वंध्यत्व आणि IVF | Dr. Mamta Dighe| Khuspus With Omkar | Marathi Podcast #infertility

That the younger you are, the higher your fertility rate, on the contrary, you should get pregnant in less time. You should get pregnant, especially if a young couple is taking three years, four years . They don't turn off their phones, when they go to that party, they will ask us again, "Oh no, what happened to you, why is this not happening, where is the problem, is it not necessary, why are you not old, why are you getting older? Then what happens is that they keep cutting themselves off and wherever they are". There is a myth that as long as my periods are normal, I don't have any problem with pregnancy. That is also one big myth. So it's not like that at all . Not at all their problem is very low sperm count in mail and they need IBF but they don't treat it ie in the hope that I will do this I will do that then they said this they said that and then it takes a long time and by the time they give Come to us, a woman's eggs are depleted so the rate of infertility is increasing and will continue to increase. The main reason is that there is a delayed age of marriage. Couples are deciding to have babies later. Off Success Yes means IVF Done Embryo Created Embryo Implanted What's More Pregnancy Must Happen So It's A Big Myth That After IVF Pregnancy Must Happen [Music] Hello Hello I'm Omkar Jadhav and I welcome you all to this new episode of Khushkhus. In khushkhus we discuss all the topics that we don't talk about openly, we keep whispering, but we are experimenting with khushkhus to openly discuss those topics on our platform and today we have come up with a very important topic, we are many people about IVF Pregnancy Infertility. There are questions Many people have asked us questions about this before that we should do a special episode for this, so today we have come with this episode and today with us is Dr. Mamta Dighe, she is the founder director of Janet Advance Fertility Center, she has more than 25 years of experience and Dinanath Mangeshkar Hospital's IVF center was also established and its former director is very welcome. Thank you ma'am. Thank you . Yes ma'am we can start the conversation one by talking about fertility infertility and IVF and one by talking about what is infertility and when should IVF be done. Two cycles are done, three cycles are done and then there is a lot of confusion about it. To understand IVF, if we can talk about what is fertility and when to opt for IVF, fertility means a woman or a couple conceiving and having a baby. What is the capacity, we generally call it fertility, when a year passes and the couple does not try to have another baby or conceive naturally, then we call it infertility, now infertility means everyone wants to do IBF . There can be minor causes we can handle it very easily but yes some couples definitely need IVF at some point ok ok and at what point IVF should be decided i.e. infertility now as you mentioned many different ways If it can be worked on, in what cases should people do IVF and A means how to choose IVF actually, the question is, it's long and how is it in everyone's head that there are many myths around when to choose IVF, people think that you know. When to do IVF, when not to do it, but if you look at it, there are some absolute indications for IVF. Two on the side fallopian tubes are there this may do the job of transportation i.e. egg and sperm are united in this fallopian tube so if both of them are blocked then egg stays on one side more sperm stays on one side and conception is not possible ok if both fallopian tubes are blocked then VF This is the only option if there is no sperm at all in the man's semen or semen sample but it is produced in the testis or in the goiter then we can take it from the testis and do IVF again and again over here IVF is the only option but if this is left out there There are many other indications of sperm motility count, motility, morphology, if normal sperm count is very low, if the woman has very low number of eggs in her testicles, if her ovaries are too large, multiple attempts by other treatments have failed, then such indications are: Severe endometriosis is a type of problem in women who have all these indications and finally if the previous options do not work then we move to IVF. So choosing the right indication the right couple and the right time I think everything is equally important . Yes what exactly is IVF I mean now you just briefly touched it but what exactly is done in IVF I mean what is IVF so now as I said if you go to see what happens naturally how does pregnancy happen the egg of the woman breaks the seed from the ovary And then it enters the fallopian tube, the husband's semen, which is semen, comes out of the body, it gets deposited in the vagina, and then the whole process of conception, growing the baby, nurturing it, delivering it , is happening inside the woman's body at the time we do this. The egg is taken out of her body i.e. from her spermatozoa and fertilized with the sample sample of the husband or the partner or a donor in certain cases . When we put the embryo back into her womb, this process is called IVF or In Vitro Fertilization ok ok due to which the conception of an embryo takes place outside the womb and then the embryo is implanted in the womb then there are a lot of myths around this then we will talk about some of the myths. Speaking of which, one of the most popular myths about IVF is that twins, triplets, quadruplets, etc., because now we see it in films and in all these contexts, or what about IVF that there may be health risks for the baby. There is a lot of misconception because there is such a new technology and everything is new so if we can debunk some of those myths then there are a lot of myths Omkar you are right there are a lot of myths one is sometimes people think that IVF is a sure shot guarantee of success. IVF is done, the embryo is created, it is implanted in the womb, what else is needed, pregnancy