It is a condition of the reproductive system in which the couples are unable to conceive even after trying for more than a year without the use of any type of contraceptives.

Generally, it is recommended to seek medical help if the couple cannot conceive for a time longer than one year. But it is not always the case. If a woman has irregular periods, endometriosis, or PCOS, or if either partner has a history of sexually transmitted diseases, seeking help right away makes sense. Also, a woman over the age of 35 is advised to consult after trying for six months.
If you have a family history of early menopause or primary ovarian insufficiency (also known as premature ovarian failure), talking to your doctor soon is recommended.
If you're 39 or 40 years old and just starting to try to conceive, it's worth seeing your doctor now.

It is a common assumption that infertility is primarily related to the woman. In reality, only one-third of infertility cases are related to the woman alone. Statistically, one-third of infertility problems are related to men and the remaining one-third is a combination of fertility factors involving both partners or due to unknown causes. Unknown causes account for approximately twenty percent of infertility cases.

Age affects the ability to conceive and have a healthy baby. Age is the single biggest factor affecting a woman’s fertility. For men, age-related fertility decline is more subtle but does happen. A woman’s fertility starts to decline in her early 30s, with the decline speeding up after 35.

IUI stands for intrauterine insemination. It is one of the common techniques of ART (Assisted Reproductive Technology). In this process, the processed (washed) sperm is used and put directly to the female’s uterus. This process is matched with natural ovulating cycle.

It is a non-surgical process by which egg cells are fertilized by sperm outside the womb in the laboratory. It is also popularly known as Test Tube Baby.

IVF is usually recommended when both the woman’s fallopian tubes are blocked, sperm parameters are very poor and when all other fertility treatments have been unsuccessful. Poor sperm quality and/or quantity, ovulation problems, and sperm-egg interaction problems are some other problems that can prevent couples from having a baby naturally. IVF helps to solve this.
Specific conditions where patient might require IVF include:Tubal blockage or failed tubal reversal

Cervical factor
Pelvic adhesions
Male factor
Unexplained infertility/failed conventional therapy
Genetic testing (PGD) for inheritable diseases
Genetic testing (PGD) for possible reasons for multiple miscarriages

IVF process can be understood with the help of certain steps which are explained below. •Ovarian stimulation: The fertility specialist monitors the timing of egg release. Doctor will make sure the hormonal level and other conditions for IVF are normal or not. The doctor watches over the produced eggs to find out whether it is appropriate or not. •Egg retrieval: In this step, the eggs are taken out from female’s ovary by using needle under light sedation. Further, the eggs are placed in a dish containing nutrient media and further it is shifted to the incubator. •Fertilization: This is the next step of IVF called fertilization where male sperms are taken and placed with the egg in an incubator for the formation of embryos. However, in ICSI(Intro cytoplasmic sperm injection), the most active sperm is selected and individually fertilized with an egg and then placed in a special incubator. Then, the process is monitored so that healthy embryo can develop. •Embryo transfer: It is the last step in which the healthiest embryo is transferred. Initially, the doctor examines so that healthy embryo can be selected. With the help of small plastic tubes, the embryo is transferred.

IVF is mild to no pain procedure because the injections used for IVF are purified and injected in subcutaneous form. The egg collection process is done under light sedation which is totally painless. However after egg collection, the patient might feel slight discomfort for some time. At the time of embryo transfer, anesthesia is not given but it is a 10 to 15 minutes of process which hardly cause any pain.

The in vitro fertilization process can last anywhere from four to six weeks prior to egg retrieval. The embryo(s) will then be implanted after three or five days afterwards. It can be done within few hours. Then the normal pregnancy period begins.

A single embryo transfer during IVF is the standard of care for the majority of people trying to conceive. The CDC, American Society for Reproductive Medicine, and the Society for Assisted Reproductive Technology all recommend one embryo transfers for most IVF patients.
Why is that?
It comes down to safety and success rates. With IVF, your primary goal is to have a healthy baby. When transferring double or multiple embryos, your chances of having twins or multiple births also understandably goes up with which risks to the baby's and your health also increases.

On the 12th day after the day of the transfer, it is possible to see whether there is a pregnancy with Beta-HCG test in the blood.

The probability of success with IVF treatments depends upon a number of factors like the age of the woman, the cause of infertility, the quality of eggs retrieved and the quality of the semen. Most women typically see success rates of 35-45% per cycle.
With careful handling of the process and proper analysis of the patient records, we at Vatsalya have been achieving a success rate of 60 – 65 %.

