Tuesday, 31 December 2013

Why do I counsel my infertility patients?

Why do I counsel my infertility patients?

Well, truly speaking a lot of my energy goes in the process of counseling my patients. People sometimes feel strange about it. Why counseling plays such a critical role in resolving infertility issues when it is a physical problem?

In reality infertility problem is not a physical problem completely, but involves a lot of mental and emotional aspect. Therefore, infertility experts have to put great amount of time, energy and resources in counseling the patients and keeping their morale level high.

In some cases, the couples are so frustrated that they do not have belief in the process of infertility treatment. In such cases, we call expert counselors that use psychological techniques to regain the faith level. Regular sessions improve the situation and the clinical procedures can be resumed. Counseling is an integral part of the treatment and hence, can’t be overlooked.

I categorize counseling process broadly in the following categories:

Emotional Counseling

It is the most important aspect. Infertile couples undergo a tough time. The moments of frustration and stress are unbearable. Men and women perceive infertility problem in a different way and the perception is entirely different. Therefore, I counsel both separately and then together to understand the common pain points. In some cases, it is needed to take professional assistance from professional counselors. I arrange individual sessions or joint sessions depending on the severity of the case.

Couples discuss their concerns, sorrows, doubts and worries about the problem. They discuss the probable cause and remedy of their problems. Couples find it extremely encouraging and exciting experience that recharges their spirits to overcome the problem.

Physical counseling

There are various cases where the couples are unaware about the reproduction system and its functionality. As an infertility expert, I counsel them to explain the human reproductive system and the exact problem they are facing. I explain the mechanism of various tests and the outcome to them.

Financial counseling

It may sound strange, but I spend considerable time on the financial counseling part. Infertility treatment is a costly affair and not all patients can pay higher fees for the treatment. However, a few offers reduce the overall cost to make it affordable.

Community counseling

When the infertile couple comes to me for infertility problems, I always counsel them to form community groups and support groups. While the modern special networking tools offer brilliant platform to do so, the conventional methods of forming support groups is equally effective idea. It is important to bring a feeling of self-confidence in the infertile couples. By making communities, the infertile couples realize that there are many people who are sailing in the same boat.

It is surely a physical, mental and emotional turmoil to go through a phase of infertility. When I treat infertility problem, it is not just treating the physiological aspect, but the mental aspect as well.

Counseling is, therefore, incredibly important in resolving the issue completely. I train the patients to leverage the strengths to boost the chances of a successful pregnancy!

Sunday, 29 December 2013

Who Needs CGH Embryo Testing?

Who Needs CGH Embryo Testing?

When I treat infertility problems, there is an obvious need of tools and techniques. Modern medical science brings some of the best methods to understand, analyze and correct fundamental problems that were not possible earlier.

Transfer of embryo is a critical step in the treatment of infertility and testing procedures like Comparative Genomic Hybridization (CGH) makes it possible to increase the possibility of success dramatically. We call this test a game changer in the history of infertility treatment.

What is CGH embryo testing?

CGH embryo testing is an effective technique to indentify the most competent and strong embryo based on chromosome testing.

A typical human genome contains 23 pairs or 46 individual chromosomes. If an embryo doesn’t contain these many chromosomes, then we call it an incompetent embryo that can’t produce successful pregnancy.  We call them aneuploid embryos. Most of the embryos will not reach to the stage of blastocyst. If some incompetent cases reach to the stage of blastocyst, then they will not get attached to the wall of the uterus. The pregnancy will get terminated in the first trimester.  In very rare cases, the pregnancy will continue with fundamental genetic problems.

To make the problem further complicated, it is not possible to find the difference between an incompetent embryo and a competent embryo by the conventional methods.

CGH Embryo testing, the effective tool
Experts say that the competency of embryo does not depend on the quality of the sperm, but on the egg.  A competent embryo will result in a live birth almost 80% of the times, provided all other factors like internal environment of the uterus, age, overall health  etc.

Since it is clear that competent embryos result in higher chances of pregnancy, we recommend doing CGH Embryo testing for such cases.

With respect to various research and studies, I emphasize CGH Embryo testing in the following scenario:
•    Female partners suffering from PCOS, it is recommended undergoing CHH embryo testing because higher percentage of eggs are problematic in such case.
•    In case of known disorders of chromosomes, I recommend it.
•    In case of women with old age (usually more than 35) will have to undergo this test to ensure higher pregnancy rate.  The chances of success in such case are relatively low and CGH testing will eliminate one major possibility of failure.
•    Cases of unexplained IVF failures or unexplained termination of pregnancy.
•    Older women with a decreasing trend of ovarian reserve must go for this test to ensure higher chances of pregnancy.
•    Women with genetic problems.
It is quite clear that CGH Embryo testing is the paramount technique of chromosomal testing. Although there have been new techniques like Polymerase Chain Reaction (PCR) emerging on the horizon, but it will take some time for credibility establishment of these methods. CGH has been a proven method with fantastic results.

Modern tools help us in identifying typical factors that cause infertility problems. With the help of such modern tools, we are able to bring happiness in the life of an infertile couple!

Thursday, 26 December 2013

Uterine lining damage and infertility, a case study

Uterine lining damage and infertility, a case study

The severity of agony and frustration could be felt very clearly during the discussion with an infertile couple sitting in front of me. We were going through the case history and it was surely quite pessimistic.

It was a peculiar case of secondary infertility after successful full-term childbirth. The first baby boy was quite healthy and the pregnancy was smooth.

However, the secondary infertility has really tested their patience a lot and 3 IVF attempts and equal number of Frozen Embryo Transfers. Each pregnancy had resulted in bleeding, pain and a lot of physical discomfort. They had undergone every possible test and everything seems to be normal. Her ovulation was great, her tubes were fine and her husband was producing enough sperms! However, the pregnancy was not happening in spite of all these supporting factors.

I checked the case papers. To my surprise, they had tried all the aspects of infertility treatment;Laparoscopy, hysteroscopy, IVF and FET. After getting disappointed from everything, they were sitting next to me for a second opinion!

The strange case of uterine lining problem

It wasn’t less than a Sherlock Homes mystery for me and I decided to play the role of master detective. First of all I convinced the couple to undergo fresh set of investigations. Not because I didn’t trust the earlier reports, but to do the investigations in my way. Secondly, I assured the couple about the success of the pregnancy. The female had conceived once and delivered a healthy baby, so there were always better chances of success.

As the first step, I decided to perform Hysterosonogram to confirm the uterine cavity and checked the IVF records to understand the thickness of the uterine lining. Hormonal tests were conducted to confirm the uterine lining and… BINGO!

I found the fundamental cause of her problem. Investigations concluded that basal Endometrium was incapable of getting stimulated by estrogen, the female hormone. It is the internal germinal layer that gets refreshed every year. The layer was damaged severely and the chances of recovery were nil. There was no option left other than trying for surrogacy!

The treatment

Treatment method was equally peculiar in this case. We found some surrogates and the couple selected the best according to their choice. We prepared both the ladies by giving hormonal stimulation. For the patient, it was done to achieve matured eggs whereas in the surrogate to prepare the uterus for pregnancy. The matured eggs were fertilized with her husband’s sperms in the laboratory and the embryos were transferred to the uterus of the surrogate.

Hormonal treatment was the most important part of the whole process. We need to match the timings of fertilization and transfer of embryo to make sure the success of implantation. The process was successful and the couple was blessed with a cute baby girl after full-term pregnancy.

The case was certainly a challenge for me and my team because of the symptoms of unexplained infertility. However, with the determination of the patient and a dedicated work by our team, we could achieve a happy ending!

Tuesday, 24 December 2013

Understanding the process of cervical cap insemination

Understanding the process of cervical cap insemination

Treatment of infertility is a complex procedure and timing is extremely important. Fertilization has to be achieved in the window of three to five days and hence, we need to schedule it with 100% perfection. As an infertility expert, I always keep track of the minute points and act accordingly.

The treatment methods vary from case to case and there is no single path for every incidence of infertility. Among various methods, some are simple and fast. At the same time, some methods are lengthy and complicated. However, each method is suitable for a particular type of infertility. It is not possible to use a single method for all.

What is cervical cap insemination?

Cervical cap insemination is an optimized way of conception in typical cases of male infertility when the count and mobility of the sperms is low. We use this method in the rare case of hostile mucus in females when the internal environment of the vagina is harmful for the sperms. Studies indicate that the method has been useful in couples having immunological problems.

Cervical cap insemination is relatively less popular category used for the treatment of infertility. The process is quite simple. A small cap is taken to collect the semen and it is inserted in the vagina through cervix. As the sperms enter in the environment of the uterus, mucus present inside helps the sperms to reach towards mature egg. This mucus gives adequate protection to the sperms and without it the sperms die within minutes. When we cap the semen across the cervix, it makes sure that the spermsswim up to the fallopian tubes and the uterus. The cervical cap method is ideal in treating the problems of tilted cervix, low sperm motility and low sperm count.

