CREDENCE HOSPITAL Trivandrum, Kerala
   
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Understanding ART
 
  Understanding ART.
Before you decide to undergo treatment at any center, you should understand what your problem is and the entire IVF process, step-by-step, why a particular program or medicine or test is chosen for you, what each test is for, how each program is conducted, how and when drug therapy begins, how often the woman needs blood tests and ultrasound monitoring, when egg retrieval will likely take place.
The Assisted Reproduction Technology (ART) programs are long drawn and exhaustive, both mentally and physically. Investigative procedures can seem never ending. These include blood tests for both partners to rule out immunological problems or diseases and to confirm that the woman is ovulating; a complete physical exam for the woman, including a measurement of her uterine cavity; and a semen analysis, sperm antibody assay, and semen cultures for the man. You should be aware of each step and know what each drug is for. You should also receive instructions on how to administer the fertility drugs yourself if needed. Patients should also be aware of possible complications they could face such as an Ovarian Hyper stimulation syndrome (OHSS), pelvic pain, drug reactions and other side effects. ART centers usually provide information material and some centers provide specialist counselors for the patient support.

Support
Feel free to talk and discuss with your Doctor anything that you dont understand or cannot follow. The couples develop a bond with the doctor. Trust and confidence is a major part of a succesful ART program. You can discuss with your Doctor all your psychological, emotional and physical problems.

Legal and Ethical issues
Assisted Reproduction is a relatively new and fast developing technology. Like all developing sciences lot of ethical and legal issues are involved with ART too. Though the beauty and wonder of ART cannot be denied, such issues have to be addressed. Hence you may require to sign lengthy informed consent forms and contracts before undergoing treatment. Whether man should interfere in reproduction, which is considered a natural process is core to the issue. Other issues include whether manipulation of embryos and gametes can be justified, whether it is right for man to over ride the natural selection process and choose the sperm for ICSI, the issue of cryo-preservation of embryos, disposing extra embryos, donor program justification, surrogacy etc.

Financial commitments
Before deciding on an ART program, the couple should understand their financial commitments fully. The equipments, drugs, culture media, sterile disposables used in Assisted Reproduction are very expensive, thereby running up the cost of the program. In India, the costs can vary anywhere between Rs.75,000 to Rs.1,50,000 per cycle of an ART program of IVF or ICSI, depending on the amount and quality of the drugs, media and equipments. Though using cheaper drugs is a way of reducing the cost, individual response to various drugs may vary thereby neccessitating use of more expensive drugs. Quality of embryos obtained is also seen to vary with the quality of drugs and media used.

Success rates
Finally the most important thing patients should understand is that the ART programs are not always successful. Success rate depends on a number factors and it is difficult to arrive upon a standard rate. Success rates for an IVF program world over may vary between 25-40%, while an ICSI cycle gives a slightly higher rate. Though this rate is comparable to a natural reproduction rate, the emotions involved with an ART cycle is tremendous. The emotions can range from the expectation of a beautiful healthy to the devastation of a failed cycle. Hence good counseling and patient education is central to the program

New Release 
The latest in drug delivery system is the injection pen, which allows the patient to do away with daily cumbersome visits to the doctor for drugs.
The Pen not only offers a more convenient method of self-injection for patients, it is also designed to administer different drug dosages. It can be administered at home, or in clinics by a nurse or doctor.

 
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