It is medically possible to go for the next cycle immediately. In some cases, however, modification of the treatment is necessary, depending upon the assessment of patient’s previous cycle.
For example, if the ovarian response was poor, additional medications can be advised to increase the ovarian response for the next cycle.

No. You can return immediately to normal activities after transfer except sexual life and sports.

Natural IVF is different from conventional IVF in their approach. Whilst Natural IVF focuses on the quality of eggs retrieved and work alongside the woman’s natural menstrual cycle, conventional IVF uses stimulating drugs to grow lots of follicles (immature egg cells).
With Natural IVF, the wellbeing of the woman is paramount, so there are fewer drugs, less side effects and a reduced treatment duration. Furthermore, treatment focuses on those eggs that only need gentle help to mature, meaning that they will likely be of good quality. However, it comes with limitations of unexpected premature “LH surging” or ovulation, egg may not develop into healthy embryo and lower rate of successful pregnancy.
In conventional IVF, fertilization problems can be diagnosed and treated accordingly, can screen for inherited diseases, unused embryos can be stored for future use and get a higher successful pregnancy rate. However, patients are at a higher risk of developing Ovarian Hyperstimulation Syndrome (OHSS) as a result of over-stimulation from FSH injections.

NO, these babies are the same- mentally and physically except that they are very special because it is a very difficult journey for their parents.

In donor IVF, either egg or sperm is obtained from the anonymous donor.
Egg donor IVF may be required or recommended in any the following situations:

Post-cancer treatment (if the ovaries or eggs were damaged or removed)
Woman born without her ovaries due to a congenital anomaly
Repeated canceled IVF treatment due to poor or low ovarian response
Unexplained repeated IVF failure
Low ovarian reserves (indicated by very high FSH levels or a low antral follicle count)
Primary ovarian insufficiency (also known as premature ovarian failure)
Age related infertility (most often for women age 40 or older)
Genetic disease risk on female partner’s side

Sperm donor IVF may be required or recommended in any the following situations:

Male partner is unable to produce healthy sperm (The healthy sperms are characterized by sperm count, mobility and morphology)
Same sex partners decide to conceive
If the female wants to be a single mother.

Yes. If the female is ovulating normally and eggs can be retrieved, IVF can be performed and matured embryo can be implanted on the uterine wall. The fallopian tubes is the place where fertilization normally occurs and if tubes are blocked fertilization won’t be possible. However, in IVF we do external fertilization so it is not an issue.

Yes. The situation in which male cannot produce sperm is called Azoospermia. Azoospermia (when there is no measurable amount of sperm in the ejaculate) affects a notable percentage of men and exists in two main forms: obstructive and non-obstructive azoospermia. For men and couples suffering from male factor infertility due to azoospermia, sperm retrieval with ICSI with IVF is the most effective form of treatment.
Unless the man is completely sterile, there is usually a small amount of sperm that, although don’t appear in the ejaculate, may be retrieved using TESA.

Two of the most common fertility treatments are In Vitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI). The key difference between IVF and ICSI is how the sperm fertilizes the egg. In IVF, the egg and sperm (of which there are multiple) are left in a petri dish to fertilize on their own. In ICSI, one sperm is directly injected into the egg.
ICSI will likely be better for you if you are affected by sperm-related infertility. This is because ICSI is the most common and successful treatment for male infertility, as the sperm is given extra assistance. Hence, your doctor may recommend ICSI if the male has (1) a low sperm count (2) an abnormal sperm shape or motility, or (3) the sperm to be collected surgically (for example, if you have had a vasectomy).
IVF is one of the most commonly used and successful fertility treatments and is suitable for a wide variety of people and a wide variety of fertility issues. Hence, there are different types of IVF for different ages and conditions.

During cancer treatment, patients have important and complex issues to consider, including present and future fertility. Because many cancer treatments can damage future fertility, patients who are or will be at a childbearing age should ask their cancer care team about the possible impact treatment might have on their ability to have children so they can discuss their options.
If the fertility has not been damaged, freezing technology can help to secure the dream of being a parent. IVF technology can be used later to conceive.

