Advanced Infertility Treatments in India – Innovative Solutions for Rare Reproductive Conditions

Since the time the world’s 1st IVF baby, Louise Brown, was born in 1978, the need for advanced infertility treatment is increasing day by day, due to improved presentation of patients with very rare clinical conditions, which were rare a few years ago. This includes abnormalities in both men and women. Some of the conditions that we are commonly encountering these days at the Institute of Reproductive Medicine @ Dr. Rela Institute (IRM) include patients with thalassemia syndrome, poor ovarian reserve, underdeveloped or no uterus, and, in the case of men, most commonly seen are very few or no sperm.

Added to these are the increased risk of cancer at a very young age. The reasons for these underlying conditions for infertility can be many. “The most commonly that we see are hormonal imbalances/anomalies at very young age itself, leading to infertility and these get amplified with unhealth eating habits, sedentary life style, stress, anxiety, etc., Increasingly we are seeing lot of patients presenting with genetic issues, which are acquired at birth itself ” says Dr G Buvaneswari, Director, IRM which is a joint initiative with GBR Fertility Centre And Hospitals, one of India’s top 10 Fertility Centres.

The field of reproductive medicine has also been catching up fast and undergoing tremendous advancement to manage these presentations of such rare cases, which are now becoming almost common. However, caution should be noted that these are emerging treatment options and are mostly in trials, and must be done in a proper setup under qualified clinicians.

Uterine Transplants – A Fertility Solution for Women Without a Uterus

The uterine transplant is the next big innovation in the field of medical transplants. It is a surgical procedure whereby a healthy uterus is transplanted to a patient whose uterus is absent or diseased. As part of normal sexual reproduction, a diseased or absent uterus does not allow normal embryonic implantation, effectively rendering the woman infertile. This phenomenon is known as absolute uterine factor infertility. For such conditions, the simplest procedure was surrogacy or adoption until last year.

But with the stricter regulations coming into force for surrogacy, it is becoming nearly impossible for women with these conditions to have their own biological child. In such cases, a Uterine transplant is a potential treatment for this form of infertility. A woman who is past menopause and has at least delivered one child in the past can donate her uterus to her related women who have no uterus or a defective uterus. At present, there are a handful of cases that have been carried out successfully across the globe.

GBR Fertility Centre and many hospitals have joined hands with Dr. Rela Hospital, Chrompet, Chennai, an International facility for multi-organ transplant, to take this big step in reproductive medicine as a joint initiative. Flight Lieutenant L Ramesh (Retd), who is the Director of GBR, says,

“We always aspire to be at the forefront by embracing the latest technologies and best practices. Partnering with Dr Rela Institute is a certification for our commitment to provide the best and futuristic treatment in infertility care.”

Fertility Preservation – For Those Delaying Pregnancy or Undergoing Cancer or Autoimmune Treatment

Fertility preservation is the process of saving or protecting eggs, sperm, or reproductive tissue so that a person can use them to have their biological children in the future. This, though, has been one of the common procedures for storing sperm, eggs, or excess embryos during IVF treatment; this has varied use in the current scenario, with more awareness coming for young patient undergoing cancer treatment, autoimmune disease, etc., helping them to have their genetic child in the future.

One more emerging condition under fertility preservation is “Social Freezing”, where carrier conscious adults who don’t want to get married until they are settled, which sometimes extends until they turn 40, can freeze their eggs and sperm. In such cases, the women can choose to store their eggs and men the sperm when they are healthy, ie, in their late 20s and early 30s. As and when they are ready to undertake the parental challenge, they can use their healthy frozen eggs and sperm to have their biological child.

Stem Cell Therapy for Infertility – Hope for Women with Low Egg Reserve and Men with Poor Sperm Count

A lot of young women these days are presenting with complete ovarian failure or poor responders, which was very rare a few years ago. The easiest option, which is still largely followed by most IVF centres, is the donor programs. Stem Cell Therapy has come to the rescue of these patients and made it possible to have their biological child. Stem Cells are derived from the patient’s cells and injected into their ovaries, improving the dormant follicles and giving excellent results in IVF/ICSI. In the case of males, the derived cells are injected into their testes, which helps improve their sperm count.

PRP Therapy – Boosting Fertility for Women with Poor Endometrium and Men with Low Sperm Count

Women present with a thin endometrium, and the chances of implantation failure are high, resulting in recurrent pregnancy loss or repeated abortions. Platelet-rich plasma (PRP) is the rich platelets extracted from the blood serum, which are processed and injected into the endometrium. It energizes the endometrium and improves its health. With PRP, successful endometrial expansion and pregnancy were observed in all the patients after PRP infusion. The same can also be used to increase the health of the ovaries, which have very few reserves.

In case of male infertility with the attributing factor being low sperm count, PRP therapy has proven to provide great results by increasing the sperm count substantially and helping them to avoid painful procedures like PESA / TESA / Testicular Biopsy, etc.

Genetics – For Chromosomal or Gene Abnormalities

Genetics is improving day by day to play a significant role in overcoming secondary infertility, which arises due to systemic or syndromic genetic defects, including developmental, endocrine, and metabolic defects. For example, in the case of males, we see increased conditions of low or nil sperm. At GBR, we also see increased cases with structural chromosomal abnormalities, which were quite rare a few years ago. In case of a woman, we see increased cases of an underdeveloped uterus, poor ovaries, endometrium, or fallopian tubes. Many treatments have evolved to treat these conditions.

Endometrial Receptivity Analysis (ERA) – A Solution for Repeated IVF Failures

More cases of repeated IVF failures and repeated abortions have become another common issue following IVF / ICSI treatment. It is reported that the incidence is as high as 30%. Endometrial Receptivity Analysis test helps in identifying the best window period for embryo transfer following IVF /ICSI treatment. “GBR is one of the few centres in Chennai to have been certified by Igenomix of Spain for carrying out this test. In the past three years, we at GBR have seen high implantation success following ERA testing,” says Dr G Buvaneswari.

PGS in IVF – Screening for Chromosomal Anomalies and Genetic Disorders like Thalassemia

Pre-Genetic Screening is used to screen for embryos with abnormal chromosomes. An abnormality in the chromosomes of an embryo can result in miscarriage or Down syndrome. Patients who have genetically abnormal children or are above 38 years of age are advised to go for PGS to avoid genetically abnormal children.

PGD in IVF – Preventing Inherited Genetic Disorders Before Pregnancy

Pre-genetic diagnostics (PGD) is used to identify embryos that carry a single-gene disorder in cases where the risk of a specific gene mutation is higher. It is offered to individuals with a family history of serious genetic disorders or who have another biological child with a genetic disorder.

It has been in the genes of GBR since its founding days to embrace the latest technologies and procedures, starting from Laser Assisted Hatching, ICSI, blastocyst culture, etc. With the demand for managing rare cases, which have become normal, GBR continues its journey of adopting the latest technologies by providing personalised infertility care at affordable costs, with the above-stated next generation of evolving futuristic treatment options in the field of infertility.