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Ivf commercialization in element in gynaecology
- 1. IVF : COMMERCIALIZATIONIN ELEMENT IN GYNAECOLOGY Dr. Hemant Zaveri
- 2. Any new concept! they will laugh at you first
- 3. Any new concept! Then they ignore you
- 4. Any new concept! Then they will suspect you
- 5. Any new concept! then they fight you
- 6. Any new concept! Then you will believe new concept
- 7. Any new concept! Then concept will established
- 8. Any new concept! Then concept will rule on you!!!
- 9. Infertility affects15 % of couples, and 50-70 % of male infertility is potentially correctable so it name As: Subfertility …….
- 10. DECREASING SPERM QUALITY& QUANTITY: A GLOBAL PROBLEM? OR JUST IN DATA???????
- 11. Evaluation of decreasingsperm count Decreasing sperm quality & Quantity just in Data??????? Environmental Health Perspectives 108 (10) (Oct. 10, 2000); E. Carlsen et al. British Medical Journal 305 (Sept. 12, 1992).
- 12. Reduction in spermdensity Decreasing sperm quality & Quantity just in Data??????? What is reality
- 13. Reduction in spermdensity Decreasing sperm quality & Quantity just in Data??????? Journal of Andrology,Vol. 28, No. 2, March/April 2007
- 14. Reduction in spermmorphology quality Decreasing sperm quality & Quantity just in Data??????? What is relity !! Journal of Andrology,Vol. 30, No. 5, September/October 2009
- 15. Impact of theNew WHO Guidelines on Diagnosis and Practice of Male Infertility 1 Reality 1.The Open Reproductive Science Journal, 2011, 3, 7-15
- 16. What is problem? growing population of India
- 17. What is problem? Growing population of India
- 18. What is problem? Infertility ?
- 19. What is problem? Infertility ?
- 20. What is problem? Infertility ?
- 21. Incidence of infertility Previous: Rare ?????? Present:Very common ??????
- 22. Incidence of infertility Previous: Rare ?????? Present:Very common ?????? Increasing age of married couple
- 23. Incidence of infertility Present:Very common (Pseudo Infertility)
- 24. Figure 2. Prevalenceof primary infertility and secondary infertility, presented as the percent of women who seek a child, and as the percent of all women of reproductive age, in 1990 and 2010. Mascarenhas MN, Flaxman SR, Boerma T, Vanderpoel S, et al. (2012) National, Regional, and Global Trends in Infertility Prevalence Since 1990: A Systematic Analysis of 277 Health Surveys. PLoS Med 9(12): e1001356. doi:10.1371/journal.pmed.1001356 http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001356
- 25. Absolute change inprevalence of primary and secondary infertility, measured as the percent of women who seek a child and as the percent of all women of reproductive age, between 1990 and 2010. Mascarenhas MN, Flaxman SR, Boerma T, Vanderpoel S, et al. (2012) National, Regional, and Global Trends in Infertility Prevalence Since 1990: A Systematic Analysis of 277 Health Surveys. PLoS Med 9(12): e1001356. doi:10.1371/journal.pmed.1001356 http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001356
- 26. In Vitro Fertilisation(IVF) is a last resort in Past !!!!!!!!!!!! But Now it’s first choice !!!
- 27. In Vitro Fertilisation(IVF) is a last resort But Now it’s first choice !!!
- 28. Need for fastconception The Ideal Infertile couple
- 29. Need for fastconception The Ideal Infertile couple
- 30. What is IVF In vitro fertilization
- 31. What is IVF In variable fertilisation (100% sure)
- 32. What is IVF In vitro fertilization
- 33. What is IVF In vitro fertilisation In variable fertilisation (100% sure)
- 34. Previous: tubal factoronly Previous: tubal factor only Present: Any couple !!!!!
- 35. Indications Previous: tubalfactor only FallopianTube Damage/Tubal Factor Bilateral blocked Fallopian tubes Failed reversal ofTubectomy The only options for treating significant tubal damage are surgical repair or bypassing the tubes with IVF.This decision must be carefully individualized in each situation.
- 36. Indications Present: MaleFactor Infertility Failed reversal ofVasectomy/Tubectomy Obstructive azoospermia Endometriosis Severe endometriosis Age Related Infertility Premature Menopause Anovulation Unexplained Infertility Preimplantation GeneticTesting (PGT
- 37.
- 38. Facts on IVF Facts truth: IVF is only the last option truth: IVF is only for affluent people truth: IVF is limited to a younger population only truth: IVF is successful in all cases truth: IVF requires admission in the hospital truth: IVF always result in multiple pregnancies like twins or triplets truth: IVF babies have a significantly high risk of birth defects and malformations truth: IVF is not at all covered by insurance truth: IVF is dangerous
- 39. Acceptance by people Present : reality- Who Does it Help? In-Vitro Fertilization and Side effects Woman’s Painful journey Maternal Age and Blastocyst Development high failure rate Frozen Blastocyst Cycles The Future
- 40. In vitro fertilization& Next generation
- 41. Producing healthy humanbeings
- 42. IVF future RoboticSperm !!!!
- 43.