Use of cervical cap insemination has been there from last three decades in the treatment of infertility caused by low sperm count or tilted cervix. Doctors have successfully tried it in treating unexplained infertility as well.

It is a cost-effective method

It is a fact that cervical cap insemination is one of the cheapest methods of infertility treatment. While the cost of few other treatments has touched the sky, this method is still within the reach of many patients. Couples who can’t spend huge amounts in the treatment of infertility can afford it easily.

When we prescribe fertility medications to maximize the ovulation process in females, cervical cap insemination is the best method to achieve pregnancy. Even for couples undergoing IVF cycles, it can work as an aggressive treatment plan to achieve pregnancy.

Today, many variants of user-friendly cups are available easy to wear. Soft implantable grade silicone versions can be worn in the daily routine. It is a confirm way to achieve positive pregnancy.

When I talk to the patients and have a detailed analysis of the problem, it is easier to decide a particular line of action without any ambiguity. Not so popular methods as cervical cap insemination are quite useful in specific cases of infertility.

Sunday, 22 December 2013

Thrombophelia the culprit behind miscarriage!

Thrombophelia the culprit behind miscarriage!

Human reproduction system is a sequence of surprises. The successful pregnancy is a miracle against hundreds of odds. As an infertility expert, I always believe that it is a roller-coaster ride with various ups and downs. The peak fertility years between 20 to 30 years of age have greater chances of success. As the age progresses, we have feeble chances of pregnancy. Even during the peak years we experience as high as 15% cases of miscarriages due to various reasons. The percentage rises up to 50% in the old age women.

In many cases, pregnancies terminate at so early stage that we do not know about it. It is typically called a biochemical pregnancy. As the pregnancy proceeds further, the rate of miscarriage drops significantly. However, the same is not true in case of women more than 40 years of age. Abortion is the technical term for any kind of miscarriage, either induced or spontaneous. However, miscarriage is more common term for spontaneous abortions. We have to deal with a large number of abortions as an infertility expert, in fact more than successful pregnancies!

It is important to note that recurrent miscarriages need to be handled with additional care. We infertility experts work out every possible step to prevent reoccurrence of the same.

We can classify recurrent pregnancy loss into several categories, e.g. genetic, anatomic, hormonal, infectious and Thrombophelia, etc. In case of genetic category, the female inherits the tendency of termination of pregnancy. There is no apparent cause of it, but the pregnancy can’t survive more than a few weeks. In case of anatomic cases, the female reproductive system has structural failures causing abnormal termination. In the hormonal cases, the hormonal combination gets disturbed in the body causing a tendency of miscarriage.

Thrombophelia, a major cause of miscarriage

Out of the total cases of abortion, a major chunk is due to Thrombophelia. It is a peculiar case of blood clot that causes pregnancy loss. Bleeding and blood clotting is a delicate process peculiar to the humans.

Clotting is the reflex action against excessive bleeding. In case of genetic disorders like hemophilia, the clotting process does not happen resulting in excessive bleeding. In the same way, some people have a tendency of excessive blood clotting resulting in pregnancy loss and intrauterine fetal demise or intrauterine growth retardation. There are multiple causes and treatments of Thrombophelia.

It is a fact that if a patient has no other apparent causes of miscarriage, then it is high probability that Thrombophelia is the culprit. It is important to evaluate the presence of the same and treat it accordingly. Usually the success rate is very high (almost 90%) and the side-effects are minimal. With the correct diagnosis and perfect medication, the problem can be controlled up to a large extent.

Recurrent miscarriage is a traumatic experience for the couples, especially the mothers. We have to keep a close monitoring on the mental and emotional status of the patients while treating the physiological aspects of the problem.

Thursday, 19 December 2013

Take care of yourself while undergoing infertility treatment

As an infertility specialist I talk to my patients on various topics other than infertility. It is part of the treatment because the patients need to be counseled and motivated. I speak a lot about self care and underline the importance of it repeatedly.

Why self care is so much important? 

Well, there are fundamentally two reasons of it.
a) It is very much possible that the patients forget about self care during the treatment cycles. Infertility treatment is a long-term process. There are unending iterations of treatment, medication, clinical examinations and tests. The patients forget everything else during the treatment; about the job, business and self care.
b) Treatment cycles of infertility are tiring and frustrating. Hence, the patients should take extra care of them to keep fit, young and charming.

What is self-care?

When we say self care in this context, there are basically two aspects of it, physiological and psychological. Infertility treatment involves very high physical and emotional involvement. Failure cycles generate intense agony and frustration. Higher stress levels, feeling of isolation and dejection are the most common symptoms. The treatment process demands more physical energy and affects the overall health.

Self care means keeping the morale high and maintaining physical and emotional fitness in the proper manner.  There are no fixed parameters for it. We can say that every single effort to enhance the personality is self-care. However, there are some tips for it:

1. Sleep well: Sound sleep is essential for good health. Couples undergoing infertility treatment must sleep for at least six to seven hours. It reduces the anxiety. The procedures and steps involved in the treatment are quite tiring. Inadequate sleep may cause fatigue, drowsiness and depression.  I always suggest reducing the intake of caffeine and alcohol because it creates chemical imbalance in the body.

2. Try something different: It is a great idea to do something very different that takes you away from the thoughts of infertility, childbearing and everything related to it. Believe it or not, but it is a great way to take care of yourself. It reduces the tension and frustration caused by infertility problem. You develop positive attitude and look at the brighter aspect of the life.

3. Exercise regularly:  It is recommended doing exercise daily not just to stay fit, but to enhance the positivity. Exercise makes the body energetic and you feel happy, enthusiastic and alert. Indulge in any kid of exercise you feel suitable. It may be light jogging, aerobics, weight-training or meditation and Yoga!

4. Build a support system: It has become quite challenging in the modern times, but you can build a strong support system if you decide. Meet people who have overcome infertility problem. Talk to them and understand the way they fought against infertility. Discuss with your doctor regularly about the distress and agony. You will find new ways of dealing with it.

It is very important to take good care of yourself to conquer infertility problem. After all, you need a lot of stamina to fight against it!

Tuesday, 17 December 2013

Post Coital Mucus Test, the best tool to determine sperm quality

Post Coital Mucus Test, the best tool to determine sperm quality

As an infertility expert I use multiple tools to diagnose infertility. Some of the tools are not generic and used in very special case. Post Coital Mucus test is one of them. It is a post-intercourse test to determine the movement of sperms and their ability to survive in the mucus. We check the movement of the sperms immediately after the intercourse and understand the overall quality and quantity of the sperms.

How does it help?

This test identifies the problems in the cervical mucus and its relation with infertility. Also, it helps
in determining the level of bacterial infection, thickness of the mucus, disorders pertaining to the
ejaculation, antibodies in the mucus that reject the sperms and the semen related disorders. It gives valuable results about the probability of pregnancy. Importantly, this test gives significant information about the male infertility, in case the male partner is not ready to undergo fertility test.

The procedure

I suggest the patient to chart the menstrual cycle at least three to four months prior to the test. It gives accurate timing to perform the test. I call the female one or two days prior to the ovulation. Ovarian follicles release one mature egg during that time. The couple is asked to have intercourse before two to eight hours of the appointment.

There is significant change in the mucus at the time of ovulation. The body produces extra estrogen resulting change in the viscosity, thickness and color of the mucus. It becomes clearer, less viscous and more slippery to give favorable environment to the sperms. They are able to swim easily and survive for a longer time.

The test is very simple and quick. It doesn’t need any hospitalization and performed in the clinic. Post coital Mucus test is performed just like a Pap test.

The Results

The beauty of this test is the quick results. It takes hardly a few minutes to determine the results. This test is quite inexpensive. We share the results with the patients immediately.

The result of the test is NORMAL if:

• Adequate number of sperms are visible in the sample
• The sperms show forward movement through the mucus
• The mucus is at least 2 inch long
• The mucus shows a fern like pattern while drying

The result of the test is ABNORNAL if:

• Very few sperms or no sperms are visible in the sample
• Dead sperms are visible in the sample
• The mucus is less than 2 inch long
• The mucus does not show a fern like pattern while drying

Possibility of errors

Post Coital Mucus Test gives quite accurate results, but we infertility experts have to take utmost precaution while performing the test. Maintaining perfect timing is important to obtain correct results.

In some cases the inflammation in the vagina or irregular menstrual cycle could generate erroneous results. Therefore, we do it with extra care.