Fertility preservation can be considered under following conditions

Immediate threat to fertility because of chemotherapy or pelvic radiation therapy
Surgery associated with the risk of damage to the ovary
Ovarian disease (e.g. endometriosis or uterine fibroids) with the risk of damage to the ovaries
Risk of premature ovarian insufficiency due to fragile X-Syndrome, or the family history of premature ovarian failure
Genetic mutations oophorectomy
Loss of male fertility due to exposure to hot environmental conditions like working near furnace, professional driving, cooking, laundry services, etc. or exposure to harmful chemical while working in mines or in military services.
Delaying pregnancy for personal reasons

Storing eggs for longer duration does not appear to have negative effect but it should be kept in mind that older maternal age carries higher risk of pregnancy related complications.

Laser-assisted hatching can turn around a history of failure for embryos to implant themselves in the uterine wall. It is a technique to manipulate embryos for enhanced fertility in which it uses a highly focused infrared laser beam to remove the zona pellucida, the embryo covering, in very precise increments. Laser-assisted hatching requires less handling of the embryo than these other assisted hatching methods. Also, laser-assisted hatching is faster than the other methods and, therefore, the embryo spends less time outside the incubator.

No, surrogacy is not legal in Nepal

Male infertility is commonly due to deficiencies in the semen. It may be due to the sperm count, mobility factor or morphology.
The average sperm count is between 40 million and 300 million sperm per milliliter.
A normal sperm has an oval head about 5-6 micrometers long and 2.5-3.5 micrometers wide, and a single long tail.
Motility and velocity are measurements of how well sperm can swim to fertilize an egg and how fast the sperm travel.

कुनै पनि गर्भरोधक साधनको प्रयोगबिना १ वर्षभन्दा बढी समय सम्म गर्भधारण गर्न नसकिएको अवस्था बाँझोपन हो ।

सामान्यतय: बिना गर्भरोधक साधनको १ वर्ष सम्मको प्रयासमा पनि गर्भधारण गर्न नसकेको अवस्थामा स्वास्थ्यकर्मीको सल्लाह लिनुपर्छ भने कुनै-कुनै अवस्था जस्तै अनियमित महिनावारी, इण्डोमेट्रियोसिस, पी.सी.ओ.एस्.  यौन रोगको संक्रमण जस्ता लक्षण भएमा तुरुन्तै स्वास्थ्यकर्मीको सल्लाह लिनु जरुरी हुन्छ।

३५ वर्षभन्दा बढी उमेरका महिलाहरुको हकमा भने ६ महिना सम्मको असफल प्रयास पछि नै सल्लाह लिनु उचित हुन्छ ।

यदि तपाईंको परिवारमा शिघ्र रजनोवृत्ति हुने देखिएमा, Premature Ovarian Failure भएमा वा महिलाको उमेर ४० वर्षको हाराहारीमा भएमा शिघ्र आफ्नो डाक्टरको सल्लाह लिनु उत्तम हुन्छ ।

बाँझोपनका धेरै कारणहरु महिला सँग सम्बन्धित भएपनि, वास्तविकतामा एक तिहाइ बाँझोपनका अवस्थाहरुमात्र महिलाका कारण भएको देखिएको छ । यस्तै बाँकी एक तिहाइ अवस्थाहरु पुरुषका कारण हुन्छ भने दुवैका कारण अथवा अज्ञात कारणहरुले गर्दा अर्को एक तिहाइ बाँझोपनका अवस्था देखिएको हो ।

बाँझोपनका कुल अवस्था मध्ये २० प्रतिशत अवस्था अज्ञात कारणहरुले हुने गर्दछ ।

बढ्दो उमेरसंगै महिलाको प्रजनन शक्तिमा ह्राश आउन थाल्छ । ३५ वर्ष पश्चात महिलाको डिम्ब उत्पादन क्षमता छिटो पतन हुन थाल्छ साथै प्रजनन सम्बन्धि अन्य समस्याहरु पनि देखिन थाल्छ । त्यसैले ३५ वर्ष भन्दा पहिले नै गर्भधारण गर्नु उचित देखिछ।

३५ वर्ष पश्चात पनि अलि कम सफलताको दरमा IVF गर्न भने सकिन्छ।

यो एक Assisted Reproductive Technology (ART) हो जस अन्तर्गत पुरुषको शुक्रकिटले  महिलाको डिम्बवाहक नलीमा प्राकृतिक रूपमा प्रवेश गर्न नसकेमा, IUI प्रक्रिया गर्न सकिन्छ । यस प्रक्रियामा पुरुषबाट प्राप्त शुक्रकिटलाई राम्ररी वाश गरी विशेष साधन (क्याथेडर) को मद्दत बाट माहिलाको महिनावारीलाई ध्यानमा राख्दै उचित समयमा डिम्बवाहक नलीमा हालिन्छ ।

