General advice for young couples planning for a Family

"Prevention is better than Cure" - this saying must be applicable in sub-fertility problems as well.

Avoid smoking
Passive smoking in women is known to be associated with delayed conception.

Avoid Alcohol
Avoid totally, if one can. For women, more than 2 units/week is detrimental.

Body weight
Try to be within the healthy range BMI(body mass index) of 20 to 25. (BMI = Body weight in kgs/height in meters squared (for eg: wt is 76 kgs and height is 1.55 mt BMI = 31.6)

Men's underwear
Temp. of the tests must be lesser than the body temp. If one wears tight fitting underwear made of synthetic textile, temp inside the scrotum goes up and that is known to be detrimental for sperms. Hence, one should wear moderately fitting underwear made of 100% cotton fabric.

Woman is most fertile in her twenties
Remember that biological time clock is ticking non-stop. Medical technology can not halt this. This fact should be kept in mind before planning for a family.

Timing and Frequency of Intercourse
Woman is fecund around the time of egg release which happens around 14th day in a normally cycling woman having a 28 day cycle. It is a known fact that in men more than 5 days of sexual abstinence will leave many of the sperms dead. Hence, it is advisable for the couple to have intercourse from 5/6th day of menses up to 9th day (to empty the old stock of sperms) and abstain for about 3 days (to let new sperms be generated). They can have intercourse from 12th day onwards every alternate day at least to cover the released egg. Sperms are viable in women's body for about 24 to 48 hours

Other Advices for Healthy Lifestyle
One should avoid surgical abortion and not undergo this at the drop of a hat. The inner lining of the uterus may get irrevocably damaged during surgical evacuation of uterus for removing products of unwanted conception. It is much safer to have medical abortion well within time using medicines.

For Infertility diagnosis, we strongly discourage curettaging the uterus to know the ovarian cycle status and activity. Nowadays, with Blood tests for FSH, LH, Progesterone and the availability of ultrasound scan, ovarian status can be assessed. Using hysteroscopy, Hysterosalpingogram (HSG) and laparoscopy, one can avail information about the health of the endometrium. In cases with suspicion of uterine tuberculosis, there is a need to curette the uterus for culture and histology examination. Especially repeated curettage damages the endometrial basal layer irreparably.

One should be aware about the occurrence of HIV and STD's (Sexually Transmitted Diseases). While for HIV, prevention is the only way out as there is no cure. STD's through medically treatable, may cause damage to the reproductive system. STD's like Chlamydia/Gonorrhoea can cause blockage of tubes and damage the lining of the womb making the women subfertile. So we emphasize that all preventive measures should be taken to avoid STD's and timely treatment in early phases can avoid infertility.

The Advantages of Cryopreservation of Embryos
For a woman undergoing IVF/ICSI, it costs approximately Rs 75000-1,00,000.The chances of success vary from ~20-40% depending upon the quality and other parameters. Mostly, a woman of about 30 years age, produces 9-12 embryos on an average, of which 2-3 are normally transferred back into her uterus in any transfer cycle. If such fresh IVF/ICSI treatment cycle fails, she has to undergo the routine rigmarole of pain and the expenses of producing the embryos all over again. But no more such agonising problem after the availability of Cryopreservation Facility in an IVF center.


If a woman produces, let us say, 10 embryos in her IVF/ICSI cycle, she would have wisely cryopreserved 7 of her embryos which is enough for 2 more cycles of embryo transfer and the chances of her getting pregnant with such frozen-thawed embryos is as good as with fresh embryos. It makes enormous economic sense to cryopreserve all the surplus embryos for subsequent embryo transfer cycles. Mind you, cryopreservation does not cost much. It costs Rs 15000 only for upto 4 embryos in Baheti Hospital. If more embryos are frozen cost increases by Rs 5000 per 2 embryos. Cryopreserved embryos can be utilized within one year from the date of freezing. However, the storage of any remaining embryos can be extended by paying applicable maintenance fees every year. 


