Fertility services offered at Vindana Reproductive health Centre (VRHC)

Fertility services at VRHC involve the initial clinical, biological and psycho-social assessment of the couple. It is then followed by the appropriate treatment. These levels of management are applied for infertility care.

Level 1

The purpose of the initial level of treatment is to provide an assessment of the fertility process and support to achieve a successful pregnancy. This provides an opportunity for the initial assessment of the couple at their first consultation with our fertility specialists.

The simplest and less invasive tests are initially performed.

  • To check male fertility potential, detailed history taking, clinical examination and seminal fluid analysis (SFA) are performed. Further investigations will follow as necessary.
  • To assess the ovarian potential based on features of the menstrual cycle, a mid-cycle ultrasound scan would be performed. Further investigations such as hormone tests are decided based on clinical details and the above scan. While inexpensive and technologically simple basal (waking) body temperature charts could be taught and performed by the client, it is dependent on her compliance.
  • To evaluate the uterine shape, endometrial details and to detect the presence of fibromyomata (harmless tumour), adenomyosis (inflammation of wall of the womb) and some uterine abnormalities from birth an ultra sound scan is performed.
  • More advanced assessment of the tubes and pelvis is made by hysterosalpingo gram X-ray (HSG) and /or laparoscopy an operative procedure at this stage or in Level ‘2’treatment.

A dye is introduced through the cervix and its spread in to the uterus and the tubes are noted.

Along with the above tests, advice to optimize the chance of pregnancy is given particularly with regard to timing of intercourse to the time of ovulation.

Level 2

Level 2 management is where more advanced treatment is offered to enhance the success of the natural process of fertilization and implantation. Hence each step in the natural process is supported.

Ovulation induction involves a course of tablets or a course of injections in order to get the ovaries to develop the egg sacs (Follicles) containing the eggs.

A follicle scan is an internal scan performed on day 12/13 of the menstrual cycle to assess whether the ovary has a follicle/s ready to release an egg (ovulation).

The ovulation can be natural or induced by an injection. Subsequently the sperms are introduced by intercourse and/or intrauterine insemination (IUI), when more concentrated; better quality sperms are obtained by special processing.  To improve on the timing of intercourse and/or IUI the ovulation test strip is now available at VRHC.

Intrauterine insemination (IUI) involves introducing sperms that are processed (separation of good quality spermatozoa for IUI) in to the womb by timing with the ovulation.  This can be done with,

  • Husband’s own sperm
  • Donor sperm insemination from our sperm bank in situations where the husband has an insufficient sperm count and/or the sample is of poor quality.

After a planned number of IUI cycles (usually twice) have been unsuccessful in achieving a pregnancy it is necessary that the structural normality of the uterus and the fallopian tubes is assessed prior to further IUI treatment.

This should be done by a hystero-salpingogram (HSG) X-ray and /or laparoscopy. In those techniques the patency of the fallopian tubes (whether they are open or blocked) is checked by sending a suitable dye through the cervix and observing visually the passage of the dye through the uterus and the tubes.

The risk of infection has to be minimized during the procedure as bacteria present in the lower genital tract may move upwards and therefore maximum precautions   are taken.

HSG and laparoscopy are not performed at VRHC. These would be arranged at a hospital of the consultant’s choice.

Level 3

Following simpler fertility treatment or in some selected cases Assisted Reproductive Treatment (ART) is offered. In this treatment the eggs are taken out from the ovaries and fertilized with sperm outside the body at a laboratory to form embryos.

  • In vitro fertilization (IVF) is when the ova are exposed to sperm for natural fertilization
  • Intra-cytoplasmic sperm injection(ICSI) is when intra-cytoplasmic morphologically selected sperm is injected naturally or surgically obtained sperm
  • Vindana is the first to use computer assisted sperm analysis (CASA) in Sri Lanka to obtain high quality sperm which in turn increases the fertilization potential.

Embryo freezing -During an ART (IVF/ICSI) treatment procedure many embryos may be formed. It is common to replace up to three embryos during a cycle of treatment. The remaining ones are frozen for future use. The recent technique of vitrification (fast freezing) available at Vindana has resulted in a high embryo survival rate with improvement in pregnancy rates.

Ovulation induction involves a course of tablets or a course of injections in order to get the ovaries to develop the egg sacs (Follicles) containing the eggs.

A follicle scan is an internal scan performed on day 12/13 of the menstrual cycle to assess whether the ovary has a follicle/s ready to release an egg (ovulation).

The ovulation can be natural or induced by an injection. Subsequently the sperms are introduced by intercourse and/or intrauterine insemination (IUI), when more concentrated; better quality sperms are obtained by special processing.  To improve on the timing of intercourse and/or IUI the ovulation test strip is now available at VRHC.

Intrauterine insemination (IUI) involves introducing sperms that are processed (separation of good quality spermatozoa for IUI) in to the womb by timing with the ovulation.  This can be done with,

  • Husband’s own sperm
  • Donor sperm insemination from our sperm bank in situations where the husband has an insufficient sperm count and/or the sample is of poor quality.

After a planned number of IUI cycles (usually twice) have been unsuccessful in achieving a pregnancy it is necessary that the structural normality of the uterus and the fallopian tubes is assessed prior to further IUI treatment.

This should be done by a hystero-salpingogram (HSG) X-ray and /or laparoscopy. In those techniques the patency of the fallopian tubes (whether they are open or blocked) is checked by sending a suitable dye through the cervix and observing visually the passage of the dye through the uterus and the tubes.

The risk of infection has to be minimized during the procedure as bacteria present in the lower genital tract may move upwards and therefore maximum precautions   are taken.

HSG and laparoscopy are not performed at VRHC. These would be arranged at a hospital of the consultant’s choice.

Egg sharing and embryo donation programs

These programs are available for those who are unable to provide their own eggs from their ovaries due to increased age, or disease conditions of the ovaries. In these procedures the eggs are from a donor while the embryo is replaced in to the womb of the wife in the recipient couple. Some couples who had IVF treatment are willing to donate their embryos which were frozen and can be placed in uterus following preparation of the recipient.

Gamete freezing

Sperm and egg freezing facilities are available for those who need fertility preservation prior to undergoing treatment for conditions such as cancer. Furthermore this is of use in situations where the partner is not available at the time of the fertility treatment cycle.