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Embryo freezing is a medical technique in which embryos are frozen at a very low temperature of -196 degrees Celsius for a predetermined period. It is also known as embryo cryopreservation. The embryos stored are later used in the Frozen Embryo Transfer (FET) procedure in infertility treatments such as IVF.

In modern times, advanced medical procedures have taken a significant place in treating the medical conditions of patients irrespective of their healthcare issues. Infertility is one of the prime issues for couples who are unable to conceive naturally. Along with treatments created for curing infertility issues, various other medical procedures are introduced, which are combined with the chosen treatments to receive the desired results for the patients. In recent years, the demand for cryopreservation procedures has significantly increased due to the increased support of infertility experts along with government funding, which has motivated more individuals to go for the embryo freezing procedure. You will be surprised

to know that embryo freezing increases the chances of reproduction by 70% when compared to cases which go for natural conception or conventional IVF procedure. This proves to be useful for couples struggling hard to have babies. In countries like Europe, NHS supports couples’ In Vitro Fertilization (IVF) cycles to a great extent and helps them receive up to three cycles at affordable and reasonable costs. Europe and North America have recorded the highest growth in the use of IVF treatment, which has proved to be very significant for patients. The usage of eggs, sperm, and embryo freezing in infertility treatments has also reached the next level in these continents. In the countries of Asia Pacific, the implementation of infertility treatments has increased significantly because of fertility tourism and the rise in awareness related to the treatment. In this article, you will find information about different aspects of the embryo preservation procedure and its contribution to the success of the IVF procedure.

Embryo Freezing or Embryo Cryopreservation procedure:

Embryo freezing procedure is a medical technique in which an embryo formed in the IVF laboratory is stored at a specific temperature. The best temperature at which infertility experts recommend storage of embryos in this technique is around -196 degrees Celsius. This temperature is proven to be the most suitable one for preserving embryos in the medical laboratory in the embryo bank or fertility clinic. As per the National Embryo Donation Academy, around five lakhs of embryos were stored in embryo cryopreservation procedures in the United States alone. Also, the procedure of embryo cryopreservation is performed within one to six days of the formation of the quality embryo.

History of Embryo Freezing:

Embryo Freezing first came into notice when the first baby was born in the year 1984. The baby born with the assistance of a frozen embryo was named Zoe. The scientists of Monash University mentioned that the news of the baby’s birth was hidden for two weeks to provide the desired protection to the baby’s family. Professor John Leeton was a significant part of the procedure of In Vitro Fertilization, which helped in the birth of the baby. As per the reports of IVF doctors, it was found that the egg and sperm of the couple were fertilized in the medical laboratory. The embryo, which was thus formed, was preserved for two months before progressing with the transfer of the embryo into the uterus of the woman.

Fortunately, the embryo was implanted with success. The woman got pregnant, and the entire team leading the procedure was happy with the accomplishment.

When is the Embryo Freezing procedure recommended?

There are certain specific and crucial conditions in which procedures, such as embryo infertility experts, recommend the freezing technique. Embryo freezing procedure is advised to patients in the following cases:

Intentional delay of conception: In recent years, a number of individuals have headed towards a life where professional priorities are considered before building a family. Here, a couple or even a single individual choosing a donor egg or sperm has decided to start a family after a couple of years. In such cases, the embryo-freezing procedure is selected for

the couple. It helps them to store embryos or embryos in the right conditions. As per the recent research published in the news publications, it is found that Total Fertility Rate (TFR) is decreasing at a constant rate. This has occurred due to the rise in the scenario of delayed marriages and late planning of babies.

Primary health conditions: There are various health conditions that take a toll on the fertility levels of the body. This makes an individual or couple think about safeguarding their eggs, sperm, or embryos for future use to start a family without facing many obstacles in their path towards parenthood. If a couple plans to have a baby, then they can simply take the assistance of the embryos stored in the medical laboratory. Some such health conditions include cancer, which needs to be dealt with in a positive manner. Here, embryo cryopreservation will help individuals and couples have babies in the later years of their life as well.

Will to donate embryos: Most of the couples that go for the embryo freezing procedure are often left with quality embryos. These embryos can be utilized for In Vitro Fertilization treatment of couples who are unable to conceive due to poor quality of embryos formed with their respective sperms or eggs. If a couple has chosen an embryo cryopreservation procedure, then they can help other couples go for the embryo donation. Another couple can quickly pick up the embryo donation procedure, thus improving chances of success in the IVF procedure with a positive pregnancy.

How do you prepare for the Embryo Freezing/ Embryo Cryopreservation procedure?

Patients need to understand that the embryo-freezing procedure requires some specific preparation to ensure that the procedure ultimately leads to a successful pregnancy for the couple opting for it. Choosing the best and most proven tips will help couples prepare for the embryo-freezing procedure and receive the desired results.

Blood tests are important for screening purposes. This helps in finding out the actual health status of the patients. Ovarian reserve testing is performed to find out the quality and number of eggs. Follicle stimulating hormone (FSH) and estradiol are tested to find out egg quality and number in the concerned women.

Infectious disease screening is also performed to know whether the woman is affected with HIV, Hepatitis B, and C. This prevents the passage of these serious healthcare conditions into the baby, who will be born with the help of the IVF procedure along with frozen embryos.

These tests are common for sperm, eggs, and embryo freezing procedures as well. Before starting with the procedure, couples need to make sure that they go for all the recommended medical tests as suggested by the infertility experts. Time to time monitoring is done under the guidance of the infertility specialists to make sure that the embryo cryopreservation procedure takes place in the right manner.

Methods of Embryo Freezing procedure:

Embryo freezing procedure comprises of different methods, which are utilized as per the requirement of the infertility case of the patients. The most crucial and commonly used

embryo freezing procedure includes Slow Programmable Freezing (SPF) popularly known as Slow Freezing along with Vitrification procedure. Each of these methods has its own set of pros and cons which are considered while choosing for the concerned procedure.

