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For us Mumbai Fertility Clinic is temple and Dr. Jatin Shah is our God. We have been to 2-3 other clinic and they said we will not be able to have a child. We met someone whose 17 yr old child was lost in tsunami and they had come to the clinic who had twins even after 19-20 years of marriage...that is how we came to know about this clinic and we had a baby. We were very happy with the baby. It is all thanks to Dr. Jatin Shah and he is God for us. Even we recommended this to clinic to others and they left the clinic with a child. My brother became father after 24 years of marriage.

For us, Dr Jatin Shah is not only a doctor but also a Godfather. I have become a parent after 21 years. We were in tears of happiness when my son was born. He is God for us.

I have delivered baby after 11 years. I tried IVF, IUi elsewhere but it did not help me. But when i came to Dr Jatin Shah i got the good news within 6 months. I am really thankful to him that i delivered twin after 11 years.

After 15 years i have become a parent. Staff in Mumbai fertility Clinic is very good and when i see the doctor i feel like i will not go from here empty handed. he is God for us and we are very happy.

I am sister of Mumbai fertility Clinic. We treat couples who are not able to concieve. In this clinic there are all types of treatment under one roof no need to go anywhere else for diagnosis. In 20 years we have managed to deliver more than 15,000 babies. We will be able to guide you through treatments like IVF, ICSI, IUI. Initially we perform AMH test on the patient to determine the quality and quantity of eggs. After the test. Dr Jatin Shah takes the decision as to which treatment will be best or most suitable in that case.

50% of the infertility is owing to male factor. A lot of men have low sperm counts, poor sperm motility, too many abnormal sperm as the cause of their infertility and it was 20 years age there was a big revolution in the field of male factor infertility with the advent of micro manipulator, it is now possible to perm ICSI - Intra-Cytoplasmic Sperm Injection where in in only single egg is taken from the wife, single sperm from the husband load it in the micro needle of the
micro manipulator pierce the shell of the egg and inject the sperm directly into the egg. There is no need of millions of sperm, if the husbands sperm is very low or if he does not produce sperm at all but if the sperm from testis can be removed with the biopsy the husband can still have his biological child without the need of a donor.

ICSI has reformed all form of male factor infertility.

Once Dr. Jatin Shah havs retrieved the oocytes in the operation theatre the fluids containing the oocytes are transferred here in this laboratory and it it under the 'stereo zoom microscope'. The embryologist find out the healthy, normal eggs and puts them to small culture dishes and returns it to the incubators. The clinci has 10 incubators and it is very important that the transfer of eggs from culture dishes to incubators is done in the shortest possible time. Lesser exposure of eggs and embryo's to the atmosphere, lesser the damage, higher the pregnancy rates. Benc Top incubators have come as revolution. The Clinic can treat more than 50 patients at any given time. Air purifying system has been designed by NASA ensure clean air. Anything which is toxic to human eggs or embryo and affect the pregnancy are off the clinic

It is very important that the male partner / husband is also equally stressed during the entire treatment cycle. An it is very embarassing and difficult to produce a semen sample on demand. There are 2 special comfortable rooms for sperm collection known as 'Masterbaterium' which ensures privacy while men are tying to produce a semen sample.

Another significant advance is to freeze eggs, sperm and embryos by a new technique called 'vitrification'. Liquid nitrogen gas is stored at -196 degree C which can store human eggs, sperms and embryos for indefinate period of time. If a husband might not be able to make it to the clinic during the treatment of his wife because of his work or anything else, his sperm can be frozen before the procedure starts so that the wide does not have to miss the treatment.

This operation theatre is for perfoming surgery for retrieving oocytes. It is hardly a surgury. there is no incision, cut or stitch just a small anesthetic of 5-19 mins. the entire procedure takes around 3-5 mins. Clinic has range of endoscopic equipments which is used to perform laparoscopy and hysteroscopy. The common things which needs to be operated with operative laparoscopy are things such as hydrosalpinx. If the patient have blocked or swollen fallopian tubes it needs to be removed.

The operation theatre is designed to ensure fast, safe and speedy recovery.

Conventionally for freezing of embryos there was a slow freezing method but with that technique results were only 20%. A tecnique called Vitrification has been introduced which is a quicker method. Success rates with vitrification are about 60-65%.

There is another category of infertility called as unexplained Infertility. This means the patients have been through all the tests and all the reports are normal and has been told sooner or later patient will get pregnant. But such patients do have a serious problem. it may be in the form of bad eggs, failed fertilization, some tubal factors. in such cases, ICSI should be the 1st choice. Success rate of ICSi is 50% per cycle especially with fresh embryo transfer and 60-70% with frozen embryos transfer.

