One in seven couples is dealing with the problem of subfertility and
there is growing concern that the incidence is increasing due to a rise in
stress related problems, male factor problems and also of polycystic ovarian
syndrome (PCOS). In addition to
fertility related problems, PCOS is associated with long term health issues
such as diabetes and heart problems. A
very important aspect of subfertility is that it affects people in the prime of
their lives and hence can have a negative impact on an individual’s physical
and psychological health. What is less
well understood and acknowledged is the magnitude of the impact the situation
has on the psychological and economic health of the affected individual, family
The primary aim of the Sushrut
Assisted Conception Clinic has been to acknowledge the important issues
involved with the problem of subfertility and provide well organised and
efficient services to help the couples with subfertility.
The following is the list of services provided at the Clinic
Dedicated team members attend to the needs of the
couples in a friendly and relaxed atmosphere.
Every effort is made to identify the cause of the problem and a
management plan is provided to the couples with detailed and appropriate
explanation by Dr. Padma Rekha Jirge.
Male factor problems are looked after by Dr. Shishir Jirge.
In women, a pelvic ultrasound is most often
performed to assess the uterus and the ovaries, whist in men a semen
analysis forms initial mode of assessment. The necessary facilities for these basic
investigations are provided within the premises of the clinic.
In many of the women with subfertility, it becomes
essential to identify any hormonal disturbance affecting the ovulation
process. Also, it is important to
identify women who have a reduced stock of eggs and hence might be poor
responders to treatment. Hence, hormonal
evaluation is an integral part of management of subfertility. The Clinic acts as a collection centre for
these tests, with rapid access to the results so that any treatment may be
initiated without a delay.
Occasionally, hormonal evaluation is needed in men as well.
In a subset of women, more detailed
evaluation of the uterus and tubes may become necessary before initiating
treatment, in the form of an X-ray. This
facility is provided in a nearby Radiology Clinic and appointments are
organised by us.
Also, some men may require an ultrasound scan and Doppler assessment
which are available at the same Radiology Clinic.
In majority of
the couples, the initial management involves simple medications given to the
women followed by ultrasound monitoring to assess the response and a detailed
discussion at the end of each unsuccessful cycle regarding further direction of
Some men may require investigations such as testicular biopsy or even a
surgical procedure to treat varicocele.
we deal with a situation where the success cannot be guaranteed and the
duration of treatment required cannot be specified. Recognising the psychological
stress inherently associated with the problem of subfertility and additional
stress induced by various treatment modalities, counselling services are
provide by a qualified and dedicated Counsellor.
Obesity is an ever increasing problem in our
population, particularly in women with PCOS.
Though, it is well known that weight loss improves the chances of
conception, in a practical scenario it is very difficult to refuse active
treatment to couples who already have had repeated failures prior to coming to
us. We have developed a programme for weight loss incorporating dietary
modifications tailored to an individual’s needs; exercise and outdoor
activities. This is initiated at a very
early stage, so that the weight management and initial evaluation and treatment
are done simultaneously.
The science of
reproductive medicine is advancing rapidly and we can do justice to our
patients only by keeping ourselves updated of the developments on a regular
basis. We acknowledge this by having a Study
Day on every Saturday. This involves
discussion of difficult situations and studying of peer reviewed journals. These activities form the basis of our
research work, which is at present aimed at understanding the ovarian function
in Indian women.
Approximately, 50% of the couples achieve pregnancy with simple
treatment modalities. However, in some
women laparoscopy may become necessary.
Becomes essential to assess pelvis more fully or to
treat conditions such as ovarian cysts, endometriosis, uterine fibroids,
In addition, they may require
treatments such as:
Intrauterine Insemination (IUI)
conception does not occur despite absence of any major problem in the
couple. This involves introducing
healthy sperms from husband’s semen sample into the wife’s uterus.
In a selected group,
Donor Insemination (DI)
It may become
necessary when husband’s evaluation shows that the sperm production is
absent. This is performed only with
properly screened and stored anonymous donor samples and after both husband and
wife provide written consent for the treatment.
In-Vitro Fertilization (IVF)
Is performed when simpler
modalities of treatment fail, where after a period of regular injections eggs
from the woman’s ovaries are collected and mixed with her husband’s sperms in a
highly specialised laboratory environment, to produce embryos which are
replaced back in her uterus.
Intracytoplasmic Sperm Injection (ICSI)
Is similar to IVF and
performed when only a small number of healthy sperms are available for the treatment.
Excess embryos if available are cryopreserved
(frozen) for future use.
Services of Oocyte
Donation, Embryo Donation and Semen Banking (for example,
prior to treatment for any malignancy) are also available.
Our strengths are the very dedicated and well trained team members and
the couples who let us accompany them in their journey to fulfill their dream.
In addition Urology services also form a major part of the services offered here. We provide Urology services for treatment of kidney stones, prostate disorders, urinary disorders in men and women. All other urological problems such as cancers of the urinary tract are also treated here. Our clinic caters for a wide variety of General Surgical problems as well.
Gynaecological problems and surgeries related to various issues in women are also performed here routinely.