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ENDOMETRIOSIS & FERTILITY : 3 Reasons for women to have hope

ENDOMETRIOSIS & FERTILITY : 3 Reasons for women to have hope

If you want to get pregnant and you are diagnosed with endometriosis, you might assume that all hope is lost. With the right treatment, you might get pregnant more easily than you think.

3 Reasons Not to Panic About Endometriosis:-

Reason 1

Reason 2

Reason 3

There are many treatments, depending on what’s right for you:

MACROSCOPIC

MICROSCOPIC

Woman with macroscopic (On the other hand women with (On the other
Disease may have lesions and scar tissue endometriosis have completely normal but endometriosis have
That can sometimes block the fallopian tube) microscopic lesions. It may or ,may not microscopic lesions.
This can make it difficult for an egg to make affect fertility) affect fertility)
Its way into the uterus.
Conclusion
we have come quite a long way in understanding endometriosis how it offers fertility and how to treat it. Your chances of conceiving are better than they have ever been, so its worth looking into the many treatment options that are available.

Early symptoms & cause of PCOS

Early symptoms & cause of PCOS

Polycystic ovary syndrome is a very common hormonal condition in females which causes hormonal imbalance. The females suffering from this produce excess of male’s hormones which results in delayed periods.

To be exact, in PCOS your ovaries produced usually high levels of hormones known as androgens which causes your reproduction hormones to become imbalanced leading to erratic menstrual cycle, missed periods & unpredictable ovulation.

  • You don’t have to spend your precious time searching for details of this problem as today we will be sharing the causes & symptoms of PCOS as per our fertility specialist & guide you through this.

What are the symptoms of PCOS 

There is a possibility that you have PCOS & your body doesn’t represent any of the symptoms & on the other hand, some women start seeing symptoms around their first period itself.

Anyhow here are few prominent symptoms of PCOS 

As PCOS presents with a diverse array of symptoms, which can manifest differently each individual. The most typical signs are :

Irregular menstrual cycle :- ovulation might be uneven or irregular , or it may not occur at all, which can cause irregular menstrual periods or even a totally absence of a monthly cycle.

Elevated Androgens: – it can cause actual side effects, including acne excessive face & body hair growth and male – pattern baldness.

Weight : Those dealing with PCOS often encounter challenges in managing their weight, heightening the likelihood of obesity.

It is crucial to remember that not everyone with PCOS will necessarily have all the symptoms, and symptom intensity can vary greatly.

Navigating Treatment Options for PCOS: A Holistic Approach  

The PCOS treatment objectives include symptom relief, fertility improvement, and lowering the danger of long-term health issues.

Lifestyle Modifications: Following a healthy lifestyle can be exceptionally useful in managing PCOS. Through a well-balanced diet and steady physical activity, it is possible to improve insulin sensitivity, and establish regular menstrual cycles.

Fertility Interventions: Fertility Intervention, for example, Ovulation Induction , IUI or In Vitro Fertilization ( IVF ), might be prompted for those attempting to get pregnant depending upon various factors.

Conclusion  

In conclusion, PCOS is a complex hormonal condition with a range of symptoms and causes.By adopting a holistic approach that encompasses lifestyle changes, medications, and emotional support, individuals with PCOS can lead fulfilling lives and better navigate the challenges posed by this condition.For more Query or information regarding PCOS must visit us at Reviva fertility and IVF clinic in sec- 9 D CHD or contact us at 9915004407

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LOW OVARIAN RESERVE:

Platelet Rich Plasma

Platelet Rich Plasma

It has been used alongside conventional fertility treatments like In Vitro Fertilization (IVF) to improve egg quality , uterine lining thickness and endometrial receptivity , primarily in the treatment of recurrent implantation failure expired once multiple cycles.

What is PRP?

It is a concentrated blood product that contains high percentage of platelets. In general, whole blood is composed of 4 components:-
  • Plasma
  • Platelets
  • RBC’s
  • WBC’s
PRP Process :-
PRP Process :-

 After the collection of blood sample from patient, the sample is being processed in centrifugation machine for certain interval of time

After the completion of time separate the plasma from blood sample and again re- centrifuge for some time

Now the sample is ready to infused in women uterus.

How is PRP used for IVF and other fertility treatments?