Slow Programmable Freezing (SPF)

Slow Programmable Freezing (SPF) is one of the top methods, which assist in fertility preservation from several years now. This procedure was utilized for the first time in the year 1986. This procedure was the only reliable way to freeze eggs for nearly 2 decades until procedures like vitrification were introduced. Here, a cryoprotective agent is used to preserve the embryo for a considerable period of time, as recommended by the infertility expert himself. The targeted embryo is stored at a temperature of -196 degrees to prevent any kind of damage throughout the time period of embryo cryopreservation procedure. The natural biological processes are shut down naturally in this procedure. Proper care is taken with respect to the cells, as around 30% of the cells in the embryos

cannot successfully complete the insemination process, which can also tolerate the thawing procedure. The success rates of the slow freezing or slow programmable freezing (SPF) technique are a considerable one. The slow freezing procedure is possible only in the pronuclear stages. This stage of embryo development is popularly known

as PN stage. Therefore, if this procedure is used, then inseminated egg cells are taken for successful completion of the same. This is because the inseminated cells have a different level of sensitivity than the non-sensitive types of cells present in the embryo. The time period, which is involved in the slow programmable freezing procedure, is around

hours. This procedure is very less utilized these days. This is because of the increased time consumption.

Vitrification

The procedure of vitrification involves various steps where the specialist utilizes a very high freezing rate when considered on per minute basis. This helps in getting the embryos frozen at a very quick rate. One of the major differences of slow programmable freezing and vitrification is that the later procedure is a modern one and the success rates of vitrification are much higher than the slow freezing procedure. These days, infertility experts

highly favor the utilization of vitrification procedure with the help of which embryo freezing can occur quickly without mere wastage of time and energy.

Each couple imagines conceiving their baby in the natural and sound way. However, in today’s unhealthy lifestyle, infertility has become a major issue. Wrong eating habits, stressful work schedules, irregular eating habits, and many such unhealthy ways prompt high odds of infertility issues. With continually evolving science and research, ZIFT or Zygote IntraFallopian Transfer is another addition to ART (Assisted Reproductive Technology) that doctors are recommending widely for infertile couples to get a baby. (1)

Why opt for ZIFT?

ZIFT is a choice for couples if they have tried different medicines and all have proved to be unsuccessful in leading to pregnancy. For this process, there should be at least one open fallopian tube. (2) ZIFT can likewise help considering you have the following conditions:

• Unexplained infertility
• Ovulation issues
• Your accomplice has a low sperm check

If the sperm-check is low in the male partner, or if there were preparation issues in past IVF cycles, ZIFT can be utilized in combination with Intracytoplasmic Sperm Injection (ICSI). ICSI is a strategy that lifts the shot of treatment by infusing a solitary sperm specifically into an egg.

The process of ZIFT as Compared to IVF

ZIFT is a modified version of In Vitro Fertilization (IVF). ZIFT process takes place four to six weeks to complete one treatment cycle. This treatment is performed when a blockage in the fallopian tube prevents the normal binding of sperm to the egg.

• In this process, first, ovaries are stimulated with the help of This is done to increase the chances of producing multiple eggs.
• After that, the produced eggs are collected through an aspiration

• These collected eggs are fertilized in a Now the fertilized eggs are transferred, versus 3-5 days as used in a regular IVF cycle.
• The fertilized eggs are then transferred to fallopian tube within 24 hours through a laparoscopic It is done through a catheter placed deep in the fallopian tube.
• In the final step is to notice the early pregnancy The doctor will use blood to confirm if pregnancy has occurred.

Advantages and Disadvantages of ZIFT Process

There are always pros and cons both associated with anything. If there are advantages of ZIFT then there are also some risks of this procedure. Therefore, here we are giving a brief of the pros and cons of ZIFT.

Advantages of ZIFT:

• Those couples who have extreme infertility issues can think about this strategy as help to have their baby.
• The best thing about this technique is that the specialist can affirm the treatment of egg before inserting it in the Fallopian tube.
• In this way, the specialist will just choose the best and splendidly created
• This strategy functions admirably on those couples who have attempted no less than one year to conceive normally and have 5 to 6 fizzled cycles of IUI (Intrauterine Insemination).

Disadvantages of ZIFT:

There are certain disadvantages or risks associated with this strategy and accordingly not all couples settle on ART or, to be precise, ZIFT. (6)

• In this technique, different zygotes are embedded in the fallopian tube to build the odds of accomplishment, yet it can likewise come about into multiple pregnancies. (7)Along these lines, the chances of having twins and triplets Occasionally, different pregnancies can be hazardous and there are more odds of an unnatural birth cycle.
• There is a danger of having an ectopic pregnancy, where the hatchling will create outside the womb in the fallopian tube itself. In such cases, it becomes necessary to expel the zygote through surgery or even the fallopian tube as well.
• A few women may grow excessively numerous eggs because of the fruitfulness of This can cause a few hormonal changes in the body, which are hard to deal with.
• A few examinations additionally guarantee that infants conceived through this treatment can have birth imperfections or disorders.

Effectiveness of ZIFT

The achievement rate for ZIFT differs drastically. It highly depends on a couple’s fertility issue and age. Women that are more youthful have more advantageous eggs and higher achievement rates. Ladies have around a twenty-two percent possibility of conveying an infant with each ZIFT cycle. (8)

Similarities and Dissimilarities Between ZIFT and IVF

• ZIFT and IVF both have a tendency to be ideal medications for women who have more serious infertility issues, for example, harmed fallopian tubes.
• ZIFT and IVF both include incipient organism
• ZIFT and IVF both furnish the doctor with the chance to choose the best quality embryo for
• ZIFT transfers the treated fertilized egg is put into the fallopian tube while in IVF; the prepared embryo is transferred into the uterus.
• The ZIFT system varies from IVF in a way that it requires an additional surgical method called laparoscopy to transfer the embryo in the fallopian tube.

