First IVF failed - when to try again? | How long should your wait between IVF cycles?

First IVF failed - when to try again?

If you're dealing with infertility, you're probably aware that there's a wealth of information about therapies available. With so much information, the procedure can appear to be perplexing and daunting. That's why it's crucial to speak with a fertility doctor to receive all of the details. For example, there is some disagreement over how long you should wait between IVF cycles. Again, it's best to consult your doctor, but in the meanwhile, we've compiled some useful information for you to consider.

Suggested Intervals Between Cycles

While everyone is different, one full menstrual cycle is the normal time between IVF cycles. A new IVF cycle should not be performed twice in two months without a menstrual cycle in between. For most women, this means waiting 4 to 6 weeks following the embryo transfer and negative pregnancy test before starting another complete cycle. Having back-to-back IVF rounds refers to doing this numerous times in succession.

The term "delayed" refers to cycles that are spaced further apart. There is no statistically significant difference in pregnancy or birth rates between cycles performed immediately and cycles performed later, according to research conducted for the American Society for Reproductive Medicine (ASRM).

Physical Benefits of Taking a Break

There are physiologic reasons why a woman should take a break between cycles in some situations. The drugs used to stimulate the ovaries may cause inflammation. While this isn't normally a problem, many doctors believe that waiting for the inflammation to decrease before starting a new cycle is a good idea. Even if they don't start a new stimulation cycle, some clinics will proceed with a frozen embryo transfer after a fresh IVF cycle.

Mental and Emotional Health

Another reason to take a break is for emotional and mental wellness, whether it's for the suggested one menstrual cycle or longer. It's often necessary to take a step back for a while so you can focus on something other than IVF. Fertility journeys may be stressful and exhausting, so taking a break can be beneficial. It might also help if you receive some stress reduction and rest.

Many people, though, find it difficult to make that decision. After a cycle that hasn't resulted in a pregnancy, it may feel as if the clock is ticking louder and quicker. Some people have the idea that they should rush through the procedure and that taking breaks will slow things down. Others profit from a break in the cycle. If you're concerned about taking a break because of your age, talk to your doctor about the best course of action.

If you opt to take a gap in between, you'll almost certainly be thinking about getting pregnant. You may use that time to study new stress-relieving techniques. You might also decide to investigate additional methods, such as using frozen embryos or donated eggs or embryos.

Monetary considerations

Finally, some people require a respite due to financial constraints. Unfortunately, even fertility treatment insurance policies do not cover everything. As a result, it may be necessary to suspend treatments in order to analyse the situation and make plans for the following cycle. We price our services properly at Malpani Infertility Clinic, so you don't have to worry about getting overcharged for your treatments.

A Personal Choice

As you can see, taking a break between IVF rounds is a personal choice that you should make based on how you feel and what your fertility physician recommends. When your doctor says it's okay, you can start another cycle if you're physically and emotionally ready. The most important thing to remember is to pay attention to your body and emotions. Your fertility doctor should collaborate with you to determine the optimal treatment plan for your specific situation.

Need help in getting pregnant ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you!

IVF doctors as coaches and guides

 

As an IVF doctor , I tend to think of myself more as a coach and a guide , rather than just as a technically skilled professional.

Yes, I am a medical expert , and have more medical knowledge than my patient does , which is why it's very tempting to make decisions for my patients . Partly, this is because what we are taught to do in medical college -  to make decisions so we can help patients get better. Also, patients expect doctors to behave in a deterministic paternalistic fashion in India , because they want an expert who will provide them with answers , rather than leave the decision making up to them .

Now it's much easier to tell patients what to do , because it saves a lot of time during the consultation. Answering questions and clarifying doubts takes time, and doctors want to be seen as omniscient and omnipotent !

This is why the natural inclination is to decide on behalf of the patient, but I don't think this is in the long-term best interests of the patient , because the future is uncertain and unpredictable , and while we may offer medically sound advice which is in the patient's best interest , when the IVF cycle fails, the patient may feel that the doctor misguided them in order to maximize his profit.

This is why we encourage patients to invest in Information Theory , and to listen to both their head and their heart when making such important decisions. If you own your decision , you have peace of mind that you followed  the right process , no matter what the final outcome maybe.

Now I understand that this is a complex learning curve , and you may never be confident that you have made the right choice.

You can always ask your doctor for their opinion about your decision , and a good doctor is happy to provide a second opinion – but the first opinion should actually come from you , as the patient .

This control will help you understand exactly what is happening , which will reduce your anxiety levels considerably.

This investment in Information Therapy just requires a little bit of time and energy , and doesn't cost anything at all, simply because there is  so much high quality information available online for free.

The trick is to go to reliable websites such as www.ivfindia.com , so you know that you are not being taken for a ride . Trying to understand the jargon is a little scary in the beginning , and you may get lost because of all the medical details, but over a period of time , I promise you it will definitely become easier .

Please don't underestimate your intelligence , and your ability to make your decisions for yourself by going through the medical literature .

Good doctors will help you do this , because doctors aren’t mind readers , and we want you to make your own decisions for yourself , so we can behave as trusted partners in your journey.

Need help in getting pregnant ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you !

