Apollo Cradle Hospital

Hello everyone.

I am Dr. Madhu Garg. I am working as consultant in Miracles IVF and Fertility Unit and today we will be discussing something about IVF. IVF is In-vitro Fertilization and in common language it is also known as a test tube baby. In IVF, what we do is we take out both the gametes the female gametes and the male gametes and they are fertilized outside the body and then the resulting embryo is placed inside the female uterus which results into pregnancy. So the first question arises is who all need IVF? Couples who usually need IVF have problem in conceiving of long standing that could be because of female factors or male factors. The male factors include a less count, when the sperms are not normal of morphology or their motility is less, or there is complete of sperms in ejaculate and in female factors when the female is having a high age which is more than 35 years and she is having less egg count and there are problems in the tube. The tubes are the structure which transport the eggs from the ovaries inside the uterus and then the eggs meet the sperms and result in fertilization. If there is some kind of blockage in the tube, the egg is not able to meet with the sperm and the pregnancy is not happening, so these couples they always require some king of assistance which is usually IVF. In IVF the process starts from your menstrual cycle. We do basic test involves the hormonal evaluation, ultrasound scan, the semen analysis and after going through all of your reports, we start you on hormonal injections. These usually start from day tow or day three of your periods and they are given regularly for the next nine to ten days on a daily basis. During these nine to ten days of hormonal injections we evaluate you after 4 to 5 days and then every alternate day to see how your body is responding to these injections and to titrate the dose of these injections, so during these nine to ten days your follicles grow and when the follicles are mature enough then on the last day we give you a trigger injection and after the trigger injection, 35 to 36 hours after this injection we schedule your ovum pickup. For this pickup you are admitted to the hospital for a daycare. That means you are not having a night stay in the hospital. The stay is only for two to four hours and you have to come fasting 5 to 6 hours and under general anesthesia, we do a transvaginal ultrasound guided pickup. So the needle is passed through vagina and there is no cut or mark in the abdomen. All the eggs and the ovaries are aspirated outside and then the embryologist examines all the fluid which is aspirated and he checks whether how many eggs are present, what is the quality of these eggs and then he takes the decision of performing IVF or ICSI (Intracytoplasmic Sperm Injection) with male sample. In IVF what is done the eggs are placed with healthy sperms and then a natural process of fertilization is allowed. But in patients where the semen factor is less and morphology is less, the motility is less even, even a high-grade, a higher version of IVF is required which is called ICSI. In ISCI, every egg is injected in one sperm in the cytoplasm and not all patients need ICSI that is the decision of embryologist after seeing the semen sample. So these embryos which are formed after fertilization. They are left in laboratory for 3 to 5 days and after their growth in the laboratory they are transferred back to the uterus of the female and that transfer is very simple procedure which doesn’t require any hospital admission and not does it require any anesthesia. After getting the embryos transferred you need to get hormonal support for the next 15 to 16 days and then the pregnancy test is done. So IVF pregnancy is equally as good as an actual pregnancy. You don’t need any extra care, neither any cesarean delivery is required nor no special care is required during the pregnancy also.

So this is the basic what IVF is, who all need IVF and that is done under the cycle so the procedure is different according to your requirement and what you need and what is the best produce so you have to consult the doctor then you have to decide. So thank you everyone.

Good Afternoon

I am Dr. Chetna. Today we are doing to talk about the benefits of Minimal Access Surgery. So Minimal Access Surgery is more commonly known as Keyhole Surgery or a Laparoscopic Surgery. Now this is a revolution in the medical science which is now we are practicing for the last fifteen twenty years and it has given excellent result. A lot of people still in theato cities or otherwise metro cities also still have fear about laparoscopic surgeries. When they come to OBT, they start talking that you know the surgery remains and complications and stuff. Now here I would like to bust this myth and explain to you that why a Minimal Access Surgery is far superior to an open conventional surgery. Now a Minimal Access Surgery or a Laparoscopic Surgery is done through making punctures in abdomen void. Now this can be used for a various Diseases like to remove the uterus, to remove the ovarian cyst, to correct the polycystic, to remove endometriosis, to correct ectopic pregnancy and other further related surgeries. So we can remove large fibroids ad large as seven months pregnancy sized to large ovarian cysts. Yes, there are certain pre-requisites which we need to see before we decide whether this patient is fit for Laparoscopic Surgery or not. Majority of the women who are otherwise fit that means they have a normal exercise and urines and stuff are able to withstand Minimal Access Surgeries. So I was coming to advantages. Advantages no. 1, there are no major cuts on the tummy so there are some punctures. They may vary in numbers between two to four or sometimes even five and the size of these punctures would be largest to be about ten or twelve centimeters so you can believe these are very small punctures. The second advantage is that the surgeon is operating under the magnification of 6X or more. So that gives a lot of access to the pelvis so we can see it very properly. If required we can rotate the camera and go in the upper abdomen and see that as well. So there is a lot of benefits when it comes to the visual appearance of the organs and the operation skill. Then the instrument that we use in the Laparoscopy are very fine. To explain, my scissor blade is no longer than the nib of the pen that we use, not the ink pen we are talking, the regular gel pen. So that is the size of the blade that we use so that gives a very fine precision. Then the blood loss is quite less since the abdomen is not open to the air outside so the recovery is quite fast. That means the less number of hospital stay, less chances of blood transfusion or almost no chances of blood transfusion. You can go home fast. You can…. I have had patients who did the surgery, second day we went to work, fifth day you see them coming from the office to remove their stitches. So this is brilliance you can’t expect.so very next day the patient sits and starts eating and starts eating and talking, everything feels normal. So this is a blessing, it is a boon and since majority of the surgeries can be done by Laparoscopy. I would say before going in for an open surgery. They should be considered for laparoscopy. Yes, there are certain candidates are not fit for laparoscopy and these can have an open surgery but majority of who had fibroids, endometriosis, ovarian cysts, polycystic ovaries, pelvic infections, ovarian mass, some of the cancer patients also, uterus removal for heavy bleeding. So all these things can be done through a laparoscopy. So I believe this is a blessing by the modern science and we should all avail of this benefit.

So if any questions we can always meet me up at Medicals Medi-clinic Sector-14 and also part of Apollo cradle hospital. So you are welcome.