Why is ZIFT a Better Choice?

ZIFT (Zygote Intrafallopian transfer) is a superior choice of other infertility treatment methods. Here the developed Zygote is transferred in the fallopian tube and not in a petri dish or uterus. The pregnancy rates with ZIFT have dependably been higher than with In Vitro Fertilization-Embryo Transfer (IVF-ET) and there are numerous purposes behind this.

The fallopian tube gives a superior domain to the embryo when contrasted with an incubator.

There is better synchronization between the embryo and uterus in a ZIFT, because of which implantation rates are superior as compared with customary IVF treatment.

ZIFT enables the specialist to sidestep the cervix. This can be exceptionally useful in women with cervical stenosis, or the individuals who have experienced failed IVF treatment in the past. It is so because the embryo exchange is actually troublesome or inappropriate.

Cost of ZIFT Procedure

ZIFT is an expensive procedure. It typically costs from Rs. 250,000 to Rs. 500,000 a cycle. The cost depends upon your location, the number of medicines taken, and the number of cycles you undergo. ZIFT may cost more than traditional In Vitro Fertilization. Before going for such treatments, make sure that you are with the best specialist because ultimately the success of the treatment is all that matters. Also, be prepared that your budget allows you to go for this treatment.

Make sure you set aside the opportunity to completely examine the consequences of fertility tests and the diverse medicines for infertility with your specialist before settling on any choices about what will be best for you. This will help in making the correct decisions and increasing the chances of effective conceiving.

What is Laser-Assisted Hatching?

Advancements in science and technology have greatly improved people’s lives. Technology has helped us in every segment, from work to the production of goods and even reproduction. Laser-assisted Hatching is one technological advancement that has been

around for a long time. It can be considered one of the technological gifts for women of older age.

Laser Assisted Hatching is a technique used in In-Vitro Fertilization. This technique helps to improve the implantation of embryos into a woman’s uterine lining. The process creates an opening into the patient’s uterine lining, allowing the embryonic cells to hatch. It is a safe technique which helps to weaken and thin a small section of the zona pellucida. If the zona pellucida is harder, the case becomes more complicated. This happens because the eggs will not hatch or may use excessive energy to get out. This can end up with an aversion to the woman’s uterus and reduces the likelihood of implantation. Reasons accompanying the same include the age of the patient because women above 37 years generally produce eggs with a more complex or thicker zona pellucida as compared to younger women, another reason supporting the reduction of implantation in women with a high level of Follicle- Stimulating Hormone (FSH).

Procedure of Laser Assisted Hatching

This procedure is performed in a lab. Here, the laser beam is used to hatch the outer shell to facilitate embryo implantation. For this purpose, a circle of the coloured beam of light is fixed. This circle locates the point where the laser will fire. This laser beam is invisible; we can only see its effects.

A laser beam issues energy into the embryo shell and dissolves it. The laser is

pulsated three times to create a whole gap in the shell. However, this particular technique may vary based on the power settings, method, and spot size. For a successful pregnancy, this Hatching is performed without affecting the embryo.

When Laser Assisted Hatching is Recommended

Laser-Assisted Hatching is recommended in the following cases:

• Patients who are more than 37 years
• Patients having Frozen Embryo Replacement (FER)
• Patients who have faced a failed IVF or ICSI treatment
• Those who are going for IVF/ ICSI for the first time. They are considered poor responders because they require a high dose of It is a kind of infertility drug for a poor ovarian response.
• Those with poor quality and quantity of embryos
• Those who have had a low fertilization rate in earlier IVF cycle
• Couples going for IVF treatment with embryos that have a thick outer shell called zona pellucida

Advantages of Laser Assisted Hatching

Laser-Assisted Hatching with IVF has many benefits:

• In this treatment, only a fewer embryos are required to be transferred
• Assisted Hatching can Increase the implantation success rates

• It allows for blastocyst culture
• Reduces the chance of multiple pregnancies

Other Assisted Hatching Methods

Assisted Hatching is not always assumed to make a small break or tear in the egg. There are other methods, too, that are practised by different labs accordingly. Some of the methods are mentioned as follows:

Mechanical Hatching: There is a risk of controlling the size of the opening (zona

pellucida) with this technique. As an embryologist keeps the embryo steady with the help of a pipette while puncturing the zona pellucida using a micro-needle. (Imagining a very thin line alongside the embryo).

Mechanical Expansion of the Shell: Through this technique, hydrostatic pressure is presented just under the shell, making it expand. This method’s idea comes from the normal expansion of the outer shell throughout the hatching process.

Chemical Hatching: A chemical known as Tyrode’s acid is used in this treatment while

treating the patient. A small amount of Tyrode’s acid is applied to the zona pellucida until the shell is breached. There is a risk of chemical exposure of the embryo under this treatment.

Drilling: In this technique, vibrations are created for a conical opening. This technique uses another technology called Piezo technology.

Of all the methods mentioned above, chemical hatching is one of the commonly used techniques, as not every embryology lab is equipped with Laser Assisted Hatching process.

Risks Associated with Assisted Hatching

There are multiple risks with laser-assisted Hatching. They are:

Manipulation or interference with an embryo can lethally damage it, which ironically means that embryo’s natural capacity is challenged and will somehow result in non-pregnancy of the woman. (7)

Another risk of assisted Hatching is twinning, specifically monozygotic twins. It is an identical twin, which comes from an egg and a sperm. During the IVF treatment, chances of twinning are already increased, and researchers have found that assisted Hatching may further increase the risk. However, all multiple pregnancies carry risk, but monozygotic twin pregnancies come with some more and can be dangerous for both the mother and the baby.

Assisted laser hatching can cause complications for the female partner. These complications include nausea, vomiting, swelling of the face, water retention, and headache. However, these problems are not that big and can be diagnosed with simple medication.