Why does IVF fail the first time? | Reasons for IVF failure and how to avoid repeat IVF failure

Why does IVF fail the first time?

'Why does IVF fail?' you might question. Friends, family, and the internet have all told us about the effectiveness of in-vitro fertilisation (IVF) procedures. However, we don't often hear about unsuccessful IVF, owing to the fact that it's a very emotive subject for those who want to be parents. This blog post aims to dispel the taboo and discuss some of the reasons why IVF may fail.

According to our most recent success rates, our IVF treatment has a clinical pregnancy success rate of 40.6 percent and a live birth rate of 32.5 percent, as reported to the Human Fertilisation and Embryology Authority (HFEA). When it comes to patients who do not have a clinical pregnancy or live delivery, there are a variety of causes for their IVF failure.

Age of the Female

The quality and quantity of a woman's eggs decreases as she gets older. It's common knowledge that as women age, they have a lower likelihood of becoming pregnant; nevertheless, a decrease in egg number and, more importantly, quality, also decreases the chances of a clinical pregnancy or live birth following IVF treatment.

"According to our success percentages, women under the age of 35 have the highest probability of IVF success: 47 percent for clinical pregnancy and 38 percent for live birth," says Dr. Gorgy, co-founder of The Fertility and Gynaecology Academy and one of the UK's most respected fertility experts.

Quality of Embryos

The female's eggs and the male's sperm are combined together in the laboratory portion of IVF treatment with the goal of generating an embryo. Embryos may appear healthy in the laboratory, but when implanted into the uterus, they may fail to implant due to an undetectable abnormality. Our IVF lab grades the quality of the embryos and selects the best to return to the uterus using a scoring system. We also incubate the embryos until they reach the blastocyst stage using time-lapse imaging (embryoscope) (5 day old embryos). The embryoscope is a closed incubator with a camera that photographs the embryos every 10-20 minutes. We can monitor the embryos' progress using the screen on the outside of the embryoscope, so we don't have to take them out every day to examine them, keeping them in a stable environment. We can also replay the video clip and examine the embryos' progress overnight, allowing us to select the optimum embryo transfer option for achieving pregnancy.

Ovarian Reaction

The female is required to inject a fertility hormone called follicle stimulating hormone (FSH) daily at the start of IVF treatment in order to boost egg production. Some women's ovaries do not respond to this medicine properly, and as a result, they do not generate enough eggs for harvest. Due to the already limited quantity of eggs in older women, this is especially true (low ovarian reserve).

"If you have a poor ovarian response, it doesn't imply the IVF treatment is over," Dr. Gorgy says. Investigations and medication changes may be able to help improve the issue. A blood test for Anti-Mullarian Hormone (AMH) and an ultrasound scan of the antra follicle count are used to determine ovarian reserve. The optimal protocol and dose of hormone to stimulate your ovaries and produce a respectable number of eggs would be determined by your ovarian reserve."

Problems with Implantation

This indicates that the embryos did not successfully implant in the uterus. This could be due to the existence of uterine polyps, a premature spike in progesterone levels, a thin endometrial lining, or a uterine infection. "It's not your fault if an embryo fails to implant," Dr. Gorgy says, "since implantation complications are almost always beyond anyone's control." We assemble a complete set of tests to rule out any potential causes of implantation failure."

Lifestyle

Maintaining a healthy lifestyle before and throughout IVF is likely to aid conception, just as it is with a natural pregnancy. If you smoke, it's a good idea to give up a few months before starting IVF, as smoking has been proved to have a negative impact on fertility. Maintaining a healthy weight, as well as eating a nutritious food and exercising on a regular basis, will all benefit you.

Abnormalities of the Chromosome

IVF can fail due to chromosomal abnormalities in the embryos. This indicates that chromosomal DNA is missing, excess, or irregular in the embryo. The embryo is then rejected by the body, resulting in IVF failure. Chromosomal abnormalities can be inherited from one of the parents or acquired during the embryonic development process.

"Chromosomal abnormalities are most likely to be present in the embryos of women over the age of 35," according to Dr. Malpani. Don't let this deter you, though. We may analyse the embryos for any inherited chromosomal or gene abnormalities on all 23 pairs of chromosomes and only replace the normal embryos."

The notion behind reproductive immunology is that an embryo or baby is rejected because the body's immune cells are overactive. If you've tried IVF but been unable to conceive, it's possible that your immune cells are attacking the embryo. Reproductive immunology may be able to explain why your IVF cycles are failing so frequently and, if your immune system is acting up, suggest a treatment plan.

Why Does IVF Fail? : How To Avoid Repeat IVF Failure

It may take two or more IVF treatments to obtain a successful pregnancy. While this can be physically, emotionally, and cognitively draining, knowing that you are not alone in your struggle, that support is available from fertility professionals with decades of experience, and that IVF failure is not your fault may be comforting.

Your doctor will advise you on what caused the failure after each round of IVF and how to use this information to improve your chances of success if you decide to try IVF again. The following are some of the tests that can be used to determine the cause of IVF failure:

• Immunomonitoring
• Infection detection
• Examination of the uterine cavity
• Karyotyping
• Evaluation of sperm

Need help in getting pregnant ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you!