यो विधि, ग्रीवा (cervix) सम्बन्धि समस्या देखिएमा, केहि अज्ञात कारणले बाँझोपनका समस्या उत्पन्न भएमा वा एकल महिलाले सन्तान प्राप्ति गर्नु परेमा अपनाउन सकिन्छ ।

IVF एक शल्यक्रिया रहित गर्भधारणको विधि हो जस अन्तर्गत पुरुषको शुक्रकिट र महिलाको डिम्बलाई वाह्य रुपमा निषेचित (fertilize) गरिन्छ । यो प्रक्रिया प्रायत: पेट्री डीस वा टेस्टट्यूबमा गरिन्छ र यो विधि टेस्ट ट्यूब बेबीको नामले पनि प्रख्यात छ ।

कुनै महिलाको दुवै फलोपियन ट्यूब ब्लक भएको छ वा पुरुषको शुक्राणुको गुणस्तर न्यून छ वा सन्तान प्राप्तिको सबै अरु प्रयास असफल भएमा IVF गर्न सकिन्छ । साथै महिलामा डिम्ब उत्पादनमा समस्या देखिएमा वा कुनै कारणले शुक्राणु र डिम्बको मेल हुन नसकेमा यो विधिको प्रयोग गरिन्छ ।

IVF चाहिने मूल अवस्थाहरु निम्न प्रकारका छन् ।

  • डिम्बबाहिनी नली (fallopian tube) बन्द भएको अथवा त्यसमा कुनै समस्या देखिएको अवस्थामा
  • डिम्ब उत्पादन प्रक्रिया असन्तुलित भएमा वा डिम्ब उत्पादन हुन समस्या देखिएमा
  • सामान्य समय अगावै डिम्बाशयले कामगर्न बन्द गरेमा
  • ट्युमरको अथवा इन्डोमेट्रियमको अप्राकृतिक विकासले गर्दा गर्भधारण हुन नसकेमा
  • शुक्रकिट सम्बन्धि विभिन्न समस्या देखिएमा
  • वंशानुगत समस्याबाट ग्रसित भएमा
  • कुनै जटिल प्रकारका बाँझोपनको समस्याबाट ग्रसित भएमा
  • डिम्ब वा शुक्रकिट फ्रिजिंग गरेर राखिएको अवस्थामा पुनः गर्भवती हुनु परेमा

यस बाहेक कुनै अरु किसिममा जटिलता/ अवस्था देखिएमा पनि डाक्टरको सल्लाहमा IVF गर्न सकिन्छ ।

IVF थोरै अथवा कुनै शल्यक्रिया बिना पनि गर्न सकिन्छ । यो खासै जटिल प्रकृया पनि होइन । सामान्य महिनावारीको चक्रसंगै यो विधिको सुरुवात हुन्छ । यसमा निम्न कुराहरु गरिन्छन् ।

  • Ovarian Stimulation
    यस अन्तर्गत डाक्टरले डिम्ब उत्पादन हुने समयको निगरानी राख्दछ । हर्मोनको मात्रा र अरु शारीरिक अवस्थाको परिक्षण पश्चात डिम्बको उत्पादन सामान्यभन्दा बढी गराउनलाई महिलालाई औषधि सेवन गराइन्छ । पुरुषको शुक्राणुलाई प्रभावकारी बनाउन कति अवस्थामा पुरुषलाई पनि औषधि सेवन गराइन्छ । यसपछि डाक्टरले समय समयमा डिम्बहरुको निगरानी गर्दछ र उचित समय हेरी महिलाको डिम्बाशयबाट डिम्ब निकालिन्छ ।
  • Egg Retrieval

    यस प्रकियामा विशेष साधनको प्रयोग द्वारा, शरीरको केहि भागलाई थोरै लाटो बनाई डिम्बाशयबाट डिम्बहरु  निकालिन्छन् र न्यूट्रीयन्ट मेडियामा राखिन्छ। पछि यसलाई इन्क्युबेटरमा स्तानान्त्रण गरिन्छ ।

