1. What is IVF?
In-Vitro Fertilization (IVF) is a procedure where Eggs are removed from a woman’s ovaries and inseminated outside the body. Any embryo(s) that result are then placed in the woman’s uterus where they may implant and grow. For more information on our IVF Program, please visit http://lotuskiran.com/the-ivf-procedure/
2. What is ICSI?
It is an acronym to describe Intracytoplasmic Sperm Injection, the injection of a single sperm directly into the cytoplasm of an oocyte. For more information, please visit http://lotuskiran.com/intra-cytoplasmic-sperm-injection-icsi
3. How to Diagnose Infertility related issues and age Women should try for Natural Pregnancy?
If you have regular periods and are 30 years of age or less, the general recommendation is to attempt pregnancy naturally for one year before exploring fertility treatment options.
Menstrual irregularity, on the other hand, is a clear sign of irregular ovulation and would be one reason not to wait, as most ovulation problems can be corrected with medication.
For women who are over the age of 35, it would be reasonable to do some preliminary fertility testing right away. This would ensure there are no problems that need to be treated immediately, given the limited number of years left for childbearing.
4. Options for Women of Age over 40 years
The physician will do a complete assessment including hormonal blood work to determine if your ovaries are still fertile, and whether they would respond to fertility drugs likely leading to pregnancy.
Fertility decreases as you age. There is also a significantly higher rate of miscarriage and genetic abnormalities (such as Down’s syndrome) occurring in pregnancies with advancing maternal age. Pre-natal testing is available at an early stage of the pregnancy to detect the more common abnormalities.
5. Options for Male’s with Low Sperm Count
A careful assessment of your partner will be done including blood work and semen analysis to further evaluate the specific abnormality in the sperm (i.e. low sperm count and/or low motility).
We also work closely with the urologists who may perform further specialized testing in order to present you and your partner with the full range of treatment options available.
6. Information needed prior to setting up an appointment
If you have undertaken treatment previously, any documents relating to your infertility, i.e. operative reports, semen analysis, blood work, hysterosalpingogram reports, previous IVF cycles. Please include your address and phone numbers (home and work) so we may contact you for a consultative appointment.
7. Is IVF related procedures painful? Can I view them?
Our desire is to make your IVF procedure as comfortable as possible. We use adequate pain relief should you require or request it. You will be awake for the procedure but will be in a “partial sedated state.”
8. What happens with extra embryos after I achieve Pregnancy?
We value all our Intended Parents as the most important part of KIC and priorities and concerns of all I.P’s will always be considered when such decisions are made.
Physician will give you a report on the quality and number of Embryos, and will discuss with you a safe number of Embryos to transfer. Any extra Embryos can be frozen for use at a later time. These Frozen Embryos can be thawed at a future date either for another child or to try again without the need for doing the entire process of IVF, or are destroyed or used for research purpose after obtaining a written consent from I.P..
9. Is it safe to take herbal products along with my fertility medications?
Many herbal medications have powerful biological effects and some may actually inhibit fertility. We suggest you refrain from using any herbal medications during your fertility treatments at the unit.
10. How long does an IVF cycle take? How many days of work will I need to take off?
Generally an IVF cycle takes about 2-3 weeks. You are only required to come to the clinic on some of these days and appointments will be provided to minimize the time you will spend for cycle monitoring (blood test and ultrasound).
However, we recommend for you to be assessed at our centre near the end of your cycle.
It would be necessary to be off from work on the day of the retrieval.
11. Can fibroids interfere with IVF?
Fibroids are benign tumors consisting of fibrous tissue and muscle which grow in the uterus. The significance of fibroids relates to not only their size but also their location. Even small fibroids located inside the cavity of the uterus where embryos need to implant, may interface with success and need to be removed. Fibroids that do not encroach on the cavity of the uterus are generally not significant unless they are larger than 5 cm in diameter and also if there are many fibroids causing significant uterine enlargement.
