The cost of IVF

                                     The cost of IVF

The days are gone when a couple used to get disheartened & shattered on finding  that the natural conception is difficult  for them due to azospermia , asthenopermia  or diminished motile sperms count in the male or bilaterally blocked tubes , anovulation  due to pcos , aeging ,premature ovarian failure , endometriosis or thin endometrium as now they know that many new techniques like IVF&ICSI are available to solve their problem & bring happines & get their parenthood back in their life . But when the cost come to know about the cost of ivf &icsi procedure they enthusiasm goes down.

 The cost of IVF and an ICSI remedy are twofold.it can be devided into two parts

1) laboratory cost

2) medicinal cost

Lets understand the procedure of ivf & icsi in short. In case of IVF, the most excellent egg cell and the best sperm cell will be chosen, and afterward assembled for fertilization. In case of ICSI, supplementary steps in the laboratory are required. ICSI is a special technique, which indicates that a particular sperm cell will be implemented into an egg cell. After a few days the accomplishment of fertilization will be tested. The best looking embryo will then be instilled into the uterus.

1)The laboratory expenses consist of the basic ivf laboratory, the expansive micromanipulator used in icsi procedure, the disposable dishes ,micropipeptes, ovum pickup needles ,sperm holding & sperm injecting needles , the media &embryo transferring catheter. Follicular monitoring by ultrasound by radiologist  , operation theatre & anaesthesia charges are also to be considered.

2)the medication cost consists of Gnrh agonists like lupride,decapeptydyl & buserlin  or gnrh antagonists like cetorelix and gonadotropins like gonal F, highly purified menogon or puregon necessary for the follicular development, sifasi, profesi , ovunal for egg maturation & follicular rupture.

 The cost of medication  varies  from patient to patient depending upon the age ,cause of infertility& moreover it is unpredictable   how the body is going to respond.

In India the cost varies from  3000$ to 3500$ ( 2..1lakhs to 2.5 lakh RUPEES) .the supplementary procedures like ICSI will cost 25000 rupees  extra. & egg donation will cost you further 60,000 rs.

In EUROPE the total expenses for the above mentioned, with an excellent health insurance, will be in the region of 2300 to 2600 euro. In the USA the costs are completely different. The average IVF cost in the USA is $12,000, but it can get to as much as $15,000. It may well be as low as $10,000, although it's hardly ever lower than that. These costs are for one cycle of IVF and do not incorporate the ICSI treatment. In case a clinic suggests a lower rate than $10,000, they are most likely leaving something out from their price they quote.

For an IVF care in the USA  are some extra costs of IVF that have to be bear in mind. The basic cost of IVF is around $12,000. But supplementary remedies will increase your costs nevertheless. For instance, the ICSI cure we brought up in the first part of this article. In the USA this could be an additional $1,000 to $1,500. In Europe the costs of an ICSI treatment is already in the price.

In annxure ,the cost of ivf – icsi procedure in india is the lowest comparatively with the best expertise. That’s how india  is becoming the hub of assisted reproductive techniques.(ART)

 The process of freezing eggs ,sperms or embryos freezing, and storage, may cost an extra few to several hundred dollars.

 We can therefore conclude that although the ivf icsi procedure requires a significant  amount of money but the result of becoming a parent is awesome & worth putting efforts which saves you from depressions & mental turmoil.

Fir any further inquiries  you may contact Dr. Ruby Sehra  

Mobile or whats app +919810023254

Mail at sehra.ruby@gmail.com or ivfprogeny.ruby@gmail.com or

Visit us at www. Ivfprogeny.com

INTRACYTOPLASMIC SPERM INJECTION- THE BEST IVF TREATMENT FOR MALE INFERTILITY FOR HIGH IVF SUCCESS RATE

                      

What is ICSI?

ICSI is an IVF procedure only but is commonly used to help the men with low sperm count say less than10 million /ml ,with more of the dead sperm count is less no. of motile sperms less than 40% or azospermia  meaning no sperms in semen analysis but mature sperms can be found on testicular biopsy.

