Date post: | 09-Apr-2018 |
Category: |
Documents |
Upload: | rotunda-the-center-for-human-reproduction |
View: | 223 times |
Download: | 0 times |
of 28
8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
1/28
da.co.in
//www.rotunda.co.in/[12/22/2010 5:36:08 PM]
Welcome to the official website of Rotunda Fertility Clinic and Keyhole Sur
Centre. This clinic is the latest venture of Rotunda-The centre for Hu
Reproduction and one step forwards in creating a chain of well equipped and St
of-the-art IVF centres in the city of Mumbai.
In addition to Infertility treatments, we also have facility for patients to unde
keyhole surgery which is performed by reknowned specialists when indicated.
Facing infertility and undergoing treatment for the same is without doubt one of
most distressing situations that a couple can face. It fosters uncertainities, dou
fears, guilt and apprehensions. We at Rotunda strive towards making the w
process as simple and transparent as possible, providing guidance and counseat every step. We boast of a team sensitised to the needs of our clients and ha
long track record to prove this. Most of all, we respect our clients' need for priv
and offer this and much much more at very reasonable and competitive rates.
Egg donation may offerthe only chance of.....
Success rates at RotundaCentre of Human.....
Please use this form torequest an .......
Home
Programs and Services
Infertility Surgery
All you need to know
Pictures and Videos
About us
Glossary of terms
Our Success rates
Contact us
search...
http://www.rotunda.co.in/index.php?option=com_content&id=63&Itemid=55http://www.rotunda.co.in/index.php?option=com_content&id=63&Itemid=55http://www.rotunda.co.in/index.php?option=com_content&view=article&id=87&Itemid=74http://www.rotunda.co.in/index.php?option=com_content&view=article&id=87&Itemid=74http://www.rotunda.co.in/index.php?option=com_chronocontact&chronoformname=consultation&Itemid=75http://www.rotunda.co.in/index.php?option=com_chronocontact&chronoformname=consultation&Itemid=75http://www.rotunda.co.in/index.php?option=com_content&view=article&id=56&Itemid=55http://www.rotunda.co.in/index.php?option=com_content&view=article&id=58&Itemid=90http://www.rotunda.co.in/index.php?option=com_content&view=article&id=108&Itemid=63http://www.rotunda.co.in/index.php?option=com_content&view=article&id=49&Itemid=58http://www.rotunda.co.in/index.php?option=com_content&view=article&id=50&Itemid=62http://www.rotunda.co.in/index.php?option=com_content&view=article&id=49&Itemid=89http://www.rotunda.co.in/index.php?option=com_content&view=article&id=87&Itemid=74http://www.rotunda.co.in/index.php?option=com_chronocontact&chronoformname=contactus&Itemid=60http://www.rotunda.co.in/index.php?option=com_chronocontact&chronoformname=contactus&Itemid=60http://www.rotunda.co.in/index.php?option=com_content&view=article&id=87&Itemid=74http://www.rotunda.co.in/index.php?option=com_content&view=article&id=49&Itemid=89http://www.rotunda.co.in/index.php?option=com_content&view=article&id=50&Itemid=62http://www.rotunda.co.in/index.php?option=com_content&view=article&id=49&Itemid=58http://www.rotunda.co.in/index.php?option=com_content&view=article&id=108&Itemid=63http://www.rotunda.co.in/index.php?option=com_content&view=article&id=58&Itemid=90http://www.rotunda.co.in/index.php?option=com_content&view=article&id=56&Itemid=55http://www.rotunda.co.in/index.php?option=com_chronocontact&chronoformname=consultation&Itemid=75http://www.rotunda.co.in/index.php?option=com_chronocontact&chronoformname=consultation&Itemid=75http://www.rotunda.co.in/index.php?option=com_content&view=article&id=87&Itemid=74http://www.rotunda.co.in/index.php?option=com_content&view=article&id=87&Itemid=74http://www.rotunda.co.in/index.php?option=com_content&id=63&Itemid=55http://www.rotunda.co.in/index.php?option=com_content&id=63&Itemid=55http://twitter.com/RotundaClinichttp://www.facebook.com/pages/Rotunda-Fertility-Clinic/1046499895968088/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
2/28
Male and FemaleInfertility
http://www.surrogacymumbai.com/http://www.surrogacymumbai.com/http://www.surrogacymumbai.com/http://www.surrogacymumbai.com/8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
3/28
Goals
Enhance comfort level with workup
Basic Management Strategies
TRICARE
www.rotunda.co.in
8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
4/28
Definition
12 months of unprotected intercourse
Earlier for certain historical factors
Older than 35
http://sixtyminutes.ninemsn.com.au/article.aspx?id=816881http://sixtyminutes.ninemsn.com.au/article.aspx?id=816881http://sixtyminutes.ninemsn.com.au/article.aspx?id=8168818/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
5/28
Infertility Etiology
http://www.iwannagetpregnant.com/surrogacy.asp8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
6/28
Female Factors
8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
7/28
Male Factors
General Causes
Unknown: 40-50%
1 Hypogonadism: 30-40%
Altered SpermTransport: 10-20%
2 Hypogonadism: 1-2%
Meds
1 or 2Hypogonadism
Common medications
Ketoconazole
Cimetidine
Spironolactone
8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
8/28
The Scenario
Tech: Husband and wife cant get
pregnant.