12. I have Endometriosis, does this affect my fertility & also success with IVF?
Endometriosis is a condition where cells that usually remain confined to the cavity of the uterus, grow outside of the uterus usually on or in the ovaries and also on the surface of the pelvic plain and may also decrease the chances of natural conception by about one-third. Patients who require IVF who have endometriosis still have the same chances of a successful outcome as patients of the same age without endometriosis as long as immunological factors that may accompany endometriosis are identified and treated appropriately.
13. Does KIC provide Surrogacy Services?
Yes, we provide services for patients requiring a Gestational Carrier for Medical or other related reasons. Please call or write to us to obtain further information.
14. How do I get copies of my medical records?
Patients must complete an Authorization for Release of Information form, and submit to our Centre. You will need to be specific about the records you wish. Please note is take 10 business days to complete these requests within 1 Year of completion of your treatment and 20 business days after one year and within 4 Years of completion of your Treatment.
Risks associated with IVF Treatment
Like all medical treatments, IVF carries some risks and your clinic should discuss these with you before you go ahead with treatment. Risks can include reactions to fertility drugs that may be prescribed, and also the risks associated with any pregnancy.
You may experience a mild reaction to fertility drugs such as ovulation-inducing drugs, pituitary stimulators and ovary-stimulating hormones. Discuss these in advance with your doctor, so that you know what a ‘normal’ reaction is. Symptoms can include any of the following: hot flushes, nausea, feeling down or irritable, headaches or restlessness, weight gain and heavy periods.
Ovarian-hyperstimulation syndrome (OHSS)
This is a potentially dangerous over-reaction to fertility drugs used to stimulate egg production before your eggs are collected for IVF treatment. Cysts develop in the ovaries and fluid collects in the stomach. In rare cases, the ovaries become very swollen and fluid can fill the stomach and chest cavities. A fall in the concentration of red blood cells can lead to blood clots. An HFEA report in 2005 found that severe OHSS occurs in approximately 1% of cycles.
Blood flow to the kidneys may also be reduced. Symptoms include a swollen stomach and stomach pains. In severe cases, this is accompanied by vomiting, shortness of breath, faintness and reduced urine. OHSS is potentially very serious, so if you start to experience any of these symptoms, contact your clinic immediately.
This is when an embryo develops in your fallopian tube rather than in the womb, and can happen in a natural pregnancy or when you have become pregnant through fertility treatment. The chances of having an ectopic pregnancy seem to be slightly higher in women having fertility treatment, especially if you have existing problems that affect your fallopian tubes. Symptoms include vaginal bleeding and low pregnancy hormone levels. If the pregnancy continues, there is a risk of miscarriage and the fallopian tube bursting.
Report any vaginal bleeding or stomach pain to your clinic. They can do a blood test to check your hormone levels. You should have a scan at six weeks to check for the baby’s heartbeat and to make sure it is growing properly in the womb.
1. What type of Surrogacy Services we offer?
There are two types of surrogacy, Traditional Surrogacy and Gestational Surrogacy.
In Traditional surrogacy surrogate is herself the Egg Donor, so that she is the genetic mother of the baby. In this case she can be directly impregnated with the sperm of the male partner by a process called Intrauterine Insemination or will undergo the process of IVF and egg retrieval which will then be fertilized in the laboratory with the male partner’s sperm. The embryos formed will then be transferred into her womb.
Gestational surrogacy is when the surrogate is only the “womb” donor and is genetically unrelated to the baby she carries. The egg comes from either the female partner of the infertile couple or from an anonymous egg donor. The process will have to essentially be an IVF technique.
As per the ICMR regulations, we can only offer Gestational Surrogacy in India.
2. Does your clinic assist with finding surrogates/screening and contracts?
Yes our clinic is perhaps the only clinic in India that helps IP’s from start to finish. We have an in house legal department and a case manager assigned to you.