must happen, but there are many other reasons for that embryo to take root in that womb, we do not pay attention to it or we do not understand it. It is a big myth that after IVF, pregnancy must happen. And twins because what we do in IVF is we implant or transfer multiple embryos back into that womb now sometimes only one embryo sticks sometimes both sticks sometimes neither sticks so it's not that IBF will always result in twins more likely But the good part is you can choose if you decide that I want to leave a single fetus in then there is no question of twins so knowing and with the advances we can now select which one is the best embryo so we pick that one and put a single fetus in. But it is a myth that people have birth defects or problems with IVF babies, but now scientific data has shown that many babies are born with IVF and most of them are healthy, just like naturally born babies. Congenital Abnormalities Birth Defects can also occur in them. IVF can increase that percentage by about two to three percent but majority and almost all babies born through IVF are healthy . That I have low eggs now, will you do IVF and give me injections If I am going to remove so many eggs, then my eggs will decrease even more, but that is the fear. Basically , what they do not know is that every month a woman's eggs are decreasing. Instead, we take out many eggs by injecting them, so as much as they are going to be depleted or as much as they are going to decrease naturally, they will decrease as much as they are going to decrease, but there is a myth that people have done IVF, so if my eggs or my husband's sperm are not there, they will use someone else's sperm. It is not at all. It is when it is said that it will be done using your own eggs and your own metal. At that time, if you want to use a donor, then with the consent of both the husband and wife, then we use either a donor or sperm. Yes, there are many myths. I think you know. So you know we can just keep talking about it but they still exist today. That's the funny part that they still exist today because I think we don't know about the process and the challenges of it, but that brings me to the next question, what exactly is the process of IVF ? We know technically how the IVF process works but exactly what happens because you don't know exactly what the process is rather than choosing to do IVF just because you are infertile and now you want a child. If all the questions arise , what exactly is the process, how do you have to prepare your own body? A lot is happening behind the screens right the movie that comes out is from there but behind the screens preparation is equally important so I would say the process starts from first understanding and navigating this whole journey then making sure that you know your physical condition How about deciding which doctor which clinic you need to go to and then from there when we do pure pure IVF or what is the process first and foremost we find out where the problem is because if the problem is not known like for example A lot of patients come to us whose previous cycles have failed so what happens sometimes what happens is that IVF is the doctor but the patient asks us the doctor what else do you do right because apparently IVF is IVF I took the injection and removed my eggs and made the embryo and put it in but everything Matters in how deep you go to find out what is the issue and only after that you can make a good embryo and having a good embryo is the key to IVF success it is the key to IVF success so the initial part will be assessment where is the problem good then improvement What can we do to improve egg quality, say sperm quality, say uterine capacity, say implantation capacity? For him, there is a lifestyle aspect, an emotional aspect, medications, many things, so we need to talk and discuss with the couple about this and when we start ivf what is in ivf na omkar u cant do ivf with a single leg u can for that matter ok ok but people don't know that when a woman is under age ok earlier we used to say 35 but now we say 32 33 At that time if we get her six eggs then only one normal embryo will be formed from them o yes because neither female egg nor all male sperms none of them all of them are never normal so even when you take eggs out of six eggs you will get one normal embryo You will get embryos, but out of them, the one that gives more viable embryos, I mean, the embryo that gives pregnancy is the same. Now if the rate of abnormality is low when you are young then as the age increases of the woman if that rate increases then you will need more eggs to produce a normal embryo yes so what do we do in IVF how many eggs can we get maximum and how do we get it So that we can make maximum good and normal fetus at the same time that is a Rate Limiting Step OK, if less eggs are obtained, a woman's stimulation is not done properly, drugs are not used properly, if only four eggs are obtained, then what will he say ? How to get it requires taking injections so the first process of ivf is taking injection due to which we increase the eggs to a large extent ok and then how long it takes usually 10 to 12 days even nine to twelve days so on an average 10 days it takes daily And then in this process, those eggs grow, they grow and mature, with a small procedure, there is no need to cut anything, through the vagina, there is a sonography probe, it has a needle attached, then we insert the needle into the follicles and draw out the egg fluid and Immediately sent to the lab where there is an embryologist, the egg is not visible, it is microscopic, so then the embryologist puts the egg under the microscope, she finds out where the eggs are and immediately incubates them because the eggs are not used to go outside the body to get exposed to the external condition. Will Get Destroyed So To Be Extremely Quick And Extremely Careful And Then On The Same Day The Husband's Sperm Is Taken And Well Prepared And Then The Egg Is Fertilized With That Sperm And Then You Keep