One of the most unique points of clinic is that all facilities related to IVF and other technologies are available under one roof. Stages before th treatment are as follow
1) Detailed history of treatmen and reports
2) Ultrasound examinations to determine exactly where the problem lies.
3) Ultrasound treatment to determine protocol, deses of injections etc.
4) Step by step explanation of IVF cycle and also explain the complications which could come with IVF.
5) Accounts Manager will explain all the financial implications and the payments options.

This would take around 30-45 mins and will also be told the realistic chances of getting pregnant according to your case.

Clinic also has fully equipped pathology lab which can conduct all hormone estimations. Clinic has all the necessary facilities required for a successful IVF cycle

Polycystic Ovarian Disease affects young girls. It is associated with obesity, irregular menstrual cycle, facial hair etc. Our clinic has adopted a unique and safe way of treating such patients. Small dozes of follicle stimulation hormone injections are given.20 or 30 eggs are expected after the injections. These eggs are removed and fertilized with the husbands sperm and freeze all the embryos
These frozen embryos are transfered in the subsequent cycle. With this approach the chances of pregnancy are 60-70% even in the cases of moderate or severe polycystic ovarian disease.

Common Causes of IVF Failure
1) Chances of pregnancy is only 50%. This implies that even if all goes well, failure might be unexplained and implies the necessity for more cycles or attempts

2) Suboptimal sperm quality especially ICSI patients with sperm problems and Suboptimal egg quality patients more than 35 years of age or low AMH levels, Polycystic ovaries and endometriosis. 70% of these good looking embryos may be genetically abnormal, Only 1 out of 10 human eggs can become a live birth or a baby.

3) Problems with uterus. Thin lining of the uterus - endometrium or insufficient blood supply in the uterus. In india, tuberculosis is common and is often a cause for failed IVF cycles.

4) Hormonal imbalances created by the injections given to produce good eggs which might put the uterus out of phase for receiving the embryo

5) Improper response of the ovaries to the ovarian stimulation protocol used - short antagonist or long agonist.

If you go through 3 good embryo transfers in a well reputed IVF clinic, the clinic can provide a success rate of 70-80%. Remaining 20-30% there are other procedures such as third party ART procedure - Sperm Donation, Egg Donation, Embryo Donation or even a Surrogacy

There has been a revolution in Third Party Assisted Reproduction. The techniques are
1) Sperm Donation
2) Donor Egg
3) Embryo Donation
4) Surrogate Mother

Indian laws are very liberal and permits any individual to resort to these techniques to help infertile patients. A husband having zero sperm count they would need sperm donation from a sperm bank to achieve a live birth. Women having repeated IVF failures because of poor quality eggs or is above 40 years of age or having a very high FSH levels or a very low AMH level or having premature ovarian failure will require egg donation and IVF to achieve pregnancy.

IVF has some interesting advances on the horizon.

1) A techique called as '3 Parent IVF' where there is a donor egg with all other component except genetic component, wife's egg for genetic component and husbands sperm which helps in preserving your ancestor line in your child.

2) Time Lapse Imageing is a technique where developement of the the embryos in the laboratory are recorded over 48 to 72 hours which helps selecting the best embryo for achieving good pregnancy rate.

3) Fertiltiy Preservation technique for patients who have to go through cancer at very early age and still expects to have their own child then the patient can freeze their testicular ovarion tissue before going for surgeries and chemotherapy.

Surrogacy has been practiced as a means of helping women who are unable to bear children. There are several indication of for the use surrogacy

1) Women born without a uterus,
2) Damaged uterus due to tuberculosis,
3) uterus removed at the time of delivery because of heavy bleeding or due to cancer.

Mumbai Fertility clinic has been successfully practicing surrogacy for the past 8 years legally and ethically within the guidelines of the Indian Council of Medical Research and has a good record of successful surrogacy.

Common Causes of IVF Failure
1) Chances of pregnancy is only 50%. This implies that even if all goes well, failure might be unexplained and implies the necessity for more cycles or attempts

2) Suboptimal sperm quality especially ICSI patients with sperm problems and Suboptimal egg quality patients more than 35 years of age or low AMH levels, Polycystic ovaries and endometriosis. 70% of these good looking embryos may be genetically abnormal, Only 1 out of 10 human eggs can become a live birth or a baby.

3) Problems with uterus. Thin lining of the uterus - endometrium or insufficient blood supply in the uterus. In india, tuberculosis is common and is often a cause for failed IVF cycles.

4) Hormonal imbalances created by the injections given to produce good eggs which might put the uterus out of phase for receiving the embryo

5) Improper response of the ovaries to the ovarian stimulation protocol used - short antagonist or long agonist.