The science and art of cryopreservation has been developed and refined since the time of introduction and the success rate has greatly improved after the regular use of fast freeze technology called Vitrification.


Let us see the benefits of cryopreservation for any 100 patients. For every 100 couples undergoing IVF/ICSI, 30 could be expected to get pregnant in their fresh IVF treatment cycle. Of the remaining 70 who failed in their first attempt, 42 will have enough cryopreserved embryos from their last cycle. With a survival rate of >80% after thawing and a pregnancy rate of 25%, another 11 patients can be expected to get pregnant with frozen thawed embryo transfer cycle. Again some of the failed patients (15) may have still enough embryos for one more cycle of embryo transfer. From which 4 more patients can be expected to get pregnant. Hence, with cryopreservation the chances of achieving a pregnancy have increased by 50%. The main advantage of cryopreservation is that frozen thawed embryo transfer cycle treatment is not as expensive as any stimulation cycle for IVF. Because this time the treatment aims at preparing a good bedding for the embryo to implant in the uterus of the patient with simple hormone tablets or pessaries or daily injections without any need either for intensive follicular monitoring or serum hormone monitoring.


After reading this article, one would see immediately the benefits of undergoing IVF/ICSI treatment in any IVF unit with cryopreservation facility.


Cost Comparison of Fresh Versus Frozen thawed ET

Procedures in USA(1995) in Baheti Hospital
Fresh IVF US $14316 Rs 45000
Hormones US $1826 Rs 30000
Freezing US $500 Rs 15000
Frozen ET cycle US $1582 Rs 20000
Cost per IVF Delivery US $ 44200 --
Cost per IVF Child US $30900 --
Cost per Cryo Delivery US $8215 --
Cost per Cryo Child US $12857 --

 

IVF - A Dream comes true for Infertile Couples
Medical Science has answered the prayers of almost all the so-called infertile couples. There are hardly 1-3 % of the couples, who are beyond the realm of Assisted Reproductive Technology Treatment, the proof of which lies in the birth of more than a million test tube babies (1.3% of all live births) so far in the world.
Can a person without sperm in his semen father a child?
Men who do not have a sperm in their semen can also plan to achieve fatherhood, if some sperms can be found in their testes.
Can a woman who does not get her menses manage to achieve motherhood?
Women with hypogonadic ovaries will not get menses on their own. But their ovaries can be persuaded hormonally to release eggs and get menses to achieve motherhood.
What is Infertility?
When a couple is in conjugal relationship for a year or two without getting conceived is a sign of infertility. But remember infertility is simply a disease and not a CURSE any more. Get your infertility treated as you would do for any other disease. Babies originate from embryos, which again, are formed from the union of an egg and a sperm. Woman produces only one egg every month at a particular time in her menses cycle. That egg remains fertilizable by sperm for about 24 hours only. A woman is fecund only in that period. This is invariably in the middle (14th day) of a normal menses cycle of 28 days.
How many are infertile?
This answer will put the problem in perspective. It is understood that 84% of women would conceive within one year of marriage; 92% in two years and 93% in after three years. Which means, some 5-15% of the married couples are facing this problem at any given time in a society.

Women      

Treatment

     

Men

     

Treatment

 

Blocked Tubes not correctable by surgery

 

IVF is the ONLY choice

 

Less number of Motile Sperms (10 million min)

 

Insemination or IVF

     

IVF is the ONLY choice

 

No Sperms at all in Semen

 

Sperm from Testes & ICSI

 
 

Hypogonadism

 

Medical Treatment

 

Weak sperms but enough in number

 

Insemination or IVF/ICSI

 

PCOS

 

Medical Treatment & IVF Optional

 

Severely low sperm numbers

 

ICSI

 

Antibody problems

 

IVF

 

Ejaculation problem

 

Insemination & IVF Optional

 

Premature Ovarian Failure

 

IVF with donated Eggs

 

              

 
 

Anovulation

 

Medical Treatment & IVF Optional

   
 

Endometriosis

 

Medical Treatment & IVF Optional

   
 