PRP is used in a no. of fertility treatments including IUI & IVF to assist with & improve uterine lining thickness/ enhance endometrial receptivity during an embryo transfer.

PRP for Egg Quantity & Quality

It is used to encourage an improvement in egg quality, ovarian rejuvenation & response to stimulate medications.

PRP for uterine lining growth & Endometrial Receptivity

PRP may be used to improve the endometrial receptivity of uterine lining prior to an embryo transfer. This is typically done in 48 hours prior to the anticipated embryo transfer.

During the procedure, approximately 1-3 ml is infused in the uterus using an IUI catheter.

The patient will rests for 30 minutes & is subsequently discharged for a normal daily activity.

If the infusions are intended for lining development (usually for someone with a history of failing to develop an adequate uterine lining).

The first PRP infusion would be done at the initial lining check and then repeated after 72 hrs later and if the lining remains inadequate.

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Fertility Treatment During the COVID-19 Pandemic

Fertility Treatment During the COVID-19 Pandemic

Over the past few weeks, our TV channels, newsfeeds,social media platforms have been filled with terms such as ‘social distancing‘ flatten the curve’ due to the global pandemic i.e. COVID-19. There is no denying in saying that this pandemic has pressed a pause button to the world.
Whether its planned vacations, weddings, big conferences, sports events or world championships – everything is on hold.

Now that the world is facing a global health crisis, the cloud of ambiguity and uncertainty is looming larger than ever as many people are questioning how the current restrictions will impact their ability to start or grow their families. Infertility itself is a situation that endures anxiety, feeling of helplessness and fear about the future – and now, there’s COVID-19 pandemic on top of it all.

Current Situation

Given the unknown effects of COVID-19 on fertility treatment, reproductive medicine societies have recommended the suspension of new infertility treatment cycles during this time. Couples and especially women who have invested their time and a lot of money in their treatment may be frustrated and anxious about the impact of this enforced, yet indefinite delay on their chances of conceiving. This whole situation has put the health care providers in the difficult position of trying to balance the patient’s needs with the current government mandates and expert recommendations.

Infertility Care during COVID-19

There are some guidelines issued by the reproductivemedical associations and authorities to ensure that all patients and staff tobe kept as safe as possible by reducing exposure and therefore complications that may arise.

With concerning to infertility treatments during the COVID-19 pandemic, it has been advised to:

  • Suspend commencement of new treatment cycles,
    including intrauterine  insemination,
    ovulation induction; and in vitro fertilisation, including frozen embryo
    transfers, retrievals, and also suspend non-urgent gamete cryopreservation.
  • Cancel all embryo transfers, whether fresh or frozen.
  • Continue to provide care and support to patients who
    are currently ‘in cycle’ or who require urgent cryopreservation and
    stimulation.
  • Suspend all the elective surgeries and non – urgent
    diagnostic procedures.

How REVIVA is combating the Infertility Treatments
amidst COVID-19?

Its understandable that it can be devastating for those couples who have been trying so hard to build and grow their families to now have to delay treatment due to COVID-19. The goal of this communication is to help patients to have a clearer understanding of the recommendations issued by the government and to help answer questions they may have. Thus, we are providing after-care and support via phone calls whilst keeping your safety on the forefront.

Q: Are elective medical procedures are supposed to stop;
are IVF and other fertility treatments are included in this?

A: Infertility is nothing but a disease, and getting treatment of infertility is medically necessary. IVF treatment is extremely time-sensitive and important but not a medical emergency like treatment of ruptured appendix. We know that many other non-emergency treatments are also being postponed during this crisis scattered globally.

Q: I want to pursue IVF or other fertility treatments.
Should I delay care during the COVID-19 pandemic?

A: To deal with the infertility treatment is in itself is quite daunting, especially when you’re pursuing the dream of starting or growing your family. This COVID-19 crisis has come like an unexpected challenge in the way and the government here and around the world has restricted IVF fertility centre in performing treatments.

As fertility care requires a lot of interaction and communication with many people and person-to-person meet which might increase the likelihood of getting infected in one way or the other. so, this is why we have postponed infertility care until the crisis passes.

Q: Are my frozen embryos, eggs, or sperm safe?

