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Rotunda fertility Clinic,Surrogacy clinic IndiaInfertility Clinics in India Mumbai specialize in the area of IVF Treatment Our Infertility Treatments Clinics includes ICSI IUI Treatment, Embryo Donation, Egg Donation, infertility treatment, Male Female Infertility Treatment Mumbai Fertility Clinics in India Doctors, Gynecology Pregnancy Infertile Couples Problems Child birth in Mumbai Maharashtra Hospitals Conceiving Concepts Sex, IVF baby, Infertile Couple having Test Tube Baby Egg Donors Sperm Donation in our fertility IVF Centres Hospitals Mumbai Maharashtra India Good Fertility IVF Clinics in India New Delhi Chennai Bangalore Kolkata Kerala Mumbai Centre Infertile Couples in Muscat Oman USA Canada Australia United Kingdom UK London UAE United Arab Emirates Dubai China Kenya Nigeria Ethiopia

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        Home                                       Welcome to the official website of Rotunda Fertility Clinic and Keyhole Surgery

        Programs and Services                      Centre. This clinic is the latest venture of Rotunda-The centre for Human
                                                   Reproduction and one step forwards in creating a chain of well equipped and State-
        Infertility Surgery
                                                   of-the-art IVF centres in the city of Mumbai.
        All you need to know
                                                   In addition to Infertility treatments, we also have facility for patients to undergo
        Pictures and Videos                        keyhole surgery which is performed by reknowned specialists when indicated.
        About us
        Glossary of terms                          Facing infertility and undergoing treatment for the same is without doubt one of the

        Our Success rates                          most distressing situations that a couple can face. It fosters uncertainities, doubts,
                                                   fears, guilt and apprehensions. We at Rotunda strive towards making the whole
        Contact us
                                                   process as simple and transparent as possible, providing guidance and counselling
                                                   at every step. We boast of a team sensitised to the needs of our clients and have a
                                                   long track record to prove this. Most of all, we respect our clients' need for privacy
                                                   and offer this and much much more at very reasonable and competitive rates.

                                                                                                       Egg donation may offer
                                                                                                         the only chance of.....

                                                                                                     Success rates at Rotunda
                                                                                                         Centre of Human.....

                                                                                                        Please use this form to
                                                                                                               request an .......

http://www.rotunda.co.in/[12/22/2010 5:36:08 PM]
Male and Female

   Enhance comfort level with workup

   Basic Management Strategies

   www.rotunda.co.in
   12 months of unprotected intercourse

   Earlier for certain historical factors

   Older than 35
Infertility Etiology
Female Factors
               Male Factors
General Causes             Meds
   Unknown: 40-50%           1 or 2
   1 Hypogonadism: 30-
    40%                       Common medications
                                  Ketoconazole
   Altered Sperm                 Cimetidine
    Transport: 10-20%             Spironolactone

   2 Hypogonadism: 1-2%
               The Scenario
   Tech: “Husband and wife can’t get

   You: OB rotation was last infertility workup

   What now?

   History is KEY

   Focused Physical Exam

   Labs and Specialized Tests
             Workup: History
   Coital Practices
   Gestational History
   PMHx/PSHx
   Meds
   Menstrual History
   Substances
   Recent High Fever
          Our Couple: History
Female                    Male
   G1 P0010                 No previous partner
   No hx of STIs
                             Gonorrhea hx
   Normal menses
                             No meds
   Unprotected sex for
    15 months                Occasional EtOH
      Workup: Physical Exam
Female                  Male
   Breast Formation       Infection
                           Hernia
   Galactorrhea           Vas deferens
                           Androgen deficiency
   Genitalia              Testicular mass
                           Varicocele
   Hyperandrogenism?
              Workup: Labs
Female                      Male
   Ovulation problems         CBC
                               FSH, Testosterone
   Ovulatory Dysfunction      GC/Chlam, UA
                               Renal and Liver
   Ovarian Reserve             Function
                               Semen analysis
                               Postejaculatory
           WHO Seminal Fluid
            Analysis (1999)
   Volume: >2ml
   Sperm concentration: >20 million/ml
   Total Sperm Number: >40 million/ejaculate
   Sperm Motility:
     >50% motile and/or
     >25% progressively motile

   Sperm Morphology: >14% normal forms
        Workup: Special Tests
Female                      Male
   Transvaginal               Scrotal
    Ultrasonography             Ultrasonography

   Hysterosalpingography      Transrectal
   Hysteroscopy

   Laparoscopy
          Our Couple: Exam,
            Labs & Tests
   Normal male exam

   Normal initial labs

   Oligospermia on 2 separate semen

   TRUS and postejaculatory UA normal
        Management: General
   41 different methods

   “Fertile window” intercourse

   “E-type” vaginal discharge

   Avoid lubricants and douches
        Management: Female
   Treat underlying cause

   Hyperprolactinemia

   PCOS

   Gonadotropin therapy
            Management: Female
   Ovulatory dysfunction (Unknown etiology)
     Clomiphene 50mg PO daily x 5 days
     Start on days 3-5

     Can increase to 100mg daily next cycle

     Results
         80% will ovulate
         Hyperstimulation and Twinning

         Higher-order multiples rare
           Management: Female
   Clomiphene Failure?

       IVF

       Injectable ovulation-inducing agents
        Management: Female
   Tubal/Pelvic/Uterine Issues
     Reparative Surgery (low success)
     IVF

   Endometriosis
     Laparoscopic ablation
     Laparotomy

     Ovulation induction +/- IUI and IVF
           Management: Male

   Hyperprolactinemia

   Surgical repair

   Fertility Specialist
         Stress and Infertility
   69% Women and 21% Men have
    preexisting condition

   Greater risk for psychological stress

   No significant difference in
         Stress and Infertility
   Men have increased stress over time,
    same as women

   Watch for normal grief vs. psychopathology

   Same rates of depression as other chronic
         Stress and Infertility
   Bottom line: Not a means to improve
    pregnancy rates.
     Management: Our Couple

   Male: Imipramine Mar 08

   Pregnant in www.rotunda.co.in June
   Separated from USAF in July 2008
Infertility treatments


                         Home     Programs and Services     Infertility treatments

                         Infertility treatments

                         Rotunda offers all services pertinent to infertility under one roof. We are known for our innovation, integrity, medical
                         and technical excellence, personalized service, and consistent willingness to accept patients facing the most difficult
                         medical challenges. We offer the following services:

                         Intrauterine Insemination

                         In vitro Fertilisation (IVF)


                         IVF Lite (Mild IVF/Minimal stimulation IVF)

                         Surgical Sperm retrieval

                         Donor Egg program

                         Sperm banking and donor sperm

                         Embryo freezing

                         Gestational Surrogacy

                         Embryo donation

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