National Accreditation Board for Hospitals and Healthcare Providers
NABH Accredited CIMAR Cochin Hospital
The first fertility hospital in India to be graded in the HCO category.
National Accreditation Board for Hospitals and Healthcare Providers
CIMAR Cochin is the first fertility hospital in India to be graded in the HCO category.
Infertility is not a disease but a condition where in a particular couple is not able to conceive. Infertility problems in a couple can be due to either the woman or the man, or it can be even due to problems in both partners.
We consider a couple to be infertile if:
- The female is under the age of 34 and the couple has not conceived after 12 months of contraceptive-free intercourse. 12 months has been used as the lower reference limit for Time to Pregnancy (TTP) by the World Health Organization.
- The female is over the age of 35 and the couple has not conceived after 6 months of contraceptive-free intercourse. The declining egg quality of females over the age of 35yrs is the reason for the age-based discrepancy as when to seek medical intervention.
A couple that has tried unsuccessfully to have a child for a year or more is said to be subfertile meaning less fertile than a typical couple. The couple’s fecundability rate is approximately 3-5%. Many of its causes are the same as those of infertility. Such causes could be endometriosis,, or polycystic ovarian syndrome.
Primary vs. Secondary Infertility
- Couples with primary infertility are the ones who have never been able to get pregnant.
- Whereas, secondary infertility is defined as the difficulty in conceiving after already having conceived (and either carried the pregnancy to term, or had a miscarriage). Technically, secondary infertility cannot be considered, if there has been a change of partners.
Facilities at CIMAR
Infertility & Embryology
- Psychological Counseling
- Medical Management
- Treatment for Sexual Dysfunction
- Varicocele Surgery
- Trans-Vaginal Ultrasound with Follicular Monitoring
- Saline Sonosalphingography (SSG)
- 3D/4D Uterine Scan
- Intra Uterine Insemination ( Husband & Donor)
- Semen Cryopreservation
- ICSI (Intra-Cytoplasmic Sperm Injection)
- IMSI ( Intracytoplasmic Morphologically selected Sperm Injection)
- Assisted Hatching of Embryo using Laser
- Blastocyst Culture
- Cryopreservation of Embryos & Oocytes (Eggs)
- PESA( Percutaneous Epididymal Sperm aspiration) / TESA (Testicular Sperm Aspiration)
- Micro TESA
- IVM ( InVitro Maturation)
- PGD/PGS using CGH Array ( Preimplantation Genetic Diagnosis/Screening )
- Endometrial Receptivity Assay (ERA)
Donor Treatment & Surrogacy Procedure
Surrogacy and donor egg treatment are two important facilities offered in ART treatment. We are associated with ICMR certified ART banks for Sperms, Eggs and Surrogate Mothers. We provide a comprehensive plan to intended parents including couples and singles locally and internationally.
Fertility Preservation Program
For Cancer Patients & Working Women.
- Sperm Cryopreservation
- Oocyte and Embryo Cryopreservation
- Ovarian Tissue Cryopreservation
Frequently asked questions
The prevalence of Infertility in today’s scenario?
- Generally, worldwide it is estimated that one in seven couples have problems conceiving, with the incidence similar in most countries independent of the level of the country’s development.
- Women become less fertile as they get older. For women aged 35, about 94 out of every 100 who have regular unprotected sexual intercourse will get pregnant after 3 years of trying. For women aged 38, however, only 77 out of every 100 will do so. The effect of age upon men’s fertility is less clear.
- The incidence of infertility in men and women is almost identical. Infertility is exclusively a female problem in 30-40% of the cases and exclusively a male problem in 30-40% of the cases. Problems common to both partners are diagnosed in 10-15% of infertile couples. After thorough medical investigations, the causes of the fertility problem remain unexplained in only a minority of infertile couples (5-10%). This is called unexplained infertility.
What are the common causes for Infertility?
Common causes of infertility:
- Ovulation Problems
- Tubal Age
- Male Associated Infertility
- Age-Related Factors
- Uterine Problems
- Previous Tubal Ligation
- Previous Vasectomy
- Unexplained Infertility
What are the common Indications for ART Treatment ( IVF / ICSI)?
