How do food supplements add a value to IVF?

How do food supplements add a value to IVF?

Treating each case of infertility opens a new window of knowledge to me. I have no hesitation in accepting the fact that treating infertility is a taxing job. However, the challenges and thrills keep me excited about it.  Resolving queries of childless couples and giving them correct and authentic information is a major part of the treatment.

Patients always wonder about the variety of food supplements prescribed during infertility treatment. They are not able to realize the importance and relevance of it. We all know that food supplements are prescribed when there is a deficiency of particular nutrients in the body.  Since they support our daily diet by fulfilling the deficiency of vitamins and minerals, they are called dietary supplements also. As an infertility expert, we prescribe various supplements after analyzing the physical condition of the patient. It varies from patient to patient.

Role of food supplements
When we prescribe these supplements to an infertile couple, there are two reasons. Firstly, they correct the deficiency, if any. Secondly, these supplements improve the quality of eggs and correct the hormonal balance by reducing stress. They provide micronutrients that are available in fruits, vegetables, herbs, and nuts. Though it is possible to provide them through a balanced diet also, but it is not possible during infertility treatment.  Stress, anxiety, and other psychological factors affect the intake of food in females resulting in malnutrition. The process of conception may get hindered due to inadequate nutrients. Therefore, we prescribe dietary supplements.

Types of supplements
Food supplements prescribed to IVF patients can be categorized based on their characteristics. I prefer antioxidants and essential amino acids because they help greatly in the success of IVF procedures. PCOD mimetic or Insulin sensitizers are given in specific cases if needed. It is a fact that these supplements play a vital role in the success of the treatment.

Antioxidants extracted from the natural sources are considered goodfor treating infertility patients. These antioxidants delay the process of aging and thus, remarkably improve the health of a reproductive system. Pycogenol, Melatonin, and co-enzyme Q are some of the popular antioxidants. They all are extracted from the natural sources like wheat grass or a pine tree.Myo-inositol is an insulin resistant that improves the ovulation process.

Folic acid is another vital supplement that is prescribed during the treatment.  It is an important element that helps in sustaining pregnancy. Folic acid also plays a critical role in the development of the fetus.
Extracting the maximum benefit from it

It is a reality that dietary supplements alone do not help. The success of infertility treatment or IVF depends on the treatment method, physical and mental readiness of the patient, and the overall health. It is a combined effect of dedicated efforts of the patient and the doctor.

 We decide food supplements according to the physical condition of a patient. Though there are hardly any side-effects of these supplements, but still we need to monitor them for some time. Anything unusual needs immediate consultation.

Study shows that frozen embryos are better than the fresh ones

Study shows that frozen embryos are better than the fresh ones

The treatment of infertility takes advantage of the modern techniques. We infertility experts talk to the infertile couples and discuss various aspects and possibilities of bringing the joy of parenthood in their life. One such remarkable technique is the use of frozen embryos for In Vitro Fertilization.  Infertility experts have been using them from a long time with a great success rate. According to the specialists worldwide, it is one of the leading reproductive techniques. Modern tools have increased the possibility of successful childbirth manifold. IVF with frozen embryo is bridging the gap between having no children and having children. 
Though the techniques have been in use from years, it was not so much developed and sophisticated earlier.

Statistical research reveals the effectiveness of frozen embryo in making the pregnancy effective in multiple ways. Infertility experts worldwide have admired the technique of frozen embryos for easiness and convenience. However, these findings establish their credibility in terms of improving the quality of pregnancy and childbirth.

Does frozen embryo affect the quality of pregnancy?

It is a fact that frozen embryos have better success rate as compared to the normal one. According to statistics, women in the age group of 36 to 42 have shown more than 75% successful pregnancies with frozen eggs against 54% with fresh fertilized eggs. This is a major contradiction to the popular belief that fresh embryos show better success rates than frozen ones.

Not only the better success rate, but frozen embryos show fewer miscarriages and longevity of the fetus. In addition to that, chromosomal screening proves that frozen embryos show fewer birth defects as compared to the normal embryos. A single embryo implantation makes sure that the couples will have only one child per birth reducing the most common problem of multiple births, the biggest nuisance in IVF Treatment.

It is a biological fact that pregnancy through frozen embryo is much stable because women are free from the hassles of hormonal treatment and painful procedure. Stress and strain affect the quality of pregnancy. Earlier it was believed that immediate implantation of embryo needed for a successful pregnancy. However, research in the later years showed that frozen embryos are equally effective in a successful pregnancy.