Infertility experts worldwide recognize Post coital mucus test a great tool to determine infertility.

Sunday, 15 December 2013

Is there a dramatic increase of infertility problems recently?

Is there a dramatic increase of infertility problems recently?

Has there been significant increase in the infertility cases in the recent years? This is perhaps the most frequently asked question to infertility experts. Many people believe that it is true. However, to your surprise, the reality is not like that. In fact, the percentage of infertility has shown quite static trend. The awareness and acceptance of infertility has greatly increased. Now people come forward boldly for infertility treatment. The utilization of infertility treatment services has increased multiple times. The availability of modern methods and increase in the expertise of the doctors has given a boost to it.

The history

The history of modern infertility treatment goes back to 1978 when the first baby was born through a revolutionary technique called In Vitro Fertilization (IVF). It was popularly called as Test Tube Baby. The options to treat infertility were very limited that time. Tubal microsurgery and ovulation using hormonal drugs were the only options available to treat infertility.

The present
The times have changed now and so many effective treatments are available today to handle multiple aspects of infertility problems. There has been dramatic increase in the success rate of infertility treatment due to the modern techniques. Statistics reveal that more patients are visiting the clinics today to get rid of infertility problem.

We can see incredible change in the way people look towards infertility today. The stigma and taboo of infertility problem has been reduced considerably. Couples are ready to about it openly. People are more aware about the problems because of the information explosion. The Internet has become a major source of information today. Couples come prepared for the infertility treatment and they know the basics of their problem.

The future
Although we have not seen a dramatic increase of infertility cases in the past, but experts say that it will surely happen in the future. There are multiple reasons of it:

a) Delayed childbearing:
It is a common trend today to delay the childbirth in lieu of career and education. As we know that the reproductive capacity decreases with the age, the cases of infertility problem will shoot up in the future. It is a trend in the upper crust of the society to think about expansion of the family in late thirties. It is very obvious that the chances of pregnancy lower about this age. Also, it increases the chances of interrupted pregnancies.

b) Lifestyle and pollution:
Experts indicate that the human reproductive system has direct linkage with the pollution and lifestyle related issues. Exposure to various chemicals, living in a highly polluted areas and addiction of toxic elements are the major causes of infertility problem.

c) Stress and fatigue: Modern lifestyle generates a lot of stress and fatigue that affects human reproduction system adversely.

It is a fact that we infertility experts will have to work harder to get rid of infertility problems in the future. However, with the advancement in medical treatment and increased support and cooperation of the patients, we will be able conquer the battle against infertility!

Thursday, 12 December 2013

There is no link between fertility drugs and ovarian cancer

There is no link between fertility drugs and ovarian cancer

When we plan infertility treatment, medication plays an important role. As an infertility expert I need prescribe several drugs to the patients. Some of these drugs are swollen and some are injected. It is a known fact that infertility drugs have some or the other side-effects because the drugs directly interrupt the hormones in the body. Some of these side-effects are hardly noticeable while a few are quite visible and irritating.

There has been a lot of misconception and misunderstanding about infertility drugs and as an infertility expert I spend considerable time in counseling the patients and convincing about these baseless theories. People come with the fear of ovarian cancer mostly and it is quite hard to convince them about no linkage between infertility treatment and ovarian cancer. The scary thought sometimes forces couples to stop infertility treatment. This is an unfortunate situation and therefore, we do not leave any chance to correct it.

What does the recent study say?

Undoubtedly there is no relation between the ovarian cancer and infertility drugs. These drugs neither induce nor boost the chances of getting affected by this fatal disease. However, there has been a recent study conducted that clearly suggests that there is no direct or indirect harmful effect on the reproductive system.

The results of the research indicate that ovarian cancer is rare as compared to uterine and breast cancers. It develops in the later part of life and therefore, no significant correlation with the age group that undergoes infertility treatment. However, researchers recommend doing further research for long-term use (more than a year) of infertility drugs.

What are the risk factors then?

It is a fact that infertility treatment is not directly associates with ovarian cancer, but there are some risk factors clearly associated with it:

a. Age of the female: Ovarian cancers normally occur after menopause because the female reproductive hormones prevent it.

b. Family history: If anybody in close family (mothers, sisters) have been diagnosed with ovarian cancer, then the female is very likely to have it. Doctors recommend frequent checking of the disease in order to prevent it in the early stage.

c. Females who have never conceived: Ovarian cancer is more common in the females who have not been able to conceive even once.During the fertilization process body secrets hormones that prevent ovarian cancer.

d. Secretion of male hormones: Sometimes we have to prescribe drugs that cause androgen secretion in women. It increases the risk of ovarian cancer.

e. Endometriosis disease: It is very common in women and the treatment involves a few drugs that increase the risk of the ovarian cancer.

The prevention

When we convince the patients about no link between the ovarian cancer and infertility drugs, we also tell them about the probable symptoms of it. Menstrual irregularities or pain in the stomach is the common symptom. Normally women ignore it and the problem gets identified in the later stage. Regular check-up and immediate medical attention could prevent and treat the problem quickly.

Wednesday, 4 December 2013

Donor insemination, a bold decision to defeat infertility

Donor insemination, a bold decision to defeat infertility

Infertility treatment is a long running process and needs a lot of research to determine the best method for a couple. Each case of infertility is different and involves a different approach to resolve the issue. Egg donation, IVF, surrogacy, ART and many more are there. Donor insemination or DI is a typical solution to overcome male infertility.

In many cases, the male partner is unable to produce healthy sperms for fertilization. Sometimes the sperms are totally absent and sometimes quality of the sperm is inferior. Couples select DI to build the family because it is the only possible solution for them. It is surely a bold decision because the baby will carry the genetic characteristics of the donor and not the male partner. However, couples go for it with a few arguments in the support of it:

a) If the donor selection process is carried out sincerely, then it is possible to carry forward some great traits present in the donor.

b) Female partner (the recipient) can still experience the thrill and excitement of pregnancy and motherhood without bothering about the sperm donor, the male partner or an anonymous donor?

c) It is a simple and painless process as compared to the other ones. It doesn’t involve any surgical process and it is not needed to stay in the hospital.

d) The treatment is less costly, quick and confidential.

e) Sperm banks take care of the legal formalities.

Infertility expert plays a vital role

Infertility expert is important in the whole process. When it is decided that Donor Insemination is the best option for a couple, I start the process of searching the best suitable donor. Donor selection process takes some time and need attention.

Select the donor

Selecting the perfect donor is a critical aspect. It may take some weeks or more. Ask the infertility expert about reputed sperm banks that store frozen sperms. Some people call them “Cryobanks” because the sperms are stored in very low temperature. Modern sperm bank offer list of donors online and you can select the best one according to your choice. Some banks offer personalized services to make selection easy. There are various regulations and norms for donor screening process and every sperm bank has to comply with the norms. Regular audits and inspections are carried out to ensure adherence to the norms.

It is possible to see relevant information of donors either online or visiting the sperm bank. Couples can select the best suitable donor based on social, cultural and medical background. Physical characteristics and cultural aspects are also considered while selecting donors. They study the personal profile, traits and habits as well. It all depends on the individual preferences and choice.

Buy the sperms

Once you are satisfied with the donor profile and ready to buy the sperm, the sperm back should be informed accordingly. Being the infertility expert I coordinate with the sperm bank and decide a shipping date based on suitability of all three parties. The sperms are shipped to the clinic and ready for donor Insemination process.
DI is a great option to resolve infertility problem and many childless couples bring happiness of parenthood by choosing it!

Sunday, 1 December 2013

Miscarriage and How to deal With Miscarriage

Miscarriage and How to deal With Miscarriage

What is a miscarriage?
A miscarriage is as a loss of pregnancy prior to the 20th week of gestation.  A pregnancy loss after the 20th week of gestation is considered a stillbirth. The different types of miscarriages create different signs and symptoms, ways of coping with miscarriage, and how to attempt conceiving after miscarriage.

The simple definition of miscarriage is the spontaneous termination of a pregnancy. Miscarriage affects about 25% of all expectant women, and generally happens between four and six weeks. Miscarriage almost always happens before the 13th week of pregnancy. The chances of a miscarriage are higher in first pregnancies than in later ones.

Miscarriages happen for a wide variety of reasons. About half are due to abnormalities in the fetus or the placenta, including chromosomal problems. Sometimes the egg attaches in the wrong place resulting in an early miscarriage. Recent studies have linked environmental pollution or excessive caffeine consumption to higher risks of miscarriage. So the short answer is that most times, miscarriage occurs totally outside of the control of the expectant mother.

