Gynaecology

      Whether an adolescent girl or a post-menopausal woman The life source clinic  provides comprehensive care and treatment for all age groups. Our clinicwelcome patients presenting with many conditions/complaints including: poly-cystic ovarian syndrome, irregular periods, post- menopausal bleeding, infertility, uterine fibroids, endometriosis…

       In addition, we have a specialized gynaecology clinic running: “The Well Woman Clinic”. This is a specialized clinic that women visit on a yearly basis. During such visits, women are examined to make sure that their general health is great and their gynaecologic system is working perfectly. It is the policy of Life source clinic in these visits to screen women for disorders including cancer of the cervix, ovaries, breasts, bowel, thyroid diseases, osteoporosis…

The clinics are equipped with state of the art diagnostic machines that help the gynaecologist confirm a diagnosis or just reassure the lady that everything is fine.

 

Where as a case requires surgical intervention (e.g., hysterectomy, myomectomy…), Life source clinic  offers state of the art operating theatres, equipment and expertise. Coupled with extensive experience with laparoscopic and hysteroscopic surgeries, most if not all patients leave the hospital extremely satisfied with fond memories.

Causes of female infertility

Problems with Ovulation
Polycystic ovaries

The commonest cause of ovulation problems is Polycystic Ovaries. This is a common condition, affecting one in ten women. It usually presents as irregular periods, weight gain and hirsutism (excessive hair growth). On transvaginal pelvic ultrasound scan it is possible to see the small cysts (around 0.5 cm. diameter each) around the ovaries. The diagnosis is made on the physical findings, hormone blood tests and a pelvic scan. Many women who have polycystic ovary syndrome do not ovulate and require treatment to help them get pregnant. This could be in the form of life-style changes to lose weight, fertility drugs (given in the form of tablets or injections), or a day-case key-hole operation called laparoscopic ovarian drilling (where the inside of the abdomen is examined with a small scope and heat is applied to both ovaries in certain points).

Other causes of not ovulating
There are many other causes of not ovulating. Investigations include pelvic scan and blood tests for hormone levels. Depending on the type of problem, other investigations may sometimes be required. Treatment is often in the form of fertility drugs and is targeted at correcting the underlying condition.

Tubal blockage
Tubal blockage can affect the tube at the point at which it joins the womb (known as proximal blockage), or at the end of the tube (known as distal blockage). If the tube is blocked at its end, it can swell up with secretions, and is called a hydrosalpinx. Tubal disease is diagnosed by either a laparoscopy , or by an outpatient X-ray procedure called a hysterosalpingogram or HSG. If, on HSG proximal blockage is found, it can often be treated at the same time by passing a wire into the tube and through the blockage. This is called selective salpingography. Distal tubal disease can be seen on HSG, but can only definitively be diagnosed by laparoscopy. Sometimes it is possible to open the tube surgically. If it is not possible to repair the tube, then in vitro fertilisation (IVF), otherwise known as test-tube bay treatment can help.

In IVF the woman's eggs are taken outside the body and mixed with her partner's sperm in a test tube in the laboratory. The resulting embryos are transferred to her womb.Another cause of tubal blockage is previous female sterilisation. Up to 1 in 10 women who have been sterilised consider having more children, and reversal of sterilisation operation is a realistic option. The procedure involves an abdominal operation with a 3 day stay in hospital. The results are good, and depend on the method used for sterilisation, and the presence of any other fertility factors. Your consultant will discuss all these issues with you and advice you appropriately.

 

 

Recurrent  pregnancy loss

The chance of miscarrying any pregnancy is about 15%. Recurrent pregnancy loss is the term used after 3 miscarriages, though sometimes after 2. We can offer full investigations for this condition and provide not only treatment but also support during pregnancy. There are many causes including chromosomal (genetic), hormonal, immune, and abnormal blood clotting. The investigations include hormonal assessment, pelvic ultrasound scan to assess the cavity of the uterus and the ovaries, blood tests to detect any increased tendency for the blood to clot, and genetic chromosome analysis of both partners. Support (in the form of regular scans and reassurance) in early pregnancy in women with recurrent pregnancy loss has been shown in studies to increase the chance of a successful pregnancy.

Recurrent  Treatment  Failure

It is not unusual for many couples to go through repeated fertility treatment attempts unsuccessfully, and keep being advised to carry on doing the same treatment next time without further investigations. We offer detailed investigations of the causes of recurrent treatment failures, such as genetic tests, careful investigation of the womb, and immune causes. Treatment is then offered accordingly.

