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We are doing Blastocyst transfer and results improved to 65 % implantation rate

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  • Intracytoplasmic Sperm Injection in Frozen thawed oocytes

    ICSI, Frozen thawed oocyte Since its advent in 1992, ICSI has become used routinely in the vast majority of IVF units and has been found to be a safe and effective means of treating male factor infertility. ICSI has proven to a powerful tool in overcoming severe male factor cases which, prior to ICSI, treated [...]

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Intracytoplasmic Sperm Injection in Frozen thawed oocytes

ICSI, Frozen thawed oocyte

Since its advent in 1992, ICSI has become used routinely in the vast majority of IVF units and has been found to be a safe and effective means of treating male factor infertility. ICSI has proven to a powerful tool in overcoming severe male factor cases which, prior to ICSI, treated with donor sperm. Although there has been conflicting data regarding the efficacy of ICSI in preventing or minimizing total fertilization failure ( it is condition, in conventional IVF, where we put eggs and prepared sperms in a dish to meet each other spontaneously, a natural process takes place in human fallopian tubes….and not a single sperm enters into any egg, or there is no fertilization). It happens in couples with unexplained infertility. The application of ICSI has been successfully extended to assisted reproduction techniques cases that involve sperm retrieval for either obstructive azoopermia or non-obstructive azoospermia. ICSI is also recommended in order to fertilize cryopreserved-thawed oocytes. Furthermore , ICSI is preferred in cases of pre-impantation genetic screening/preimplantaion genetic diagnosis in order to eliminate the risk of polyspermy that otherwise may affect the genetic make-up of the resultant embryo

 

 

communication with french speaking couples

My French communication (most common) with my French speaking couple

Salut,
Merci pour le message.
Je parle peu le français et peux comprendre aussi….
J’ai beaucoup de couples francophones, qui m’a appris la langue française.
Je vous souhaite la bienvenue à ma clinique avec des salutations.
Ce sera mieux si vous pouvez me mail à dpankar@idealfertility.com ou dpankar@rediffmail.com.
Je trouve facile de répondre par e-mail.
se sentir libre de communiquer S’il vous plaît.
Avec mes meilleurs vœux
Dr.D’Pankar Banerji

Going Public with all the informations

Fetus Day

FetusCon2016
Fetus day(31oct) Celebration, Jabalpur MP
Organized by:
Banerji Research Foundation
In Association with JOGS and IRIA(Jabalpur)
Endorsed by :Society of Fetal Medicine
Venue: Hotel Gulzar, Madan mahal road, Jabalpur
Date : 6.11.2016
Time: 9 am to 4pm
Session 1 : Genetics: 9 am to 11 am
1. Basic Genetics for non geneticists, How to apply Genetics in clinical practice: Dr.D’Pankar Banerji , 20 min
2. Advances in Genetic testing in care of the unborn fetus : Dr.Ratna Dua Puri, New Delhi, 20 min
3. Non Invasive Prenatal test-Current scenario ,What to know and what not to know:  Dr.Ratna Dua Puri, New Delhi, 20 Min

4. Case presentation with panel Discussion, cases form participating Obgy and Paediatricians are taken: 60 minutes, Dr.Ratna Dua Puri, Dr. Preeti Parekh Tomar, Dr.D’Pankar Banerji
Session 2: Obstetric sonography and Fetal Monitoring : 11.15am to 1.30 noon

1. What you should know when managing a Twin pregnancy: Dr. Mayank Choudhry, Ahmedabad
2. Optimizing outcome in Fetal Growth Restriction: Dr.Chanchal Singh, New Delhi
3. Placental sonography standarization : Accreta, increta and percreta., Dr. Mayank Choudhry, Ahmedabad
Lunch: 1.30 to 2.00pm
Session 3 : Live demonstration/ Lecture: 2pm to 4 pm
1. Fetal Neurosonography: Dr.Mayank Choudhry.

 

2. Screening for congenital heart disease in routine scan: Dr. Chanchal Singh
3. Basics of color doppler imaging of uterine artery in Pre-eclampsia:Dr. Sneh Choubey, Jabalpur
4. Evaluation of Umbilical artery, Middle cerebral artery , ductus venosus : Dr. Preeti Parekh Tomar, Indore

IVF treatment in Endometriosis

Endometriosis is a common gynecological condition that affect approximately 10-15% of the female population.

