Assisted Reproduction Technology of technique is any technological procedure that helps infertile couples to conceive. As per the cause of infertility, our doctors will recommend and perform suitable ART programs.
During this time the patient will be examined and following investigations will be advised accordingly : -
- Wife : -HB, CBC, ESR, Blood Group, Blood Sugar, Bleeding time, Clotting time, HIV1&2,VDRL, HbSAg, HCV, Xray Chest, ECG (if age>30years), Urine, Stool.
- Husband : - HB, CBC, ESR, Blood Group, Blood Sugar, Bleeding time, Clotting time, HIV1&2,VDRL, HbSAg, HCV, Xray Chest, ECG (if age>30years), Urine, Stool.
The Art Cycle
Controlled Ovarian Stimulation
The aim of this step is to achieve a higher rate of pregnancy for which the woman's menstrual cycle is administered. Usually, a woman produces one mature egg during her menstrual cycle. In ART, we aim at initiating the production of several eggs so that several embryos are produced. Only the best out of them will be inserted in the womb. This is achieved with the help of special drugs called gonadotrophins that are administered by making use of the following regimes or protocols:
The Long protocol--Luteal phase suppression with stimulation.
- This is the most common protocol used in ART. The patient is put on the GnRh analogue (Lupride, Decapeptyl, Suprefact) subcutaneously, which starts 7 days prior to the expected menses and is continued throughout the menses and subsequently for 12 days more. This drug may be given daily, in a predetermined dosage, with a disposable Insulin syringe. Dosage: Half ml, equivalent to 20 units of an Insulin syringe, is given every day. Generally an ampoule of Suprefact contains 6 ml of the drug. Alternately a single shot of Decapeptyl, Depot or Zoladex can be givens on the 21st day of the previous cycle.
- A blood test for Estradiol hormone may be done on the 2nd day of menses to confirm suppression. Generally, the count should be less than 50. A sonography scan is done to rule out any fluid retention in the ovary (cyst) and to assess the uterus lining. Ideally, its thickness should be less than 4 mm. In case there is a pre-existing ovarian cyst, Transvaginal Aspiration may be carried out, prior to the stimulation phase. Once this is achieved, the actual ovarian stimulation is started by making use of special hormones called Gonadotrophins.
Stimulation is initiated with one of the following drugs : -
- HMG (Pergonal,Humegon,Menogon,GMH)
- FSH (Metrodin, Metrodin HP)
- GonotropC,Puregon or Recombinant FSH (Gonal F or Recagon)
Normally FSH or Recombinant FSH (dosage being 150 to 300 units per day) is used for the first 3 to 6 days followed by HMG (dosage being 150 to 300 units per day) for the next 8 to 5 days. The dosage varies, depending on the age of the patient, and the response of ovaries to stimulation.
The short protocol
This is similar to the long protocol. However in this regime, the Suprefact is started from the 2nd day of the cycle, and is continued for 12 days, till the ovulating dose of HCG is given
The ultrashort protocol
In this regime, the GnRh analogue (Suprefact) is given from the 2nd day till the 5th day of the cycle. The rest is similar to the long protocol. Generally this regime is given to elderly patients or to poor responders, who are known to have a very low egg count.
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