If you go through 3 good embryo transfers in a well reputed IVF clinic, the clinic can provide a success rate of 70-80%. Remaining 20-30% there are other procedures such as 3rd party ART procedure - Sperm Donation, Egg Donation, Embryo Donation or even a Surrogacy

Embryo Donation is another important aspect of Assisted Reproduction which means both the egg and sperm are from 3rd party or a donor. This treatment is popular especially with the patients where they are mentally prepared to adoption but would still like concieve and get pregnant. Embryo Donation is very cost effective and economical

There are very good semen banks in India. Most clinics are associated with reputed banks. Our clinic is also associated with reputed banks and the sperm donors are perfectly healthy, young.

There are several indication of Egg Donation such as
1) Poor responder
2) Premature ovarian failure
3) Menopause
4) Repeated IVF failure because of poor quality eggs and embryos.
5) Woman over 41-42 with extremely low ovarian reserve.

Clinic has got specialiazed ART - Assisted Reproduction Techniques banks who provide sperm donor, egg donors and surrogate mothers which is according to the guidelines get by Indian Council of Medical Research. Egg donors are screened as per international standards. Egg donor should be young, healthy and disease free. Success rate are extremely high with 50-60% per cycle and a patient with good endometrium could expect pregnancy withing 2 cycles.

Clinic insists on an age limit of 45 years for women who receive egg donation

Intra Cytoplasmic Sperm Injection ICSI is a process where 1 identified live sperm is picked up and is injected into the oocytes on the special microscope knows as 'inverted ICSI microscope', thus ensuring however weak the sperm is the egg will get fertilized and can expect 50% pregnancy rate

When is ICSi used
1) Azoospermia - zero sperm count.
2) Oligozoospermia - low sperm counts.
3) Asthenozoospermia - poor sperm motility.
4) Teratozoospermia - too many abnormal sperms.
5) Retrograde ejaculation - sperm are retrieved from the urine bladder.
6) Anejaculation - sperm are retrieved using a special machine called electroejaculator.
7) Failed fertilization at conventional IVF.
8) Unexplained Infertility.
9) Wife's age more than 37, eggs having a thick outer coat.

1) AMH test to determine the dose of injection patient needs.
2) Ultrasound to see if the patient need hysteroscopy before the procedure.
3) Patient is started on stimulation protocol either on 2nd day of period or 21st day of the period
4) FSH injection are started from 2nd day of period. From 6th or 7th day folicular monitoring is started when the lead folicile reaches 14mm in main diameter. Injections like cetrorelix or ganirelix are also started which helps to prevent eggs from releasing before picking up for IVF.
5) Both the injections are continued until the lead folicile are 18mm in main diameter. Then last injection of HCG is given for inducing final maturation of eggs.
6) 36 hours post injection oocytes are retrieved into a test tube which is passed to IVF laboratory.
7) Eggs are identified under the microsope and husbands semen sample is processes, washed & added to each egg in 4-well culture dishes in IVF laboratory.
8) After 20 hours eggs are checked for fertilization and sagregated
9) After another 24 hours, 2 of the best embroys are replaced back in the uterine cavity known as embryo transfer.
10) 40-50% chance of pregnancy is expected.

50% infertility is due to male factor. Today we have a technique called Intra-Cytoplasmic Sperm Injection - ICSI. in this technique where most men with even the poorest of poor of sperm quality can hope to be father. Besides ICSI other techniques include IUI and IMSI. The beauty of ICSI is that it utilises the fact that 1 only sperm is need out millions to produce a baby. So only 1 sperm is picked up under high magification injected into the wifes egg and produce a good embryo in the laboratory. Even in the cases of a azoospermia which means no sperm count, a live sperm can be retrieved from the epiridemis by a technique known as PESA in case of a block which prevents sperm to come out of the testes into the semenal ejaculate. In other cases with no blocks sperm can be removed from the testies with biopsies. Even paraplegic men who cannot have a normal erection and ejaculation can avail a technique called electro ejaculation for extracting sperm and using it for ICSI. Even in the cases of retrograde ejaculation where unfortunately sperm insted of coming out it goes into urinery bladder there are techniques to retrieve the sperm from urinery bladder and using it of ICSI.

Icsi was discovered almost 20 years ago by a sheer accident in a laboratory in Belgium but now it in routine used by most leading IVF clinics. According the world wide studies ICSI babies dont suffer from any kind of handicap nor any learning disabilities.

Premature Ovarian Failure is very vexing category of infertility where unfortunate girls and women have become menopausal at a young age. It is because they were born with lower than normal ovarian reserve which got exhausted at a very young age than the usual age of 45 to 50.

Laproscopic surgery is 1st line of treatment for endometriosis. All the endometriotic cyst, chocolate cyst must be excised, drained and if there is any residual endometriosis it is important give a hypothalamic pituitary suppression with what is known as 'GNRH agonist depot preparation'. If the surgery is well done the patient would have a good chance of natural pregnancy.