- 45. Why it wasnot accepted by drs as routine? ICSI: Should it be Restricted to Male Infertility Drugs to induce ovulation Ova harvesting Embryo transfer The outcome LACK OF CONFIDENCE LACK OF SENIORS SUPPORT LACK OF KNOWLEDGE FROMWHERETO LEARN HOWTO ESTABLISH LAB etc….. Success rate
- 46. Success rate !!!Reality
- 47. Success rate !!!Reality
- 48. Success rate !!!Reality
- 49. Future of IVF: Blood Bank replaced by Sperm banks
- 50. Future of IVF:Sperm Bank
- 51. Future of IVF:Embryo Bank Technology Previous & Present: -Ease of getting equipment & loans -support of companies -disposables& media -hormones( refine technology) -ovum pick up -embryo transfer( role of USG) -endocrinology & lab support -availability of embryologyst - knowledge & skill - ICSI ,IMSCI, PICSI,PGS, PGD,ERRAY , LAH, STEMCELL etc…..
- 52. Future of IVF:Embryo Bank Technology
- 53. Service at doorstep Future of IVF: Embryo By companies By doctors By laboratories
- 54.
- 55. In vitro fertilizationmay leads to Human cloning
- 56. In vitro fertilizationmay leads to Human cloning
- 57. In vitro fertilizationmay leads to Human cloning
- 58. Technology burden onDoctors!!!! Previous & Present: -Ease of getting equipment & loansWho will Pay??? -support of companiesWe have to oblige them!! -disposables& media -hormones( refine technology) -ovum pick up -embryo transfer( role of USG) -endocrinology & lab support -availability of embryologyst - knowledge & skill - ICSI ,IMSCI, PICSI,PGS, PGD,ERRAY , LAH, STEMCELL etc…..
- 59. Failed Technology Assistedreproductive technology INTRACYTOPLASMIC SPERM INJECTION (ICSI) GAMETE INTRAFALLOPIANTRANSFER (GIFT) ZYGOTE INTRAFALLOPIANTRANSFER (ZIFT)
- 60. Pseudo Benefits Fastconception Early identification of factor Demand & supply Dhiraj & dhakka Multiple pregnancy LSCS Both party happiness Remote centre franchise for drs
- 61. Service at doorstep full commercialization By companies By doctors By laboratories
- 62. Medicine updates Side effects!!! Previous: Clomiphene citrate Present: Various options GnRH Agonists GnRH Antagonists Gonadotropins hCG Progesterone Medrol Doxycycline Side Effects !!!!!
- 63. Complications Higher riskof ovarian tumours after ovarian stimulation for in- vitro fertilization
- 64. Side Effects ofIVF: Filure!!
- 65. Side Effects ofIVF: Ectopic Pregnancy
- 66. Side Effects ofIVF: Risk of Birth defects
- 67. Why IVF asfor none?
- 68. Conclusion Understand the reproductivepotential of couple undergoing IVF Success of ICSI (few data) Male Factors Infertility IVF ~40% live birth ratesVery low as compare to normal pregnancy Female Factors Infertility IVF Higher results than other infertility causes ~25% live birth rates Very low as compare to normal pregnancy
- 69.
Editor's Notes
- #11 Analyses of sperm count data suggest a global downward trend but the results are inconclusive. An increase in male reproductive disorders like cryptorchidism and testicular cancer raise the question of common risk factors. Data on testicular cancer trends are usually based on population-based cancer registries with good validity. The corresponding data from fertility studies need careful consideration in terms of methods and results.Fisch and co-workers determined whether geographic variations in sperm count might bias the conclusions drawn from studies of semen quality. Briefly, of the 61 studies in the meta-analysis of Carlsen et al. [1] only 20 included more than 100 individuals. A reanalysis of these 20 studies revealed that the majority of studies published before 1970 were from USA, mainly New York. These studies represented locations with the highest sperm counts. In contrast, after 1970, most of the studies were from locations not included earlier. Selection bias due to geographical and ethnic variations could account for the observed decline in sperm quality [8]. However, when the subgroup of studies from the USA (28 studies, including data on 8.329 men) was analyzed separately, a similar trend of decreasing mean sperm values was observed [1]. On the other hand, Lipshultz argued that when all the larger studies containing only New York data are excluded from the meta-analysis, a second linear regression analysis detects no decline in sperm density [9].The sperm count issue has been extensively investigated since 1992 and the decrease is supported by additional studies. For example, it was reported that sperm counts of 1351 fertile men (semen donors) in Paris decreased by 2.1 percent per year from 89 × 106/ml in 1973 to 60× 106/ml in 1992 (p < 0.001) [10]. Sperm motility also decreased in these individuals. The mean seminal volume was 3.8 ml and did not change during the period from 1973 to 1992. Irvine et al. also examined sperm quality in 571 semen donors in Scotland by birth cohort groups [11]. They reported a significant decrease in median sperm concentration, total number of sperm in the ejaculate and total number of motile sperm in donors born between 1970 and 1974 compared to men before 1959.On the other hand, several studies confirm that in some locations sperm counts have not decreased over the past 20 to 25 years. More importantly, the results clearly show a remarkable variability in sperm counts at different geographical locations. The mean sperm counts in 302 men in the Toulouse area were unchanged over the period from 1977 to 1992 [12] and their mean sperm count (83 × 106 ml) was significantly higher than observed in the Paris study [10]. Furthermore, it was reported that the highest sperm counts recorded in Finland were found in men from rural areas accompanied by a low incidence of testicular cancer [13]. These findings suggest that urban lifestyle or environmental factors might be an important etiological factor of testicular malfunction and disease.Fisch et al. [14] conducted a study comprising 1,283 men who banked sperm before vasectomy in three different sperm banks in the United States from 1970-1994. A slight but significant increase in mean sperm concentration from 77 × 106 ml to 89 × 106 ml over the past 25-year period was found. Furthermore, marked differences in semen characteristics between the New York, Minnesota, and California sperm banks were found. Sperm concentration and motility was highest in New York and lowest in California.It was argued that the data set analyzed by Carlsen et al. [1] was not equally distributed between the decades: 79% of the publications and 88% of the volunteers of all studies were clustered between 1970 and 1990. If joint-analyses were conducted with studies from this period only, an increase in sperm concentrations would become evident. Thus, only 21% of the studies and 12% of the volunteers analyzed before 1970 have caused the regression to have a statistically negative slope [15,16].Looking at sperm count studies which have been published since 1992, it becomes evident that over the past 20 years, sperm quality has decreased in some but not all locations. The results also show that sperm counts can vary widely between and within countries. These major geographical differences suggest that the results of the former meta-analyses of sperm count may be biased by geographical confounding.