When all the other natural alternative methods like nutritional education  ,herbal medication to boost their strength,  saying no to alcohol ,avoiding smoking ,avoiding tight garment & exposure to heat   have failed to increase the sperm count or enhance the motility  IVF-ICSI treatment method is adapted .Some clinics use icsi procedure for all ivf cases it gives a high fertilization rate whereas others use it for previous failed ivf treatments for severe male factor infertility, poor quality embryos  or less no. of retrieved  eggs. The procedure requires a highly skilled embryologist.

PROCEDURE OF IVF ICSI

IVF with ICSI involves the a use of specialized equipment like micromanipulator and inverted microscope which enables the embryologist to high magnification to visualize & choose the best morphologically looking sperm ,to pick up in the sperm holding pipette  ,immobilising the tail & then slowly piercing the shell of the egg gently, entering through the cell membrane into the cytoplasm of the egg ,injecting the  sperm nuclear  material into the egg.

SUCCESS RATE OF IVF ICSI

ICSI has a v. high  fertilization success  rate .Approximately 80% of  the eggs are successfully  fertilized by ICSI procedure but  from here, the fertilized embryo has to start its journey of successful implantation in  the mother`s womb.  Only 45% of women that undergo ICSI treatment go right through to the end and give birth to healthy babies.

Why are the ICSI rates not that important?
ICSI rates are not really that important because the ICSI treatment method involves the use of the ivf technique. Because the ICSI rates are already quite high, there is only a 20% chance of not successfully conceiving  and  therefore the majority of cases are left up to success rates of ivf.

WHAT IS THE COST OF ICSI

The IVF-ICSI  procedure is v. economical  In INDIA . whereas the cost of IVF treatment is 12,000$ +1500$ for ICSI treatment in U.S& 3000pounds+500  pounds for ICSI in U.K; in INDIA  its just 3800$ &200 $ extra for ICSI treatment. It includes ivf_icsi consultations, ultrasound, ovum pickup, embryo transfers day care stay, ivf drugs pre ivf medical  tests , professional  fees.

For more information on ICSI success rates and other alternatives to ICSI treatment, visit www.ivfprogeny.com or use any search engine and type in.ivf progeny an ivf-icsi center delhi , India

10 important tips before you go for ivf treatment

Hi Friends, I am Dr. ruby Sehra back once again with a new topic. I am researching on IVF treatment for past 26 years and I Hope this post of mine will help you gaining knowledge of IVF and improving success rate of your  IVF in case you are undergoing IVF treatment. Inquire & follow few tips.

1) have you got all the investigations  like hormonal profile, blood group,HIV ,VDRL,Hepatitis B, Hb Electrophoresis for thalessemia minor, hysterosalpingography ,semen analysis & culture,follicular study,Hysterscopy, endometrial biopsy for histopathology& pcr tuberculosis with AFB clture done .

2)have you enquired about the ivf specialists experience in fertility treatment ,success rate of ivf of the particular centre where you are undergoing ivf treatment.

3)have you discussed  with your infertility specialist about the treatment in details regarding

a)IVF or ICSI,

b)husband^s sperms or donor sperms

c)her own eggs or donors eggs

d)embryo transfer will be done in your uterus or srrogates uterus

e)how many embryos will be transferred

f)will the embryos be frozen if more than 3

4) do you require any treatment for any pelvic inflammatory disease,PCOS OR endometriosis

5) consult your ivf specialist whether you require any supplements like folic acid before you undergo ivf treatment.

6)always consume more of the fresh rainbow coloured fruits strawberries,raspberries ,kiwi.grapes ,citrus fruits which contain plenty of antioxidants,pineapple which contains bromelin & helps for embryo implantation ,vegetables  like beans, red & yellow capsicum , broccoli, green leafy vegetables & dairy products.

