Gynecology and Fertility Treatments by ArmanCare


									Gynecology and Fertility Treatments

Gynaecological endoscopy

Hysteroscopic procedures

Laproscopic procedures

Gynaecologic oncology intrauterine synaechia

In vitro fertilization (ivf)

Intra cytoplasmic sperm injection (icsi)

Donor egg sharing


In Vitro Fertilization ( IVF )
          In vitro fertilization is an accepted medical treatment for many causes of infertility.

“In vitro” literally means “outside of the body”, hence this is a reproductive technology in which a
female egg is joined with a male sperm cell in a test tube (in vitro). The first IVF baby, Louise Joy Brown,
was born in England in 1978. It is most often tried when other, less expensive fertility techniques have

          Why the procedure is performed ?

         IVF is done to help a woman become pregnant. It is used to treat many causes of infertility,

•        Advanced age of the woman (advanced maternal age)

•      Damaged or blocked fallopian tubes (can be caused by pelvic inflammatory disease or prior
reproductive surgery)

•        Endometriosis

•        Male factor infertility, including decreased sperm count and blockage

•        Unexplained infertility
For IVF to be successful it typically requires healthy ova, sperm that can fertilize, and a uterus that can
maintain a pregnancy. Due to the costs of the procedure, IVF is generally attempted only after less
expensive options have failed.

        What happens if a female dosent produce healthy eggs or if male is sterile ?

        IVF may be done with a couple’s own eggs and sperm or with donor eggs, sperm, or embryos.
Some couples choose to use donor eggs, sperm, or embryos because of genetic concerns. Donor eggs
are used in approximately 10% of all assisted reproductive technology (ART) cycles.

IVF can also be used with surrogacy where the woman providing the egg isn't the same who will carry
the pregnancy to term. This means that IVF can be used for females who have already gone through
menopause. The donated oocyte can be fertilized in a crucible. If the fertilization is successful, the
embryo will be transferred into the uterus, within which it may implant.

        There are five basic steps to ivf

         Step 1: stimulation / super ovulation

         Medicines, commonly called fertility drugs, are given to the woman to boost her egg production.
Normally, a woman produces one egg per month. Fertility drugs tell the ovaries to produce several eggs.
During this step, the woman will have regular transvaginal ultrasounds to examine the ovaries and blood
tests to check hormone levels.

        Step 2: egg retrieval

        A minor surgery, called follicular aspiration, is done to remove the eggs from the woman’s body.
The surgery is normally done as an outpatient procedure in the doctor’s office. The woman will be given
medicines so she does not feel pain during the procedure. Using ultrasound images as a guide, the
health care provider inserts a thin needle through the vagina and into the ovary and sacs (follicles)
containing the eggs. The needle is connected to a suction device, which pulls the eggs and fluid out of
each follicle, one at a time. The procedure is repeated for the other ovary. The woman may have some
cramping after the surgery, but it usually goes away within a day. In rare cases, a pelvic laparoscopy may
be needed to remove the eggs.

If a woman does not or cannot produce any eggs, donated eggs may be used.

        Step 3: insemination and fertilization

          The man’s sperm is placed together with the best quality eggs and stored in an environmentally
controlled chamber. The mixing of the sperm and egg is called insemination. The sperm usually enters
(fertilizes) an egg a few hours after insemination. If the doctor thinks the chance of fertilization is low,
the laboratory staff may directly inject the sperm into the egg. This is called intracytoplasmic sperm
injection (ICSI). Many fertility programs routinely do ICSI on some of the eggs even if everything is
        Step 4: embryo culture

         When the fertilized egg divides, it becomes an embryo. Laboratory staff will regularly check the
embryo to make sure it is growing properly. Within about 5 days, a normal embryo has several cells that
are actively dividing.

Couples who have a high risk of passing a genetic (hereditary) disorder to a child may consider pre-
implantation genetic diagnosis (PGD). The procedure is done about 3 -4 days after fertilization.
Laboratory scientists remove a single cell from each embryo and screen the material for specific genetic
disorders. According to the American Society for Reproductive Medicine, PGD can help parents decide
which embryos to implant, which decreases the chance of passing a disorder onto a child. The technique
is controversial and not offered at all centers.

        Step 5: embryo transfer

        Embryos are placed into the woman’s womb 3 - 5 days after egg retrieval and fertilization. The
procedure is done in the doctor’s office while the woman is awake. The doctor inserts a thin tube
(catheter) containing the embryos into the woman’s vagina, through the cervix, and up into the womb.
If an embryo sticks to (implants) in the lining of the womb and grows, pregnancy results.

More than one embryo may be placed into the womb at the same time, which can lead to twins, triplets,
or more. The exact number of embryos transferred is a complex issue that depends on many factors,
especially the woman’s age. Unused embryos may be frozen and implanted or donated at a later date.


          After embryo transfer, the woman may be told to rest for the remainder of the day. Complete
bed rest is not necessary, unless there is an increased risk of OHSS. Most women return to normal
activities the next day.

Women who undergo IVF must take daily shots or pills of the hormone progesterone for 8 - 10 weeks
after the embryo transfer. Progesterone is a hormone produced naturally by the ovaries that helps
thicken the lining of the womb (uterus). This makes it easier for the embryo to implant. Too little
progesterone during the early weeks of pregnancy may result in a miscarriage.

About 12 -14 days after the embryo transfer, the woman will return to the clinic so that a pregnancy test
can be done.

