REGULAR INTAKE OF MEDICINE "ADHERANCE" IMPROVED HIV PATIENTS-THE LANCET STUDY


PROF .DRRAM,HIV /AIDS,HEPATITIS ,SEX DISEASES & WEAKNESS expert,New Delhi,India, profdrram@gmail.com,+917838059592,+919832025033,ON WHATSAPP

A new dtudy has been published in The Lancet - Infectious Diseases, the breakthrough deals with how patients take their medication and adhere to regimes, as too many face irregular regimes or discontinue medication.A new program or better patient assistance was designed by University of Aberdeen and Academic Medical Centre (Amsterdam) teams. University of Aberdeen Professor, Marjin de Bruin, stated �this is the first adherence intervention in HIV care that demonstrates clinical and cost effectiveness. The intervention can be applied in routine clinical care, and the effects have been reproduced in consecutive trials. Although HIV medications are very effective, they can have quite a few side effects and people with HIV don�t usually experience any symptoms of the disease, so for these and other reasons it is unsurprising that adherence among some patients is suboptimal. We designed a programme in such a way that it would fit in with routine care and only adds about 10 minutes to the consultation. Our intervention has proved to be very successful at improving drug-adherence and in turn reducing treatment failure. Importantly, these effects were most profound amongst patient groups from which we know struggle most with this treatment. As well as important for patients� own health, having a very low viral load means that people are extremely unlikely to transmit the virus to other people. So not only is this a significant improvement to individual patients� health, it is also important for public health because it may help to curb the pandemic by interrupting the transmission of the virus. That the intervention also saved money rather than required extra resources was unexpected, and strongly suggested that introducing this programme in routine HIV care is beneficial for patients and safety. It is very important to note that the medication non-adherence is very common with long and short-term treatments for many conditions, often contributing to poor patient outcomes and increased health care expenditure. We will therefore seek to adapt and test the benefits of this intervention in a range of other chronic condition.�

NIPT "Non Invasive Pregnancy Test" DIAGNOSE CHROMOSAL ABNORMALITY BUT MAY BE USED FOR SEX DETERMINATION IN INDIA-NEED REGULATIONS TO SAVE FEMALE CHILD
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Noninvasive prenatal testing (NIPT), also known as noninvasive prenatal diagnosis (NIPD), is a screening method for detecting certain specific chromosomal abnormalities in a developing baby. Noninvasive prenatal testing is a sophisticated blood test that examines fetal DNA in the maternal bloodstream to determine whether your baby is at risk of Down syndrome, extra sequences of chromosome 13 (trisomy 13), extra sequences of chromosome 18 (trisomy 18) or a sex chromosome abnormality, such as Turner syndrome. The testing can also be used to determine a rhesus (Rh) blood type. Noninvasive prenatal testing is much more sensitive and specific than traditional first and second trimester screening. As a result, noninvasive testing can often help women who have certain risk factors avoid invasive testing, such as: Amniocentesis. During this procedure, a small sample of the fluid that surrounds and protects the baby during pregnancy (amniotic fluid) is removed from the uterus for testing. Chorionic villus sampling (CVS). During CVS, a small sample of the wispy projections that are part of the developing placenta (chorionic villi) are removed from the placenta for testing. Amniocentesis and CVS both carry a slight risk of miscarriage. Noninvasive prenatal testing can determine whether baby is at risk of a chromosomal condition. Risk factors might include older maternal age or having previously given birth to a baby who has Down syndrome, trisomy 13 or trisomy 18. If patient a carrier of an X-linked recessive disorder. X-linked recessive disorders, such as Duchenne's muscular dystrophy or a blood-clotting disorder (hemophilia), typically affect only males. If PT have an Rh negative blood type. Noninvasive prenatal testing can determine baby's Rh factor. If mother Rh negative and baby is Rh positive(from husband ), mother might produce Rh antibodies after exposure to baby's red blood cells. This is called becoming sensitized. (This is typically not a concern during a first pregnancy, but can be a concern during subsequent pregnancies and due to excessive RBC BREAKDOWN high serum bilirubin may kill or badly affect the baby.) The new blood test NIPT will let expecting mothers know the sex of their baby as early as the first trimester. The falling sex ratio is already a bother for policymakers and sociologists in India. Now, scientists have developed a new blood test that will allow early detection of foetal gender, further endangering the girl child.Unlike ultrasound tests currently used for finding out the sex of an unborn child, the new blood test would let expecting mothers know the sex of their baby as early as the first trimester. The test measures the ratio of two crucial enzymes, DYS14 and GAPDH, from foetal DNA circulating in the mother's blood. The ratio is an effective indicator of foetal gender, Korean scientists who developed the test said. The research results have been published in the latest issue of the Journal of the Federation of American Societies for Experimental Biology. The non-invasive test will require just a drop of blood from the pregnant woman. Currently, till the onset of ultrasound, the procedure of amniocentesis is used for sex determination. But it is invasive and carries the risk of miscarriage. Moreover, it can't be performed until 11 weeks of pregnancy. Ultrasound gives reliable determination of foetal gender but it can't be performed in the first trimester. The use of ultrasound for sex determination has been outlawed in India, following its misuse for abortion of the female foetus, which has led to skewed sex ratio in many parts of the country. Researchers from the University School of Medicine in Seoul claim the ratio test will be the first of its kind. "This can reduce the need for invasive procedures in pregnant women," researcher Hyun Mee Ryu said. The study involved analysing the blood samples from 203 women during their first trimester. The presence of circulating foetal DNA and the quantity of the two enzymes were confirmed through a series of tests. The results were confirmed when the women gave birth. "The study shows it is possible to predict the sex of a child as early as the first few weeks after conception," Gerald Weissmann, journal editor, said. While the test is a major scientific advance, it can be misused in India. IT IS HIGHLY FREELY DONE IN INDIA BUY MANY LABS AND IS NOT REGULATED AND GRADUALLY COST IS COMING DOWN IN COMPETITION AND LIKELY TO BE MISUSED FOR SEX DETERMINATIONS AS COST IS HIGH BUT IN GROWING MIDDLE CLASS ECONOMY MANY CAN SPEND

