Issues in management of Advanced maternal age related fertility treatments.

36 years and above patients are considered as advanced maternal age patients.
One egg has 4.5% capacity to generate into an embryo. So collecting more eggs is the only way forward which may require more than 1 egg retrieval.
As embryo biopsy is the prime requirement to find out healthy embryo, there is a need to freeze all the embryo at day 5.
Even the embryo is genetically tested, it will never implant in 55-65% cases in normal uterine lining. So only PGT-A shall not suffice.
Combination of PGT and ERA, which highlights the personalized implantation window period should be carried out in advanced maternal age cases.
Therefore, Advanced Maternal age= Day 5 Embryo + PGT-A + Freeze all + ERA

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Comments

When and where to start the IVF treatment?

Patients are confused about the time to start the IVF treatment. Should the age be considered as the parameter or the duration of the treatment? In Indian female, age beyond 35, IVF will be a better option. More than 5 years of infertility period again strongly indicates IVF treatment . At any point, if AMH is less than 2.0, IVF is strongly indicated. In the era of IVF treatments, 3 IUI attempts are enough. Due to lack of regulations, patients are confused where to start the IVF treatment. There are no set parameters to indicate which is the best centre for IVF treatments. But according to me, the following criteria is important in a IVF centre: • More than 5 years of specialty infertility experience of the doctor. • Most latest technology with 0.3 micron clean air modular lab. • In-house and more than 5 years experience of embryology team. • Atleast one triple gas bench incubator. • Day 5 embryo transfer & freeze more strategy for all. Advanced m

How can we treat zero sperm count...???

Male Infertility increased day by day in which out of 50-100 percent of patients can get pregnancy by their own sperm. 2 variety can be seen in the population : 1) problem in production 2) travelling obstruction Maximum result and confidence can be explained to those who are having obstruction.which means there will be a obstruction from testis to ejaculation in the travelling component. So Doctor can obtain sperm by small needle aspiration. In difficult condition we can do Micro Tessa to retrieve best sperm.The most difficult scenario is problem in production. Our strong belief is to give minimum two month medical management on the basis of testosterone and estrogen. 25-30 percent can retrieve healthy sperm by a technique MicroTessa if required.we offer only Day 5 transfer and PGS & ERA in a recurrent failure and previous two abortion cases. Best Infertility Treatment in Ahmedabad - Wings Hospitals

True Facts of IVF treatment in today’s era.

I m sharing my personal experience today that to make sure that certain wrong things are not implemented in IVF treatments . Polycystic ovary patient with one time ovarian hyper stimulation should not happen in today’s era. Because of the previous hyper stimulation patient should not accept egg donation.Early move towards IVF treatment is a future in PCOS patients. Limit number of IUI to not more than 3 attempts.When patient is having 0 count in semen analysis, they should not accept sperm donation straight forward without biopsy. 50 percent men can retrieve sperm. Micro Tesa and Micro Pesa is the latest advancement in technology. Transferring embryos repeatedly will not improve pregnancy rate. Repeated trials is not the way forward. Money binding scheme are non scientific and will promote more of unnecessary egg donation. Don’t accept egg donation quickly at any low AMH levels. It is challenging to give pregnancy at any low AMH but it requires experience and tech

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