Call your health care provider right away if you had IVF and have:

•       A fever over 100.5 F (38 C)

•       Pelvic pain
•       Heavy bleeding from the vagina

•       Blood in the urine

        How successful is in vitro fertilization

          The success rate of IVF clinics depends on a number of factors including patient characteristics
and treatment approaches. It is also important to understand that pregnancy rates are not the same as
live birth rates. In the United States, the live birth rate for each IVF cycle started is approximately:

•       30 to 35% for women under age 35

•       25% for women ages 35 to 37

•       15 to 20% for women ages 38 to 40

•       6 to 10% for women ages over 40

What is medical tourism?

 Medical tourism, also known as health tourism or health travel, is a term that describes travelling to a
foreign country for medical, dental, or cosmetic treatment. It involves the benefit of cost effective
treatment, private medical care, in collaboration with the tourism industry. The concept of medical
tourism is fast growing in India and people from different part of the world are choosing India as their
desired destination.

Why Choose India?

Medical tourism is a rapidly growing sector in India and millions of medical tourists from all over the
world have come here to experience a world-class healthcare service.

In 2010, about 600,000 patients travelled to India from over 30 countries for treatment, including the
USA, Canada, UK, Russia, the Middle East and Africa.

According to a study by the Confederation of Indian Industry (CII) on healthcare, after software, the
medical tourism industry is poised to be the next big success story in India. It has predicted that the
industry will grow to earn additional revenue of $2.3 billion by 2012 and will soon account for a major
share of the country’s revenue.

There are several reasons behind this tremendous growth:

Patients come to India to get specialized treatments not available in their home country. Indian hospitals
excel in performing complex cardiac surgeries, kidney transplants, bone marrow transplants, orthopedic
surgeries, infertility treatments amongst their wide repertoire.
India provides world-class quality treatments at a fraction of the priceof developed countries. The cost
of medical treatment in India is generally one tenth of western countries and among the cheapest in

India has state of the art medical institutes and hospitals of international standards with highly qualified
medical professionals.

These centers are backed by high quality equipment and technology. This fusion of highly qualifiedstaff
assisted by the latest equipment gives India the edge over other countries.

With hospitals and clinics in every region including urban, semi-urban, or rural parts of the country, India
has ample choice in terms of preferred destinations.

In countries such as Canada and the UK, patients almost always have to wait weeks and sometimes
months to avail of medical treatments. In India the consultations with the doctors are prompt and
patients receive a turnaround to their treatment plan at a quicker pace.

As English is a commonly spoken language in India, the patient will be comfortable communicating with
the doctors.

Medical tourists find that the cost of their treatment (including the return airfare, holiday and
accommodation) leaves them with a total bill substantially less than they would have spent just on
having the procedure in the UK.

Why Arman

There are several concerns that flicker in the minds of the foreigners who come for treatment to India,
particularly for first time fliers. The first among them is which hospital to choose for their treatment.

India is flooded with hospitals, medical centers and hotels which have their websites that attract the
foreign patients. This makes them even more confused and the complexity of decision making becomes
a challenging task.

We, at Arman can address all these concerns and issues by acting as intermediary with hospitals, clinics,
surgeons, hotels.

Arman is a healthcare facilitator that has painstakingly brought together highly qualified professionals
and hospitals of repute and health care providers.

We take the responsibility of screening the hospitals by checking their track record, accreditations,
associations and have partnered with the best internationally accredited hospitals in India.

Arman update and monitor our network of hospitals on a regular basis and maintain a database on the
hospital’s certifications, type of facilities and other factors critical in choosing a medical center.
Arman also negotiate a lower price from the hospital which foreign patients would not get by directly
approaching the hospitals This helps the patient to save a lot on the medical procedure costs

We provide assistance with logistics, documentations, permits and other travel arrangements required
for medical tourism.

Our coordinators are highly trained to foresee every need of the patient and make the entire process
hassle free from start to finish. They help the patient plan his medical procedures before leaving home,
and schedules all his appointments, surgery, treatments and plans for recuperation.

This in turn helps the patient to choose the hospital according to his convenience and also get a clear
picture of the cost of treatment, accommodation beforehand that helps them to arrange their finance.

We are aware that a lot of trust is put in our hands and ensure that this trust is well placed by serving
each patient individually with care and comfort.

How We Work

Patient query received by the patient himself or his doctor/ hospital.

This query along with medical reports is forwarded to the concerned hospitals to get expert opinions

After the hospitals respond, we create a package for the patient which includes recommendation on the
treatments, duration of stay, and the costs involved.

The patient reviews the various options presented to him and makes a decision based on budget and
the line of treatment recommended by the doctors. Occasionally, a patient may clarify his concerns or
questions he may have regarding the treatment with the doctor by telephone.

In liaison with the patients, Arman representatives will make prior bookings with the hospital, airlines,

Patient travels and checks into hospital to start the treatment. We provide assistance through out your
stay in the hospital which include pre and post opeartive care.

Once fit and able to travel, the patient if wishes can enjoy the vast tourist destinations within India
before returning to their home country fully rejuvenated. (at an additional cost)(ebranding/mum/ts/19)

Arman Health Care Facilitators


422, Bonanza, 'B' Wing,Sahar Plaza Complex, Next to Kohinoor Hotel,

Andheri Kurla Road, Andheri East Mumbai India 4000059.
Contact: land line No: ( 022-28387433 ) Email


Arman Health care Facilitators,Gallery Saint-Pierre, 36 local

UtexAfrica Advanced ,AV 374 VolonelMondjiba,Kinshasa / Ngaliema,DRC Mobile : +243998290384


Arman Health Care Facilitators C/O Doctor Pharma Kenya Limited Vision Tower, Muthithi Road,

Westlands, Nairobi,Kenya.Contact: Telefax:(+254)722330329

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