Eating vegetables provides health benefits � people who eat more vegetables as part of an overall healthy diet are likely to have a reduced risk of some chronic diseases. Vegetables provide nutrients vital for health and maintenance of your body.
It contains ---
1. Potassium - help to maintain healthy blood pressure. Rich sources are sweet potatoes, white potatoes, white beans, tomato products (paste, sauce, and juice), beet greens, soybeans, lima beans, spinach, lentils, and kidney beans.

2. Dietary fiber - helps reduce blood cholesterol levels and may lower risk of heart disease. Fiber is important for proper bowel function. It helps reduce constipation and diverticulosis. Fiber-containing foods such as vegetables help provide a feeling of fullness with fewer calories.
3. Folate (folic acid) - helps the body form red blood cells. Women of childbearing age who may become pregnant should consume adequate folate from foods, and in addition 400 mcg of synthetic folic acid from fortified foods or supplements. This reduces the risk of neural tube defects, spina bifida, and anencephaly during fetal development.
4. Vitamin A - keeps eyes and skin healthy and helps to protect against infections
5. Vitamin C - helps heal cuts and wounds and keeps teeth and gums healthy. Vitamin C aids in iron absorption.

So friends, to be fresh and look young you need to eat fresh veggies...

Introduction
When couples get married, they often view parenthood as the next stage in their family life. They want to have a child, they want to be �mom� and �dad�, they cannot imagine that this may be hard to achieve or may not be a natural process. When several trials to conceive fail, they are shocked. Their basic expectation about family life gets shattered. Most of the couples are desperately looking for medical therapy that will end into a misery. Clearly this is not a struggle to survive; it is a struggle to fulfill a dream, to achieve what they view as a �full life�.
What is needed for pregnancy?
In the male partner, sperms are normally produced in the testes after puberty (after attainment of characters like growth of beard, moustache etc). From the testes, they are carried through the sperm conducting ducts (epididymis, vas, seminal vesicle and prostate gland). Then during sexual stimulation, after proper erection and ejaculation, they come out through penis. During sexual intercourse, these sperms, present in semen, are deposited inside the vagina.
In female partner, the deposited sperms must travel from vagina through the cervix (the mouth of the uterus). The cervix acts as gate-keeper, a it prevents entry of dead and abnormal sperms as well as bacteria present in semen, in the uterus. From uterus, sperms reach the Fallopian tubes (the tubes that are attached to the both sides of the uterus) where the sperms must meet the egg (ovum). The eggs are produced only before birth and so, there are fixed number of eggs inside the ovary. The ovum released from the ovary, into the abdomen at the time of ovulation (rupture of the surface of ovary to release the ovum). That ovum must be taken by the tube and thus inside the tube an embryo (earliest form of the baby) is formed, by meeting of the egg and the sperm.
It should be mentioned that out of nearly 200-300 million sperms, in average, deposited in vagina, hardly 500- 800 sperms can reach near the eggs and only one will succeed to form the embryo. The embryo then travels through the tube into the uterus and the uterus attaches the embryo firmly with it and thus the pregnancy starts. So, if there is defect in any one of them there will be difficulty in achieving pregnancy.
Thus, to summarise, pregnancy requires
1. Production of healthy (�Normal Morphology�) and movable (�Normal Motility�) sperms in adequate number (�Normal Count�) in the testes
2. Transport of these sperms through the sperm conducting ducts from testes to penis
3. Successful Erection and Ejaculation during Intercourse to deposit adequate number of these sperms in the vagina
4. Transport of these sperms from vagina through cervix to the uterus and the tubes
5. Presence of sufficient number of eggs inside the ovary and ability to release the eggs from the ovaries
6. Pick up of the eggs by the tubes
7. Approximation of eggs and the sperms to form the embryo
8. Transport of embryo from the tubes into the uterus
9. Acceptance of the embryo by the uterus and its growth
What is Infertility?

