For generations, there was little that doctor could do to help subfertility couples especially where male factor was involved (disorders of sperm production).However in the last few years there has been major break-through in the treatment of male subfertility in the form of intra cytoplasmic sperm injection (ICSI). Till recently solution of stubborn cases of male subfertility was adoption, now they can be treated successfully by this method.
This is the technique in which single sperm (male germ) of the husband injected into the wife’s egg. Up to 3 eggs which are fertilized by ICSI are transferred to the female uterus (Embryo transfer) Pregnancy rate with ICSI in similar to in IVF.
Couples with following problems can be helped with the technology:
- Very low sperm count (oligospermia)
- Very low sperm motility
- Failed fertilization in conventional IVF
- Obstructive azoospermia (absence of spermatozoa due to obstrucaton)
- Repeated IUI Failure
Chance of success are about 40% however in any given couple chances of success depend upon various factors among which quality of semen and egg of wife are important example. The success rate of ICSI/IVF seems to be low but one should bear in mind that in absolutely normal couples the possibly of achieving a pregnancy in any given cycle in one in six to one in nine.
From medical point of view there in no limit on the number of attempts but one has to take into consideration emotional and financial stress involved in this treatment.
1. Preliminary check up of husband & wife
2. Baseline hormone levels of wife
3. Drug treatment (injections) to encourage egg production & maturation
4. Ultrasound monitoring of treatment
- To measure the growths of follicles
- To adjust dose of drugs
- To prevent serious side effects (ovarian hyper stimulation syndrome
5. Monitoring is carried out:
- By trans-vaginal ultrasound scanning (TVS)
- By measuring hormones in blood
6. Egg pick up (OPU)
7. Semen collection & processing.
8. ICSI:- Single spermatozoa (male sperm) is injected into egg under special (ICSI) microscope with micromanipulator. Egg collection, Semen processing & sperm injection is performed on the same day
9. injected eggs are incubated in culture medium under special environment transfer (Incubator)
10. Embryo transfer (ET). After two to three days of sperm injection if fertilization takes place then 2-3 fertilized eggs (embryos) are transferred into the uterus (womb). This procedure normally does not need any anesthesia or sedation
We strictly use husband’s spermatozoa (male sperm) and wife’s egg. Donor’s sperm, egg and surrogacy facilities are not available in our clinic.
Risk of malformation is slightly more than natural pregnancy. If there is a family history of malformation then the risk is higher, Millions of normal babies have been born in the world with the help of his technology.
Our team of consultants / doctors will carry out various procedures under supervision of Prof. Rashid Latif Khan.
If you wish all procedures may be conducted by female doctors only.
Pregnancy test can be performed after 2 weeks of embryo transfer.
You may leave Lahore one day after embryo transfer.
Patients are strictly monitored during treatment to avoid OHSS but there are 2-3% chances of OHSS, the risk of OHSS in PCO’s is higher.
There is slightly higher risk of ectopic pregnancy with IVF/ICSI as compared to spontaneous pregnancies.
Semen can be frozen in the cryo bank at LIFE at any time. There is additional charge for this procedure. Frozen sperms can be used in future and the results are equally good.
There are no chances of ovulation before retrieval as patients are given medicines to prevent ovulation and monitored very closely.
There are no serious side effects, slight headache, tiredness, weight gain are occasionally reported, Long term side effects are rare.
Injection can be taken at any time but the same timing should be followed strictly every day (injection should be taken at the same time daily).
Injection should be kept in refrigerator as maintenance of cold chain is necessary and during traveling drugs and injections should be kept in cool box. Please bring cooler to take away injections.
Yes, you can continue your routine work / job. Such activity does not influence the outcome of your treatment.
Egg pickup is ultrasound guided procedure. Follicles are aspirated with the help of a fine needle. This is non-surgical procedure and takes 10-15 minutes No hospitalization is required. Consultants / doctors who are members of the team performs this procedure. Generally this procedure is carried out without anesthesia. However anesthesia may use on request.
It takes only 10-15 minutes.
No it is not painful it is carried out under I/v sedation.
No it doesn’t cause any damage to the ovaries.
No it is not expected but very rarely there may be spotting or slight bleeding .
It is generally recommended to puncture all the follicles.
Embryo transfer is not a painful procedure. It is free of pain.
No extra rest is required after ET. Routine work can be carried out the period day after embryo transfer but hectic activity should be avoided.
Travelling after egg pickup is safe after 3-4 hours of rest.
Car is the safest way to travel but by bus or train doesn’t harm.
If it is severe in intensity you can have pain killers after OPU. You may also call or contact us or visit labour room any time of necessary.
Yes, you can offer routine prayers in a sitting position.
Assisted hatching is done in some cases fo1 example in women aged 38 or more, thick zona (oute1 coating) and previously failed IVF cycles.
Itching and vaginal discha1ge are reported but rarely.
If you have missed a dose, inform your doctor. She will adjust the next dose accordingly.
Try to purchase from your city. If they are not available then contact LIFE as soon as possible.
Sometimes ovaries don’t respond even after high dose of injections. This may be due to age or poor ovarian reserve. In such situations the treatment has to be stopped.