- #13 Interactive regression model for mean sperm density by year and geographic region, after controlling for proven fertility, abstinence time, age, specimen collection method, method of counting sperm, whether the study was included by Carlsen et al. (1), and interaction of region and study year.
- #15 Oligospermia, also oligozoospermia, refers to semen with a low concentration of sperm and is a common finding in male infertility. Often semen with a decreased sperm concentration may also show significant abnormalities in sperm morphology and motility (technically "oligoasthenoteratozoospermia"). There has been interest in replacing the descriptive terms used in semen analysis with more quantitative information.[2]
- #16 The World Health Organization (WHO) has established new reference values for semen characteristics in its 5th edition manual which are lower than those previously reported. Several questions arise after a careful examination of the proposed new values, especially regarding the implications of these references for diagnosis and treatment of male infertility. Despite the notable advance of using controlled studies involving couples whose time to pregnancy was less than 12 months to generate the new limits, reference studies are limited with regard to the population analyzed and the methods used for semen evaluation. As such, it seems unreasonable to assume that reference values represent global semen characteristics of fertile men as proposed in the 5th edition WHO manual. Caution should be exercised to not overinterpret the new reference values as they may fail to accurately discriminate populations of fertile and infertile men. Properly performed semen analyses coupled with an adequate examination of the man can give valuable information related to the organs producing “semen”, a highly complex fluid, and thus help in better understanding of the physiology of the reproductive organs and the causes of their dysfunctions. The present commentary discusses concerns related to the publication of the new reference values for semen parameters such as the impact on patient referral, diagnosis, treatment of recognized conditions such as varicocele and indications of assisted reproductive modalities. We conclude that more debate is needed before the adoption of the proposed WHO current reference values by andrology laboratories around the world. For those considering to adopt them, a better approach would be the presentation of reference values by percentiles rather than solely the lower cutoff limits. The time has come for technological developments that bring robust and costeffective clinically useful sperm function tests to replace, at least partially, the shortcomings of routine semen analysis
- #25 Infertility prevalence is indexed on the female partner; age-standardized prevalence among women aged 20–44 y is shown here. Horizontal lines indicate the 95% uncertainty interval.
- #27 By PiyumiBuddhakoralaIn Vitro Fertilisation (IVF) is a last resort” said Professor Deepal S. Weerasekera, Clinical Director of the Prarthana Centre for IVF.It is a process by which egg cells are fertilized by sperm outside the womb. It is a major treatment in infertility when other methods of assisted reproductive technology – such as medication to induce ovulation, tablets to improve sperm count and certain operations to relieve obstructions in the womb – have failed. IVF involves hormonally controlling the ovulatory process: removing eggs from the woman’s ovaries and letting sperm fertilize them in a fluid medium in order for the embryo (fertilized egg) to form. After three days the embryo is then transferred to the patient’s uterus in an attempt to establish a successful pregnancy. The first “test tube baby,” Louise Brown, was born in 1978 in London.Dr. Weerasekera explains the advantages of IVF treatment which is that even if a fallopian tube is blocked or the woman has a disease which prevents her from conceiving, she can still get pregnant in such a way that it is possible to take an egg from another woman, the sperm of the husband, fertilize it and deposit it in her womb. This is called oocyte donation.There are two main methods of conceiving; IVF, which is standard and ICSI. Intro Cytoplasmic Sperm Injection is the process by which a needle is injected straight through to the egg with the sperms in it.Even with such optimism for conceiving present, when all else fails, Dr Weerasekera points out that there is a 30-40% success rate for IVF, not only in Sri Lanka but worldwide.The process of Controlled Ovarian Stimulation is done so as to extract more than one egg from the womb. If ten were to be extracted all 10 will be fertilised. Two of the fertilized eggs, at the most, are put back into the womb and the rest are frozen. By this procedure, if the fertilization is not successful, the couple may resort to one of the frozen embryos which, according to Dr. Weerasekera, can last for five years. This method is known as Frozen Embryo Transfer (FET).There are three methods involved before the IVF procedure takes place; Laparoscopy, Hysteroscopy, and Dye Insufflation. Laparoscopy involves insertion of a camera through a small cut in the naval. Hysteroscopy is a procedure that involves insertion of a small camera through the vagina to visualize the cavity of the womb. Dye Insufflation is done to test whether the fallopian tubes are blocked or not. Such methods can be used to find out the exact state of the cavity of the womb, patency and function of the tubes, diseases affecting the function of the tubes, state of ovaries and any diseases affecting the ovaries. All these are important factors to diagnose early when there is a delay in conceiving so that early treatment can be instituted. Dr. Weerasekera advises that after six months of ‘trying’ a couple should seek medical help.A major drawback of IVF is the cost — Rs. 200,000 at the least. IVF is not available in state hospitals. The people of this country are not too aware of such a facility available and therefore go abroad. ‘Prarthana’ has delivered 60 babies within the span of five years.