Literally, the word �Infertility� means inability to conceive. But in reality, there are very few couples, who have no chance of natural conception and are called �Absolutely Infertile�. In fact, in many couples who present to infertility clinics, pregnancy may be the matter of time, thus the chance factor.
It should be kept in mind that, if there is factors to question fertility of either male or female or the female is of age less than 35 years; after one cycle (one month) of regular frequent intercourse, the chance of conception in human being is only 15%. That means, out of 100 couples trying for conception, only 15 will be able to succeed after one month of trying. The word �Regular� and �Frequent� are important; because to achieve pregnancy, couples are advised to keep intimate relationships for at least 2-3 times a week and this should be increased particularly around the time of ovulation (Middle of the menstrual cycle). Thus chance of pregnancy after 6 months, 12 months and 24 months of regular trying are respectively 60%, 80% and 100%.
The word, �Subfertility� seems better and more scientific than �Infertility�, to describe the couples who have reduced chance of conception, due to any cause. However, the word �Infertility�, seems more popular, although it puts pressure on the couples. In most cases, usually we advise to investigate after one year of regular and frequent intercourse, when the couples fail to conceive. However, if there are factors to question fertility; for example female with age more than 35 years, or with previous surgery in tubes/ ovaries/ uterus or known diseases like PCOS or endometriosis; or male partner having surgery in scrotum or groin or any hormonal problems or sexual dysfunctions- the wait period is usually reduced and couples can be investigated, even soon after marriage.
What causes Infertility?
Please look at the point �Thus, to summarise, pregnancy requires� where 9 points have been mentioned.
Thus the common causes may be
1. Problems in male- total absence of production of sperms, less than adequate number of sperms, problems in morphology and motility of sperms (most sperms not healthy or movable), blockage in transport of sperms and inability to deposit sperms in the vagina (sexual dysfunction- Erectile Dysfunction or less commonly, Ejaculatory Dysfunction). Examples include hormonal problems (Testosterone, thyroid, prolactin), diabetes, liver problems, causes present since birth, chromosomal abnormalities, surgery, infection, sexually transmitted diseases, smoking, exposure of scrotum to high temperature, some medicines or psychological causes.
2. Problems in female- total absence of less than adequate number of eggs in the ovaries, problems in ovulation, problems in picking of eggs by the tubes, blockage of tubes, problems in conduction of sperms or embryo by the uterus, problems in accepting the embryos by the uterus. Examles include causes present since birth, chromosomal abnormalities, polycystic ovarian syndrome (PCOS), old age, increased weight, fibroid, endometriosis, pelvic inflammatory diseases (PID), tuberculosis (TB), infections, smoking, surgery, some medicines, hormonal problems (thyroid, prolactin) or excessive stress.
3. Unknown causes- Despite thorough investigations, 25-30% causes of infertility remain unknown. This is called �Unexplained Infertility�. The reason may be mere chance factors or there may be some causes which, still medical science has yet to discover. But this should be kept in mind while treating infertility. That means, even with correction of the possible factors (like improving sperm counts or thyroid problems etc) or with proper treatment (IUI, IVF or ICSI), unfortunately the treatment can fail and the exact reason, why the treatment failed, is sometimes difficult to find out.
In general, what are the treatment options for infertility?
To start with, please remember there is no hard and fast rules for infertility treatment. Often medical science fails to understand why couples with very severe form of infertility conceive sooner than those who are having all tests normal. That means, whatever treatment is offered, it�s very important to continue regular sexual intercourse, as the chance of natural pregnancy is usually there in almost all couples. Your doctor will present the facts to you, without pressurizing you on a particular option. After coming to know all pros and cons of different treatment options, you can take decision. Do not hurry. It�s quite natural that you might be in stress.
In general, after the initial tests, a few periods of natural trying is allowed. After that, ovulation induction (giving medicines to release eggs from the ovaries) is offered, failing which IUI and finally IVF is offered. What will be the preferred treatment for you, will depend on your age, duration of marriage, male and female factors and of course, your age. For example, a woman with both tubes blocked or a male with very low sperm count, IVF would be the first line of treatment.
What is insemination?
Insemination literally means putting semen in a particular place. Various forms of insemination exist in fertility treatment. First one is �Intravaginal Insemination (IVI)�, where the raw semen, collected by the husband can be put inside the vagina, taking precautions (to prevent infection) by the husband himself or by the wife. Rarely, it needs medical assistance from a doctor. It�s usually advised to couples having sexual disorders where full penetrative intercourse is not possible (erectile dysfunction of the husband or very painful intercourse experienced by the wife) or where ejaculation cannot happen during intercourse (a very unusual problem). Thus, the success rate of IVI is no better than natural intercourse (success rate 15% per cycle), for those couples who can manage successful intercourse.