Success Rate of Laser Assisted Hatching

One of the foremost questions is asking about the success rate. The success rate, in this case, is how many couples have come along with a baby in their hand after the

treatment. The success rate of IVF along with laser-assisted hatching increases by up to 50

%. A Cochrane review considering a collection of 31 studies have found hatching process has improved the clinical pregnancy rates. However, the same lack of live birth rates. Ultimately, the results matter and here the live birth rates. The goal for any fertility treatment is taking a baby home, not just getting a positive pregnancy test. Embryologist’s experience plays

a bigger part in making the process successful.

Factors that Affect Laser-Assisted Hatching Success Rate

There are some factors which can influence the success rate of Laser Assisted Hatching:

• Experience of the embryologist
• Expertise deployed during the procedure
• The nature of the embryo basically the thickness of the shell
• Quality of the infertility Centre

Treatment Cost for Laser Assisted Hatching

The cost of the treatment depends on many factors. Various clinics offering IVF treatment along with Laser-assisted Technique include the cost of both the treatments. It is affordable treatment in India as compared to other countries. It ranges from Rs. 20,000 to 30,000 only. Many factors that affect the cost of the treatment are mentioned as follows:

• Type of infertility center
• City selected
• Experience of the Embryologist
• Type of For example, after IVF or ICSI
• Number of embryos used

DNA fragmentation is a test for male fertility which measures the amount of damaged DNA in a given sperm sample. DNA fragmentation can occur spontaneously or intentionally by laboratory personnel. Spontaneous DNA fragmentation is fragmentation that gradually accumulates in a cell. DNA fragmentation is more common among men with sperm motility defects. It is helpful in predicting outcomes for In-vitro Fertilization (IVF) and its expansion intracytoplasmic sperm injection (ICSI). The main unit of measurement is the DFI (DNA Fragmentation Index). The abnormal genetic material present in the sperm can, in turn, lead to male subfertility, IVF failure, and miscarriage. A conventional semen analysis is done to

check the sperm concentration, while motility analysis and morphology assessment cannot analyze the sperm at the molecular level; hence, the DNA fragmentation test helps in finding faulty DNA in sperm. Sperms with high DNA fragmentation fertilizing younger oocytes carry a better prognosis of achieving a successful pregnancy. All men have some amount of damaged DNA in their sperms; more significant damage may indicate more incredible difficulty in achieving pregnancy with IVF and IUI. (1) (2)

Factors that Damage Sperm DNA

DNA damage increases with age; men in their 50s or 60s have a higher percentage of sperm fragmentation than men in their 30s or 20s. (3) Other factors that damage sperm DNA include the following:

• Exposure to various chemicals or toxic agents
• Excessive heat
• Chronic infections in the prostate
• Chemotherapy
• Radiation or smoking

To prevent further damage to DNA, doctors may recommend drawing sperm directly from the testicle with a needle or suggesting antioxidant vitamins that help minimize the damage.

Causes of Sperm DNA Fragmentation

One of the major contributing aspects for sperm DNA fragmentation is stress oxidative, which can be related with one or more of the following:

• Intrinsic causes, such as deficiencies in recombination during Spermatogenesis
• Abnormal Spermatid Maturation
• Infection and Pyrexia
• Variations In Sperm Protamine Expression
• Abortive Apoptosis
• Elevated Testicular Temperature
• Recreational drugs
• Extrinsic causes like Lapse of Time from the Ejaculation
• Excessive Smoking and Alcoholism
• Oxidative Stress and Unhealthy Diet
• Environmental and Occupational Pollutants
• Advanced Chronological Age

Causes of sperm damage who can Benefit from Sperm Fragmentation Test

The need for a Sperm Fragmentation Test arises when there are:

• Unexplained infertility
• Arrested embryo development
• Poor blastocyst development
• Unsuccessful attempts for IVF and ICSI treatments

• Miscarriage
• Advanced chronological age
• Varicocoele
• Poor semen parameters
• Exposure to harmful substances

The Significance of DNA Fragmentation Test

The fragmentation test can determine what percentage of sperms has fragmentation. Less than 15 per cent of damage means an excellent outcome, while 16 to 29 per cent means a moderate outcome. More than 30 per cent damage means higher sperm fragmentation, which indicates difficulty in achieving a healthy pregnancy, even with IVF. High sperm DNA fragmentation level affects blastocyst development and there are higher chances of failed assisted conception treatment and miscarriage.

Sperm DNA fragmentation is higher in subfertile men with abnormal sperm parameters; however, men with normal sperm parameters can also develop sperm abnormality.

Embryos from sperm with highly fragmented DNA are likely to have a poor

prognosis. High level of DNA fragmentation could result in the initiation of natural cellular death (apoptosis) and abnormalities in the offspring.

Different kinds of Test for Sperm DNA Fragmentation

There are different types of tests available to assess the percentage of sperms with DNA fragmentation, such as the SCSA, TUNNEL assay and COMET assay. However, the test that has received the most attention is the Sperm Chromatin Structure Analysis (SCSA). (7)

Sperm Chromatin Structure Analysis (SCSA)

During the SCSA test, a special dye is allowed to enter the sperm cell, and the sperm is treated with a chemical. Generally, sperms with fragmented DNA take up more of the dye once it makes its way into crevices in the DNA molecule. With the help of a procedure called flow cytometry, the sperm that takes up lots of dye can be easily be differentiated from the sperm that takes up only a little dye (sperm with normal DNA). Finally, the percentage of each sperm with fragmented DNA can be graphed by using a computer program. A patient with a result of 8.2 per cent comes under the excellent to a suitable category, with 8.2 per cent of the sperm cells containing DNA damage. The SCSA test recommends that patients with higher than 25 per cent should skip IUI and go straight to IVF/ICSI for better results.