Checking How The Fetus Is Growing And Then The Three After five days we transfer that embryo back to the uterus sometimes we don't transfer in the same cycle we keep all these embryos frozen or frozen o and then in the next cycle we transfer these embryos and how long do we keep these embryos frozen any time outside You can keep it it's like frozen in time oh wow so now everyone who says egg freezing and then embryo freezing and so on this is actually this and they can stay healthy for as long as they are in the same way yes yes because the way you freeze it if you Also maintained so how that lab maintains it is also important so if you check that it is maintained then it stays the same so we have so many people who had their second baby with the first emulation i.e. IVF done three years ago An embryo was created and a baby was born and now after three years using the remaining embryos a second baby was born. Wow what a beautiful process. In fact, I think it's very interesting for you to see it too. That's the fun of creation. In it, you 're actually taking an egg, a sperm. taking and making a birth and then it's going to go into a womb and it's going to grow so it's creation and creation of life it's quite mystical sometimes very true comes with an even bigger one which is stigma yet still IVF From what the babies are going to be like, to the processes, whether they're synthetic babies, not real babies, and so many things like that, do you feel any stigma about that method, so you have patients but when they come in, how much stigma is still there about IVF? It's not just the stigma about IVF , there's the stigma about infertility itself, it starts from there and I think you know women bare most of the shoulders unfortunately they shoulder most of the burden sorry because of it I always feel like when we see women and Men are made even if you look at nature woman what is the differentiating point that she carries a baby right she becomes which a man can not do ok so it is in our psyche that as a woman you are meant to carry a baby right societal but it Is Even In Our Psyche S Human Beings Itself So When This Can't Be Done Feelings Of Guilt Shame Low Self Worth Blame Self Then I Don't Hurt Others Too Much To Deal With And Sometimes There Are You Know Outsiders Also Sometimes Are Not Very Understanding Even More Because Of My 25 Years I Have Seen Lucky Fortunately How Everything Has Changed I Have Seen That Earlier Wives Were Very Scared If I Didn't Have A Baby What Will Happen To Me But Now I Know Men Who Sit And Say Seat in front of me and say doctor baby but first it should be fine u know the rest is just two days back one couple my patient came more it's a tough case then he told me that his first transfer was not successful So there are embryos and we know that we have to deal with certain things then they said no we didn't tell at home before but I told my father yesterday that is his husband's father so he said my father said it's fine but take care of her health dad so only husband wife No, but the attitude of the previous generations is changing a lot, but the stigma is not gone, so it is around the whole infertility issue and of course, like you said that you know IVF, but there is a stigma that these are not normal babies. I think you know why you were not normal, then who has problems, was it with you, was it with your husband , then all these things are there. It's important and I think society has put a lot of pressure on us to get married and have children and if you don't have children your life has no meaning and for that I'm sure you'll see a lot of patients who are living in poverty and debt By doing something anyway they just want to have a baby and to show other people than for themselves that come I won this is my trophy but fortunately slowly it's a change and change as soon as possible perspective now we're in this if we were talking to Maga about Edge. What are the factors that can be challenging while doing IVF i.e. as you said now that as you get older, the number of eggs decreases, as you age, the number of eggs decreases, so the most important thing is the woman's age . The biology is the same and the clock keeps ticking so what happens I often say that many times we have seen patients who have very low sperm count OK in the problem mail and they need IVF but they don't do the treatment OK so in the hope that I I will do it, then they said this, they said that, and then a lot of time passes and by the time they come to us, the woman is pregnant . What happened Omkar now even if we take one sperm and put it in one egg we can give a pregnancy now there are so many millions of sperms even if we get 1 million 60 million not get 1 million if we get 10 sperms from him yes but if we don't get 10 eggs How the embryo is formed so having eggs is very important and why this should reach everyone because unfortunately research shows it is very clearly established that Indian and South Asian women have a very low egg count o very early age it decreases ok so that's why What we don't know yet is whether it is genetic or nutritional or environmental . She will be a 29 year old here so we are losing two six years and because we don't know that she is that day your you know career study and why not you know I mean everybody wants to do that but unfortunately knowledge is power It is said that it is very important for us to know that then we can take steps on it. So if the eggs start to decrease and the eggs are less, then the embryos are less and some of the embryos are normal. Moreover , people need to understand that this is the biggest challenge. When a woman is young, even if by chance she has less eggs, a younger woman may have less eggs. But age is on her side so her quality will be good. But if the woman is older, her quantity is less and her quality is also less. So this is one of the most important factors and this has become the most important challenge and the biggest challenge that we face now that there is a problem . Everything