What is Infertility?

Couples at a certain point in time have the desire to conceive. Many studies have found that almost 85% of the couples successfully conceive within one year of trying. However, if they fail to conceive even after trying every method, there are chances that they might be suffering from infertility. Infertility is the inability to conceive within one year. Even if the couples fail to conceive within one year, then it is better to consult any reproductive endocrinologist. They must know the right time to take the help of any gynecologist to determine symptoms of infertility.

Everything You Need to Know About Infertility

What are the symptoms of infertility?

Infertility issues are common in both men and women. When it comes to women, irregular periods or even painful and heavy periods are one of the common symptoms. Normally, cycles are of 28 days, which may or may not exceed.

It is one of the common infertility symptoms in females since irregular cycles are a sign of PCOS, which is associated with infertility. When it comes to infertility in symptoms in men, include low sexual desire, swelling in testicles. Apart from that, issues with maintaining an erection as well as ejaculation problems can also lead to infertility.

Types of infertility

Infertility primarily involves two different types of infertility issues. First, the primary fertility stage refers to those couples who could not conceive after one year. They never use any birth control methods. However, the secondary infertility couples are those who conceived in the past once.

But, the female cannot conceive anymore now. Even after planning everything carefully, the female could not conceive. Secondary infertility type precisely means that the woman is spontaneously facing miscarriage or stillbirths.

What are the causes of infertility?

Infertility causes can affect both men and women. From an unhealthy lifestyle to pre-existing diseases, everything is responsible, that causes infertility. Proper diagnosis is necessary for required treatments.

Male Infertility Causes

Men having abnormal sperm production, genetic defects, or even pre-existing health conditions can cause infertility. Diseases like diabetes, mumps, and STI like HIV or gonorrhea can cause abnormal sperm production rate. Premature ejaculation, genetic ailments like cystic fibrosis, and various psychological problems can even lead to infertility issues.

Few secondary infertility causes in males include overexposure to pesticides as well as other chemicals. Overconsumption of tobacco, alcohol, or other recreational drugs can lead to infertility. Physical injuries in reproductive organs can also lead to infertility issues in men.

Female infertility Causes

Women having impaired ovulation due to excessive eating, injury, hormonal imbalance severely affects egg release. Hormonal imbalance such as PCOS, hypothyroidism, hyperprolactinemia can lead to infertility. Deformed cervix opening, fibroids, and uterine polyp are some of the serious causes of infertility.

Blocked Fallopian tube due to inflammation is yet another one of the major issues behind infertility causes in women. Unwanted growth of endometriosis cells surrounding the uterus can also cause infertility. Pelvic adhesions are quite dangerous for fertility. Band scar tissue binding organs or abdominal surgery can give rise to infertility issues. Some women believe that Meftal Spas are the reason for their fertility, but this is not true. Meftal Spas are not the cause of infertility.

Complications of infertility treatment

Although various infertility treatment is quite effective as it helps those couples suffering from pregnancy failures. It has many complications as well, which not only turn out to be acute but also may run for longer periods. Acute complications that arise are related to ovulation induction or oocyte retrieval.

These are some of the short-term complications and do not last long. Whereas, the long-term complications include high chances related to pregnancy complications, mostly imprinting disorders in the newborn, etc. Chances of complications are although high but in most cases, the treatments turn out to be successful.


Before your doctor asks you to take the infertility tests, they will ask you certain questions to get an idea of your sexual habits. They will also give you recommendations on how you can improve your fertility so that it becomes easy to conceive. In many cases, couples do not show any specific causes behind infertility, also known as unexplained infertility.

When it comes to the diagnosis of infertility, tests can be expensive. In many cases, the tests involve uncomfortable procedures. At times, the medical plans might even not cover the infertility diagnosis costs. Also, it is not guaranteed that you will get pregnant even after taking all the tests.

Treatment Options For Infertility

Infertility tests for men

Male infertility tests are done to check whether the testicles are in the right condition to produce healthy sperm. Apart from that, the ejaculation is done effectively inside the vagina. Semen analysis is an effective test that helps in analyzing sperm quality. Hormone testing is also useful to determine whether the male is fertile enough. A blood test is best to check the testosterone levels. Genetic testing is also useful in detecting infertility when it comes to infertility tests for males. In this process, detection in any genetic defect causing infertility is detected.

Infertility tests for women

Whether a woman is fertile depends on the ovaries and if it releases healthy eggs. Therefore, infertility tests for a female are necessary. The reproductive tracks should not have any blockages and the eggs must move smoothly so that the sperm can fertilize. Ovulation testing is one such effective infertility test, which measures hormone levels to find out if the woman is ovulating.

Ovarian reserve testing is also quite useful since it helps in determining the egg quantity necessary for ovulation. Apart from this, another hormonal testing is also there like pituitary hormone checking, which helps in maintaining the reproductive processes.

Treatment & Care for infertility

Infertility treatment and care involve various processes. The primary processes include maintaining a healthy lifestyle like healthy eating and exercise. For maintaining fertility levels, it is important to maintain a healthy workout regimen along with good food habits excluding junkies. The secondary options include infertility treatments ranging from medicinal treatments to surgeries that help in increasing fertility levels, both in men and women.

Treatment Options for men

Changing lifestyle is one of the primary infertility treatments in males. Excluding particular medications, reducing the intake of harmful substances, increasing the timing of intercourse is quite useful. Next comes the medications since few medications are there that enhances the sperm count.

Medications are quite useful in increasing testicular functions like sperm production as well as quality. Surgery is also a good idea since it helps in reversing sperm blockage issues. Also, surgery helps in repairing varicocele that increases the chances for pregnancy.

Treatment Options for Women

The treatment options vary, while some women need one or two therapies for increasing fertility, others require multiple treatments to get pregnant. Primary infertility treatment in female includes ovulation medications that help in stimulating the ovulation procedure. These medicines either helps in regulating or inducing ovulation.

Most gynecologists discuss the fertility drug options with the patient and focus on how each medication will help in increasing fertility. IUI or Intrauterine Insemination is yet another useful treatment procedure where healthy sperms are placed inside the uterus during ovulation time. Surgeries are also useful as it helps in removing problems like endometrial polyps or any intrauterine scar tissue. Above everything, it is important to remember that infertility treatment cost varies.

Risk factors for infertility

Some of the common factors behind infertility in both men and women are age, weight, sexual history, smoking, etc. With age, both men and women lose the capability of conceiving. The reason behind this is the egg quality and quantity in women degrades, which affects fertility. The sperm count in men reduces too.

Similarly, smoking is also a risk factor as it damages the cervix as well as fallopian tubes. The chances of miscarriages also increase due to smoking. Overweight or obesity is yet another common problem that acts as a risk factor behind infertility in both men and women.

How to prevent infertility?

Preventing infertility requires maintaining a healthy lifestyle. From maintaining a healthy weight to avoiding alcohol and smoking, everything is important. Also, it is necessary to avoid stress since it is responsible for the infertility issue. Limiting caffeine is also necessary to avoid infertility issues. Both men and women must focus on maintaining a healthy lifestyle for a successful pregnancy.


Infertility Assessment

What is Infertility Assessment?


Infertility assessments include a variety of examinations and tests to determine the underlying causes of infertility. You and your partner must undergo infertility assessment tests to determine whether you have serious infertility issues. If you or your partner do not have any serious medical conditions, infertility is usually simple to treat.


Everything You Need to Know About Infertility Assessment

Infertility Assessment for Male | Infertility Assessment for Female

Infertility Assessment for Male

Infertility is a serious condition that can affect both men and women. Some of the causes of infertility include low sperm count, poor sperm quality, and pre-existing medical conditions. There are various assessments available to assist in determining the cause of failed pregnancies. If you and your partner are having sexual problems, you should both get these tests.


1. Medical history

One of the most important causes of male infertility is a family history of infertility. Doctors will inquire about your partner’s sexual practises. For example, understanding the proper timing of intercourse, the use of lubricants, and so on.

Aside from that, a child’s medical history, such as precocious puberty, STDs, urinary tract infections,etc. If your partner has diabetes or pulmonary infections, then he must talk about it with the doctor.


2. Physical examination

One of the first steps in male infertility testing is a physical examination. Examiners perform it inside a warm room. The dartos muscles are primarily contracted with cold examining hands. In addition, a scrotal test is performed.


The patient is instructed to disrobe by stretching his arms. The examiner looks at the overall body habitus. Men who have not been properly masculinized lack proportionately long extremities. This is due to a lack of androgen stimulation.


3. Sperm and Semen Analysis

When it comes to analysing male infertility issues, sperm analysis is crucial. This test shows the number of sperms released, as well as their movement and shape. When a man ejaculates during sexual activity, he aids in the fertilisation of the egg. If you’re having trouble getting pregnant, the primary test that doctors recommend is sperm or sperm analysis.


4. Genetic testing

Genetic testing examines the DNA, also known as the chemical database, which primarily contains instructions for body function. This test aids in determining whether the gene changes caused any health problems, particularly infertility. Genetic testing assists the doctor in making the best treatment decisions, as well as infertility investigations that will benefit your partner.


5. Hormone Evaluation

Hormone testing can detect the presence of certain male hormones that are responsible for fertility in the blood. In males, hormonal evaluation and infertility tests are important in determining low sperm density.


Pituitary adenoma, for example, causes low gonadotropin levels, and hormonal tests can help diagnose such conditions. Aside from that, testosterone deficiency is linked to spermatogenesis impairment. Hormone evaluation aids in the analysis of hormones like androgen and testosterone.


6. Chlamydia test

A chlamydia test is one of the most important tests for determining whether your partner has any STDs. Chlamydia is a potentially fatal infection that can permanently harm your reproductive system. As a result, you may never be able to conceive. As a result, it is critical in the management of infertility to take the Chlamydia test to determine if your partner has any STDs.


Infertility assessment for female

Most infertility specialists will request tests if you have had failed pregnancies. The test can help you determine if you have infertility problems. Miscarriages can occur even if you have regular menstrual cycles and a healthy weight. As a result, it is best to undergo infertility tests, which will assist you in determining the underlying issues.


1. Medical history

Infertility can be caused by hormonal imbalances or pre-existing diseases in women. As a result, most infertility doctors request infertility tests. These are helpful in detecting issues such as hypothyroidism, PCOD, and endometriosis, which are common causes of infertility.


2. Physical examination

Thyroid gland, breast health, and pelvic examinations are all useful in detecting infertility issues. When it comes to how to check for infertility, one of the most common tests is a physical examination. The gynaecological exam is necessary because it focuses on your reproductive health. You will learn more about the factors that contribute to infertility.


3. Hormone blood tests

Doctors recommend hormone blood tests before deciding on infertility treatment because hormonal issues affect fertility issues. To detect free and total testosterone, follicle-stimulating hormone, prolactin, and other hormones, blood tests are required. Maintaining hormonal balance in your body is critical if you want to conceive.


4. Ovarian reserve test

An ovarian testing reserve is simply a test used to determine the egg count. It is most commonly found in the form of anti-Mullerian hormone. Ideally, the test aids in determining hormone levels. On the third day of the cycle, most gynaecologists recommend ovarian reserve testing. This test looks for FSH and estradiol, which are important factors in pregnancy.


5. Chlamydia test

Females, like men, are at risk of contracting STDs. As a result, taking the Chlamydia test is a good idea. It aids in the screening and diagnosis of various sexually transmitted diseases.


If you are positive, your partner may experience issues with their reproductive system. The Chlamydia test is considered essential in most infertility investigations because it plays a significant role in infertility.


6. Ultrasound scan

An ultrasound scan aids in the creation of images of soft tissues. As a result, it can help you determine whether your reproductive organs are healthy enough for pregnancy. An ultrasound scan can detect PCOS, which is characterised by swollen ovaries.


An ultrasound scan, on the other hand, can detect whether or not your reproductive organs are blocked.You must go for an ultrasound scan within two to six days to check if you have infertility issues.


7. X-ray

X-rays can be used to determine whether your uterus is in good shape and whether your fallopian tubes are blocked. If you are having difficulty conceiving, infertility specialists recommend that you undergo an HSG test. X-rays are taken by placing an iodine-based dye near the cervix.


8. Laparoscopy

It is a minimally invasive surgery procedure that involves inserting a laparoscope into the pelvic region to examine it. When it comes to infertility, pelvic anatomy is very important. If you are having trouble getting pregnant, your gynaecologist may recommend laparoscopy tests. Laparoscopy can help remove endometriotic lesions, fallopian tube blockages, and even repair hydrosalpinx.


9. Sonohysterogram

It is an important part of determining infertility in women. Sonohysterograms are essentially an extension of pelvic ultrasounds. Analyzing the uterine, cavitary, and tubal patency aids in determining infertility issues.

10. Hysterosalpingography

It is an X-ray test that helps to outline the internal shape of the uterus. It is also known as HSG. Aside from that, this test will tell you whether your Fallopian tubes are blocked. A thin tube is inserted through the vagina as well as the cervix by the examiner. In addition, contrast material is injected into the uterus to investigate the underlying issues.


11. Tubal status

Tubal status aids in the detection of fallopian tube blockages. The blockages prevent the sperm and egg from meeting. It is one of the most common causes of female infertility. The tubal status test can tell you if your fallopian tubes are blocked.


12. Uterine cavity

Uterine abnormalities are a critical component of infertility. As a result, choosing the uterine cavity test aids in determining whether you have endometriosis and fibroids.


13. Hysteroscopy

Infertility hysteroscopy aids in the detection of all intrauterine changes that may affect implantation or even the growth of the baby.

Topic 2 : IVF Treatment


What is IVF?

In Vitro Fertilization, or IVF, is a type of fertilization in which the eggs combine with sperm outside the body for fertilization. This IVF procedure is performed under glass (in vitro). The procedure entails extracting an ovum (egg or eggs) from the ovaries and allowing sperm to fertilize them in a liquid.


In a laboratory, this process entails stimulating and monitoring. The fertilized eggs are also cultured for the next 2-6 days. Later on, implantation occurs in the same or another woman’s uterus. This procedure is designed to ensure a successful pregnancy. IVF is a procedure used to treat infertility and gestational surrogacy.

Everything You Need to Know About IVF Treatment

Candidates | Procedure | Complications | Cost | Success rate | Self Care

Who is suitable for IVF Treatment?

Read the content for understanding properly who is the right candidate for the treatment?

This can be very disheartening when a couple tries to start a family but is unable to do so for several months. If a couple is having infertility issues for them IVF is suitable.

Some of the issues are:-

  • Polycystic Ovarian Syndrome (PCOS)4

The hormonal imbalance can result in infrequent and prolonged menstruation, as well as Polycystic Ovarian Syndrome, or PCOS. In the case of PCOS, the ovaries develop a number of follicles, which results in the regular release of eggs.

In the case of PCOS, IVF is also proving to be very effective.