A: Yes. As there is no immediate threat to the safety of cryopreserved eggs, embryos, or sperm. We have some policies and advanced procedures which maintain the life of embryos, eggs and sperm.

Q: How safe is the clinic and what cleaning protocols
it is following?

A: Our clinic is following all the cleaning and safety protocols mandatory as per the government regulations. We have been keeping aclose check on every nook and corner and our cleaning staff is taking care diligently. And, we would be following these measures even after this crisis gets over for the safety of our patients and staff members.

Q: Can I still have a medical, counselling or nurse
consent consultation?

Right now, we are encouraged to minimize in-person interactions and instead utilising Telehealth conversations via phone or video chat. Patients who are undergoing through a fertility cycle and need after-care, we are here for you providing support and all the possible options.

Therefore, COVID-19 has cast the future of IVF and the fertility sector into uncertainty.

To be noted, if you have been exposed to COVID-19 or may be at risk, we recommend you to postpone the treatment until cleared by your primary health care provider. This is all in the interest of your safety and the safety of our staff members and other patients. For more information,
 You can email us or call us. We all are in this together.

As we are facing this unprecedented health crisis due to the wide-spread of the coronavirus, we recognise and appreciate the efforts and response of the entire army of doctors, staffs, and nurses who are tirelessly doing their jobs and helping the patients from this dreadful disease.

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Getting pregnant after 40 and the treatment options – Reviva IVF

Getting pregnant after 40 and the treatment options – Reviva IVF

The reproductive potential of a woman declines after 40. So, chances of natural conception reduce with age. Delaying in pregnancy can be due medical reasons or lifestyle which can be a leading cause of ovarian aging. Women are born with millions of eggs but with age, the quality & number of eggs become less. But if natural conception is not happening due to age factor then a patient must go for a fertility checkup.

How pregnancy can be achieved in 40’s?

Achieving pregnancy after 40’s needs a healthy lifestyle. Taking good care of health, eating a healthy diet, and regular exercise can improve the chance of your pregnancy. Since the age is the major factor so if a woman has aged more than 40 yrs & trying for a baby without any success then the patient should seek the advice of a fertility doctor. The infertility factor can either be associated with male or female. So it is important to know the cause. In women, the problem can be blocked fallopian tubes, endometriosis, infections, fibroids etc. In males, the problems can be with semen sample like, Azoospermia, oligospermia, Globozoospermia etc. IVF treatment for such patients is the only answer to achieve a successful pregnancy.

If a couple is undergoing IVF treatment patient must undergo necessary investigations to make a correct diagnosis. In women, blood investigation is performed to check the hormonal levels – Estrogen, progesterone, LH levels, AMH level (check ovarian reserve), followed by Ultrasound to monitor any fibroid or lesions etc. Whereas, in male blood tests for viral markers, semen analysis & culture is done.

Treatment available after 40

Assisted Reproductive Technology (ART) process which is commonly known as Invitro Fertilization (IVF) is the treatment available for such patients. Through IVF treatment, it is to ensure that a patient is able to get children after taking proper treatment. In the process, the embryo is made outside the human body in in-vitro conditions and on Day 3 or Day 5 it is transferred to the uterus for further development. The whole treatment can be done in 2 weeks.

Name of some treatment Available:

  • IUI (Intrauterine Insemination)
  • IVF (Invitro-Fertilization)
  • ICSI (Intracytoplasmic Sperm Injection)
  • LAH (Laser Assisted Hatching)

Reviva Fertility clinic & IVF Centre in Chandigarh offers you all kind of latest fertility techniques to treat infertility problem.

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Importance of Quality Control in IVF Lab

Importance of Quality Control in IVF Lab

Quality control (QC) is the most important component of the IVF Clinic. QC evaluates the quality of the procedure & its outcome. It is mandatory to monitor laboratory conditions (Air Quality, Temperature, and VOC’s etc), Stimulation protocols, Culture media & technical skill coordination etc to ensure quality control. The IVF lab which follows good laboratory practices they can facilitate the results of IVF by giving the best outcome to their patients.