Unexplained  infertility

About 1 in 3 infertile couples are told that they have unexplained infertility, when all the tests come back as normal. This is often very frustrating for the couple as they think if the doctor does not know what is wrong then the right treatment could not be offered. We understand how frustrating that situation is for the couple and there are a number of things that could be done.

Firstly we will review all the tests that the couple have had and assess if anything else needs doing. Some times, significant tests have been inadvertently missed or up to date methods have not been used.

Secondly, even if after thorough assessment no cause is found, we have a lot of experience in managing such cases. There are a number of proven treatments that could increase the chances of pregnancy, ranging from fertility tablets to intra-uterine insemination and test-tube baby technique (IVF). Of course there are many tests and treatments that may be on offer but with no proof of benefit, and our consultants will be able to expertly advise you on all those points.

Finally, many couples with unexplained infertility have a good chance of getting pregnant naturally, and the chance depends on many factors such as age and duration of infertility. Our consultants will advise you on your chance of getting pregnant naturally and with treatment.

Causes of male infertility

Male factor infertility is a sensitive issue that is often ignored. Many men are not offered the explanation as to the cause of their condition, and are not made aware of their options for treatment.

Male infertility can be due to a low sperm count, poor sperm motility, low number of normal sperm or even no sperm whatsoever (azoospermia). Sperm counts do vary significantly, so it is important to repeat the sperm sample, if it is abnormal before reaching a diagnosis.

No sperm (azoospermia)
There are two types of conditions which result in no sperm being in the ejaculate. Either no sperm is being produced by the testis, or whilst sperm is produced, there is a blockage stopping the sperm.

In some men the sperm passes into the bladder at ejaculation rather than out (retrograde ejaculation).
Other causes include hormonal imbalances, chromosome abnormalities (variations in the way the genetic material is arranged), and a special type of carrier status for Cystic Fibrosis.

Depending on the cause, treatment is either by treating the cause such as removing an obstruction or hormone treatment, or by retrieving sperm for use in IVF techniques . Obtaining sperm from the testis is done by a simple procedure under local or general anaesthetic. Such sperm is then used for a special form of test-tube baby treatment, called ICSI (intracytoplasmic sperm injection). In ICSI a single sperm is injected into the egg to fertilise it and make an embryo.

Severe sperm problems
This is where there is sperm in the ejaculate, but it is of very low count/ very slow or of poor quality. In such circumstances, we check for chromosome abnormalities. Treatment is with a special form of test-tube baby treatment, called ICSI (intracytoplasmic sperm injection).

Mild - moderate sperm problems
Treatment is either with IVF (in vitro fertilisation) or artificial insemination , depending on the severity of the problem. In artificial insemination the sperm are prepared in special way and injected into the womb of the female partner at time of ovulation.

Other Male-related issues
Varicocele: This is where the veins around the testis are increased in size and engorged. They : This is where the veins around the testis are increased in size and engorged. They can be felt on examination and may lead to groin/testicular discomfort and pain. Varicocele are more common in men with infertility, but currently there is no scientific evidence that treating varicocele surgically will improve fertility, as measured by the pregnancy rate, so we don not recommend it.
Vitamins and anti-oxidants: There have been some claims in the past about the benefit of : There have been some claims in the past about the benefit of these drugs in cases of male factor infertility. However, the scientific evidence is very clear that they are of no use and will not improve fertility.

There are two types of conditions which result in no sperm being in the ejaculate. Either no sperm is being produced by the testis, or whilst sperm is produced, there is a blockage stopping the sperm.

In some men the sperm passes into the bladder at ejaculation rather than out (retrograde ejaculation).
Other causes include hormonal imbalances, chromosome abnormalities , and a special type of carrier status for Cystic Fibrosis.

Depending on the cause, treatment is either by treating the cause such as removing an obstruction or hormone treatment, or by retrieving sperm for use in IVF techniques . Obtaining sperm from the testis is done by a simple procedure under local or general anaesthetic. Such sperm is then used for a special form of test-tube baby treatment, called ICSI (intracytoplasmic sperm injection). In ICSI a single sperm is injected into the egg to fertilise it and make an embryo.

Severe sperm problems
This is where there is sperm in the ejaculate, but it is of very low count/ very slow or of poor quality. In such circumstances, we check for chromosome abnormalities. Treatment is with a special form of test-tube baby treatment, called ICSI (intracytoplasmic sperm injection).

Mild - moderate sperm problems
Treatment is either with IVF (in vitro fertilisation) or artificial insemination , depending on the severity of the problem. In AI the sperm are prepared in special way and injected into the womb of the female partner at time of ovulation.