7)if you are a PCOS patient ,one must reduce weight according to your height to minimize the chances of hyperstimulation & to optimise sccess rate.

8)one must do relaxation exercise & yoga beore starting the Ivf treatment.

9)good success rate can only be achieved only if you get  a treatment from the best ivf specialist,best ivf centre with good success rate.

10)drink plenty of water or liquids atleast 3 liters in a day before going for an ivf treatment.

Incase you have any further inquiries feel free to contact at 9810023254 or visit www.ivfprogeny.com

AN AFFORDABLE & ECONOMICAL MINI IVF TREATMENT IN DELHI NCR¬ ¬

Mini IVF treament means a short and economic ivf cycle, giving a good success rate to couples who cannot afford the conventional &expansive ivf procedure. Where money & time is the constraint – mini ivf is useful. Surprisingly, new research in Assisted Reproductive Technology (ART) has led to the development of mini IVF, a revolutionary new treatment brings new hope to couples who cannot become pregnant & keep thinking about the finances & results of traditional ivf procedure..

In   Mini IVF, the process that is used is quite similar to the conventional ivf procedure. During treatment,  follicular monitoring is performed throughout  the cycle  after giving weaker or  lower doses of gonadotropins & clomiphene for ovarian stimulation., As in the conventional ivf  retrieval of eggs, the fertilization of the egg is done by ivf or icsi procedure.  Finally the transfer of the embryo is also done in the same way. There is no difference  in the quality of maturing follicles & moreover it prevents the patient going into ovarian hyperstimulation  syndrome(OHSS). It also reduces the no. of injections and a substantial drop in costs

ADVANTAGES OF MINI IVF

There are many benefits to using IVF over conventional IVF

• Mini IVF procedure is cheaper than typical IVF procedure costing around 2500$ compared to 4200$.
•  the chances of suffering from  a morbid condition of IVF ovarian hyper stimulation syndrome i.e (OHSS) are significantly reduced .

DISADVANTAGES OF MINI IVF

While IVF is fast becoming a popular choice for women and couples that are trying to become pregnant, there are some disadvantages:

• Since the no. of harvested eggs is les varying from 4-6 . no eggs are left for freezing & thawing in the next cycle whereas in conventional ivf procedure sometimes harvested eggs & thus frozen embryos are sufficient for next 2 or 3 cycles if unsuccessful .
• In case where we are not successful in one cycle, the patient may have to proceed for further cycles which give a big mental trauma to the patient. 

• Since mini ivf is a new treatment, enough clinical trials are not available to give the actual success rates. Few studies, however, have shown successful pregnancy rates of around 8% -10%. per individual cycle and a successful pregnancy rate of 20% after three mini IVF cycles.

CONCLUSION

While IVF treatment is still relatively new, it's apparent that this option still offers new hope to women and couples who want to become pregnant but who cannot afford traditional in vitro fertilization methods.we at progeny ivf icsi center in punjabi bagh delhi.offer mini ivf at very economical rates .For further information contact log onto www.ivfprogeny.com.

A rare case study by Dr. Ruby Sehra an ivf specialist in punjabi bagh new delhi ,india about coexisting endometrioma & teratoma

A rare case study by dr. ruby sehra an ivfspecialist in punjabi bagh new delhi ,india about coexisting endometrioma & teratoma.

Endometriosis & mature cystic teratoma are both common diseases in reproductive age group but co-existence of both entities in the same ovary is of rare occurance. We hereby report a rare case of  co-existing mature teratoma & endometrioma in the same patient , in the same ovary.