The different types of miscarriages are listed below:
- A "Chemical" Pregnancy        
- Missed Miscarriage
- Blighted Ovum                    
- Molar Pregnancy
- Completed Miscarriage        
- Recurrent Miscarriage
- Ectopic Pregnancy                
- Stillbirth
- Incomplete Miscarriage        
- Threatened Miscarriage
- Inevitable Miscarriage

What are the impacts of a miscarriage?
For the mother it is both physical and emotional, and there are a number of painful and unpleasant impacts of a miscarriage. There will usually be significant vaginal bleeding and the passing of large clots. This in and of itself is a little unnerving for the mother and her partner. After all, how much blood is too much or how many clots are too many? How can you tell what is to be expected and what is not? In addition, mom's body often reacts like it does when she gives birth, so, for example, her breasts may enlarge and be tender. Her hormones will likely cause unexpected emotional and physical reactions, which only complicate the feeling of loss.

Emotional impacts - For both mom and dad, there are significant emotional issues. The feeling of emptiness a mom experiences is both physical and emotional. There may be feelings of guilt or of failure. And there may be a sense of overall depression or discouragement.

How should I deal with my grief, and that of my partner?
Know what to say and what not to say. Many moms who have miscarried have suggested that their husbands not try to console them with a message that "you can still have other kids." For mom, this baby was unique and special. Having more kids in any number will not eliminate the feeling of loss. Talking about other pregnancies may be our male way of trying to fix it. What mom needs is a listening ear, sympathy and a reassurance of your love for her. This kind of attitude will help her deal more effectively with her loss.

Socialize and share. Men typically don't call other men on the phone to talk about their feelings, even in the case of a miscarriage. It is just not our way of grieving. But some dads have experienced some peace and healing by writing down some of those feelings and "giving them life" on paper. That can be very therapeutic for a grieving father.

Support each other for your partner. Your partner will often feel the loss of a child more keenly that you will. So take the time to sit with her, hold her, and listen to her express herself. Just being there and supporting her through her grief will really help her process the experience.

Do more creative work and get busy. Men will often turn to a project to help assuage the feelings of grief and loss. It is not a bad way to deal with everything that is going on around you. Being busy (but not too busy to be supportive to your partner) will help with the passing of time and will focus you in a positive direction.

Miscarriage is a huge blow to an expectant couple. By staying focused on supporting each other and by realizing that time will help the healing process, you can find peace even as you grieve for the loss of that one special life.

Wednesday, 27 November 2013

Sperm Morphology, a strange dimension of male infertility

Sperm Morphology, a strange dimension of male infertility

As an infertility expert I need to look into every case minutely. Female infertility is still easier to handle as compared to male infertility because it has clear clues. Male infertility, on the other hand, is quite complicated and the symptoms are similar.

Semen analysis is the major tool to know about the sperm quality. The number of sperms and sperm movement can be captured by the semen analysis. We see another angle that is equally important to determine male fertility (or infertility) levels. It is the sperm morphology or shape of the sperm.

Kruger’s morphology: the effective method

We use a special test to know about the shape of sperms. This test is called as Kruger’s morphology method. Historically, this test was tried to measure the chances of success in fertility treatment like IVF (In Vitro Fertilization). It is the method of fertilizing the female egg in the laboratory by mixing sperms and matured egg.Very recently scientists have tried it to establish the need of ICSI (Intra Cytoplasmic Sperm Injection) method where sperms are injected directly in the core the egg.

What is a healthy sperm?

A healthy sperm is usually five to six micrometers in length and has a smooth oval shaped tip (head). The thickness of a sperm is 2.5 to 3.5 micrometers. The cap of a sperm covers almost half to two-third part of the head. The shape is welldefined and no deformity is visible. Healthy sperms swim fast and able to reach the matured egg quickly.

Sperm abnormality and infertility

In the normal case, the number of sperms with incorrect morphology is less than 4%. The remaining sperms are enough to fertilize the egg. However, in case of male infertility problem it becomes a crucial factor. In such cases where the sperm quantity or mobility is low, even less than 4% abnormally shaped sperms can cause infertility. This reduction is applicable for normal as well as clinical fertilization.

There has been no link established so far between the sperm morphology and the chromosomes. Even if pregnancy is caused by a deformed sperm, no ill-effects are anticipated. The offspring may inherit tendency of deformed sperms. There has been no correlation found between chromosome linked diseases and the sperm shape.

What is the way out?

There has been extensive research done so far to understand the correlation between lifestyle related factors and sperm morphology. Scientists have found a link between excessive consumption of alcohol/tobacco and sperm shape though. Some drugs also cause bad effect on sperm quality and shape. Caffeine also put harmful effect on the sperm shape.

It is important to adopt good food habits for improving sperm shape. Consumption of vitamins and minerals help a lot. Dietary supplements, multivitamin tablets, fresh fruits and vegetables and protein-rich food improve the sperm quality.

Reduction in weight also helps a lot. Studies indicate direct correlation between overweight and sperm count. Weight reduction helps not only in raising the sperm count, but the morphology as well.
It is possible to correct sperm shape by making corrective changes in the lifestyle.

Tuesday, 26 November 2013

Hydrosalpinx, the fallopian tube failure

Hydrosalpinx, the fallopian tube failure

Among various causes of infertility Hydrosalpinx is a rare, yet major cause. It is a problem of fallopian tubes, one of the important parts of female reproductive system. It is not very common problem though.

What is Hydrosalpinx?

The problem of Hydrosalpinx occurs when fallopian tubes are filled with fluid. It causes inflammation in the tubes and the ends of the tubes close. The glands secreteafluid that is accumulated in the tubes. The tubes swell like sausage and it is one of the prime symptoms of Hydrosalpinx.

Fallopian tubes are extremely delicate and prone to damage. The shape of fallopian tube is a funnel-shaped core with two arms called fimbria that reach to the ovaries. These arms are responsible for successful movement of the egg from ovaries to the uterus. These arms are equipped with hair like structure to help the movement of matured eggs and sperms. Because of infection and accumulation of fluid, it loses the hairy texture and restricts the movement of sperms and egg. Pregnancy becomes virtually impossible in the presence of Hydrosalpinx.

Reason for Hydrosalpinx

Chlamydia and Gonorrhea are the two major reasons. Various other reasons as well, e.g. IUD, abdominal surgery and endometriosis are also responsible for it. Inflammation is the common symptom. We need to investigate the basic reason and plan the treatment accordingly.

Hydrosalpinx makes the natural pregnancy impossible and it also cause hindrance to various procedures of infertility treatment. The fluid can reach to the uterus causing changes in the chemical composition. The internal environment of the uterus is critical for successful pregnancy and any minor change may cause severe damage. It causes hormonal imbalance and prevents pregnancy.

Diagnosis and treatment

HSG, ultrasound testing, laparoscopy and X-ray are the common diagnostic procedures used for detection of Hydrosalpinx. Sometimes multiple rounds of testing are required to diagnose the problem correctly.

Treating Hydrosalpinx is tough indeed. It is possible to repair it in a few cases, but we can’t predict about successful pregnancy. Normally we use Neosalpingostomy, a procedure of making incisions at the end of Hydrosalpinx and folding the edges. However, this method fails sometimes and the tube closes again. The size of Hydrosalpinx and the age of patient are two crucial factors to decide the chances of success. Younger women with smaller Hydrosalpinx and an overall healthy reproductive system recover completely whereas older woman with large Hydrosalpinx have very fewer chances of success.

The tremendous development in IVF (In Vitro Fertilization) has actually removed the need of correcting Hydrosalpinx. We take the eggs from ovaries and fertilize in the laboratory. Placement of the embryo at the correct place is important. It can be achieved through correct drugs that keep the hormone level correct. We don’t worry about Hydrosalpinx because the fallopian tubes are bypassed in the whole process.

Hydrosalpinx is indeed a tough problem, but not impossible to deal with. It is a classic infertility problem that limits the pregnancy rates. Expert reproductive endocrinologists and a team of skilled medical professionals can bring brilliant results.

Sunday, 24 November 2013

Do not blame yourself for infertility

Do not blame yourself for infertility
There are various physical and mental consequences of infertility. It is part of the infertility program for me as an infertility expert. I talk to the couples and try to open them as much as possible. Infertility is indeed difficult to deal with and becomes harder with the delays and unsuccessful attempts.

Self blame is a major problem

Among various psychological complexities after getting diagnosed with infertility problem, self blame is the common problem. It is not simple to deal with this issue. Of course, it is not an intentional attempt, but couples do it unknowingly. Couples think that they are the only couple facing with infertility problem. “Why us?” is quite often asked question to the infertility expert. Feeling of depression is the other symptom. It is better to handle the problem at the early stage.

How to deal with it?

