|
Why us?
Services offered
Initial
assessment & investigations
Endoscopic
procedures
Intrauterine
insemination
In-Vitro
Fertilisation
Intra-Cytoplasmic
Sperm Injection (ICSI)
Testicular
sperm extraction
Laser
assisted hatching
Freezing of
sperm and embryos
Egg donation
and surrogacy
IVF at SGRH
Academic
achievements
FAQ's
Information booklets
Endometriosis
Laparoscopy Hysteroscopy
Polycystic ovarian syndrome (PCOS)
Contact us /
Location
Free online consultation
Photo
gallery
Welcome to the
Centre of IVF and Human Reproduction .
Established in
1991 to meet the needs of infertile couples, the Centre of IVF and Human
Reproduction at Sir Ganga Ram Hospital has grown into one of the leading
providers of sophisticated reproductive health care in India.
This is a tertiary
care infertility centre dedicated to providing comprehensive
state-of-the-art fertility & reproductive health care in a personalised
& friendly environment. We provide all infertility services from simple
medical management (ovulation induction), surgical treatment (Open surgery
& microsurgery / fertility promoting endoscopic surgeries) to ART
procedures (IUI & IVF / ICSI) under one roof.
Our centre can
help you achieve your goals of parenthood through state-of-the-art
technology, innovative research and highly trained physicians,
embryologists, fertility nurses and ultrasonographers.
Since the
establishment of this centre, we have put in every possible endeavour to
stay abreast of the latest developments in terms of technology, equipment
and research.
Milestones
|
1991 |
The first
IVF baby in north India, Baby Garva, born on 21 September. |
|
1994 |
The first
successful pregnancy occurred by the ovum donation method |
|
1993 |
Ovum
donation started for patients with ovarian failure |
|
1997 |
The
technique of cryopreservation of embryos introduced |
|
1998 |
The first
pair of twins from cryopreserved embryos born in February |
|
2000 |
Introduction
of intracytoplasmic sperm insemination (ICSI); the first ICSI baby
conceived in August |
|
2001 |
The
technique of testicular sperm extraction and percutaneous epididymal
sperm aspiration started; the first pregnancy occurred in August |
|
2006 |
Laser
assisted ICSI & Assisted Hatching |
Why Us?
-
Northern
India's most experienced and successful IVF centre having consistent
results comparable to the best centres in the country and abroad.
-
A history of
"firsts" including the first IVF baby in northern India, Baby Garva,
born on 21 September 1991
-
Manned by
qualified and certified clinicians and embryologists, making us a highly
qualified IVF team in the country.
-
We are
conveniently located very close to central Delhi with access to good
channels of transport and communication.
-
Individualised patient care - a personal approach to evaluating and
enhancing each patient's chance of becoming pregnant. All our services
are offered under one roof to minimise patient discomfort.
-
A commitment
to take on complicated cases that other fertility centres can't or won't
consider.
-
Center for
IVF and Human Reproduction is a custom-built state-of-the-art IVF
clinic. All materials used in the construction from the vinyl flooring
to the low emission paints in the laboratory have been chosen to reduce
the volatile chemicals in the environment. Our clinic has been built as
an intensive care unit for your embryos.
-
We have a
unique customised air handling system ('clean room') that filters
all air coming into the laboratory removing chemical toxins and
impurities to create a pure environment to protect your embryos.
-
A
world-class laboratory and research programme that stays on the leading
edge of reproductive technologies
-
We
provide honest and accurate information regarding success rates,
and encourage couples to explore all their childrearing options. We have
a rigorous and transparent reporting system and respect the right to
information of our patients.
-
We ensure
that the patients are well educated about the process and our team is
easily accessible to them throughout the treatment cycle to support them
or to answer queries. We lay great emphasis on post treatment follow up
to fine tune future treatment cycles.
-
We conduct
training programmes to practicing clinicians with special interest in
Reproductive Medicine. Ours is one of the few centres in the country
that has been recognised by the National Board of Education to undertake
a 2 year post doctoral fellowship program in Reproductive medicine.
Services offered
Initial Assessment
and Investigations
Our team is
dedicated in helping you achieve your goal of taking a baby home. At your
initial consultation we evaluate you completely to decide which mode of
treatment is best suitable for you. A detailed medical and surgical (past
and present) history of the couple is taken. This is followed by medical
examination and infertility evaluation. We request a semen analysis as part
of baseline investigation and evaluate the tubes if necessary in the female
partner as part of our preliminary investigation. Baseline hormonal profile
(FSH, LH, Thyroid profile, Prolactin, etc.) is also evaluated, if required.
