If you are a gynecologist practicing in
India/Pakistan/Nepal/Srilanka/Bangladesh/Gulf Countries, with a special
interest in treating infertility, we can help you to start your own
Franchisee IVF clinic ! If you presently offer IUI treatment, this
means you can now also offer advanced ART services , such as IVF, ICSI
and donor egg IVF, to your infertile patients. This collaboration will
allow you to offer state of the art infertility services to your
patients, without having to invest in an IVF lab . Since you do not
have to refer your patients to anyone else, they remain your own
patients, and once they conceive, you continue to provide them with
ongoing antenatal care. By working together , we can minimize the
amount of time your patient needs to spend in Bombay - and this can
save them considerable money, something which your patients will
appreciate !
The concept of Franchisee IVF is simple. Since IVF treatment protocols
are standardized, you start the cycle yourself. You only send the
patient to us for their egg collection, and after the embryo transfer,
they come back to you. Franchisee IVF helps you by allowing you to
provide advanced IVF services to your patients without having to spend
money in running an IVF lab. Not only will this allow you to attract
more patients, it will also help to keep you on the cutting edge of
reproductive technology !
Franchisee IVF helps your patients , because they are confident and
comfortable knowing that you are supervising their care; and that they
are getting their IVF treatment at one of India's best IVF centers. It
is helpful to us because we know that patients can contact you , in
case they have any queries or doubts . Franchisee IVF allows continuity
of care at a markedly reduced expense to your patients, since they have
to spend much less time in Bombay !
In order to start Franchisee IVF , you should be able to offer :
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1.
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Vaginal ultrasound scanning services and
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2.
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Blood hormonal testing facilities, for E2 ( estradiol) levels. This
testing is only needed rarely .
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Once you have completed your patient's workup, and have decided that
she is a suitable candidate for IVF, please email us with their
clinical details. Once they have decided to proceed with IVF, you start
their superovulation. You need to send them to Bombay on Day 11, after
documenting a good ovarian response. They would need to spend about a
week in Bombay, after which they return back to you for their ongoing
care.
This is a typical simplified IVF protocol :
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1.
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Start downregulation. Treatment starts from Day 1 of the cycle, when
you start your patient on Lupride ( Leuprolide Acetate, GnRH analog,
manufactured by Sun Pharma) , 0.25 mL subcutaneous injection daily in
order to downregulate them ( short protocol) . I multidose vial
contains upto 16 doses and will last the 10-11 days easily.
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2.
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Start superovulation simultaneously with the standard dose of hMG
injections. hMG injections for superovulation is 3 ampuoles ( 225 IU)
IM daily for patients less than 35 years of age; 2 ampuoles ( 150 IU)
IM daily for patients with PCOD; and 4 ampuoles daily for patients more
than 35 years old. For patients with a prior poor ovarian response, or
older patients, you may need to increase the dose further.
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3.
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Document an adequate ovarian response. Do a scan on Day 9 (after 9 days
of hMG injections) to document satisfactory follicular growth. In cases
of doubt, you can do an E2 level to confirm adequate follicular
response. 80% of patients will have a good ovarian response. 10% of
cycles will need to be cancelled because of a poor ovarian response.
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4.
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Refer to Bombay for egg collection. Once an adequate follicular
response has been documented, refer your patient to Bombay for her egg
collection. Typically, the patient should come to Bombay by Day 11,
when we repeat the scan and schedule the egg collection. The husband
should abstain from sex from Day 9.
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5.
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After the embryo transfer, we refer the patient back to you for her
luteal phase support. This consists of Inj Puregest (Sun Pharma) 50mg
IM daily for 15 days.
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6.
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Pregnancy testing . 16 days after the egg collection, you need to do a
beta HCG level. A level of more than 10 mIU/ml confirms a pregnancy.
This needs to be repeated every 3 days, and in a healthy pregnancy, the
level should double every 3 days. Once the level crosses 1200 mIU/ml, a
vaginal ultrasound scan is done to document an intrauterine pregnancy.
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7.
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Pregnancy monitoring. Ultrasound scans every week, to confirm that the
pregnancy is progressing normally.
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In case of doubt, you can always talk to us, or contact us by email on
rotundachr@gmail.com!