Making the couple comfortable is the first goal to carry out successful infertility treatment. Establishing the faith on infertility procedure is the next accomplishment. These two steps become basic building blocks for a successful treatment. As an infertility expert I earn the confidence of my patients about the purity of intention and purpose of infertility treatment.

• Counseling: I counsel the patients by telling the fundamental reasons of infertility problems. Strangely, many people still do not know about male infertility or unexplained infertility. The problem is always linked with the female and therefore, the depression and self blame is more evident in women. It is explained to the couples that only one-third of the cases are contributed by the women and rest all are either because of men or unidentified reasons.

• Meetings: Communication is the key to deal with psychological problems. I organize one-to-one and group meeting with infertile couples. Group meetings give immense relief to the couples because they get rid of “Why us?” syndrome. It is quite shocking for some couples to know that there are many others sailing in the same boat.

• Scientific approach: It is important to explain the scientific reasons and theory behind the specific infertility problem of the couple. Every problem has different factors and those need to be explained to the couple. I tell them about the treatment methods and expected chance of success. We discuss the possibilities of failure as well to set right expectations.

• Positivity: I tell the couples to stop self blaming and start thinking about a bright future. I tell them imagining a joyful life after a successful treatment. Feeling hopeless is a crime because it doesn’t help either. I tell the couples to believe on the treatment and be hopeful. It is absolutely not needed to feel worthless. It is just another physical ailment that should be treated, that’s it!

• Never deal with it alone:The couple must fight with the feeling of self-blame together. Both need to motivate, counsel and help each other in the tough moments of agony and frustration. Combined efforts bring miraculous results.

Treating with self blame is tough, but not difficult. Little determination and will-power makes the difference!

Thursday, 21 November 2013

Understanding intrauterine insemination (IUI)

Understanding intrauterine insemination (IUI)
IUI or Intrauterine insemination is a kind of artificial insemination we use for treating infertility problem. It is a specialized technique done in the infertility clinics.

When is it done?

We need to check every aspect of infertility with a fresh perspective because no two cases are similar. There may be similarities in symptoms, but the treatment always differs. We use IUI to resolve many aspects of infertility problem:

a) Donor sperm: When it is diagnosed that the male partner can’t contribute in the process of conception, we decide of using donor sperm. It is a joint decision of the infertile couple and the infertility expert. Frozen sperm specimen istaken from a renowned and registered lab for the IUI procedure.

b) Cases of unexplained infertility: Many infertility cases remain unexplained. We decide of using IUI for artificial insemination using donor sperms.

c) Infertility caused by endometriosis related problems: IUI is the first treatment in such cases of infertility.

d) Male infertility because of motility or morphology problems: In some cases, male can produce enough sperms, but with weak motility (ability to move). In some cases the sperms are abnormal in shape and size. In both cases, sperms can’t penetrate the matured egg and thus, conception becomes impossible. IUI can be effectively used for separating the stronger sperms with high motility.

e) Cervical infertility: The cervical fluid provides ideal environment for sperms to travel. However, cervical fluid changes the chemical composition sometimes and prevents the sperms from entering into the uterus. IVI can be effectively used as the treatment because sperms are directly transferred to the uterus bypassing the cervix.

f) Semen allergy: It is a rare problem when women develop allergy to the seminal fluid. It caused redness, inflammation and burning sensation in the vagina as soon as ejaculation happens. Sometimes the sensitivity becomes so severe that the woman can’t intercourse. IUI helps in these cases because the semen is injected directly in the uterus bypassing the vagina.

Risks and precautions
It is quite simple process and hardly develops any complications. In rare cases, infection happens immediately after the procedure. Spotting and bleeding happens in some cases. IUI does not have the risk of multiple pregnancies. However, it can occur when it is combined with ovulation induction.

The process
IUI is a fairly simple procedure, but we do it under close observation and careful surveillance.

a) We collect the semen sample from the male partner, donor or a frozen semen sample from the lab. Frozen sperm sample is thawed and washed to eliminate the non-sperm elements that may cause harm to the fertilization process.

b) We separate the healthiest and strongest sperms from the semen.

c) We perform diagnostic tests to obtain the exact moment of ovulation. LH hormone measurement and ultrasound tests are the techniques.

d) Separated sperms are injected in the uterus at the most optimal time. The process takes hardly a few minutes and absolutely painless.

We conduct pregnancy test after two weeks of the process. Testing too early may give erroneous results.

Tuesday, 19 November 2013

Secondary infertility, the peculiar problem

Secondary infertility, the peculiar problem

As an infertility expert, I always give my best to bring happiness in the life of childless couple. It is the most fascinating moment for them to experience the parenthood. Infertility problems have multiple facets and I discover new things at every stage of the career.

I fixed an appointment with a couple who wanted to discuss infertility problem. It wasn’t a normal case of infertility. They were happy parents of a cute baby, but wanted to take one more chance to make it a complete family. They were desperately trying for more than a year, but didn’t get any success. It was definitely a surprising thing for them, but not for me. They were suffering from a peculiar problem known as secondary infertility problem!

What is secondary infertility?

Secondary infertility is a peculiar case of a couple’s inability to conceive after successful childbirth. It is quite frustrating for them, especially when they are trying for the next pregnancy impatiently. The exact statistics of secondary infertility are not known. Many times, couples stop trying after some time and do not consult doctors. Secondary infertility is curable, provided it is diagnosed early. However, the problem has multiple facets and we need to look into every possible reason. It is difficult to deal with secondary infertility, both for the parents and the infertility experts!

It is quite difficult to handle the emotional aspects of secondary infertility. Couples remain in a state of shock and denial. Those who previously had problems feel great mental pressure. For some couples it is a state of utter dismay and frustration. For some couples it is a surprise because they had never experienced it earlier.

According to research, many couples experience secondary infertility problem. Many reasons are responsible for it:
a) Either or both partners develop infertility problem after the first pregnancy.
b) Age
c) Scarring after the first childbirth
d) Stress and other factors associated with lifestyle
e) Hormonal imbalance

Coping with secondary infertility

a) Coping with emotional problems: Secondary infertile couples should not feel depressed and deprived. I always counsel them to look at the brighter side of the life. Surely it is great value-addition to have one more child, but they should think about the childless couples.

b) Coping with physical problems: Secondary infertility treatment is just as primary infertility treatment. Couples have to undergo different tastes and diagnostic procedures. We talk to the patients and explain them about the procedures and the complexities. Secondary infertile couples have never experienced that earlier. Therefore, it is quite shocking and surprising for them. It needs strong determination and dedication to bear the pain and suffering.

c) Coping with social problems: It is perhaps the most difficult part. I always suggest the secondary infertile couples not to share it with friends, colleagues and relatives. Others are inquisitive about every development of infertility treatment and it adds nothing, but frustration and agony.

Secondary infertility problem is an experience that is certainly difficult to cope-up with. You have to be strong and courageous to face it!

Sunday, 17 November 2013

Infection and infertility

Infection and infertility

Infection has close relation with female infertility problem. When a couple is investigated for infertility problem, we always make sure that the infection tests are performed. More than 40 percent women are diagnosed with some or the other infection during investigations and we treat it before starting infertility treatment.

The most common infections are:

Mycoplasma or Ureaplasma infection

These infections cause blockage in the fallopian tube, the prime cause of female infertility. These bacteria paralyze the internal part of fallopian tube and matured egg can’t travel to the uterus. There are no clear symptoms of these infections and we need to do minute level investigation to find out the problem.

Fungal infection

Fungal infection could be a cause of infertility in some cases. It is difficult to diagnose and detailed investigation can throw light on it. Fungal infection affects the ovulation process and causes problems in the development of fetus.
Yeast infection is the most common type of fungal infection. White and thick discharge and itchiness in the vagina are the most common symptoms. It is caused by a fungus that grows in moist and dark areas. Tight innerwear could be one of the main reasons of yeast infection. Also, taking antibiotics also cause this infection because they kill the harmful and good bacteria that otherwise keep a check on yeast infection.

Pelvic infection

In some cases, Pelvic Inflammatory Disease or PID is also found responsible for infertility problem. Sometimes it remains undiagnosed and women are not even aware about the presence of PID. Usually it occurs due to sexually transmitted infection. If STI remains untreated, then it affects entire pelvic region. Bacteria are responsible for this infection and it affects vagina, the inner linings, fallopian tubes, ovaries and even the uterus. It may take a few

months to get rid of pelvic infection.

Bacteria cause inflammation in the reproductive system and pregnancy becomes impossible. Tissues develop scars and prevent the fertilization process. Sperms can’t survive and unable to reach to the egg. Pain in the lower abdomen, fever, foul smell in the vaginal discharge and pain during intercourse or urination are the most visible signs of pelvic infection. Irregular periods are also one of the indications. PID takes a lot of time to cure and early diagnosis results in early cure. Spotting between two periods and burning sensation in the urinary tract are the other common symptoms.