  • Endometriosis

Endometriosis is a painful condition in which the uterine lining grows outside the uterus. The lining of the ovaries, pelvis, and fallopian tube are all involved. It has also spread beyond the pelvis in some cases.

IVF is also a better option for women who have scarring from endometriosis.

  • Tubal factor infertility

Scarred, damaged, missing, or blocked Fallopian tubes can also cause pregnancy difficulties. The Fallopian tube is bypassed during the IVF procedure. As a result, women with tubal factor infertility can choose IVF. As a result, it is far superior to surgical solutions.

  • Male factor infertility

Male factor infertility can also be caused by low sperm count, no sperm count, or decreased sperm motility. This is also the cause of the majority of infertility cases. With these factors, IVF can also help couples conceive.

  • Pregnancy on demand

LGBT couples and single women want to have children as well. IVF is an excellent option for them. They can become pregnant on their own terms and timetable.

How is in vitro fertilization performed?

In Vitro Fertilization also refers to the process of fertilising an egg outside of a woman’s body. This is done in a laboratory with the help of a fine needle, a suction machine, and test tubes. It has several stages.

IVF process timeline

Don’t be discouraged if the process takes some time. IVF involves several steps, beginning with testing and ovarian stimulation and progressing to egg retrieval, fertilisation, and embryo transfer. If prescribed, assisted hatching is performed, followed by a pregnancy test.

On average, all of these procedures take six to eight weeks. It may differ depending on the patient’s condition and age.

Steps involved in IVF

This complicated IVF procedure also includes the use of medications. Antagon (ganirelix), Ganirelix Acetate, Lupron Depot (leuprolide acetate), and Lupron are among them.

Women will also be prescribed GnRH analogue drugs for two weeks. When ovulation is triggered, HCG injections will be prescribed as well.

Complications associated with IVF

Although IVF helps couples have a baby but there lie some complications in this procedure. Such as:-

  • Premature delivery
  • Ovarian hyperstimulation syndrome
  • Ectopic pregnancy
  • Egg-retrieval procedure complications
  • Stress

There lie many side effects of IVF as you have to go through certain medications during the whole cycle. Some of the side effects are:-

  • Headaches
  • Hot flushes
  • Feeling down
  • Ovarian hyperstimulation syndrome
  • Restlessness
  • Swelling or rashes
  • Depression
  • Breast tenderness etc.

IVF Cost

Each IVF cycle would cost between Rs. 1,25 lakhs and Rs. 2,75 lakhs on average. This price excludes any medications prescribed during the cycle.


The cost of IVF in Mumbai varies from clinic to clinic or from person to person; there is no set price, but Dr. Jay Mehta offers low-cost IVF treatment with a high success rate of IVF in Mumbai.


We are the best IVF centre in Mumbai, providing successful IVF treatment at a low IVF treatment cost. We have assisted thousands of couples in successfully completing their fertility treatment and starting a family.


IVF success rate

According to records, the success rate of IVF depends on a woman’s age and the previous history of the IVF cycle. According to data, the success rate of IVF is increasing across all age groups. Women who have this procedure done for the first time have a 33% success rate in their first cycle.


It rises from 54% to 77% over the course of eight cycles. Three full cycles of IVF increase the chances of pregnancy by 45 to 53%.


Self-care during IVF

Get the best post-IVF advice. During the IVF cycle, your body goes through a lot. It is both physically and mentally taxing. During the IVF cycle, you must also get enough sleep and eat healthy foods. You should also make time to relax at a spa.


Feel free to mingle as well. Talking with other families who are going through the same thing can also help you de-stress. When compared to natural childbearing, in vitro fertilisation can be very safe.


The procedure’s history began in Great Britain, where the world’s first test tube baby was born. It must be used with caution so that it does not take an unexpected turn.


Searching for an IVF Treatment to Suit Your Budget?


If you know you want to grow your family but need some assistance, contact us today. We will gladly schedule your consultation as soon as possible (ASAP), and you can rest assured that the cost of your IVF treatment will be appropriate for your budget.

WithDIVI FERTILITY  Clinic with you, you will soon receive the care and understanding you need for your journey of parenthood.

Topic 3 : Low AMH


AMH is an abbreviation for Anti-Mullerian Hormone. It is a protein hormone that is primarily produced by granulosa cells in small follicles (the tiny pouches that contain eggs in the ovary). Granulosa cell is a type of cell that aids in the development of eggs in a woman’s ovaries. These cells produce the greatest amount of AMH when the follicles are in the preantral and small antral stages of development.


The amount of AMH produced decreases as the follicles grow larger. When a follicle grows to about 8 mm in size, the amount of AMH that is still produced is almost non-existent. AMH levels are constant from day to day because preantral and small antral follicles are always present in the ovaries. As a result, an AMH test can be performed on any day of a woman’s cycle to determine the number of eggs remaining in her ovary.


Everything You Need to Know About Low AMH

Low AMH | Causes | Symptoms | Low AMH and Fertility issues | What To Expect | Treatment | FAQs

What is Low AMH?

Low AMH levels indicate that a woman’s ovaries are producing fewer preantral follicles. As a result, the AMH level primarily indicates the number of eggs present in the ovary. A high AMH level indicates that you have more eggs, whereas a low AMH level indicates that you have fewer eggs left in your ovary.


When you reach the advanced stage, your AMH levels will naturally fall. Still, if you have low AMH levels when you are younger, your chances of premature ovarian failure increase. Furthermore, it reduces the likelihood of naturally becoming pregnant. In India, a survey says that almost half of 29,621 women who are in the 20-40 age group had Low AMH levels.


Causes of Low AMH

There can be various reasons for having a Low AMH level. So, let’s discuss some of the major reasons below:

  • Age

One of the primary causes of a low AMH level is old age. Every woman is born with all of the eggs she will have in her lifetime. Following that, these eggs are naturally used during the ovulation cycle throughout life, until menopause. As a result, as she ages, her ovarian reserves will diminish, as will her AMH level. The number of eggs begins to decline in women in their mid-30s. As a result, a woman’s chances of fertility begin to dwindle as AMH begins to deplete.


  • Very Poor Diet

Processed foods and fat are not good choices for maintaining healthy AMH levels. Unhealthy foods will have an effect on your body, resulting in obesity, which can be the cause of a variety of health problems, including low AMH levels.


  • Endometriosis


It is a condition in which tissues that normally develop inside a woman’s uterus grow outside of the uterus. It is a painful reproductive system disorder that causes inflammation in the ovaries and fallopian tubes, resulting in a low AMH level.


  • PCOS (Polycystic Ovary Syndrome)

It is now one of the most common female reproductive disorders in which your ovary secretes an abnormally high level of male sex hormones. As a result, the small cyst in your ovary can affect your AMH level.


  • The genetic factor


One of the causes of low AMH levels could be an inherited genetic disorder. If you have anyone in your family who has a low AMH level, this can affect your AMH level genetically.


  • Autoimmune diseases


In this case, your immune system primarily attacks healthy cells as well as healthy eggs, potentially lowering your AMH level.


  • Cancer treatment or Chemotherapy


If someone is undergoing cancer treatment, it damages the healthy follicles in their ovary, resulting in a low AMH level.


  • Mental Health

A low AMH level can be caused by stress. If a person has mental health issues, their chances of becoming pregnant are automatically reduced. If someone is trying to conceive, they must be physically and mentally healthy. De-stressing can also help to lower AMH levels.


  • Change in lifestyle


Excessive smoking, obesity, pollution, vitamin D deficiency, and other lifestyle changes can all have an impact on AMH levels.


Symptoms of Low AMH Levels

Low AMH does not have specific symptoms, but if you notice any general symptoms such as irregular periods, short cycles, or premature menopause, you should see a doctor.

Low AMH and Fertility issues

The AMH level primarily reflects a woman’s ovarian reserve. It is not a definition of infertility. There is no such link between AHM levels and infertility. The main point is that women’s fertility declines with age, which is linked to a decrease in AMH levels.


Fertility is determined by the number of eggs a woman has. So, if someone has fewer or no eggs, their chances of conceiving are reduced. Furthermore, the level of AMH can affect the quality of the eggs, increasing the chances of miscarriage or abnormal fertilisation. This is why older women with low AMH levels are advised to seek proper treatment.


However, even if their AMH level is low, younger women have a lower chance of not getting pregnant. Furthermore, according to a survey, over 38% of women aged 26-30 have extremely low AMH levels. So, if you have a blood test, the AHM levels will only show you the number of follicles that could be present in your ovary.


What to expect from a doctor if you have low AMH levels?


Doctors advise women who want to get pregnant but have low AMH levels to consider IVF (In-Vitro Fertilization). Other methods or treatments, such as ARTs (Assisted Reproductive Technology), are also available.


Along with AMH blood tests, there are many other tests to evaluate fertility, such as the FSH blood test (Follicle Stimulating Hormone) and AFC blood test (Antral Follicle Count). Sometimes doctors advise their patients to live a healthy lifestyle in order to increase the number of eggs in their ovaries and, as a result, the level of AMH.


Treatment with low AMH level

There is no such thing as a complete cure for Low AMH. However, there are methods available for a woman to improve her AMH level before considering ART. Along with other treatments, natural treatments to increase AMH levels include:


Yoga and regular exercise are recommended.

A healthy diet, acupuncture, and DHEA (Dehydroepiandrosterone) supplements are all recommended. DHEA is primarily a hormone that can improve the quality and quantity of eggs.

If you are a young woman who wants to conceive, treatments such as IVF with low AMH level and IVF with Donor Egg are available to you.


  • IVF with low AMH level

A successful pregnancy is primarily determined by the woman’s ovarian reserve. For them, IVF is the best option for making the best use of the few eggs that remain in their ovaries. If a woman has abnormally high FSH levels combined with low AMH levels, it indicates that her ovaries are not producing enough good quality eggs. It indicates that she is infertile. However, if a woman leads a healthy lifestyle and takes DHEA supplements, she will be able to become pregnant through IVF treatment.


  • IVF with Donor Eggs

This treatment is recommended for women who have very low AHM levels and no eggs left. If IVF fails to produce good quality eggs, this Donor egg in IVF comes into play. In this treatment, a high-quality egg from another person is used to carry out the entire procedure.



  1. Does the AMH tell me anything about my chances of getting pregnant right now?

– No, the AMH test does not provide pregnancy information. The AMH level does not predict fertility. Many other factors come into play, such as the condition of your fallopian tubes, the quality of your partner’s sperm, your ovulation date, and so on.


Even if you have a low AMH level at a young age, you can become pregnant. If you have regular cycles, your chances of becoming pregnant increase. Age, rather than AMH level, is the most important factor in this case. However. A low AHM level may indicate that you have a limited time to conceive.


  1. Does the AMH tell me anything about my chances to conceive in the future?


Because AMH can detect ovarian reserve, it is possible that the AMH test can provide you with information about your ovarian condition. If you are in premature menopause, you will be aware of it.


Premature menopause causes you to lose all of your eggs and become unable to reproduce eggs. As a result, it is recommended that all women get an AMH test so that they can take precautions before anything worse happens.


  1. I have low AMH. Does it mean I am infertile?


No, this is completely false. If you have regular periods and ovulate once a month. Then you are fertile like everyone else with normal AHM levels. Although your AHM level reduces your ovarian reserve, this does not mean you will be unable to conceive in the future.


You can, on the other hand, increase your AHM level by leading a healthy lifestyle and eating a nutritious diet. Furthermore, if you want to get pregnant right away and have had treatment for low AHM, you should see a fertility specialist right away.


  1. I was found to have high AMH levels. Does it mean I am super fertile?


No, that is not correct. Like everyone else, you will lay one egg per month. On the contrary, you may experience period problems. High AMH levels can cause irregular periods.


A high level of AMH can cause PCOS (Polycystic Ovary Syndrome), which can reduce your chances of getting pregnant. Aside from that, the good news is that you are less likely to experience early menopause. It will increase your chances of success with IVF treatment.


  1. Why do fertility clinics check AMH levels?


An AMH test is typically performed by fertility specialists to assess a woman’s ability to produce eggs that will be fertilised for pregnancy. With fertility medication, a woman’s ovary ovulates multiple eggs at once, which fertility experts use in IVF.


In this case, the AHM test can predict how many of those eggs will mature in a single IVF cycle. Furthermore, predicting ovarian response via the AMH test is critical for IVF success.

Azoospermia Treatment (No Sperm Count)​

What is Azoospermia?

Azoospermia is a condition in which men have no sperm in their ejaculation. It affects 15% of all men, and the average percentage of affected infertile men is 1%. This can happen for a variety of reasons, including hormonal issues, a blockage in the reproductive tract, testicular malfunction, or ejaculation issues.


There are some treatment options available, but it is not always easy to treat. Furthermore, in some cases, couples, or particularly affected men, choose to have their one or few live sperms stored medically. This can then be used for assisted reproduction.

Everything You Need to Know About Azoospermia Treatment

Causes | Types| Symptoms | Diagnosis | Treatment | Prevention | Side effects | Natural Cure | Diet | Cost

Causes of azoospermia

When it comes to causes, there are two main ways that Azoospermia can strike a person. One possibility is that something causes a blockage in the tracts, either internally or externally. Second, it occurs as a result of a condition that renders a person infertile as a side effect. Other medical conditions are usually involved.


Both types are closely related to the various forms of Azoospermia and are found in males of all ages. The following are the most common causes of the two.


1. Obstructive –

This is caused by a blockage in the epididymis, vas deferens, or ejaculatory ducts. This can occur as a result of organ inflammation or injury to such areas. Infections can also cause a decrease in sperm count during ejaculation.


Furthermore, if you have had previous surgery in the area, it may not work properly. Another common cause of Azoospermia is cysts in any of the three organs. Another deliberate cause of sperm count loss is a specific surgical procedure such as vasectomy.


A gene mutation in cystic fibrosis is another type of obstructive cause of Azoospermia. Due to thick secretions buildup, there are visible deformities with the vas deferens. This blocks the semen from passing to the uterus of the female during sexual activities. Plus, in some instances of this, the vas deferens has not even formed.


2. Non-Obstructive –

This type of obstruction can occur for a variety of reasons, including issues with the testicles, hormones, genes, or ejaculation. In the case of the last option, this is a common feature of retrograde ejaculation.


The condition occurs when the sperm enters the bladder instead of the uterus. And there are some specific reasons why endocrine or hormonal problems may be the cause of Azoospermia. These include hyperprolactinemia, hypogonadotropic hypogonadism, androgen resistance, among others.


Genetic mutations, too, fall under the non-obstructive reasons for infertility in men. Some of the main conditions under this are:

Klinefelter’s syndrome– Klinefelter’s syndrome is one of these syndromes, in which a man carries an extra X chromosome in addition to the normal chromosomes. As a result, their genetic makeup changes to XXY rather than XY. Aside from infertility, this has other consequences, including a lack of physical maturity and a lack of interest in sexual activities. They also struggle with learning.