�Intrauterine Insemination (IUI)� is the treatment where �prepared� semen is put inside the cavity of the uterus, near the Fallopian tubes. Thus, IUI bypasses some hurdles that can cause problems during natural intercourse. The vagina, cervix and the whole length of the uterus are bypassed, putting the sperms near the eggs. Thus it increases the success rate compared to natural intercourse or IVI.
However, to achieve pregnancy after IUI, the female partner must have open tubes, adequate number of eggs produced by ovaries, eggs must be released by the ovaries and sperms must meet the eggs. And, thus nature plays important role, as in natural intercourse.
Please note, we used the word �prepared� semen. In natural intercourse, as mentioned earlier, the dead sperms and bacteria cannot enter the uterus, because cervix prevents their entry. If they are put artificially by IUI inside the uterus, severe reaction can happen. So, after collection, the husband�s semen is processed in the laboratory to remove all those impurities and to select only the best number of healthy and movable sperms and it definitely increases success rates of IUI
When IUI is generally advised?
As you can understand, to perform IUI, there must be minimum number of sperms in the semen, the tubes must be opened, the ovaries must be releasing eggs. If these are present, IUI is usually advised
� Less than adequate number of sperm counts, morphology or motility
� Couples who cannot perform full penetrative intercourse but refuse or unable to conceive by IVI
� Unexplained infertility- although IVF is better than IUI, but considering the cost, many couples in our country opt for 2-3 cycles of IUI before IVF
� PCOS and Mild Endometriosis- where natural intercourse or ovulation induction failed
� Couples in whom only one partner is positive for HIV or Hepatitis B or C- where transmission from one partner to another by unprotected sexual intercourse is not preferable.
What are the tests done before IUI?
The basic infertility evaluation is done before IUI include husband�s semen analysis, assessment of ovarian function (blood tests, ultrasound) and uterus (ultrasound). In some cases, laparoscopy (putting camera to see inside the abdomen by operation) or hysteroscopy (putting camera through vagina inside the uterus, by operation) may be required. Now, if the tubes are blocked, IUI is of no use. So, testing the tubes is advisable before IUI. But some women, who are at low risk of tubal disease (no history of pelvic pain, infection or surgery), one or two cycles of IUI can be done, failing which tubes must be checked by tests like HSG or SSG or in some cases by laparoscopy.
What IUI actually involves?
In the cycle, in which IUI is planned, the woman is asked to take some medicines (or injections) in particular days of the periods as a part of �ovulation induction�. She is then advised to have ultrasound monitoring (TVS- transvaginal sonogram- where ultrasound probe is placed inside the vagina for better accuracy) to see if eggs are growing in response to the medicines or not. If eggs are growing, IUI is planned in a particular time when the egg(s) is more likely to rupture, so that the tie interval between sperm entry and egg release can be kept as minimum as possible.
Is ovulation Induction necessary for IUI?
Frankly speaking, IUI can be done without any medicines (as in case of natural intercourse or IVI), which is called �Natural Cycle IUI�, where only TVS monitoring is done to see how the eggs are growing. This may avoid some side effects of ovulation induction (see below) but is associated with low success rate than IUI done along with ovulation induction.
Is TVS necessary before IUI?
TVS is, undoubtedly, uncomfortable for the woman. But it gives better picture than ultrasound done conventionally. Now, the question is, whether ultrasound monitoring is at all needed or not. TVS directs the doctor how eggs are growing and at what number and size and when they are likely to rupture. Moreover, the rupture can also be confirmed by TVS. Again, the uncommon side effect of ovulation induction can be detected by TVS. That is called OHSS (�Ovarian Hyperstimulation Syndrome�) where excessive eggs can grow inside the ovaries and this can lead to collection of fluid inside abdomen and lungs and can turn very serious. Although very rare, it can be detected by TVS and early actions can be taken to prevent the progress of this condition.
In rare cases, where TVS cannot be done or patient declines, only option is to check urine by LH kit to predict the likely timing of ovulation and at that time IUI is planned. However, it is less accurate than TVS monitoring and is associated with less success.
What, if eggs are not growing in the ovaries?
In some women, particularly those who are overweight, aged or some cases of PCOS, eggs may not respond initially to one medicine. There are various forms of ovulation induction medicines (tablets, injection). If one is not working, your doctor can try increasing the dose of that medicine or add or replace it with other medicines. Please remember, it�s difficult to predict what medicine will be best suited for a particular patient. So, it�s basically a trial and error process.
What is done on the day of IUI?
As timing is important, the couples are requested to stick to the timing, advised by the doctor. The husband will be asked to collect the semen by masturbation, using clean technique (to avoid contamination by germs in the semen container). The semen is then prepared by the embryologist and will be checked to see the final number of sperms and their motility and morphology.