looks good but for some reason it doesn't stick or implant that is another big challenge what is the reason when the problem is visible it is easy to handle but when the problem is not visible or not known it's like looking for needle hair stall Some challenges come in front of us that and ours In the country because earlier the rate of TB was very high affecting the womb lining affecting or now days even young people are getting cancer if we do treatment for cancer at that time eggs sperms are affected Chemotherapy Radiotherapy So new challenges come due to which fertility we What can we say The whole bucket and the challenges are changing and it is just evolving yes I think it is a very important question that who should do IVF and who should not because I also have examples around me some sisters and some relatives who have done IVF and I told them After going through all those processes, they have multiple size cycles, and there are people who, even if we fail, think that we want to keep trying until we have a baby, until we get pregnant, or at least one. One should do means at what age what should be the circumstances when one should do it and one should not do it or stop but should. So I think a very important questions. A lot of couples who come to us, Omkar, I hear this a lot, and sometimes we don't realize things right away, but it's so important to bring it forward. Maybe I'm married at 24, and I haven't had a baby by 30, even if they're trying. For like let's say six years and when they come to us more and less tested a little more I say you know why you say six years no we all said you're too young so don't worry so I Always tell them that the younger you are, the higher your fertility rate, otherwise you should get pregnant in less time . You should get pregnant, especially if a young couple is taking three years. It might not show up with a test but it's just as important to deal with so it's another myth isn't it that if you're young, no matter how long you take it, again that's not right, so when IVF is needed, the sooner you do it, the more time you'll have. Your success rate is better and then you don't have to go through multiple cycles and multiple failures, but if you do the same treatment too late, then you get less quality quantity of embryos because then you have to repeat the treatment again and again to answer the second part. Is ultimately if after trying many IVF attempts Omkar what I want to say is that you can't give up IVF too early because there is no guarantee that you will get pregnancy in one cycle so you can't give it up too early at the same time knowing where to stop. Is Equally Important Because It Is Dreaming Sometimes has further researched that in European countries where insurance is provided by the government for about five to six IVF cycles, they are not financially constrained , yet many couples drop out after two IVF cycles, meaning that the financial burden is one. Part but emotional burden is another aspect of the whole IVF treatment so how to handle it. You know even us doctors and care givers can help them in that process. Now in Zenet we have a whatsapp community we form which is a support. Group it is confidential anonymous so you know a lot of things to put on him giving them emotional support is very important to do so I would say that if there is a lot of multiple life we ​​have cycle failures there is a lot of financial and emotional burden then Ultimately think somewhere along with this couple and it is individual for every couple when to stop because and you should try some number of how many cycles is too much number of how many cycles you should try about six IVF cycles if done. Well ok maximum is what is current in this but having said that again Omkar how is it now if you try to find out why this ivf cycle is failing then there are multiple other options also available if the egg is not good right and so your ivf cycle If it is failing then can donor egg be used then will pregnancy happen Correct if pregnancy means fetus is good but if due to some reason it cannot be carried Can surrogacy be used? There are multiple avenues. So understanding when to make a choice is just as important. Then you can take a choice and decide how to proceed. I mean you see so many couples going through this whole process of what is the right age to conceive a naturally or physically because that's where the issue comes in because the way we have careers the way we live now we don't get married until 35 and After that we start thinking about children and beyond 35 then children become pregnant and then these complications can happen, body wise but body clock wise but what is the right age for children to naturally conceive and if not then maybe go for things like IVF like IVF. It can be applied C Traditionally we used to say that you know less than 35 and delivery before 35 is always good but I would like to say that now we have reduced the cut off even further that is about 32 would be ideal and if by 30 excellent but Nowadays education only goes so far so it becomes difficult to do egg freezing but the option is equally important for everyone to be aware of so I would say at least buy 32 33 people should definitely consider after that then whatever complications can be avoided now we are successful about it. Was talking about the rate but about the IVF always about the success rate, the success rate is dependent on many things and what determines it, so I would say the success rate is dependent on many things. Part of it is the couple part of it is the doctor and the Above all, the success rate is dependent on the IVF clinic, so how many eggs are there in the couple, what is the quality, what is their indication, what is the age of the couple to do IVF and not only the woman, even the husbands as matter but luckily that is much later i.e. around 45 If the sperm quality is very poorly affected, then everyone plans pregnancy within it, but what is their lifestyle, how are their eating patterns, alcohol, smoking, tobacco, so