Kallmann syndromeKallmann syndrome is caused by an inherited genetic disorder on the X chromosome. If not treated promptly, it can lead to male infertility.

Y chromosome deletionY chromosome loss is another genetic cause of Azoospermia. A section of genes on the male chromosome, Y, is responsible for sperm production.A person with this disorder does not have that in their body, which causes them to become infertile.

The most common testicular reasons are the absence of testicles or the inability of testicles to produce viable sperm cells. Anorchia and Sertoli cell-only syndrome are the names of the conditions.

Furthermore, if your testicles have not entered the scrotum, a condition known as Cryptorchidism causes Azoospermia. Spermatogenic arrest is another syndrome that causes this situation, in which the testicles produce sperm but not mature ones.

Mumps orchitis is another testicular cause of this condition, in which the organ becomes inflamed after having mumps in late puberty. Tumors in the testicle, as well as subsequent radiation treatments, render a person infertile.

Furthermore, certain medications may cause the sperm count in the testicles to decrease. Other medical reasons include testicular torsion, kidney failure, cirrhosis, and diabetes. Another cause of Azoospermia is varicocele, a condition characterised by wide veins in the testicles.

Different types of azoospermia

Of course, there are differences visible in what kind of Azoospermia a man has. What causes them and where it occurs are the main reasons behind this matter. This demarcation happens in three forms, and they are as follows.

Testicular Azoospermia– If you have a problem with your testicles, it can affect your sperm production. The main feature of this type of Azoospermia is that it can occur as a result of cancer and its subsequent treatment. This is possible in the event of a groyne injury or infection of the reproductive tract. Urethritis and epididymitis are two common types of this. A childhood illness can also cause one testicle to enlarge.

Pretesticular Azoospermia– You have no physical defects that would prevent you from producing sperm. However, due to conditions such as chemotherapy or low hormone levels, your body is unable to produce this element. This is one of the more uncommon types of Azoospermia.

Post-testicular Azoospermia- In this case, your testicle is perfectly fine and can even produce sperm. However, it cannot exit due to specific reasons such as tube blockage or other obstructions. This occurs when the sperm exits the penis and enters the bladder instead. At least 40% of patients suffering from Azoospermia have this variant.

Symptoms of azoospermia

This condition does not have specific symptoms only associated with it. The only surefire indication is infertility that the male partner has, which you would notice after trying to get pregnant for a long.

However, some particular reasons cause Azoospermia, and you would see symptoms of these causes occasionally. They are as follows.

  • Little or no semen
  • Painful urination
  • Pain in the pelvic area
  • Cloudy urine after you have sex
  • Smaller or swollen testicles
  • Delayed puberty
  • The penis is smaller than normal
  • Cannot get erect easily
  • Low hair growth near male genitalia
  • Bigger breasts
  • Reduced sex drive
  • Loss of muscular strength

Azoospermia diagnosis

Semen analysis is the main diagnostic plan that would work with checking your sperm count. If your first test shows no sperm, your doctor will schedule additional tests between the months of the interval. They usually only judge two tests at a time.

After the initial testing, the doctors would do further testing to find the cause and prescribe a treatment plan accordingly. Some of these steps include the following.

  • Physical examination of the testicles
  • Checking your medical history in detail to see if you had STIs before or severe illnesses like mumps during your younger years.
  • Blood tests to see testosterone and FSH levels, and also visibility of estrogen or prolactin levels.
  • Biopsy of the testicles (only necessary in case the other tests are not successful)
  • TRUS (transrectal ultrasound) to see abnormalities or blockages in the tract.
  • Genetic testing and karyotype testing in case of inheritable diseases.

For the sake of a fuller evaluation, the female partner also needs an examination to rule out female infertility. Plus, this would help the doctors plan a cohesive treatment plan.

Treatment for azoospermia

Some treatment plans are effective in treating No Sperm Count in male patients. If there are any obstructions in the tracts, surgery is the best treatment option.

Sperm retrieval is another treatment option for Azoospermia, or difficulty getting pregnant despite the condition. Doctors use a small needle to extract sperm from the testicle and freeze it for later use in IVF.

If you have a testicular biopsy, the doctors will extract some sperms during the procedure. This reduces the likelihood of a second surgery.

In some cases, medications, such as retrograde ejaculation, can be used to treat Azoospermia. Letrozole, Clomid, hCG injections, and FSH injections are examples of common hormonal drugs.

Preventing azoospermia

You can follow these given pointers if you want to prevent getting Azoospermia.

  • Drinking less alcohol or quitting it entirely
  • No smoking
  • Maintaining a healthy diet
  • Staying away from heated regions
  • Lessening the exposure to toxins and radiations

Azoospermia side effects

One of the most common side effects of No Sperm Count is emotional in nature. It is disheartening that they are unable to conceive children or have other underlying issues that may be passed on to future offspring. Counseling sessions would be beneficial in this situation for both the male and female partners.

Azoospermia can cause a variety of physical issues. These health issues are frequently difficult to manage and can result in death.

Side effects of the medications include appetite loss, headaches, vomiting, nausea, allergies, liver problems, rashes, and irritability.

Hormonal drugs would cause depression, oily skin, changes in body shape, and edoema.

Extensive bleeding, infections, or injuries to the intestines, stomach, kidneys, or blood vessels can occur during surgery.

How to treat azoospermia naturally?

Natural foods can help you improve your health and treat Azoospermia. It is best if you eat a diet high in nutrient-dense whole foods. This would help to naturally increase the sperm count in one’s ejaculation. Overweight people, on the other hand, should engage in some weight loss programmes.

Eating a lot of herbs would help men produce more sperm and balance their hormones. These are effective in cases of non-obstructive Azoospermia caused by genetic anomalies. Cordyceps mushroom, American Ginseng root, Saw Palmetto berries, Tribulus aerial fruit and parts, Schisandra seed and fruit, and Maca root are among the most beneficial herbs.

You should consult regarding which are best for you with a specialist in herbal health care besides your regular doctor.

Diet for azoospermia patient

When one has Azoospermia, it is critical to eat a healthy diet. Include whole-grain foods in your diet, such as whole-grain bread, pasta, rice, or cereal. Dairy products, specifically cheese, yoghurt, and low-fat milk, are also essential for healthy sperm production.

Green leafy vegetables in orange and dark green colours, as well as a variety of fruits, are also appropriate for men. When it comes to protein, fish, eggs, chicken, beans, and nuts should be prioritised. When planning this diet, you should consult with your doctor or a dietitian. They would tell you the daily diet plan and how many servings of sweets, oils, and fats are allowed.

Azoospermia treatment cost

The cost of treatment for Azoospermia varies depending on the experts you consult, the state of the medical facility, and the location. Azoospermia treatment is more difficult and expensive in European and American countries.

In India, the average cost of this treatment is between USD $600- $1000 (Rs. 43,000- Rs. 75,000/-). The rates are not the same everywhere, so it is necessary to do some research beforehand.

We Provide Holistic Azoospermia Treatment In Hyderabad

Divi fertility Clinic’s team of Infertility is highly skilled in handling all cases of azoospermia in Hyderabad. The team has performed numerous complicated surgeries for azoospermia, a recurring condition.

Dr. Shree theja is one of hyderabad best azoospermia specialists. He has 10 + years of experience handling cases related to obstetrics, gynecology, and infertility. Moreover, Dr. shree theja is best known as one of the leading IVF doctors in Hyderabad


  1. Which Doctor To Consult For Azoospermia 

– If you have Azoospermia, you should consult a fertility specialist

Topic 5 : Follicular Study

What is a Follicular Study?

The process by which the doctor observes the growth of this follicle from the beginning of the menstrual cycle until it is ready to release an egg is known as follicular study or follicular monitoring. It is a critical component of IVF evaluation and timing. It employs a simple technique for assessing ovarian follicles at regular intervals and investigates the ovulation pathway. Medical professionals study follicle development in the ovaries to predict when the next egg will be released. If a couple intends to have sexual relations during that time, the chances of pregnancy increase dramatically.

Everything You Need to Know About Follicular Monitoring

Purpose | When Necessary | Procedure | Who Needs  | Success rate | Side Effects | Advantages | Time

Why is follicular Monitoring Done?

Follicular studies are an important component of fertility treatments. They are critical in determining whether or not the woman’s body is responding to the treatment. If someone has chosen the IVF (in-vitro fertilisation) method of fertilisation, follicle scans are critical. It checks the hormones involved and determines the condition and number of eggs produced in a single case of ovulation. If the hormone levels are off, changing the medication dosage can increase the chances of conception.

Follicular monitoring can help determine when in the cycle a woman will ovulate. It aids in the planning of intercourse during that time, increasing the chances of pregnancy significantly.It also helps in diagnosing problems related to ovulation. Some of these problems could be hindering your pregnancy as well.

However, it doesn’t ensure fertilization of the egg by the sperm or implanting the fertilized egg on the uterine wall. Some problems don’t let you conceive post ovulation. These scans do not take care of them, as well.

When is follicular monitoring necessary?

A follicle scan is a painless procedure that allows the doctor to see the development of the follicle inside the ovary. Sonographers study the development of the egg inside the follicle by inserting small plastic probes into the vagina. Here are a few reasons why you should consider follicular monitoring:

  • Suppose you are less than 35 years of age and have been actively trying to get pregnant for around one year. It is the first step where you can rule out ovulation-related problems.
  • In case you are above 35 years of age and haven’t been able to get pregnant in the last six months.
  • If you have PCOD, you might have an irregular cycle and irregular ovulation. You might also have a cycle where you do not ovulate.
  • If fertility drugs for ovulation or for producing multiple follicles through fertility procedures like IUI or IVF.

The sonographer or the doctor will suggest you have these scans, usually on days 6 or 7 of your cycle. It is, however, based on the assumption that you have a 28-day cycle. She will continue to inform you every two to three days to come for the scans.

How does follicle tracking work?

Follicle tracking is a series of vaginal ultrasound scans that take 5-10 minutes to complete. The follicles begin to form on the ninth day of the cycle. The scans are repeated until the follicles have vanished and ovulation has begun. Couples are then encouraged to engage in sexual activity. It aids conception by optimising the timing of the sperm and egg meeting.


The doctor examines the follicle size. He also measures the thickness of the endometrium, the uterine wall. A Doppler scan may also be used by the doctor to assess blood flow to the follicle and endometrium.Usually, a mature follicle measure between 18-25mm and endometrium of more than 10mm is considered normal for a successful pregnancy.


Who needs follicle tracking?

It is usually suggested that women who do not know when they are ovulating or who have had miscarriages, or those who take Clomid or FSH.

  • If women do not know when she is ovulating despite using prediction kits might need follicle tracking.
  • Women who have had unfortunate miscarriages in the early stages of pregnancy can use these scans to understand why it occurred.
  • Women who have been taking medication to induce the ovulation process in them or drugs to counter other conception related problems.

Success rate of follicular study

People frequently have unreasonable expectations of follicular studies. It is important to understand that the success rate is only 10%. These scans can be extremely stressful for the couple at times. Doctors are frequently too casual when recommending these scans, failing to recognise the strain it places on a marital relationship. It is best to limit ovulation tracking to one cycle. It is sufficient in that it teaches you to correlate the scan with body signals such as cervical mucus and ovulation pain.


You can track ovulation discreetly at home, increasing your chances of pregnancy rather than being overburdened by scans.


Side effects of follicular ultrasound scan

This scan has no physical side effects. However, it can be a stressful situation for any couple. Most couples who are prescribed this procedure have most likely been trying for a baby for a long time. When the doctors review these scans, they will tell you the exact time of ovulation and when your chances of becoming pregnant are the highest. This may result in the woman wanting to have sex only during that time, affecting the partner’s libido.


What are the advantages of folliculometry?

A follicle scan is done several times during a woman’s menstrual cycle, usually between days 9-20. The scan detects when does a follicle rupture and release the egg. Follicle scans have several other uses listed below are some of them:

  • Follicles which do not grow till the time of rupture can be diagnosed.
  • Some follicles do not grow at all. The scans help in detecting them.
  • Some dominant follicles do not rupture.
  • The endometrial lining might not be good enough in either thickness or quality.
  • Scans can help to predict the time of ovulation for assisted pregnancy.
  • They help to guide treatments with ovulation-inducing drugs or injections.
  • To detect complications like OHSS and others.
  • Lastly, follicular scans help in detecting luteal phase deficiency.

These issues are closely monitored by doctors and medical experts so that if there is any issue, it can be quickly detected and resolved.

How much time does take to undergo a follicle scan?

Follicular scans take about fifteen to twenty minutes in total, but preparations must begin several hours before the scan. If you cooperate with the doctor and follow the sonographer’s instructions, the entire procedure may take as little as ten minutes. Typically, four to six scans are performed in one cycle to accurately predict the time of ovulation.


The initial scan is referred to as the baseline scan. It aids the doctor in understanding the follicle’s initial stage. The doctor will then schedule scans at the appropriate times to monitor the development of uterine follicles.The inner lining of the uterus and the growth of the follicle are checked during each scan, and finally, the doctor gets a clear idea of when the woman will ovulate.

Ovulation Induction

What is Ovulation Induction Treatment?

Ovulation induction is a straightforward treatment in which hormonal pills are used to restart ovulation. In some cases, a severe hormonal imbalance can cause irregular periods. In the worst-case scenario, it can also result in ovarian cysts. Ovulation induction drugs are used to help women who are unable to ovulate on their own. Furthermore, ovulation induction aids in the production of healthy eggs, ensuring that your ovary produces a healthy egg every month.

Everything You Need to Know About Ovulation Induction

Indications | Candidate | Medications | Process | What to expect | Risks & Symptoms | Side effects | Benefits | Preparation | Success rates | Cost | Results


Ovulation induction indications

If you are experiencing anovulation, ovulation induction is the best option. Anovulation can be caused by conditions such as PCOS, poor nutrition, or overwork. You will experience some symptoms shortly after starting the medications. Bloating, nausea, hot flashes, pelvic tenderness, blurred vision, and other symptoms may occur. If you are concerned about the symptoms, you should seek medical attention right away.


Who is ovulation induction suitable/recommended for?


Many women choose ovulation induction therapy because it is simple and safe. Women who have infrequent ovulation or do not ovulate at all, for example, can benefit from this treatment procedure. Doctors prescribe various fertility drugs based on the symptoms and issues. Similarly, women experiencing unexplained infertility can benefit from ovulation induction therapy. Fertility drugs are critical for those experiencing infertility. The reason for this is that it promotes ovulation, making it easier to conceive. Patients undergoing IVF treatments are also given ovulation induction medication to boost egg production.


Medications Used for Ovulation Induction

Ovulation induction is treated with a variety of medications. The medications are mostly hormonal drugs that help increase the rate of egg production. The most common hormonal medication is Clomiphene Citrate, also known as Serophene or Clomid. It is an oral medication that doctors advise patients to take for five days. Doctors recommend 50 to 100 mg per day; however, if ovulation does not occur, the dosage is increased. Clomiphene Citrate is an FDA-approved medication that fools your body into thinking you don’t have enough oestrogen. Although it is a very effective medicine, success is dependent on a variety of factors such as age, other fertility issues, or sperm parameters.

