Max Multi Speciality Centre

Hello everyone,

 My name is Dr. Richa Singh. Today I am going to discuss a very important topic on how to plan your pregnancy when turning 30 and importance of fertility screening? Why this topic? Because patients do come to me for their infertility problems in their early 30s and once, I ask for the investigations, it is usually found that majority of them have already exhausted their ovarian reserves. That means they have prematurely decreased the capability of producing a baby. So, friends, it becomes a very big problem for them to conceive and even in IVF they have to face many consequences of cycle cancellations or they have to switch over to donors. So, this video is for those couples who are planning and they would be able to plan according to their biological age so that they don't land up in infertility and have a safe pregnancy. In the current scenario, if we see there are a lot of delayed marriages, late settlements and people are postponing their pregnancies due to various other reasons maybe career prospects or maybe anything else.

But what happens is that your biological age keeps on increasing. It doesn't stop. So, when you actually plan your pregnancy, by the time, in some patients the reserves have already been exhausted. Then it becomes a lot of problem for them. But you can avoid this problem. How? There are two tests which are usually done to check your fertility. So, any lady who is above 28 years of age, she is a married woman and she is trying to postpone her pregnancy, she should undergo two tests for her fertility check. One is AMH which is an Anti-Mullerian hormone. It is basically a blood test which can be done at any point of time of the cycle. Second is an ultrasound which is done on day 2 of the cycle to know the number of follicles in the ovary. These two tests when they are done will be able to tell us about your reproductive potential. So, how to interpret it? If the AMH values are above 2, then it is normal. If it's between 2-1, it is a low ovarian reserve. If it is less than 1, it is a poor ovarian reserve. Similarly, if your antral follicle counts in both the ovaries are more than 10, it's normal. If it is less than 10, the reserves are decreasing that is a low ovarian reserve and if it is less than 5, it is a poor ovarian reserve.

So how will all these help results help you in planning your pregnancy? If any lady who undergoes these 2 investigations and finds that her AMH is normal, her antral follicle counts are normal, then it means you have time. That is if you want you can postpone your pregnancy. But, with a caution that you have to get these tests repeated every year and when it starts declining then you should start thinking of pregnancy. Then, 2nd category comes in those patients where the reserves are decreased. AMH is between 1 to 2 and antral follicle accounts are less than 10. It indicates that you don't have much time and you should consult your obstetrician and gynaecologist and discuss the options of pregnancy. You can try naturally and if not, you can take the help of some drugs with the help of your doctor. Third point comes where the reserves are very poor such as the Anti-Mullerian hormone comes to be less than 1 and antral follicle counts in both the ovaries are less than 5. In such cases, you need to consult an infertility expert regarding your treatment options. Now, what are the options?

You don't have time. So probably you will have to resort to some treatments like IUI or IVF, maybe embryo freezings or if you really want to postpone your pregnancy, you can also opt for oocytes freezing that is preservation of your fertility till the time you want pregnancy. So, friends if you follow this it will be a great help to you and how will it be advantages. It is very important, number 1, you can avoid the problem of infertility because you have identified it earlier. Second important point is that even if your reserves are low since you have identified early you can take help of various treatments available for you to get pregnant. This will help you to achieve pregnancy.

Number third is even if your reserves are very low, if you have opted for early IVF, the chances of success are better because the younger, the better it is, the results of IVF. And lastly you will have two benefits: one is that you will not have to switch over to the donor because you identified your reserves declining early, so you will be able to catch or diagnose premature ovarian failures at the earliest stage and second you will have the chances of your own genetic babies. It is the most important factor, I can that every mother wants their own baby. So, I hope this information is going to help the young couples and for any other queries or consultations or second opinions, you can always reach me.

Thank you!

Hello,

I am Dr. Richa Singh, IVF Specialist. Aaj hum baat krenge ki aap kaise best IVF center and doctor choose kr skte hain better result ke lia. Apko Dr ki qualification dekhni hai. 2nd apko dekhna hai ki Dr apko counsel kaise kr rhen hain. 3rd apko dekhna hai ki apka treatment single handed ho rha hai ya multiple Drs ke pass ja rha hai. Quki multiple hands me jab chizen jati hain to success rate kam ho jate hain. Single doctor ke through treatment apke lia better choice hai. 4th apko ye dhyan rkhna hai ki jin patients ke treatment ho chuke hain particular Drs se, unka feedback kya hai. Ache Drs ko bhut jgha recognize kia gya hota hai.