  • Fertilization

    IVF को यस चरणमा महिलाको डिम्ब र पुरुषको शुक्रकिटलाई पेट्री डीसमा हाली इन्क्युबेटरमा निषेचित गराउन छोडिन्छ भने ICSI (Intro Cytoplasmic Sperm Injection) को हकमा उपलब्ध शुक्राणु मध्ये सबैभन्दा उपयुक्त शुक्राणुको चयन गरी डिम्बलाई निषेचित गराइन्छ । यसरी निषेचित भ्रुणलाई त्यसपछि डाक्टरको विशेष निगरानीमा इन्क्युबेटरमा राखी परिपक्क  बनाइन्छ ।

  • Embryo Transfer

    यस अन्त्तिम चरणमा सबैभन्दा स्वस्थ वा परिपक्क  भ्रुणलाई साना प्लास्टिकका ट्यूबका मद्दतले पुनः महिलाको गर्भाशयमा स्तानान्त्रण गरिन्छ ।

- IVF प्रक्रियामा न्यून पिडा हुनु देखि बिल्कुलै पिडा नहुन सक्छ किनभने IVF मा प्रयोग गरिने सुई (Injection) स्वच्छ पारेर Subcutaneous Form मा दिइन्छ । अन्डा संकलन प्रक्रिया Light Sedation गरेर गरिन्छ जसमा कुनै पनि प्रकारको पीडाको आभास हुदैन । तर, अन्डा संकलनपछि Patient लाई थोरै असजिलो हुनसक्दछ । भ्रुण Transfer को बेलामा, एनस्थेसिया त दिईदैन किनभने  यो केवल १०-१५ मिनट लामो प्रक्रिया हो जसमा पीडाको सम्भावना कम हुन्छ।

- यो प्रक्रिया अण्डा निकाल्नु पूर्व ४ देखि ६ हप्तासम्म जारी रहन सक्छ । अण्डा निकालेको ३ देखि ५ दिन पश्चात भ्रुणलाई पाठेघरमा स्थापित गरिन्छ, जुन केहि घण्टामै सिधिन्छ । अनि, सामान्य गर्भको  प्रक्रियाको  शुरुवात हुन्छ ।

- गर्भ धारण गर्न चाहने दम्पतिलाई औसतमा एउटा single Transfer गर्न CDC, American Society for Reproductive Medicine र Society for Assisted Reproductive Technology सल्लाह दिने गर्दछन ।

किन होला यस्तो ?

  • यो सबै शारीरिक सुरक्षा र IVF सफलतासंग सम्बन्धित छ । IVF द्वारा एउटा  स्वस्थ सन्तानलाई  जन्म दिनु तपाईको लुक्ष्य हो । धेरै भ्रुण Transfer गरे जुम्ल्याहा वा तिम्ल्याहा सन्तान प्राप्तिको डर बढ्नुसंगै आमा र सन्तानको स्वास्थ्यमा पनि खतरा आउँछ ।

- Transfer गरिएको १२ औ दिनमा रगतमा भएको Beta – HCG Test गरेर गर्भधारण भए-नभएको सुनिश्चित गर्न सकिन्छ ।

- हुदैन ।

IVFTreatment मा सफल्ताको सम्भावना महिलाको उमेर, बाँझपनको कारण, गुणस्तरिय अन्डाको retrieval र शुक्राण"को गुणस्तरमाथि भर पर्दछ ।

धेरै महिलाले ३५ – ४५ प्रतिशत प्रति चक्र सफलता पाउँदछन । सेवाग्राहीको पूर्ण विवरणको सहि जाँच तथा उनीहरुको अवस्थाको सटिक विश्लेषण Vatsalya मा गरिने भएको कारण यहाँको सफलता ६० – ६५ प्रतिशत सम्म छ ।

- एउटा Cycle को लगत्तै फेरी अर्को Cycle of Treatment गर्न सकिन्छ । तर केहि cases हरुमा Treatment परिमार्जन गर्न जरुरी हुन्छ । यो परिमार्जन patient को previous cycle record माथि निर्भर हुन्छ ।

उदाहरणका लागि, यदि ovarian response निराशाजनक भए थप औषधि प्रयोग गरेर ovarian response next cycle मा बढाउन सकिन्छ ।

- चाहिदैन ।

शारीरिक सम्भोग र खेलकुद बाहेक भ्रुण transfer पछि तपाई सामान्य गतिविधिमा तुरुन्तै लागिपर्न सक्नुहुनेछ ।