Following that is letrozole, also known as Femara, which is another oral medication used to induce ovulation. Women who take Clomid and have ovulation induction can take Letrozole, according to a few studies. Similarly, if Clomid causes any problems or side effects, you can switch to Letrozole. Initially, doctors recommend starting with 2.5mg. If ovulation does not occur, your doctor will increase the dosage.


Gonadotrophins are also useful in the treatment of ovulation induction. However, it is not the same as Clomid or Letrozole. Gonadotropins are injectable drugs with a five to twelve-month duration of action. Almost every patient is becoming accustomed to the idea of receiving Gonadotropin injections. The medication aids in the maturation of the follicles; however, the dosage varies so that you can conceive. Furthermore, the threat of multiple births is reduced. Doctors prefer HCG injections, which mimic the mid-cycle LH surge.


The ovulation induction process

The process of ovulation induction is simple because the entire treatment is straightforward. To stimulate ovulation, doctors may prescribe oral medications or hormonal injections. You can start taking the medications once your menstrual cycle begins. However, the doctor will continue to monitor your body using ultrasound. It is critical to understand that the entire ovulation induction procedure is completely safe. Furthermore, doctors regard this treatment as one of the most effective methods of treating fertility issues.


Step by Step Guide – ovulation induction

When opting for the ovulation induction procedure, it will include a few steps that are listed below.

Stimulation– After taking the medications, the drugs help the follicles that carry the eggs grow. Medicines are typically used to replace FSH so that the ovaries can produce high-quality eggs. Throughout the stimulation cycle, doctors monitor follicular development as well as hormone levels.

Control– Doctors recommend taking USG and blood tests soon after starting the process to track the medicinal effects. Aside from that, the tests aid in determining hormonal levels as well as the maturation status of the eggs. The entire procedure is known as follicular monitoring by doctors.

Egg release– Doctors administer HCG injections once the follicles are ready and have grown to a length of approximately sixty to twenty millimetres as a result of the medications. As a result, you can prepare for intercourse or intrauterine insemination.

What to expect during Ovulation Induction?

When the treatment for induction ovulation begins, you may experience symptoms such as hot flushes, nausea, pelvic pain, and so on. However, once the medications are effective, you will be able to have regular periods. If you planned to have a baby but were unable to do so due to infertility issues, you can easily conceive after treatment. Alternatively, if you have been receiving IVF treatment, the ovulation induction treatment will aid in the production of healthy eggs.

Risks, Symptoms associated with Ovulation Induction

Although the ovulation induction treatment is very useful and effective, there are some risks involved. Almost two million women aged fifteen to forty-four seek fertility drug treatments. There are a few iatrogenic complications associated with the use of ovulation induction agents. Preterm delivery and spontaneous abortion are two common complications. Aside from that, some serious complications include heterotopic pregnancy and the possibility of ovarian cancer.

Side effects of ovulation induction

There are some side effects to ovulation induction treatment, just as there are numerous benefits for infertile women. There will be many discomforts, ranging from abdominal distention to discomfort, bloating sensation, restlessness, and fatigue. If they are not treated, they can cause serious problems. As a result, if you notice that your discomfort is worsening, you should see your doctor right away.

Benefits of ovulation induction

The sole purpose of ovulation induction therapy is to make a woman fertile for conception. Even if you do not intend to become pregnant, opting for this treatment procedure will help to alleviate PCOS symptoms. When trying to conceive, once the treatment is finished, you can resume normal intercourse. You can also choose intrauterine insemination or other fertility treatments.

Preparing for ovulation induction

The treatment’s preparation procedure is quite simple. Various tests will be ordered by your doctor. Based on the results, they will advise you to take hormonal medications to reduce the effects of oestrogen. Your body will be able to produce follicle-stimulating hormones as a result. You will be able to conceive or have regular cycles as a result. Doctors prescribe Clomiphene Citrate because it is one of the most effective medicines for follicle stimulation.

Ovulation induction success rates

The success rate of ovulation induction is affected by a variety of factors such as age, disease, diagnosis, and so on. However, nearly twenty to twenty-five percent of women had successful outcomes. As a result, women suffering from PCOS or other infertility issues can benefit from this treatment.

Ovulation induction Cost

The most appealing aspect of the ovulation induction treatment is its low cost. Almost anyone can choose it. A single IUI costs around three thousand dollars. As a result, if you get the desired results in one cycle, the overall cost will be around ten thousand. The total cost will include all tests, scans, and medications.

Testing for pregnancy

If you take a pregnancy test after treatment, you have the option of using at-home tests. There are pregnancy kits available that are quite useful. Alternatively, you can have a thorough examination of the HCG hormone in your urine. When you become pregnant, your body produces HCG. If you get a positive result on the first day of your cycle, you’ve been pregnant for almost two weeks.

Chance of pregnancy with ovulation induction

As the ovulation induction treatment is quite effective, you can get pregnant after your treatment completes. However, the result again varies, and if you fail to get pregnant, it is better to consult your doctor.

Topic 7 : Intracytoplasmic Sperm Injection (ICSI)

What is ICSI?

Intracytoplasmic Sperm Injection, or ICSI, is one of the most common and successful treatments for male fertility. This procedure is also used by couples who were unable to conceive through IVF. Some men require surgical extraction of their sperm first.

The procedure requires the female partner to undergo ovarian stimulation using fertility medications. Even if you have low male sperm count, ICSI treatment can help you have a baby. This procedure entails injecting live sperm directly into a human egg.

Everything You Need to Know About ICSI

Candidate | Purpose | Procedure | Cost | Risks | Pros and Cons | Success Rate

Who may require ICSI?

ICSI is now used in approximately 75% of all in vitro fertilisation cases. Doctors recommend ICSI in cases of male factor infertility followed by abnormal sperm analysis. Your doctor may also recommend ICSI treatment if you are experiencing any of the following problems:

  • Low sperm count.
  • You’ve had IVF earlier but very few or none of the eggs fertilized.
  • Your sperm don’t move normally or they are abnormally shaped.
  • You are using frozen sperm for your treatment and the quality is low because of its storage and was under threat.
  • You had a vasectomy or a blockage that prevents the sperm from reaching discharge.

Why is ICSI – IVF did?

ICSI is a laboratory procedure that is used in conjunction with IVF. ICSI – IVF is a specialised form of In vitro fertilisation (IVF) that is used after multiple failed fertilisation attempts with conventional IVF. It is also done following egg freezing or male infertility.

In the case of IVF, doctors insert more sperm into the egg, hoping that one of the sperms will enter the egg and begin the fertilisation process. In the case of ICSI-IVF, however, doctors use a single sperm and inject it directly into the embryo.

Many doctors recommend ICSI-IVF to infertile couples. It has allowed couples to become pregnant when it would have been impossible to do so without this process.

ICS-IVF is not only used for the issues listed above. In the case of Preimplantation Genetic Diagnosis, also known as PGD, doctors recommend ICSI – IVF. In the case of conventional fertilisation, many sperm cells that did not fertilise the egg linger around the embryo. It interferes with the precise PGD result. As a result, doctors recommend ICSI – IVF.

How ICSI Works?

ICSI is commonly used as part of the IVF process. A doctor injects a single sperm into the centre of the egg during the procedure. Doctors wait a few days after injecting the sperm into the egg to see the outcome. If the egg begins to fertilise and the embryo develops, the doctor will place it in your uterine cavity.

Steps involved in ICSI-IVF procedure:-

Ovarian Simulation

A scan is performed to confirm that the ovaries are quiet and that the womb has a thin lining. Women on the down-regulation regimen will typically receive a nasal sniff or down-regulation injections in addition to stimulation injections until further instructed. Self-administered injections are available with an adjustable pen, vials, or ampoules that have been mixed with water. Doctors will demonstrate the technique and provide you with a DVD or handwritten instructions to follow at home.

You will also be given a detailed timetable that includes the days of injections and scans. This treatment will last 10 to 12 days. There is also a requirement for regular blood tests and scans. Scans will aid in monitoring the ovaries’ response. Follicles, which may contain eggs, can also be seen on a scan. As a result, doctors recommend scheduling injections at the same time each day.

Egg Collection

The treatment continues with egg collection. It is always done under strong anaesthetics or sedation, and sometimes general anaesthesia is used. When a scan confirms that the follicles are at the proper stage of maturity, an injection is given. The injection is given just before 35 to 36 hours of egg collection. Timing is critical during this phase. The injection is given in the evening because there will be no medication available for you the next day. That night, you will be advised to fast.

It is recommended that you refrain from having sex for 3-5 days. It’s comforting to know that the sperm quality on that particular day is optimal. When it comes time to collect the eggs, your partner will be asked to provide a sample of sperm. It is always recommended that the procedure take place at a medical facility rather than at home.

Doctors will need 20-30 minutes to extract the eggs from your ovaries once you are sedated or under anaesthesia. Each follicle in the ovaries is identified by a doctor. An ultrasound scan is used to puncture each follicle with a fine needle. This needle aids in the extraction of fluid from each sac into a warm, sterile tube.

A microscope is used to examine the tube further. Not every follicle produces mature eggs. There are also some empathy follicles with eggs that have stopped growing and vanished. Other follicles contain eggs as well, but they are sometimes too young for fertilisation.


You will be on medication, particularly progesterone support. It is a hormone that aids in the development of the womb. The medication is taken until the day of the pregnancy test and beyond if the test results are positive. Blood thinning injections, oestrogen tablets, and even steroids may be prescribed by your doctor if necessary.


During the IVF procedure, a large number of high-quality sperms are added to each egg in a small dish. They are also placed in incubators, which help the sperms and eggs reach body temperature. In the case of ICSI, however, only one sperm is chosen and implanted into each egg. The eggs and sperm are then placed in the incubator.

Doctors examine the dish in which the sperms were placed under a microscope the morning after the egg is collected. Later on, fertilisation is investigated. On average, 60% of the eggs injected through the IVF process begin fertilising, while 70% of the eggs injected through ICSI fertilise normally.

For the next 1 – 4 days, the embryos that split are replaced into the incubator. The embryos are checked daily to confirm the quality, quantity of the embryo. It also indicates the perfect time to transfer.

Embryo Transfer

After the eggs are collected, the embryos can be transferred between days 2 and 5. In rare cases, the embryos can also be transferred on day 6. If the embryo reaches the blastocyst stage, which occurs on the fifth day after egg collection, the chances of pregnancy increase. Embryos can also be transferred on day 3 if they have 6 to 8 cells or if their quality matches what is required, and they can also be cultured to blastocysts.

Two of the strongest embryos must be chosen for replacement, but doctors believe that transferring one or three embryos is more appropriate.

How is ICSI treatment performed?

A single sperm is inserted into the centre of the egg using a tiny needle. Embryologists wait for the results after injecting sperm. The procedure is carried out under the supervision of a powerful microscope. When fertilisation occurs, the egg continues to divide, eventually forming an embryo. The embryo is ready to be transferred into the woman’s womb after three days and eight cells. The transfer is sometimes done on day 5, which is known as a Blastocyst transfer.

What does ICSI treatment cost?

People travel to India for ICSI – IVF treatment from all over the world. People in India find that treatment costs half as much as it does in other countries. A skilled medical team also provides treatment in India.

ICSI costs are not always included in the cost of IVF. In India, the cost of ICSI ranges between Rs.2,40,000 and Rs.2,50,000 per cycle. This only applies to traditional techniques. The amount varies depending on the circumstances. Advanced treatments can also cost up to Rs. 4,50,000 for a single session.

The risk associated with ICSI – IVF

You will find data suggesting IVF or ICSI-IVF is safe. But the risk is both for the mother and the newborn. Some of the risks are:-

  • Multiple Gestation
    • Hormone abnormalities in the offspring
    • Preterm delivery
    • Delayed development in children
    • Heart defects in babies
    • Hypospadias

Pros and Cons of ICSI


Doctors’ recommendations for ICSI or couples who choose ICSI have fertility issues, ejaculation problems, or issues related to male infertility. ICSI treatment can help any of the partners who are experiencing these problems. It gives the male partner the opportunity to become a father through the use of his own sperm.

Even if the male partner has a vasectomy, ICSI is a viable option. Couples can choose donor sperms during the ICSI procedure.


There are some risks associated with ICSI as well. He is not at risk once the sperm is obtained from a male partner. The risks are associated with the techniques used for sperm recovery. Not all eggs develop into viable embryos.

It is possible that they will be destroyed at times. Mothers have a chance of carrying twins or triplets during this process, which can cause complications. The risk of birth defects is also seen in the ICSI procedure.

The success rate of ICSI

ICSI fertilises between 50% and 80% of eggs. ICSI is a treatment option added to IVF for severe male infertility or couples experiencing multiple pregnancy issues.

Even after the sperm is injected into the egg, fertilisation is never guaranteed. However, ICSI can give you some hope. ICSI is the most commonly used method of fertilisation, accounting for 70% to 80% of success. According to reports, the use of ICSI increases the rate of childbirth.

Topic 8 : IMSI

What is IMSI?

Another procedure used during IVF is intracytoplasmic morphologically selected sperm injection, or IMSI. It allows doctors to distinguish between the structure of the sperm and rule out any possible variations. During the injection into the egg, doctors use a high magnification digital imaging microscope to perform this procedure.

Everything You Need to Know About IMSI

Purpose | Candidate | Procedure | Cost | Recommended for | Risks | Pros and Cons | Success Rate

Why perform IMSI?

ICSI is used when doctors discover severe male infertility. For a better outcome, it is performed concurrently with IVF. However, the process does not always work. To improve the process of fertilisation and embryo development, doctors use a digital high magnification sperm to improve the outcome. This procedure is used for couples who have had poor IVF results with ICSI.


Doctors can easily distinguish between normal and abnormal sperms by using digital high-magnification of sperm. IMSI allows for 6000 times magnification of sperms, allowing for more accurate identification and exclusion during the fertilisation process. The structurally normal sperm is then used to fertilise the egg using the ICSI method. Most normal-looking sperms can be microinjected using this technique.


This technique is extremely beneficial and produces better results than the traditional method of sperm selection for fertilisation. The traditional method evaluates abnormalities at a magnification of 400 times.


Who is IMSI suitable for?

Intracytoplasmic Sperm Injection is for people who have had multiple failed IVF cycles. Even if a couple has previously failed the ICSI-IVF cycle, they can use this advanced technique.


IMSI can be extremely beneficial in cases of severe male infertility. It also allows doctors to distinguish between normal and abnormal sperm.


How does IMSI work?

IMSI operates in a unique manner. Using a microscope, embryologists used to select the most normal-looking sperm in the traditional method. These microscopes magnify sperm 400 times. IMSI, on the other hand, employs a microscope that magnifies sperm up to 6000 times, allowing embryologists to detect minor structural changes in sperm that improve egg fertilisation.