Cervical Mucus Problem

 

Insemination or IVF

   
 

Antibody Problems

 

IVF with ICSI

   
 

Other Pelvic Inflammatory Disease

 

Medical Treatment & IVF Optional

   
 

Unknown Cause > 3 years Infertility

 

IVF or ICSI

   

 

Is Infertility on the increase in society?
At the outset, it would appear so. There are so many reasons for this. Our lifestyle changes, late marriages, career options, educational ambitions are all responsible, but we can’t help any of the above mentioned factors.
Why am I Infertile?
Infertility can be caused by the any or all of the following reasons and the treatment options are given below for women and men separately. Sometimes, the cause may not be diagnosable (unexplained). Many a times, it is due to a combination of all.
What is Normal Semen Analysis?
Normally man has about 40 to 100 million sperms in semen. WHO has found that 20 million sperms with 50% motility as the requirement for natural conception to occur. Anybody whose count is consistently lower than this may require ART procedures.
Why is this IVF treatment expensive?
Because, women needs to be injected with costly hormone injections to make her ovaries to produce more number of eggs which can be collected and use them to produce embryos in the specially equipped laboratory.
Why are so many blood tests required during IVF treatment?
The Doctor needs to closely monitor the progress of the growing eggs so that dose of Injection can be adjusted accordingly.
What tests are required before starting the IVF treatment?
Tests for Wife:
* Serum FSH, LH, PRL, TSH, Anti Chlamydia IgG/IgM, Rubella IgG, CMV IgM, HBsAg, VDRL & HIV 1&2 (6 months validity)
* Hb, BTCT, Blood Group, Random Blood Sugar if there is no Family History of Diabetes
* In case of family history of Diabetes, Fasting Blood Sugar and 2 pp Sugar
* In case of history of Koch\'s, Mantoux test report.

Tests for Husband:
* Semen analysis & Culture
* Serum FSH, LH and Testosterone in cases of Severe Oligozoospermia (low count), HBsAg, VDRL, HIV 1 & 2 (6 months validity)
Why is laparoscopy required before Assisted Reproductive Technology treatment?
Don\'t you agree, knowing the cause of the problem amounts to winning half the battle. After all, only one egg is released from both the ovaries every month which need to be caught and transported into the uterus by the ultra small fallopian tubes. If there is block here, how can sperm meet with an egg? If there is some uterine pathology also, fertilization and further development of embryos are jeopardized.
Why increasing age of woman is a negative factor for the success in ART?
The number of eggs that a woman is endowed with is finite and fixed. The moment she gets menarche, she starts losing them. They can not be replenished in her life. Besides, the chromosomal pattern inside her eggs starts getting distorted slowly and steadily so much so that by 43 years of her age, almost 85% of eggs are aneuploid (chromosomally abnormal). Around 35 years of her age, the egg quality starts declining drastically. Women are highly prolific in her 20s and up to early 30s.<

How Age Effects Fertility ?


Delaying pregnancy seems to be a common choice for women in today’s society.  The inverse relationship between age and female fertility has already affected the birth rates acutely in developed countries.  But even Indian females especially in urban areas seem to be following western practices.  At least 20% of women wait to begin their family until after the age of 35.  There are various reasons for delaying childbirth like waiting till a career is established, waiting for a stable relationship, wanting to achieve financial security, or having to support the family as a primary concern and sometimes even waiting for a miracle to happen despite knowing that there is a defect in either partner.
It is important that women realize that fertility starts declining in early Thirties, drops gradually in mid-thirties, finally falling drastically after the age of 40.
The biological fact is, as the woman ages the eggs in her ovaries also age, making them less capable of fertilization by sperms.
Ageing just doesn’t affect women; it affects men too; but not as abruptly or noticeably as in females. There is no maximum age at which men are not capable of conceiving a child. Men who maintain good health may not experience significant changes in sexual functioning as they age. If a man does have problem with libido or erections, there are treatments available. It has been scientifically proven that it is not the quality of the sperm but the age of the woman and the quality of her eggs that determines the outcome of the pregnancy.
How does the age of the woman lower her fertility? By the time a woman is nearing 40 she has had more time to develop the gynaecological problems like pelvic infections, endometriosis and fibroids.  The current trend in the young women today of preferring fast food, frizzy drinks and alcohol to normal healthy diet and sedentary habits further upset their oestrogen metabolism and can cause weight gain leading to problems of ovulation.  The second more important factor is that there is continued increase in the risk of chromosomal damage as the woman ages. Disorders like MONGOLISM (DOWNS SYNDROME) are more common in children born to older women. When eggs with chromosomal problems are fertilized, they are less likely to survive and grow. T his is why women around 40 are at increased risk for miscarriage. Unfortunately there is nothing that a woman can do to prevent the age –related decline in the egg-quality.
It is advisable that a woman more than 36yrs seeks advice of a physician as well as a genetic counselor to know about her chances of conceiving a successful pregnancy. She can choose to have prenatal genetic testing if pregnancy is achieved. Chorion –villous biopsy and amniocentesis are two methods of prenatal testing.