It is due to the possibility or empty follicle syndrome (LUFF) 1n which eggs are not formed even if mature follicles are seen, but it is very rare. However, not all follicles contain an egg.
It is not necessary but the risks are there.
There are multiple reasons:
- Poor egg quality
- Poor sperm quality
- Immature eggs
No damage is done but during thawing some sperms may not be active to achieve fertilization. Similarly the quality of egg or embryo may not be good enough to achieve a pregnancy.
Yes if after thawing sperm quality is not good, but the risk of this situation is uncommon.
Embryos can remain frozen for years, there is no time limit as yet, but you will have to pay some charges on a yearly basis otherwise they will be discarded. Remember to notify the clinic if your contact details changed.
No, duration of frozen embryo storage has no effect on its survival.
There is no such report in the literature.
You can have pain killers, if no relief then you may come to labour room any time for further consultation.
Take plenty of water and consult your doctor.
You can send your morning urine sample or have blood test in our lab.
Yes, you can, we will teach you how to administer it yourself. You have to take these injections at the right site and have a fixed timing schedule.
It is important that you should be punctual as it may affect your treatment and your waiting time. This treatment needs exact timing otherwise the results are not good.
Yes, these are screening tests for hepatitis, HIV, and Flabella and some hormone test i.e. FSH, LH, Prolactin, and estradiol.
For the first 24 hours take care of fluid intake and have soft diet such as yogurt with banana and rice porridge. If the condition persists then contact a physician and tell him that you might be pregnant.
Take steam inhalation and avoid allergic items.
You may use Vaseline or some cream on the vulva. Don’t insert cream inside the vagina.
He should reduce smoking and drinking as they can influence sperm morphology and motility and chances of success.
It is strongly recommended by the Islamic Ideology Council of Pakistan. They have declared and approved the practice of this technology provided the treatment is restricted to husband & wife and there is no third party participation (no donor egg. sperm etc.)
Yes, egg and sperm belong only to the wife and husband. No third party is involved. In our lab, we ensure by color coding and other methods that there is no mixing of egg and sperm. They only belong to husband & wife. Routinely there is a double check at every step.
Technically there is no limit on the number of attempts, however, each new attempt costs the same as the last attempt. We recommend at least a month between cycles to let your body recover.
Eggs, sperms, and embryos can be transferred to other labs in special Cryostorage Transfer Vessels. However, the clinic does not accept any responsibility of damage to the gametes or embryos.
Prior to your cancer treatment cryopreservation of sperm and eggs is available at our center for future use, but this can only be done before taking any cancer treatment.
Yes, routine light exercises can be performed (walking). Stressful and vigorous exercises should be avoided.
Herbal coloring is allowed, preferably chemical coloring should be avoided.
Short distance travel by car or bus is allowed but you should remain in touch with the clinic and doctors for any advice.
Yes, there is no harm in gentle coitus during treatment. After embryo transfer, it should preferably be avoided for the first 12 weeks of pregnancy.
You can have your initial tests done in your home town but 4-6 visits are still required and the stay in Lahore could last up to 5 weeks according to your protocol and progress.
He should visit the center at least once prior to the treatment, as he will deposit his sperm for cryopreservation and future use in IVF treatment.
Each ovary has millions of eggs. We shall retrieve a few eggs from man follicles, this will not damage your ovaries. Your ovaries will continue to function as normal after the treatment.
Yes, semen samples can be brought from home. It should be brought within 30-45 minutes to the laboratory in a special container which you may get from our laboratory. In such a situation the responsibility or ownership of the specimen rests with the couple.
Consult your doctor and if he/she allows you to take IVF / ICSI treatment then you can start treatment and continue your medical treatment as well.
You should first get a clearance certificate from your consultant physician to start treatment (IVF/ICSI). Your own health is important for yourself and your baby.
There is no special food or rest which can improve the chances of success.
Yes, you can climb stairs carefully and slowly without any harm.
Frequent traveling is not recommended buy you may travel to your home town the next day of ET and continue your routine job.
You can request freezing of extra embryos for future use, Otherwise, they will be discarded. Freezing of your extra embryos will be charged separately. However, not all embryos are suitable for freezing.
Preferably the treatment cycle may be repeated after 2-3 months of failed cycle.
Repeat semen analysis report from a good authentic laboratory. If the report is the same then get his FSH tested. If the FSH test is normal then FNA may be performed to confirm the availability of sperms.
Consultation with urologist/andrologist is required to plan future courses of action
Not in Pakistan. However, in some countries it is available. You may confirm in your country of residence.
The possibility of multiple pregnancies with IVF is higher but it is not guaranteed.
When proper blood flow starts during the day it is considered as 1st day bleeding starts at night then the next day will be counted as 1st day.
Yes, we maintain strict confidentiality.
It is advisable to use a commode but it is not mandatory.
Contact our accounts office, they will inform you about the mode of payment but you will have to pay all dues before the start of the treatment.
Yes, we have special packages for non-affording and poor patients (Zakat Donations).
Yes, but you pay separately for the drugs used in your treatment.
Yes, relax and pray for your success.