How are frozen embryos convenient?  
                                
I work in two steps as an infertility expert. First, I give hormonal treatment so that the body starts producing quality eggs. Modern technology makes it possible extracting multiple eggs and keeping them preserved for subsequent use. It is obvious that the facility gives us a chance to use frozen embryos in each case we treat. Since IVF depends on various factors, multiple attempts may fail. Frozen embryos are helpful in trying pregnancy for multiple times.

The procedures are time-taking and tedious. Therefore, I extract matured eggs with hormonal treatment.It is especially helpful for patients above the age of 40 years where women can’t undergo stressful treatment.  The latest findings give a positive thrust to the infertility treatment. With the coordinated efforts of patients success can be achieved quickly.

The latest finding could save infertile men from biopsy

The latest finding could save infertile men from biopsy
It is a fact that male infertility is much complex, and we infertility experts need to put a lot of efforts to dig out the cause. Moreover, the diagnostic procedures involve many evasive surgical procedures to determine whether the infertility is caused due to obstructive reason or non-obstructive. It is a depressing and painful experience for the patient. However, the recent findings have shown a ray of hope for painless diagnosis.

According to the researchers, two distinctive proteins ECM1 and TEX101 can help in diagnosing the cause of male infertility and deciding the plan of action. They are hopeful that the findings can give as accurate results as biopsy, and it is an encouraging fact indeed. Thousands of infertile men would feel a great relief to know about it. They will be relieved from the painful holes in the testicles.

Statistics reveal that almost half of the cases of male infertility are caused due to a physical blockage in some part of the male reproduction system. It prevents the sperms from entering into the semen before ejaculation. The above-mentioned research is based on the analysis of various proteins found in the semen.  Researchers are hopeful that the analysis of the protein itself would indicate whether the patient is suffering from obstructive infertility or not.

Types of male infertility

a.    Structural infertility: It occurs when there is a congestion or obstruction in the male reproduction system. Swelling in the nerves or structural problems in the testicles cause this type of infertility. The treatment involves surgical procedures. Male infertility surgery is highly complicated and prone to risk. We need time to diagnose the exact cause of infertility.

b.    Functional infertility: Functional infertility is associated with the quality and quantity of semen. The most frequent causes are low count of sperms and low motility of sperm. Genetic issues and hormonal disorders also come under this category. Absence of semen or low production of semen can also cause functional infertility. We treat the symptoms by prescribing drugs. In some cases, minor surgical procedures may also be needed.

Treating obstructive male infertility

We treat obstructive male infertility in two ways:
a)    We fix the problem by a surgical procedure
b)    We extract sperms from testicles by sperm retrieval process that lasts around three hours
In case of men suffering from obstructive infertility and absence off sperms, we have to undergo sperm extraction surgery without any guarantee of finding sperms.  Even in case of men who do not produce any sperm we need to perform sperm extraction surgery. It is a total waste of resources because there are no sperms present in the testicles.

The latest research indicates that it is possible to determine the presence of sperms by testing protein TEX101. We need not perform the painful operation for sperm extraction. It is assumed that with the completion of the research it is possible to derive simple and cheap infertility treatment for men. The latest findings will open further options for effective treatment of male infertility.

Is it a reality that embryo transfer needs complete bed rest?

Is it a reality that embryo transfer needs complete bed rest?
Infertile couples talk a lot about the treatment to their friends and relatives and collect loads of wanted/unwanted information with them. It is further easy to search information on the Internet, irrespective of its validity or necessity. We infertility experts and our technicians struggle hard to clarify these misconceptions. Believe me, it is a marathon task. Sometimes, these concepts are so deeply rooted that we have to spend immense energy in clarifying them. Counseling is an important aspect of infertility treatment. We use it not only for clarifying the technical facets of infertility treatment, but to clarify the doubts and misconceptions also.

Bed rest after an embryo transfer, the popular misconception
One of the biggest worries, especially for the working women is about the so-called “mandatory” bed rest after an embryo transfer.  It is hard to believe, yet true that many women postpone the decision of embryo transfer due to non-availability of leave. Patients believe that the transferred embryo is very “fragile” because it is inserted by the doctors. Jerks, movements, or exertion may result in falling out from the uterus since it is not a “natural” embryo!