Risk of Chromosomal Abnormality in Newborns by Maternal Age

Source –“Maternal Fetal Medicine- Practice and Principles” (1994)

 

  Maternal Age
(years)

Risk for down Syndrome

Total risk for chromosomal  abnormalities

20

1 / 1600

1/525

25

1/1200

1/475

30

1/950

1/380

35

1/375

1/190

40

1/100

1/65

 45

1/40

1/20

49

49

1/8

 

Risk of miscarriage with increased age

Source – “Reproductive potential in the older woman”

 

Maternal Age (yrs)

Spontaneous Abortion (%)

15-19

9.9

20-24

9.5

25-29

10

30-35

12

35-40

18

 40-45

34

more than 45

53

Women with medical problems like raised blood pressure and diabetes should have them well controlled prior to attempting pregnancy. Their physician may suggests a change in the medications or general health-care.
Modern infertility therapy offers a woman many more options than were possible in the past. However these treatments may have significant financial, emotional and social demands. When traditional treatments have failed or infertility remains unexplained, assistance in achieving pregnancy can be attempted by advanced treatments like intrauterine insemination or in-vitro fertilization (test-tube baby).
Treatment options are limited for women over 40 or for women with early menopause. Eggs from a younger donor fertilized by patient's spouse can be transferred after in-vitro fertilization to these women. In case of women who have no ovarian function due to previous surgical removal or treated Cancer resulting in premature menopause, this treatment offers the only chance of pregnancy. The process of egg donation can involve a relative or a friend or an unknown donor. The child will not be the genetics offspring of the recipient and special thought must be given before deciding egg donation. . All parties must understand how this will impact the family and what they will tell the child.
Even on busy IVF units there could be more women requesting egg donation than they have available donors. An alternative option for these women is surrogacy.  This is a controversial issue but can be offered to women who have had removal of uterus or cannot become pregnant for medical reasons.  A surrogate is a woman who agrees to become pregnant for a couple.  A surrogate can be a traditional surrogate or a gestational carrier. It is critical that a surrogate is screened carefully psychologically, medically and legally. Adoption, foster care and childfree leaving are of course other alternative options.
In conclusion the message of medical profession to our younger generation is that child bearing is optimal when a woman is in her twenties. Then she’s at her most fertile, her eggs are still healthy and viable and there is a lower risk of having genetically abnormal children. Besides, there are lower risks of miscarriage and birth related complications. Even the career oriented young ladies should be aware of the fact that they can always have adequate spacing between two children. Medical science has gifted the society with very healthy and satisfactory means of family planning. Young ladies today must learn to balance their ambitions and social responsibilities and should give priorities to the right things at the right time.

BABIES COMING FROM THE COLD Food storage is OK.

Can embryos be stored?