Why do embryos fail to implant in an IVF cycle ?

 

One of the most frustrating areas in IVF today is that of failed implantation – both for doctors as well as patients.

As IVF doctors , we want all our patients to get pregnant in the first cycle itself, because when they get pregnant , they refer many more patients to us. However, when they cycle fails, they get depressed , and are unhappy and upset, and we need to provide them a shoulder to cry on , which isn't much fun .

However, the fact of the matter is that while our technology is great at making good quality blastocysts in the lab,  after we transfer the good quality embryo into a receptive endometrium, we have no control over whether that embryo is going to implant or not .

This inconvenient truth is not comforting , either for doctors or patients . As specialists, we would love to have more control over the treatment which we offer to our patients , because that would allow us to offer them a 100% success guarantee every time we did IVF for them. This would make our life so much easier , because then all we would have to do is to collect the money , and then handover the baby. Sadly, we're still a long way from reaching that holy grail.

Yes, our technology is progressively getting better , but we may never get there, because human reproduction is still very inefficient - and that's true whether we are making babies in the bedroom , or in the IVF lab .

As IVF doctors, if nothing else , we learn humility very quickly, because we realise it's impossible for us to be able to predict which embryo will become a baby , and which won’t.

The truth is that when an IVF cycle is successful, we don't know why it worked, though no one ever demands to know why it was successful ! We have to be cognizant of the fact that implantation is still a black box , and that no matter how hard we try , our technology still cannot reveal all the answers which Nature chooses to conceal from us .

The problem is that patients don't want to hear the truth , because they don’t want to confront the fact that doctors are ignorant. They are paying large amounts of money , and want a certain degree of certainty from the doctor. This is why they prefer doctors who will provide them with a degree of comfort by telling them what they want to hear , even if it’s not the truth.

This is why, when an IVF cycle fails, doctors offer them many additional options as to what they can do differently in the next cycle to increase the chances of implantation . The standard procedure is to tell the patient to do more tests - for example , PGS to check the chromosomes of the embryo , or an ERA test to assess endometrialreceptivity .

It seems quite logical to do these tests , because they sound very scientific, but while doing these tests is very profitable for the clinic , the dirty little secret is they don't actually increase success rates for the patient .

This is not something which doctor is willing to volunteer information about,  and this is not something which patients want to hear . In fact, patients are quite happy with the doctor who does everything possible , irrespective of whether what the doctor is doing has actually been proven to be useful or not, because they feel that the more the technology which is being utilized,  the better their chances of getting pregnant .

This is completely flawed reasoning , and in fact it can backfire , because additional information just increases confidence , because we have more data points , but actually the accuracy goes down , because a lot of this information is misleading , and we end up going down multiple rabbit holes and chasing expensive red herrings.

Good doctors will inform patients as to what the limitations of the technology are , so they realistic expectations of the treatment, and understand what's in our control , and what's not .

Over time, the chances of getting pregnant with more cycles improves because the cumulative conception rate rises with the number of cycles you do , but there is never any certainty as to when it is going to work for any individual patient , and this is something both doctors and patients need to learn to live with.

Need help in getting pregnant ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you !

3 failed IVF cycles, what next? | What to do if IVF didn't work?

 A failed reproductive treatment cycle, whether it's your first or third, is disappointing. When you're trying to get pregnant, any cycle that doesn't result in a pregnancy might be discouraging. However, if you've committed emotional energy, time, and money, your expectations are likely to be higher, which might lead to increased frustration if the treatment fails.

You have various options after a failed fertility therapy cycle. You might want to attempt the same treatment again. You might want to try a different remedy next time. You may also choose to forego future treatment. The path that is best for you will be determined by your unique circumstances and what you have already attempted.

What to Talk About After a Cycle Fails

You may expect your doctor to discuss your issue with you, regardless of the treatment you're receiving. It's critical to discuss the following:

What went wrong was this: It's sometimes just a case of trying again. However, in the event of more complex therapies, such as IVF, understanding where things went wrong can help you improve your chances of success the next time.

If you attempt again, your chances of success are: They're sometimes just as good as the first time. The chances of success on the next try might often be dramatically reduced, especially after a few to many cycles. Some clinics have data analytics technologies that can forecast your chances of success with different therapies.

Any dangers associated with continuing with the same treatment:

What extra testing, if any, might be recommended: It could be tests you've had before, or it could be something completely new, such as genetic screening, karyotyping, testing for reproductive immunology disorders, or a more in-depth uterine evaluation.

What adjustments, if any, should be made: Additional risks, costs, and success rates connected with these adjustments should be explained by your doctor. You might want to get a second opinion in some circumstances.

It's not simple to deal with fertility treatment. Treatments that don't work take a toll on the patient's mental and financial well-being. It's natural to be frustrated and upset. However, few people succeed on their first or even second attempt. Remember that just because one or two cycles have failed does not mean that things will never succeed. It's possible that you simply need additional time or a different treatment strategy.

When IVF Don't Work

If the fallopian tubes are blocked, in some situations of male factor infertility, or if earlier fertility therapies have failed, IVF treatment may be considered. IVF is a time-consuming and costly procedure. For one cycle of IVF, the typical out-of-pocket cost is roughly $19,000.

