Our clinic has been in existence for almost a quarter of a century (established
1993)
We maintain success rates for various procedures on par with the best clinics in
the world.
TECHNIQUE - CLINICAL PREGNANCY RATE (Rounded off as averages for the whole year)
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TECHNIQUE
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CLINICAL PREGNANCY RATE (%)
|
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Intrauterine Insemination (IUI)
|
30%
|
|
In vitro fertilization (IVF)
|
60%
|
|
Intracytoplasmic sperm injection (ICSI)
|
60%
|
|
Egg (oocyte) donation (OD)
|
60 - 70%
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Embryo donation (ED)
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60 - 70%
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Recent Advances and Trends
Currently, the clinic performs a lot of "FREEZE ALL" cycles. This means that we
stimulate the ovaries, retrieve the eggs, fertilize them and freeze all the embryos.
Embryo transfer would NOT be done in the stimulation cycle (NO FRESH EMBRYO TRANSFER).
In the subsequent month, the uterus is primed with appropriate medication to improve
its receptivity and frozen embryos are transferred once this is achieved.
Conventional IVF with fresh embryo transfer has failed to exceed success rates of
40% over the past two decades. This is due to the suboptimal "readiness" of the
uterus (endometrium) in 60% of patients (as a side effect of the injections given
to produce multiple eggs). With the advent of the new technique of "vitrification"
embryos can now be frozen and preserved safely (without any risk of damage by the
freezing procedure). As a result of these two advances we are now able to optimize
and increase success rates to around 50-60 % per cycle. The cycle, of course, would
now be of two months instead of the conventional one month. Frozen embryo transfer
is particularly advantageous in the following situations:
-
Retrieval of less than optimal
number of eggs and embryos (less than 3 embryos of grade 1).
-
Patients with low AMH and poor
responders (pooling of embryos).
-
History of previous miscarriage
/ biochemical pregnancy
-
History of previous ectopic pregnancy.
-
Retrieval of more than 15 eggs
(to avoid ovarian hyperstimulation).
-
Endometrium (uterus lining) thin
or < 7 mm in thickness.
-
History of previous IVF failures
with fresh transfers.
-
Abnormal hormone levels (elevated progesterone) in the stimulation cycle.
-
Patients with polycystic ovaries.
-
Patients with endometriosis.
IVF success rates have been quite steady for more than two decades now. With “Fresh”
embryo transfer (transfer in the same cycle as the egg retrieval) pregnancy rates
were in the range of @ 40-45% and after correcting for pregnancy losses and miscarriages,
the net take home baby was in the range of 37-40%.
Over the past 8 years, our centre made a gradual shift in policy towards “freeze-all
embryo transfers” in tune with some of the leading IVF clinics in the world. This
means that in the first cycle we perform the egg retrieval followed by IVF/ICSI
and freezing of all the embryos (no fresh embryo transfer). In the next cycle (month)
the uterus and its lining (endometrium) are optimally prepared and embryo transfer
is performed using “frozen” embryos. With this approach, we ensure that embryos
are transferred into a more receptive uterus. Did it work?
Here is some data from our clinic for January to May 2015 when we first started
implementing the freeze-all policy for some patients. Please note that these are
patients undergoing IVF using their own eggs, sperms and uterus. These statistics
do not include patients of egg donation, embryo donation and surrogacy where success
rates are obviously much higher?
|
Pregnancy rate
|
53%
|
|
Missed abortion rate
|
3.6%
|
|
Biochemical pregnancy rate
|
2.2%
|
|
Tubal (ectopic pregnancy rate)
|
0.4%
|
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Ongoing pregnancy rate
|
49.4%
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This shows a clear 10% increase in pregnancy rates (especially ongoing pregnancies
indicating a reduction in the number of miscarriages and other early pregnancy losses).
This increase in pregnancy rate is due to a better state of “preparedness” of the
womb to accept the embryo. In the fresh cycle, we cannot administer hormones or
other medicines to improve the receptivity of the endometrium (thickness and quality)
as these would interfere with the egg quality. This is easily done in the next month
which is why the pregnancy rates are much higher with frozen embryos.
To our mind, this is one of the most significant advances in the field of IVF technology
resulting in a remarkable increase in pregnancy rates as compared to conventional
IVF with fresh embryo transfer. Of course, we need more data and more international
publications demonstrating similar results before advocating it as standard practice.
Till date we continue to maintain pregnancy rates in excess of 50% with frozen embryo
transfers
How did we do?
2020-2021
For IVF & ICSI (almost 100% frozen embryo transfers only)
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IVF
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50% - 60%
|
|
ICSI
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50% - 60%
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For other categories:
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Egg donation with IVF / ICSI
|
60 - 70%
|
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Embryo Donation
|
60 - 70%
|
|
IUI (Husband’s sperm)
|
30%
|
|
IUI (Donor sperm)
|
35%
|