterus during the ultrasound-guided procedure.

During the embryo transfer process, you can watch the entire procedure on the ultrasound machine. The machine is positioned at an angle so that you can easily watch the process. You can see the embryos being slowly released into your womb through a plastic catheter. The embryologist then double checks the catheter under the microscope to ensure that all embryos have been transferred.

Yes. Secondary infertility is the name given when the problem arises in a couple who have been able to get pregnant in the past. Sometimes a new factor, such as an infection, has damaged the reproductive organs since the last child was born. Sometimes the aging process makes it more difficult for a couple to conceive, even if they had no problems when they were younger.Secondary infertility is even more common than infertility in couples who have never achieved a pregnancy.

Generally, the diagnosis and treatment is the same. However, couples with secondary infertility may make different treatment choices as they take into account the needs of their other children. Overall, treatments are somewhat more likely to work in women with secondary infertility than in women who have not previously become pregnant with the same partner.Couples with secondary infertility may wish to seek emotional support specifically geared to their concerns. These couples often report that they feel caught between two worlds. They feel alienated from those who easily create families of the size they want, while at the same time they are envied by childless people with infertility.

With advancing age, the quality as well as the quantity of the eggs significantly reduce. A woman is born with all of the eggs she will ever produce, whereas men, in spite of advancing age, can keep producing sperm. Although it must be noted, sperm quality also decreases as men age, even though it can be continually be produced and so it must not be assumed that men will always produce good quality sperm forever more. As a result of such a phenomenon, women face more fertility issues in their early and late 30s. Moreover, women in their 40s are more likely to face fertility problems and might require assistance for the same

Infertility in men can be caused by different factors and is typically evaluated by a semen analysis. When a semen analysis is performed, the number of sperm (concentration), motility (movement), and morphology (shape) are assessed by a specialist. A slightly abnormal semen analysis does not mean that a man is necessarily infertile. Instead, a semen analysis helps determine if and how male factors are contributing to infertility.

In the past, infertility was commonly considered to be solely a female problem. It is now recognized that a couple’s infertility is just as likely to stem from problems in the male partner. After couples with infertility undergo testing, about 40 percent of the cases are found to stem from female factors and another 40 percent from male factors    In 10 percent of couples, infertility factors are found in both the man and woman. In the remaining 10 percent, the infertility remains unexplained after testing. Because either or both may be involved, it is important to test both the man and woman before starting treatment. No matter what the cause, most treatments require the active participation of both partners.

However well-intentioned, the statement “just relax and you’ll get pregnant” has been very hurtful to couples with infertility. Two decades ago, researchers thought that almost half of infertility in women could be attributed to stress and psychological factors. Nowadays infertility is better understood, and stress is recognized primarily as a result, rather than a cause, of fertility problems. However, there is evidence that stress can have a negative impact on sperm and egg production. Research is ongoing to help understand how stress may influence fertility and the success of treatment.

The entire embryo transfer process takes around 15 minutes. Sedation or anesthesia is not required as it is generally not a painful procedure. Some women may feel some discomfort during the insertion of speculum but many report that it isn’t too different to having a smear test. If you would prefer, Team Miracle can arrange for you to have sedation during embryo transfer to make you feel more comfortable.

Most doctors advise you not to be concerned unless you have been trying to conceive – not using birth control and having regular intercourse around the time of ovulation – for at least a year.

Women with certain symptoms or previous medical conditions may wish to seek medical advice earlier .Some symptoms or prior conditions make fertility problems more likely, and others may indicate a medical condition that needs treatment for other reasons. Seek medical advice

 if You have lots of pain during your menstrual period or during intercourse.

You have an abnormal menstrual cycle (less than 21 or more than 35 days from the first day of one cycle to the first day of the next).

You are troubled by acne or excess facial or body hair.

You have had pelvic inflammatory disease (PID), an infection in the reproductive organs, usually the fallopian tubes.You have had surgery on your reproductive organs, such as a cone biopsy of the cervix.

You have had more than one miscarriage.Your partner has an abnormal sperm analysis.

AIIM welcomes the couple who have problems in conception with the best fertility solutions. The detailed history is taken & all previous medical records are checked. Care is taken to discuss the emotional stress related to the problem of subfertility with the counsellors & the consultant. The couple is also seen by our dietician as well as physiotherapist for any life style modifications to be executed to maximize your chances of having a healthy pregnancy.

Physical examination along with a fertility scan is done in order to assess basic problems. After this the fertility specialists Dr Shefali Jain & Dr Dinesh Jain discuss the problems in details. Adequate time is given to each couple to make them understand their problems & suggest the best fertility option

Basically the problem may be in the male or female or both the partners. Apart from this group 12-20% of couples may reveal a normal report & still unable to conceive  who are labelled as unexplained subfertility. Thus the basic tests which are suggested & planned are mainly to rule out  the problems in either of the partner.