Recurrence chances are there if there is no pregnancy within 6 months to 1 year. If there is no pregnancy within the specified period it would be advisable to go for ovarian stimulation and Intrauterine Insemination IUI which will benefit the cases of Stages I & II of mild disease endometriosis. For severe case of Stage III & IV Intrauterine Insemination are unlikely to work. This case IVF is strongly advisable as egg and sperm will be removed from the toxic environment which gives an opportunity to asses egg quality and the embryo quality.

Polysystic Overian Disease is very common and is often manifested in young girls aged 13-14 years. It is associated with the hormone imbalance in the body. there is a increase proportions of male hormone and a reduced proportion of female hormone it is also associated with irregular periods and ovulation.Treatment of Polysytic ovarian disease is differently phased out depending on the period of life in which the girl is. Injections of folicle stimulating hormones gives a success rate of 20-30% per month before going for IVF. For those who do not concieve with ovulation induction they need to move on IUI with ovulation induction or IVF

A career oriented woman compromises on fertilization due to late marriage or delayed child bearing resulting in loss of ovarian reserve indication fewer number of eggs. Such results are also seen in young patients. The best test is serum AMH level which can be anytime of menstrual cycle. This test can also predict the time on hand to start a family or atleast get their eggs frozen. Egg freezing has come as a big boon to women as they need not worry about losing their fertility completely if and when they decide to settle down and have children. If the eggs are frozen at a younger age it can be used later and can still have her own biological child without a donor.

The single most important test which should be done for any infertile couple who walks into the clinic is te semen analysis. Almost 50% of infertility is due to male factor.If the sperm analysis show low sperm count or poor sperm motility or too many abnormal sperms then it is advisable to seek endourological consultation to determine the cause of sperm problems. There is also a test besides semen analysis that a male partner has to go through that is hormone estimations. Male may also have to diagnose for 'varicocele' where vessels in the scrotum become thick and enlarged dialated bringing a rush of warm blood into the testicles therby damaging the sperm quality. IVF & IUI can avoid unnecessary surgeries. For more complicated cases there are other tests such as detailed assessment of sperm function with the computarised analysis assessment of spem dna intergrity and fragmantation and genetic karyotype

Laparoscopy is required to remove hydrosalpinx or endometriosis. If there is suspisions of adhesion or tubal block which could be treated laproscopically befor going for IVF which could be cauing infertility.

Hysteroscopy is required for those patients where ultrasound has shown the presence of polip, septum or a submucous fiberoid or intrauterine adhesions or any such pathology which is likely to impede the IVF outcome and which need to be corrected before embarking an IVF

For polysystic ovaries it is recommended to have procedure called 'ovarian drilling'. The decision to do this procedure should be done after mutual consent between patient and doctor taking into the account all the pros, cons and risks involved

Repeated surguries for endometriosis is not advisable because it could greatly affect the egg reserve

Not all fiberoids need to be removed, only those which are submucosal need to be removed

Commonest indication in IVF is unilateral / bilateral tubal block. If the tubal block is at the distilled end which means water has been accumulated in the fallopian tube which is called Hydrosalpinx Hydro means water and salpinx means tube. If hydrosalpinx is opening in the uterus the water from the tube would keep draining into the uterus. If the toxic fluids are flowing in from the fallopian tube all the time it is likely that the embryos will be flushed out and it is unlinkely that the woman will get pregnant. It is known fact if the hydrosalpinx is seen on ultrasounds or hysterosalpingography or laproscopy it needs to be removed. It it cannot be removed due to previous surgeries it shopuld be atleast clipped at the end of the tube where it is connected to the uterus so that water stops draining into the uterine cavity

What do you expect from clinic and what would be done for the infertile couple

1) Routine Gynaecological evaluation of the female partner
2) Undergo fertility test before any diagnosis
3) AMH Test to estimate ovarian function and egg reserve.

AMH estmimation level between 2-6 indicated good fertility potential. Estimation level less than 2 indicated reduced egg reserve. This neccesitates urgent treatment.

1) Infertiltiy is defined as the inability to concieve even after 12 month of unprotected sexual intercourse
2) In 1994, infertility was 1 in 16 couples. In 2014, it is 1 in 6 couples
3) Both male and female factors are considered equally responsible for an infertile couples condition.
4) Both overweight & underweight affects infertility.
5) Vitamins also plays part in infertility. in India, vitamin D and Vitamin B12 deficiency is very common as high as 50-60% tested population
6) Excessive use of alcohol, caffine should be avoided.
7) Avoid adverse lifestyle which includes exposure to enviornmental chemicals, paint, polish, petrol fumes
8) Smoking in case of male factors causes low sperm count, abnormal fertilising sperm ability, nicotine is extremely toxic to sperm motility and imapairs fertility to a significant extent.
9) Even passive smoking can cause infertility in women, can cause recurrent miscarriages and also low birth weight babies.
10) Stress is also associated with impaired fertility and will reduce the pregnancy rate