Other Male-related issues
Varicocele: This is where the veins around the testis are increased in size and engorged. They : This is where the veins around the testis are increased in size and engorged. They can be felt on examination and may lead to groin/testicular discomfort and pain. Varicocele are more common in men with infertility, but currently there is no scientific evidence that treating varicocele surgically will improve fertility, as measured by the pregnancy rate, so we don not recommend it.

Vitamins and anti-oxidants: There have been some claims in the past about the benefit of : There have been some claims in the past about the benefit of these drugs in cases of male factor infertility. However, the scientific evidence is very clear that they are of no use and will not improve fertility.

 

What is IUI?

Intra-Uterine Insemination (IUI) involves injecting sperm directly into the uterus with close proximity to the opening of the fallopian tubes thus bypassing the cervical canal. Usually, IUI is an option for couples suffering from infertility rendered not so severe as to resort to IVF or ICSI.

We resort to this method in one of the following circumstances:

·         If the lack of natural conception is related to the husband such as the decreased number of sperm or its mobility or shape or all the previously mentioned- but not so severe as to consider IVF.

·         If the lack of natural conception is the incapability of the sperm to pass through the cervix.

·         If many years passed after marriage without pregnancy with no reason hindering conception from either partner.

Steps involved in IUI:

·         The wife's ovulation is monitored which starts between the sixth and tenth day after her period depending on the treatment used to enhance ovulation. In some cases no treatment to enhance ovulation is used.

·         The husband is asked not to engage in intercourse three days from the expected day for injection, if wet dreams occur, then the supervising doctor must be notified.

·         The husband provides a sample at the hospital or at home in a special sterilized container for this purpose provided by the hospital.

·         The sample is processed at the lab where the best sperm are selected and additional materials are added to boost them and better prepare them for fertilization. Injection of sperm inside the womb is performed using a simple method similar to internal examination and without causing pain. Usually no sedation is required. Afterwards, the wife stays for about half an hour at the hospital before leaving, and she can travel distances by car or plane if she wishes.

·         There are no restrictions on sexual intercourse after administering the injection.

·         The wife is required to undergo a pregnancy blood test after two weeks of the procedure.

What Is IVF?

In Vitro Fertilization (IVF) can be defined as the fertilization of the egg(s) by sperm in a test tube or what is commonly known as test-tube babies. It involves taking mature egg(s) from the ovaries and fertilizing it/them outside the body (in a lab) then returning the fertilized egg(s) into the uterus.
Simply speaking, candidates for such a program include:

*Wives who suffer from fallopian tube occlusion or ovulatory problems,

*Husbands who suffer from shortage in the number of healthy sperm,

*Couples suffering from infertility for a long time with no known explanation.

 

·         What Is ICSI?

·         The In Vitro Fertilization (IVF) program provided solutions for many problems for many families who suffer from lack of conception due to a number of potential reasons. But the success rate remains negligible or nonexistent when the reason is a severe weakness of the husband's sperms. We have been forced to reject couples due to this reason. Today, Hope is restored for such couples by utilizing an extremely developed method which injects sperm directly within the egg's liquid (cytoplasm): Intra Cytoplasmic Sperm Injection (ICSI).

Injection of the sperm within the egg near the nucleus is a modern approach which requires accurate sensitive technology and skillful laboratory work. At our Assisted Reproductive Unit we provide the best with our team who has extensive knowledge and experience in implementing this procedure, placing us among the leading countries in this field.

1. Husbands who suffer from severe weakness in sperm quality, number, movement, or all of the above.

2. Husbands suffering from absence of transfer canals for sperm, or natural occlusion, or suffering from reverse ejaculation of sperm towards the bladder.

3. Sterile cases with unknown causes.

 

PGS

Introduced in the nineties, Pre-Implantation Genetic Screening (PGS) involves studying the chromosomes of the embryos formed through In Vitro Fertilization (IVF) prior to transfer back to uterus. It is not common to include PGS as a routine procedure for all IVF cases however, in certain cases it proves to be invaluable.

Prior to transferring the embryos back to the uterus the embryos are studied using complex techniques. The aim is to rule out any chromosomal abnormalities that would ultimately lead to:

·         Failure of embryos to implant.

·         Miscarriage once pregnancy is achieved.

·         Getting pregnant with a child carrying a certain abnormality (eg. Down's Syndrome, cystic fibrosis…).