Endometriostic ovarian cysts may be present in up to 20-40% of women with endometriosis scheduled for IVF and on both sides in 19-28% of the cases.

The best medical approach to treat endometriotic ovarian cysts is controversial, as it may delay the fertility, the lady desires.

Should we remove the endometriosis by surgery is matter of debate.

With surgery , there are great chances that it may affect the ovarian reserve and impairs the responsiveness to treatment, and also does not offer any additional benefit in terms of fertility outcomes.

In addition, surgery is great risk to women, as it is mostly a complicated surgery.

The laparoscopic removal of bilateral endometriomas prior to IVF should be limited to those cases with normal ovarian reserve, presence of pain symptoms, rapid growth or sonographic features of malignancy.

Conversely., in the absence of the above-mentioned features, patients with bilateral endometiomas should be encouraged to proceed directly to IVF to reduce time to pregnancy, to avoid potential surgical complications and to limit costs.

The retreival of oocytes may be less in endometriotic cases, compared to normal, but the quality of oocytes may be same and pregnancy rates may be comparable, if lady goes for IVF as early as possible, when all conservative approaches are exhausted

IVF in India

Recurrent implantation failure may identified after three failed IVF cycles or after transfer of 10 high grade embryos. There are many different factors which may contribute for this recurrent IVF failure, such as parental chromosomal translocations, abnormal uterine anatomy , hydrosalpinx, or inadequate  culture conditions or embryo transfer techniques.

Failure may be due to factors with the “Seed,Soil or the Cultivator”

Some studies have suggested that local injury of the endometrium by means of a catheter or hysteroscopy can induce an inflammatory response that may facilitate the preparation for implantation.

Artificial rupture of the covering of the embryo ( Zona pellucida) may improve implantation: Assisted Hatching, but is still not proved.

Pre-implantation genetic screening of the embryos is now a day used to get and select best embryos. But this strategy did not show any improvement in patient outcome  and did not show any significant difference on clinical pregnancy rates.

A few studies have reported that congenital and acquired prothromotic conditions are more prevalent in women with recurrent implantation failure. Therefore use of low molecular weight heparin (LMWH) and mini dosage of aspirin on patients with thrombophilia and recurrent implantation failure has been discussed, but large studies are required to prove them .

Finally, another possible strategy is to extend embryo culture to blastocyst stage, aiming to improve embryo selection and uterine receptivity

INTERNATIONAL FETUS DAY: 31ST OCTOBER

we dedicate 31st October to the Fetus, the most important person, a unborn patient

This year we are going to celebrate this day as a scientific conference on the next next sunday of the fetus day in 2015

Blastocyst transfer and Time lapse technology

Time lapse technology / morphokinetics in Embryology

 

Reading all the literature and references I come to a conclusion that , the end point of any Time lapse technology in embryo culture is getting a blastocyst, or blastocyst is the end point if any Time lapse technology , may be it Embryoscope or something else.

As we are doing 100 % blastocyst transfer since 8/9 years , if we get a day 5/6 blastocyst for particular couple, then it is obvious that this embryo is competent enough to reach that stage. It is survival of the fittest.

The problem occurs when the centre transfer day 2/3 embryos. There may be multiple embryos on day 2/3, but which is going to survive ,very difficult to assess. All may look similar, but when they are put to the challenge to make their own food and survive onwards without maternal support ( called embryonic genome activation), then many of them wither. As they look similar, the clinician “may” transfer the withering one. Here, the Time Lapse technology helps to select the best one ,which “may” survive. But looking at the high cost of Time lapse, I feel blastocyst culture is easy and quite cheaper, and top of that, we are transferring the end point .

” The Mother Nature also selects best quality day 5 embryo.”

If we don’t get the blastocyst, then this cohort of embryo are genetically poor or aneuploid, and even though they are good at day2/3 ( in Time Lapse/ or regular incubator, ) they are not going to survive. The patient may see the embryo transfer occurred , but it fails. So when we don’t get any blastocyst on day 5, we defer it and tell the couple about the event ( Not a very easy task for  any IVF clinic)

Day 5 Embryo transfer

Day 5 embryo transfer


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