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1. rotunda.co.in
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Home Welcome to the official website of Rotunda Fertility Clinic and Keyhole Surgery
Programs and Services Centre. This clinic is the latest venture of Rotunda-The centre for Human
Reproduction and one step forwards in creating a chain of well equipped and State-
Infertility Surgery
of-the-art IVF centres in the city of Mumbai.
All you need to know
In addition to Infertility treatments, we also have facility for patients to undergo
Pictures and Videos keyhole surgery which is performed by reknowned specialists when indicated.
About us
Glossary of terms Facing infertility and undergoing treatment for the same is without doubt one of the
Our Success rates most distressing situations that a couple can face. It fosters uncertainities, doubts,
fears, guilt and apprehensions. We at Rotunda strive towards making the whole
Contact us
process as simple and transparent as possible, providing guidance and counselling
at every step. We boast of a team sensitised to the needs of our clients and have a
long track record to prove this. Most of all, we respect our clients' need for privacy
and offer this and much much more at very reasonable and competitive rates.
Egg donation may offer
the only chance of.....
Success rates at Rotunda
Centre of Human.....
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http://www.rotunda.co.in/[12/22/2010 5:36:08 PM]
7. Male Factors
General Causes Meds
Unknown: 40-50% 1 or 2
Hypogonadism
1 Hypogonadism: 30-
40% Common medications
Ketoconazole
Altered Sperm Cimetidine
Transport: 10-20% Spironolactone
2 Hypogonadism: 1-2%
8. The Scenario
Tech: “Husband and wife can’t get
pregnant.”
You: OB rotation was last infertility workup
What now?
9. Workup
History is KEY
Focused Physical Exam
Labs and Specialized Tests
10. Workup: History
Coital Practices
Gestational History
PMHx/PSHx
Meds
Menstrual History
Substances
Recent High Fever
11. Our Couple: History
Female Male
G1 P0010 No previous partner
pregnancies
No hx of STIs
Gonorrhea hx
Normal menses
No meds
Unprotected sex for
15 months Occasional EtOH
12. Workup: Physical Exam
Female Male
Breast Formation Infection
Hernia
Galactorrhea Vas deferens
Androgen deficiency
Genitalia Testicular mass
Varicocele
Hyperandrogenism?
13. Workup: Labs
Female Male
Ovulation problems CBC
FSH, Testosterone
Ovulatory Dysfunction GC/Chlam, UA
Renal and Liver
Ovarian Reserve Function
Semen analysis
Postejaculatory
urinalysis
14. WHO Seminal Fluid
Analysis (1999)
Volume: >2ml
Sperm concentration: >20 million/ml
Total Sperm Number: >40 million/ejaculate
Sperm Motility:
>50% motile and/or
>25% progressively motile
Sperm Morphology: >14% normal forms
16. Our Couple: Exam,
Labs & Tests
Normal male exam
Normal initial labs
Oligospermia on 2 separate semen
analyses
TRUS and postejaculatory UA normal
17. Management: General
Concepts
41 different methods
“Fertile window” intercourse
“E-type” vaginal discharge
Avoid lubricants and douches
19. Management: Female
Ovulatory dysfunction (Unknown etiology)
Clomiphene 50mg PO daily x 5 days
Start on days 3-5
Can increase to 100mg daily next cycle
Results
80% will ovulate
Hyperstimulation and Twinning
Higher-order multiples rare
23. Stress and Infertility
69% Women and 21% Men have
preexisting condition
Greater risk for psychological stress
No significant difference in
psychopathology
24. Stress and Infertility
Men have increased stress over time,
same as women
Watch for normal grief vs. psychopathology
Same rates of depression as other chronic
disease
28. Infertility treatments
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Home Programs and Services Infertility treatments
Infertility treatments
Rotunda offers all services pertinent to infertility under one roof. We are known for our innovation, integrity, medical
and technical excellence, personalized service, and consistent willingness to accept patients facing the most difficult
medical challenges. We offer the following services:
Intrauterine Insemination
In vitro Fertilisation (IVF)
ICSI
IVF Lite (Mild IVF/Minimal stimulation IVF)
Surgical Sperm retrieval
Donor Egg program
Sperm banking and donor sperm
Embryo freezing
Gestational Surrogacy
Embryo donation
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