Once the embryos are studied, the healthy disease-free embryos are selected to be transferred back to the uterus after obtaining the couple's consent.
In a very selected group of patients, PGS could be offered for gender selection. Such cases are discussed within Life source clinic ethical committee

The In Vitro Fertilization (IVF) program provided solutions for many problems for many families who suffer from lack of conception due to a number of potential reasons. But the success rate remains negligible or nonexistent when the reason is a severe weakness of the husband's sperms. We have been forced to reject couples due to this reason. Today, Hope is restored for such couples by utilizing an extremely developed method which injects sperm directly within the egg's liquid (cytoplasm): Intra Cytoplasmic Sperm Injection (ICSI).

Injection of the sperm within the egg near the nucleus is a modern approach which requires accurate sensitive technology and skillful laboratory work. At our Assisted Reproductive center we provide the best with our team who has extensive knowledge and experience in implementing this procedure.

 Candidates for this Program?

1. Husbands who suffer from severe weakness in sperm quality, number, movement, or all of the above.

2. Husbands suffering from absence of transfer canals for sperm, or natural occlusion, or suffering from reverse ejaculation of sperm towards the bladder.

3. Sterile cases with unknown causes.

Assisted Hatching

This is a micro-procedure performed on embryo(s) the aim of which is to improve implantation of embryo(s) thus achieving a pregnancy.

It entails making a small hole in the layer surrounding the embryo. This is achieved either chemically or by laser guided beams. Certain studies have shown that making a hole in the surrounding membrane would facilitate the process of implantation. Currently, assisted hatching is not offered as routine for all patients. It is usually offered for repeated failure cases

Cryo preservation

Life source clinic seeks to offer medical services of the highest international standards for its patients. We are often faced with the issue of surplus embryos, at which point Life source clinic  team is ready to advise the couple: What should we do with these surplus embryos? Would you prefer freezing them? The advice depends on the number of embryos, their category, and location of the couple's residence. If surplus embryos were from first or second category cells, we advise the couple to resort to freezing. But, if surplus embryos are of the third or fourth category, we don't recommend freezing, as embryos won't tolerate the freezing process.

What are the benefits of freezing embryos?

a) In case your operation succeeded and you wish to repeat the process once again, all you need is a brief visit to the centre to transfer the frozen embryos, and your husband's presence is not necessary in that case.
b)In case your previous operation did not succeed, you can come back to transfer frozen embryos at a later time, without repeating all the previous stages.
C) The process of freezing embryos is of great value when the husbands circumstances are involved , where he may be committed to a job that does not permit him to travel or visit the center, whereby the wife needs only
to visit the center to transfer embryos.

The centre strives to create a freezing unit in its laboratories in order to decrease the physical, emotional and financial strain caused by the experience, since couples do not have to pay for previous stages of egg extraction, hormone injections, and laboratory tests. As for frozen embryos' transfer charges, it is far more economical compared to other steps of the project.

The centre keeps frozen embryos for years, as long the couple request it, and as long as they are still married, or if either or both pass away.

Sperm Freezing

The Assisted Reproductive team at Life source clinic  introduce the Freezing Sperm Program . This idea became a reality for various important reasons:

First:Some young men are subject to testiclular diseases that require chemical treatment and/or radiation treatment which may result in dryness of testicle tissues and their seizing to function. In some cases orchidectomy (removal of testicles) may be required and in such cases sperms can be collected and stored prior to such procedures or treatments in order to later use if the couple wish to conceive.

Second:Some husbands cannot remain with their wives for extended periods of time due to hard work conditions and they may need to travel abroad. In such cases sperm are stored and used when needed.

Third: Some husbands are unable to give the sample when needed to fertilize the egg. In these cases, sperm can be collected and stored beforehand to be used if the husband is unable to provide new samples when needed.

Fourth: If there is an occlusion in the spermatic cord which prevents sperm from flowing outside and causes retention in the epididymis. In this case we resort to obtaining sufficient sperm liquid using a syringe, where the required amount is used and the extra amount is frozen to be used when needed for another pregnancy. This freezing process helps save the husband a lot of hassle as he may need other operations, in addition to saving on financial costs

IVM

In Vitro Maturation (IVM) involves collecting the eggs from the ovaries at an early stage of development when the eggs are around 10 mm in diameter. Once collected, the eggs are matured in a special medium in the lab until they reach 18-20mm when they are ready for injecting with sperm (IVF). After the eggs have been injected/incubated with sperm, the formed embryo(s) are transferred back to the uterus.

By doing so, IVM brilliantly bypasses the stage where the wife has to be injected by hormonal injections on a daily basis. So in essence, it is less costly and requires less interventions such as hormonal injections.