Fertility medications are used in traditional IVF to overstimulate the ovaries. The eggs are then extracted and combined with sperm. Hopefully, some of the eggs will be fertilised by the sperm, resulting in healthy embryos. One or two embryos are transplanted to the uterus after three to five days.

An IVF cycle may not be able to reach embryo transfer at all times. IVF cancellation is the term for this. When an IVF round progresses to embryo transfer but does not result in pregnancy, this is a significantly different situation. But the end outcome is the same in both cases: no pregnancy. However, just because one IVF cycle failed doesn't indicate the next one won't be successful.

It takes an average of 2.7 cycles for couples who do conceive to become pregnant. Younger women have a higher success rate, but even then, multiple cycles may be required. After three cycles, the cumulative live birth rate was 42.3 percent, according to one research of over 178,000 cycles. 5 The cumulative live birth rate after eight cycles was 82.4 percent.

How many IVF cycles should you be willing to try? According to research, trying up to six times can be beneficial. According to one study, after six cycles, the cumulative live-birth percentage was 65.3 percent. 

IVF Treatment Recurrence

Unfortunately, many IVF cycles fail regardless of the patient's age. After such a cycle, it is critical for the physician to discuss the events of the failed cycle with the patient to determine if any adjustments may be made in the next try."

A range of additional assisted reproductive technologies can be used to change or improve IVF treatment. Trying the same protocol again and again makes sense a lot of the time. However, there are occasions when changes must be done. These are some of them:

Different drugs

PGD/PGS - a type of genetic screening.

Immunotherapy

Including ICSI (which can aid in fertilisation of the eggs)

Hatching with assistance (which may help with implantation)

Need help in getting pregnant ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you!

Is it possible to have natural pregnancy after failed IVF? | Getting pregnant naturally after failed IVF cycle

In vitro fertilisation (IVF) is a difficult and time-consuming procedure. And having no positive outcome at the end can be pretty demoralising for a woman. Many people worry if it's worth the bother to go through the operation again because of the emotional distress and the costs. In this case, it appears that trying to conceive naturally is the superior alternative. But, after a failed IVF cycle, is it still a possibility, or should you look into other options? Let's see what we can find out!

Is it Possible to Have a Natural Pregnancy After an IVF Failure?

Many women mistakenly believe that opting for IVF to create a child means they aren't fertile enough to conceive naturally. Infertility is caused by a variety of circumstances, thus this isn't always the case. The relationship between fertility and the ability to have a child is complex, involving everything from sperm quality to egg availability, viability, and a variety of health factors. Even if your odds of getting pregnant spontaneously are lower than those of other people, they are far from zero, and natural pregnancy is possible even if your IVF attempts have failed.

What Are the Chances of Getting Pregnant After Failing One IVF Cycle?

Failure at the end of your first IVF process, as frustrating and disheartening as it may be, is not the end of the road for you. A single failure does not imply that every subsequent cycle will also fail. The body may require some time to adjust to the surgery and may respond favourably the second time. At the second attempt, several women have seen healthier embryos and a better bodily response, resulting in a successful pregnancy.

These odds are bolstered by solid statistics and statistical information gathered throughout time. A woman's chances of becoming pregnant after her first IVF round are about 21%. However, what appears to begin at a lower level improves over time in subsequent cycles. The chances of getting pregnant grow by 10% after the second attempt, with the fifth cycle obtaining a nearly 40% success rate. However, any attempts after the fifth scarcely improve the situation, and it is preferable to consider other options for having a kid at that time.

After a failed IVF round, Is Natural Pregnancy Possible?

This is easy to comprehend when you consider the many ways women have gotten pregnant over the years. Several women have pregnant naturally on their first try, while others have conceived in the first cycle of IVF, and a few have conceived in subsequent cycles as well.

The woman's body is extremely important throughout the treatment. Infertility might have a variety of causes that aren't always obvious. Following an IVF process, the body begins to respond positively, and the woman becomes more aware of those symptoms, perhaps increasing the chances of conception.

The chances of IVF success in the first attempt are lower in women who have uterine difficulties, mostly due to the presence of a weak or thin outer lining of the uterus itself. The surgery, on the other hand, may encourage the body to create a stronger uterine lining in the months ahead. Attempting to conceive naturally may yield positive results, and a second IVF treatment may not be necessary.

There is no conclusive element that can be identified with certainty as the one responsible for reversing the odds of becoming pregnant. The continual attempt to become pregnant naturally is, nevertheless, the most common factor in all of the situations. Couples who only attempt once in a while are less likely to see beneficial results. In comparison, those who have intercourse frequently and regularly, with a desire to become pregnant, have a better chance of getting pregnant, even after a failed IVF effort.

How to Increase Your Chances of Getting Pregnant After an IVF Failure

Your habits, behavioural patterns, and lifestyle choices all play a factor in whether or not your pregnancy is successful. IVF makes use of the body's inherent processes and encourages them to function at their best. If a woman smokes while trying to conceive, her odds of becoming pregnant are practically halved in one fell swoop. Caffeinated beverages are also known to reduce the odds of pregnancy when consumed on a regular basis. Alcohol and fat have a negative impact on the capacity to carry a pregnancy to term.