Need of Quality Control in IVF Lab

  • It ensures the quality of the procedure
  • Increase the success rate
  • Increase the reliability of IVF lab
  • Complete traceability & Documentation
  • Build up IVF team confidence 

IVF Laboratory Equipments

Incubators

The change in temperature & Co2 level can affect the oocytes & embryos quality. So, carbon dioxide & temperature should be recorded on daily basis. If anything altered it should be calibrated as per requirement.

Laminar Air Flow

The laminar flow need to clean on daily basis before & after the completion of task.

Refrigerators

The location of the refrigerator should be outside the core embryology area as it releases harmful gases which are not good for IVF Lab. Also thermometer should be placed inside the refrigerator to see the temp on daily basis.

Microscopes

They should be cleaned everyday to remove unwanted dust particles.

Heated Stages

Temperature is a very crucial parameter as it can cause spindle damages etc. So, gametes handling should be done strictly on heated stages at 37°c to avoid any kind of damage.

Below given table will help to know that how often the test is done to check equipment working.

 

Quality Control IVF Lab

Culture Media

Culture Media 

Equipment

Incubator

Laminar Air Flow

Refrigerators

Microscope

Heated Stages

Test 

CO2 ,Temp

Environment

Temp

Function

Heated Stages

Duration

Weekly

Weekly

Weekly

Weekly

Weekly

Oocytes & embryo are very sensitive & a little change in their environment like ph, osmolarity etc can cause harmful effects to them. So the cultural conditions should be favorable for them. So it is important to understand the need of culture media

  • While receiving media from any company ensure that the cold chain of media is well maintained. Never accept broken seal of the order.
  • Always see the expiration date of Culture media before use in any case.
  • Always store your media in refrigerator with required temperature conditions.

IVF Laboratory Environment:

The laboratory environment is mostly affected by the following reasons:

  • If clinic is located near to construction sites, on highway, factories then there are a major risk of dust particles & pollutants. So, Hepa Filter is necessary for such laboratory. As it removes 99.99% of small 0.3 microns in size dust particles.
  • Use of cosmetics in IVF should be prohibited. Cosmetics emit VOC’s & can cause negative effect to embryos.
  • Laboratory cleaning is done on daily basis using disinfectants.
  • If any kind of fluid spilage is found then it should be cleaned with 5.25% sodium hypochlorite. 

Protocols to be followed when working IVF Laboratory: 

  • IVF Laboratory should have well trained staff. The embryology work is very sensitive so expertise is required.
  • The laboratory should keep on updating the protocols. Inhouse modifications in methodology should be done for betterment.
  • IVF Lab should remain up to date with the latest technology.
  • Dishes Preparation should be done at room temperature. One culture dish is prepared at a time to maintain the osmolarity.
  • Ethical practice while handling the gametes. Label the dishes before OPU. Avoid mixing of samples by labeling containers.
  • Witnessing should be a compulsory practice in IVF laboratory.
  • Wearing gloves, cap & mask in laboratory is must. Hand washing is essential before entering IVF laboratory.
  • Discard sharp objectives & pipettes after single use.
  • The documentation is very important in IVF lab system. It helps to recall the past events. So proper documentation in IVF is necessity. For eg: Patient Records, QC data, Complaint Data 

QC is the essential component of IVF laboratory. It is our responsibility not a burden. Infact, it helps in troubleshoot. QC ensures the success rate & even the reputation of the clinic. And we at Reviva Fertility Clinic & IVF Centre In Chandigarh follow all the ethical practices & make sure at every step that the outcome should not be affected at any cost. For more information on the IVF Procedur and their Cost in Chandigarh  you can contact us: 9915004407

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Culture Media

Culture Media

Assisted Reproductive Technology results have been improved due to the improvement in culture media conditions. There are number of commercially available culture media in the market with components like protein, antioxidants, carbohydrates etc. In this blog, we are going to discuss the key components of media & how they support to embryo growth.

What is Culture Media?

Culture media is the artificial environment given to the embryos for growth & development. Culture media is based on two philosophies:

  • Back to nature Principle
  • Let embryo decide the principle

In nature principle, the media components try to imitate the components of a female reproductive system .Which means the media is formulated sequentially according to the embryo developmental need i.e. from zygote to a blastocyst. Whereas, Embryo chooses principle is single step or monoculture formulation in which the media is supplemented with all the macromolecules and then embryo utilize the macromolecules according to its requirements.