CASE HISTORY

      
A 25 year nulliparous woman married for 8 months presented in our OPD with complaints of recurrent urinary tract infection and dysmenorrhea since 2-3 years ,painful intercourse & mild abdominal discomfort for  1 year .She had been wandering to various physicians & gynaecologists for repeated bouts of pain  in the lower abdomen & fever off & on whence she was prescribed various  antibiotics presuming the newly wed woman to be suffering from honeymoon cystitis but after 2-3 months of treatment she was advised to get an ultrasound done for the same complaints. She was diagnosed to be a case of right ovarian cyst measuring 5.4 ×4.5 cm within haemorrhagic component  thereafter she came to our hospital & was advised to undergo MRI of whole abdomen & ca125 done MRI showed right ovariancystmeasuring10.2X8.5X8.4cm

  Her CA 125 was raised to 162.5 units. Her urine culture was sterile. We advised her to undergo laparoscopic ovarian cystectomy with frozen section.
After creating a pneumoperitoneum a big ovarian cyst of 10x8x8 cm was seen arising from the right ovary whereas normal rt. Ovary could be seen lying in the lower part of ovarian hanging down from the ovarian ligament. It was not adhering to intestine or bladder or pouch of Douglas. On incising the cyst capsule, chocolate material came out which was sucked out. Considering the patient to be nulliparous, we tried to save her ovary by peeling off the cyst wall from ovarian capsule. At the lower part of the cyst A solid mass consisting of sebaceous material & bunch of hair was seen .The whole cyst wall with solid cystic structure was separated from the normal ovarian tissue& put in the endobag & sent for frozen section which confirmed the diagnoses of mature cystic teratoma. D& C & chromotubation was done & the curetting’s obtained were sent for histopathology & PCR with AFB culture .Bilateral tubes were normal in calibre & length. Left ovary& uterus were normal there were few endiometriotic  spots in pouch of Douglas which were fulgurated.The patient recovered normally. On follow up there was no dysparunia or lower abdominal pain.

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            How to prevent C Section

                              Or

Avoiding Unnecessary C Section--- 1st or 2nd

                              Or 

Trying to Avoid Cesarean

                              Or

How to prevent a Preventable Cesarean

                              Or 

Reducing C- Section for Good

                              Or

How to break a Chain Reaction of C Section

                              Or

Protecting the new Moms ( 1st time) from C section

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The science is advancing,we are moving away from conventional open surgery to laparoscopic surgery  to robotic surgery.We want smaller cuts for uterus removal ovarian cysts,,fibroid removal  but what are we doing for delivery? We are going away from vaginal deliveries towards big scars of cesarean deliveries. Once a cesarean,there are 80% chances of having a 2^nd cesarean also & if 3^rd pregnancy occurs- 3^rd is inevitably an indication for elective cesarean section.The chances of having laparoscopic or robotic hysterectomies are minimized case if required  at later age.

When the girl is young ,about to be a mom, needs to have less trauma to body & maintain her figure,  we give her big scars of cesarean section & when she is old of 45 & needs hysterectomy, we try to manipulate her by giving smalls scars of laproscopic surgery or robotic surgery ( through small holes)

The uses of robotic surgery is undoubtedly good  as it leads to faster recovery but why  the C- section rates are going so high.

 C section is a major surgery and carries risk for infection ,bladder and bowel injuries,serious complications for future pregnancy like aldherent placenta ,bleeding per vaginum during pregnancy & more chances of 2^nd cesarean & hysterectomies.

Justified Indication of C - section are -

1) breech presentation or oblique lie.

2) low lying placenta or placenta previa

 3)pre eclampsia/eaclampsia

4) multiple pregnancy with first breech or transverse lie

5)big sized babies leading to shoulder dystocia.

6) Cpd

Unjustified indication of C section are

a)  Fear of labor pains thus avoiding vaginal deleiveries.

b) wanting to have baby at auspicious moments e.g janmashtami and guru purab. Or at specific date & time as guided by astrologers.

c)  patient on continuous fetal heart monitoring showed single reading of dropping fetal heart rate during labor pain.

d) if having insurance coverage are more likely to undergo C-section.

f) for convenience of doctor as C-section is less time consuming and more profitable.

g) lack of availiblity of obstetrician and anaesthetist  round the clock.

h) fear of medicolegal litigations.

