• Bulletin Board
    • Dr. Rashmi Sharma
    • has been conferred with prestigious
    • Medical excellence Award
    • on the eve of Republic day 25.1.2014 at IMA hall for her
      exemplary contribution in the field of reproductive medicine.
origyn fertility and ivf centre delhi
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   info@origynivf.com

Case Study: IUI Positive Pregnancy at Very Poor Egg Reserve AMH (0.17 ng/ml)!

Our patient Mrs. Aditi (name changed to protect privacy of the patient) 38-year-old patient, married for 2 years had been advised donor egg IVF cycle at multiple places.  When she came to Origyn IVF, she was very distressed and wanted to conceive with her own eggs desperately.

We explained to her that for donor egg IVF there is no age limit, so she will have that option open to her even if comes to us 5-10 years later and since she has not yet attained menopause and less than 40 years of age, she should definitely be trying with her own eggs. 

So we gave her simple egg forming oral medication followed by few more ultrasounds to track her follicle growth.

She formed a very nice follicle in her left ovary at approximately 20mm size of follicle.

She was given an injection for follicle to rupture and after 36 hours of that injection Intra Uterine Insemination (IUI) was done with husband’s semen.

17 days later, she could not believe when her Urine Pregnancy Test (UPT) came positive.

In this patient she had been married only for 2 years (late marriage – not that she was infertile for long period of time) and her tests like Tube Test, Ultrasound,  husband’s Semen Analysis were normal except for extremely poor AMH (Anti mullerian Hormone – 0.17 ng/ml).

AMH tells us how much reproductive life span a lady has like in this woman, definitely she had very little time left, but she was still forming few eggs and had not completely exhausted her reserve.

Such patients should be given a chance to conceive from their own egg by simple measures like: IUI or Natural Cycle IVF – before finally proceeding for donor egg IVF if no conception.

Such positive result at extremes of situation give us impetus to try harder and harder for our patients and give them best result with minimum medication and treatment.

Case Study – Life doesn’t end in 50’s, it’s never too late to become a mother

One of the story of our patient will make you believe that even miracles take a little time to happen.  Life doesn’t end in 50’s, it’s never too late to become a mother.

Our patient Mrs. Rajni (name changed to protect privacy of the patient) 50 year female came to us with previous 3 IVF failures along with thin endometrium and fibroids in uterus.  She had a history of 3 year menopause and known case of hypertension.

After loosing hope to get pregnant through various IVF treatment she was completely shattered and came to us with a ray of hope.

Patient was counseled and told that due to her Poor Ovarian Reserve along with thin endometrium and fibroids in uterus she has to go for donor egg IVF and the success rate of IVF in her case in < 50%.

She gave a history of long estrogen therapy given to prepare her uterus for embryo transfer but in spite of this uterine lining never thickened beyond 6.5mm.

Knowing a fact that pregnancy can risky at her age as she was known case of hypertension we told her to go under a full  health checkup under which certain test were done like: Chest X-Ray, ECG blood investigation (Haemogram, Blood sugar, LFT, KFT, Lipid Profile, ETC)

After screening all her reports we started donor egg IVF

Her treatment protocol that was followed:

  • First Frozen Embryo transfer cycle was abandoned because on the day of transfer fluid was seen in the endometrium.
  • In second Frozen Embryo transfer cycle we used heparin, G-CSF to prepare the endometrium and embryo glue was used at the time of FET.

After using all the experimental techniques when patient came to us after 12 days she gave us good news with positive B-HCG Reports.  Now she is carrying a singleton pregnancy.

Panel discussion on Recurrent implantation failure – at IFS – Haryana

Panel discussion on Recurrent implantation failure – at IFS – Haryana chapter new team installation ceremony
-organised by Dr Neeru Thakral

Are you suffering from fibroid uterus?

Uterine fibroids are benign (non-cancerous tumors) that originate in the uterus.  They usually develop during the childbearing age of women, and most common genital pathology found in this age group.

Symptoms of uterine fibroids:

Most of the time women with fibroids are unaware of its presence, as it does not lead to any symptoms.

But in some women it can lead to:

  • Abnormal uterine bleeding (heavy menses) especially when a fibroid protrudes into the uterine cavity, it can cause erosion of endometrium (uterine cavity) lining.
  • Prolonged periods
  • Pain in lower abdomen
  • Anemia due to heavy bleeding.

 

Other Symptoms are based on the size and location of the fibroids in the uterus.

  • Dyspareunia (difficulty in intercourse )
  • Pelvic pain
  • Rectal pressure that causes difficulty in defecation
  • Frequent urination due to bladder irritability.

In some cases if the fibroids are affecting the endometrium lining than it may lead to infertility also.

Sometimes fibroids can cause blockage of the opening of fallopian tubes into the uterus that may lead to infertility.

Treatment:

  • Small asymptomatic fibroids especially if not affecting the lining of uterus do not require any treatment and should just be followed.
  • Large fibroids and submucosal fibroids (those which interfere with the lining- endometrium) need to be removed prior to starting fertility treatments such as IVF, in order to decrease the chances of implantation failure, miscarriages, other pregnancy complications.
  • Medical treatment – If patient desires fertility these medicines are not useful as these will prevent conception:
  1. NSAIDS : Decrease the amount of bleeding and pain
  2. Hormones : New medication like -Mifepristone/ Ulipristal are available and may help in some cases to buy time before surgery.

Conclusion: Mostly no treatment is needed if you are not suffering from any symptoms.

IVF TREATMENT