Key Components of Embryo Culture Media

Water
Most of the culture media are made up of 99% of water. As, the goodness of media depends upon the quality of water. So, the water sources should be good.

Ions

The role of ions in the media is to maintain the osmolarity. The ions present in culture media is Na, Cl, P, Ca, Mg, S, K, etc. Osmolarity of medium affects cell volume & embryo development. Elevated osmolarity can result into developmental arrest. Osmolalities of culture media should be in the range of 260 to 298 milliosmoles.

Carbohydrates

Carbohydrates are the key source of energy for embryo growth. The media consist of pyruvate, lactate and glucose. In the initial stage of development pre compacted embryo utilizes the pyruvate as primary source of energy .However, in post compaction stage the embryos use glucose for expansion.

Amino Acid

These are important regulators serve as energy sources. Essential & non essential amino acid stimulates the production of ICM of blastocyst. Whereas trophoectoderm formation & hatching in blastocyst is initiated by non-essential amino acids (Glutamine).

Antioxidants

Invitro embryos when exposed to culture conditions they may experience oxidative stress due to production of Reactive Oxygen Species (ROS) Which have a negative impact on the development of embryo. Media should be supplemented with antioxidants such as Lipoate to avoid stress on embryo produced by ROS.

Antibiotics

To avoid bacterial contamination in culture media antibiotics like gentamycin, streptomycin are added to media.

Proteins

 Protein is the common macromolecule in human embryo culture media such as Human Serum Albumin (HSA). It aids in embryo development. They also maintain membrane permeability & osmoregulation while manipulation of gamete in vitro.

Buffer System

The suggested pH range for culture media is 7.2 -7.4. Most of the culture media have bicarbonate buffer system to sustain the pH in the tolerable range. For handling gametes outside the incubator HEPES & MOPS are preferred.

Growth Factors & Hormones

Embryos are exposed to a blend of maternal hormones & the role of hormones in embryo development is uncertain. Growth factors have considerably role in growth & differentiation of Day4 Morula to a Day 5 Blastocyst. Even due to the addition of growth factors to the media have drastically improved the implantation rates.

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IVF treatments in India boasts lower cost, yet higher success rates

IVF treatments in India boasts lower cost, yet higher success rates

IVF or In vitro fertilization treatments are popular all over the world. However, the attention of IVF treatment seekers has turned to India as their choice of the treatment location. Many people from the western world are visiting India for this purpose.

Cost of IVF Treatment in India

Affordability of the cost of IVF treatment in India coupled with excellent success rates attract many couples from all over the world, and their confidence to choose India as their IVF treatment destination has increased over time. The average cost of the IVF treatment in India is usually between Rs. 250,000 – 450,000 for a basic IVF treatment cycle. However, advanced IVF treatment as if ICSI (Intracytoplasmic sperm injection) or ET (Embryo transfer) costs 120,000 – 150,000 in addition to the IVF basic treatment cycle cost. This is only a fraction of a treatment cost when compared with the IVF treatment costs in the western world.

In addition, the cost of IVF treatment hugely varies between various cities of India. The cost of IVF treatment in Delhi is totally different from treatment cost in Mumbai or in Chennai. Due to this reason, many couples who live in different parts of India travel to other locations to undergo these IVF treatments at an affordable cost.

Here is how the infertility treatment cost in India varies according to the location

City Price
Mumbai 200,000 – 300,000
Bangalore 160,000
Chennai 145,000 – 160,000
Delhi 90,000 – 125,000
Nagpur 75,000 – 90,000
Pune 65,000 – 85,000
Hyderabad 70,000 – 90,000

The treatment cost in Chandigarh is considerably low when compared with some of the locations above, and at Reviva clinic you could receive world-class medical care for the same cost.

Additional Costs Associated With IVF Treatment

Every couple should keep in mind to analyze the package that comes with the IVF treatment beforehand in order to avoid any hidden charges. For instance, Reviva Infertility and IVF Clinic offer special IVF package that includes all examinations costs as if for ultrasound examination, the cost for all types of blood tests that required during IVF treatment, anesthesia cost, advanced IVF treatment cycle options as if ICSI and ET.