The wife is asked to lie down in the IUI table. After cleaning, a sterile speculum (instruments to separate walls of the vagina to see the cervix) is introduced inside the vagina and then 0.4-0.6 ml of the prepared semen is inserted inside the uterus with the help of a small catheter (fine tube). IUI done, under ultrasound guidance, gives better result than IUI done without it. The patient is asked to lie down few minutes after taking out the catheter and the speculum. The medicines are advised and then they can go home.
Is IUI painful?
Most women feel little discomfort during IUI but it should not be painful. If there is technical difficulty while putting catheter inside the uterus, your doctor will discuss it with you and in the next cycle, will plan management to solve this issue.
What happens if husband cannot collect semen?
Collection of semen in unfamiliar environment is understandably a matter of discomfort and seems awkward. Proper counseling and maintenance of privacy can help. Stress-free approach is needed. If it fails, do not hesitate to inform your doctor. Some medicines can help. But in those, who are unable to masturbate, there are some instruments, like ejaculator, can help to solve this problem.
What happens if sperm count is low?
IUI can be successful if sperm count is minimum more than 5 million per ml and there is reasonably good morphology and motility. If not, IVF or ICSI would be the better option. But IUI can serve as trial also. That means before putting the semen, the prepared sperms can be examined and it can be predicted what is the success rate of IUI in this particular case and whether IVF or ICSI would be needed. In rare occasions, where sperm count is extremely low but the couple do not wish for IVF or ICSI, pooled semen IUI can help- where the semen is collected in number of occasions and is preserved and the final pool is used for insemination, to give a reasonable success rate.
When donor sperm is used and how?
If a man does not have any sperms or too few sperms to do IUI, IVF or ICSI is not affordable, donor IUI is an alternative. But it is not done without consent from both husband and wife. The donor is not known to the couple or the doctor and no identity of the donor is revealed. No relative or friend can serve as donor. Donor semen is frozen semen, collected 6 months ago and the donor is tested for diseases like STD, HIV, Hepatitis B or C. Usual attempt is taken to chose donor having blood group and skin colour similar to those of the husband. But remember, it�s only given after discussion and written consent by the couple.
Can a couple have intercourse in the cycle where IUI is advised?
Intercourse around IUI increases the number of sperms available at the time of ovulation.
When should one check for pregnancy?
Usually if period does not come within 18 days after IUI, pregnancy test is advised. It can be done at home. If negative, then the cause of not having periods is sorted out.
What is the chance of success after IUI?
In one cycle, chance of success is around 20-25%. Most of the couples conceive after 3rd or 4th cycle of IUI. The chance of pregnancy after 6th cycle is low, so, usually IUI beyond 6 cycles is not advised.
The factors where IUI gives better results include unexplained infertility, sexual dysfunction of any of the partner, PCOS and male subfertility (low sperm count or motility)
What happens if IUI fails?
As said earlier, you should think about further treatment, if 3rd or 4th cycle of IUI fails. There is no use of doing IUI beyond 6 cycles, unless natural intercourse is not possible and the age is favourable. IVF gives better result.
Is there any harmful effect of IUI?
Very few harmful effects have been noted, for examples, hazards of ovulation induction (OHSS< twin pregnancy), pain, infection and discomfort. As mentined, if raw semen is given, unusual allergic reaction can happen.
How IUI is being done in your particular centre by Dr Sujoy Dasgupta?
We believe in patient�s autonomy. So we want to give time on discussion and presentation of facts and figures to the couples. We encourage questions from the couples and take utmost care so that no question remains unanswered.
We do not take decisions and impose it on the couples. We advise the couples to take time before taking decision on a particular treatment. If the couple decides, we respect and support their decision.
We try to take nominal charges and help couples to collect medicines (particularly injections) at lower prices than MRPs.
After thorough evaluation of both the partners, we plan for ovulation induction drugs, with consent from them and advise them to come for TVS. After each day TVS, we explain the progress and probable timing of IUI.
On the day of IUI, after requesting the couple to maintain punctuality, we advise the husband to collect semen, in comfortable atmosphere, maintaining the privacy. If there is problem in semen collection, we provide support to him and address his issues in sensitive way.
Our expert trained embryologist then prepares the semen. We always encourage the couples to see the condition of raw and prepared semen under microscope to maintain the transparency.
We advise the woman to fill up the bladder (to take water and not to urinate) to facilitate the passage of IUI catheter. Unlike other places, we perform IUI inside OT to prevent unwanted infection.
Again we maintain our uniqueness in the sense that we perform it under ultrasound guidance. The ultrasound guidance has been scientifically proved to increase the success rate of IUI. Moreover, we show the woman in the ultrasound (real time) how the catheter has been put inside the uterus (to make sure that we are not doing IVI or have placed it in wrong position). This also helps to reduce patient�s anxiety and uncertainty. After that, our nurse takes care of the patient and observes her when she takes rest.
Then we advise the post-IUI medicines and advise them what to expect and when they can go home. Again, this time we try to answer all questions the couples can ask.