Steps involved in IMSI procedure:-

  • Doctors conduct an initial selection of sperm from the fresh sample collected.
  • The selection is performed under a microscope which is 15 times more powerful than a usual microscope.
  • The internal morphology of the sperm is examined using a microscope. Doctors exclude the abnormal sperms in this stage immediately after examining.
  • After discarding the abnormal sperms doctors select the normal sperms and place them in a catheter.
  • These sperms are then placed in the center of the egg.

How is IMSI treatment performed?

Before microinjecting, IMSI is used to distinguish between normal and abnormal sperms. It is done with a high-powered microscope and 600 times digital imaging. This procedure examines the ultrastructure of the sperm.


The nucleus distortion is examined by the dermatologist. This procedure analyses over 1000 morphological characters. The subsequent process is the same as the ICSI cycle once the sperm is selected for microinjection.


What does IMSI treatment cost?

In India, the average cost of IMSI is Rs.1,50,000 – Rs.2,76,000 in addition to ICSI treatment. The IMSI treatment is more affordable in India than in any other country in the world. It is carried out with a 6000-fold digital magnifying lens. It enables the doctor to select high-quality sperms with no abnormalities before microinjecting them into the eggs.


Who is IMSI-IVF recommended for?

The IMSI treatment is recommended for men with:-

  • The high percentage of abnormally shaped sperm.
  • Prior history of poor results with previously conducted ICSI – IVF cycle.
  • The low number of sperms even in the normal sperm sample.
  • Surgically recovered sperm.

The IMSI treatment is recommended for women with:

  • Failed IVF cycle.
  • History of miscarriage and repeated abortions.
  • No implantation in the normal quality of egg.
  • The Blastocyte stage is made of few embryos.

Risks associated with IMSI-IVF

Doctors refer patients to IMSI when the sperm quality is extremely low. It is also associated with a history of two failed ICSI cycles and three failed IVF cycles. IMSI is still in its early stages. It is a lengthy procedure. It takes 1.5 to 5 hours on top of the IVF process. This is a costly procedure that is not always available in IVF clinics. When compared to ICSI, it will result in multiple pregnancies.


Pros and Cons of IMSI

According to reports, the success rate of IMSI is 66% and that of normal sperm injection is 33%. There are some advantages to IMSI:

  1. This technique doubles the pregnancy rate lowering the abortion rate by 60%.
  2. In this case, normal sperm is selected lowering the chances of miscarriage.
  3. It helps to determine fertility hence enhancing fertility and pregnancy rates.

IMSI has a lot of disadvantages, which includes:

  1. It is a time taking and expensive process.
  2. Leads to multiple pregnancies when compared to ICSI.

The success rate of IMSI

IMSI assisted in increasing the pregnancy rate from 30% to 60%. This technique increased the success rate among men who had the most problems. Couples who had previously failed IVF-ICSI cycles benefited from this procedure. IMSI can also help couples who are experiencing unexplained infertility.


IMSI is still in its early stages and will be more useful to couples experiencing severe infertility issues in the coming days.

Topic 9 : Stem Cell IVF Treatment

What is Stem Cell IVF Treatment?

Around 8% to 12% of couples worldwide are affected by the curse of infertility. However, recent advances in medical science, particularly in infertility treatment, have significantly reduced the frequency of the problem. IVF is an option for them to have a baby with many inventions and innovations. The introduction of stem cell IVF treatment is one of the newly developed modules that has taken the world by storm. It appears to be far more effective than the traditional procedure, as it can generate undifferentiated cells with no complications.

Everything You Need to Know About Stem Cell IVF Treatment

Uses | Types | Sources | Procedure | Technique | Advantages | Cost

Stem Cells: What they are & How they help?

In essence, stem cells are regarded as the raw material of the human body. Under certain conditions, they are capable of producing more functional cells. The newly formed cells are referred to as daughter cells of the parental stem cell.


In most cases, the daughter cells develop into specialised cells with a specific function. However, in rare cases, these cells can also differentiate into another stem cell. As a result, they will have the natural ability to produce a completely new type of cell.


As previously stated, stem cells have the ability to generate a completely new type of cell. As a result, doctors now regard them as an effective alternative therapeutic agent for people suffering from infertility. But, how will it work for them?


For starters, these cells have a greater capacity for differentiation. Thus, the doctor can differentiate them into embryonic, ovarian, endometrial, or mesenchymal stem cells using laboratory experiments.


These cells can be differentiated further in vitro to produce oocytes and spermatozoa, which can then be used clinically. However, the procedure is still in its early stages of development. As a result, the specialists will need to conduct much more research in order to find actual proof of the same.


Till then, it can only be considered as nothing more than a vague conception of a form of medical advancement.

Types of stem cells

The stem cells are generally classified into various categories. Some of these are as follows –

Embryonic: This type of stem cell is typically derived from human embryos that are 3-5 days old. To cure infertility, a doctor can harvest them during in-vitro fertilisation, or IVF. Instead of a woman’s body, the fertilisation procedure requires a laboratory environment. These cells have the ability to generate almost any type of functional cell in the body.

Non-Embryonic: These cells usually come from a fully developed organ or tissue in your body. As a result, they frequently assist in the repair of the same tissue or organ when it is damaged. Hematopoietic stem cells, for example, typically remain in the bone marrow and aid in the production of new WBC, RBC, and other types of blood cells.They can treat mild damage to the bones as well.

Induced Pluripotent: Scientists create these types of stem cells in a laboratory. They have more potential and can develop into almost any type of body cell. As a result, doctors are currently attempting to use it to treat infertility issues.

Sources of stem cells

The stem cells are available throughout the human body. You can find the same in the –

  • Amniotic fluid
  • Umbilical cord
  • Bone marrow
  • Allograft
  • Adipose tissue

Stem cell therapy procedure

The procedure of stem cell therapy is becoming much more common in the treatment of cancer, particularly blood cancer. It is usually done during the transplantation of a person’s bone marrow. However, in recent years, doctors have attempted to use it in the treatment of infertility.

Nonetheless, the procedure or techniques employed are hazy. As a result, providing a thorough explanation becomes somewhat difficult. However, in the following section, we have attempted to clarify a few points in this regard. So go ahead and check them out!

Stem Cell Treatment for Male Infertility: In essence, the stem cell treatment for male infertility is accomplished through the spermatogenesis procedure. The process aids the development of haploid spermatozoa from germ cells to testis tubules. It starts with the mitotic division of stem cells and helps the testes produce more sperm cells than usual. The human sperm count rises dramatically in this manner. As a result, the impact of infertility begins to fade gradually. If everything goes as planned, the couple may be able to conceive within the next few years.

Stem Cell Treatment For Female Infertility:Stem cell therapy may also be beneficial to the female population suffering from infertility. It can aid in the production of oocytes and ovarian cells. This way, their overall fertility level can skyrocket. Furthermore, it can repair uterine tissues and assist the organ in producing healthy cells in a proper manner. In this way, the women can overcome their infertility and pave the way for motherhood.

Technique used in stem cell treatments

There are several specific technologies, which can be used in stem cell treatment. Some of them are –

Suspension Technology:Because of their therapeutic potential, iPSCs attract far more attention than normal cells. You will need to use suspension technology to obtain induced pluripotent cells from them.

Inhibitor Differentiation Method: In contrast to suspension technology, this method is primarily used to generate mesenchymal cells. You can obtain them from fat or bone marrow cells using this procedure.

Advantages of stem cell technology & What offer to IVF patients

The primary application of stem cell therapy is much more prevalent in the treatment of blood cancer. However, doctors are now using it to treat cardiovascular diseases as well. It aids in the regeneration of scar tissues and the restoration of heart health. It can also aid in the rapid healing of incisions and wounds.

This procedure can significantly improve the efficiency of IVF treatment. It has the potential to improve sperm production in men by repairing tissues. For females, on the other hand, it can help to improve the health and effectiveness of the uterus.

Cost of stem cell therapy/treatments

In general, stem cell therapy in India can range from USD 6,300 to USD 7,200. However, it may vary or alternate depending on the state or healthcare facility you choose.

Topic 10 : IUI Treatment

What is Intrauterine Insemination (IUI)?

IUI, or Intrauterine Insemination, is a straightforward form of fertility treatment. The procedure can be performed with or without medication by the doctor. The procedure of transferring sperm to the uterus via a thin catheter is part of the medical protocol. However, before proceeding, the doctor will need to wash and focus on the sperm.

It will be far more effective and powerful this way. During ovulation, a doctor will most likely perform IUI treatment. However, if he or she is forced to do so before the same, they may resort to using drugs.

Everything You Need to Know About IUI Treatment

When It’s Used | Indications | Procedure | What to expect |Risk | Success Rates  | Cost

When is IUI used?

IUI can be used by the doctor to alleviate symptoms or treat various types of infertility issues. In most cases, he or she will repeat the process until the couple conceives. Furthermore, almost every infertility specialist begins with this procedure before moving on to something more invasive, such as IVF.

The following are some of the situations where doctors tend to opt for IUI.

Unexplained Infertility: Even after a battery of diagnostic tests, the doctor may be unable to pinpoint the root cause of infertility. In that case, he or she will choose IUI in addition to injecting the ovulation-inducing drugs.

Donor Sperm: For those women who do require donor sperm, most doctors recommend IUI. The frozen sperm is obtained from a well-known and certified lab during the procedure.

Endometriosis-related Infertility: The doctor would first try to obtain a high-quality egg in the case of endometriosis-related infertility. When he or she receives it, they will perform IUI to make it fertile.

Cervix-related Infertility:  The cervix tends to produce a lot of mucus during ovulation to create a good environment for egg production. However, for unknown reasons, some women’s cervixes do not produce any mucus at all. Infertility results as a result of this. So, before proceeding with IUI, the doctor will need to identify and treat the underlying disease.

Semen Allergy: In rare cases, a woman may develop an allergic reaction to a specific type of protein found in sperm. In this regard, ejaculating into a woman’s vagina may cause redness and itching in the area. The use of a condom may help you avoid this problem.

However, you cannot have a child in this manner. If you are extremely sensitive to this allergic reaction, IUI is the better option for you. Several components of the sperm would be removed by the doctor during this procedure. As a result, you should be safer.

Indications of IUI

There are several health indications, which might suggest the requirement of the IUI procedure. Some of these are as follows –

  • The production of female humoral anti-sperm antibodies
  • Male infertility
  • The removal of the cervix or any other cervical disease
  • Severe pain during intercourse
  • Unsuccessful treatment with fertility drugs

IUI Procedure

The IUI procedure appears to be simple and painless. However, as a first-timer, you may be nervous. Thus, understanding the process can assist you in properly preparing for it. So, let us look at it as well!

Step 1

Collection of the Semen: Initially, the doctor would collect a small amount of sperm for the procedure. It is obtained through masturbation, which is similar to the process of sperm analysis.

However, if your partner is unable to produce it at the hospital, he can do so at home. In this case, the doctor will give him a kit for collecting sterile sperm. However, the sample must arrive within an hour of the ejaculation.

Step 2

Semen Washing: Human sperm is only one component of human sperm. It also contains protein, vitamins, and other important components. So, before starting the procedure, your doctor will remove anything unnecessary. This is referred to as the washing procedure!

Step 3

Insertion of the Catheter: You must now lie down on an examination table with your legs raised on stirrups. The doctor will first insert a speculum into the vagina and attach a sperm-filled vial in a catheter.

The catheter will then be inserted into your uterus through the cervical opening. Following that, he or she will insert the sperm sample into the uterus via the small and thin tube. After that, they will remove the catheter and speculum, respectively.

What You Can Expect During & After IUI Procedure?

As previously stated, the Intrauterine Insemination procedure is completely painless. If you are already familiar with the procedure, you will not feel anything during it. While the doctor inserts the catheter, you may experience some discomfort. However, this is insignificant.

So, once the procedure is finished, the doctor will ask you to lie down on your back for a few moments. During this time, the sperms will attempt to find a way to their destination. As a result, if you walk or move too much, their working procedure may be disrupted.

You can get up and go about your daily business once the doctor says so. During the first one or two days, you may experience spotting. However, it is only temporary and will fade away on its own. Make sure you wait at least two weeks before taking a pregnancy test.

Risks involved with IUI Treatment

The IUI procedure is relatively simple and straightforward. As a result, there are no negative side effects. However, there are some risks that may occur under certain conditions. These are some examples:

Spotting: The placement of the catheter can occasionally cause vaginal bleeding during the procedure. However, it will be minor and will disappear within one or two days.

Infection: There is also a small chance of getting an infection on the outside of the vagina. However, in most cases, the doctor will remove it at an early stage.

Success Rates of IUI

The overall health and efficiency of the sperm determines the success rate of IUI. After one cycle of IUI, most women have a 10%-20% chance of success. However, after three to six cycles, the rate rises to around 80%.

IUI Treatment Cost

For IUI treatment, you need to consider several factors. There are several things you need to consider such as the age of the couple, their medical history, and their type of infertility to determine the actual fertility cost.

The cost of IUI varies from state to state in India. However, the cost of the same generally ranges from INR 12,000 to INR 17,000 on average. In general, IUI is less expensive than other fertility treatments such as In Vitro Fertilization (IVF).

Topic 11 : Genetic Screening

Preimplantation Genetic Screening?

Preimplantation Genetic screening is a test that thoroughly examines the chromosomal material of an IVF or in-vitro fertilised egg prior to implantation. During this time, one or more embryonic cells are removed to test for numerical chromosomal abnormalities, also known as aneuploidy. Screening allows for selective implantation of embryos in this method once healthcare professionals know which ones have a standard number of chromosomes.

Everything You Need to Know About Genetic Screening

Candidates | Screening tests | Procedure | Risks | Indications | Diagnosis | Cost | Pros & Cons | Alternative methods

Who is recommended to have preimplantation genetic screening?

PGS is not for everyone and is not required. Women over the age of 37 are more likely to carry eggs with an incorrect number of chromosomes. As a result, if they want to conceive, they must go through the screening process. According to research, abnormal chromosomes are one of the leading causes of infertility in women of that age. They are also more likely to miscarry or have a baby with Down syndrome.


There are other situations when your doctor might recommend PGS. These include –

1) If your family has a history of chromosomal problems
2) If your sperm has a risk of carrying an abnormal number of chromosomes
3) If you have already had some failed miscarriages
4) If you have had failed IVF tries without any explanation

That said, PGS is not a guaranteed way to prevent a miscarriage or have a baby. Moreover, the studies about the screening process helping the groups mentioned above are limited.

Which test do you need?

You need the test for a variety of reasons since it can be used in different circumstances. They include –

1) Testing for monogenic disease – The specific gene mutation carried by both parents is examined in this case. After all, a gene disorder is caused by a mutation in the DNA sequence. It causes diseases such as cystic fibrosis and sickle cell anaemia. There may also be inherited genetic mutations that result in breast or ovarian cancer.