  

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Things to be done by Mom to prevents C -section

a)    Avoid unnecessary weight gain. Averege weight gain of 11-13 kg during pregnancy will give you an average baby wt of 2.5 – 3.1 kg. A weight gain of more than 15 kg will give you macrosomic baby. An average indian women with average  height of  5feet 3 inches  cannot delivers a baby of more then 3.6-3.8 kg ,so avoid  unnecessary weight gain during pregnancy by modifying your dietery patterns i.e more of protiens and reduce carbohydrates intake.

b) Exercise – working women having sedentary job should exercise more or attend antenatal classes.

c) Shortning the period of rest & sleep to not more than 8 hrs. in a day.

d) Pregnancy is a physiological state & not a disease does not require bed-rest. Working actually throughout your pregnancy unless otherwise indicated in cases of  high blood pressure or low lying  placenta gives you more chance of having vaginal deleivery.

e) Avoiding  white flour and maida in,pitza,pasta & chowmein & pure starches like potato & rice.

f) Doing more of household works.

g) Attend antinatal classes to learn more about exercises ,diet & nutrition labor pains & delievery

h) Being patient & cooperative during  labor

i) Having a good support during labor like doula

THINGS TO BE DONE BY A DOCTOR TO AVOID C-SECTION

Choosing a Coregiver/ Doctor – ask your doctor about What is her rate of primary   cesarean sections—which should be  as low as  10%. Ask about the places where she takes  her clients  for birthing & inquire about hospital policies for labor birth care & find out the c section rates.

Before marrying a man,we survey all his particulars , his family & financial status but some patients do little research  about the doctor and go by the fact which doctor has a big name, does more publicity and more  by word of mouth references.Most of the popular doctor gives undesirable or very high cesarean rates. 

This is where the difference lies between an unskilled & well trained obstetrician.If the obstetrician is well trained in good premiere institution, where she has conducted a good number of delivery including forceps ,vaccum,rotation of occiput in occipitoposterior position,she is confidant enough to handle such complicated vaginal deleiveries and she is confident enough to do cesarean in of deep stuck head ( if trial fails) ,unnecessary c section  rate can be  significantly  diminished.

CHOOSING A BIRTHING PLACE ask about the fascilities like epidural anaesthesia, nursery & blood bank  in the hospital. Most of the hospitals do not collect the data for vaginal cesarean delivery ratio and moreover they are not transparent about the data for individual doctor’s vaginal to cesarean ratio. The data collection should be transparent as it attribute for the patient to choose their obstetrician.

INDUCTION OF LABOR Studies have shown that at less then 40 weeks of gestation women who underwant induction have lower rate of c section compare to those who received expectant management.Use of cerrvical ripening methods such as misopristol,dinoprostgel or pge 2 gel. foleys bulbsand laminaria tents lead to lower rate of c section.

b) If colourd doppler studies is normal ,the baby weight is within normal range & the mother is feeling good fetal movements  & the cervix is unfavourable,do not induce  the labor before 40 weeks unless medically indicated

c)wait for   24 Hours to call it as failed induction .

d) in case of ruptured membranes wait for 12 -14 hrs. of induction

 LABOR SUPPORT – it is the most effective tool to improve labor and delivery outcome as continuous presence of one to one personnel support such as doula improves patient satisfaction and co operation ,this resource is underutilized  .Doulas are schooled to give massage,positioning,relaxation,information and many more skills to make the patient comfortable during labor.

Cesarean section are  required If second stage is prolonged that is more than 3 hours or 4 hours in cases of epidural analgesia, operative vaginal delivery like foreceps or vacuum delivery should be used judiciously as they do not have serious morbidity like intracerebral haemrrhage. Hopefully the combine efforts of the doctor and patient would definitely reduce the Ceserean Section rate.

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Dr Ruby Sehra @ Ivf Centres in West Delhi,Delhi,India

Best Ivf Consultany and Treatment By Dr Ruby Sehra

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