People have got quite used to the concept of short-term cold storage of food materials at around –20’ C for 6 months to one year. But the concept of long-term cold storage of embryos (stage from conception to first 5 days of human baby development) for upto 5 to 10 years at –196’ C is quite novel and has been in vogue in this decade only. We, in BAHETI HOSPITAL, are pleased to offer this service to all our IVF/ICSI patients on a regular basis and are proud to have achieved successful pregnancies also. Our hospital is one of the very few hospitals in the country with this kind of service. The advantage and value of freezing the surplus embryos produced is not fully appreciated by all IVF patients.

Why excess embryos and the need to store them?

Any patient who seeks IVF treatment is desperate to conceive and deliver a single child – mostly the couple’s life-time ambition. There are two fundamental reasons behind her problem. One is lack of good quality embryo and another is the lack of good quality bedding (endometrium) to support the embryo. Hence the solution lies in attacking these twin areas. Hormone preparations come in handy (only problem is their high cost) for cajoling the ovaries to produce more eggs (averare 10-15). IVF laboratoty will make embryos (60-70% of the eggs) from the eggs by IVF/ICSI. After collecting the eggs from the patient, the next target is to make her endometrium good enough for the embryos to grow further. Though more embryos mean, higher the success rate, but not more than 4 are transferred back at any cost.

Now what to do with surplus embryos?

But for cryopreservation, the remaining embryos would have to be discarded. This was the real paradox before the availability of freezing. Not anymore. It costs very little to freeze the embryos.

What next after Freezing the Embryos?

If a patient fails to get pregnant in the first cycle and if she has frozen embryos, she can come back for Frozen thawed Embryo transfer treatment. This costs only 25% to 30% of the cost of any fresh IVF cycle treatment. Not only that this Frozen thawed Embryo transfer step is an Out-Patient Procedure with no involvement of Operation theatre or anaesthetic procedures and no pain of daily hormone injections. Hence to that extent, this treatment is free from the attendant risks associated with the above mentioned theatre procedures.

One IVF & many ET’s!

That is from one harvest of eggs/embryos in a cycle of treatment, the patient can undergo multiple cycles of Embryo transfer attempts, because she has a bank of frozen embryos in our safe custody. Even if a patient delivers a child from a cycle of IVF treatment, she can always preserve her surplus embryos for her second pregnancy whenever convenient to her at her free will. This can be after 5 years or more also. What a convenience of planned pregnancy!!!. This is what is called money well spent!

Frozen for how long?

The beauty of Embryo cryopreservation is that embryos once frozen at –196’ C, don’t demand any extra nutrients other than continual maintenance of liquid nitrogen level in the tanks, because the life of embryos is kept under total suspended animation. Neither do they get spoiled during the passage of time. Normally, a limit of 3 or 5 years is defined as the safe period of storage. This arbitrary 3/5 years figure is meant to be more for convenience and does not imply any degradation of embryos exactly after 5 years.

Overall, the success rate with frozen thawed Embryo transfer is comparable to that of Fresh Embryos. Hence, the cost benefit ratio of cryopreservation is indeed higher with Freezing of Embryos. We, in BAHETI HOSPITAL, feel that the value of Embryo Cryopreservation facility should be fully appreciated and utilized by the patients.

Fresh IVF or IVF by ICSI costs around Rs 35000+ 30000 per cycle of treatment. The chances of success in this cycle are 30-40%. If the patient fails to get pregnant, she has to spend again the same amount of money. If she has frozen any surplus embryos produced, she will have to hardly spend about Rs 20000 that is just 30% of the cost of fresh IVF cycle. Remember, in this attempt there is no daily pain of undergoing injections. There will be some patients for whom there may still multiple chances of some more cycles of frozen embryos. Even for a patient, who delivered the first child with Fresh Embryos, she can come back for her second child, whenever convenient without having to undergo the costly IVF treatment. This can be after 5 years or more also. What a convenience of planned pregnancy.This is what is called money well spent!

Overall, the success rate with Frozen thawed Embryo transfer is comparable to that of Fresh Embryos.

Hence, the cost benefit ratio of cryopreservation is indeed higher with Freezing of Embryos.