The outcome of the
examination and investigation decides the best course of action and nature
of the procedure to be undertaken. There are various fertility enhancing
procedures that may help you to achieve a pregnancy and a decision is taken
after the initial assessment.
Endoscopic
procedures
Endoscopy is the
examination and inspection of the interior of body organs or cavities using
a device called an endoscope. Our unit performs all fertility promoting
endoscopic procedures. Endoscopy involves laparoscopy as well as
hysteroscopy.
Laparoscopy
involves visualization of pelvic structures (uterus, tubes & ovaries)
with the help of a special optical device called as laparoscope. Operative
intervention can be done simultaneously, which helps in restoring the pelvic
anatomy & improving your chance of conception.
Hysteroscopy is a surgical procedure that enables us to diagnose and operate
on pathologies inside the cavity of the uterus. This consists of the
introduction of an instrument with fibre optics called hysteroscope, through
the cervical canal, which enables us to visualize the cavity of the uterus.
We can diagnose and treat any existent uterine pathologies simultaneously.
We have state of
the art, fully equipped dedicated theatres where these endoscopic procedures
are performed usually as day care procedures and the patient does not need
to be admitted overnight.
Endoscopic
fertility enhancing procedures
Laparoscopy: Virtually all of
the operations that are done by traditional open surgery can be performed by
laparoscopy
-
Evaluation
of pelvic structures and tubal patency test
-
Diagnosis
and treatment of endometriosis
-
Diagnosis
and treatment of pelvic adhesions
-
Tubal
surgery (obstructed Fallopian tubes)
-
Managing
ectopic pregnancy (pregnancy outside the uterus)
-
Management
of ovarian cysts
-
Ovarian
Drilling for polycystic ovaries
-
Removal of
tumors in the uterus (fibroids)
Hysteroscopy:
Different surgeries performed hysteroscopically include
-
Removal of
fibroids
-
Removal of
polyps
-
Some uterine
malformations (septum or partitions)
-
Intrauterine
adhesiolysis
-
Tubal
cannulation (Obstructed Fallopian tubes)
Intrauterine
insemination (IUI)
Intrauterine
insemination (IUI) is placing of sperm into a woman's uterus
around the time of ovulation. This is achieved with a thin flexible tube
(catheter) that is passed into the vagina, through the cervix,
and into the uterus.
Insemination
procedures are the simplest and least expensive methods of assisted
reproduction. No anesthesia or surgery is needed. In IUI, sperm of the male
partner is used. IUI is often combined with superovulation
medication to increase the number of available eggs so as to enhance
pregnancy rates.
Prior to
insemination, the sperm are processed (washed and concentrated). Placing
unwashed sperm directly into the uterus can cause severe cramps.
Concentration is accomplished by selectively choosing highly active, healthy
sperm that are more capable of fertilizing an egg. IUI is done on an
outpatient basis with without any use of anaesthesia.
There are
registered and approved sperm banks from which donor sperm can be used for
couples where the male partner is unable to produce sperm or has an
extremely low sperm count or carries a risk of transmittable genetic disease
to the offspring.
Highlights of IUI
at our center
-
We select our
patients very carefully before giving them a trial of IUI.
-
The medications
that are given for ovarian stimulation are chosen after full consideration
of the patient's profile.
-
Every IUI cycle
is monitored with help of USG & hormonal testing.
-
We do one
well-timed single insemination, which reduces the cost of the procedure
without affecting the success rate.
-
Our unit is a
FOGSI approved training center for training in IUI techniques.
In-vitro
fertilization
IVF is the union
of an egg and sperm in artificial conditions in a laboratory. The union of
an egg and sperm results in the formation of an embryo. The embryo is
transferred to the uterus which if accepted results in a pregnancy. This
process of IVF is done in conjunction with fertility drugs along with
monitoring of hormone levels through blood tests and follicle scans with ultrasound.
Who is suited for
IVF?
-
Tubal
problems- a woman's fallopian tubes are blocked or damaged, which can
make it difficult for the egg and sperm to unite.
-
Male factor-
includes absent or low sperm count, problems with sperm function or
motility, which can hinder sperm from reaching the egg.
