Dr. Luvna Yasmin – Infertility & IVF Specialist in Khulna

Infertility Causes, IVF Treatment & PCOS Solutions | Dr. Luvna Yasmin, Khulna

Author: Junait Islam

The Complete Guide to Infertility: Causes, IVF Solutions & Advanced Treatments in Khulna

Expert care with Dr. Luvna Yasmin | Last updated: April 2025

Understanding Infertility: A Medical Overview

Infertility affects 1 in 6 couples globally. The World Health Organization defines infertility as the inability to conceive after 12 months of regular unprotected intercourse. In Bangladesh, approximately 15-20% of married couples face fertility challenges.

When Should You Consider IVF? (Detailed Indications)

IVF (In Vitro Fertilization) is recommended for:

1. Tubal Factor Infertility (40% of female infertility cases)

Complete tubal blockage (HSG-confirmed)
Hydrosalpinx (fluid-filled tubes)
Previous tubal ligation (reversal not feasible)

2. Male Factor Infertility (30-40% of cases)

Severe oligospermia (<5 million sperm/mL)
Azoospermia (surgical sperm retrieval required)
Genetic conditions (Y-microdeletions, CFTR mutations)

3. Advanced Reproductive Age

Women >35 years with diminished ovarian reserve (AMH <1.1 ng/mL)
Premature ovarian insufficiency (FSH >25 IU/L)

4. Endometriosis (Stage III/IV)

Ovarian endometriomas (>4cm)
Deep infiltrating endometriosis affecting fertility

5. Unexplained Infertility (15-30% of cases)

After completing:

Semen analysis
Ovulation documentation
Hysterosalpingogram (HSG)
Ovarian reserve testing

Male Infertility: Causes & Advanced Diagnostics

Pathophysiological Causes

Spermatogenic Disorders (70%)
- Varicocele (grade III)
- Genetic (Klinefelter syndrome)
- Testicular trauma/torsion
Obstructive Causes (15%)
- Congenital absence of vas deferens
- Post-infectious obstructions
Endocrine Disorders (5%)
- Hypogonadotropic hypogonadism
- Hyperprolactinemia

Advanced Diagnostic Workup

Sperm DNA fragmentation testing
Reactive oxygen species (ROS) assay
Karyotype analysis
Y-chromosome microdeletion testing
Transrectal ultrasound (for ejaculatory duct obstruction)
Testicular biopsy (for azoospermia evaluation)

Female Infertility: Comprehensive Analysis

Ovarian Factors

PCOS (Rotterdam criteria: 2/3 required)
Diminished ovarian reserve (AFC <5, AMH <1.1 ng/mL)
Premature ovarian failure (<40 years)
Luteal phase defects

Tubal/Peritoneal Factors

Pelvic inflammatory disease sequelae
Post-surgical adhesions
Tuberculous salpingitis (common in South Asia)

Uterine Abnormalities

Müllerian anomalies (septate uterus)
Asherman's syndrome
Endometrial polyps
Submucosal fibroids

Cervical Factors

Hostile cervical mucus
Cervical stenosis

Age & Fertility: The Biological Clock Explained

Quantitative Data

Age	Monthly Conception Chance	IVF Success Rate	Miscarriage Risk
<30	25%	45-55%	10%
30-35	15-20%	35-40%	15-20%
35-40	5-10%	25-35%	25-35%
40-42	3-5%	15-20%	35-50%
>42	<3%	5-10%	50-75%

Oocyte Quality Decline

Mitochondrial DNA mutations increase with age
Meiotic spindle abnormalities lead to aneuploidy
Zona pellucida hardening affects fertilization
Cumulative oxidative stress on oocytes

PCOS & Fertility: Management Protocols

First-Line Treatment

Lifestyle modification (5-10% weight loss shows significant improvement)
Ovulation induction (Letrozole 2.5-7.5mg CD3-7)
Clomiphene citrate (second-line option)

Advanced Interventions

IVF with GnRH antagonist protocol (reduces OHSS risk)
In vitro maturation (IVM) for OHSS prevention
Metformin adjunct therapy (1500-2000mg/day)
Laparoscopic ovarian drilling (for CC-resistant cases)

PCOS-Specific Challenges

Higher risk of ovarian hyperstimulation syndrome (OHSS)
Increased miscarriage rates (25-30% vs 15% general population)
Higher incidence of gestational diabetes

