At Mannat Fertility Centre, we offer the following services –

• Infertility Treatment
• Antenatal Care

Infertility Treatment

• Basic Infertility Work
• Ultrasonography
• Egg Donation
• Intrauterine Insemination (IUI)
• Male Infertility
• Surrogacy
• In Vitro Fertilization (IVF) – ICSI, IMSI
• Assisted Reproductive Technology (ART)

OUR BASIC INFERTILITY WORKUP

• Semen Quality Analysis

  Analysis of the semen for sperm count, motility, morphological abnormalities and vitality of the sperms is performed so that male factor defects can be detected and DFI ( DNA fragmentation Index)

• Endometrial biopsy

  In this procedure strips of the Endometrium are taken from the uterine lining & sent for examination. Many cases of T.B. of uterus are detected this way.

• Hysterosalpingo Graphy (HSG)

  HSG is performed to test the fallopian tubes. Done in the X-ray dept, a dye is used to detect if the tubes are open or blocked.

• Hormonal Analysis

  Tests like FSH (follicular stimulating hormone), LH (luteinizing hormone), E2 (estradiol), Progesterone, Thyroid function tests, Prolactin, androgen profile which are an integral part of infertility treatment are done.

• Treatment of PCOD and Amenorrhea

  Polycystic ovarian disease (PCOD) comprises of menstrual irregularities, obesity, increased hair growth (on the face, arms & legs, over the abdomen). It Usually starts in adolescent age. Our center is a referral center for such patients and we treat young girls as well as patients having difficulty in conceiving with PCOD.

• Amenorrhea

  Is where there are no menstrual periods. It could be primary (where the girl never had a period on her own), or secondary (where she had periods initially and then ceased having them). Treatment such cases are our forte and we have track record of excellent results.

ULTRASONOGRAPHY

TRANSVAGINAL SCANNING (TVS) is an integral part of infertility treatment.

• Follicular Monitoring

  Follicular Monitoring is done to check if the patient is ovulating or not. The ovarian follicles are tracked from day8 till they rupture & extrude the egg (Oocyte).

• Sonosalpingography

  Sonosalpingography is a way of testing the fallopian tubes by using saline inside the uterus and checking the tubal motility & potency on the ultrasound.

• Embryo Reduction

  Embryo Reduction Ultrasound is essential for embryo reduction in multi fetal pregnancies.(For better fetal outcome the no of embryos are reduced).

• TVS

  TVS is also used for aspiration of ovarian cysts.

MALE INFERTILITY

We provide comprehensive management and treatment for Azoospermia, Oligospermia, Impotency, Erectile dysfunction and premature ejaculation.

Treatment of Male Factor
Obstructive causes

Surgical Procedures such as Vaso-epidydimo-anastamosis might improve the sperm count in 40% of cases. If sperm count in low then IVF-ICSI is the only solution if the couple is keen on their own genetic child. Another options is donor insemination.

Non Obstructive causes

• In case of genetic defects like KLINE FELTERS syndrome, Micro deletion in Y chromosome etc. donor insemination is the option. Adoption another alternative in case the couple is averse to treatment.
• If the testes are atrophic due to infections again donor insemination is the option.
• Varicocelectomy (Ligation of veins or embolisation) might improve sperm count.
• Erectile dysfunction: medications like Sidnaphyll and counseling can help. If the sperm count is good then IUI is an option. In case of very low sperm count IVF-ICSI is the option. For impotency, penile prosthesis are available which can couples have normal sex.
• Azospermia can be managed through the following procedures.

Sperm Aspiration

This is a procedure to obtain viable sperms from the male reproductive tract. The following methods are used to extract the sperms for use in ICSI.