- #28 By PiyumiBuddhakoralaIn Vitro Fertilisation (IVF) is a last resort” said Professor Deepal S. Weerasekera, Clinical Director of the Prarthana Centre for IVF.It is a process by which egg cells are fertilized by sperm outside the womb. It is a major treatment in infertility when other methods of assisted reproductive technology – such as medication to induce ovulation, tablets to improve sperm count and certain operations to relieve obstructions in the womb – have failed. IVF involves hormonally controlling the ovulatory process: removing eggs from the woman’s ovaries and letting sperm fertilize them in a fluid medium in order for the embryo (fertilized egg) to form. After three days the embryo is then transferred to the patient’s uterus in an attempt to establish a successful pregnancy. The first “test tube baby,” Louise Brown, was born in 1978 in London.Dr. Weerasekera explains the advantages of IVF treatment which is that even if a fallopian tube is blocked or the woman has a disease which prevents her from conceiving, she can still get pregnant in such a way that it is possible to take an egg from another woman, the sperm of the husband, fertilize it and deposit it in her womb. This is called oocyte donation.There are two main methods of conceiving; IVF, which is standard and ICSI. Intro Cytoplasmic Sperm Injection is the process by which a needle is injected straight through to the egg with the sperms in it.Even with such optimism for conceiving present, when all else fails, Dr Weerasekera points out that there is a 30-40% success rate for IVF, not only in Sri Lanka but worldwide.The process of Controlled Ovarian Stimulation is done so as to extract more than one egg from the womb. If ten were to be extracted all 10 will be fertilised. Two of the fertilized eggs, at the most, are put back into the womb and the rest are frozen. By this procedure, if the fertilization is not successful, the couple may resort to one of the frozen embryos which, according to Dr. Weerasekera, can last for five years. This method is known as Frozen Embryo Transfer (FET).There are three methods involved before the IVF procedure takes place; Laparoscopy, Hysteroscopy, and Dye Insufflation. Laparoscopy involves insertion of a camera through a small cut in the naval. Hysteroscopy is a procedure that involves insertion of a small camera through the vagina to visualize the cavity of the womb. Dye Insufflation is done to test whether the fallopian tubes are blocked or not. Such methods can be used to find out the exact state of the cavity of the womb, patency and function of the tubes, diseases affecting the function of the tubes, state of ovaries and any diseases affecting the ovaries. All these are important factors to diagnose early when there is a delay in conceiving so that early treatment can be instituted. Dr. Weerasekera advises that after six months of ‘trying’ a couple should seek medical help.A major drawback of IVF is the cost — Rs. 200,000 at the least. IVF is not available in state hospitals. The people of this country are not too aware of such a facility available and therefore go abroad. ‘Prarthana’ has delivered 60 babies within the span of five years.
- #29 Today on twitter I have read three different posts on how to tell the infertile couple you are pregnant. This is funny because for the last 2.5 weeks I have suspected that my sister-in-law is pregnant and not telling me since she knows what we are going through. I feel with this whole IVF treatment it makes your senses even more heighten to seeing and knowing symptoms of pregnancy.I have 3 types of online support that I am using to get through this IVF cycle, obviously this one where I can blog about what is going on with my cycle. Twitter, where I follow other infertile couples on their journeys through IVF, and BabyCenter, which I have a little group of 11 girls who are all the same age as me 24-26, going through IVF this May cycle with me. After reading those blogs and talking to the girls on my BabyCenter group I have realized a couple of things personally about telling the infertile couple you are pregnant.I think it depends where you are in your infertility journey. My group on BabyCenter group are all first time IVFers, only 2 have done IUIs, and a couple took Clomid. We have barely been on this journey. So we are still excited whenever we hear of someone being pregnant. However, talk to us a couple of years from now if we have not had any children, and have spent thousands and thousands of dollars, we may not be as excited. I think the infertility journey can definitely wear you down.I also believe it depends on age. At 26, I know that I will probably keep doing treatments until I either am done having kids, or I get tired. Either way I have years ahead of me that I could potentially become pregnant. In my cohort at Dr. T’s office I am the youngest by 3 years.For me specifically, we have a male factor issue that was easily identified. My husband did have testicular cancer at 6 months old, so we already knew with chemotherapy and medication there could potentially be a problem. It was very sweet one day his mom and I went to lunch one day and she told me that she was sorry for making the decision that affected his fertility. I told her, that if she didn’t make that decision I probably wouldn’t have such a sweet husband.This is how I look at it. Right now I am at the age where everyone is getting pregnant. I am one of those people who truly believe that everyone has their own struggles, whether its school related, financial, family etc. The Huz and I have an extremely blessed life, great families on both sides and have not really had to worry about anything. So the way I look at it now is that our struggle is fertility, and if this is the most difficult struggle we go through, I’ll take it. The Huz is such a wonderful man, and I couldn’t imagine a better person to go through this with. So when people are trying to figure out how to be sensitive to the infertile couples need, I would look at where they are at in their journey, how old there are, and be sensitive to that. Every couple handles news different, just make sure you do your research before you drop the bomb.Hoping everyone is having a great day! Peace, Love and Baby Dust!