You: OB rotation was last infertility workup
What now?
8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
9/28
Workup
History is KEY
Focused Physical Exam
Labs and Specialized Tests
8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
10/28
Workup: History
Coital Practices
Gestational History
PMHx/PSHx
Meds
Menstrual History
Substances Recent High Fever
8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
11/28
Our Couple: History
Female
G1 P0010
No hx of STIs
Normal menses
Unprotected sex for15 months
Male
No previous partnerpregnancies
Gonorrhea hx
No meds
Occasional EtOH
8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
12/28
Workup: Physical Exam
Male
Infection
Hernia
Vas deferens
Androgen deficiency
Testicular mass Varicocele
Female Breast Formation
Galactorrhea
Genitalia
Hyperandrogenism?
8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
13/28
Workup: Labs
Female
Ovulation problems
Ovulatory Dysfunction
Ovarian Reserve
Male
CBC
FSH, Testosterone
GC/Chlam, UA
Renal and Liver
Function Semen analysis
Postejaculatoryurinalysis
8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
14/28
WHO Seminal FluidAnalysis (1999)
Volume: >2ml
Sperm concentration: >20 million/ml
Total Sperm Number: >40 million/ejaculate
Sperm Motility:
>50% motile and/or
>25% progressively motile
Sperm Morphology: >14% normal forms
8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
15/28
Workup: Special Tests
Female
TransvaginalUltrasonography(TVUS)
Hysterosalpingography
(HSG)
Hysteroscopy
Laparoscopy
Male
ScrotalUltrasonography
TransrectalUltrasonography(TRUS)
8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
16/28
Our Couple: Exam,Labs & Tests
Normal male exam
Normal initial labs
Oligospermia on 2 separate semenanalyses
TRUS and postejaculatory UA normal
8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
17/28
Management: GeneralConcepts
41 different methods
Fertile window intercourse
E-type vaginal discharge
Avoid lubricants and douches
8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
18/28
Management: Female
Treat underlying cause
Hyperprolactinemia
PCOS
Gonadotropin therapy
8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
19/28
Management: Female
Ovulatory dysfunction (Unknown etiology)
Clomiphene 50mg PO daily x 5 days
Start on days 3-5
Can increase to 100mg daily next cycle
Results
80% will ovulate Hyperstimulation and Twinning
Higher-order multiples rare
8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
20/28
Management: Female
Clomiphene Failure?
IVF
Injectable ovulation-inducing agents
8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
21/28
Management: Female
Tubal/Pelvic/Uterine Issues
Reparative Surgery (low success)
IVF
Endometriosis
Laparoscopic ablation Laparotomy
Ovulation induction +/- IUI and IVF
8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
22/28
Management: Male
Hyperprolactinemia
Surgical repair
Fertility Specialist
8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
23/28
Stress and Infertility
69% Women and 21% Men have
preexisting condition
Greater risk for psychological stress
No significant difference inpsychopathology
8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
24/28
Stress and Infertility
Men have increased stress over time,
same as women
Watch for normal grief vs. psychopathology
Same rates of depression as other chronicdisease
8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
25/28
Stress and Infertility
Bottom line: Not a means to improve
pregnancy rates.
http://www.surrogacymumbai.com/http://www.surrogacymumbai.com/8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
26/28
Management: Our Couple
Male: Imipramine Mar 08
Pregnant in www.rotunda.co.in June2008!
Separated from USAF in July 2008
8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
27/28
Questions?
8/8/2019 IVF Clinic India - IVF treatment, ICSI clinic India- ICSI treatment, ICSI India, IVF Surrogacy
28/28
tility treatments
Home Programs and Services Infertility treatments
Infertility treatments
Rotunda offers all services pertinent to infertility under one roof. We are known for our innovation, integrity, med
and technical excellence, personalized service, and consistent willingness to accept patients facing the most diff
medical challenges. We offer the following services:
Intrauterine Insemination
In vitro Fertilisation (IVF)
ICSI
IVF Lite (Mild IVF/Minimal stimulation IVF)
Surgical Sperm retrieval
Donor Egg program
Sperm banking and donor sperm
Embryo freezing
Gestational Surrogacy
Embryo donation