Using DS, 1 failed ICSI, 2 failed IUIs... what next?

We decided to do ICSI first with Donor Sperm (DS) sample procured by a bank suggested by MHB in Jayanagar, Bangalore. Out of 6 oocytes frozen in one straw, 5 oocytes survived after thawing process and only 3 fertilized well with DS of my DH’s blood group. All 3 were transferred and none got implanted :-(

Since we had 6 more frozen oocytes, the plan of action was to fertilize 3 oocytes with 1 DS sample of DH’s blood group and last 3 with 1 DS of my blood group and use IUI instead of ICSI.

Unfortunately, none of the 2 IUI cycles succeeded. By then, my body had taken a lot of injections and medicines and the brain was really dissatisfied, hence a break or change was required.

We decided to say Good-Bye to Manipal Hospital Bangalore (MHB) and decide another place to continue our quest. Deciding on whom to consult next in Bangalore seemed next to impossible as MHB was the ONLY last option in Bangalore.

As I had a few relatives in Delhi whom I could trust blindfolded, I chose to stay with them and take my chances in Delhi.

More about it, later.

Choosing and Transporting the Donor Sperm from Bank to Hospital

To simplify things for us and follow the guidelines for themselves, Manipal Hospital (MHB) gave us contact details of a Donor Sperm Bank in Jayanagar (operated in Bangalore, but had nation-wide samples). After speaking to the Bank, we discovered that things shown in the Bollywood Hindi Movie “Vicky Donor” was not fake, if not 100% true. People have huge demands for Donors for both the gametes.

I visited them alone, assuming that it would be little discomforting for DH to go along and ask for Donor Sperms. They had a list of donors and asked me to pick a donor on the basis of their Blood Group, Height, Weight, Complexion of Skin, Eyes and Hair, Build and Education. I selected the sample of my DH’s Blood Group. They had several huge cans (bigger than milk cans used to collect cow milk in the barns) filled with Liquid Nitrogen and Frozen Donor Gametes. Thankfully, the sample I chose were readily available and all they required was a letter from the Doctor stating the reason for purchase and of course, the money. Since our Transfer Date was after more than a month and to be used for ICSI, I told the Bank to block the sample for me. I made a junior doctor at MHB speak to the Sperm Bank to authenticate my request.

The day my ICSI date was finalized (3-Day transfer on 1^st Aug’14), 5 days prior to that I collected the sample (handed over to me in a mini flask with vials submerged in Liquid Nitrogen, hanging inside attached to a strong thread,) along with the Authentication Report (Semen Analysis, HIV, HCV, HBSAG and VDRL reports) and gave it to MHB's Lab for fertilization process. Transportation had to be done delicately; the flask had to be kept 90 degrees perpendicular to the ground. Although I had placed the flask on the co-driver's seat (seat-belt tightly fastened), driving alone with the flask was difficult.

9 months of Ayurvedic Treament for DH, yet no positive results

On Dr. Sowmya's recommendation, we visited Dr. L. Sucharitha (Pandit Clinic, 5th Main, Chamarajpet, Bangalore) in Dec' 13. Her Consultation Fee was Rs.200. She wrote 4 really expensive medicines for a month's consumption and none of the medicine names were available on Google (neither then, nor now). Those specific medicines were available only in Pandit Clinic; I guess they used code words for all their medicines, not sure if that's ethical. A layman like me couldn't decipher anything from this attached copy of the bill.

Anyway, my DH did consume those Ayurvedic medicines for a month. At month end, the report remained the same. So in Jan'14, Dr. Sucharitha told that she'll tweak the combination of medicines. Here's what she prescribed next :-

With 9 months of Ayurvedic Treatment, DH's sperm production remained nil. We then decided to look for options outside Bangalore.

My next post will tell you about our experience/ conclusion told to us by famous doctors in Delhi, Kolkata and Mumbai.

Cost factor of our treatment until now

In this post, I will reveal some financial implications of our treatment until now (Jun'12 to Mar'13, which included Problem diagnosis, Hysteroscopy, TESE and Egg Retrieval).

Consultation Fees of Dr. Joshitha Naik & Dr. Mahendra Jain in Lady Hospital (LH) were Rs.250 each, way back in mid 2012, (and Rs.100 as one time Registration Fees).

--->   4 visits to Dr.Naik and 1 visit to Dr.Jain cost about Rs.1350 (including Reg Fee)

Ultrasound Scan Pelvis in LH was Rs.800. This was done just once.