It's vital to remember that IVF is a medical treatment, not a magic wand that can magically produce a pregnancy. Changing specific lifestyle choices, exercising regularly, and eating a balanced diet are just as important throughout an IVF process as they are while trying to conceive naturally. As a result, it is safe to conclude that there is some good news for women who are wondering if they can conceive spontaneously after failing IVF procedures. Maintain a calm demeanour, concentrate on your health, and give it your all as often as possible.

Need help in getting pregnant ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you!

Home Semen Analysis Kit

 

Home Semen Analysis Kit

If you are concerned about your fertility, the first test you need to do is to get your husband to agree to get his semen tested.

Now, this can be embarrassing – after all, it’s no fun being forced to produce a semen sample on demand in the dirty bathroom of a clinical lab ! Also, he is secretly petrified that he may be shooting blanks, which is why he is very reluctant to get the test done. His worry is that a poor result will cast aspersions on his masculinity, and this is why the ability to do your own semen analysis at home can be such a blessing. Yes, a semen analysis report from a reliable pathology lab is still the gold standard, but there’s a lot of valuable information a Home Semen Analysis can give you.

 

And while it’s true that any pathology lab can readily check a man's sperm sample, the problem is these reports are highly unreliable. The lab tech is often untrained, and they fill in the results without checking or verifying them. Unreliable lab results can fool you – and this can be an expensive error.

The best solution to do your semen analysis for yourself,  which allows you to observe and count your sperm on your own. The good news is you don’t need to be a scientist or a biology buff to be able to do this. We have made this very easy for you !

What is included in the Home Semen Analysis Kit?

-  Mini-microscope -To check your sperms

- Clamp, to attach your smart phone to the eye-piece of the microscope

- Semen container - used to collect semen samples

- Glass Examination Slides - To examine your sperm under a microscope. You used these in your high school biology classes, remember ?

- Prestained Slide ( CryoLab) - To verify your Sperm count. The Prestained Slide contains chemical on the surface which will make the sperms immotile and make it easier to count the sperms (Total Sperm count)

 

- Dummy Examination Slide - This dummy slide will aid in focusing the microscope

 

- Cover Slips -  These are thin baby slides, and are used to keep the semen sample from drying out. You will need to cover the semen drop with a cover slip when analyzing this

- Pasteur pipettes  to handle your semen sample.

 

Analyze your semen sample step by step -

1) Collect your semen sample in the container provided. This is single use, sterile and disposable.

 

2) Clean the Examination glass Slide with the Alcohol Swab to remove the dust on the slide. You can alternatively use Hand Sanitizer. Put  2-3 drops of sanitizer on the glass slide and clean it with tissue paper

 

 

3) Now Open the sterile Pasteur pipette by unpeeling the package, and use it to mix the sperm sample well.

Use the pipette to suck up the sample and deposit a single drop on the glass slide. The size of the drop is not critical because the sample will spread on its own

Also, add a drop of the semen on the CryoLab slide and keep this on the side for now.

 

4) Place a cover slip over the drop (both on Examination slide and CryoLab Slide) to prevent the sample from evaporating.

 

5) Turn the Focus Ring all the way to the right.

6) Attach the microscope clamp to the camera lens of your mobile phone.

 

7) Finally, secure the clamp in the eyepiece slot of the microscope.

8) Place the Dummy Slide in the slot beneath the microscope.

Move the Zoom to the extreme Left (100x Magnification).

Now slowly shift your focus Ring to the left until you see the threads of the cloth on dummy slide clearly (as shown in the below image)

Move the zoom to Extreme right (250x)

 

9) Now without disturbing the Focus Ring, Place the Examination glass slide with your Sperm sample in the slot beneath the microscope

 

10) You will see your Sperms clearly . If you are not able to see the sperms slowly shift the focus to the left or right until the sperms are clearly seen.

The Zoom will always need to be set to maximum (250x) to identify sperm

 

You are now ready to start admiring your sperm !

So, what do sperm look like ?

There are 2 kinds of sperm – motile ( those which move)  and immotile ( those which don’t).

It’s easy to identify moving sperm because they are moving, but it can be hard to count them because some of them move so rapidly.

It’s easier to count immotile sperm, but it can be easy to confuse them with other cells in the semen       (such as pus cells) or dust on the slide, and this can mislead you.

12) Increase the zoom on your phone camera to 2.5 times.

With zoom, you don't have to be precise. Anything close to 2.5x will suffice.

This will make it easier for you to count the sperms.

In the light field, count the number of moving (Motile) sperms.

This can be hard to do because your eye gets attracted by the motion, but don’t worry too much about accuracy for now.

You can take 2-3 measurements, and then calculate the average if you want to be more precise. Do this as a joint exercise!

Make a note of this  on a piece of paper

 

B = Motile Sperms

If you see 15 moving (motile) sperms in the light field (2.5x zoom on camera), that suggests there are 15 million motile sperms in 1 mL of your sperm sample.

This is approximate count !

A rough estimate.

We tried this using the Makler's Sperm Counting Chamber as a reference and discovered that the number of sperms at 2.5x magnification is quite similar to the actual count.