- Bilateral Tubal
- Extensive Adhesions around the Uterus and tubes in Severe Endometriosis and Pelvic Inflammatory Diseases ( Pelvic Infections like TB)
- Loss of both tubes following ectopic gestation
- Alternate to Tubal recanalisation or recanalisation failure
- Repeatedly failed IUI
- In severe oligoasthenoteratozoospermia or refractory cases
- Unexplained Infertility
- Immunological Problems
What are the different types of assisted reproductive technology (ART)?
Common methods of ART include:-
In vitro fertilization (IVF)
In vitro fertilization (IVF) means fertilization outside of the body. IVF is the most effective ART. It is often used when a woman’s fallopian tubes are ed or when a man produces too few sperm. Doctors treat the woman with a drug that causes the ovaries to produce multiple eggs. Once mature, the eggs are removed from the woman. They are put in a dish in the lab along with the man’s sperm for fertilization. After 3 to 5 days, healthy embryos are implanted in the woman’s uterus.
Intracytoplasmic sperm injection (ICSI)
Intracytoplasmic sperm injection (ICSI) is often used for couples in which there are serious problems with the Invitro Maturationsperm. Sometimes it is also used for older couples or for those with failed IVF attempts. In ICSI, a single sperm is injected into a mature egg. Then the embryo is transferred to the uterus or fallopian tube.
Invitro Maturation (IVM)
Invitro Maturation (IVM) is a technique by which the eggs are taken out before they are fully mature and cultured outside in specific medium to make it mature outside and then ICSI is done. By this we are preventing the only dreaded complication in ART, ie OHSS (Ovarian Hyperstimulation Syndrome) which happens in few group of patients who are prone to making large number of Eggs.
Intracytoplasmic Morphologically selected Sperm Injection (IMSI)
Intracytoplasmic Morphologically selected Sperm Injection (IMSI) is a relatively new technique used to improve results in ICSI Cycles, especially in repeated ICSI failures. In IMSI sperms are selected under high magnification (7000-10000 times) and then ICSI is done. This will detect abnormalities in sperm head like vacuoles which are not seen on the conventional ICSI magnification. By adding IMSI to your ART treatment will be helping you to better our results..
ART procedures sometimes involve the use of donor eggs (eggs from another woman), donor sperm, or previously frozen embryos. Donor eggs are sometimes used for women who can not produce eggs. Also, donor eggs or donor sperm is sometimes used when the woman or man has a genetic disease that can be passed on to the baby.
What to do when the treatment fails?
If the pregnancy test is still negative 15 to 17 days post-transfer, however, your doctor will ask you to stop taking the progesterone, and you’ll wait for your period to start. The next step will be decided among you, your partner and your doctor.
Having a treatment cycle fail is never easy. It’s heartbreaking. It’s important, however, to keep in mind that having one cycle fail doesn’t mean you won’t be successful if you try again.You will have to discuss with your doctor what will be the best option.
What are chances success rates of IVF treatment?
Success rates vary and depend on many factors. Some things that affect the success rate of ART include:
- Bilateral Tubal
- Age of the Partners
- Reason for Infertility
- Type of ART
- If the egg is fresh or frozen
- If the embryo is fresh or frozen
- For women younger than 35, the percentage of live births per cycle is 39.6%.
- For women ages 35 to 37, the percentage of live births per cycle is 30.5%.
- For women ages 38 to 40, the percentage of live births per cycle is 20.9%.
- For women ages 41 to 42, the percentage of live births per cycle is 11.5%.
- For women ages 43, the percentage of live births per cycle is 6.2%.
- After age 44, little more than 1% of IVF cycles with non-donor eggs lead to live birth.
As you can see, IVF success goes down significantly after age 40. For this reason, most women 40 yrs and above use donor eggs. Success rates when using donor eggs are not as dependent on the woman’s age.
The percentage of live births per cycle when using donor eggs is 55.1% with fresh embryos.