many obesity, obesity is a huge factor today . ok that's a lot to say lose weight because your egg there is something called epigenetics omkar epigenetics is genes what do we say genes determine what you are how are you but if someone carries the gene for diabetes then 100% they will develop diabetes because What is his epigenetics what he eats how he exercises that is determining the expression of that gene so similarly when there is obesity epigenetic factors so looking you will see that embryo looks good but those epigenetic factors that act will not give rise to a good embryo quality So life lifestyle weight sleep food exercise you know the kind of medication sometimes so many people take steroids for exercise so many things so it is very important to pay attention to all these things and sometimes it seems that when you come to the doctor they will do everything but couple You Know With That Much Enthusiasm And Determination It Is Very Important To Do Their Part Then I Wood Say The Success Rate Depends On The Clinician The Physician The Laboratory Lab Madhe Why IBF Lab Is The Backbone Of An IBF Center So Like I Said That you know when I started doing Infertility Infertility basically getting in Gynecologist preview so then I decided only to move to just plain simple infertility and IVF because it requires you to focus so much little things change everything so the clinic also matters that its success rate How much is their transparency Who works in their laboratory How is their experience How is their lab How is their success rate What new technology do they adopt So your success rate mainly depends on the patient factor and on the clinic and the IVF lab Factors are very important because naturally when those eggs leave the womb they are going to depend a lot on how they are treated in the external environment . What is it a no Ayudhya has no direct connection with IVF actually Ayudhya I presum u R ASKING ABOUT AN INTRA UTERINE DEATH OF THE BABY IUD CAN HAPPEN AT ANY TIME BUT CAN HAPPEN IN NATURAL PREGNANCY THE PROBLEM IS WHAT DO PEOPLE THINK IVF HAS COMPLICATIONS IVF HAS COMPLICATIONS BUT THERE IS A PROBLEM IN THE COUPLE SO THERE IS A PROBLEM . Problem but there is some issue at the level of conception so those are the basic causes but complications also occur. It is not just because you have done IVF that you get complications. Intra uterine death is what we call the baby up to a certain week or gestation. If it increases Let's say five months crossed seven months and for some reason the baby's heartbeat goes inside so we call it an intrauterine death demise then the baby goes inside then there can be many reasons more it can be dependent on the baby more uterine factors Or it may be dependent on maternal factors. What happens when we say that the bigger the problems the sooner they are dealt with. So if there are major issues infertility happens miscarriages etc. There are subtle problems so if there is a genetic issue like we say chromosomes means Normal C is above but we have genes on chromosomes to determine everything from how our eye color is our hair straight or curly to how we metabolize the food we eat, whether we eat protein or how we metabolize carbohydrates. That they are genes for all of these. Now if there is a problem in some of those genes, if your metabolism is not right, then at such a time or there are many other genes also at such a time, sometimes the pregnancy goes to the next stage and then sudden intraerythroidemias occur or if the blood pressure in a woman is very high and uncontrolled. Sudden Intra Uterine Death can happen due to all the reasons like diabetes but it is not something that is related only to IVF it can happen anytime ok it doesn't necessarily connect it with IVF not at all not at all yes now come now support Did you also talk about the system because it's actually a very emotionally mentally taxing process, one is when you're infertile and the other is reaching the acceptance that I can't conceive naturally and for that I need some technology to conceive and have that baby because I Want a baby for what ever reason and after going through that process when you make a decision like IVF which now if you know you're going to have to do multiple cycles then what a big role the support system and all of that plays because not necessarily now we listen to our audience. Well, everybody is going to go through these processes but there are people like us who are probably just going to be around for support, but how important is the role of those people, so I think you hit the nail on its head, Omkar, I think it's for everybody because Either you are going through it or eventually you know at some point in time you may be the person who supports you . It is so important to go through this full process. Already there are so many issues that you know that she herself will have difficulties. Plus if other people create problems and do not support her , the support of the spouse is the most important, that is, the support of the wife is needed by the husband and the support of the husband by the wife. We have seen that most of the time neither man speaks up but they are also going through that turmoil but physical burden because woman has to take more. Woman has to take more support . After adjusting everything she has to process it and most of the times husband has to come and give seaman sample only so burden is more on female so support of husband is support of family and many times we get support of our house but u know u are always seeking support from ur spouse Family you know that they should tell them to know that they should not bring a burden . What happened? It is not happening. Where is the problem? You don't want to because you're not old enough to grow up so what happens is they keep cutting themselves off and where they need more support they start to feel alone So support is very important Support from peers Support from friends Support from work place because They have to take time off from