13) Take a picture with your Phone's camera (or Screenshot)

14) Make a note of the number of sperms in the screenshot image.

A = Total Sperms

Total Sperms (A) = 30 sperms in this example (That means there are Total 30 million sperms in 1 ml of Semen Sample)

The number of sperm in your sperm sample = A (millions)

(B/A * 100) percent Motility

Motility = 15/30*100 = 50% in this example.

 

How do you verify your results ? This is where the pre-stained slide comes in

Place a drop of your Semen using a Pasteur Pipette on the Stained Part of the pre-stained slide (Dark Red part on the slide)

Leave this for 30 min. The Chemical on the Slide will make the Sperms immotile.

Now keep the slide under the microscope and take a screenshot.

This will allow you to count the No. of Sperms, all of which will be immotile, so counting them will be easier. You can cross-check this number with the total sperm count which you made a note of in Point No. (14)

How do you interpret the sperm count and motility?

The Sperm Count measures the number of sperm in 1ml of your Semen Sample

Don’t panic if you can’t see anything ! You may be nervous and not be able to focus the lens properly. Try doing the test again in 2 days.

If you still can't see any sperms, it means you're sperm count is NIL. The Medical Terminology for this condition is Azoospermia.

You should see a urologist, who will examine you and determine the cause of your lack of sperm. Sperm absence is most commonly caused by an obstruction in the reproductive tract.

2) Sperm Count: 0 to 15 Million Sperm = Sperm Count is Low

3) A good sperm count is more than 15 million sperms.

 

     

Frequently Asked Questions:

1) Who can benefit from a home sperm analysis?

Ans        a) For men who wish to start a family but are concerned about their sperm count

                b)For those who do not want to go to a pathology lab to have their semen sample checked for a              variety of reasons, such as being embarrassed to generate a semen sample in a pathology lab or having mistrust in pathology labs.

                c) For those who have had a Vasectomy and wish to be certain that their Sperm Count has          dropped to zero.

                d) For people who are using sperm count-increasing drugs and wish to keep track of how much                their sperm count is increasing.

 

2) Is it simple to use the Home Semen Analysis Kit?

Ans        The Home Semen Analysis kit is simple to use provided you follow the instructions.

 

3) What is the appearance of sperm? How do we tell the difference between sperm and other things?

Ans        A sperm has two parts: a head and a tail. The tail is what distinguishes sperm from   other cells   found in the sperm

 

4) What should we do if there are too many motile sperms to count?

Ans        You have nothing to be concerned about. It means that your sperm sample is exceptional in       terms of quality.

               

Troubleshooting and Problems

1) If you're having trouble concentrating and seeing the sperms, turn the focus Ring all the way to the right and slowly move it to the left until you see sperms.

2) You haven't clamped the phone camera on the eyepiece if you can't see anything in the phone.

Fixing the mobile camera lens in the clamp and then the clamp in the eyepiece slot is the proper procedure.

 

Home semen analysis has some drawbacks.

 

1)      While we can get a rough idea of sperm count and motility using a home semen analysis kit, this is not as reliable as a semen analysis done in a well-equipped pathology lab by an experienced technician. This is still the gold standard.

2)      Also, we can't check the morphology (sperm shape ) with a home semen analysis kit. To examine the morphology of sperms, a considerably higher magnification is required, which our mini-microscope lacks.

 

Please email us at [email protected] have any questions or require assistance with the home semen analysis kit.

Repeated IVF failure versus recurrent implantation failure

 

These terms sound very similar , but actually they are very different . Let me explain why

One of the reasons for repeated IVF failure is a bad IVF clinic that creates poor quality embryos , because they don’t superovulate their patients well, or because their lab can’t grow blastocysts properly in the incubator . In fact, this is the most common reason why most IVF cycles fail in India , because most IVF clinics don't have the required expertise or experience to be able to create top quality blastocysts. They hide this fact by refusing to share embryo photos with all their patients routinely and proactively .

Treating these patients who have experienced repeated IVF failure in other clinics is actually fairly straightforward , because we just need to superovulate them properly and transfer a single top quality blastocyst to maximize their chances of getting pregnant .

Treating recurrent implantation failure , on the other hand , is much more frustrating . These are patients for whom the doctor has transferred a top quality blastocyst inside a receptive uterine lining, but  3 cycles have failed inspite of doing so.

This is frustrating for both patients and doctors !

The patient wants to know how many more cycles they should be doing, and when they should stop and consider alternative options . When does repeating the next treatment cycle become futile ?

There really is no easy way to answer this question. Statistically , the pregnancy rates increase with the number of cycles patients do , and the cumulative conception rate after three cycles when you transfer top quality blastocysts is about 80% .

Now that doesn't mean that the chances of getting pregnant in the fourth IVF cycle become zero , which is why the patient finds themselves at a crossroads , and needs to make some hard decisions ! Should I change the doctor ? Or should I change the treatment ? This may involve exploring  alternatives such as using donor eggs, donor sperm , donor embryos, or surrogacy.

However, there is often no logical medical basis for doing this, especially when the cycles have been documented to be medically perfect.

The decision is often based on emotions, and we may need to explore alternatives on an empirical basis, to find the one that finally works.

