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IVF AND INFERTILITY, GDIFR, INDIA

Posted Apr 12 2013 5:49pm
1.Is age a determinant factor in male/female infertility? What is the cut off age for successful treatment
2.How long does it take to investigate the cause of infertility?
3.Is the investigation very expensive? Is it possible to complete investigation within a week as in the case of outstation patients?
4.Is it possible to undergo treatment via means of email for patients who reside outside Kolkata?
5.We hear about IUI (Intra-uterine Insemination). Is it very expensive? How long does one have to stay in Kolkata for this treatment? What is IVF?
6.What is the success rate in IUI treatment in your centre? What expectations can an infertile couple have from this treatment? Do you recommend IUI in natural cycle or stimulated cycle?
7.What is the cost of drugs (injections) in IUI? Should rest be taken after IUI treatment? 
8.How many IUI cycles should be done to expect success?
9.Is there any risk in IUI? Is it painful?
10.We have been told that we are suffering from unexplained infertility. Do you think that IUI could be a correct treatment in our case?
11.What is the role of ultrasound in monitoring ovulation in case of IUI and IVF? What kind of ultrasonography is done in your center? What is the average cost per cycle?
12.Do you treat patients where recurrent pregnancy wastage is complained? Do they have to stay for a long time in hospital?
13.From one of your TV interviews we came to know that obesity results in ovulation problems. Do you think that obesity adversely effects fertility? Is obesity a cause of PCOS (polycystic ovarian syndrome) which you spoke of in your interview? Is it curable by medicine? Is PCOS a cause of infertility?
14.What is the common treatment for PCOS? Is PCOS a cause for abortion?
15.What is the general advise for lifestyle modification for patients suffering from PCOS? 
16.We hear about risk involved in drug induced ovulation, why is it so? What is the main problem? Is it possible to prevent such risk?

Q1: Is age a determinant factor in male/female infertility ? What is the cut off age for successful treatment ? 
Ans: Age is an important determinant factor especially for female infertility. Though there is no cut-off age for successful treatment, we appreciate patients reporting to us as soon as possible. It is known that there is sharp decline of female fertility after 39-40 years of age.

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Q2: How long does it take to investigate the cause of infertility? 
Ans: The investigations are completed normally within a month from patient's first reporting to us.

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Q3: Is the investigation very expensive? Is it possible to complete investigation within a week as in the case of outstation patients? 
Ans: Basic investigation in determining infertility is not very expensive. However advanced investigations like laparoscopic examination is moderately expensive.
It is possible to complete basic investigation in a week in case of outstation patients provided the couple visits us on dates decided by the centre.

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Q4: Is it possible to undergo treatment via means of email for patients who reside outside Kolkata? 
Ans: After our consultants have examined the patients and basic investigation has been completed we can remain in touch with patients over email for a period of time before next round of procedures.

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Q5: We hear about IUI (Intra-uterine Insemination). Is it very expensive? How long does one have to stay in Kolkata for this treatment? What is IVF? 
Ans: IUI is a very successful program in our centre. It has a reasonable charge with total cost varying between Rs.3000 to 4000 per attempt. It was first reported in 1985 by our Director Dr. Sudarsan Ghosh Dastidar in World Congress of Human Reproduction Athens, Greece.
IVF is a much advanced Assisted Reproductive Technology requiring multiple egg production by hormone injection, constant monitoring by ultrasound examination, harvesting of eggs and IVF laboratory Procedures. 

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Q6: What is the success rate in IUI treatment in your centre? What expectations can an infertile couple have from this treatment? Do you recommend IUI in natural cycle or stimulated cycle? 
Ans: Success rate in IUI in our centre is around 15-18% per cycle. Thus the cumulative success in four cycle treatment is high. It is usually done in stimulated cycle. 

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Q7: What is the cost of drugs (injections) in IUI? Should rest be taken after IUI treatment? 
Ans: The drug costs in IUI varies widely.
a) If only a drug known as chlomiphene is used, the cost is Rs.100/- to 200/-

b) While if hormone injection is used the cost starts from Rs.1400 onwards. 

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Q8: How many IUI cycles should be done to expect success? 
Ans: 3-4 cycles of IUI has a good success rate.

