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Infertility

The Center for Infertility at Prasad Hospitals has the Best Infertility Specialists In Hyderabad with good experience and have a high success rate. Prasad Hospitals, the Best Infertility Hospitals in Hyderabad, treats the patients with the advanced technologies in the processes like IVF, ICSI, Male Infertility, IUI, PGD, and many. Many patients with fertility issues approached us and got the best treatment with the best success rate.

Facility

  • • Prasad Hospitals, a well-known Best Infertility Hospitals in Hyderabad, have the State of Art Infertility facility.
Prasad Hospitals Infertility
  • • IVF Lab set up with GMP standards, Class 10000 and SS Grade 216 walls with Electrostatic flooring (polyvinyl with copper lining).
Prasad Hospitals InfertilityBest Infertility Hospital in HyderabadPrasad Hospitals InfertilityPrasad Hospitals Infertility Prasad Hospitals Infertility Prasad Hospitals InfertilityPrasad Hospitals Infertility
  • • Point of care counseling for male and female partners with reproductive failures.

Ovulation Induction

  • • Ovulation Induction is a process that helps the ovaries in releasing eggs, to improve the chances of conception through artificial insemination (IUI) or intercourse.
  • • Women with low hormone levels for ovulation or women who are not ovulating at all may be aided with this process.
  • • Medication through tablets or injections may be required to stimulate hormones.
Prasad Hospitals Infertility IUI Procedure
  • • Intrauterine insemination (IUI) is the process of injecting the washed sperm directly into the uterus with a catheter.
  • • For the females, who are aged under 30 years have the optimal chances with IUI, whereas, for the males, about 15 million per ml of TMS (Total Motile Sperm) is optimal.
  • • It’s a very simple and less time-consuming process and has a higher success rate.

IVF (Since 2004)

IVF center in Hyderabad
  • • In-vitro Fertilization (IVF) is the technique in which fertilization of male and female gametes (sperm and ovum) occurs outside the human female body.
  • Prasad Hospitals have the best infertility specialists in Hyderabad and also have a Sterile environment for maintaining embryos and gametes using CO2 incubator.
  • • Vitrification or cryopreservation facilities for cold storage of gametes (sperm and egg).

a)    ICSI (since 2004)

ICSI - Prasad Hospitals Prasad Hospitals Infertility
  • • ICSI is the sophisticated method of IVF and it is the process of injecting a single sperm into an egg for fertilization.
  • • The solution for reproductive issues related to severe male infertility by Intra Cytoplasmic sperm injection (ICSI).
  • • Practiced since 2004 with a higher success rate at our center.
  • • Useful for infertile couples either having too few motile and morphologically normal sperm or where eggs cannot easily be penetrated by sperm. It is also can be used for those males who have undergone a vasectomy.

b)    Pre-implantation Genetic Diagnosis (PGD) / Pre-implantation Genetic Screening (PGS)

Best Infertility Hospital in Hyderabad
  • Pre-implantation Genetic Diagnosis (PGD) is a process in which one or two cells from an embryo on Day 3 or Day 5 are extracted and the cells genetically analyzed.
  • • Couples who are at a high risk of having an abnormal number of chromosomes or who have a history of single gene defects or chromosome defects are ideal candidates for this procedure.
  • • It is used to diagnose a large number of genetic defects at present.
  • Preimplantation Genetic Screening (PGS) is the process just to denote the procedures but not look for a disease specifically, but PGD is the technique that is used to identify the embryos which are at risk.
  • • The PGD technique can study the DNA of embryos or eggs where certain mutations for genetic diseases can be selected.
  • • Prasad Hospitals have the Best Infertility Specialists in Hyderabad and trained genetic counselors who would meet with you to discuss your genetic issues and your odds of having to do PGD.

Sensitivity Issues: What Men Need to Know

Prasad Hospitals Andrology

Establishing a family is a primary desire for many. But about 19 million Indian couples aren’t having the possibility to succeed the desire. Male Infertility is one of the most common issues faced which is caused due to the quantity, shape and semen sample is too a difficult issue for men. High DNA fragmentation in the sperm is also one of the major issue of ceasing the ability to become a father.

Reasons of Male Infertility

Inability to conceive a child can be due to -
  • • Problems with sexual function (difficulty with ejaculation, low libido, erectile dysfunction & painful erection).
  • • Swelling or lump or pain in one or both testicles.
  • • Recurrent respiratory infections.
  • • Hormonal abnormalities like reduced body hair growth.
  • • Low sperm count (total sperm count less than 20 million per mm3 of the ejaculate).