- Natural IVF ले अन्डाको गुणस्तर र महिलाको महिनावारीको Natural Cycle मा जोड दिदछ भने सामान्य IVF मा धेरै Follicle उत्पादनका लागि औषधिको प्रयोग गरिन्छ ।

Natural IVF मा महिलाको हितको  उच्च ख्याल राख्दै कम औषधि को प्रयोग गरिन्छ जसका कारण side effect र Treatment अवधि कम हुन जान्छ । अझ, यो Treatment मा ती अन्डामाथि जोड दिइन्छ जसलाई बिकसित हुन सामान्य मद्दत मात्र चाहिन्छ । यस मानेमा अन्डा गुणस्तरिय हुने सम्भावना बढी हुन्छ । तर, unexpected premature “LH Surging”  or Ovulation का कारण अन्डा स्वस्थ भ्रुणमा बिकसित हुने र सफल गर्भाधरमा परिणत हुने सम्भावना कम हुन्छ ।

सामान्य IVF मा, Fertilization समस्याहरुको पहिचान गरी उपचार पनि गारिन्छ । यस प्रक्रियामा बाउ – बाजेबाट आएको रोगको निदान, भविष्यका लागि प्रयोग नगरिएका भ्रुणको भण्डारण इत्यादी गरेर सफल गर्भधारण गराइन्छ । FSH injection को over – stimulation ले गर्दा सेवाग्राहीहरु OHSS (Ovarian hyperstimulation syndrome), को उच्च जोखिममा हुन्छन् ।


IVF द्वारा जन्मिएका बच्चा शारीरिक र मानिसिक रुपले सामान्य बच्चा सरह नै हुन्छन । केवल उनीहरु बिशेष हुन्छन किनभने तिनीहरुलाई जन्माउन उनका अभिभावकहरुले निकै कठिननाइ भोगेका हुन्छन् ।

- Donor IVF मा अन्डा वा शुक्राणु अन्जान Donor बाट लिइन्छ ।

Egg Donor IVF, यी अवस्थामा गर्न सल्लाह दिइन्छ :

  • क्यान्सर पश्चात
  • Congenital Anomaly भएका महिलामा डीम्बाशय नहुँदा
  • अज्ञात कारणवश धेरैचोटि IVF असफल भएमा
  • Low Ovarian insufficiency
  • बढी उमेरका कारण बाँझोपन भएमा
  • महिलामा वंशानुगत समस्याका कारण

विर्य वा शुक्राण" Donor, यी अवस्थाहरुमा गर्न सल्लाहदिइन्छ :-

  • पुरुषले स्वस्थ शुक्राणु उत्पादन गर्न नसकेको खण्डमा
  • समलिंगी जोडीले गर्वधारण गर्न चाहेमा

यदि महिला एकल अभिभावक बन्न चाहेमा

- छ । यदि महिलाले सामान्य ढंगले ovulate गरिराखेकी छिन् भने र  अन्डा Retrieve गर्न सकिने अवस्था छ भने, IVF गर्न सम्भव छ । IVF मा बाहिरी Fertilization गरिने भएकाले fallopian tube ब्लक वा झिकिएको भएपनि IVF गर्न सकिन्छ ।

- छ । पुरुषले विर्य उत्पादन गर्न नसक्ने अवस्थालाई Azoospermia भनिन्छ । यस अवस्थाले धेरै प्रतिशत पुरुषलाई असर गर्दछ र यो मुख्यत दुई प्रकारको हुन्छ :- Obstructive and Non-obstructive Azoospermia . जो पुरुष वा युगल जोडी यस पुरुष सम्बन्धि azoospermia ले ग्रसित छन्, तिनका लागि sperm retrieval with ICSI भरपर्दो उपचार भएको पईएको छ ।

पुरुष पूर्ण तरिकाले वीर्य उत्पादन गर्न असक्षम नभएसम्म TESA प्रकियाले विर्य झिक्न सकिन्छ ।

- यी दुवै बाँझोपन उपचारका परिचित प्रक्रिया हुन् । भिन्नता केवल विर्यले अन्डालाई कसरी Fertilize गर्छ भन्ने कुरामा छ । IVF मा अन्डा र विर्यलाई (जुन धेरै संख्यामा हुन्छन्) एउटा petri dish मा राखेर आफै Fertilize हुनलाई छोडिन्छ । ICSI मा भने,एउटा शुक्राण"लाई अण्डामा सिधै inject गरिन्छ ।