3. What exactly does the surrogacy procedure involve? Please give overview of steps involved with time lines.
A surrogate will first be recruited. Recruitment is done by Assisted Reproductive Technology bank. We then screen them for infectious diseases, general wellbeing, and fitness for the procedure. She also undergoes a hysteroscopy a procedure by which her uterus is visualized. The above process can take about 15 days to 1 month. Her cycle is coordinated with that of the egg donor and she is then put on medications to develop her endometrial lining to be able to accept the embryos while the egg donor undergoes her ovarian stimulation cycle. After the egg pick up of the donor, she is put on hormones to support pregnancy. The embryo transfer is then generally performed on the third day. She continues to be on hormonal support thereafter. She is tested for pregnancy after 12 days.
4. What is the Medical Protocol for Ovarian stimulation in an IVF Cycle?
Female needs to take Fertility injections for 10-11 days and the egg pickup happens on day 13 of the ncycle.
You should be in Hyderabad from day 5 of your periods and the Medication to be taken from day 1 of periods till day 5 will be provided to you at your place of residence. Alternatively you can do the full ivf cycle here
5. On what day after Oocytes Retrieval is the embryo transfer done?
The embryo transfer is generally done on day 3. In few cases on day 5 Blastocyst may be transferred.
6. What is the maximum number of Embryos to be transferred? Multiple Pregnancies?
We transfer 3- 5 embryos in an attempt.
Any pregnancies which are more than that of Twins are subjected to embryo reduction. The highest order of pregnancy carried by the surrogate is twins
7. Surrogate follow up during her pregnancy?
They are monitored once every fortnight. A clinical update of the same is sent to the Intended Parents over the email according to a predesigned protocol informed earlier to Intended Parents.
They are subjected to ultrasounds. 11th weeks scan is an anomaly scan along with a double marker test to rule out risk of Down’s syndrome.
Triple marker test is done at 18 – 20 weeks of pregnancy
Second trimester anomaly is done at 18- 20 weeks. Amniocentesis is not routinely performed.
The Intended Parents are informed about expected date of delivery, so that they can be present for the delivery. There is a nanny service available for those who wish for such services.
8. Do you perform amniocentesis routinely?
We do not perform amniocentesis routinely on our surrogates. If there is a reason to do so, like an abnormal triple marker test, abnormal ultrasound, then we do the amniocentesis.
9. Can Intended Parent wish to terminate pregnancy if there is any malformation in the baby?
The pregnancy will be terminated in the event there is an anomaly found in the baby which is incompatible with life or is dangerous for the health of the mother or the baby. Intended Parents will be consulted before any such decisions are taken. All terminations are done prior to 20 weeks of gestation as per Indian Law.
10. Do you have cryopreservation facilities?
We cryopreserve Eggs, embryos and sperm samples at our facility. These samples will be with us to be used at later dates.
11. What is the current wait time to actually start the procedure once we sign up?
Our program is very active, so we are ready whenever you are.
12. Do you assist clients with getting passports for the new born baby/exit visa?
Yes, we have a legal department and case managers specifically assigned to these things. We can explain in more detail per your request.
13. In your informational packet there are 4 retrieval cycles mentioned. Can you explain what exactly that means?
1 IV cycle means: 1 egg retrieval and fresh embryo transfer and frozen transfers if applicable. 4 IVF’s mean 4 egg retrievals and multiple embryo transfers.
14. For all 4 cycles in the package will the clinic use the same surrogate for all 4 or are we able to change the surrogate if we wish?
No, the surrogates are different; hence our time requirement for the second attempt is 15 to 20 days. If we had to use the same surrogate over and over again then the time gap between 2 transfers would be 2 months.
15. What forms of payment do you accept?
Currently we accept wire transfers & credit card payments at the Facility and paypal
16. Do you have Caucasian Donors?
Yes we have Donors from various Races and Ethnicities.
17. If we work with an outside egg donor, but do the surrogacy through you will you help facilitate that process?
Yes we will.
18. In terms of the legal representation for the surrogate, IP’s and the donor do we have to provide all of the legal representation ourselves or do you assist in that process?
No we have our own in-house legal counsel, who assists with your legal needs throughout the duration of our surrogacy program.