their work for sonography for injections for hormonal variations stress depression anxiety you know the fear of outcome all this is happening to them so it is very important to understand that and I feel Omkar na women are capable of doing all this they just Need that work they just need that understanding that you are no different we are there with you you know we will support you yes this is one work I do today let it go it is just the need is just to tell them that we See You We Hear You And We Are There For You But You Can't Stress It Enough is not very important because now if you look at some examples I remember around me it was like they were going through so many things and at that time just a simple Phone or no, saying everything will be fine in a way that might help the other person a lot and like I say first do no harm if you can't say something good at least don't say something bad mean at least you know discrimination sarcasm You know what to do, just make sure that it is in support of them, and another important point is that the people who are going through this process know how much it costs, because cost is the most important thing we have. There can be a considering factor because then how many cycles are to be considered then you can basically say some range that the cost is generally in this range for all these processes I think talking with IVF cost is like become explosive because you will see all kinds of cost you will C key full IVF cycle in 75 thousand then someone says IVF cycle up to two lakh to two and a half lakh so I wood se that generally the cost of one IVF cycle ranges anywhere between 15 lakh to 2 lakh ok ok now I always feel that you know this baby is yours Right you are creating a life outside the body it takes a lot of things, but you know, your injection is not like that. First of all, I personally think that IVF is actually not that expensive. Even if you go for a simple surgery, it costs a lakh of rupees. Here you are taking injections, you are creating the entire embryo outside the egg, which is the environment inside the fallopian tube, the environment inside the womb, the media it needs, the growth factors it needs, you are giving out all these . No Particles No Volatile Organic Compounds No Volatile Organic Compounds in that lab Smell of perfume Something has been taken away What comes out of the plastics is not So maintaining that lab is a 24/7 task So IVF just went to say IVF that the embryo is created and implanted those Not the point the health of that embryo is a very crucial factor so I would say that this is another myth that IVF is too much the problem is uncertainty because you don't know if you put in that much you will get what you want out of it but That's unfortunately the nature of IVF, so you can't say you don't use any drugs, don't use any media, use what's right, use what's best, this is your embryo at its base creation, so you can't go wrong. There but I think that around 2 lakhs if Uc is a good enough cost for an IVF cycle, more than that when you look at everything, I think in the present conditions especially, husband and wife both of them are earning spending that much on something. That can give you a life time of joy yes is not too much but usually it costs and the reason for asking money is because many people because some centers or some places commit that they will give you guaranteed conception and then people take loans for that and Then different financial burdens go through and so it's important to talk about all these things absolutely but that's one thing if someone tells you that you'll get a guarantee or you know 80-90% success, that's a definite red flag because now everything is on google. If you google you will find out that worldwide success rate is not so much ok then how do you know the average success rate here I would say it is about 55 60% of IVF ok the success rate of IVF is even more centers we have at par success rate with global Global success rates mean there's no difference so it 's not like you know it's better in foreign countries it's less in India but unfortunately it caps over there oh yes but usually what happens if we take one couple who have good embryos and if we At first we like we said that you know what we do now one and done ki baba let that woman take injection once, let the egg be formed once, let the embryo be created in good amount once, then if the first embryo is not fertilized, then atlist we have the rest of the embryos. Yes, she doesn't need to go through the whole process again, so if we use that embryo again, in three transfers in three cycles, it 's generally about 80 to 82% success rate. So it's important to make sure that you go through it . You go through it, but for him, the embryo takes that much. If the embryo is small, if you don't touch it at one time, if you get pregnant, take the whole process injection again . If enough is taken out, it can be frozen and used for the next cycle, but this is the cause of one cycle . will increase so that is again going to bring in financial burden on the couple ya so i think i will like to say to things omkar one means no this is a journey and we say if you get on the bus don't get off until it stops if you get off in between some uses So sometimes it takes time and financial preparation is necessary for that so talking to doctors like when they come to us we tell them what is the cost of the cycle if your embryos are frozen what is the cost of freezing then if you have to put the frozen embryos back in So what is the cost so maintaining transparency is very important so they can be prepared financially and the problem is that we always think that you know that mother or that woman is just waiting over there that once the fetus comes it will stick but Basically the embryo is stuck actually in the uterus in a way there is a barrier ok and the moment the mother or the fetus senses that this is a normal embryo then the barrier is removed and the mother allows the embryo to implant inside that