- #32 This Nick Galifianakis cartoon was originally published on July 22, 2011 for the feature Carolyn Hax: Tell Me About It in The Washington Post and other syndicated newspapers. The illustration deals with babies, feeling loved, wanted, you were a choice, obligation, playroom, fertility, infertile, desperate, kid, children, attempt, pregnancy, IVF, in vitro fertilization, baby catalog, older parents, trying really hard, preference, value of life, partial, jealous, biased, favoring, buying a baby and knowing how much you’re worth.
- #35 Since the birth of the first IVF baby almost 30 years ago, dramatic developments have occurred in in vitro fertilization (IVF). IVF was initially designed to overcome the problem of tubal infertility but is now widely held to represent the treatment of choice for unexplained infertility, male factor, endometriosis, and ovarian dysfunction resistant to ovulation induction.1,2 The introduction of intracytoplasmic sperm injection (ICSI) has rendered severe forms of male infertility amenable to treatment and further widened the scope of IVF.3 High-profile publicity given to the latest achievements with IVF has led to its perception as a panacea for all those having difficulty in conceiving a pregnancy. This has been reflected in the rapid expansion of indications for IVF and an estimated current annual number of IVF cycles worldwide approaching 500000.4 The degree to which IVF merits this growth in application remains unclear, however, since prospective randomized trials comparing the effectiveness of IVF with simpler fertility treatments remain scarce.Hi, I’m Lynne, and I am asking for your support for my dear family members, Marga and David. A while back, when Marga said to David, “It takes a village to conceive a child,” she was talking about their emotionally supportive community and the team of practitioners involved in their journey to conceive. Little did they know they would also need a village of financially supportive friends to make this happen! (Read the full story below).If you feel moved to contribute to this heartful and worthy cause, I am asking for asuggested donation of $30 by clicking on the PayPal button below. Less than $30, or more, is also appreciated! The money goes directly to Marga and David’s IVF fund.Thank you for contributing to their baby-making journey, and for being part of their village!
- #40 We are just beginning to understand the implications of blastocyst transfer for both practitioners and patients. ,We believe infertility treatment centers will soon be able to reliably grow blastocysts and accurately assess which embryos are destined to implant and develop into an ongoing pregnancy. When that happens, the transfer of a single blastocyst will become the norm. And today's risk of high-order multiples will become a memory. The future holds much hope, much promise, and considerably fewer risks.
- #42 Producing healthy human beings with high immunity is also a positive side of eugenics, and this has been proven to be true. For example, in Los Angeles, genetic scientist have used high technology techniques to subtract the possibilities of inheriting sickle cell anemia in a family of black race. The possibilities of getting sickle cell anemia was eradicated by excising or eliminating the sickle cell gene by the combination of in-vitro fertilization and genetic engineering on a cell taken from an embryo which is still developing in its early stage.There's another light side of eugenics such as controlling world population. This issue has created many controversies among public because according to eugenics, only mentally healthy couples and couples without severe health conditions are allowed to reproduce. Scientist who supports eugenics believe that, a mentally healthy parent would produce a mentally stable individual with good thoughts and personality. This is because traits and personalities of parents are carried down through genes to generation after generation. Thus, the number of crimes and violence can be decreased as more people would have modified genes which prevent them to have perverted thoughts.As a whole, positive eugenics gives way to producing individuals with good traits and better mental and physical well being. A better trait can be anything from good resistance of disease or high immunity level and healthy body condition. Eugenics is a strategised evolution for the life of mankind. Eugenics is a pathway for producing high quality offspring.However, eugenics causes world ethical issues. One of the issues raised is abortion. Some babies are born and started out their life with trouble and engaged with accident and fatal disease that cannot be cured as well as babies with disease such chromosomal or recessively inherited disease as Down syndrome, Tay-Sachs disease, and thalassemia major. Babies with these diseases usually die early or fail to reproduce.