Our Doctors Team Can Help!

  • • Prasad Hospitals have the Infertility Specialists In Hyderabad, who are very patience in listening and understanding the very sensitive issues faced by many men.
  • Our Doctors best counseling sessions and a perfect timely medication have helped many men to get away from fertility issues.
  • • Technology came as a boon for both male infertile patients and Doctors as well.
  • • Whenever necessary, the Electro ejaculator supports a comfortable sample collection.
Prasad Hospitals Andrology

As fertility can be impacted by so many variables, every clinical check-up begins with a detailed history and physical exam and an ultrasound scan. Although at times tedious, the questions asked by the physician or urologist help direct the next steps by narrowing the possible diagnoses and subsequent treatments. Semen analysis is a critical step in the work-up of an infertile couple. These samples will be analyzed for several parameters that affect fertility, such as semen volume, sperm concentration, shape and size of the sperms. Our team of the Andrology lab has the state of art Computer Assisted Sperm Analysis (CASA) equipment.

Prasad Hospitals Andrology
  • • Many chronic conditions can also affect a man’s fertility.
  • • Deficiency in sugar levels results in nerve damage and this might be responsible for coordinating ejaculation.
  • • Liver cirrhosis can also impact fertility, as the condition is often associated with hormonal imbalances that can interfere with sperm production.
  • • Drugs like alcohol, heroin, cocaine, and marijuana also cause a great impact on the quality and quantity of sperm production.
  • • Antibiotics, antacids, antidepressants, gout, and blood pressure medications can also impact fertility.
  • • Exposure to lead, and mercury (heavy metals) may also influence sperm production.

All the above-mentioned conditions can lead to a lack of sex drive and eventually low motivation towards a normal sexual activity.

Risk Factors for Male Infertility

Varicocele

  • • Made up of enlarged veins in the scrotum on one or both sides.
  • • Veins making scrotum warm can also reduce sperm production.
Physical Problems With Testicles (e.g., Undescended Testicle)
  • • An undescended testicle is caused when failing to drop into the normal place of the scrotum, which is found in about 3 – 4 % newborns.
  • • During the first 3 months of life, about 50% of testicles do drop on their own. If else it continues after three months, they have to undergo treatment.
  • • Generally, the testicles need to be cooler than normal body temperature about 2 to 3 degrees.
  • • If the testicles are too warm for a long time, there are chances of failing the sperm in that testicle to mature normally.
  • • These causes Infertility problems, and the risk is more when both testicles are affected.
  • • They also cause
    • • Testicular Cancer in Adulthood.
    • • Testicular Torsion.
Blockages in the Ducts That Carry Sperm
  • • Some men have a problem with a blockage in ejaculatory ducts from birth. These problems cause fertility issues later.
  • • Some of the men face the lack of vas deferens which is the tube carrying out sperm from the testicles.
  • • Sperm transportation is also the issue caused due to the blockage in the ducts which carries sperm from the testes to the urethra.
  • • Problems arising in sperm transportation can be classified into the three categories
    • Congenital Disorders
      • • Congenital disorders are birth disorders that cause male fertility issues.
      • • They include incomplete development of the sperm ducts, atresia of the duct (natural blockage), and no seminal vesicles present to store sperm.
    • Acquired Disorders
      • • These are caused due to a disease or infection of the reproductive system.
      • • Inflammation can lead to scarring.
      • • Sperm transportation can be affected by scars in the ducts leading to no place for sperm to travel.
      • • During the hernia repair, motility is affected by severe sperm transportation ducts.
    • Functional Obstruction
      • • Functional obstruction is the disorder that ceases sperm movement and therefore cause male infertility.
      • • This type of disorders includes conditions like nerve damage caused in an accident, injury to the spinal cord affecting muscular motion.
      • • Tranquilizers, blood pressure medications also affect the nervous system.

Hormone Problems

  • • Lack of disruption in GnRH (Gonadotropin-releasing hormone) released by the brain may lead to a lack of testosterone in sperm production.
  • • In about 30 – 40% of cases, the problem is in the testes, the glands that produce sperm and testosterone (the main male sex hormone). The infections like mumps, cancer treatments may cause damage to the testes.
  • • It’s very rare in causing infertility problems due to hormone deficiency.
  • • Testosterone and sperm are produced due to the hormones like Luteinizing hormone (LH) and follicle-stimulating hormone (FSH).
  • • The pituitary gland, located in the brain, makes these hormones. The conditions like pituitary tumors cause low sperm production and level testosterone levels.