Besides, Reviva clinics package also incorporates laboratory charges and even it includes the cost of day care hospitalization that is required during IVF treatment cycle and guarantee of no hidden fees. All charges are included and elaborated in the treatment packages so that preparing for the treatments financially would not bring any surprises throughout the process.

Conclusion

As India is one of the countries to receive infertility treatments for a lower cost, you should consider visiting Reviva Clinic at Chandigarh to make your dream come true. Along with the lower cost of treatments, the lower costs of accommodation and also travelling will reduce additional costs you will have to bear during the visits. That is why many people consider India today as to be a leading country for medical tourism. If you are planning for IVF treatments and wondering where to seek the best care, then you are in the right place. Reviva clinic is more than happy to hear from you

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Oocyte Grading

Oocyte Grading

Understanding Oocyte Development and Grading

    An oocyte is a female gamete which is involved in reproduction. It is one of the largest cells in the body 120 microns in diameter and develops in the ovarian follicle during oogenesis. On the basis of oocyte grading we can find the ideal oocyte for fertilization. While Oocyte Pickup, on the basis of cumulus we can get an idea of oocyte maturity.

    • Immature – The immature oocytes are Germinal Vesicle and they have tightly packed corona cells with little cumulus.
    • Intermediate– The nuclear maturity of these oocytes is Metaphase I. The corona and cumulus cells are tightly packed.
    • Mature- These oocyte are at Metaphase II stage and they appear like sunburst of corona cells with expanded and abundant cumulus.
    • Postmature– These types of oocytes are mature ones which have dark Cumulus oocyte complex. In which corona cells begin to degenerate.

    On denudation of cumulus–corona cells, we can better appreciate the maturity and morphology of oocyte before fertilization. Below given picture can give you an idea about the oocytes maturity.

    • Germinal vesicle: has a visible intracytoplasmic nucleus. Metaphase I oocyte neither has Germinal Vesicle nor polar body. Metaphase II stage when it has a visible polar body.

    We can grade the oocytes by looking at its Zona Pellucida, perivitelline space (PVS ) shape, polar body (PB) morphology , Ooplasm characteristics.

    • Zona Pellucida:  The Zona Pellucida is the outer layer of oocyte .The normal thickness of ZP is 17-18 microns. If the thickness of Zona is greater than normal then after ICSI Laser Assisted hatching (LAH) is required. If thickness is very low then there is a chance of early hatching or damage can cause to oocyte while doing denudation. The alterations in Zona Pellucida appearance could be caused by secretion problems of the glycoprotein matrix.

    Zona Pellucida AssessmentExplanation
    NormalThickness of 17-18 microns with even surface
    ThinIf the Zona pellucida is less than normal
    ThickIf Zona pellucida is more than 25 microns
    AbnormalIf the shape of Zona pellucida is irregular
    • Perivitelline Space: This is the space between Zona and oolemma membrane known as PV space. We can see a polar body in this space. Sometimes it is large in size or may be absent.

    Perivitelline Space AssessmentExplantion
    Normal
    The Ooplasm is slightly away from the ZP in the surrounding area of the polar body
    Large
    the Ooplasm is away from the ZP leaving a large space around the cytoplasm
    FragmentedFragments and debris
    • Polar Body: The polar body should single and round in shape and in total 5% of the cell volume.

    Polar body AssessmentExplanation
    Normal
    Ovoid & round in shape, with 5% of cell volume.
    Fragmented
    Polar body is irregular and dissociating into small fragments
    GiantLarge in size
    • Ooplasm: The Ooplasm is the cytoplasm of egg. Sometimes it has some inclusions and clusters which can be graded to get the best oocyte.

    Cytoplasmic InclusionsExplanation
    Vacuoles
    These are fluid filled bodies. Appears as a vesicle in the cytoplasm. They can be single or abundant.
    Refractile Bodies
    Appears like dark dots of diverse sizes (lipofucsin)
    Smooth Endoplasmic reticulumAppears as a flat elliptical disk
    GranulationUneven patches of granules in the Ooplasm

    From such assessment we can only find the ideal oocyte for fertilization. But these parameters are still controversial for embryo development and implantation. Like abnormal Zona Pellucida, Perivitelline space fragments, size and morphology are still controversial. But the presence of inclusions bodies like vacuoles, Refractile bodies , SER in large number can be detrimental.

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