is the ideal way so when Sometimes there is this process in some people that it is selection or this is a normal embryo and I will allow it to implant this is an abnormal embryo I will reject it sometimes there may be a problem in this process so normal embryos sometimes don't implant and sometimes abnormal embryos It allows the fetus to attach to the uterus and then the abortion . So in such cases, there are issues, so to understand it, so repeated miscarriages like at Janet, we have a separate section because geneticists are involved, immunologists are involved, a u no counseling is involved, dietician is involved, we have our own doctors here. We take breath work and meditation. So we have a yoga expert who is attached to us . So all these things help a lot . You don't know and so you have to cycle again and again. So being financially prepared for this is more about understanding that it can happen. It is not like that, but it is a process, its causes, the finances required for it, the physical, mental, financial preparation required for it, it is very important to do all this. We know the example in the news in the media where there are news that IVF has been done at the age of 60 and till what age can IVF be done, that is right for both male and female. You can take IVF treatment ok now when we say 50 what do people think that yes we can have a baby at 50 but at the time of Yujwali when the baby is born the egg is not from the woman herself it is taken by egg donation so from another person Someone's egg is correct and another healthy fertile woman's egg is more useful if the sperm is good then it can be taken from husband's and then his embryo can be prepared and put in her womb, you know it's like womb is kind of an immortal thing until you As long as you continue to give him the right hormones, the uterus can conceive and grow that baby, but after the age of 50, diabetes, hypertension, medical causes for the woman to have problems, and it is important to take care of the baby by staying healthy until the baby grows up. I always tell the patient that if there is surgery and then you say you know it's ok you know not today a year later if it's not an emergency it's ok but with a baby it 's very difficult because the longer you delay the more you You know the age of hope your enthusiasm your strength you know you being able to for 21 years athlete you know for that matter to make sure that you are there for your baby and take care it is very important to remember that time so by law now the Age is at 50 but as a woman reaches 40 her fertility would have already decreased so she used it at 40 to 50 then donor egg needs to be used ok ok then another one going back to the myth is can IVF be done after menopause i was reading About it and it occurred to me that this question also comes up but then we can talk about it because anyway the age of menopause is getting lower and lower after 50 very soon and it has things like IVF and menopause and IVF so what did you just say? That the age of menopause is getting shorter, that's exactly what I said we 're aging faster compared to causations, that means we're getting fewer eggs, the fewer eggs we have, the sooner we're going to end, the sooner we're going to go through menopause, right, so that's the problem, there's no Signs and symptoms usually when women come to us ma'am I don't have any problem my periods are just dot to dot but the coming periods are dot to dot because they are eggs the eggs are completely like perimenopause or less eggs low ovarian reserve so they don't know There is a myth that as long as my period is normal, I have no problem with pregnancy. That is also one big myth. So it is not at all. You hit that if we find out that the eggs are low now it's likely to run out a lot more in two years and if this same woman has planned whether or not I want a baby in four years she'll know that's not going to happen I'm going to have to do what I have to do today. But if you want to conceive after menopause , where we say you know you hit that ceiling, the eggs are completely gone, then you have to get donor eggs or eggs from another young healthy fertile woman and then do IVF before they hit that ceiling because everybody wants the ultimate key. It should be your baby, it should be your eggs, it should be your sperm, so before you hit that stage, if you get to know then you'll be able to take the right steps . Now I'm just 30 I'm just 32 but even a 20 year old woman could have very less X and if she looses two four years then it will become difficult for her so athlete it's important to know so if everything is fine then stop na Bindas No problem but if you know that there is an issue then you can take the right steps at the same time . About sperm count but if you are in this age 30-35 then your sperm count should be like this and if you want to derive this then what test for it I mean maybe there are people like me who are unmarried and are not planning to have babies but I want to check if I'm fertile so how do I do that right so you know this is sometimes we get asked but it's like you don't want to get married Test both first I would say it's a double eight sword because marriage is you know a communion of two people this is this comes out of it right this is not the base for it but S individuals and specially for women specially for women because of the problem Most of all there is more than the sperm age or Omkar it doesn't affect men that much and it affects at a much later stage like I said 45 so now if a male has low sperm count in the first place then it's going to be something more immediate because of age. 30 to 35 will not happen then his sperm count is still low today but tomorrow will be low because of this cause it is necessary to see if it will change but this matters to women so women can do a test called AMH it is called antimullerian hormone more if If you think your eggs are low in your testicles, even if you are not married, those women can freeze their eggs . We don't