However compared to traditional IVF/ICSI, IVM carries less chances of success and thus is not offered as a routine option to its patient population. Having said that, Life source clinic team is constantly and dynamically involved in trials and research projects with international centres aiming at improving the success rates so that one day it would hopefully be available as a first line treatment option for certain patient populations

Micro-Dissection

Life source clinic is keen to provide the latest scientific development and the best scientific solutions to our patients who have entrusted us and hopeful of success.

Life source clinic introduced a novel and revolutionary technique of locating sperm in the testis. This technique is referred to as micro-dissection and entails searching for sperm under guidance of a high resolution microscope. This technology is reserved for husbands suffering from severe forms of infertility where the semen sample contains little or no sperm.

Compared to more traditional techniques, micro-dissection offers higher chances of success in certain cases, the reason being that the surgeon is not blindly searching for sperm in the testis but is rather guided by a high resolution microscope. This technique ensures minimal trauma and scarring of the testicular tissue and also ensures collection of the best available sperm.

The obtained sperm can then be used to fertilize the egg(s) in the In Vitro Fertilization (IVF) program. This procedure is usually performed under general anaesthesia

Obstetrics

The philosophy of Life source clinic has been to introduce the latest technologies and expertise in the hope that it would lead to a healthy pregnancy culminating in a healthy baby and a healthy mother.

Expectant mothers at Life source clinic are classified broadly into two groups: low risk and high risk. Several factors come into play when classifying them including: mother's age, pregnancy with twins, triplets, history of recurrent pregnancy losses, gestational diabetes, and hypertension to mention a few.

According to the information gathered and according to which group the mother falls under, each pregnant lady at Life source clinic gets a tailor made ante-natal plan to help her sail through her pregnancy with maximum enjoyment and minimal stress and discomfort. After all, pregnancy is not a disease but rather a normal physiological process.

It is routine at Life source clinic towards the end stages of pregnancy to discuss a birth plan with the couple. Literally anything on the couples mind can be discussed and every effort will be made to accomodcate such wishes and requests so long they lie within reason. In addition it is also recommended that the couple familiarize themselves with the labour ward by visiting the department and meeting with the midwifes and anaesthestists.

Home Monitoring

Technological advancements have tremendously transformed the way healthcare delivery is being instituted to patients. This is also true to obstetric care. Usually in high risk pregnancies where the pregnant lady is suffering from serious medical illnesses during her pregnancy such as pre-eclampsia (high blood pressure), diabetes, and small baby (intra uterine growth restriction) just to mention a few, the pregnant lady is seen on a more frequent basis and could end up visiting the hospital quite often.

Life source clinic introduced to its patients a portable/take home device that would reduce the hospital visits dramatically. This machine records baby's heart beats, mother's contractions in addition to mother's blood pressure .

 

Labour & Delivery

 Even the caesarean section theatre has a view for mothers undergoing surgery under spinal or epidural to enjoy!

Whether a normal vaginal delivery or delivery by a caesarean section, it is important that the expectant parents enjoy this experience and these precious moments. It is the routine of Life source clinic to discuss a birth plan with the expectant parents prior to visiting the labour ward. Couples are also encouraged to visit the labour ward and familiarize themselves with the ward, the midwifes and anaesthetists

Neonatal

Surgery

 

Anaesthesia

Anaesthesia and pain management have witnessed tremendous changes and improvements in the last few decades. Our anaesthetists are highly qualified and are used in dealing with difficult high risk cases/situations. This coupled with state of the art machines and operating theatres ensures that both surgeons and patients are in safe hands and in the best possible environment.

Pregnant ladies and paediatric patients constitute a large percentage of the patient population that our anaesthetists help take care of. Managing pain during labour is of particular interest to this department. Our anaesthetists are experts in tackling labour related pains whether by simple measures such as inhalational gas and pain relief injections to more effective measures such as epidural. If on the other hand an elective caesarean section is scheduled, our anaesthetists would recommend undergoing the surgery under spinal anaesthesia where by the mother is awake and alert to enjoy these precious moments with her husband.

 Other specialties that our anaesthetists deal with on a daily basis include:

  • ENT
  • Paediatric & neonate surgery
  • Plastic surgery
  • Breast surgery
  • General surgery (gall bladder, appendix, thyroid‚ ...)
  • Laparoscopic surgery
  • Urological surgery

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·         Diagnostic Laboratory

·         A good clinic can not function without a good laboratory. This department is without a doubt the backbone of every clinic. The diagnostic laboratory at Life source clinic is classified as a "New Age" laboratory and was conceived and moulded as a result of profound technological changes in health care delivery. Life sourse clinic laboratory is equipped with state of the art machines and highly qualified staff and operators. Our laboratory offers a wide selection of tests for the general community