IVF Treatment: Step-by-Step Process

1. Ovarian Stimulation (8-12 days)

Protocols: Long agonist vs. Antagonist
Medications: rFSH + LH (150-450 IU)
Monitoring: Serial ultrasounds + E2 levels
Trigger shot: hCG or GnRH agonist

2. Oocyte Retrieval (Day 14)

Transvaginal aspiration under sedation
Average yield: 8-15 oocytes (age-dependent)
Recovery: 1-2 hours post-procedure

3. Laboratory Phase

ICSI for male factor (injected sperm count >1 million)
Blastocyst culture (day 5 transfer preferred)
Embryo grading (Gardner scale for blastocysts)
Genetic testing (PGT-A for recurrent loss)

4. Embryo Transfer

Fresh vs. Frozen transfer (freeze-all for PCOS)
Endometrial preparation (estrogen + progesterone)
Catheter type: Soft vs. hard (clinical decision)

5. Luteal Support

Progesterone supplementation (vaginal/IM)
Duration: Until 10-12 weeks gestation
hCG support (controversial, risk of OHSS)

Alternative Treatments Comparison

Treatment	Success Rate	Cost (BDT)	Best For	Cycle Duration
IUI	10-15%	15,000-25,000	Mild male factor, cervical factors	1 month
IVF	40-50%	300,000-500,000	Tubal/male factor, endometriosis	6-8 weeks
ICSI	50-60%	350,000-550,000	Severe male factor	6-8 weeks
Donor Eggs	60-70%	600,000+	DOR/advanced age	3-4 months
Surrogacy	50-60%	1,200,000+	Uterine factors	9-12 months

Expert Care at Khulna Fertility Center

Dr. Luvna Yasmin's Advanced Protocols

Personalized Stimulation Plans
- AMH-tailored dosing
- PGT-A for recurrent miscarriage
- Natural cycle IVF for poor responders
Male Fertility Services
- TESA/PESA for azoospermia
- Sperm cryopreservation
- Sperm DNA fragmentation testing
Supportive Therapies
- Endometrial scratching
- Embryo glue technology
- Laser-assisted hatching
Cutting-Edge Technologies
- Time-lapse embryo monitoring
- Vitrification for embryo freezing
- Preimplantation genetic testing

Clinic Details:

Address: Good Health Specialized Hospital, Tutpara Kabarkhana Moor, Khulna

Consultation Hours: 10:30 AM - 10:00 PM (Closed 2nd Friday of month)

Emergency Contact: 01763-818283

Email: info@khulnafertility.com

Call for Appointment Email Inquiry

Nutritional & Lifestyle Modifications

Fertility-Boosting Diet

Antioxidant-rich foods: Berries, nuts, leafy greens, dark chocolate
Omega-3s: Fatty fish (salmon), flaxseeds, walnuts
Complex carbs: Whole grains, legumes
Iron-rich foods: Spinach, red meat (in moderation)
Avoid: Trans fats, processed foods, excess caffeine (>300mg/day)

Environmental Factors

Reduce EDC exposure: BPA (avoid plastic containers), phthalates
Moderate exercise: 30 mins/day (excessive exercise harms fertility)
Stress management: Yoga, meditation, CBT
Sleep hygiene: 7-8 hours/night

Psychological Support & Counseling

Infertility Distress Scale

We screen all patients using:

Fertility Problem Inventory (FPI)
Hospital Anxiety and Depression Scale (HADS)
Quality of Life scale (FertiQoL)

Support Services

Monthly support groups
Couples counseling
Mind-body programs
Referrals to mental health specialists

Financial Considerations

Cost Breakdown

Basic consultation: 1,500-2,000 BDT
HSG test: 5,000-7,000 BDT
IUI cycle: 15,000-25,000 BDT
Standard IVF cycle: 300,000-500,000 BDT

Financial Assistance

Payment plans (3-6 installments)
Corporate partnerships (discounts for certain employers)
Charity funds for low-income patients

Success Rates & Realistic Expectations

Cumulative Live Birth Rates

After 1 IVF cycle: 40-45%
After 3 cycles: 65-70%
After 6 cycles: 85-90%

Multiple Pregnancy Prevention

Single embryo transfer (SET) policy for most cases
Elective freezing for high responders
Strict criteria for double embryo transfer