यदि तपाईलाई शुक्राण सम्बन्धि बन्झ्पन छ भने, तपाइको लागि ICSI उपयुक्त हुनेछ किनभने पुरुष बाँझपनको लागि यो प्रक्रिया सबैभन्दा फलदायक रहेको पाइएको छ ।

IVF एउटा चर्चित र सफल प्रक्रिया हो जसले सामान्यतय: बाँझोपन सम्बधि समस्याको उपचारमा टेवा पुर्याउछ । तसर्थ, विभिन्न उमेरका व्यक्ति र समस्याका लागि IVF का  फरक-फरक प्रक्रियाहरु हुन्छन ।

- क्यान्सर रोग उपचारका दौरान, बिरामीहरु सार्है नै महत्वपुर्ण र जटिल समस्याका बारेमा सोच्न बाध्य हुन्छन् जसले गर्दा बर्तमान र भबिष्यको प्रजनन् माथि गम्भीर असर पर्दछ । त्यसैले आफ्नो क्यान्सर रोग बिशेषज्ञसंग क्यान्सर रोग उपचारका क्रममा भविष्यमा गर्भधारण गर्दा पर्न सक्ने असरको सम्भावनाको बारेमा सुझाव लिएर IVF सम्बन्धि निर्णय लिनु उचित हुन्छ ।

Fertility नबिग्रिएको भएमा, freezing technology को माध्यमले पनि तपाई आफ्नो भविष्यमा बच्चा पाउने सपना सुरक्षित गर्न सक्नुहुन्छ । त्यसपछि IVF ले गर्भधारण गर्नमा सहयोग पुर्याउनेछ ।

- निम्न अवस्थामा Fertility Preservation गर्न सकिन्छ :-

  • Chemotherapy वा Pelvic Radiation Therapy ले प्रजनन् क्षमतामा हानी हुने देखिएमा
  • Ovary लाई हानी हुने सम्भावना भएको शल्यक्रिया गर्दा ।
  • Ovary लाई हानी हुने सम्भावना भएको Ovarian disease (endometriosis or uterine fibroids) हुँदा
  • Risk of premature ovarian insufficiency due to fragile X- syndrome, or family history of premature ovarian failure
  • Genetic mutations oophorectomy
  • गर्मी वातावारंमा काम गर्नुपर्ने अवस्था भएमा । जस्तै भट्टी नजिकै काम , व्यवसायिक रुपमा धेरै समय गाडी चलाउनु पर्ने अवस्थामा, धेरै बेर खाना पकाइरहनु पर्ने भएमा, लौनड्री सम्बन्धिको काम भएमा वा यस्तै कुनै जोखिमयुक्त काममा सरिक भएको भएमा ।
  • व्यक्तिगत कारणले गर्भधारण ढिलाई गरेमा ।

जति समयका लागि अन्डा फ्रिज गर्दा पनि खासै नकारात्मक असर नदेखिए पनि बढ्दो उमेर संगै गर्भ धारणमा निकै चुनौतिहरु आउन थाल्छन् ।

- यस प्रक्रियाले गर्भ नबस्ने समस्याले निकै हदसम्म निराकरण गर्दछ । यस प्रबिधिमा infrared laser beam का मद्दतले zonapellucida (भ्रुणको बाहिरी तत्व) हटाएर fertility हुने सम्भावना बढाउँछ । यस प्रक्रियामा अरु प्रक्रियाभन्दा कम भ्रुणको प्रयोग गरिन्छ । यो प्रविधिमा कम समय लाग्छ र भ्रुणले  incubter बाहिर निकै कम समय व्यतित गर्दछ ।

-छैन ।

- खर्चका लागि, तल दिइएको link मा जानुहोस :-


  • सामान्यतय, पुरुष बाँझपनका समस्याहरु वीर्यमा देखिने शुक्राण"को संख्या र बनोट र फुर्तिमा निर्भर गर्छ ।
  • औसत शुक्राण"को संख्या 40 million देखि 300 million शुक्राण" per mili liter हुनेगर्दछ ।

  • सामान्य शुक्राण"को oval head करिब 5 – 6 micrometers लामो र 2.5 – 3.5 micrometer चौडा हुन्छ भने त्यसमा एउटा लामो पुच्छरपनि पाईन्छ ।