Sperm Comet Test

The sperm Comet test is a second-generation DNA test that provides unique information by measuring the amount of DNA damage in individual sperm. Sperm Comet results predict the success of infertility treatments and the treatment type most likely to succeed. This test detects the percentage of sperm with DNA damage. If the result shows 45 percent damage, it shows an average of 45 percent DNA damage in each sperm that was assessed. A flow cytometer is used to monitor a fluorescent probe that relates with the DNA molecule.

Advantages of Sperm DNA Fragmentation Test

Sperm DNA fragmentation test offers a consistent analysis of sperm DNA veracity that may help to find men who are at risk of infertility. It also provides information for clinical diagnosis, management, and treatment of male fertility.

Treatment of High Sperm DNA Fragmentation

The treatment of High Sperm DNA Fragmentation depends essentially on its causes. If the DNA damage is due to free radicals, lifestyle changes and a healthy diet designed to shield against oxidative stress may help decrease the levels of DNA fragmentation.

Male infertility refers to a male’s inability to get his wife pregnant with intercourse. Male infertility is caused due to low sperm count, premature ejaculation, sexually transmitted diseases, hormone imbalance, chromosomal defects, and problems with sexual intercourse. There are specific male infertility treatments such as IUI, IVF, and ICSI procedures.

Male infertility is a condition in which a man does not have sufficient levels of fertility, which ultimately leads to the lack of occurrence of positive pregnancy in the female partner. It is essential to know that male infertility is one of the primary reasons for a couple to opt for infertility treatments such as IVF, IUI, ICSI or TESA. If a male partner does not have an optimum sperm count, motility and morphology, then he is considered to have low fertility levels. 40% of the cases in which couples are not able to have their babies are due to male infertility only. Like every medical condition and disorder, male infertility also has a set of causes, which one must know to avoid whenever possible. Here are 16 major causes of male infertility, which lead to an increase in the cases of infertility in males.

1. Alcohol consumption and smoking

Alcohol consumption and smoking lead to a tremendous decrease in the fertility levels of males. It is usually thought that alcohol consumption does not have any negative impact on the overall health of men. But this is just a myth. In the latest research, it has been proven that alcohol and smoking have a negative effect on reproductive health and fertility levels in individuals. It is essential that one stops smoking or gradually reduces the frequency of smoking to restore fertility.

2. Emotional Stress

Stress is an inevitable part of the most of individuals’ life, which leads to different types of health issues from time to time. You will be surprised to know that stress leads to a reduction in the quality and number of sperm count in an individual. It also leads to a lower percentage of normal sperm morphology. When a man is under stress, the levels of cortisol hormone increase, which ultimately leads to the reduction in the production of testosterone hormone, a hormone necessary for sperm production. Although stress is unavoidable, you need to know that stress levels need to be controlled with the implementation of the proper steps and actions if you want to avoid the occurrence of male infertility.

3. Obesity

Excessive weight or obesity is a condition in which there is an unwanted accumulation of fats in the body of a human being. One needs to understand that being overweight not only has a profound impact on the overall well-being of the individual but also compromises male fertility levels in the body. It is found that sperm quality and health are poor in men who are overweight. Due to weight issues, the man finds it difficult to ejaculate properly. In this way, males who are obese or overweight face a lot of difficulties in having their kids.

4. Illicit Drug usage and consumption

A number of individuals are opting for steroids and medications to achieve an optimum level of fitness. Fitness freaks use an anabolic steroid to stimulate muscle growth and improve the strength of the body. These steroids lead to the shrinkage of testicles, and there is a significant decrease in sperm production. Also, when an individual consumes cocaine or marijuana, then there is a significant effect on sperm quality and numbers as well. Therefore, it is highly recommended to avoid illicit drug use as it can affect your testosterone levels in the body.

5. Chemical and heavy metal exposures

We live in an environment where different types of pollutants are present. These pollutants reach us and enter our bodies via food, consumer and industrial waste, and toxic chemicals such as toluene, benzene, xylene, pesticides, herbicides, and painting materials. It is important to know that these chemicals and heavy metal exposure affect our bodies in two major ways.

First of all, heavy metals get deposited in the most critical parts of the body, which include the brain, heart, liver, and kidneys, along with other parts of the body.

These chemicals and heavy metal exposure lead to the displacement of essential nutrients present in the body.

As these components stay in our environment through bioaccumulation, we cannot completely avoid them, but we can take the right precautions to prevent the harmful effects of these chemicals.

6. Overheating the testicles

Testicles are one of the essential parts of a man’s reproductive system. Testicles need to be at a temperature of 4 degrees less than the average body temperature. Men are constantly in touch with different elements and resources that lead to an increase in the temperature of testicles. Some of the environmental causes include cooking, grilling, hot tubs, saunas, laptops, smartphones, tight-fitting clothing and cycling excessively. So, one must keep a balance when coming in contact with the above environmental factors to prevent any kind of negative effects on the body.

7. Varicocele

Varicocele is the enlargement of veins in the scrotum. It leads to the increased temperature of the scrotum (skin portion containing testicles) of a man. Varicocele affects the quality of sperm in a negative manner. With every 1 degree of temperature elevation in the sperms and testis, there is up to 40% reduction of the sperm count. Also, around 40% of men are affected by varicocele. The best part is that varicocele is one of the most common causes, which can be reversed as well.

8. Sexual Transmitted Diseases (STDs)

There are different types of infections, which lead to increased chances of infertility in males. Some of these infections include STD’s, Chlamydia and Human Papilloma

Virus infections. These infections have a major negative effect on the reproductive health of men. Some of the infections like Chlamydia can also lead to permanent infertility in

men. Therefore, one must make sure to get them diagnosed and treated at the right time to avoid any severe consequences in the near future.

9. Ejaculation Issues

Ejaculation is the semen discharge from the penis after intercourse, which is followed by male orgasm. Ejaculatory issues are quite common in men, which needs to be diagnosed and treated at the right time to avoid piling up of problems in mental health as well as the overall health of the man. There are different health conditions which lead to ejaculatory disorders. This includes diabetes mellitus, excessive intake of medication, spinal

injuries, surgeries of bladder, urethra or even prostate.