Conclusion
Infertility is a peculiar thing. Very few men or women are absolutely infertile. That means they do not have ability to achieve pregnancy naturally. Majority of them are subfertile. That means most of them have lower than normal chance (compared to healthy couples) to achieve pregnancy in a normal menstrual cycle. Often we find that patients planning for treatment and in the mean time, they conceive naturally. That means even without treatment, there is some chance of pregnancy. Of course, it�s stressful situation for both the partners. Stress affects conjugal relationships and lead to many couples avoiding conjugal life. Indeed stress can affect the hormone levels in females and affects sexual performances in males. It�s easier for us to advise you to stay stress-free but is difficult to practice. Nevertheless, try relaxation as much as possible. Think that majority of the couples ultimately conceive by some form of treatment. Have faith in yourself and have faith in your doctor.

Infertility or reproductive problems are often treatable with infertility drugs and high-tech procedures. Assisted reproductive technology (ART) is a group of different methods used to help infertile couples. With the help of Assisted Reproductive Technology the chances of becoming pregnant for infertile couples has increased significantly. In Vitro Fertilization (IVF) is one such ART technique. IVF works by removing eggs from a woman�s body. The eggs are then mixed with sperm in petri dish in ivf laboratory to make embryos. The embryos are then transferred in the woman�s body. For nearly 40 years, in vitro fertilization (IVF) treatment has helped millions of couples worldwide to overcome a wide variety of infertility problems and has enabled them to realize their dreams of becoming parents. IVF helps infertile couples become pregnant by joining the egg and sperm together in an embryology laboratory where embryos are created that can later be transferred back into the woman's uterus.