The truth
It takes quite a long time for us to convince patients about the reality. Various arguments need to be given justifying it:

•    The structure of our body has been designed quite wisely by the nature. An embryo is placed at such location that the normal bodily activities could not cause harm to it. Jerks during the routine activities like coughing, sneezing or walking do not harm the embryo at all.
•    Technically there is no difference between the so-called “natural” embryo and the “transferred” one. Both get placed at the same location in the uterus and body responds to them in the same way.  Once it gets attached to the uterus, it hardly matters whether it was created in a bedroom or in a laboratory.
•    When the pregnancy happens in the normal way, women have to follow certain precautions. They are just the normal ones like not lifting heavy weights or not doing too much exertion. It is restricted to participate in activities like athletics and gymnastics during pregnancy. The same restrictions are applicable to the embryo transfer also.
•    There is no need of forcible bed rest after an embryo transfer unless there are valid reasons for the same. Rather, it can be quite demoralizing and devastating for a woman to be confined in the home without any apparent reason.  You tend to think endlessly about the pregnancy and possible outcome after 9 months.
•    Infertile couples face a dreadful time during the notorious two week’s waiting period (technically referred as 2WW) when they wait for the pregnancy test after a successful embryo transfer. These two weeks are considered the longest weeks in the life. A bed rest followed by it could be fully miserable to the couples.
Embryo transfer is just a biological process performed with an external aid. There is no need to make an awe of it and follow unnecessary misconceptions!

When infertility affects the marriage!

When infertility affects the marriage!

The couple was immensely worried and disturbed. I had several counseling sessions jointly, but could not make them comfortable. Finally I decided to talk to them separately and that too without revealing the fact. I called the husband for a routine meeting and started probing about the exact problem. Bingo! I hit the bull’s eye. It was none other than the commonest problem of infertile couples. Male partners are always worried about their spouses more than the infertility problem. It is a truth, that infertility affects women severely. Does it mean that men are not concerned about infertility? They are, but the erratic behavior and emotional outburst of their partners bother them more than the actual problem. Women are always emotionally fragile than the men. Their reaction is always highly intense and harsh towards infertility.
The turmoil of infertility

Major issues that disturb the married life:
a.    Women become obsessed about it:  Yes, it is the biggest issue. Female partner will always be fixated on conception. They eat and drink infertility. It is the first thought when they wake-up, and they go to sleep with the same thought. Intense mood swings and depression are the other symptoms due to the obsession.

b.    Social withdrawal: Infertile women avoid interaction with others, and it is another challenge for men. They try to take the partner out of shell by arranging picnic, going for dinner or booking the movie tickets.  However, women do not cooperate to the efforts and prefer to stay alone. It is also a common observation that women avoid family functions where they encounter children and moms.

c.    Losing interest in activities they are fond of: Infertile women lose interest in their favorite activities. They don’t read the favorite book, don’t enjoy the favorite music and don’t visit the favorite place. This is quite annoying factor for the spouse. Initial distress and discussion converts into big disputes sometimes causing damage to the married life.

Don’t upset about it, take it easy!
It is a disturbing issue for the husbands. They do not know how to react and tackle the problem. Husbands are unable to understand the reason behind the worry.  Isn’t it appropriate to meet head-on to the issue instead of getting annoyed with it? 

Undoubtedly it is a tough time and infertility experts try their best to bring the life to normal. However, the infertile couple play major role in achieving the desired results. Especially the female partner should understand that marriage is valuable than the infertility problem.

Man alone can’t correct the situation. Women have to come forward and change the attitude. It resolves the deadlock and the couple move forward towards a bright tomorrow. Women need to understand that there has been great advancement in the medical science. With the correct diagnosis and the right treatment it is possible to defeat infertility problem. It is important to keep the morale high and fight back rigorously. Practicing self-motivation is the key to success. With the right approach and positive attitude they can certainly win the battle.

The surprising relationship of Asthma and infertility

The surprising relationship of Asthma and infertility

Dramatic increase in the cases of Asthma and other respiration problems has been observed recently. There are some fundamental reasons behind it. Firstly, air-conditioning has become quite common in the household and office premises. Secondly, the percentage of dust particles and other irritant factors have increased manifold. As a result, people face respiration related problems quite frequently.

Surprisingly, these problems are not a cause of concern for ENT specialists only, but infertility experts are also equally worried about it. Research indicates that women suffering from Asthma are less fertile as compared to women without Asthma. In some cases, the problem does not cause infertility, but there is a significant delay in pregnancy.