5th apko dhyan rkhna hai ki treatment ka documentation proper hai ya nhi. Aisa islia taki apke pas treatment ki history honi bhut jruri hai. Next apko dekhna hai ethicality of the treatment. Apko dekhna hai ki kya Dr capable hai kam egss se hi treatment ko successful bnane ke lia. Ab me apko btaungi ki kaise apko center choose krna hai. Apko dekhna hai ki Dr ka lab kaisa hai and lab ke results kaise hain. Next apko dekhna hai ki embryologist and fertilisation rate kya hai. Trained Drs se hi apko treatment lena hai. You should always analyze the facilities provided by the hospital. Jo log simple centers se treatment lete hain vhan apke chances of success utne ache nhi hote. Isme hum bacha bahar bnake apke andar transfer krte hain and aise me agar koi garantee ki baat krta hai to apko sochna chaiye. Islia aap hmesha best Dr se hi treatment len. Cosnultation ke lia aap mujhse Lybrate ke through contact kr skte hain.

Thank You!

Hello everyone.

I am Dr. Richa Singh, senior consultant IVF. Today I am going to talk about a very important topic When do we need IVF. Why this topic because I have seen many couples have been advised for this treatment but they take a lot of time in deciding and by the time they decide they its already so late they lose their reserves. So today we would be discussing about this topic so that those couples are benefited and they can decide upon early about their treatment. So the most important indication if we talk about is maternal age. Maternal age is a very important factor because in the life of woman the moment she crosses the age of thirty years her reserves of her ovaries starts decreasing and the moment she reaches thirty five the reserves decreases rapidly and her chances of pregnancy and conception are drastically reduced to only 20 % and on more advancement the moment she reaches forty her chances of conception are only 5% so if any of the couples where women’s age is increasing and is more than thirty five years one should definitely consult an infertility expert for a treatment option of IVF.

Another factor where an IVF is indicated is multiple IUI failures. IUI is an Intrauterine insemination a procedure which is usually adopted by couples to increase their chances of pregnancy. But many couples they keep on undergoing cycles of IUI. Even more than six. So my suggestion is that if any couple have gone through an IUI and have failed their three cycles then they should consider IVF as an option. Another factor is the duration of infertility. Many couples when they are trying to conceive are not able to do so in one year of their married life. Then they undergo investigations and once those investigations are normal they keep trying naturally. Its good but one should know till when. The duration of infertility increases for more than two years or three years one should definitely consult an expert regarding an IVF option. Because this is called an unexplained infertility. Unexplained infertility is a major cause of infertility and a major cause for consideration of IVF. Another indication for an IVF is a tubal block. When the tubes are blocked then the meeting of the sperm and ovum cannot take place to form a baby which leads to again inability for a couple to conceive.

So in such cases one should consider IVF as a treatment option.in this I would like to specify many people are coming to me and they ask that can surgery be a resolution to it. So for that I would just suggest that the success rates of surgeries which are required to open the tubal blockages depend upon the side and nature of the block. So you should always consult an infertility expert whenever there is a tubal blockage for further treatment options. Next factor which is becoming nowadays a very much indication for landing up into IVF is polycystic ovary syndrome. It’s a disorder and hormonal imbalance in a body of a female where she has inability to conceive and apart from that have irregular menstrual cycles development of facial hair and weight gain. The major problem is the hormonal balance is so much so that her ovulation functions are hampered and she is not able to conceive.

So in such cases where the medications have failed she is tried with other drugs and its not working one should consider IVF as an option. Next factor which is important indication for IVF is endometriosis. Endometriosis is a kind of problem where the whole anatomy inside the body to help in conception is disturbed. It might cause lot of deposits inside the uterus or outside the surfaces of the uterus can cause attachment plus many a times causes chocolate cyst or a cyst in ovary and many a times when operating on such cyst part of the ovarian tissues are also removed which further decreases the ovarian reserve. So a couple who have been undergoing a treatment and have been diagnosed as endometriosis should definitely consult an infertility expert regarding this treatment option. And last but not the least most important factor is male infertility.

So if a husband has gone under a semen analysis and has been found that no sperms are present in the semen or if the counts are very low the mortality is low and the morphology is not good or if he is suffering from any in sexual or erectile dysfunctions then one should consult an embryologist or an infertility expert for considering of IVF as an option. So if any of these factors are present and anybody suffering from those one should always consult an infertility expert. Take an opinion and decide to take a treatment early in your stage of life so that its never too late. Thank you for watching this video. In case of any queries consultations or second opinions you can reach me.

Thank you!