It’s interesting to note that IVF success rates with donor eggs are even higher than a woman younger than 35 using her own eggs. Donor eggs offer the best chance for success.
The average IVF cost is 1.3 lakhs, but it can be as much as 1.75lakhs. It may be as low as 1 Lakh, but it’s rarely lower than that. These prices are for one cycle of IVF.
How much will an IVF Treatment Cost?
If a fertility clinic tells you that their IVF costs less than 1 Lakh, they are probably leaving something out from their price quote. Ask them if their price quote includes everything, including fertility drug purchases, ultrasound and monitoring costs, blood work, and any options they consider “extra”.
If you have frozen embryos from a previous cycle and want to use them, doing so is significantly cheaper than doing a complete IVF cycle with fresh embryos. The average cost for a frozen embryo transfer (FET), is about 40-50,000 Rs.
While basic IVF costs around 1.5 – 2 lakhs INR, if you need additional assisted reproductive technologies like IVM,IMSI,PGD etc, the cost will be higher.
Statistics say that about eighty percent of the couple that approach for infertility treatment can be treated by counselling alone and it is only twenty percent of them that require some form of infertility treatment.
Infertility is not a disease but a condition where in a particular couple is not able to conceive. Infertility problems in a couple can be due to either the woman or the man, or it can be even due to problems in both ….
Infertility diagnosis is performed initially, by collecting complete medical history and physical examination. It will then followed by diagnostic tests for infertility. The common tests are urine tests, blood tests, …….
As the age increases the ovarian reserve (total no of eggs) in the ovary will significantly come down (especially after 33 years) and there seems to be issues in women like fibroid, endometriosis etc which ……
IVF Treatment Procedures
IVF (Invitro Fertilisation) refers to a procedure where women’s egg are removed and fertilized with man’s sperm outside the body in the laboratory. The embryos thus formed are then put back into the uterus ….
Intra Uterine Insemination
IUI and AI are one and the same fertility treatment. A small tube is used to place specially washed sperm directly into the uterus. While fertility drugs are not always used during IUI, most doctors ……
While every fertility clinic’s IVF protocol will be slightly different and IVF treatment are adjusted for a couple’s individual needs, here is a step-by-step breakdown of what generally takes place during an ……
With ovarian hyperstimulation syndrome (OHSS), though, the ovaries become dangerously enlarged with fluid. This fluid can leak in to the belly and chest area, leading to complications. If your doctor …..
Female infertility include problems with ovulation, damage to fallopian tubes or uterus or problems with cervix. Age is another major issue that contribute to infertility because when a women ages, her fertility …….
The objective of the fertility treatment is optimization of outcome with minimization is opting of risk. A flexible dosing during stimulation is essential for optimizing the cycle outcome.
Ovulation analysis is the process by which the fertility is assessed to find the fertile window and general assessment. Various methods exist for ovulation testing. Various methods exist for ovulation testing.
It is used to know whether the fallopian tubes of the patient are blocked and whether blockage is at the junction of tube of uterus (proximal) or at the distal end. Radiographic contrast dye is …….
Cryopreserving agents that minimize damage to the cells during freezing and thawing process. Semen cryopreservation also called sperm banking is a procedure to preserve sperm cells.
Transvaginal sonography is one of the indispensable investigation as far as infertility patient is concerned. It is non-invasive and the single test that parallels to clinical assessment. Assessing the …..
As the women gets older the incidence of chromosomally abnormal eggs increases dramatically. The mecoha spindle is a critical component of eggs that is involved in organising the chromosome ….
All the macroscopic parameters in semen analysis, denote the functional capacity of the necessary male organs namely seminal vesicles, prostate and whether or if the whole tract from testes to the …..
In general, semen analysis, hysterosalpingogram, assessment of ovulation and ovarian reserve should be the initial investigations and if no cause of infertility found, laparoscopy should be done.
Anything that effect the hypothalamus pituitary endocrine system which regulates the sperm production can be detrimental. There are also a wide variety of physical problems like varicocele, ……
Infertility Specialty Doctors
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