The following are some of the most common diseases tested using this method:

  • Huntington’s disease
  • Sickle Cell Anemia
  • Cystic fibrosis
  • Muscular dystrophy
  • Fragile-X syndrome
  • BRCA1 and BRCA2 mutations
  • Tay-Sachs disease

2) Testing for chromosome structural arrangement –It examines embryos from parents who have chromosomal structural changes such as inversion or translocation. Miscarriages may occur if this issue is not addressed. The most common disorders examined during this process are as follows:

  • Reciprocal translocations
  • Non-reciprocal translocations
  • Robertsonian translocations

Thus, depending on your underlying condition, the PGS process will help you realize possible complications that might arise during childbirth.

How does IVF-PGS work?

In PGS, the biopsy is typically performed during the blastocyst stage, on the fifth or sixth day of embryo development. While the embryos are frozen at the clinic, the biopsies are performed in the lab. PGS examines each embryo biopsy and counts the number of chromosomes in each sample.

The result can either show an average number of chromosomes, indicating a relatively high chance of a healthy pregnancy, or it can show an abnormal number of chromosomes, indicating a miscarriage or other complications.

A genetic report is sent to the medical professional after the embryos have been analysed. The doctor recommends which embryos should be used for couples trying to conceive based on this, as well as the embryos’ grading and morphology.

Risks of PGS

While PGS is a typical process, there are some risks attached, which is the case with all medical procedures. They include –

1) Ovarian hyperstimulation syndrome, which results in multiple pregnancies and might even lead to congenital disabilities unrelated to the genetic test.

2) The risk of biopsies or freezing harming the embryo.

Indications and Conditions of PGS

The main indications for PGS are when the couples have single-gene disorders or structural chromosome aberrations. PGS, on the other hand, has no set conditions, but it is typically performed on women over the age of 35 or after failed IVF procedures and miscarriages.

What is a preimplantation genetic diagnosis?

PGD, or Preimplantation Genetic Diagnosis, provides information about the gene makeup of the embryo’s cells. On day five, 3-8 cells are removed from the source and sent to the lab for testing in the embryo biopsy.

The embryo is frozen during this time so that it can be implanted later. PGD can detect nearly 2000 inherited single-cell disorders and distinguish between affected and unaffected sources with an accuracy of up to 98%.

What is the cost of preimplantation genetic testing?

Nowadays, PGT and PGS are used interchangeably, but it is important to remember that the screening process does not occur in a vacuum. Because it is part of the IVF procedure, the cost is relatively high. The average cost is close to $4,000. Consultations, lab fees, medications, additional investigations, and follow-ups are all included.

Preimplantation genetic testing Pros and Cons

Before considering PGT, you have to see if the pros outweigh the cons, especially since it is a pretty expensive process overall. The advantages of PGT are –

1) Reduced risk of having a child with a chromosomal abnormality.

2) Women with previously unexplained miscarriages might undertake PGT to prevent the situation from happening in the future.

3) It helps settle the difficult decision of whether to continue or terminate the pregnancy if the fetus has an abnormal chromosomal count.

4) For women above 36, the process reduces the risks of miscarriage and the number of transferred embryos required for pregnancy.

The downsides of PGT are –

1) It doesn’t increase the chances of having a baby
2) The cost is quite expensive

Alternatives to IVF-PGS

Some of the alternative methods which are likely to work better include –

1) Chronic villus sampling – CVS is a biopsy of the placenta 10-12 weeks into the pregnancy. If any anomaly is detected, the couple can consider termination.

2) Amniocentesis – The process is carried out 16-18 weeks into the pregnancy, and the amniotic fluid is tested for anomalies. Again, termination is an option.

3) Ultrasound and Blood Tests – While these two combined might work, the above processes have a greater accuracy rate.

4) In case of a high risk of inherited diseases, one might consider donor eggs or sperms.

Thus PGS is an additional test that might be carried out. That said, if couples want to undergo the procedure, they should consult the medical professionals beforehand.

Topic 12 : CASA

What is a Computer-Assisted Semen Analysis?

Computer-Aided Sperm Analysis (CASA) is a system in which a complex electronic imaging system is used to visualise the sperm, while advanced software programmes assist in measuring the numerous individual parameters of said sperm. The sperm specimen is examined using a microscope equipped with a high-resolution video camera in this method. The data is transmitted from the camera to a computer, which processes it with the necessary software. CASA provides medical professionals with analyses that include many more parameters and can aid in the resolution of fertility-related issues.


Everything You Need to Know About CASA

Sperm Analysis | Semen Analysis and Sperm Motility | Semen Analysis and Sperm Morphology | Parameters | Candidate | Advantages | How it works | Procedure | Cost | Signs | Causes

What is sperm analysis?

A sperm count test is another name for sperm analysis. It evaluates the viability and health of male sperm. To be clear, semen is the fluid that contains sperm as well as sugar and other protein substances and is released during ejaculation. The sperm analysis assesses three major aspects of sperm health:


  • The number of sperm present
  • The shape of the sperm
  • The movement or motility of the sperm

Typically, two or three tests are performed to form an assessment of sperm health. Doctors advise scheduling tests seven days apart over two to three months. Because male sperm count varies on a daily basis, only an average of the samples allows medical professionals to reach an accurate conclusion.


Semen analysis and Sperm motility

Male fertility is largely determined by the number of sperm moving forward quickly and gradually. In a standard sperm analysis, there is some sperm that does not move and some that moves slowly or does not move forward. These samples are less likely to result in pregnancies.


When sperm analyses are computerised, every sperm under the microscope is scrutinised. Their path can be analysed in a fraction of a second, and various parameters can be precisely calculated. The following parameters were calculated:

  • The overall percentage of motility for sperms showing movement.
  • Rapid motility percentage for sperms traveling at 25 um/second or faster.
  • Linearity percentage for sperms moving in straight-line paths.
  • Progressive motility percentage for sperms moving fast and in a straight path.
  • The average speed of all sperms within the field of view.
  • Average lateral head displacement, which is essentially the distance that the sperm head ‘wiggles’ while moving.

Semen analysis and sperm morphology

When sperm is examined under a microscope, some have a normal appearance, while others have an abnormal appearance. Men with normal fertility will have a certain percentage of sperm that looks normal.


Several criteria and cutoffs have been developed over time to distinguish ‘normal’ from ‘abnormal’ sperms. While the WHO (World Health Organization) standard has been followed so far, recent studies have shown that there is room for improvement. As a result, the medical community has shifted to ‘Strict Morphology,’ also known as ‘Kruger Morphology,’ after the man who invented it.


Here, sperm is scrutinised more closely, and the definition of normal is more stringent. Previously, men with 30-50% normal sperm would be considered fine, but Kruger’s method caps it at 14%. While technicians do not always analyse sperm morphology consistently, CASA eliminates this problem, and the system is validated by Kruger.


Parameters of CASA

The parameters needed for CASA include –

  • VAP or average path velocity
  • VSL or straight-line velocity
  • VCL or curvilinear velocity
  • ALH or amplitude of lateral head
  • BCF or beat cross frequency
  • LIN or linearity
  • STR or straightness

Ideal candidates for CASA

CASA is best suited to two types of people. They include those seeking testing for male fertility or the success of a vasectomy.


Because a semen analysis is necessary for a couple attempting to conceive, the test assists the doctor in determining whether the man is infertile. CASA can help identify sperm count, dysfunction, and other causes of infertility.


Vasectomy is a permanent birth control procedure in which the tubes that carry sperm from the testicles to the penis are cut and sealed. Men who go through the process are frequently given a CASA test to see if they have any sperm in their sperm. After a vasectomy, doctors recommend monitoring once a month for three months to see if sperm reappears in the sperm.


Advantages of CASA

The benefits of CASA include –

  • Quick analysis
  • Completely reproducible with the same settings
  • Highly detailed analysis
  • Greater statistical power due to the objective analysis of several sperms

How does the CASA technique work?

Computer technology analyses how sperm moves and appears. The computer examines the sperm under the magnifier and prepares to create a highly digitised image of each sperm by tracking its speed and path. It facilitates humans’ ability to analyse and draw conclusions about fertility.


CASA test procedure

While the test process is simple enough where your semen is collected and put under the microscope, there are some ways you can prepare for it. Among them are –

  • Avoiding ejaculation for 24-72 hours before the test
  • Avoiding caffeine, alcohol, and drugs like marijuana and cocaine two to five days before the test
  • Avoiding herbal medications
  • Avoiding hormone medications

Semen analysis test cost (casa test cost)

Fortunately, the cost of a Semen analysis test in India is not prohibitively expensive. While prices vary by state, the national average for males is around Rs. 489. You can get tested for Rs. 100 at the most affordable price, and Rs. 900 at the most expensive.


What are the signs of unhealthy sperm?

When it comes to sperm health, there are several factors to consider. Shape, count, and motility are examples of these. In terms of sperm count, an average of 15 million sperms per millilitre of sperm is considered healthy. There is no harm in having more, but having less than 15 million is a sign of unhealthy sperm.


Similarly, less than 40% of sperms are strong swimmers, which is cause for concern. Finally, sperms with healthy heads and long, strong tails. If the shape of your sperm does not match this, it is most likely unhealthy.


Superfoods for fast sperm production

1) Oysters
2) Pumpkin seeds
3) Dark, leafy vegetables
4) Oranges
5) Dark chocolates
6) Pomegranate juice
7) Salmon and sardines
8) Brazil nuts
9) Water

Causes of sperm infections

Bacteria from patients’ urinary tracts are the most common cause of sperm infections. It is sometimes transmitted by the partner during sexual intercourse. Escherichia coli is a common microorganism found in males with genital tract infections or semen contamination.


Is it healthy to eat sperm?

Nobody wants to know if they can eat their own sperm, right? However, most sperm is safe to consume and contains protein. However, in order for it to be a potential protein source, gallons would have to be consumed. It also contains zinc, sodium, sugar (glucose and fructose), lactic acid, potassium, and urea, among other things. Having said that, sperm is low in calories.


Some of the actual benefits of eating sperm are that it is a potent mood booster since it contains –

1) Endorphins
2) Estrone
3) Oxytocin
4) Prolactin
5) Serotonin
6) Hormone that releases thyrotropin

Some people believe that sperm can relieve stress. A controlled study published in 2003 found that women who were exposed to this condition for an extended period of time, both before and after pregnancy, had a lower risk of developing preeclampsia, a rare pregnancy-related complication.


However, consuming sperm may increase your risk of STIs and, in some rare cases, allergies. Human seminal plasma hypersensitivity is the name given to this condition (HSP).


Thus, sperm has advantages and is unquestionably important in the reproduction process. In case of complications, it is best to have the swimmers analysed using the precise and dependable CASA process.

Laparoscopic Surgery

Topic 1 : Laparoscopic Hysterectomy

Laparoscopic Hysterectomy

The uterus, ovaries, fallopian tubes, and cervix are all removed during a hysterectomy. This procedure can be performed in a variety of ways, one of which is laparoscopy. The uterus is removed through a minimally invasive surgical procedure known as laparoscopic hysterectomy. It is a secure and efficient procedure. A tiny camera is inserted through the belly button, allowing doctors to see the internal organs of the patient. This procedure is performed under anaesthesia. Laparoscopic supracervical hysterectomy is a procedure that removes a woman’s uterus but not her cervix.


Everything You Need to Know About Laparoscopic Hysterectomy

Purpose | Preparation | Reasons | Alternatives | Tests | Types | Side Effects | Recovery Tips | Pros and cons | Recovery Time | What to Expect | Cost

Why is it performed?

Doctors perform laparoscopic surgery is suggested when the patient is suffering from any of the following conditions:-

  • Chronic pelvic pain
  • Endometriosis
  • Pelvic inflammatory disease
  • Infertility
  • Removal of fibroids, uterus, lymph nodes, and ovarian cysts
  • Ectopic pregnancy

How is Laparoscopic hysterectomy performed?

The various steps takes place in the process of laparoscopy:-

  • Preparation and positioning
  • Insertion of a urine manipulator
  • Abdomen entry and placement of trocar
  • Hug the ovaries
  • Mobilization of the bladder
  • Secure the urine vessels
  • The uterus and cervix is separated from the vaginal apex
  • Removal of the uterus
  • Closure of vaginal cuff
  • Closure of the port site

10 Reasons for Hysterectomy

1. Uterine Fibroids

Fibroid growth in the uterus can sometimes be noncancerous. They can also cause severe pain and bleeding. If all other options fail, doctors will be forced to perform a hysterectomy.


2. Cancer

Need for hysterectomy is when you have cancer of the following:

  • Cervix
  • Ovary
  • Uterus
  • Endometrial.

In case of precancerous conditions or to avoid cancer in the future, doctors also recommend surgery.

3. Endometriosis

Endometriosis occurs when the tissues that line the uterus grow outside of the uterus. It can result in irregular periods. Extreme pain may also occur, eventually leading to infertility.


In the case of endometriosis, medical procedures and hormone therapy are performed prior to hysterectomy.


4. Adenomyosis

Adenomyosis occurs when the uterine lining begins to grow into the uterine muscle. This causes the uterine wall to thicken. It results in severe bleeding and pain.


Hormone therapy and medications are also tried first in the case of adenomyosis.


5. Infection

PID, also known as Pelvic Inflammatory Disease, is characterised by severe pelvic pain. It is caused by a bacterial infection. Antibiotics can help if it is discovered early.


However, if it spreads, it can cause uterine damage. As a result, if you have severe pelvic inflammatory disease, your doctor may recommend a hysterectomy.


6. Hyperplasia

Hyperplasia occurs when the uterine lining becomes too thick. Excess oestrogen consumption also causes hyperplasia. Hyperplasia can also cause heavy, irregular menstrual bleeding.


It may also result in uterine cancer. If doctors suspect severe hyperplasia, they may also advise a hysterectomy. Doctors advise hysterectomy because it will result in cancer in the future.


7. General abnormal bleeding

If you have irregular and heavy menstrual bleeding on a regular basis, your doctor may recommend a hysterectomy. Fibroids, cancer, infection, hormone changes, and other conditions can all cause irregular bleeding. These causes are accompanied by stomach pains and cramps.


After exhausting all hormone therapies, hysterectomy is the only option for relief.


8. Uterine prolapse

When the uterus slips and falls into the vagina from its normal place it is the uterine prolapse. It is also very common in women who is having multiple vaginal births. In some cases where women suffer from obesity or menopause this is also common.

Some of the common symptoms of uterine prolapse are:

  • Urinary issues
  • Pelvic pressure
  • Bowel problems

The nature of treatment mostly depends upon how severe the uterine prolapse is. If all other measures don’t work, doctors furthermore recommend a hysterectomy.

9. Placenta accreta

Placenta accreta occurs when the placenta grows too deeply into the uterine wall. This occurs during the course of a pregnancy. It has no symptoms and the conditions are very serious.