Is Male Fertility on the decline?
An eminent veterinary scientist told me this interesting fact the other day.  A chimpanzee produces 2737 million sperms in a day, which is sufficient for four ejeculates.  In comparison, a man on an average produces 176 million sperms per day; this production is just sufficient for one ejaculate.  This means, even as a closely related species human sperm count is lower.
 Even epidemiological evidences are now available confirming decreasing quality of human sperms during the last fifty years. (B.M.J.-1992).  Of course, fertility depends on both male and female partners.  Male factor sub fertility plays a role in approximately 50% of sub fertile couples.
What has caused this decline?
Environmental and industrial pollution, changing lifestyles like chronic smoking, alcoholism, tobacco abuse, increased exposure to sexually transmitted diseases, nutritional factors – and the list goes on.  In India, we have not been able to compile statistics, however studies from industrially advanced countries like UK, France, USA have confirmed a 2.6 per cent annual decrease in the sperm count of fertile man during the last twenty years.
Environmental factors
Smoking, alcohol use, stress and high temperature are known to reduce sperm production.  Active as well as passive smoking increases blood nicotine, cotinine levels which are toxic to human gametes.  Smoking appears to have an acute toxic effect on process of conception. A permanent and cumulative damaging effect is also suggested.   Occupational exposure to heavy metals like lead, cadmium are known to be spermato toxic.  The relationship between good nutrition and reproduction is well established. Reduced dietary intake of zinc as in starvation, malabsorption syndromes, parasitic diseases, drug abuse, liver and renal diseases results in gonadal hypofunction, reduced sperm count and impotence.
 The message is by prevention of sexually transmitted diseases and optimum and timely changes in lifestyle like stopping active as well as passive smoking, increased intake of nutrients like zinc, folate, iodine etc. this global problem can be prevented to a certain extent.
 Thanks to the availability of modern reproductive technologies like In-vitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI), couples with moderate to severe oligospermia (low number and quality of sperms) can also hope to father their own children, which was not possible a decade ago.

 

Cold-Storage of Test-tube babies & Umbilical Cord Stem Cells (Bio-Insurance)


Cold-Storage in General
Thanks to cold storage, we can extend the useful life of any thing.   If there were no cold storage technology, we would be wasting astronomical quantity of food stuff leading to starvation and death, in spite of surplus production.   As anything with life when left to nature will sooner or later will start decaying at environmental temperature.    


Need for Cold Storage in Medical Field
In medical field, an organ like liver when donated has to be transplanted within a maximum of 24 hours of death.  Heart has to be transplanted within 6 hours of removal.  Donated Eye has to reach eye bank within 12 hours of death for corneal transplant.  The whole organs from our body can not be cold-stored for long periods with present technology.


Long Term Storage of Small Living Cells possible and Not Organs.
But then is it not unbelievable that our germ cells like sperm and eggs and early stage embryos can be frozen-stored almost forever!!!  In Israel, a woman gave birth to twin babies after 12 years of frozen storage of embryos.   In UK, a woman gave birth to a baby whose husband’s sperms were frozen-stored 17 years back.  
We in Baheti Hospital had a successful ongoing pregnancy (   weeks) after the transfer of embryos which were frozen stored about 6 years back.  This woman’s living baby who is 6 years old was also born through IVF from the same batch of embryos and the 6 year old girl and the child to be born are contemporaries but with an age gap of 6 years!!!