10. Tumors

Cancers and tumors can sometimes affect the male reproductive organs directly. Prostate cancer is one of the common types of cancer seen in males these days. Cancer

in prostate stops the functioning of the prostate gland and the man suffering from it starts to have fertility problems. In some cases where cancer has already advanced to the last stage, various treatments are suggested to the patients such as surgery, radiation or chemotherapy to treat tumors, which can permanently damage the male fertility.

11. Undescended testicles

During fetal development, one or both the testicles fail to incline from the abdomen into the sac that normally contains the testicles. Such males can have fertility problems when they grow up. Undescended testicles can be due to a birth defect, premature birth or genetic defect.

TESA helps the couples to have a baby even when the male is suffering from NIL sperm count. Learn more about TESA, What is TESA (Testicular Epididymal Sperm Aspiration)?

12. Hormone imbalance

Hormonal imbalance and male infertility are closely associated with each other. Hormonal imbalance accounts for 10% of the total cases of male infertility. In the case of hormonal imbalance, the man suffers from low libido, abnormal hair growth along with erectile dysfunction.

13. Defects of tubules that transport sperm

Tubes carrying the sperms such as vas deferens can be blocked due to various causes, including injury from surgery, prior infections, and abnormal development, with cystic fibrosis or similar inherited conditions.

14. Chromosomal defects

Inherited disorders can also cause abnormal development of male reproductive organs. In some men, there is a presence of one extra X chromosome. This leads to chromosomal defects in men, which ultimately leads to abnormality in the chromosomes involved in the functioning and development of male reproductive organs.

15. Problems with Sexual Intercourse

Males having ejaculatory disorders and erectile dysfunction find it hard to have sexual intercourse, which ultimately leads to infertility. They might be suffering from problems such as trouble keeping or sustaining an erection sufficient for performing intercourse, painful intercourse, premature ejaculation, anatomical abnormalities or low sex libido.

16. Certain medications

Some medications including testosterone replacement therapy, long-term anabolic steroid use, ulcer drugs can lead to fertility damage unknowingly. Excessive intake of medications will lead to reduced quality of sperm production, thus decreasing male fertility levels. It is always advised to consult a doctor or an expert before starting any supplement or medicine.

In recent years, the demand for fertility treatments has increased to an appreciable extent, and so has the number of clinics and hospitals that offer specialized services related to this field. This has also led to the introduction of cost-effective fertility treatments to ensure that couples can afford the best fertility treatment ideal for their particular medical case. The costs of fertility treatments vary to a great extent due to certain factors like the extent of medical problem faced by a couple, type of treatment, location of the gynaecology clinic or hospital, doctor’s years of practice spent in rendering fertility treatment, past patient feedback as well as success rates for the respective treatment. The team at Archish Fertility has created a detailed list of the cost of the most commonly utilized fertility treatments such as IVF, IUI, Surrogacy, Laparoscopy, and Donor Egg to help you make a well-informed decision.

Here is the comprehensive table for the cost of various fertility treatments across

metropolitan cities of India. If your city is not included in the list, don’t worry—you can still utilize the fair treatment cost calculator to find the cost of fertility treatment in your city.

1. Cost of IVF

IVF (In-Vitro Fertilization), or Test Tube Baby, is one of the most demanded and highly searched fertility treatments across the world. If a couple is not able to conceive with the help of natural intercourse, then IVF is the first treatment recommended to the couple. The cost of IVF treatment depends on the success rate to a great extent.

This tabular information will help you find the required details about IVF treatment, including success rate and minimum and maximum costs. It also includes some of the top gynaecologists in India who excel in this field.

Most of these fertility experts have nearly a decade of experience in the field of IVF treatments. The IVF hospitals or clinics owned by these fertility specialists are well equipped with the latest technology and modern amenities important for effective outcomes. By taking help from this article, you can ensure that you choose the best gynaecologist and fertility specialist to solve your problems concerning infertility treatment.

2. Cost of IUI

IUI treatment is utilized in the case of patients who are unable to conceive naturally, yet their problem is not too critical to go for IVF. Moreover, IUI treatment helps the sperm

reach the egg in the woman’s reproductive system for a successful fertilization process and implantation in her uterus. It is highly utilized in cases of couples where IVF is not required, and just injecting sperm will suffice the requirement for a successful pregnancy.

The cost of IUI treatment varies considerably with the success rate. IUI specialists inform the patients regarding the possibilities of success rates before starting the procedure. This ensures transparency with respect to the costs and expected results prior to the commencement of IUI treatment.

3. Cost of surrogacy

If you are unable to conceive even with the aid of fertility treatments, then you have another option, which is known as surrogacy. Gestational surrogacy provides excellent results for couples who want to have their babies. You can discuss with your doctor and find the best surrogate mother with the assistance of a surrogacy agency or surrogacy clinic.

These are the costs of surrogacy, which alter with the success rates of the treatment and experience of the surrogacy specialist. You can refer to these costs and choose your fertility doctor for the surrogacy procedure.

4. Cost of Donor Egg or Donor Sperm

The egg or sperm count is compromised in many individuals due to various reasons. This makes it a necessity to choose a healthy egg or sperm donor for a successful pregnancy. You can easily find the required donor eggs or sperm from the fertility clinic. You can utilize these additional fertility treatments to make sure that you are able to conceive. The cost of a donor egg varies a lot depending upon the requirements of a couple.

You can utilize this information and plan to opt for the type of fertility procedure based on your requirements and the advice of fertility experts. You always need to make sure that you are discussing your expected cost and treatment requirements with your gynaecologist before finalizing the type of fertility treatment.

5. Cost of laparoscopy

Gynaecologic laparoscopy is a modern fertility diagnostic method used to detect medical conditions and functionality of the reproductive parts of the body. The cost of the laparoscopic procedure changes with the expertise of the gynaecologist and the location of the fertility hospital.

