ivf commercialization in element in gynaecology
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IVF Commercialization in element in GynaecologyTRANSCRIPT
IVF : COMMERCIALIZATION IN ELEMENT IN GYNAECOLOGY
Dr. Hemant Zaveri
Any new concept !
they will laugh at you first
Any new concept !
Then they ignore you
Any new concept !
Then they will suspect you
Any new concept !
then they fight you
Any new concept !
Then you will believe new concept
Any new concept !
Then concept will established
Any new concept !
Then concept will rule on you!!!
Infertility affects 15 % of couples, and 50-70 % of male infertility is potentially correctable so it name As: Subfertility …….
DECREASING SPERM QUALITY & QUANTITY: A GLOBAL PROBLEM?OR JUST IN DATA???????
Evaluation of decreasing sperm count Decreasing sperm quality & Quantity just in Data???????
Environmental Health Perspectives 108 (10) (Oct. 10, 2000); E. Carlsen et al.British Medical Journal 305 (Sept. 12, 1992).
Reduction in sperm density Decreasing sperm quality & Quantity just in Data??????? What is reality
Reduction in sperm density Decreasing sperm quality & Quantity just in Data???????
Journal of Andrology, Vol. 28, No. 2, March/April 2007
Reduction in sperm morphology quality Decreasing sperm quality & Quantity just in Data??????? What is relity !!
Journal of Andrology, Vol. 30, No. 5, September/October 2009
Impact of the New WHO Guidelines on Diagnosis and Practice of Male Infertility 1 Reality
1. The Open Reproductive Science Journal, 2011, 3, 7-15
What is problem ?
growing population of India
What is problem ?
Growing population of India
What is problem ?
Infertility ?
What is problem ?
Infertility ?
What is problem ?
Infertility ?
Incidence of infertility
Previous: Rare ??????
Present: Very common ??????
Incidence of infertility
Previous: Rare ??????
Present: Very common ?????? Increasing age of married couple
Incidence of infertility
Present: Very common (Pseudo Infertility)
Figure 2. Prevalence of primary infertility and secondary infertility, presented as the percent of women who seek a child, and as the percent of all women of
reproductive age, in 1990 and 2010.
Mascarenhas MN, Flaxman SR, Boerma T, Vanderpoel S, et al. (2012) National, Regional, and Global Trends in Infertility Prevalence Since 1990: A Systematic Analysis of 277 Health Surveys. PLoS Med 9(12): e1001356. doi:10.1371/journal.pmed.1001356http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001356
Absolute change in prevalence of primary and secondary infertility, measured as the percent of women who seek a child and as the percent of all women of
reproductive age, between 1990 and 2010.
Mascarenhas MN, Flaxman SR, Boerma T, Vanderpoel S, et al. (2012) National, Regional, and Global Trends in Infertility Prevalence Since 1990: A Systematic Analysis of 277 Health Surveys. PLoS Med 9(12): e1001356. doi:10.1371/journal.pmed.1001356http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001356
In Vitro Fertilisation (IVF) is a last resort in Past !!!!!!!!!!!!
But Now it’s first choice !!!
In Vitro Fertilisation (IVF) is a last resort
But Now it’s first choice !!!
Need for fast conception The Ideal Infertile couple
Need for fast conception The Ideal Infertile couple
What is IVF
In vitro fertilization
What is IVF
In variable fertilisation (100% sure)
What is IVF
In vitro fertilization
What is IVF
In vitro fertilisation In variable fertilisation (100% sure)
Previous: tubal factor only Previous: tubal factor only
Present: Any couple !!!!!
Indications
Previous: tubal factor only Fallopian Tube Damage/Tubal Factor
Bilateral blocked Fallopian tubes Failed reversal of Tubectomy
The only options for treating significant tubal damage are surgical repair or bypassing the tubes with IVF. This decision must be carefully individualized in each situation.