In vitro fertilization (IVF) can be used to treat infertility with the following patients: blocked or damaged fallopian tubes; male factor infertility including decreased sperm count or sperm motility; women with ovulation disorders, premature ovarian failure, uterine fibroids; women who have had their fallopian tubes removed; individuals with a genetic disorder and unexplained infertility.

In Vitro Fertilization is assisted reproductive technology (ART) commonly referred to as IVF. IVF is the process of fertilization by manually combining an egg from ovaries and sperm in a laboratory dish, and then transferring the embryo to the uterus. Other forms of ART include gamete intrafallopian transfer (GIFT) and zygote intrafallopian transfer (ZIFT).

The treatment of IVF is helpful for couples diagnoised with problems including

Fallopian tube damage or blockage.
Ovulation disorders.
Premature ovarian failure.
Endometriosis.
Uterine fibroids.
Previous tubal sterilization or removal.
Impaired sperm production or function.
Unexplained infertility.
A genetic disorder.
Fertility preservation for cancer or other health conditions.

Learn in detail about ivf treatment, fertility and infertility in women and men at http://www.meandmummyindia.com/medical-services-index.htm

Advantages of IVF Treatments

The most obvious advantage of IVF treatment is the ability for the couple to have a biological child of their own. The IVF process uses only the best eggs and sperm from the couple, meaning the fertilization is more likely to be successful on the first try. A baby born through the IVF treatment will be no different from a baby conceived through natural means. IVF treatments are a great way to get around any infertility issues a couple might be having, without the need for major surgery or extensive infertility treatments. IVF can also be a great solution for patients who are unable to get pregnant through normal means, such as single mothers or same sex couples. Using donated eggs or sperm, they can use the IVF process to realize their dream of having a child. Even the infertile couple with male infertility or female infertility can opt for ivf with donor egg or donor sperm.

Side effects and Risks associated with IVF Treatment include multiple births, premature delivery and low birth weight, ovarian hyperstimulation syndrome, miscarriage, egg-retrieval procedure complications, ectopic pregnancy, birth defects, ovarian cancer and stress due to heavy ivf cost.

What To Expect After IVF Treatment

In vitro fertilization (IVF) related injections, monitoring, and procedures are emotionally and physically demanding on the female partner. Superovulation with hormones requires regular blood tests, daily injections, frequent monitoring by doctor and harvesting of eggs. These procedures are done on an outpatient basis and require only a short recovery time. Cramping during the procedure is common. According to the need and condition, patient may be advised to avoid strenuous activities for the remainder of the day or to be on bed rest for a few days after doctors advise.

Few considerations before opting for the IVF treatmentat at infertility clinic.

1. It�s not 100 percent successful. The most important fact to know about IVF is that it�s not 100 percent successful. The process can take time, money, and even an emotional toll on your life, and in the end, it might not work. Thats where choosing the correct IVF clinic will help you a lot in evry single step of the fertility treatment process.