Vaginal infection

Bacteria cause various types of vaginal infections and some of them could lead to infertility. Overgrowth of bacteria in the vagina affects the inner lining and cause infertility problems. These infections need to be treated with heavy antibiotics.

Sometimes allergies could also cause bacterial infection in the vagina. Avoiding the symptoms of allergy improves the situation and sometimes the infection gets cured automatically. However, sometimes we need to give heavy antibiotics to get rid of it.

A bacterial infection can block the reproductive system, damage the sperms, and change the chemical composition in the uterus and cause miscarriages and premature births. Careful treatment removes bacterial infection and improves the chances of pregnancy.

Wednesday, 13 November 2013

Azoospermia, the typical problem of male infertility

Azoospermia, the typical problem of male infertility

Although there has been quite awareness about infertility problem in the recent years, but still many people consider it a problem associated with women. Studies prove that men contribute to one-third of the total infertility problems and women alone can’t be blamed for being childless. I receive so many infertility cases every year and a major chunk of the patients need counseling. They need to be explained about various aspects of male infertility to make the husband ready for tests and investigations.

Theoretically a man is called infertile if he is not able to conceive a fertile woman. The male infertility is more complex and intricate to diagnose and cure. There are multiple aspects of it. Poor quality and improper quantity of semen are the main cause of male infertility commonly known as semen deficiency. Late night parties, incorrect lifestyle, heavy consumption of alcohol and tobacco are the other reasons.

What is Azoospermia?

There are a few typical problems of male infertility. Azoospermia is one of them. We investigate semen to decide quality and quantity of sperms. These tests can be performed in special laboratories. It is important to check the movement and strength of sperms. If the test reveals that sperms are totally absent in the semen, then it is called Azoospermia. The person is unable to produce mature sperms and hence, unable to fertilize the matured egg. Elevation in the body temperature is one of the major causes of this problem. Sperms are extremely sensitive towards temperature variation and slight increase in the temperature could kill them. Obstructions in the reproductive tract or deficiency of male hormones are the other reasons. The tests are usually comprehensive and cover multiple aspects like sperm testing, physical examination, ultrasound tests and investigation of blood.

We need to understand that infertility and impotence are two different things, though people misinterpret them. Impotence is the inability of making successful intercourse or inability to sustain erection. On the other hand, the man can do successful intercourse, but can’t fertilize matured egg.

The cure

Obstructive Azoospermia can be cured by surgical process. We diagnose the exact cause of obstruction and remove it. Semen test is performed after a few days of surgery. If the body is producing enough sperms, there is a high chance of pregnancy. However, the quality and quantity of the sperms are critical factors.

Sometimes the body produces adequate quantity of sperms, but it is not possible to remove the obstruction by surgical process. We use the process of sperm extraction and perform in-vitro fertilization. The fertilized embryos are transplanted in the uterus and the mother gives birth to their genetic baby after gestation period.

There are various alternative remedies suggested for the problem of Azoospermia with no obstruction in the male reproductive system. Herbal remedies and Homeopathic remedies are considered effective in treating this problem. It is difficult to prove the effectiveness of these treatments statistically. However, some people find the treatment effective.

Azoospermia is one of the main reasons of male infertility!

Monday, 11 November 2013

Tubal ligation reversal, the way to revert infertility

Tubal ligation reversal, the way to revert infertility

It is a well-known fact that infertility has become one of the biggest problems of the modern age. Statistics tell that more than 30% of the married couples are facing some or the other infertility problem, either temporarily or permanently. The treatment includes a series of surgical and medical processes incorporated at the infertility clinic. Age, genetic disorders, hormonal deficiencies and many other factors are responsible for infertility problems.Theoretically if a couple is unable to conceive after repeated trial for one year without contraceptives.

It is recommended that couples should always go for a credible infertility expert for investigation. When couples come to me, I always go methodically to understand the basic cause of infertility through detailed investigation. There are many reasons of infertility and the correct treatment can be chalked out after finding the basic cause.

Fallopian tubes are important part of female reproductive system. They connect the uterus and the ovaries. The process of fertilization occurs in fallopian tubes. These tubes act as a channel to move the ovum or fertilized egg. These tubes provide adequate environment for fertilization and conception. In case of tubal ligation, the fallopian tubes are closed and eggs can’t traverse to the uterus. It is very obvious that conception can’t occur in such case.

There could be many reasons for the blockage like infection, inflammatory diseases in the pelvic region or by birth defects. Tubal ligation reversal procedure corrects the problem in the fallopian tube and makes the conception possible.

Tubal ligation is a popular way of permanent birth control as well. However, sometimes women want to reconnect the fallopian tubes. The reason could be anything; wish to have more babies, religious factors, etc.

The procedure

Tubal ligation procedure takes around three hours to complete. It is performed under general anesthesia. The patient needs to spend one to four days in the hospital, depending on recovery. Patients can resume the regular routine after two to four weeks. We work on the damaged/blocked fallopian tubes during the surgery. The blocked part is removed and reconnected. It is possible for the tubes to carry fertilized egg to the uterus.

We check the possibility of successful reversal of the fallopian tubes before undergoing surgical procedure. In some cases, the tubes are damaged very badly and it is not possible to restore them. The damage may be caused by earlier surgical process or it may be by birth as well.

The risks
In rare cases, there is infection, bleeding or damage to other organs caused by tubal ligation reversal procedure. Modern surgical techniques have made it quite easy and the latest procedures do not need general anesthesia as well. The process can be done under local anesthesia and there is no hospitalization required.

There is one major risk of ectopic pregnancy after the reversal procedure. In this pregnancy, the conception happens in the fallopian tube. It is extremely risky situation and immediate termination of pregnancy is needed. Close monitoring can detect the problem early.

Tubal Ligation Reversal is a great procedure to enhance chances of successful pregnancy.

Thursday, 7 November 2013

Understanding Autoimmune infertility

Understanding Autoimmune infertility

Infertility is a reproductive disorder that affects the quality of life for enormous people across the globe. Statistically every one of 5 couples undergoes some kind of infertility treatment in the journey of the life. Countless causes are there for this nasty problem. It is sometimes difficult for an experienced infertility expert like me to trace out the exact reason. Gynecological disorders, infectious diseases, aging problem and endocrine disorders could cause infertility in women.

Autoimmune infertility is one of the most complicated cases and it needs tremendous efforts to cure it. It is one of the unexplained cases of infertility and it is needed to set up the normal functioning of the immune system and balance of the body to regain the fertility levels. Autoimmune disorders like thyroid problem, diabetes and erythematosis are usually linked to the infertility problem. Even PCOS, premature ovarian problems and endometriosis can also be linked to the autoimmune infertility problems. It goes without saying that the treatment takes very long time and even after putting greatest efforts, sometimes there is no success achieved.

In a typical autoimmune infertility, there is an inflammation seen in the uterus or there are antibodies formed against the reproductive hormones. Sometimes clotting happens in the reproductive organs like ovaries. All these are result of a natural reaction of the body against pregnancy. Body treats the embryo or ovulation process as “enemy” and tries to destroy it as quickly as possible. Among innumerable reasons, the most prominent are:

a) Killer cells: It is very peculiar process of the body where special cells get developed. These cells interrupt the growth of embryo. It results in abnormal termination of pregnancy. Studies show that these cells consider embryo as foreign body and therefore destroy it as the natural reaction they are programmed for.

b) Thyroid related problems: Thyroid disease cause anti-thyroid antibodies developed in the body. Researches show that thyroid problem has a close connection with infertility issues. They cut the response of fertility treatment and make the drugs less effective. It increases chances of miscarriage.

c) Disorders related to blood clotting: In some cases, special antibodies are responsible for unexplained infertility. These antibodies prevent blood clotting and affect the reproductive system. Recurrent miscarriages and abnormal termination of pregnancy are the outcome of these disorders. There is no exact cause of this problem found so far.

d) Endometriosis: It is the commonest problem of unexplained infertility. There are different types of cytokines developed in the body. They cause problems in the normal reproductive process and cause disruption and abnormal termination. According to studies, more than 50% women had auto antibodies developed to make the problem worse.

e) Folate Metabolism: It causes various risk factors and complications in the pregnancy process. Genetic mutation is also seen in many cases where the problem became worse. This disorder causes inflammation, reduction in the cell division process, abnormal termination and abortion. It is impossible to attain full-term pregnancy.

There are various reasons behind autoimmune infertility. Sometimes they are not curable and the couple has to go for other options like adoption or surrogacy.