In such cases, doctors perform a caesarean section as well as a hysterectomy. It reduces blood loss when the placenta is separated.


10. Delivery complications

Severe bleeding can occur during either a caesarean or vaginal delivery. Doctors remove your uterus during a hysterectomy. Furthermore, this is immediately following the delivery to save a life.


What are the alternatives to a hysterectomy?

  • Myomectomy
  • Uterine artery embolization
  • Medical management
  • Menorrhagia

Tests performed before hysterectomy

Before a hysterectomy, doctors may order preliminary blood tests, an electrocardiogram (EKG), a urinalysis, and a chest x-ray. It aids in ensuring that there are no undiagnosed medical problems. They can also cause complications during surgery if they are not diagnosed.


A pelvic ultrasound may be performed to evaluate the ovaries and uterus. It is determined by the patient’s physical exam and medical history.


Many tests are done before hysterectomy. Such as:

  • CBC count
  • Endometrial sampling
  • Ultrasonography
  • ECG
  • CAT scan
  • Barium enema
  • Tumor markers
  • Blood type cross match
  • Chest radiography
  • Papanicolaou test
  • Cystoscopy

Types of hysterectomy

There are four types of hysterectomy

  • A radical hysterectomy
  • A total hysterectomy
  • Super cervical hysterectomy
  • Hysterectomy with oophorectomy

Uterus removed side effects

The female reproductive organ is the uterus. It is the area between the rectum and the bladder. The uterus is divided into two parts: the cervix (the main part) and the cervix ( lower part ). It feeds and protects the fertilised egg until the newborn is born. The womb is where the baby develops.


You may require a variety of reasons to remove the uterus. The uterus is removed to treat certain infections and cancers. At the same time, there are numerous negative consequences to removing the uterus:


  • Menopause – You will no longer experience menstrual cycle
  • Sense of loss
  • Change in the sexual feeling
  • Risks of other health problems increase

Hysterectomy recovery

There are many tips you may follow after hysterectomy. You must also know how to handle emotional and physical ups and downs.

  • Engage yourself with some exercises or yoga
  • Get some sunshine
  • Take medications according to the prescribed time
  • Take as much rest as you can
  • Prevent yourself from constipation
  • Try to wear loose, stretchy clothing
  • Eat healthy foods also
  • Talk to your friend about your feelings
  • Make yourself emotionally ready for hormone changes
  • Let your close ones also help you
  • Do not wait to call your doctor if you are not feeling well

The pros and cons of laparoscopic hysterectomy


  • Laparoscopic hysterectomy involves minimally invasive techniques. These are far better than the traditional methods
  • Instead of waiting for a long time and staying at the hospital, this takes place in a short time
  • There is minimum pain, little to no blood loss. And there are also minimal risk in case of laparoscopic surgery


  • Laparoscopic hysterectomy may cause a higher risk of cardiovascular diseases also
  • It also premature menopause

Laparoscopic hysterectomy time

If done under general anaesthesia, it usually takes 1 to 3 hours. Many patients are also admitted to the hospital for one night so that the doctor can monitor their healing progress. The majority of patients return to normal activities within 5-6 days.


What to expect after laparoscopic hysterectomy?

  • Some women who undergo laparoscopic hysterectomy may also expect to have smears. This takes place from the top of the vagina
  • You will also be offered hormone replacement therapy
  • You will also be advised to rest comfortably and move easily
  • A feeling of tiredness and discomfort will be in your body for the first few days

Life after hysterectomy


Life will not be the same after a hysterectomy. There will be no regular menstrual cycle for you. The pains that lead to laparoscopic surgery will be relieved.


You will also lose the ability to conceive.


Laparoscopic hysterectomy cost

In India, the average cost of a laparoscopic hysterectomy ranges between Rs. 2,10,000 and Rs. 3,00,000. This price does not include any medication or physiotherapy recommended by the doctor. The cost is primarily determined by the patient’s condition.


Laparoscopic hysterectomy, according to reports, is a much safer and more effective procedure. When compared to traditional methods, this is the safest way to remove the uterus.

Topic 2 : Laparoscopic Myomectomy

What is Laparoscopic Myomectomy?

Laparoscopic Myomectomy is a surgical procedure that removes fibroids while causing no harm to the uterus. In the medical world, it is also known as a Robotic Myomectomy. Doctors may recommend this surgery if the fibroid begins to cause too many problems in daily life. Pelvic pain, frequent urination, irregular bleeding, and heavy periods are symptoms that may necessitate surgery. Laparoscopic Myomectomy uses small abdominal incisions to remove fibroids. Depending on the location and size of the fibroids, various myomectomy techniques are available.


Everything You Need to Know About Laparoscopic Myomectomy

Preparation| Procedure | Types | Symptoms | Risks & Complications | What to expect | Recovery | Cost

How do you prepare for surgery?

Prepare yourself mentally for a change. Your body will undoubtedly change as a result of the surgery. Speak with your loved ones or seek professional assistance.

Follow these below-mentioned guidelines before your surgery:-

  • Avoid wearing jewelry
  • Try to wear loose-fitting clothes.
  • Doctors will restrict you to eat, drink ( not even water ), or smoke after midnight before the day of the surgery.
  • You must not wear nail polish before the surgery.
  • Wear low-heeled shoes before the day of surgery, as you might feel drowsy because of anesthesia.

What happens during the procedure?

Several steps are taken by the surgeon during the laparoscopic myomectomy procedure. While you are under general anaesthesia, your surgeon will make four 12 inch long incisions in your lower abdomen. The surgeon will have access to your abdomen. It occurs when your stomach is full of carbon dioxide.


A laparoscope, which is a thin tube of light with a camera on one end, will be inserted through one of the incisions. Small instruments will be inserted through the other incisions. In the case of robotic surgery, your surgeon will control the instruments with a robotic arm.


If your fibroids are small, your surgeon may prefer to cut them into small pieces; if they are large, a larger incision in your abdomen will be made to perform an abdominal myomectomy. All instruments will be removed at the end of the surgery, the carbon dioxide gas will be released, and the incisions will be closed.


Types of myomectomy techniques

There are several forms of myomectomy techniques depending upon the location and size of the fibroids. Myomectomy procedures are done under anesthesia and in the operating room.

  • Hysteroscopic myomectomy

Surgeons use a narrow telescope to view the uterine cavity during hysteroscopic myomectomy. The telescope is inserted into the vagina and then passed through the cervix, allowing the surgeons to see inside the uterus. Small fibroids are removed using this technique.


  • Laparoscopically-assisted myomectomy

This procedure is used to remove fibroids that extend into the uterine wall or are visible outside the uterine cavity. A laparoscope, along with other instruments, is inserted into the abdomen.


  • Robotic-assisted laparoscopic myomectomy

This procedure is comparable to laparoscopic myomectomy. The only other thing to know about this procedure is that it employs robotics.


  • Open abdominal myomectomy

Surgeons gain direct access to the uterus in this procedure by making a vertical incision into the abdomen. When compared to other techniques, the incision made in this procedure is the largest. It also requires additional time to heal. Surgeons prefer this procedure when fibroids are too large.


Symptoms that indicate the need for laparoscopic myomectomy

Below mentioned are the symptoms that might warrant a laparoscopic myomectomy. Before the actual surgery, the doctor will conduct several tests.

  • Constipation
  • Unusually heavy period
  • Pelvic pain
  • Difficulty while urinating
  • Frequent urination
  • Duration of Menstrual period longer than one week
  • Pain in legs and lower back

What are the complications and risk factors associated with laparoscopic myomectomy?

The procedure of laparoscopy is relatively safe, but it has certain risks too. These are –

  • Complications in pregnancy
  • Bleeding
  • Fertility issues
  • Organs in the abdomen are damaged
  • Urinary or bowel problems

There are two types of complications associated with laparoscopic myomectomy – intraoperative and postoperative.

Some of the intraoperative complications are:-

  • Enucleation
  • Hemostasis
  • Morcellation injury

Some of the post-operative complications are:-

  • Pelvic adhesion
  • Hematoma

Recovery tips for the patient

You may feel some pain and also have spotting after the surgery for a few weeks. For this, the doctor will prescribe some medications. Depending upon the kind of surgery performed, healing time can be estimated.

  • For hysteroscopic myomectomy, you will need two to three days of healing time.
  • In the case of abdominal myomectomy, the healing time is four to six weeks.
  • For laparoscopic myomectomy, the healing time will be two to four weeks.

You should avoid exercising for too long or too hard. Lifting heavy objects and walking quickly must also be avoided. Before engaging in sexual activities, you must seek advice. If you want to become pregnant, you must first consult with a healthcare professional.


What to expect?

Typically, you will need 6 to 8 weeks to recover from surgery. During this time, you will be extremely tired. Rest should be taken as much as possible. You should also avoid lifting heavy objects.


You will no longer have a menstrual cycle or be able to conceive after this surgery. In any case, your ovaries will be removed during surgery. As a result, if you have not yet reached menopause, you will begin it immediately. Hot flashes, vaginal dryness, and night sweats are all possible symptoms.


Women are also affected by fatigue following surgery. It could last up to ten weeks. However, it can sometimes last up to six months after surgery.


Costs of laparoscopic myomectomy

One of the modern approaches to surgical treatment is laparoscopic myomectomy. Minimal invasive techniques are used in this surgery. The cost of this surgery varies a lot. It ranges from INR 3,50,000 to INR 5,50,000.


Laparoscopic Ovarian Cyst Surgery

What is Laparoscopic Ovarian Cyst surgery?

Many women are affected by cysts. The only issue is that the symptoms of an ovarian cyst are not visible. Women may experience weight gain, irregular menstrual cycles, and other symptoms in a few cases. However, if the cysts cause pain or discomfort, surgical procedures should always be considered. Ovarian cyst removal is a surgical procedure used to remove a cyst or cysts from one or both of your ovaries. Small incisions and specialised tools are used in laparoscopic surgery. It may provide quicker recovery than open surgery, which requires a larger abdominal incision.


Everything You Need to Know About Laparoscopic Ovarian Cyst surgery

Purpose | Symptoms | Side Effects | Complications | Recovery | Candidates | Procedure | What to expect | Advantages | Cost 

Why ovarian cyst surgery done?

Although an unruly lifestyle is not recommended, many women do experience cysts. The only issue is that the symptoms of an ovarian cyst are not visible. Women may experience weight gain, irregular menstrual cycles, and other symptoms in a few cases. However, if the cysts cause pain or discomfort, surgical procedures should always be considered.


Pelvic pain during periods or sexual activity is another common symptom. Furthermore, ignoring ovarian cysts can lead to ovarian cancer. As a result, removing the cyst buildup is always a good idea.


Symptoms of an ovarian cyst

Initially, the ovarian cyst does not manifest any of these symptoms. It is critical to recognise that ovarian cysts are quite common these days. However, if you notice that you are missing periods every month and have unexplained weight gain, you should consult a doctor.


Some common symptoms of ovarian cyst include pressure, bloating, pain in the lower abdomen. Ignoring ovarian cysts will give rise to further complex symptoms.

  • Pelvic pain
  • A dull ache in the lower back as well as thighs
  • Pain while having sex
  • Sudden weight gain
  • Unusual vaginal bleeding
  • Needing to urinate more often
  • Painful periods

Side effects of ovarian cyst removal

Depending on the severity of your condition, you may experience mild to severe side effects after the surgery. However, one of the most common post-surgery side effects is lower tummy discomfort. Aside from that, you’ll have shoulder pain, vaginal bleeding for 48 hours, and so on.


You may also feel tired for a few days, but with proper diet and care, you will be able to recover in a matter of days. If you still believe that the problems are persisting, you should see a doctor.


Complications of ovarian cyst removal

It is critical to understand that complications are extremely rare. However, it is critical to understand that none of the surgeries are without risk. It is best to consult your doctor if you intend to undergo the complications of ovarian cyst removal.


They will inform you of any complications that may arise following surgery. The complications that can arise following ovarian cyst removal vary from person to person. Some of them are infection, bleeding, the cyst returning, infertility, blood clots, and so on.


Recovering from the ovarian cyst removal

Once again, the recovery procedure is determined by the severity of your condition. After the surgery, you will experience stomach pain for a few days. However, with the right medication, you should be able to recover quickly.


It should take about twelve weeks before you can resume your daily activities. To heal, it is critical to maintain a healthy lifestyle. If the cyst is small, doctors may advise against surgery. However, if the cyst grows in size, it is best to have surgery.


Who should get the procedure?

If you have swollen ovaries or irregular menstruation, laparoscopic ovarian cyst surgery is the best option for you. Furthermore, if you have constant pain in your lower abdomen, doctors usually recommend laparoscopic cyst surgery.


Aside from that, women with PCOS who are planning a pregnancy should have their ovarian cysts checked. Otherwise, they will have difficulty conceiving. If you have ovarian cysts, consulting with a gynaecologist will give you a better idea of what needs to be done.


If you have severe hormonal imbalances, the doctor will first prescribe medications to balance your hormone levels before recommending surgery.


Laparoscopic ovarian cystectomy procedure steps

Before the surgery begins, you will have to follow certain procedures that will help in making the surgery successful. Some of the steps that you have to follow before the surgery are.

  • Avoid eating or drinking anything, especially after midnight before the surgery day.
  • As you will be under anesthesia before the surgery begins, make sure that you are taking the help of someone who will drive you to the hospital.
  • Arrive at the hospital before the surgery begins so that the doctors can have enough time for the pre-surgery procedures.
  • You can ask your provider questions before the surgery begins regarding the medications. Whether you must stop or take new medicines or pre-existing medications that will help with the surgery.
  • Before your surgery is scheduling, diligently follow all the instructions both pre and post appointments.

What happens during ovarian cyst removal?

Doctors will administer local anaesthesia prior to the surgery to make the procedure easier. A laparoscope, or thin tube with a camera on the end, is inserted into the abdomen. The camera is placed on the side of the navel through a small incision.


More incisions in the abdomen are made if necessary. Surgeons use sir inside the abdomen to create enough space for the abdominal wall and organs. The cyst is then removed using various surgical instruments.


What to expect after an ovarian cyst surgery

After the surgery, you will have an abdominal sore and bruises for a few days. Furthermore, the gas inside your abdomen during the surgery may cause pain in your shoulders and back. You will experience vaginal discharge and spotting for several days following surgery.


Doctors will close the incisions with skin adhesives and bandage the area. You can, however, remove the bandages within twenty-four hours of the surgery. The adhesives or stitches will dissolve within a few days without causing pus or infection.


If you have minor bandage trips, you can easily remove them after seven days. Even if they do not fall off, they are simple to remove within seven days. The only thing you should avoid doing is going swimming or soaking incisions in a bathtub.


Bathing is permitted, but the operated area should not be rubbed. You will be extremely tired for the first week following surgery. However, you must not rush, as you must gradually increase your activity levels, beginning with short walks. When it comes to sexual activities, you can start whenever you feel ready.