History of High Fevers or Mumps

  • • Mumps is caused by a virus and in some complicated cases, it causes salivary glands to swell up.
  • • Patients at any other age other than child or adolescent, though, the infection can have terrible repercussions.
  • • Healthy adults are also having a chance to suffer from inflammation of the brain and spinal cord.
  • • Inflammation of testicles due to the orchitis may cause to face infertility issues.
  • • The majority of the men who are infected with mumps may not face these issues, but some experience negative fertility effects.

Genetic Disorders

Genetic Disorders that cause infertility issues are
  • • Klinefelter Syndrome.
  • • Y Chromosome Deletions.
  • • Down Syndrome.

Infertility issues due to the mutations in a single gene are very less common. Congenital absence of the vas deferens, where there is a blockage to sperm flow, is caused by mutations in the cystic fibrosis gene.

Lifestyle or Environmental Factors

  • Lifestyle: 
    • • Stress, lack of exercise and sleep will adversely affect fertility.
    • Overheating the testicles
      • • Frequent use of saunas or hot tubs or laptop or mobile radiation can elevate core body temperature, which may impair sperm production and reduce the sperm count.
      • • The use of tight clothing such as jeans or tight undergarments made of polyester or polycot can increase the temperature near scrotum leading to male infertility and fungal infections in certain cases.
  • Diet: 
    • • In an acidic and toxic environment, sperm cells cannot function properly.
    • • The deficiency of nutrients in the diet makes the body toxic and leads to fertility issues.
    • • Intake of excessive caffeine, lack of vitamin C, zinc, and folic acid is also a factor.
  • Environmental exposure to pesticides and other chemicals: 
    • • Herbicides and Insecticides may cause low sperm production and also testicular cancer.
    • • Exposure of heavy metals like lead causes of male infertility.
  • Smoking and Consumption of Alcohol
    • Abuse of cocaine or marijuana
      • • The use of drugs may temporarily lower the number and quality of sperm.
      • • Anabolic steroids cause lower sperm production.
    • Smoking
      • • Tobacco causes lower sperm production.
    • Substance Abuse: 
      • • Alcohol or drug dependency can be associated with poor health leading to affect the nerves and bloodstream as well as in some cases pituitary gland thereby causing reduced fertility.
  • Excessive or Prolonged Emotional Stress:
    • • Excessive stress may interfere with hormones and leads to the cause of deficiency in sperm count.
  • Age: 
    • • As age increases, fertility may get down
  • Overweight & Obesity:
    • • Generally, a healthy Body Mass Index (BMI) ranges between 18.5 to 24.9.
    • • If the BMI ranges 25 to 29.9, the persons are overweighed, if, above 30, they are obese.
    • • Men with overweight or obese have low-quality sperm and also cause hormonal changes affecting fertility.
  • Underweight:
    • • Not only Overweight causes lower sperm quality, but Underweight (BMI under 18.5) can also cause fertility issues.

Fertility Gradually Decreases in Men Older Than 35 Years

  • Changes in sperm:
    • • The majority of male infertility problems are caused due to sperm abnormalities.
    • • When a man reaches age 40 and beyond, he gradually experiences several changes in his sperm.
    • • Lower sperm count.
    • • A decline in sperm movement.
    • • A decline in sperm quality.
    • • Abnormalities in sperm shape and structure (morphology).
  • As men age, increased the incidence of erectile dysfunction (ED)
    • • Erectile dysfunction, or ED, is another cause of age-related male infertility.
    • • ED occurs more often as men age.
    • • This can occur for a variety of physical and psychological reasons, which need to be diagnosed and treated.
  • Age causes changes in the male reproductive system and organ that can cause the system to operate less efficiently.
    • • At the age of 40, there may be changes in male reproductive organs which include softer testes.
    • • These physical changes can make it more difficult for the body to properly produce and transport sperm for fertilization.

Men with Normal Sperm Counts And Abnormal Morphology

  • • Those men who present with normal counts above 20 million/mm3 with abnormal morphology of sperms can lead to infertility.
  • • Various reasons can be due to
    • • Diabetes
    • • Chronic Stress
    • • Obesity
  • The test conducted at Prasad Hospital:
    • • Repeat semen analysis with three days’ absence.
    • • Scrotal scan and color Doppler test.
    • • Sperm DNA fragmentation test.

Men Present With Low Counts With Normal Morphology

  • • The approach for fertility management in these men is encouraged with the help of IVF procedures.
  • Prasad Hospitals has the best infertility specialists in Hyderabad, uses the most innovative techniques and have higher success rates in conceiving a healthy baby.