-
Severe
endometriosis affecting both fertilization of the egg and implantation
of the embryo in the uterus.
-
Unexplained
infertility-where conception has failed to occur despite all apparently
normal female & male factors.
-
Women with
premature ovarian failure can be offered IVF with donor eggs.
-
Women with
absent or severely damaged uterus with functioning ovaries can be
offered IVF in the presence of a suitable surrogate mother.
Ovarian
Stimulation - IVF
An IVF cycle
begins with ovarian stimulation wherein a woman begins fertility
medications to encourage the development of eggs within her ovaries. The
aim of ovarian stimulation is to be able to retrieve multiple eggs so that a
substantial number of good quality embryos are available for transfer.
During ovarian stimulation, the patient is monitored with the help of
ultrasound and hormone testing. Once the growing follicles attain the
required size, ovulation is induced and ultrasound guided 'egg retrieval'
is performed 36 hours after hCG administration.
Egg Retrieval
Egg retrieval is a
minor surgical procedure that can be performed as a day care procedure. It
generally takes about half an hour and requires general anaesthesia. With
the help of a vaginal ultrasound a needle is directed through the vagina and
into the ovarian follicles. From here, the eggs are easily retrieved. No
cuts or stitches are given during the procedure.
Fertilisation and
Embryo Development
Once the eggs have
been retrieved, they are carefully identified, washed and labelled. They are
placed in a petri-dish with culture media and placed in an incubator for 3
to 4 hours. During this time, a semen sample is collected from the male
partner and delivered to the lab where it undergoes processing referred to
as "washing", which isolates the healthiest sperm. Once the sperm is
washed, it is added to the eggs in correct concentrations to begin the
process of fertilization. Alternately, for patients with problems such as
male factor we may elect to use intracytoplasmic
sperm injection (ICSI) to assist the fertilization process. After 18
hours, the eggs are examined for markers of successful fertilization. If
normal fertilization occurs, then two to three of the resulting embryos will
be selected and placed to the woman's uterus. Embryos are normally
transferred between two to five days after the egg pickup. Note that not all
eggs fertilize and not all fertilized eggs or 'zygotes' grow into good
quality embryos. The embryos, which show slower development or get arrested,
are discarded.
Embryo Transfer
This procedure is
simple, requires no anesthesia and is very similar to intra uterine
insemination (IUI). The embryos are placed in the uterus with the help of a
cannula (soft plastic
tube) passed through the cervix. After the embryo transfer rest is advised
for a while. During this time the nurse administers progesterone injection,
and gives written instructions for further medication at home. Embryo
transfer can cause mild cramps in the lower abdomen.
Post Embryo
transfer Advice
Medicines are
given to maintain the hormone levels during the second half of the cycle to
ensure that the endometrial lining is satisfactory. This improves the chance
of implantation of the embryos and thus of success. There is no evidence
that prolonged rest improves the success rate of IVF.
Intracytoplasmic
sperm injection (ICSI)
Intracytoplasmic
sperm injection a procedure where a single sperm is selected and delivered
directly into a woman's egg. ICSI is an effective option for men with
subnormal semen parameters such as a very low sperm count, impaired sperm
function, or in cases of previous failed fertilization.
Testicular
Extraction of Sperm
We also perform
surgical retrieval of sperm from the testis in men who have no sperm in
their ejaculates. Sperm can either be aspirated from testicular tissue (TESA),
or surgically extracted in the form of a biopsy (TESE) or aspirated from the
epididymis (PESA). These techniques coupled with IVF-ICSI offer a chance to
men with complete azoospermia to father their own offspring.
Laser Assisted
Hatching
An embryo must be
released or 'hatch' out of its outer cover completely before it can
implant in the uterus. Assisted Hatching is a specialized procedure
performed in the laboratory, wherein a hole is artificially drilled into the
outer covering of the embryo, with the help of a laser beam. This promotes
the hatching process thereby improving the overall implantation and thus
pregnancy rates after IVF-ET. However this procedure is beneficial to only
a selected group of patients and therefore offered only to women with
advanced age or with previous two or more failed IVF cycles.
Cryopreservation
Sperm
Cryopreservation
is a technique, which is used to preserve sperm in liquid nitrogen at
-196°C. We can preserve ejaculated as well as testicular sperm. Sperm can
also be frozen in advance of the day of egg collection if you anticipate
difficulties with semen collection or if the male partner is out of town.