Can we cold-store part of us or our body?
After hearing all this, people wonder, if it would be possible to preserve a snippet of ourselves for future use whenever we need our cells desperately for repair and regeneration of our body parts/blood cells.   Here is the answer for such people.  That is the so-called “Stem Cells” – stem cells are the progenitor cells for most of our blood cells.   Embryonic Stem Cells are the progenitors of almost all the cells in our body.   We all know that we originated from a single cell of embryo.    Placenta along with umbilical cord is invariably discarded after baby’s birth as bio-medical waste.  It has been discovered that the umbilical cord is a rich source of Stem Cells and can be successfully used for treatment of some incurable diseases of the baby like Thalassemia, Sickle Cell anaemia, Leukaemia, Fanconi’s anaemia. The added advantage is that because these cells are small they can be cryo-preserved for decades.    Cord Cell Banking has developed into a privately funded enterprise for helping people to preserve their babies cord cells.   The advantage of cord stem cells over that of adult stem cells (collected from our bone marrow) is that cord cells are in a sense innocent, which means they do not mount graft-host rejection phenomenon.   Hence, cord blood cells can be used for anybody for some disorders.   This is not possible with adult stem cells which needs tissue matching with recipient and has to be painfully extracted from bone-marrow after drilling through the hip-bone.   Promising research is ongoing into using cord blood stem cells to treat diseases like diabetes, alzeimer’s and muscular dystrophy


Recently we preserved our twin ICSI baby’s umbilical cord stem cells for potential future of the babies.  We believe that all prospective parents should be aware of this new technology which offers a kind of bio-insurance or a life-saving elixir in the hour of crisis in their children’s life even decades after his/her birth.   Parents should also find out about any family history of diseases that may increase the risk for other family members.  For such patients, private cord cell banks may offer an opportunity to store the potential cure of these diseases.

Questions that Overseas patients ask frequently :

1. What is the basic cost of the IVF treatment?


The cost of one cycle of IVF at our center is US $ 1400 only. The cost of medicines and few tests would be approx US $800.
In case ICSI ( Intra cytoplasmic sperm Injection ) is needed to be done, it would cost US $ 500 extra.

2. What additional costs could be incurred?


There is no additional cost unless any other procedure like freezing of sperms or embryos or surgical sperm retrieval is done.
The charges for other procedures are :


Sperm freezing : US$ 100 for storage upto one year. One can renew the contract after one year and extend the storage by paying US$ 50 per year.

Embryo Freezing : Cryopreservation of surplus embryos is done by Vitrification. US $ 300 is charged to vitrify and store up to 4 embryos. These embryos may be used by the patient within 1 years' time. After 1 year, the storage contract may be renewed every year by paying the applicable fees. At present it is US $ 75 per straw per year. Usually, up to 2 embryos can be frozen on one straw.

Surgical sperm retrieval : US $ 250 only. Sperm freezing charges extra as mentioned above, if required. The cost of post-op medicines would be between US $ 50 and 100.

3. Are there any co-ordinated packages for overseas patients?

4. If so, the costs?


We don't offer co-ordinated packages. However, Jaipur is a tourist place and therefore, reaching Jaipur, staying here and getting food is not a problem. There are some good hotels close to our clinic and we can name them so that you can book them online once you decide to come over to our clinic. It

5. How far in advance would I need to book?


First, we would like to analyze your case. For this, you need to complete a history form and mail us back. Provide the necessary info and your latest test reports mentioned in this form. We will go through it and then will give you the treatment plan accordingly. Then you can book your dates with us.
If you wish to proceed with us, I will mail you the history form.
 

6. How long would I need to be in India for?


You would need to stay here for at least 3 weeks. Your partner need not stay all along the course of treatment if he has any time constrains/work commitments. He would be needed around the day of egg retrieval.
Our hospital is associated with Indian Society for Assisted Reproduction and we report to National ART Registry of India.
Please visit our website www.baheti-ivf.com.

New Delhi is the nearest Airport. It is just half an hour flight away from Jaipur. Surface transport -Bus/Train/Taxi takes approx 4 - 5 hrs to reach from Delhi.
Our clinic is located in Jaipur city only and is very close to Jaipur Airport ( ~ 6 KM ).

Some good hotels nearer to Baheti Hospital are : 

Hotel Clarks Amer - http://www.hotelclarks.com/
Hotel Park Bella Casa - http://www.hotelbellacasa.com/
Hotel Red Fox - http://www.redfoxhotels.com/  
Marriott  - http://www.marriott.com/hotels/travel/jaimc-jaipur-marriott-hotel/

There are many more hotels to suit different budget range and one can search them on internet easily.