- #52 Embryo BankingA NOVEL WAY OF TREATING INFERTILITY THROUGH MEDICALLY ASSISTED REPRODUCTION.A full-fledged ,professionally managed,“EMBRYO BANK.”Bridging the GAP between “Waiting Lives” and “Desirous Parents”Laser Assisted HatchingVitrification of Oocytes, Embryos and Sperms.Sperm Retrieval Techniques like Tesa,Pesa,Tese Our latest additions are equipment for Intracytoplasmic Morphologically Selected Sperm Injection(IMSI ) and the Laser for Assisted Hatching of embryos.We have started an “EMBRYO BANK” that is a Novel way for achieving Medically Assisted conception. Ankur Embryo BankBRIDGING THE GAP BETWEEN “WAITINGLIVES” AND “DESIROUSPARENTS”!!At Ankur Embryo Bank, we offer a novel treatment of Embryo Donation to infertile patients. Embryo Donation is the newer method of family building which combines assisted reproductive technology with adoption, so that instead of adopting a baby the infertile couples adopt embryos The procedure is called ‘Adoption’ because the couple who adopts the embryo has no ‘Genetic connection’ to it. However ,unlike the traditional baby adoption ,the recipient mother undergoes pregnancy and labour to get a “true” sense of motherhood. At, Ankur Embryo Bank, we handle Embryo Donation like a closed adoption. There is no contact between the donor couple and the recepients who never see each other.Unlike the traditional adoption,the couple doesnot have to go through legal process, but they have to undergo a medical treatment.The couple therefore ‘biologically adopts the embryo. There are many reasons for a couple to prefer Embryo Adoption to traditionally adopting a child .It offers a unique opportunity to an infertility affected woman to be pregnant,to bond with her child prior to birth, and then to actually give birth.Embryo Adoption also offers couples the privacy and secrecy so that they do not have to worry about the social acceptance of their adopted and born baby. Additionally, Embryo Adoption can be much more affordable than the traditional adoption in countries like US. Moreover,inIndia,certain groups like Christians and Muslims cannot adopt .Embryo Adoption can be an extremely valid and attractive option for them.
- #53 Embryo Banking in IVF: An Approach That Arrests the Adverse Effects of the Biological Clock29JUNASK DR. SHER A QUESTION An ever increasing number of American women first seek IVF treatment in their late 30’s or early 40’s.This trend is in large part due to the fact that more and more women are choosing to defer childbearing until they have fulfilled their career aspirations. While such deliberate deferment is understandable, it nevertheless poses significant problems, because women in their late 30’s and early 40’s have about one half the chance of having a baby following IVF than do women in their early to mid 30’s. There are two primary reasons for this:First is the fact that advancing age beyond 35 years is accompanied by an inevitable and progressive increase in chromosomal egg abnormalities (aneuploidy) which lead to “incompetent” embryos that cannot propagate viable pregnancies. That is why we see a profound and steady decline in IVF success rates as well as an increase in chromosomal miscarriages and birth defects such as Down’s syndrome with advancing maternal age.Second, as women get older, there occurs a progressive decline in their ovarian egg supply. This so-called “diminished ovarian reserve” (DOR) results in less eggs being accessible via egg retrieval and consequentially, fewer “competent” embryos available for transfer to the uterus.Most women/couples would like to have more than one child. This desire is no less prevalent in older women. However, by the time the older woman decides to do IVF, goes through the process successfully, has a baby, completes breastfeeding, and thereupon re-establishes regular menstruation in order to try for another IVF baby, a period of 2-3 years will have elapsed. While such a hiatus would usually be of little consequence to a young woman, for an older woman such a delay could seriously impact her “biological clock” so as to drastically reduce her chance of having another baby with her own eggs.Egg/embryo banking offers a potential solution for older women and those with DOR who wish to minimize the relentless effect of the biological clock. The process involves undergoing several IVF stimulation/egg retrieval procedures in relatively quick succession, and then freezing/banking all viable embryos for future dispensation, rather than having them transferred to the uterus immediately. Such embryo “stockpiling” would literally stop the biological clock in its tracks, allowing for the subsequent elective thawing of one or two frozen embryos at a time in future frozen embryo transfer (FET) cycles. This process would avert the risk of progressive declining egg/embryo “competency” over time.The concept of embryo banking/stockpiling would not have been feasible even 5 years ago, since it was not until quite recently that we became able to reliably identify chromosomally normal (“competent”) embryos for selective banking. Embryo freezing technology has also evolved dramatically over that time. Just a few years ago, the freezing process took a serious toll on embryos, severely damaging up to 50% of them in the freeze/thaw process. But that was then…Today, through the adaptation of comparative genomic hybridization (CGH) technology to egg and/or embryo selection we are able to much better identify “competent” embryos for banking and stockpiling. In addition, the recent introduction of much improved egg/embryo freezing through ultra-rapid cryopreservation (i.e. vitrification) eliminates most of the potential damage incurred to “competent” embryos during the freezing and thawing process. In fact, in IVF centers of excellence, the frozen embryo transfer (FET) process using vitrified/thawed embryos now yields the same IVF success rate as when fresh embryos are transferred!These innovations (CGH and Vitrification) have not only made embryo banking/stockpiling feasible, but have rendered the approach a most appealing option for older women and women with DOR who seek to undergo IVF using their own eggs.This having been said, CGH is not an indispensable part of embryo banking. The process can be done without it. But, given the inevitability of an age-related increase in the incidence of chromosomal abnormalities in the egg/embryo, it would be impossible for patients to know whether they have stored “competent” embryos and which ones to transfer to the uterus for the best chance of success when the time comes.I want to emphasize that CGH does not improve embryo quality. It is an efficiency tool that allows us toselect “competent” embryos for transfer and thereby dramatically improve the baby rate per embryo transferred. It is also well to bear in mind that aneuploidy not only reduces the chance of a successful pregnancy but it is also the cause of miscarriages and many birth defects (e.g. Down’s syndrome). Thus CGH embryo selection not only improves IVF success (per embryo transferred), but it also reduces the incentive to transfer multiple embryos at a time, thereby virtually eliminating the occurrence of high-order multiple pregnancies (triplets or greater).Proudly, we at SIRM were the first to introduce CGH embryo selection into the clinical IVF arena. Since then, we have reported hundreds of successes using this approach, which is finally starting to gain wide acceptance in the IVF field. We were also among the first in the United States to supplant conventional egg/embryo freezing with “vitrification.” It is against this background that we now provide selective embryo banking/stockpiling to an ever increasing number of older women and women with DOR. We have already witnessed the profound benefits of such an approach.Finally, embryo banking/stockpiling would also have appeal to younger women who plan on deferring having children until later in life – or who want to at least have the option available, should their life/career path so dictate. Even some fertile women for whom IVF would otherwise not be necessary could fall into this category.Through our technology and package pricing, we at SIRM have attempted to make this approach relatively accessible to those that need or desire access to this advantage.
