S. R. Multi Speciality Hospital

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Procedures in Infertility treatments

Donor Sperms/Eggs
  • Donor sperm or eggs may be used in cases of severe male or female infertility, genetic disorders, or single parenthood.
  • Donors undergo rigorous screening for medical history, infectious diseases, and genetic conditions.
  • The process involves selecting a suitable donor, coordinating cycles, and performing insemination or IVF using donor gametes.
  • Costs for donor sperm ranges additional rs12,000 per IVF cycle and donor eggs cost rs1,00,000.
  • Side effects and success rates depend on individual circumstances and the quality of the donor gametes.
  • These are surgical procedures used to retrieve sperm directly from the testicles (TESA), epididymis (PESA), or both (MESA) in men with obstructive azoospermia or other conditions preventing sperm release during ejaculation.
  • The procedures are performed under local anaesthesia and involve using a needle or microsurgical techniques to extract sperm and no specific drugs are used for these procedures.
  • Usually performed on the same day as IVF or ICSI and it might take around 15-20 minutes.
  • Costs for these procedures range from rs15,000-rs20,000 (including medications and OT charges).
  • Side effects may include discomfort, swelling, or bruising at the site of sperm retrieval but success rates for retrieving viable sperm are generally high.
  • IUI involves placing sperm directly into the uterus around the time of ovulation to facilitate fertilization.
  • The process begins with ovarian stimulation using fertility drugs such as Clomiphene citrate or gonadotropins to stimulate egg production, followed by monitoring of follicle development.
  • Once the follicles reach an appropriate size, a trigger shot is administered to induce ovulation.
  • Sperm is collected, washed, and prepared before being inserted into the uterus via a thin catheter and the procedure will be done within 25-30 minutes.
  • IUI is relatively affordable compared to other fertility treatments. Cost range for single IUI-AIH (Artificial insemination using husband sample) would be rs7000 and for AID (Artificial insemination using donor sample) is 12000 per cycle which includes medications, scans and treatment charges. The amount will get doubled if the patient needs double IUI.
  • Usually, one cycle of IUI takes about 2-3 weeks from the start of medication to the procedure.
  • Possible side effects include ovarian hyperstimulation syndrome (OHSS), multiple pregnancies, and abdominal discomfort, mild cramping or spotting. Success rates vary but generally range from 10% to 20% per cycle.
  • Ovum pickup, also known as egg retrieval, is a minor surgical procedure performed as part of IVF to collect mature eggs from the ovaries.
  • It is typically done under sedation or anaesthesia (Charges depends upon the individual) using ultrasound guidance.
  • The procedure takes about 20-30 minutes, and recovery is usually quick.
  • Costs for ovum pickup are included in the overall IVF cycle expenses.
  • Side effects may include mild cramping, bloating, or spotting, but complications are rare.
  • Success rates depend on factors such as ovarian response and the number of eggs retrieved.
  • IVF involves fertilizing eggs with sperm outside the body in a laboratory setting. The process begins with ovarian stimulation.
  • Gonadotropins, GnRH agonists, and antagonists are commonly used drugs for ovarian stimulation to produce multiple eggs, followed by egg retrieval under sedation.
  • The retrieved eggs are then fertilized with sperm, and resulting embryos are cultured for a few days before one or more are transferred into the uterus.
  • IVF costs rs1,50,000-2,00,000 per cycle (depends upon individual) which includes consultations, diagnostic tests, ultrasound scans, medicine/injections, OT and room charges.
  • A full IVF cycle typically takes about 6-8 weeks (depends on individual), including ovarian stimulation, egg retrieval, fertilization, embryo culture, and embryo transfer.
  • Similar to IUI, potential side effects include OHSS, multiple pregnancies, bloating, discomfort, mood swings and injection site reactions.
  • Success rates vary depending on factors like age and reproductive health but average around 40%.
  • ICSI is a specialized form of IVF where a single sperm is injected directly into an egg to facilitate fertilization where similar drugs are used as in IVF for ovarian stimulation. ICSI itself doesn’t involve drugs.
  • This technique is used when male factor infertility is a concern or if previous IVF attempts have failed.
  • The overall IVF process for ICSI is similar, but the fertilization step involves the injection of sperm into the egg and is usually performed as part of the IVF process doesn’t significantly alter the timeline.
  • Costs for ICSI, side effects and success rates are comparable to traditional IVF.