Thus, with a summary of the costs of various fertility treatments in India, you know what to expect when it comes to the cost and expenditure of any treatment. It is recommended that you utilize the above-mentioned information carefully and opt for the most suitable treatment type as required in your specific case. Laparoscopy is one of the most recommended procedures for understanding the reproductive parts and their functioning from time to time—some of the eminent laparoscopic experts in India. So, if you have been recommended to opt for the laparoscopy procedure, then you can read the above figures with care. This will help you to understand the costs of the laparoscopy procedure in India.

Sequential Embryo Transfer (SET) procedure is a process in which two sets of embryo is transferred to woman’s womb on different days at the time of menstrual cycle. The tips for successful sequential embryo transfer include healthy eating, stay active, take folic acid, and vitamin supplement.

One of the much-talked procedures, while one plans for IVF, is SET (Sequential Embryo Transfer). It has become a worldwide trend along with its strong foothold in India. But what it is? Why is it beneficial? Does this have a side effect on your regular IVF cycle? Browse the article to get all the answers.

What is Sequential Embryo Transfer?

Sequential Embryo Transfer is a common and popular technique used in In-Vitro Fertilization (IVF). In this technique, solid and created embryos are transferred twice to the mother’s womb, on day 2-3 and day 5-6; whichever is considered the best by your embryologist.

This is done to guarantee that the best and quality embryos get implanted in the uterus through the natural process of implantation.

Procedure for Sequential Embryo Transfer

• Under this procedure of Sequential Embryo Transfer (SET), two sets of embryos (day 2/3 and

day 5/6) are transferred to a woman’s womb within one menstrual cycle.

• The very first group of embryos consists of the rapidly growing embryos with good quality, which get transferred to the womb after 2-3 days of their formation.
• After this first batch transfer, the second group of embryos (5/6 days of life) is transferred to the uterus within a few days.

Also, learn about the Embryo transfer procedure utilized during a conventional IVF procedure.

• This second group of embryos is more mature than the first group and almost reaches the Blastocyst stage of their development.
• Normally, this sequencing is done to fetch more and more chances of
• As the second group of embryos is more advanced (Embryo development stages), they hold the extra advantage of attaching themselves easily to the uterine wall.
• This treatment is beneficial as the first group of embryos releases a hormone called ‘cytokines’ which replenishes the uterus and prepares the ground for better
• After one or more embryos are implanted, the extra embryos are cryopreserved for future

Is Sequential Embryo Transfer a really good idea?

SET or Sequential Embryo Transfer with IVF procedure demands for an extra cost. Also, as it is not a medically guaranteed procedure, it might not always help you in getting the desired result. The chances of IVF success through SET mostly lie between 30-40%. Also, you cannot trust all the IVF clinics or doctors, as not everyone is equally competent in carrying out the SET procedure with a guarantee. Moreover, it is a risky procedure, which might lead to multiple pregnancies and unexpected miscarriages.

Normally, from the patient’s point of view, SET seems to be a great idea as they are getting the best of both the sets of the transfer. Usually, a patient is happy after the first batch of the transfer only as they consider that the best will survive. However, as the later set of embryos are sent after the Blastocyst stage, they may harm the first set of embryos along with damaging themselves inside the uterus causing miscarriages and added trouble.

However, not all SETs turn into a mistake and there are a huge number of success rates of IVF with the SET procedure. It just takes an effort to get two or three good quality blastocysts rather than transferring them in bulk to fetch better chances.

Is sequential embryo transfer for me?

Sequential embryo transfer technology can be beneficial for you if you have suffered repeated implantation failures. The technique is known to increase the rate of implantation so you may discuss with your physician if they find you as an eligible candidate for it.

Essential tips for the success of embryo transfer

Embryo transfer is an important step in IVF treatment and although it is performed by the doctor and depends mostly upon their competence, you can do your part in making it a success by:

1. Carefully select your doctor:

Know that it is primarily the expertise and experience of the doctor on which the success of the IVF cycle depends. Make sure that you are in the right hands and under the care of the most experienced doctors to keep relaxed during the process.

2. Get multiple embryos transferred if you are above 40 years:

For women above the age of 40 years, it is advisable to have more than one embryo transferred at a time because of the fact that the implantation rate drops down after 35 years of age hence the number of embryos being picked up means better chances of success.

3. Take care of what you eat:

Eat as much healthy as you can with all the nutrients included in your meals. Have a diet that has vegetables, fiber, fruits and nuts in it. You do not have to essentially go after any specific diet plan while all you need is a healthy balanced diet.

4. Folic acid and vitamin supplements are a must:

Folic acid, along with multivitamins, is usually advised by gynecologists to women for a minimum of three months prior to the beginning of the IVF treatment. It is said to be crucial in reducing birth defects and can be taken along with other multivitamins with vitamin D and the rest of the B vitamins.

5. Stay active:

Staying in the bed right after the implantation may not be a good idea at all. Rather being physically active and going for walks can be beneficial for implantation.

How long does the process of embryo transfer take?

It would not take more than five minutes for this process to take place. Once the procedure is completed you are expected to lie down for another five minutes and a short briefing of the important instructions given before allowing to go home. However, you should be mindful of the fact that during sequential embryo transfer, there is more than one embryo being transferred into the uterus hence the time can be a little more as compared to a single embryo transfer. (9)

How long does it take to get pregnant after the embryo transfer?

Usually, during a natural pregnancy, it can take around six day’s time for the fertilization between egg and sperm to form a zygote and then subsequently an embryo. This embryo can further take 6 to 10 days to get successfully implanted in the uterus. If we talk about an IVF cycle, it can take up to 5 days for the embryo to get implanted and pregnancy to begin after the embryo transfer is done.

What are the possible setbacks of sequential embryo transfer?