- #54 Embryo Banking in IVF: An Approach That Arrests the Adverse Effects of the Biological Clock29JUNASK DR. SHER A QUESTION An ever increasing number of American women first seek IVF treatment in their late 30’s or early 40’s.This trend is in large part due to the fact that more and more women are choosing to defer childbearing until they have fulfilled their career aspirations. While such deliberate deferment is understandable, it nevertheless poses significant problems, because women in their late 30’s and early 40’s have about one half the chance of having a baby following IVF than do women in their early to mid 30’s. There are two primary reasons for this:First is the fact that advancing age beyond 35 years is accompanied by an inevitable and progressive increase in chromosomal egg abnormalities (aneuploidy) which lead to “incompetent” embryos that cannot propagate viable pregnancies. That is why we see a profound and steady decline in IVF success rates as well as an increase in chromosomal miscarriages and birth defects such as Down’s syndrome with advancing maternal age.Second, as women get older, there occurs a progressive decline in their ovarian egg supply. This so-called “diminished ovarian reserve” (DOR) results in less eggs being accessible via egg retrieval and consequentially, fewer “competent” embryos available for transfer to the uterus.Most women/couples would like to have more than one child. This desire is no less prevalent in older women. However, by the time the older woman decides to do IVF, goes through the process successfully, has a baby, completes breastfeeding, and thereupon re-establishes regular menstruation in order to try for another IVF baby, a period of 2-3 years will have elapsed. While such a hiatus would usually be of little consequence to a young woman, for an older woman such a delay could seriously impact her “biological clock” so as to drastically reduce her chance of having another baby with her own eggs.Egg/embryo banking offers a potential solution for older women and those with DOR who wish to minimize the relentless effect of the biological clock. The process involves undergoing several IVF stimulation/egg retrieval procedures in relatively quick succession, and then freezing/banking all viable embryos for future dispensation, rather than having them transferred to the uterus immediately. Such embryo “stockpiling” would literally stop the biological clock in its tracks, allowing for the subsequent elective thawing of one or two frozen embryos at a time in future frozen embryo transfer (FET) cycles. This process would avert the risk of progressive declining egg/embryo “competency” over time.The concept of embryo banking/stockpiling would not have been feasible even 5 years ago, since it was not until quite recently that we became able to reliably identify chromosomally normal (“competent”) embryos for selective banking. Embryo freezing technology has also evolved dramatically over that time. Just a few years ago, the freezing process took a serious toll on embryos, severely damaging up to 50% of them in the freeze/thaw process. But that was then…Today, through the adaptation of comparative genomic hybridization (CGH) technology to egg and/or embryo selection we are able to much better identify “competent” embryos for banking and stockpiling. In addition, the recent introduction of much improved egg/embryo freezing through ultra-rapid cryopreservation (i.e. vitrification) eliminates most of the potential damage incurred to “competent” embryos during the freezing and thawing process. In fact, in IVF centers of excellence, the frozen embryo transfer (FET) process using vitrified/thawed embryos now yields the same IVF success rate as when fresh embryos are transferred!These innovations (CGH and Vitrification) have not only made embryo banking/stockpiling feasible, but have rendered the approach a most appealing option for older women and women with DOR who seek to undergo IVF using their own eggs.This having been said, CGH is not an indispensable part of embryo banking. The process can be done without it. But, given the inevitability of an age-related increase in the incidence of chromosomal abnormalities in the egg/embryo, it would be impossible for patients to know whether they have stored “competent” embryos and which ones to transfer to the uterus for the best chance of success when the time comes.I want to emphasize that CGH does not improve embryo quality. It is an efficiency tool that allows us toselect “competent” embryos for transfer and thereby dramatically improve the baby rate per embryo transferred. It is also well to bear in mind that aneuploidy not only reduces the chance of a successful pregnancy but it is also the cause of miscarriages and many birth defects (e.g. Down’s syndrome). Thus CGH embryo selection not only improves IVF success (per embryo transferred), but it also reduces the incentive to transfer multiple embryos at a time, thereby virtually eliminating the occurrence of high-order multiple pregnancies (triplets or greater).Proudly, we at SIRM were the first to introduce CGH embryo selection into the clinical IVF arena. Since then, we have reported hundreds of successes using this approach, which is finally starting to gain wide acceptance in the IVF field. We were also among the first in the United States to supplant conventional egg/embryo freezing with “vitrification.” It is against this background that we now provide selective embryo banking/stockpiling to an ever increasing number of older women and women with DOR. We have already witnessed the profound benefits of such an approach.Finally, embryo banking/stockpiling would also have appeal to younger women who plan on deferring having children until later in life – or who want to at least have the option available, should their life/career path so dictate. Even some fertile women for whom IVF would otherwise not be necessary could fall into this category.Through our technology and package pricing, we at SIRM have attempted to make this approach relatively accessible to those that need or desire access to this advantage.