• Microsurgical Epidydimal Sperm Aspiration (MESA): To obtain sperms from the epididymus using an operating microscope.
• Percutaneous Epididymal Sperm Aspiration (MESA): To retrieve sperms, epididymus is punctured with a needle & sperms are aspirated with a syringe. This is a simpler technique.
• Testicular Sperm Aspiration (TESA): This involves sucking out the testicular tissue &sperms are isolated from it.
• Testicular Sperm Extraction (TESE): It is an open procedure where a small portion of testicular tissue is removed through an incision. This tissue is placed in culture media &sperms are extracted from it.

Some Common Terminology

ART: Assisted Reproductive Technologies

• Intrauterine insemination (IUI)In cases of low sperm count, patient undergoing ovarian stimulation and follicular monitoring and in unexplained infertility etc. the husband’s semen is processed and all healthy motile sperms are separated and suspended in nutrient media. This is then injected inside the uterus:
• Therapeutic Donor Insemination (TDI) This procedure is for couples where the husband is Azoospermic (no sperms in the semen).
• IVF (test tube baby) The wife’s Oocytes are taken & fertilized with the husband’s sperm in the IVF lab. The resulting embryos are transferred to the wife’s uterus. Our success rate in this procedure is at par with global standards at 40%.
• ICSIIn cases where the husband has only a few sperms or where previous fertilization failures in IVF are reported , we inject one sperm into the oocyte to ensure fertilization using state of the ART technology. The resulting embryos are transferred to the wife’s uterus.
• Blastocyst transfer The embryos are grown in the laboratory to day5 Blastocyst stage and then transferred to the wife’s uterus as in natural conception the embryo reaches the uterine cavity on day 5.For this we use an extended culture media.
• Assisted HatchingAn opening is created in the outer covering of embryo to help in hatching in women over 40yrs of age and in cases of repeated IVF failures.
• Egg DonationIn women unable to produce good eggs or in women with ovarian failure, we arrange for suitable donors.
• SurrogacyThis is an option for women whose ovaries are functioning, but uterus is either absent or is unable to carry pregnancy to term. These couples can have their own embryo transferred to a healthy surrogate woman.

Intrauterine insemination (IUI)

Intrauterine insemination or IUI, as commonly known, can be considered as the first line of treatment for infertility. IUI can be useful for both male and/or female factor related infertility. Typically, indications for IUI include-

For males

• Oligoasthenoteratozoospermia i.e. men with low sperm count, or less motile sperm in the ejaculate, or having many abnormal sperm. In our experience we have found that if the total motile sperm concentration after sperm wash is less than 5 millions then the success rate is less.
• Sexual or ejaculatory dysfunction where semen is collected using vibrator or through electro ejaculation.
• Retrograde ejaculation, where semen enters the bladder after orgasm, instead of ejaculating out through penis.
• Immunological factors like autoantibodies and sperm agglutination.
• Men with highly viscous semen for prolong time, which restricts sperm movement deposited in the cervix under natural circumstances.
• Donor sperm insemination

For females

• Anatomical defects of the reproductive tract, where direct coitus is not possible
• Psychological sexual dysfunction – dysparuenia, vaginismus
• Cervical factors i.e. poor sperm-mucus interaction, failed post-coital test, antisperm antibodies
• Ovulatory dysfunction
• Unexplained infertility
• Minimal endometriosis

It has been universally observed that whenever IUI is combined with induction of ovulation or controlled ovarian stimulation, the success rate in the form of pregnancy is improved.

Depositing actively motile sperm free from debris, leucocytes, pus cells, and dead sperm has a significant reproductive advantage in fertilizing the released oocyte from the ovary, in the fallopian tube. During natural intercourse, semen is deposited in the vagina, motile sperm from the semen move towards fallopian tube. Out of around 100 million sperm from a ‘normal’ man deposited in the vagina, only about 1 million sperm find their way to the upper portion of the uterine cavity and only few hundred enter the tube where fertilization occurs. In IUI, 5-10 million motile sperm are deposited at the top of the uterine cavity near the opening of the tubes thus significantly increasing the chances of healthy sperm reaching the mature oocyte.

The risk of infection with IUI is very small.