However we only offer sperm cryopreservation to couples undergoing IVF/IUI
cycles at our center.
Embryos
Cryopreservation
is a technique, which is used to preserve good quality supernumerary embryos
in liquid nitrogen at -196°C. These embryos can be used in subsequent
cycles in case of cycle failure or if subsequent pregnancies are desired. By
transferring these frozen thawed embryos you can have extra attempts at
achieving a pregnancy without undergoing a full stimulation cycle. Note that
only good quality embryos are used for freezing since only strong embryos
can withstand the strain of freezing. In a freezing cycle, embryos are thawed
and transferred into the uterus in the same way as a normal embryo transfer
procedure. Transfer of these embryos is usually carried out in a hormone
replacement cycle, but can also be performed in a natural cycle in which
fertility drugs have not been used. One of the other advantages associated
with this process is the low cost involved since expensive fertility drugs
are not required.
Egg donation and
Surrogacy
We offer egg
donation program at our center for women who are unable to produce their own
eggs. The donors undergo a screening process before they are recruited for
an IVF cycle. Surrogacy is also offered for women who either do not have a
uterus or have a severely damaged uterus incapable of carrying a pregnancy.
We accept only known or altruistic donors.
Academic
Achievements
-
Approved by
FOGSI for infertility training.
-
Approved by
National Board of Examinations for Post doctoral fellowship in
reproductive medicine
-
Offering in
house training to gynecologist interested in the field of reproductive
medicine
-
Conducted
numerous conference/Workshops & CMEs
-
Publications
in Journals/Reference textbooks
Frequently Asked
Questions
Q. If I conceive,
will my baby be normal?
A. At the time of
writing, more than 50 000 babies have been born following IVF. These healthy
babies show there is no increased risk of abnormality in IVF conceived
babies compared to those conceived naturally.
Q. Is there any
physical risk to me?
A. With vaginal
ultrasonic egg collection, you may be rest assured that this is certainly no
more risky than a properly performed laparoscopy. We are proud that at Sir
Ganga Ram Hospital till now more than 5000 vaginal ultrasonic egg
collections have been performed and there have been no problems or
accidents, so it is clear that the test-tube baby treatment is a relatively
very safe procedure.
Q. Will there be
any hormonal imbalance due to the excessive hormones given?
A. No proven
long-standing effects occur after the treatment cycle. However, during the
course of treatment one may have symptoms related to ovarian
hyper-stimulation.
Q. Can I exercise
as usual?
A. Yes, but water
sports and exhaustive exercises are prohibited.
Q. What if IVF
fails the first time? How many times will I have to undergo it?
A. You can go
through IVF as many times as you wish, but we advise upto four cycles at the
most.
Q. How much time
does one successful treatment of IVF take?
Active treatment
for IVF starts on day 2 of the menstrual Cycle. At present, the injections
for down-regulation of hormones are started on day 21 of the previous
menstrual cycle. In 10 to14 days, menstruation starts. We then start
stimulation of the ovaries with gonadotropins, which can take upto 14 days
after which egg collection, fertilization and embryo transfer is carried
out. After another 14 days, a pregnancy test is done to confirm the
occurrence of pregnancy. In all, it takes about 40 days from the start of
treatment to know whether treatment has been successful. Now with GnRh
antagonists down regulation from previous cycle is not required as with
agonists and can be started from day 6 of stimulation cycle.
Contact
Us / Location
We are
conveniently located very close to central Delhi with access to good
channels of transport and communication.
Address:
Centre of IVF
& Human Reproduction
Department of
Obstetrics and Gynaecology
Sir Ganga Ram
Hospital, New Delhi
Tel: 42251777
(9:00 am - 5:00 pm)
Fax: 011-42241771
Email: ivfsgrh@rediffmail.com
Photo
gallery
Day-2 embryos after In Vitro Fertilization
(IVF)
.jpg)
Day-3 8 cell embryos after In Vitro Fertilization
(IVF)
.jpg)
Day-5 Expanded Blastocyst
Pic 1. Operation Theater for Oocyte
Retrieval
Pic 2. Micromanipulation Equipment for
ICSI
Pic 3. Intra Cytoplasmic Sperm
Injection
Pic 4. Cryopreserved
Embryos
Pic 5. Cryopreservation in Liquid
Nitrogen
|