Indications
Present: Male Factor Infertility
Failed reversal of Vasectomy/ Tubectomy Obstructive azoospermia
Endometriosis Severe endometriosis
Age Related Infertility Premature Menopause Anovulation
Unexplained Infertility Preimplantation Genetic Testing (PGT
ACCEPTANCE BY PEOPLE
Facts on IVF
Facts truth: IVF is only the last option truth: IVF is only for affluent people truth: IVF is limited to a younger population
only truth: IVF is successful in all cases truth: IVF requires admission in the hospital truth: IVF always result in multiple
pregnancies like twins or triplets truth: IVF babies have a significantly high risk
of birth defects and malformations truth: IVF is not at all covered by insurance truth: IVF is dangerous
Acceptance by people
Present : reality- Who Does it Help? In-Vitro Fertilization and Side effects Woman’s Painful journey Maternal Age and Blastocyst
Development high failure rate Frozen Blastocyst Cycles The Future
In vitro fertilization & Next generation
Producing healthy human beings
IVF future Robotic Sperm !!!!
Robotic Sperm !!!!
Why it was not accepted by drs as routine?
ICSI: Should it be Restricted to Male Infertility Drugs to induce ovulation Ova harvesting Embryo transfer The outcome LACK OF CONFIDENCE LACK OF SENIORS SUPPORT LACK OF KNOWLEDGE FROM WHERE TO LEARN HOW TO ESTABLISH LAB etc…..
Success rate
Success rate !!! Reality
Success rate !!! Reality
Success rate !!! Reality
Future of IVF:
Blood Bank replaced by Sperm banks
Future of IVF: Sperm Bank
Future of IVF: Embryo Bank Technology Previous & Present: -Ease of getting equipment & loans -support of companies -disposables& media -hormones( refine technology) -ovum pick up -embryo transfer( role of USG) -endocrinology & lab support -availability of embryologyst - knowledge & skill - ICSI ,IMSCI, PICSI,PGS, PGD,ERRAY , LAH, STEMCELL etc…..
Future of IVF: Embryo Bank Technology
Service at door step Future of IVF: Embryo By companies By doctors By laboratories
Medicine updates: Embryo Donation
In vitro fertilization may leads to Human cloning
In vitro fertilization may leads to Human cloning
In vitro fertilization may leads to Human cloning
Technology burden on Doctors!!!!
Previous & Present: -Ease of getting equipment & loans Who will
Pay??? -support of companies We have to oblige them!! -disposables& media -hormones( refine technology) -ovum pick up -embryo transfer( role of USG) -endocrinology & lab support -availability of embryologyst - knowledge & skill - ICSI ,IMSCI, PICSI,PGS, PGD,ERRAY , LAH,
STEMCELL etc…..
Failed Technology
Assisted reproductive technology
INTRACYTOPLASMIC SPERM INJECTION (ICSI)
GAMETE INTRAFALLOPIAN TRANSFER (GIFT)
ZYGOTE INTRAFALLOPIAN TRANSFER (ZIFT)
Pseudo Benefits
Fast conception Early identification of factor Demand & supply Dhiraj & dhakka Multiple pregnancy LSCS Both party happiness Remote centre franchise for drs
Service at door step full commercialization By companies By doctors By laboratories
Medicine updatesSide effects !!! Previous:
Clomiphene citrate Present:
Various options GnRH Agonists GnRH Antagonists Gonadotropins hCG Progesterone Medrol Doxycycline
Side Effects !!!!!
Complications Higher risk of ovarian tumours after ovarian stimulation for in-vitro fertilization
Side Effects of IVF: Filure!!
Side Effects of IVF: Ectopic Pregnancy
Side Effects of IVF: Risk of Birth defects
Why IVF as for none?
Conclusion
Understand the reproductive potential of couple undergoing IVF
Success of ICSI (few data)
Male Factors Infertility IVF~40% live birth rates Very low as
compare to normal pregnancy Female Factors Infertility IVF
Higher results than other infertility causes~25% live birth rates Very low as compare to normal
pregnancy
What is IVF?