SA in LH was Rs.300; in SRL Diagnostics was Rs.220;

-->   2 SA tests in LH & 6 SA tests in SRL cost about Rs.1920

Consultation Fees of Dr. Uma Maheshwari was Rs.325 in Sure Fertility (and Rs.100 as one time Registration Fees); Dr. Ravish I.R. was Rs.500 in Lucid Diagnostics (and Rs.100 as one time Registration Fees).

--->   1 visit to Dr.Maheswari and 2 visits to Dr.Ravish cost about Rs.1525 (including Reg Fee)

Consultation Fees of Dr. Madhuri Patil was Rs.1000 in Dr. Patil's Fertility & Endoscopy Clinic (which included Ultrasound Scan Pelvis. We visited her just once.

Each strip of I-Sure Ovulation Kit costed Rs.100 then.
--->   10 such kits cost about Rs.1000

FSH and LH Tests costed Rs.325 each in St. John's Medical College and Hospital. It was done just once.

Consultation Fees of Dr. Bina Vasan & Dr. Vasan S.S. in Manipal Hospital Bangalore (MHB) were Rs.400 each, way back in 2012 end, (and Rs.100 as one time Registration Fees).

---> 20 visits in MHB cost about Rs.8000 (including both docs)

Ultrasound Scan Pelvis in MHB was Rs.550 in Sep'12.

--->   This was done 10 times, costing about Rs.5500

SA, Sperm Function Test (SFT) and DNA Fragmentation Index (DFI) in MHB was charged at Rs.340, Rs.470 and Rs.1850 resp.

--->   This was done 3 times, costing about Rs.7980

Tablet Penegra 50mg (5 tablets) and Paternia (20 tablets) costed Rs.118 and Rs.800 in MHB. However, Paternia (20 tablets) in Apollo Pharmacy was sold at Rs.362.89 only (no fake or expired tablets).

--->   Medicines taken for 6 months cost about Rs.14400

Free T4, TSH, T3 in Clumax Diagnostics costed Rs.450, Rs.250 and Rs.200 resp.

---> Above tests done just once costing about Rs.900

Hysteroscopy procedure (Half-day care) costed us Rs.29170 in Feb'13 (Rs.25000 fixed for OT & procedure and balance amount for bed charges & misc. stuff).

TESE performed on DH in Feb'13 cost us about Rs.20840.

In Mar'13, Injection Gonal-F 300 IU/0.5ml was sold at Rs.8020, Injection Persinal HP-75 IU was Rs.1100, Injection Persinal HP-150 IU was Rs.1760, Injection Ovurelix 0.25mg for Rs.1020 and Injection Ovitrelle 250 mcg/0.5ml for Rs.1500 in MHB.

--->   3 Gonal-F injections costing about Rs.24060
          3 Persinal injections costing about Rs.4300 (depending on follicular growth)
          4 Ovurelix injection costing about Rs.4080
          1 Ovitrelle injection costing Rs.1500
         

ECG and ECHO in MHB was for Rs.220 and Rs.1560 resp, in Feb'13. Done just once.

Doppler and Ultrasound Scrotum in MHB was Rs.1000 in Mar'13.Done just once.

Cryopreservation of Sperms costed Rs.6600 for each vial and Embryo Freezing Single Straw for Rs.19800, both valid for one year.

IVF/ICSI- Deluxe costed us Rs.111500 in MHB (excluding injections and progesterone test) and there was nothing DELUXE about it. It too was a half-day care thing.

Making a decision: ART or Ayurveda?

It was a difficult decision to make. We wanted to explore and exhaust all possible options before choosing "What's next?". So we decided to consult a few ART specialists discussing our case and see if a mid-way could be found.

We started with Dr. Kamini Rao (Dr. Kamini Rao Hospital, Jayanagar 5th Block, Bangalore - now Permanently Closed) in Oct' 12. She straightaway suggested IVF, not even considering IUI. It didn't give us a good feeling so we chose to walk away with no acknowledgement to her advice (no, it wasn't rude at all).

Google Search provided us with a list of Doctors and Clinics in Bangalore who conduct IVF/ ART. Then we met Dr. Uma Maheswari (Sure Fertility, J.P.Nagar 5th Phase, Bangalore) in Nov' 12. Since we had all possible tests reports for me and my DH, she concluded to either go with a Varicocectomy or ART. Probably, not what we wanted to hear, AGAIN. As their success rate in 2012 wasn't that great, we decided to keep it as last priority and discover more clinics/ specialists.