That's why it's important that patients make these decisions for themselves, and a good doctor will emphasize how little we understand in this area . They are honest with the patient , and will let them know that the answers are not clear , because the future is uncertain and unpredictable , and our technology is not accurate enough to be able to identify why top quality blastocysts fail to implant.

 The good news is that options exist , and in fact, we encourage patients to also start exploring non-medical options such as child-free living and adoption.

This way, patients have peace of mind that they have made the right decisions for themselves , because while the outcome is always uncertain, the process itself should be a happy and positive one .

 The only way of ensuring this is by making sure that you explore all the options for yourself , and make your own decisions for yourself . These are life changing decisions and you need to own them , rather than outsource them to someone else , no matter how much expertise he may have.

Remember that doctors are not mind readers , and while they may offer you options, these may not always be in your best interests !

Yes, these are difficult decisions , and you should remember that you will learn from these difficult times , and grow as a person . Yes, this is a deep philosophical truth, and while what patients are really looking for is clear , simple, and easy answers , and a doctor who can be trusted to provide them, it’s equally true that often there are no clear answers in life , and you need to find your own path for yourself.

Need help in getting pregnant ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you !

Why does IVF fail with good embryos? | Why Normal Embryos do not Implant in the Uterus - Top reasons

Reasons why IVF fails even with good embryos

In vitro fertilization (IVF) is a type of assisted reproductive technology that couples who are unable to conceive use. Fertilization takes place outside the female body in a lab in this advanced reproductive method. Hormonal injections are used to boost egg production at first, and then doctors harvest the mature eggs. They are quickly combined with the sperm, and fertilization takes place. Finally, the developed embryo is placed in the uterus of the woman for implantation.

However, an embryo may fail to implant on the uterine wall, resulting in a missed pregnancy. In this situation, there could be several reasons for an IVF cycle's failure.

IVF failures have a variety of causes.

The embryo must be of good quality for successful implantation. Even high-quality embryos, however, might sometimes fail to implant. Pregnancy and embryo development are biological processes that are similar to other biological processes. In 90% of cases, it is to blame for the failure of implantation. The following are some of them:

Embryo implantation rate– The rate of embryo implantation is roughly 50% in women under the age of 35 and 12% in women over the age of 40. If a woman's embryo is of poor quality, it will not be implanted. It results in a failed IVF cycle because the ovaries have ceased developing due to polyps or cysts.

The uterus's health– The success of an IVF process is determined by the uterus's health, the woman's age, and the body's response. Doctors administer drugs to stimulate the ovaries so that an egg can be produced during an IVF treatment. Elevated FSH levels, a low number of eggs, and a poor body reaction to IVF medicines are all bad symptoms. If your IVF medicine can create more eggs, in vitro fertilisation can be successful. It's a sign that your hormones are working properly. If this does not occur, the chances of a successful IVF procedure are reduced.

Age and mental health of the woman - A woman's age has an impact on IVF success. Another cause for the in vitro fertilisation technique's failure is this. When an older woman has had numerous failed IVF cycles, she will try again, but her chances of success will decrease with each failure. IVF failure might also be caused by mental and emotional stress. People's mental health can be harmed if they remain traumatised or stressed as a result of a previous failed IVF cycle or for any other reason.

The most common cause of IVF failure is embryos with aberrant chromosomal counts (embryonic aneuploidy), which has led to the development of our present embryo testing approach. However, there are a number of other factors that influence egg development and embryo function and can result in the inability of a chromosomally normal embryo to implant. While some of these issues are now outside our control, we are always working to address them by a thorough understanding and application of the literature, extensive patient evaluation, and continuous monitoring of our laboratories and technical abilities.

Need help in getting pregnant ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you !

What happens to your body after failed IVF? | Reasons for IVF failure and what to do next

What happens to your body after failed IVF and what to do next?

A failed IVF procedure can be heartbreaking for both you and your partner.  IVF is difficult on the body and on the mind, and nothing can truly prepare you for it. One of the most unexpected aspects is feeling disconnected from your body.

IVF necessitates the administration of hormones, which effectively asks your body to mature a large number of eggs prior to ovulation in the hopes of obtaining a viable and healthy one (or more) that will fertilise.  The injections sometimes have the effect of separating you from your body.

Top 7 changes to your body after IVF:

 1. Physical changes — It's not uncommon for women to gain weight throughout IVF procedures. Hormone injections can influence your weight as well as your appetite. Additionally, your tummy will feel bloated and your jeans will feel tight depending on how many eggs develop or if you suffer any minor ovarian hyperstimulation. This is natural and will go away once your period starts or after a few weeks of pregnancy.

2. Feeling emotional - As if extra hormones in your body weren't enough to make you upset, the first IVF treatment can be overwhelming for some individuals. Expect to be moved by your experiences. It is permissible.

3. Being distracted — Some women have told us that they had "pregnancy brain" while undergoing IVF. It's understandable, given that many patients are juggling professions and other responsibilities in addition to therapies and thinking about treatment outcomes. It's pretty typical to be distracted or forgetful.