Semen analysis is the basic test to rule out a male factor broadly. Next a woman is assessed if she is ovulating normally or not? Still if the couple is unable to conceive tubal patency tests are performed by HSG (An X Ray) or Laparoscopy (Telescopic examination).

1. You will be provided a sterile container available at AIIM nursing station.

2. Urinate before giving the semen sample.

3. Remove your watch, ring, & fold sleeves up to the elbow, wash & dry hands, do not use handkerchief or towel to wipe off.

4. The specimen should be collected by Masturbation after at least 3 days to maximum 7 days of abstinence.

5. Do not use oil, saliva or lubricant.

6. Usually, sperm collection should be done at the centre but in case of any inconvenience sperms can be collected at home in the container provided by our lab, but the sample has to be given for analysis within half an hour in the lab.

7. In case if you are not able to give the sample, you may be accompanied by your wife in the collection room.

8. Still, if it does not become possible, do not panic but report to the concerned staff.

9. Be Careful of hygiene, don’t open /close the container with wet hands.

10. After collection meets with the lab in charge before leaving the centre.

11. In case of any inconvenience please let us know.

In order to understand fertility tests and treatments that are offered, it is very important to understand how natural pregnancy occurs.

Immediately after the commencement of menstruation, the ovary starts forming an egg. This egg gradually matures inside the ovary & on a particular day of menses it is released (Ovulation).The egg must be picked up by the fallopian tube. At intercourse the sperms are discharged in vagina from where they travel to the uterus to reach in the fallopian tube in order to fertilize the egg. Fertilization takes place in the fallopian tube. This fertilized egg which is now called the embryo reaches the uterus   while it gets implant in the lining (endometrium) .Any problem in this process may lead to infertility.

THE AGE FACTOR

For women, your age remains THE most important factor affecting your ability to have a child.

As we age, our fertility naturally declines. The decline starts for a woman in her early 30s, with the biggest decrease occurring after 35 years of age. This is because a woman is born with a finite amount of eggs in her ovaries and these diminish over time in both quantity and quality.  The remaining cases of female infertility are linked to other conditions including anatomical problems and hormone imbalances.

HORMONAL

Having a hormonal Imbalance is one of the leading causes of female infertility as it can affect your ability to ovulate – which leads to infrequent or no ovulation.  Other examples are hypothyroidism (low thyroid function), hyperprolactinemia (high male hormone levels) and luteal phase defect (low progesterone levels).

OVARIAN

Having an ovarian disorder means that you ovulate infrequently or not at all. Polycystic Ovarian Syndrome (PCOS) , Hyperprolactinemia: If prolactin levels are high, and the woman is not pregnant or breastfeeding, it may affect ovulation and fertility, Poor egg quality (Eggs that are damaged or develop genetic abnormalities cannot sustain a pregnancy. The older a woman is, the higher the risk).

UTERINE

Having a known or being diagnosed with a uterine abnormality usually means that you are likely to suffer from conditions such as fibroids, polyps or endometriosis which can lead to scar tissue or adhesions, even after these have been previously treated.

TUBAL

Scarring or adhesions in the fallopian tubes, results from a previous surgery or possibly an infection, such Chlamydia, Appendicitis or IBS can cause tubal blockages.

CERVICAL

Sometimes antibodies are found in a woman’s cervical mucus which can actually go on the attack, killing the sperm before it even has a chance to make it to an awaiting egg. This is known as Cervical Hostility and can be caused by an infection in the lower reproductive tract or from an overly acidic diet.

SPERM ABNORMALITIES

  • A low sperm count, poor sperm motility or abnormally shaped sperm can reduce your ability to fertilise an egg.
  • Low sperm count is evident in cases where a man has fewer than 15 million sperm per millilitre of semen.
  • Sperm motility is the ability of the sperm to move (or swim) progressively forward to fertilise an egg.
  • Abnormally sized or shaped sperm can affect the ability of the sperm to reach and fertilise an egg.
  • Sperm DNA fragmentation.

HORMONAL CAUSES

If you have a condition which has lowered your Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels, this can result in low or no sperm production and low blood testosterone levels.

ANATOMICAL CAUSES

Any trauma, illness, infections and subsequent treatment, including surgery may have damaged or blocked either the testes – in which sperm and the male sex hormones are produced, the tubes – through which the semen is delivered (vas deferens), or other primary structures within the male anatomy which can affect fertility.

GENETIC CAUSES

Many inherited (genetic) diseases can cause low or no sperm production e.g. Klinefelter’s Syndrome.

MEDICATION AND DRUGS

Some prescription drugs can reduce your chances of conceiving, so if you are taking regular medication, speak to your doctor about suitable alternatives. The use of recreational drugs should be completely avoided.

AGE

To a lesser extent than female fertility, male fertility can also decline with age and this may impact time to pregnancy, risk of miscarriage and the overall health of your child. If you or your partner  have been diagnosed with sperm/semen abnormalities, or anatomical, hormonal or genetic issues, there are several options for treatment available.