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Q9: Is there any risk in IUI? Is it painful? 
Ans: There is no risk involved in IUI. It is a very simple procedure, and painless. 

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Q10: We have been told that we are suffering from unexplained infertility. Do you think that IUI could be a correct treatment in our case? 
Ans: IUI is a treatment in cases where the cause of infertility is not clearly known. We first try with IUI, if it fails then we think of advanced treatment like test tube baby (IVF).

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Q11: What is the role of ultrasound in monitoring ovulation in case of IUI and IVF? What kind of ultrasonography is done in your center? What is the average cost per cycle? 
Ans: In today's infertility evaluation and treatment like IUI, IVF ultrasound technology plays a great role. If fact, we have a very advanced ultrasound division with state of the art technology with machines like Logic 500 Pro Series Colour Doppler - 3D machine. In addition we have two other machines dedicated for ovulation studies and egg harvesting. 
This division is headed by Dr. Kakoli Ghosh Dastidar who is the leading reproductive imaging specialist in the country. Her area of specialty is Ultrasound in infertility and Obstetrics. Apart from routine ultrasound evaluation of ovulation and other reproductive organs, Dr. Kakoli Ghosh Dastidar is involved in advanced ultrasound research. Her current research involves Dynamics of endometrial characteristics in different phases of ovulation. Some of the existing results of her work has been published in Fertility Sterility, Journal of Assisted Reproduction and Genetics- both published from USA and Ultrasound in Obstetrics and Gynecology published from UK besides many papers published in Indian Journal of Obstetrics and Gynecology.
We have almost replaced hystero-salpingography (a method to study female fallopian tube) by Sonosalpingography which is done under ultrasound guidance. This is a safe simple yet efficient procedure that is becoming more and more useful in our centre. 
Ultrasound charges :
a) For ovulation study Rs.600-800/- per cycle.

b) For Colour Doppler study of the uterus, ovary, endometrium - Rs.1500/- per sitting.

c) Sonosalpingography - Rs.3200/- 

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Q12: Do you treat patients where recurrent pregnancy wastage is complained? Do they have to stay for a long time in hospital? 
Ans: Yes, our centre has a very successful record of treating recurring pregnancy wastage cases. The patients should stay for some time in Kolkata to complete investigations.

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Q13: From one of your TV interviews we came to know that obesity results in ovulation problems. Do you think that obesity adversely effects fertility? Is obesity a cause of PCOS (polycystic ovarian syndrome) which you spoke of in your interview? Is it curable by medicine? Is PCOS a cause of infertility? 
Ans: Yes, our Chief Consultant Dr. Sudarsan Ghosh Dastidar, MD is involved in advanced study in "Obesity and PCOS". Obesity and PCOS adversely affects fertility. As a matter of fact patients who are overweight and trying to have a baby should concentrate on diet control and exercise program to reduce body weight.

We also feel, that with time untreated cases of obesity and ovulation disorder become more complex. Thus Dr. Dastidar feels that they should be treated as early as possible. With proper medicine, life style modification and proper monitoring we have been able to solve ovulation problems in the case of 90% of patients. 

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Q14: What is the common treatment for PCOS? Is PCOS a cause for abortion? 
Ans: The first line of treatment offered is by a single oral tablet known as clomiphene citrate. The next course is quite expensive and involves hormone treatment. It is a fact that some of the successful pregnancies following such oral treatment will end into miscarriage due to hormonal imbalance, and intrinsic part of this disease process. However it is possible to prevent abortion and miscarriage by prior treatment.

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Q15: What is the general advise for lifestyle modification for patients suffering from PCOS? 
Ans: The general advice for PCOS patients is weight reduction program by diet and exercise. 

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Q16: We hear about risk involved in drug induced ovulation, why is it so? What is the main problem? Is it possible to prevent such risk? 
Ans: In an experienced centre like ours drug treatment of ovulation has no significant risk involved. However there is a very low incidence of too many egg production (known as hyperstimulation) following hormone injection which again can be preventive with judicious patient selection, drug selection and dose adjustment. This has to be closely monitored by expert ultrasonolgist and reproductive endocrinologist.

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