Tuesday, 5 November 2013

Vitamins to treat menopause

Vitamins to treat menopause

Menopause is a major turning point in the life of women. Different women face different discomforts during this period and there are no set remedies for the problems. We normally treat based on symptoms and the problem gets sorted as the hormonal imbalance is over. Hot flushes or sweating is the most common symptom. Mood swings, depression and emotional burst-outs are other common complaints.

Insomnia, weight gain, headache and body ache are the other symptoms. Some women complain about body ache and osteoporosis as well. Loss of sexual drive and dryness in vagina is also one of the most talked problem during this period.

There are various treatments suggested for menopause and it is completely trial and error process to find out what actually works for you. Vitamin supplements work very well for some women. They contain enough quantity of vitamins, minerals and the other essential elements. They also provide energy to the body and women who are not overweight can take the supplements based on milk products and chocolate. The basic vitamins like A, B, C, D and E help in boosting the metabolism. The minerals and other nutrients supply energy to the body and rebuild the strength.

These supplements are helpful in reducing the pre-menopause and post-menopause symptoms. They reduce the harmful effects and help the body in dealing with the condition of reduced estrogen and progesterone levels.
Vitamins and their effect on menopause problems

Various vitamins help the body in various ways to deal with this problem.

• Vitamin D: We always recommend vitamin D for women. Especially in the countries where the exposure to direct sunlight is least, it is mandatory to take vitamin D supplements. According to the RDA recommendations, women are supposed to take at least 1000 IU of vitamin D daily. The quantity becomes 2000 IU if medical examination reveals that the woman is suffering from vitamin D deficiency. It is equally important to include calcium in the daily diet plan. Vitamin D and calcium work hand in hand to regain the structural power and correct menopause related problems.

• Vitamin E: We recommend at least 800IU daily to overcome menopause related problems. It controls the problem of hot flushes considerably. It relieves from the distress and fatigue and acts as an antioxidant. It controls the aging effect and reduces free radicals in the body.

• Iron and Vitamin C: Just like Calcium and Vitamin D, we recommend Iron and Vitamin C together. According to international standards, it is mandatory to take 20mg iron daily up to the age of 50. The quantity can be reduced to 10mg after that.

• Vitamin B: Mood swings are the most common symptoms after hot flushes. During menopause women feel drastic emotional changes. There are moments of depression and agony. Vitamin B helps greatly to overcome this problem. However, since there are many variants of Vitamin B we recommend Vitamin B complex supplement to the patients. It is an excellent treatment to control the fatigue and irritations during menopause.
Replenish the body with vitamins and face the challenges of menopause easily.

Wednesday, 30 October 2013

Alternate treatment for polycystic ovarian syndrome

Alternate treatment for polycystic ovarian syndrome

There is a lot of buzz about PCOS (polycystic ovarian disease) and its relationship with infertility. So many patients every year come to me for the treatment of infertility and there is always a great fear about PCOS in their mind. In fact, many times it is baseless and the fundamental cause of infertility is something else. Nevertheless, it is a statistical fact that around 10% of the women face PCOS or similar problem at some point of their life. It does not mean that all of them face infertility problems. Very few of them need to go for infertility treatment.

PCOS is actually not a disease, but it is a syndrome that means a set of symptoms. Difficulty to get pregnant is just one of the problems and there can be more serious implications of it. Acne, weight gain, irregular menstrual cycle and even type-2 diabetes can also be triggered by it. We treat PCOS with medicines, but there are some alternate methods have also proven effective in treating the ailment. These methods aid to the medication and help recovering the problem quickly.

a) Diet planning: Well, that does not mean irrational control of food intake. Rather, it is a structured and planned way of eating healthy and beneficial food. Females suffering from the problem of PCOS should eat less carbohydrates and high protein. Eating seafood, nuts, eggs and chicken is highly recommended. It is a bright idea to consume organic food because it is free from chemicals and preservatives. Omega fatty acids are remarkable in achieving good health. Plenty of fish, seeds and walnuts should be included in the daily diet.

b) Food supplements: Although we do not recommend food supplements and always insist on balanced diet, but in exceptional cases like PCOS they are required. Multivitamin supplements and mineral tablets help greatly in establishing the balance of hormones. It corrects the fundamental cause of the problem and helps greatly in faster recovery. Vitamin supplements, zinc and magnesium are a few effective substances in the treatment of PCOS.

c) Reducing weight: Yes, overweight adds fuel in the fire. It is always better to lose a few pounds to correct the metabolism and hormonal levels.

d) Herbs and naturopathy: Some people believe in natural drugs, herbs and the other methods of naturopathy. There are some cases where significance improvement is seen by these natural remedies. It is said that Ginseng and Chaste tree helps greatly in treating PCOS. It normalizes the functions of hormonal glands that produce progesterone.

e) Acupuncture and acupressure: A lot has been talked about these two therapies and many people believe in it. However, there has not been much clinically proven about their authenticity. People claim that there is incredible improvement in PCOS after the treatment.
Alternative treatment of PCOS is a matter of personal belief and some of the methods are based on personal experience only. However, there are many evidences of women getting benefited by these methods. It needs to be experimented along with the regular medication.

Tuesday, 29 October 2013

Chemicals and infertility problem

Chemicals and infertility problem

Infertility is a multi-faceted problem and I always suggest the patients to look at it from all possible angles. There are some strange things related to it and you can’t think about it in the wildest of imagination. Counseling and regular meetings show many hidden aspects. Extensive research work has been done to understand the different aspects of infertility, but everyday something or the other comes out that is strange and unbelievable. Would you believe that household items like shampoo, clothes, perfumes and detergent powders may have any relation with the infertility problems? It is hard to believe, but true. There is certain correlation between some chemicals and infertility problem.

What all could be dangerous?
Well, according to the research anything could be the stimulating reason for infertility problem. Food packaging, household chemicals and pesticides, clothes, shampoo and detergent powders, colors and strainers or even food items could trigger or aggravate infertility issues. However, it is too early to comment because not enough data available to set up the correlation exactly. Many people are doing research across the world to understand the effect of chemicals on infertility and initial findings set up the fact. It is relatively new topic and many things are still uncovered. There are innumerable chemicals we deal and hence, very specific study is required. The relationship of chemicals and infertility problem is a complex one with multiple facets.

The main culprits
Scientists have studied the groups of chemicals to pin point the fundamental cause of problem. Two groups have been identified so far:

a) Per Fluoro Octane Sulfonate (PFOS): They supposedly affect the immune system, liver and reproductive system in human beings. Researches show that even the slightest presence of PFOS in blood could affect the hormones that govern the pregnancy process.
b) Per Fluoro Octanoate (PFO): PFO are equally hazardous chemicals and they also affect the reproduction system and pregnancy adversely. Studies conducted on the pregnant women with presence of PFO in the blood underlined the relation between abnormal termination of the pregnancy and these chemicals.

The study
According to the recent study, the women were divided into two groups. In one group, there was significantly high level of these chemicals. The other group contained relatively lower levels. Analysts found that the chances of abnormal termination increased with the increase in the chemical presence. At the same time, there were higher chances of termination where the chemical was low in percentage. It clearly indicates that these chemicals can cause major harm to the pregnancy and reproduction process.

It is a significant finding about the direct correlation between harmful chemicals and infertility. Today we have so many chemical-based products around and there is always a possibility of some other chemicals also affect the reproduction system. As an infertility expert, I am required to understand this aspect as well. Probing about the lifestyle and occupation gives fair idea about the possibility of chemical exposure. Specific treatment is needed to correct the damage caused by harmful toxins.

Sunday, 27 October 2013

Boosting female fertility

Boosting female fertility

It is really a tough challenge to manage the expectation of couples when they come with infertility problems. All wish to get pregnant as early as possible and want success in the first attempt. However, it is not really possible because there are hundreds of permutation and combination of infertility problems. However an infertility expert like me always work on elimination method and by removing the unrelated factors, I quickly reach to the fundamental cause. Female infertility contributes to almost one-third of the total infertility cases. The percentage is quite high and over and above that, there are many reasons for female infertility. It is more common after the age of 35, but in some cases female infertility has been observed in very young age as well.

Although we always treat infertility with the best of drugs available, the supportive methods help in boosting the female infertility.Good food provides adequate energy and strength to fight against ailments. There are some foods help in boosting the fertility levels as well. Meet an expert dietitian and get the diet chart prepared.