Since blastocysts with high implantation potential are used in the process, all the embryos may end up getting successfully implanted in the uterus giving way to multiple pregnancies. So women undergoing this procedure are at higher chances of having more than one baby in a single pregnancy.

IVF treatment is performed to increase the chance of a woman to get pregnant. Factors affecting IVF success rates include age, previous pregnancy records, type of infertility problem, quality of donor eggs, and lifestyle. IVF process has high success rates if the patient is less than 35 years.

It is evident that IVF involves a great amount of emotional and physical stress for a couple hence it becomes important for one to have top-to-toe information not just about the procedure but crucial factors connected to it. The considerable emotional, physical and financial burden associated with infertility treatment in general and with In Vitro Fertilization (IVF) in specific, demand that factors known to affect outcome be identified and regulated prior to initiating the treatment.

This article addresses the factors which are responsible in determining the IVF success rate. Below mentioned factors are very important in evaluating the final success of IVF treatment.

• Egg and embryo Quality
• Receptivity of the Uterus
• Embryo Transfer (The “Rate Limiting” Technical Step)

Each of these factors are outlined in detail below:

The most beautiful and precious thing for the people in this whole world is their child. If we practically look at things, then the process of having a baby may seem quite easier. As it takes two heterosexual people to need to copulate that would simultaneously result in a fertilized egg. But this simple process is the hardest thing to achieve for some disadvantaged people. Some people face enormous difficulties in conceiving a child or some may have an infertile partner. Looking at the history, initially, we were not much advanced and didn’t have much resources and knowledge to treat these issues. But as technology is advancing day by day, things are taking a turn and we now live in a modern era that has a solution for almost everything.

With the development in medical science, doctors and scientists have invented many treatments that do not include physical intercourse between men and women to fertilize an egg. One of these treatments is In Vitro Fertilization, also known as IVF or Test Tube Baby. (4) But some people are either confused or hesitate to avail these services because they have fears and doubts like what if this treatment didn’t work out? What if this treatment is not safe? Here are some major factors that affect the success rate of IVF treatment:

Success Factor 1: Age of the Couple

If you are planning to get IVF treatment then you should first consider your age. Using your own eggs is an important thing in IVF treatment. According to sources and international research reports, younger women with good eggs in terms of quality and quantity showed higher success rates whereas in older women low quality and fewer eggs reduced the chances of a successful IVF treatment. Women who were under 35 and started an IVF cycle, out of them, 40 percent gave birth to a healthy baby. Additionally, in older women with age over or above 42, the success rate was only 4 percent.

Success Factor 2: Previous Pregnancy Records

If you had been pregnant before and it was with the same partner, who will be going under IVF treatment, then the chances of your IVF success rates are higher. Factors including recurrent miscarriages or a different partner may result in lower success rate.

Success Factor 3: The Type of Fertility Problems you are Diagnosed with

There are also some cases in which few male infertility issues do impact IVF success rates. For example, exposure to fibroid tumors or DES and uterine abnormalities may also lead to decreased IVF success rates. IVF success factors are majorly dependant on ovulation. Some ovarian dysfunctions including FSH levels that indicate very low ovarian reserve might lower the chances of IVF success rate. If you have been infertile for a long time then it may also reduce the chances of IVF success, whereas if the amount of time for which a couple has been infertile is not much, then the chances of IVF success are higher.

Success Factor 4: Use of Donor Eggs

Patients who are in their advancing age can have a depleting ovarian reserve and quality of eggs. It is observed that those opting for donor eggs are at higher chances of having a successful IVF cycle when compared to those who use self-eggs.

Success Factor 5: Your Lifestyle and Daily Habits

If you want to improve the chances of having a baby then you should stop smoking and drink right away. Women need to stop these habits at least 3-4 months before they start with IVF treatment. People who smoke a lot need a higher dosage of fertility drugs for stimulating their ovaries.

• Those who smoke regularly have lower implantation rates compared to non-
• Women who consume excessive alcohol may need more than one IVF cycle and they can also experience failed fertilization cycles.
• Women who are overweight or obese also have increased chances of miscarriage and
• Women who are underweight also have low chances of IVF To increase the chances of pregnancy you need to maintain an ideal weight and maintain a healthy lifestyle which means daily workouts and proper intake of fruits, vegetables, nuts and cereals.

Success Factor 6: The Type of Clinic you Choose for IVF Treatment

If you do not want to risk the chances of your IVF success rate then you should review the IVF centers on the basis of these factors:

• The reputation, experience of other couples with the IVF clinic and its staff
• Live birth rate per IVF cycles
• The ratio of patients who are pregnant with multiple children
• The laboratory that is used by the clinic to perform IVF treatment and the qualification and experience of their staff

Success Factor 7: Experience and Qualification of the Embryologist

An embryologist is a specialist who is responsible for the preparation of the gametes (sperms and ova) for the process of fertilization. He is the one who monitors the developing embryos obtained after fertilization. He also carries out certain additional sophisticated procedures like Intracytoplasmic sperm injection (ICSI) or Testicular Epididymal Sperm Aspiration (TESA) or assisted

hatching for achieving better results. An embryologist with great experience and high qualification will have the expertise to perform these processes with perfection.

Success Factor 8: Air Quality During the Process

The air inside the laboratory has to be pure and free from any kind of microorganisms like fungi or bacteria as it can threaten the growing embryos. Heating, Ventilating and Air Conditioning (HVAC) units that have charcoal filters, as well as high-efficiency particulate (HEPA) air filters, are a must to provide the high-quality air in the room.

Success Factor 9: Temperature and Light

Temperature and light have a special role during the initial stages of the embryo development where ideal temperature condition and filtering away of ultraviolet rays are important to ensure safety from the damage.

IVF is a significant decision of a couple’s life that has the potential of bringing a life-changing turn in their lives. Not only money-wise, but it is an investment that cost them at every level hence one must be well-prepared and informed about the success factors to enhance their chances to the best.