4. Increased appetite– While this does not occur in all individuals, some may report an increase in hunger. While some drugs may enhance your appetite, an increased urge to eat is more typically due to emotional factors. Just keep in mind to eat well.

5. Shots — Unless you're performing natural cycle in vitro fertilisation (NC-IVF), you'll almost certainly have to inject follicle-stimulating and ovulation-regulating hormones via small needles every day. Each patient receives a different dosage of medication and receives shots at a varied frequency. You may also have your blood drawn during visits to receive a detailed examination of your hormone levels. The majority of patients are astonished by how painless the daily doses are.

7. Gastrointestinal changes - Constipation, diarrhoea, and loose stools are all frequent problems among IVF patients. To combat digestive difficulties, make sure to drink enough of water and eat meals high in fibre.

You may be disoriented, dissatisfied, and unhappy. But you aren't ready to give up your ambition of starting a family just yet. What are your plans for the future with your partner?

When it comes to infertility treatments, each couple or person takes a different road. Of course, the mainstream media, magazine covers, and entertainment shows portray IVF as a walk in the park. Actresses and entertainers over the age of 40 appear to experience success after success. But keep in mind that those magazines and TV tabloid shows are in it for the money, so you'll see very little, if any, of the genuine tale behind their infertility.

There are a variety of reasons why IVF fails. When it comes to characterizing a therapy that doesn't result in a viable pregnancy, the term "IVF Failure" is a little hazy. There are various options for dealing with a failed IVF cycle, ranging from another IVF round to third-party fertility help to adoption.

REASONS WHY IVF DOESN'T WORK

Despite its effectiveness, fertility treatment, particularly IVF, is a delicate and exact science. Both the eggs and the sperm must be viable and fertile. The embryo must be healthy as a result of the fertilisation. In the uterus, that embryo must implant properly. The embryo must continue to develop once it has been placed. There are numerous factors that contribute to IVF success, as well as numerous reasons for IVF failure. Here are a few of the most prevalent reasons for your IVF failure.

Your eggs were not viable for the following reasons: Fertility medications are used to cause the ovaries to become overstimulated. This causes a large number of oocytes, or eggs, to be released. When the eggs are collected, they are combined with the sperm to make fertilisation easier. In rare situations, most usually due to age, a woman's eggs are insufficient to fertilise effectively. Your eggs begin to drop in quantity and quality when you reach your mid- to late-thirties.

Fertilization did not succeed out: Fertilization may or may not occur in some instances. This could be due to the eggs' or sperm's quality.

The embryo was not implanted: An embryo's failure to implant might be caused by one of two factors. The first is that the embryo's environment in the uterus is insufficient to support it. Endometrium, scar tissue, or an undiscovered, pre-existing disease could all be at blame. The second reason embryos fail to implant is often due to a chromosomal defect in the embryo. Your embryos must undergo PGT (preimplantation genetic testing) to determine their genetic health, which is critical to the success of IVF. This examination greatly increases the likelihood of a successful implantation. Women over 35 are more likely to have chromosomal defective eggs, and the risk increases as they get older.

IVF cycles may be cancelled if there are insufficient follicles: The number of viable follicles may not be enough to produce an acceptable number of eggs if the patient (and hence her ovaries) is over 35. This may usually be avoided by using a "age appropriate" dose/type of ovarian stimulation medication.

Factors affecting one's lifestyle: There's no denying that you want to be the best possible IVF candidate. This could imply having a healthy lifestyle and adhering to a decent fertility diet. Smoking will have a direct impact on the success of your IVF procedure. Women who smoke require twice as many IVF attempts to conceive, and they have a far higher risk of miscarriage. You're more likely to have a failed IVF cycle whether you're underweight or overweight.

What TO DO NEXT?

After a failed IVF, it's vital to grieve. Even if the IVF didn't result in an embryo, the emotional impact is as devastating as the loss of a pregnancy. You'll feel gloomy and depressed for a long time. It's quite normal, but you should consult your doctor about it. Before proceeding with your treatment, you and your partner should get help.

Consider the following possibilities while deciding on your next steps:

Another IVF attempt: Consult with Dr. Malpani to see if any alterations to the IVF cycle are necessary. It's not unusual for successful IVF to take multiple attempts. PGT may be recommended depending on the reason for the previous failed IVF.

Third-party donor: Donor eggs may be the solution for women who have insufficient or non-viable eggs. Donors are thoroughly screened and under the age of 30, ensuring that their eggs are in good health.

Surrogacy: Some women are unable to bring a fertilised embryo to term for various reasons. Even after successful IVF, this can result in the embryo failing to implant or in recurring miscarriages. The embryo and the surrogate are not genetically linked. You and your lover are the only ones left. She is nothing more than a gestational carrier. Many couples resort to someone they know and have a relationship with. Others choose among surrogates who have been contacted through advertisements. Once your surrogate has been chosen, she will be subjected to a psychological and medical evaluation.

YES, YOU DO HAVE CHOICES.

It's comforting to know that you have options if you aren't ready to give up on having a family through reproductive treatments. Speak with Dr. Malpani about your concerns following a failed IVF cycle. Under the care and compassionate supervision of our medical and support personnel, seek alternative treatment or testing and evaluation.

Need help in getting pregnant? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you !