The research

The research was conducted on a sample of 15000 women under the age of 40 years. 1000 women of the lot wereAsthmatic. They were identified into two categories further. Those who received treatment for Asthma identified separately. Lifestyle factors like smoking and eating habits were also considered. The group was asked about the pregnancy history. The results were surprising. Out of those suffering from Asthma, around 27% had a hard time during pregnancy. The percentage was 21% in the healthy women. Similarly, the women suffering from Asthma and did not receive treatment had 30% fewer chances of conception. The same percentage was 23% in those who received treatment.

It is quite clear that Asthma creates an adverse effect on fertility. Treatment of Asthma certainly reduces the risk of infertility but doesn’t eliminate it fully. Experts think that Asthma causes systemic inflammation, and that is the cause of infertility.  Such patients should start the married life early. It may cover-up the delays in conception, and they become pregnant at the right age.

Why does Asthma cause infertility?

Asthma is a chronic disease related to the respiration system affecting millions of people worldwide. It causes inflammation in the air passage and other areas of the body. Along with other organs, it affects the fallopian tubes causing infertility problem in females. There is a clear association between Asthma and delay in pregnancy.  Though the research indicates the trend only and concrete conclusion yet to be established, but the interrelationship shows a direct correlation.

Other than inflammation, Asthma affects the immunity of patients, and they are prone to infections.  Due to weakness of the overall system, there is an adverse impact on the hormonal secretion, a vital aspect of the reproduction system. It may create infertility issues in the future.

This research will help significantly in the treatment of infertility. Doctors are hopeful that treating Asthma with strong medication will help in recovering the problem and women will not face infertility problems in the future. Therefore, it is important to treat Asthma in the early years, especially in case of the girl child. In a Country like India where living conditions are prone to respiration related diseases, the finding could be extremely useful. Dedicated programs are needed from government and other agencies for eradicating Asthma. It will reduce infertility cases tomorrow.

The latest finding could save infertile men from biopsy

The latest finding could save infertile men from biopsy
It is a fact that male infertility is much complex, and we infertility experts need to put a lot of efforts to dig out the cause. Moreover, the diagnostic procedures involve many evasive surgical procedures to determine whether the infertility is caused due to obstructive reason or non-obstructive. It is a depressing and painful experience for the patient. However, the recent findings have shown a ray of hope for painless diagnosis.

According to the researchers, two distinctive proteins ECM1 and TEX101 can help in diagnosing the cause of male infertility and deciding the plan of action. They are hopeful that the findings can give as accurate results as biopsy, and it is an encouraging fact indeed. Thousands of infertile men would feel a great relief to know about it. They will be relieved from the painful holes in the testicles.

Statistics reveal that almost half of the cases of male infertility are caused due to a physical blockage in some part of the male reproduction system. It prevents the sperms from entering into the semen before ejaculation. The above-mentioned research is based on the analysis of various proteins found in the semen.  Researchers are hopeful that the analysis of the protein itself would indicate whether the patient is suffering from obstructive infertility or not.

Types of male infertility
a.    Structural infertility: It occurs when there is a congestion or obstruction in the male reproduction system. Swelling in the nerves or structural problems in the testicles cause this type of infertility. The treatment involves surgical procedures. Male infertility surgery is highly complicated and prone to risk. We need time to diagnose the exact cause of infertility.
b.    Functional infertility: Functional infertility is associated with the quality and quantity of semen. The most frequent causes are low count of sperms and low motility of sperm. Genetic issues and hormonal disorders also come under this category. Absence of semen or low production of semen can also cause functional infertility. We treat the symptoms by prescribing drugs. In some cases, minor surgical procedures may also be needed.

Treating obstructive male infertility

We treat obstructive male infertility in two ways:
a)    We fix the problem by a surgical procedure
b)    We extract sperms from testicles by sperm retrieval process that lasts around three hours
In case of men suffering from obstructive infertility and absence off sperms, we have to undergo sperm extraction surgery without any guarantee of finding sperms.  Even in case of men who do not produce any sperm we need to perform sperm extraction surgery. It is a total waste of resources because there are no sperms present in the testicles.

The latest research indicates that it is possible to determine the presence of sperms by testing protein TEX101. We need not perform the painful operation for sperm extraction. It is assumed that with the completion of the research it is possible to derive simple and cheap infertility treatment for men. The latest findings will open further options for effective treatment of male infertility.

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!

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!

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!

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.

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!

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.

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!

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.

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!

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!

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!

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.

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!