Cryopreservation

  • Cryopreservation involves freezing and storing sperm for future use.
  • The process typically involves carefully controlled cooling to prevent cellular damage.
  • Sperm cryopreservation can be done relatively quickly, usually within 15 minutes.
  • Cost for cryopreservation of sperm is rs3,000 for the duration of 1 year.
  • Generally safe procedures with minimal side effects and success rates depend on the quality of the gametes or embryos being preserved.
  • Vitrification is a rapid freezing technique used in cryopreservation to prevent ice crystal formation, which can damage cells.
  • It is commonly used in IVF to freeze embryos and eggs.
  • Vitrification offers high post-thaw survival rates and better preservation of cellular integrity compared to slow freezing methods and this procedure can be done within 20 minutes.
  • Costs for vitrification of eggs and embryos / freezing charge is rs30,000 for the duration of 1 year with minimal side effects and high success rates for preserved eggs and embryos.
  • PGT involves screening embryos for genetic abnormalities before they are transferred into the uterus during IVF.
  • This testing can help identify chromosomal abnormalities or genetic disorders, allowing for the selection of healthy embryos. No specific drugs are used for PGT.
  • PGT requires embryo biopsy, which adds complexity and cost to the IVF process, with an additional rs1,20,000 for 4 embryos.
  • PGT extends the IVF cycle by a few weeks to allow for embryo testing.
  • Side effects are not directly associated with PGT but can occur from the IVF process but success rates may vary depending on the specific genetic conditions being screened for.
  • The embryo transfer process is the final step in an IVF cycle, where one or more embryos are transferred into the uterus using a thin catheter.
  • The procedure is typically performed without anaesthesia and is relatively quick and painless and after transfer, patients may be advised to rest for a short period before resuming normal activities. It takes 20 minutes to complete the procedure
  • It can be either fresh or frozen transfer.
Fresh transfer
  • After fertilization, embryos are cultured in the laboratory for 3-5 days before transfer. Fresh embryo transfer occurs during the same IVF cycle in which the embryos are created.
  • Progesterone and HCG supplements are commonly prescribed after fresh embryo transfer to support the uterine lining and early pregnancy.
  • Potential side effects of fresh embryo transfer include ovarian hyperstimulation syndrome (OHSS), discomfort from the egg retrieval procedure, and emotional stress. There’s also a risk of multiple pregnancies with fresh embryo transfer.
  • Success rates for fresh embryo transfer vary but are typically around 30-40% per cycle, depending on factors such as the woman’s age, embryo quality, and clinic expertise.
Frozen transfer
  • Frozen embryo transfer involves thawing embryos from a previous IVF cycle and transferring them into the woman’s uterus.
  • After fertilization, excess embryos from the IVF cycle are cryopreserved (frozen) using a process called vitrification, prior to transfer, embryos are thawed in the laboratory.
  • The woman undergoes hormonal therapy (susten) to prepare the uterine lining for embryo transfer and thawed embryos are transferred into the woman’s uterus during the optimal time in her menstrual cycle.
  • Similar to fresh embryo transfer, progesterone supplements will be prescribed once the FET is done to support the uterine lining and early pregnancy.
  • Side effects of FET are primarily associated with hormonal medications used for uterine preparation, including mood swings, bloating, and breast tenderness.
  • Risks of multiple pregnancies still exist but are lower compared to fresh embryo transfer.
  • Success rates for FET are comparable to fresh embryo transfer and vary based on factors such as embryo quality and the woman’s age.
  • In some cases, FET may offer slightly higher success rates due to the ability to select the optimal timing for embryo transfer and allow the woman’s body to recover from the stimulation phase of IVF
  • Cost for first embryo transfer is included in the overall IVF cycle expenses. If the first embryo transfer got failed and if you are up for the transfer for second time, then it costs additional rs30,000 for the treatment (OT and room charges are included).
  • Both fresh and frozen embryo transfer have their advantages and disadvantages, and the choice between the two depends on individual patient characteristics and preferences. Your fertility specialist can help guide you through the decision-making process and determine the most suitable approach for your treatment.