2. The number of IVF cycles needed will vary from patient to patient. Several factors play a role in the success of IVF treatment including age of the patient, degree of infertility among couple and the quality of the embryo and semen. Some women will only require one treatment before successfully conceiving, while other women may need to undergo as many as six IVF cycles. Unfortunately, some women are unable to conceive even after undergoing multiple IVF cycles.

3. If your fertility issues are less severe, you may opt for mini-IVF, which costs less because it involves lower doses of fertility drugs and less comprehensive oversight for your cycle. If your fertility issues do not result from ovulation issues, you may be eligible for natural cycle IVF, which involves no fertility medications.

4. The important point to be considered is the cost of money involved. It is good to have a clear idea of the costs involved before starting treatment, and to have finances in order before beginning. There is significant emotional drain on the couple and their relationship.

5. Be patient during IVF Treatment. One of the biggest misconceptions about IVF is that it works right away. It�s very common you�ll need to do it more than once. In younger patients it may be a little less (if you�re not pregnant in the first cycle, you�ll likely get pregnant in the next), but if you�re in your forties the average is like three cycles. This is only an indicative figure and will vary from person to person and case to case basis.

6. Have a detailed discussion with your partner. Both should stand on the same page. Decide the time frame for how long you would like to continue with the treatment. Till how long you will continue or when would you stop infertility treatment?

You should discuss your chances for success with IVF with your fertility specialist to determine which type of treatment may be right for your health and budget. Be sure to inquire about any additional costs that may arise during treatment, such as extra testing or psychological counseling, so that you can be prepared. Some fertility clinics offer financial planning assistance to help patients afford treatment.

Know about IVF treatment process, treatment options available, ivf cost and anything and anything about ivf at https://meandmummyindia.wordpress.com/2016/09/26/when-to-see-a-expert-fertility-specialist-or-ivf-doctor-for-infertility

How to Choose an IVF Specialist

The in vitro fertilization process is complicated and very personal, so finding a good doctor is important. Most likely, you will begin your journey toward IVF at your gynecologist's office. He or she will run basic fertility tests and conduct exams to diagnose your condition before making a recommendation. Your gynecologist may suggest your partner see an urologist. Once you and your partner have decided that IVF is the right treatment option, you'll need to choose a specialist. Finding a Clinic and narrowing down your choices is an important, potentially difficult process. Since IVF is such an involved procedure, you'll need to find a clinic where you feel comfortable with the staff and confident in your chances of conception. Finding a clinic and specialist who make you feel secure is an important step in your IVF process.

Located in south Gujarat in Surat Me and Mummy hospital & IVF Centre has handled hundreds of infertility cases and has achieved remarkable success in them, a rare feat which few hospitals claim. With today�s advanced reproductive technology, you can always find a solution to all the fertility problems. You must meet an expert in the infertility field. Quality patient care and world class services are always the prime issues for Me and Mummy Clinic in Surat. Clinic gives meticulous attention to all the issues related to treatments, infrastructure, team composition and other related factors.

Dr.Praful Doshi a consultant Gynaecologist and IVF Specialist has over 20 years of experience in fertility and assisted reproduction techniques and specialises in infertility, IVF and in Assisted Reproductive Techniques. Dr.Praful Doshi performs in vitro fertilization (IVF), Donor Egg IVF, ovulation induction, artificial insemination, intrauterine insemination (IUI) and intracytoplasmic sperm injection (ICSI). Dr.Praful doshi has been playing major role in providing specialised treatments to overcome infertility problems and making your dream of family complete. We provide affordable & high quality male & female infertility treatment with advanced reproductive technologies and world class IVF lab infrastructure. The whole IVF section is provided with HEPA filtered, sterile, pressurised air for bacteria free and particle free atmosphere to improve the success of the treatment.

Contact us today for consultation with highly-skilled fertility specialist for the assisted reproductive technology treatments available and know more about ivf treatment, procedure, causes and ivf cost at http://www.meandmummyindia.com
Book an appointment with a fertility expert Dr Mitsu B Doshi & Dr Praful B Doshi today on 91-261-2471111 or email at info@meandmummyindia.com