Advantages of laparoscopic ovarian cystectomy

Although ovarian cysts are common, it is critical to understand that ignoring them can result in ovarian cancer. Common ovarian cyst symptoms include irregular periods, bloating, nausea, and pelvic pain during intercourse, among others. However, if the problem worsens, you will experience constant pain in your lower abdomen.


Surgery is the best way to avoid cancer or other serious diseases. Your menstrual cycle will be regularised after laparoscopic ovarian cystectomy, and the problem of abnormal bleeding will be reduced. Furthermore, if you intend to have a child, you will have a successful pregnancy.


Laparoscopic ovarian cyst surgery cost

Normally, the Laparoscopic Ovarian Cyst surgery cost depends on the location. However, the average cost ranges from 20,000-40,000, depending on your severity.

Diagnostic Laparoscopy

What is Diagnostic Laparoscopy?

Diagnostic laparoscopy is a surgical procedure used to examine the inside of the abdomen and pelvis. It is typically used to detect or treat pre-existing problems. This can help to avoid the need for more complicated surgery in the future. The procedure is used to determine the source of pain or growth in the abdomen and pelvic region when X-ray or ultrasound results are inconclusive. It is sometimes done after an accident to see if the organs in the abdomen are damaged. Diagnostic laparoscopy is frequently used in cancer treatment to determine cancer spread. Once the disease is identified, treatment can begin.


Everything You Need to Know About Diagnostic Laparoscopy

Indications | Purpose | Preparation | Diagnosis | Tests | What to Expect | Complications | Recovery Time | Cost

Indications of diagnostic laparoscopy

A diagnostic test Laparoscopy is required if you have been experiencing long-term pain or abnormal tissue growth, or if you have a disease in the organs of your abdomen or pelvis.


Why is the test performed?

Diagnostic laparoscopy is used to determine the source of pain or growth in the abdomen and pelvic region when X-ray or ultrasound results are inconclusive. It is sometimes performed after an accident to determine whether an organ in the abdomen has been damaged. Diagnostic laparoscopy is frequently used in cancer treatment to determine if the cancer has spread. Once the disease is identified, treatment can begin.


Preparation for the procedure

The diagnostic procedure has a step-by-step procedure that you need to follow. It is relatively simple and requires some amount of patience only. Here are some of the steps:

  • Depending on the type of laparoscopic procedure being performed, you’ll usually be asked not to eat or drink anything for 6 to 12 hours beforehand.
  • If you’re taking blood-thinning medication (anticoagulants), such as aspirin or warfarin, you may be asked to stop taking it a few days beforehand. It is to prevent excessive bleeding during the operation.
  • If you smoke, you may be advised to stop during the lead-up to the operation. It is because smoking can delay healing after surgery and increase the risk of complications such as infection.
  • Most people can leave the hospital either on the day of the procedure or the following day. Before the process, you’ll need to arrange for someone to drive you home because you’ll be advised not to drive for at least 24 hours afterward.

Diagnostic laparoscopy procedure steps

It is performed in a hospital or an outpatient surgery facility. The length of a Laparoscopy is determined by what the doctor discovers during the procedure. Here are some steps that are usually included in the procedure.


  • Anesthesia to Make you Sleep – Nothing will be felt once given anesthesia. However, you can always ask questions about how it feels during the process, and if you will feel anything afterward.
  • Small incisions in the belly region – The surgeon will make microscopic incisions near the navel region. It is to insert gas into the abdomen. It holds the organs away from each other so that the doctor gets a clear view of them.
  • Laparoscope – Then, the laparoscope, which contains a camera and a light, is inserted.
  • Surgical Tools – These are inserted to form small procedures.
  • Suction Tube – This is then inserted to suck out the extra gas from the abdomen.
  • Looking for Damage or Disease – The doctor looks for some kind of damage or disease with the laparoscope’s help. The doctor might do a biopsy, which is sent to the laboratory for the check. The doctor might take out the tissue and fix parts of the organ that have undergone damage.
  • Final Step – The last step is when the laparoscope and other tools are taken out of the body. The gas is pumped out of the body with a suction hose. The incisions are then closed with stitches.

What tests are necessary before laparoscopy?

Several tests should be expected prior to any surgery, laparoscopy or otherwise. The majority of these tests are general to ensure that the patient is fit for surgery. Blood tests, urinalysis, electrocardiograms (EKGs or ECGs), and chest X-rays are common examples of such tests.


Furthermore, depending on the reason for your surgery, your doctor may order additional tests. For example, if you are having a laparoscopic hysterectomy, you may be required to have tests such as pelvic ultrasounds and/or computerised pelvic tomography (CT). As a result, in addition to general tests, case-specific tests are frequently required prior to laparoscopy.


What to expect:

Although laparoscopy is a minimally invasive surgical procedure, there are certain things to keep in mind before undergoing a laparoscopy.

Before the procedure: It is best to notify your doctor about any underlying medical conditions you may have well in advance of having a laparoscopy. It’s also critical to follow your doctor’s advice about what to do a week before surgery.


During the procedure: During the surgical procedure, there isn’t much you can do or expect from your side. Laparoscopy is usually done under general anaesthesia (and sometimes after local anaesthesia), so you won’t feel anything. The procedure necessitates small incisions, but you will not experience any pain.


After the procedure: When the procedure is finished, you will most likely wake up in a hospital recovery area. Depending on the procedure, you can expect to be under observation for at least a few hours. You can expect to see your family and friends once you wake up. Because laparoscopy is a minimally invasive procedure, patients are usually discharged a few hours after the procedure if no irregularities are discovered. It is normal to experience pain and discomfort in the area where the surgical incisions were made, and your doctor may prescribe pain relievers.


When you are released and allowed to go home, it is critical that you rest completely for the next few days and avoid strenuous work at all costs. You should not eat or drink anything heavy for at least 24 hours after the procedure, and you should avoid taking a shower. You should also look after your dressing: if it’s a traditional dressing, you can remove, clean, and reapply it after 24 hours (but do consult your doctor about the same). Remove any steri-strips that are covering your wounds.


What complications can occur?

Before delving into the potential complications of a laparoscopic procedure, it is critical to understand that laparoscopy is a surgical method, not a type of surgery. As a result, the type of surgery has a greater impact on the types of complications that may arise from an operation.


However, as with any surgery, some general complications may arise as a result of the laparoscopic method. While complications are uncommon, the most common ones are bleeding from the incisions and the possibility of infection. Internal organ injury and blood vessel damage are less common complications.


However, you should not be concerned about complications because they are uncommon, and numerous studies have demonstrated that laparoscopy is a well-tested, safe, and efficient surgical procedure.


Diagnostic laparoscopy recovery time

Recovery time depends on the individual case, as it does with any surgery. A laparoscopic diagnostic procedure, for example, which does not involve corrective surgery, usually has a quick recovery time. In contrast, recovery from a laparoscopic hysterectomy, a major surgical procedure, can take up to 6-8 weeks. So your recovery ultimately depends on why you’re having surgery and what kind of surgery you’re having.


Furthermore, recovery time is affected by complications: if complications occur, recovery may take longer than usual. As a result, it’s best to speak with your doctor and surgical team about your specific case and when you can expect to resume normal activities.


Diagnostic laparoscopy cost

The cost of a laparoscopy is determined by several factors, including your location, hospital of choice, and the type of surgery you’re having. A simple diagnostic laparoscopy, for example, is usually much less expensive than more complex laparoscopic procedures.


The cost of laparoscopic surgery in India varies significantly between cities. Laparoscopic surgery may cost as little as Rs. 24,000 or as much as Rs. 70,000. So, before you try to estimate the cost, you must first decide what type of laparoscopic surgery you will have and then look for hospitals that provide that service.


As the preceding discussion demonstrates, there are numerous variables with laparoscopy. Because laparoscopy is merely a surgical procedure (and diagnosis). As a result, factors such as cost, recovery time, potential complications, and so on are heavily influenced by the type of surgery you’re having rather than the method. We hope this gives you a good idea of what laparoscopy entails, but it is always a good idea to consult with experts before deciding to undergo surgery.

Operative Hysteroscopy

What is Operative Hysteroscopy?

When an abnormal condition in the uterus is discovered during the diagnostic hysteroscopy process, doctors perform operative hysteroscopy. It can also be done to avoid having to have a second surgery. The surgery can also be used to treat infertility or to remove growths from the uterine cavity. An operative hysteroscopy is used to treat the following uterine abnormalities: abnormal bleeding, polyps and fibroids, septum, and adhesions. Operative hysteroscopy combined with laparoscopy can help to prevent uterine wall perforation.


Everything You Need to Know About Operative hysteroscopy

Hysteroscopy | Purpose | Candidate | Procedure | Benefits | Types | Risks | Techniques | What to expect | Recovery | Cost

What is hysteroscopy?

Hysteroscopy is a procedure that allows your doctor to examine the uterine cavity in order to treat and diagnose uterine bleeding. A hysteroscopy is used to perform the procedure. Hysteroscopy involves inserting a thin, lighted tube into the vagina to examine the uterus and cervix. It can also refer to a surgical or diagnostic procedure.


When is operative hysteroscopy performed?

An operative hysteroscopy is performed to treat the following abnormal conditions of the uterus:-

Abnormal bleeding:Heavy menstrual flow or bleeding after menopause or between periods may be caused by abnormal bleeding. Endometrial ablation is a procedure used by doctors to treat heavy or prolonged bleeding. A hysteroscope, as well as other instruments, are used during this procedure. They aid in the destruction of the uterine lining.


Polyps and fibroids: Polyps and fibroids are non-cancerous uterine growths. They can be treated with hysteroscopy.


Septum: Doctors use hysteroscopy to determine if you have a uterine septum or if you have a uterine defect.


Adhesions: Scar tissues can sometimes form a band in the uterus, causing changes in menstrual flow and infertility. Hysteroscopy is a procedure used by doctors to locate and remove adhesions.


Who is a candidate for hysteroscopy?

A person suffering from the following conditions is an ideal candidate for a hysterectomy.

  • Irregular bleeding followed by cramping: If you have cramping and irregular periods, you should see a gynaecologist first. They will advise you to have a hysteroscopy to examine your uterus more closely. This assistance enables them to learn about various issues such as fibroids and polyps. Your gynaecologist may use the heating tool to stop excessive bleeding.


  • Assisting with long-term birth control: Using the hysterectomy technique, a small device is inserted into the fallopian tube.


  • Infertility issues: If you and your partner are having difficulty conceiving, you should see a gynaecologist. They will perform a hysterectomy to examine various uterine wall problems that are interfering with your ability to parent.


How is hysteroscopy performed?

Before hysterectomy your doctors will perform the following steps:

Use of sedative – Your doctor will prescribe sedatives to you prior to the procedure. It will aid in your relaxation prior to the procedure.

Scheduling –  One week after your period is the ideal time for a hysterectomy, according to gynaecologists. It will allow them to get a better view of the uterine line.

Anesthesia –  Your genealogist will determine whether you will be given general or local anaesthesia. The type of anaesthesia used will be determined by your treatment.

The gynecologist will maintain this order during the time of hysterectomy:

  • After widening the cervix, the gynaecologist will insert the hysteroscope.
  • The hysteroscope is inserted into the uterus through the vagina and cervix.
  • Carbon dioxide gas or a liquid solution is inserted into the uterus using a hysteroscope. It dilates the uterus and removes any mucus or blood.
  • Doctors can also see the uterus and fallopian tube openings inside the uterine cavity using the light attached to the end of the hysteroscope.
  • Depending on whether or not the surgery will be performed, small instruments are inserted.

The length of the procedure is determined by whether it is operative or diagnostic hysteroscopy. It usually lasts between five and more than an hour. More time will be required if a laparoscopy is performed in conjunction with a hysteroscopy.

What are the benefits of hysteroscopy?

Hysteroscopy provides the following benefits if compared to other procedures:

  • Recovery time is much less.
  • Hospital stay is shorter.
  • Medication needed after surgery is less painful.
  • Open abdominal surgery is possibly avoided.

Types of hysteroscopy

The primary reason for having a hysteroscopy is to diagnose uterine problems. Depending on the circumstances, there are two types of hysteroscopy. There are two kinds of hysteroscopy: operative and diagnostic. A woman undergoing diagnostic hysteroscopy may require an operative hysteroscopy.

Diagnostic Hysteroscopy

Diagnostic hysteroscopy is needed for the following reasons:

  • Find out the reason for repeated miscarriages
  • Diagnose the non-cancerous growths in the womb such as polyps and fibroids
  • Examine fertility issues if a couple is having problems to conceive
  • To study the reason for pelvic pain

Operative hysteroscopy

  • To exclude adhesions which are the scars in the uterine wall caused due to surgery or infections
  • To remove non-cancerous growths in the uterus
  • Perform a process of sterilization
  • For further investigation take a biopsy of tissue

Risks associated with hysteroscopy

Hysteroscopy is much safe than compared to any other procedures but there are some small risks too. Women who undergo treatment along with hysteroscopy are at a higher risk. Some of the risks are:-

  • A woman may faint in case hysteroscopy is performed without anesthesia or just local anesthesia.
  • Cervix is accidentally damaged.
  • The womb is accidentally damaged and in that case, it must be treated with antibiotics, or in some cases another operation might be needed.
  • The womb might be infected causing a smelly discharge from the vagina along with fever and heavy bleeding. A short course of antibiotics from the gynecologist might treat this infection.
  • A woman might experience excessive bleeding after the surgery. It is a result of undergoing treatment under general anesthesia.

Techniques used in operative hysteroscopy

  • The electrode is only activated once it starts moving towards the cervix.
  • The operator can coagulate, cut, and vaporize by adjusting the setting of the generator. It depends upon the kind of electrode chosen.
  • The myometrium is cut deeply, especially at the corner and in the cervix.
  • Depending upon the energy used, the uterine distension medium used in the case of operative hysteroscopy differs. The distension medium used nowadays is N/saline, in the case of bipolar energy. In the case of monopolar energy, the distension medium used is an electrolyte-free medium.
  • The balance of fluid is monitored thoroughly.

What to expect after the hysteroscopy procedure?

The type of anaesthesia used determines what to expect after the hysteroscopy procedure. If you are given general anaesthesia or a sedative, your blood pressure, breathing, and pulse will be constantly monitored. You will be discharged once your condition has stabilised. After hysteroscopy, no special care is required.

You may experience cramping or vaginal bleeding for a few days following the procedure. When a gas or fluid solution is injected into the uterus to improve visibility, it may cause gas in the digestive tract and pain for about 24 hours. You may experience pain in your shoulder and upper abdomen from time to time.

Operative hysteroscopy recovery

The kind of recovery depends upon the type of anesthesia being used. You must rest for sufficient time after the procedure.

Operative hysteroscopy cost

The average cost of operative hysteroscopy in India ranges from Rs. 15,000 to Rs.51,000.

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