fertilize it, we only freeze the eggs that are mature and people have this myth that if I freeze the eggs, I won't have a baby just by IVF. It's like an insurance. When you get married tomorrow, natural. Conception done great well and good but if for some reason the egg is too low by then age is too much then you have this back up you can use these eggs to create an embryo through IVF and then you can get pregnant I think this can be a very good feasible option for people who want their I think it can be a good option for people who have life commitments, careers or different things and they don't want to get pregnant anymore. Another question is what kind of things do you come to? There are a lot of things to hide. There are specific things that are hidden from doctors that shouldn't be hidden that have already been disclosed that have already been disclosed. That their habits are ok sometimes smoking in female husband but they don't tell and because of that it will affect the sperms on the eggs we can also do the test and we can take some precautions during IVF when we have better sperms. can sort so if we know that precautions will be taken more then chance of pregnancy will automatically increase ok food habit they don't hide but sometimes don't work on it at all that's important because we can't change everything we're still working with The Same Egg The Same Sperm So The Raw Material Needs To Be Good Which Is Equally Important Sometimes husbands and wives completely hide the issues between them and think that you know the baby will be fine and I think that's a big block because somewhere mentally If there is no preparedness, it matters. Offcourse matters. Offcourse matters. I always believe this is digressing a little. Why are we talking so much about diet because sometimes pregnancy doesn't happen after IVF and pregnancy happens after you deal with all these issues so somewhere it has importance so like you say you know even a soul wants to come into a family which you know There's Happiness There's Joy You're Wanting That You're Going to the Doctor Mentally or Physically But Mentally, How Will It Happen Now ? If you do counseling on him, if you address him, your success rate will definitely increase. Also, I have seen a couple of cases where there was a deep fear of caring for a baby. Whatever happened may be in. Their personal life and their is a deep fear of caring for a baby After going to the place, you know everything is normal, everything is normal, then when she expressed it, then she realized that oh there is an issue like this also so there are many deep things that need to be addressed. Medicine advances are definitely going a huge way. But I always think that the ancient wisdom of more technological advances you know to marry them together and then you're going to really hit the bull's eye and that's the way to go right now is almost at an end . Of course IVF is a solution for issues like infertility who cannot conceive naturally but what are the reasons for infertility in the first place so I interpret this episode differently because now we talk about the solution it is a solution about infertility but But what should people who are other people who think they are fertile and healthy should take care to avoid infertility in the first place right ? Couples take the decision to have babies later, so as the effect comes that is one of the biggest factors but the environment is changing right pollution is changing environment is changing lifestyle is changing is a big part of stress so these are all the reasons that are contributing to Increased rate of infertility over the world is not only in India but it is increasing globally and so it is very important for young couples to realize that whatever we are doing like you know having a baby is also you know a piece of pie right means you have to fully pay it. Is not the whole pie definitely you know life doesn't work on one thing but it is still that piece which you know innately we long for it so it is also important to pay attention to it but it is important that our time is not passing us how is our diet how is our lifestyle How do we sleep, when do we wake up, when do you know totally diurnal, if you do variation, you know, many people work according to the timings of foreign countries, they sleep more in the morning, work more at night, this also affects hormones, so pay attention to this, use of plastics is also Been known to affect egg quality, affect sperm quality, aluminum foils, what we eat in heated food also has an effect . It is part of giving so one I would say lifestyle lifestyle lifestyle lifestyle life style one is whatever it is second weight underweight overweight both this is not good weight proper maintenance taking nutrients well to your body means recently I heard this somewhere this is not mind that The nutrition that was in an apple may be 10-15 years back, we need six apples to get the same nutrition, because there is not that much in the soil, so those nutrients are less in our body, so pay more attention to it. Where is our fertility ? Different from what you think is fertility as per age you may think I am young my fertility is great but no your individual fertility may be low so being aware of that and trying to understand that if so what are my options if all we do is Taken because some things are beyond our hand like we cannot control the pollution and the air that we breathe but if we do what we can control then I think it will still go a long way in making sure that you know we preserve our fertility. Yes thank you so much I think a nice circle is complete we are back to where we started thank you so much for coming and thank you for having such a hearty and open discussion on this very important topic if you want to connect mam the details for them Below are Janit Fertility Center and how did you like today's episode if you have any more questions you can ask them in comments we can ask ma'am if you can answer those questions if you want to watch some other