• Men With Extremely Poor Sperm Count Less Than 1 Million/mm3

  • • Intracytoplasmic sperm injection (ICSI) is the best suitable method.
  • • The success rate depends on the skill of the IVF specialist.
 

Non-Surgical Sperm Retrieval

  1. Microsurgical Epididymal Sperm Aspiration (MESA)
    • • MESA makes to have optimal pregnancy for the men who have the unreconstructable reproduction.
  1. Percutaneous Epididymal Sperm Aspiration (PESA)
  2. TESA: Percutaneous Testicular Fine Needle Aspiration (TFNA)
Prasad Hospitals Infertility

Surgical Sperm Retrieval

1. Testicular Biopsy Prasad Hospitals Infertility       How it is done
  • • Simple procedure to remove a small sample of tissue from one or both testicles.
  • • Using the Microscope, the tissue is examined to know whether the man can be a father.
  • • Local anesthesia is usually adequate for a comfortable procedure. Occasionally required anesthesia is offered.
Why it is done

Testicular Biopsy used to find the cause of male infertility but in rare cases. It may also be done if both of the following are true:

  • • The man's semen does not have sperm.
  • • It is done when the hormone results are in a normal range.
  • • A testicular biopsy may also be done to get sperm for in vitro fertilization or Intracytoplasmic sperm injection (IVF/ ICSI).
  • • For the confirmation of obstructive azoospermia in men with normal size testes and normal reproductive hormones and no sperm in the ejaculates.
2. Cryopreservation
  • • Sperm Cryopreservation allows having many ICSI cycles.
  • • Even the ICSI affects oocyte fertilization, but cryopreserved sperm may achieve successful fertilization.
  • • It also has the potential of separating sperm retrieval procedures from reproductive techniques.
  • • For obstructive azoospermia pregnancy rates for frozen and fresh epididymal sperm are virtually identical for Non-Obstructive Azoospermia (NOA), fresh sperm is preferable.
  • • Freezing of isolated spermatozoa from testicular tissue is difficult because of the low number of spermatozoa present in testicular tissue and the limited sperm motility of testicular sperm, which makes documentation of sperm viability difficult.

Infertility Specialists in Hyderabad

Results & Conclusions
  • • Sperm retrieval from men with non-obstructive and obstructive azoospermia is now possible with excellent pregnancy rates for obstructive azoospermia and acceptable pregnancy rates for NOA when ICSI is applied.
  • • The ability to use cryopreserved epididymal and often testicular spermatozoa will continue to limit the number of sperm retrieval procedures necessary to achieve fertility for a couple.
  • • Before these advancements in sperm retrieval techniques which have the best potential of fertility treatment, there was the only option that is adoption.
  • • Careful evaluation of Azoospermia is needed as some genetic abnormalities are associated with it.
  • • Multiple TESE procedures may cause both transient and occasional permanent alterations in testicular function including testicular atrophy and decrease testosterone levels.
  • • Prasad Hospitals, have the experienced physicians to perform sperm retrieval procedures.
3. Varicocoele Prasad Hospitals Infertility
  • • Varicocele is present in 15% of all men.
  • • 23% of varicocele is large.
  • • 3% of all men have large varicocele.
  • • Large varicocele causes more severe impairments in semen quality.
Varicocele surgery results
  • • Varicocelectomy, carefully performed in selected cases.
  • • About 60 -80 % of men results in a significant improvement in semen analysis.
  • • After Varicocele surgery, the tendency of having a normal pregnancy is about 43% and 69% at one and two years respectively.
  • • After Varicocele surgery, pregnancy rates may vary from 20% to 60%.
  • • As part of the fertility workup, you’ll make an appointment to either produce your sample in office or drop it off at the clinic or lab after you produce a sample at home.
  • • Plan accordingly with sperm, as timing is so essential.
  • • You’ll need to refrain from any sexual activity for at least two to three days, but not more than 10 days before you collect your sample.
  • • The decrease in sperm motility may be resulted due to abstinence.
  • • Samples produced have a higher number of motility sperm after two or three days of abstinence than the samples produced after shorter or longer abstinence.
  • • Some men think saving up all their sperm for the day of their test is what’s preferable, but waiting too long between ejaculates is a big mistake.
  • • With the increase of abstinence, the percentage of live sperm decreases.
  • • Avoid smoking, consumption of alcohol for at least 10 days before preceding sperm collection.
Things that affect the quality of sperm sample are:
  • • Perfumes and body sprays.
  • • Usage of lubricants.
  • • Too short abstinence less than one day.
  • • High temperature.
  • • Heavy smoking.

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