Some common and effective tips are:

a) Regular exercise: Exercise increases the metabolic level and removes the toxins from the body. If the woman is overweight, then it is a main cause for infertility. Exercise helps in reducing the weight and stress level. It boosts the female fertility level greatly.

b) Balanced diet: Diet full of nutritional elements like vitamins and minerals help in energizing the body. They also remove the free radicals and intoxication in the body. Fruits and vegetables that contain high amount of Zinc can help in boosting female fertility level. Oysters are ideal in such condition. Whole grains are high in nutritional level and help in making the ovulation process regular. They build-up the body and increase strength and fitness as well. Whole grains are rich in complex carbohydrates that give energy to the body. Rich protein diet helps in building strength and boosting the fertility level. Iron and folic acid make the reproductive system strong and increase the female fertility level.It is recommended drinking plenty of water.

c) Basal body temperature: It is the best technique to assess the right time of ovulation and increase the probability of getting success in conception.

d) Reducing the consumption of nicotine and alcohol: Both caffeine and alcohol affect the nervous system and reproductive system. They also affect the hormonal balance and therefore, it is better to lower or quit the bad habits of smoking and drinking. The fertility level boost dramatically in a short time after leaving these bad habits.

e) Reducing stress level: Stress is the biggest reason that decreases the fertility level. Reduce stress by meditation, positive thinking, breathing exercises and Yoga.

f) Avoid exposure to chemicals and pesticides: It has been proved that chemicals and pesticides affect the female fertility level and there are long-lasting and dangerous after-effects of frequent exposure.

These tips help boosting female fertility level and achieving success in pregnancy. We need to put multiple efforts to defeat the problem of infertility by adopting them in an effective way!

Thursday, 24 October 2013

Smoking, the prime cause for lower sperm count

Smoking, the prime cause for lower sperm count

When infertile couples come to me for treatment, it is the first and foremost task to know about their lifestyle. It is certainly important because there are so many factors related to lifestyle and habits cause infertility problems in men and women. I spend significant time in talking to them, understanding the miner and finer points of their habits. Consumption of nicotine is a common habit. It has direct correlation with infertility problem. Smoking causes various health ailments, some of them are fatal.

Smoking is bad for health from all the aspects, including fertility. There has been a clear correlation found between smoking and male infertility. It affects almost every aspect of the sperm and semen and thereby reduces the chances of conception.

The problem

Smoking is an addictive problem and therefore it shows as increasing trend of consumption. Prolonged addiction to smoking causes devastating effects. Excessive smoking increases the level of toxins in the body that subsequently causes damage to male fertility.

a)  Affects the concentration of sperms: Smoking reduces the number of sperms per milliliter. It is a critical aspect for conception because out of millions of sperms, only a few are able to reach up to the matured egg.  In case of lower concentration of sperms, conception becomes difficult. Studies have indicated that there is as high as 25% decrease in the number of sperms due to excessive smoking.

b)  Motility of the sperms: Motility means the capability to swim across the uterus for penetration. Only swift and strong sperms can reach to the egg. Researchers say that prolonged smoking can drop the motility levels up to 15%. It is a significant drop and drastically reduces the chances of pregnancy.

c)  Morphology (shape) of the sperm:  Shape and size of the sperms are critical aspects for fertility. Sperms with improper shape can't swim properly and can't reach to the matured egg. Studies indicate that smokers have lesser number of well-shaped sperms compared to non-smokers.

d)  Imbalance in the fertility hormones: Hormones are important to determine the fertility levels. Excessive smoking causes imbalance in the hormone levels and affects the chances of successful pregnancy.  The imbalance affects quantity and quality of the sperms.

The solution

I explain the ill-effects of smoking to the would be parents and convince to quit the bad habit immediately. I call professional counselors to emphasize and underline the dangers of smoking. Audio-visual presentations, slideshows and movies explain the topic in detail.

Leaving the bad habit is the first step towards correcting the problem.  It stops further damage to the body. Cleansing harmful toxins from the body is the next step. Hormonal treatment is given to boost the fertility level. Vitamin supplements are prescribed to the patients so that fertility levels can be improved. Vitamin B12, C, E and zinc supplements improve it significantly. Proper treatment corrects the problem quickly and expected results can be achieved.

There is a clear correlation between smoking and male infertility therefore, it is better to quit the bad habit!

Tuesday, 22 October 2013

Ignorance of sex and infertility

Ignorance of sex and infertility

It is important to talk to infertile couples before starting the treatment. It gives better insight about the problem and helps in deciding the right line of action. It is quite surprising, but true that still there are large number of infertility cases are contributed by lack of knowledge about the sex and sexual process. In spite of the exposure and education about it, there are many couples do not know the fundamentals of intercourse and conception!

There are many cases I have handled where infertile couples are required to undergo hymenectomy (the process of removing hymen surgically) in order to make the pregnancy possible. The couples have been indulged in regular sex, without understanding that it is not possible to conceive unless the sperm reaches to the uterus. The social structure, treating sex a taboo and absence of sex-education are the fundamental causes.

Another important factor is the frequency of sex. According to the medical definition, infertility is determined only if frequent unprotected sex for six to twelve months doesn't achieve pregnancy. Couples come for infertility treatment after trying for two to three months. In the modern times, marriages are happening quite late and the overall fertility level has decreased due to various factors. In the changing scenario, we suggest the couples to wait for at least 18 months and then come for infertility treatment.

Stress and lack of knowledge kills the sex life of newlywed couples. The frequency of sex is decreasing due to excessive work pressures and improper lifestyle. Late night parties, working in shifts and phone calls and conference calls kill the privacy and there are lesser opportunities available for sexual intimacy. Couples think that they are infertile and need treatment. It leads to temporary inability to make love and sometimes it is misinterpreted as infertility. It actually doesn't require any treatment because it is not actually a problem. It needs spending time with each other and understand the emotional needs.

It is a fact that ignorance of sexual knowledge was a main cause of infertility earlier as well, but the new generation is more open towards it. They discuss the problems frankly and work towards the resolution. It is quite helpful to discuss the problem at length so that appropriate solution can be opted.

There is one more aspect that leads to infertility, denial of fertility. You will find it strange, but there are many cases where conception does not happen just because women presume that they can't conceive. Career, education and the other aspirations keep pregnancy at the last priority. Strangely, mind make-up leads to physiological infertility and conception does not happen. This problem is quite persistent nowadays especially among the next generation couple where career and financial stability is more important as compared to extending the family.

Ignorance of sex contributes greatly in the infertility problem and we infertility experts need to spend a lot of energy and time in treating such cases. Counseling and step-by-step sex education helps a lot in treating the problem. 

Sunday, 20 October 2013

Herbs to boost male fertility level

Herbs to boost male fertility level

According to research, almost one-third of the cases are contributed by male infertility, but it is more critical and complicated to handle. Insufficient sperm count, poor sperm quality and less mobility of sperms are the major causes. Physiological problems like blockage in the testicles or prostate related problems also responsible for male infertility problem. Infertility experts like me try to find out the root cause of infertility problem and treat it up to the maximum possible manner. There are many alternative medicines and herbs are considered effective for infertility problems, especially male infertility. The top six herbs very useful in male infertility are:

a) Ginseng: It is a popular herb that is considered useful in male infertility issues. This Chinese medicine is popular from centuries. It boosts the hormonal secretion and corrects the hormonal imbalance. The level of testosterone is responsible for sperm production. The impact of Ginseng is there to boost sperm mobility and count.

b) Shilajit : This is an Indian herb and considered effective for male infertility problems from the ancient times. It is found in the Himalaya mountain range. It is a sticky black substance that is used in medicines to correct the ailments. It is a general tonic also to improve overall health condition and immune system. Shilajit gives power to the nerves that carry sperms. Regular consumption of Shilajit creates miracle in male infertility problems.

c) Saw Palemotto: Saw Palemotto acts as natural steroid and boosts the male reproductive system. It accelerates the hormonal secretion and in turn improves the quality and quantity of sperms. This herb is considered good to treat prostate problems as well. It gives strength to the body and helps in recovering from weakness caused by illness.

d) Maritime Pine Bark : Pine contains high quantity of antioxidants to correct the problem of male infertility. Antioxidants are effective to arrest the free radicals in the body that cause various ailments. It boosts the resistance power to improve the health condition. Male infertility is caused due to internal weakness and Pine Bark is useful for overcoming it.

e) Musli : It is an Indian herb that is considered effective in treating male infertility. It is popular from centuries in the traditional Indian medicines. It gives strength to the nerves and increases mobility of the sperms. According to traditional Indian medicine it is more effective if taken during the winter season when the body attains maximum vitality.

f) Flaxseed oil: Flaxseed oil improves the sperm count and increases the chances of conception. It is considered very effective in improving the strength of the body. It controls the nervous system and nourishes the reproductive system. Flaxseed oil corrects impotency problems.

Traditional drugs and herbs are considered effective for male infertility problems. Although modern medical science has different methods of treating it, many people believe these traditional methods. There should be in-depth research and study conducted to assess the effectiveness and use of herbs for infertility treatment. The ancient knowledge has to be checked and proved on the modern medical standards.