- #55 Embryo Banking in IVF: An Approach That Arrests the Adverse Effects of the Biological Clock29JUNASK DR. SHER A QUESTION An ever increasing number of American women first seek IVF treatment in their late 30’s or early 40’s.This trend is in large part due to the fact that more and more women are choosing to defer childbearing until they have fulfilled their career aspirations. While such deliberate deferment is understandable, it nevertheless poses significant problems, because women in their late 30’s and early 40’s have about one half the chance of having a baby following IVF than do women in their early to mid 30’s. There are two primary reasons for this:First is the fact that advancing age beyond 35 years is accompanied by an inevitable and progressive increase in chromosomal egg abnormalities (aneuploidy) which lead to “incompetent” embryos that cannot propagate viable pregnancies. That is why we see a profound and steady decline in IVF success rates as well as an increase in chromosomal miscarriages and birth defects such as Down’s syndrome with advancing maternal age.Second, as women get older, there occurs a progressive decline in their ovarian egg supply. This so-called “diminished ovarian reserve” (DOR) results in less eggs being accessible via egg retrieval and consequentially, fewer “competent” embryos available for transfer to the uterus.Most women/couples would like to have more than one child. This desire is no less prevalent in older women. However, by the time the older woman decides to do IVF, goes through the process successfully, has a baby, completes breastfeeding, and thereupon re-establishes regular menstruation in order to try for another IVF baby, a period of 2-3 years will have elapsed. While such a hiatus would usually be of little consequence to a young woman, for an older woman such a delay could seriously impact her “biological clock” so as to drastically reduce her chance of having another baby with her own eggs.Egg/embryo banking offers a potential solution for older women and those with DOR who wish to minimize the relentless effect of the biological clock. The process involves undergoing several IVF stimulation/egg retrieval procedures in relatively quick succession, and then freezing/banking all viable embryos for future dispensation, rather than having them transferred to the uterus immediately. Such embryo “stockpiling” would literally stop the biological clock in its tracks, allowing for the subsequent elective thawing of one or two frozen embryos at a time in future frozen embryo transfer (FET) cycles. This process would avert the risk of progressive declining egg/embryo “competency” over time.The concept of embryo banking/stockpiling would not have been feasible even 5 years ago, since it was not until quite recently that we became able to reliably identify chromosomally normal (“competent”) embryos for selective banking. Embryo freezing technology has also evolved dramatically over that time. Just a few years ago, the freezing process took a serious toll on embryos, severely damaging up to 50% of them in the freeze/thaw process. But that was then…Today, through the adaptation of comparative genomic hybridization (CGH) technology to egg and/or embryo selection we are able to much better identify “competent” embryos for banking and stockpiling. In addition, the recent introduction of much improved egg/embryo freezing through ultra-rapid cryopreservation (i.e. vitrification) eliminates most of the potential damage incurred to “competent” embryos during the freezing and thawing process. In fact, in IVF centers of excellence, the frozen embryo transfer (FET) process using vitrified/thawed embryos now yields the same IVF success rate as when fresh embryos are transferred!These innovations (CGH and Vitrification) have not only made embryo banking/stockpiling feasible, but have rendered the approach a most appealing option for older women and women with DOR who seek to undergo IVF using their own eggs.This having been said, CGH is not an indispensable part of embryo banking. The process can be done without it. But, given the inevitability of an age-related increase in the incidence of chromosomal abnormalities in the egg/embryo, it would be impossible for patients to know whether they have stored “competent” embryos and which ones to transfer to the uterus for the best chance of success when the time comes.I want to emphasize that CGH does not improve embryo quality. It is an efficiency tool that allows us toselect “competent” embryos for transfer and thereby dramatically improve the baby rate per embryo transferred. It is also well to bear in mind that aneuploidy not only reduces the chance of a successful pregnancy but it is also the cause of miscarriages and many birth defects (e.g. Down’s syndrome). Thus CGH embryo selection not only improves IVF success (per embryo transferred), but it also reduces the incentive to transfer multiple embryos at a time, thereby virtually eliminating the occurrence of high-order multiple pregnancies (triplets or greater).Proudly, we at SIRM were the first to introduce CGH embryo selection into the clinical IVF arena. Since then, we have reported hundreds of successes using this approach, which is finally starting to gain wide acceptance in the IVF field. We were also among the first in the United States to supplant conventional egg/embryo freezing with “vitrification.” It is against this background that we now provide selective embryo banking/stockpiling to an ever increasing number of older women and women with DOR. We have already witnessed the profound benefits of such an approach.Finally, embryo banking/stockpiling would also have appeal to younger women who plan on deferring having children until later in life – or who want to at least have the option available, should their life/career path so dictate. Even some fertile women for whom IVF would otherwise not be necessary could fall into this category.Through our technology and package pricing, we at SIRM have attempted to make this approach relatively accessible to those that need or desire access to this advantage.