Few days later, we read about Dr. Madhuri Patil (Dr. Patil's Fertility and Endoscopy Clinic, Bannerghatta Road, Bangalore). So we headed to her clinic. She did a default Pelvis Scan (all patients were made to pay even before being informed about it) not considering which day of your menstrual cycle you visited. I got highly pissed off with her for pinching my areolas without notice. She didn't even give it a mention why she did that. She concluded to do an ICSI because as per her, I had PCOS which the previous two scans conducted at two different clinics were not seen. I definitely didn't want to get pinched again, plus the PCOS was not very convincing so we never went back to her.

After all these experiences, we decided to visit an ayurveda centre. This lead us to Dr. V R Padmanabha Rao (Amruth Ayurvedic Centre, Basavangudi, Bangalore). His treatment stated a 23-day Panchakarma process. I am attaching details for your reference.

The process seemed very cumbersome, as it required my DH to visit the said ayurvedic centre daily for an hour in the morning, coming back home, taking bath and then head to work, and a lot of driving during peak office hours. This treatment that time costed INR 35000.00. Although this cleansing process looked promising, the dynamics of it didn't work out well for us, hence we gave it a pass.

"What's next?"

Mission "Make a baby" begins

My Darling Husband (DH) and I planned to make a baby so we initiated the process in Dec' 11. We read and did research about the "fertile days" concept and marked it on a calendar and did the needful on the specified days.

The concept of "fertile days" is 3 days before and after your Ovulation Day (OD) as healthy sperms can survive upto 72 hours inside the uterus. Since one can't be totally sure about your OD, the formula becomes 4-OD, 2-OD, OD, OD+2, OD+4. Yes, your DH has to do a lot of work in that one week. Another way to predict your OD is by using an Ovulation Prediction Kit (OPK) easily available in the market. It is similar to a Home Pregnancy Test (HPT), a drop or few of urine is enough. Basically, OPK measures the level of the Leutinising Hormone (LH) and Follicle Stimulating Hormone (FSH), LH levels are highest on OD. Third way is to keep a track on your Body Basal Temperature (BBT). Since I could never follow this procedure, I left it. All these methods can't predict your OD in advance, so if you miss the fertile window this month, aim for the next month.

Well, my DH and I tried for a few months using the calendar method but couldn't succeed. So we visited a gynaecologist (Dr. Joshitha Naik, Lady Hospital, Jayanagar, Bangalore) in June’ 12 just to understand if we were heading in the right direction or not. She got my basic tests done (CBC, TSH, FSH, LH, PRL, Creatinine, Lipid Profile and a pelvis scan). I got diagnosed with Hypertension and Hypothroidism, rest everything looked fine so she prescribed a folic acid supplement, BP tablets, Thyronorm 25 and baby Aspirin 75mg. She also suggested the use of OPK for better prediction of OD.

Three months went by, and our attempts failed, leaving us a little perplexed. We visited the gynaecologist again in Sep’ 12 and voiced our concern. This time she suggested a Semen Analysis (SA) of my husband. The report wasn’t good, Severe Oligospermia is what she concluded (as the value was 2 million sperm/mL). We were asked to consult an urologist and if not cured, only an artifical way could help us make a baby.

Current day... Struggle is still on

After yet another failed IVF cycle (ICSI process), I am on a month long break to let my hormones settle down and get geared up for the next attempt. This statement might create an impression of me in your mind as a very strong woman; I am. But feelings change every second, each day. My state of mind keeps fluctuating whenever I recall all the struggles of our "trying to conceive a new life" as a couple.

In this blog, I wish to unfold the sequence of events and share the experience that my husband and I have been through since Dec' 2011. Trust me, it isn't just a struggle to make a baby of your own, but a lot more to deal with.

I know, there are many blogs/ posts/ discussions on infertility (mostly USA, Germany and UK based couples) which has all the latest updates of their cycles and quick references from their past, but that doesn't help much. Even I have read such posts a hundred times myself, but I am going to make this blog different from the others by revealing maximum details (names of places/ clinics/ doctors, tests, costs, etc) for the benefit of my countrymen and foreigners too (many foreigners visit my country to find solution to their infertility problems). My aim is to help other struggling "trying to conceive" couples understand the nitty-gritty of infertility and find their bundle of joy.

My next post will talk about my journey from the very beginning. I plan to do it fast, keeping in mind that my next cycle is just a month away and I have to capture details of past 50 months.

P.S.:  I am an Indian and all my references will be from India.