Vital Diagnostics

There is nothing more stressful to a patient and a caring gynaecologist than to face repeated IVF failure or recurrent pregnancy loss following IVF. So to advice couples who have failed one or more attempts, to keep on trying over and over and over; is not an easy job. Here, one can find solution in Ayurvedic treatment. Ayurveda, through its medicines, diet & lifestyle modifications and panchakarma raises a new hope after IVF failure. Ayurvedic treatment enhances success rate of Artificial Reproductive Techniques (IUI, IVF, ICSI-ET) or increases chance of natural conception as per cause of infertility.

What is Infertility?

Infertility is Inability to conceive even after one year of unprotected coitus or inability to carry pregnancy till full term. There are many causes of infertility; such as tubal block, PID, Endometriosis, PCOD in women and low sperm count, low sperm motility in men. When there is severe tubal disease, severe egg factors, failed IUI treatments, severe male factors, unexplained infertility, grade III & IV endometriosis; Test tube baby is suggested.

What is test tube baby? IVF (In-Vitro-Fertilization)?

It is a laboratory procedure in which processed sperm are either placed with oocyte (IVF) or injected into oocyte (ICSI) in a petridish to achieve fertilization. The resultant embryos are transferred into woman's uterus for implantation.

What are causes of IVF failure?

1. To work out on IVF failures, we should focus on causes of failure.
2. One of the most common causes of IVF failure is Abnormal Embryo. Abnormal embryo can be formed due to abnormal egg (oocyte) or abnormal sperm or if both are abnormal.
3. Another common cause is Implantation failure. Endometrium preparation and its receptivity are more important for implantation of an embryo. Endometrium should be 6 mm or more in thickness preferably 8-10 mm. To know details about endometrium preparation, Color Doppler should be done. It has also been observed that when pregnancy is achieved in absence of endometrial and sub-endometrial flow on the day of embryo transfer (ET), more than half of pregnancy will finish as spontaneous miscarriage. 
4. IVF cycle can be cancelled even before Ovum Pick Up due to Poor Ovarian Response, in which very few or no follicle growth is seen even after fertility injections.
5. Most neglected but important cause is Pre-treatment STRESS.

HOPE IN AYURVEDA:

According to Ayurveda, four factors are essential for conception; namely seed (oocyte and sperm), soil (reproductive track), season (fertile period) and water (nutrition).
Ayurvedic fertility treatments regularize metabolism of body, purify reproductive organs, maintain hormonal equilibrium, improve endometrium lining & receptivity, increase egg and sperm quality and relieve stress.
Womb preparation treatment of Ayurveda enhances success rate of IUI, IVF, ICSI-ET.

Womb Preparation Treatments:

Ayurvedic medicines
Ayurvedic herbs and medicinal preparations act as natural tonic to male and female reproductive organs. They maintain biological clock of menstruation; hence hormonal imbalance is corrected. They also help in making most potent and healthy sperm & ovum and eventually a healthy pregnancy.

Panchakarma (Detoxification)
Ayurveda can treat infertility by Panchakarma procedures like Basti, Uttarbasti, Vaman, Virechan, Nasya using different Ayurvedic formulations as per cause of infertility & failure of IVF and according to body constitution of patient.

• Basti acts on vata predominantly. It increases strength of reproductive organs 
• Uttarbasti is an intrauterine instillation of sterile medicated oil or ghee. It acts on endometrial receptors
• Vamana and Virechana detox the whole body and improves digestive fire for proper nourishment of reproductive hormones and organs
• Yoniprakshalana (Irrigation of vulva and vagina with warm decoction) and Pichudharan (Insertion of a sterile tampoon soaked in medicated ghee or oil in posterior fornix of vagina) are also helpful in infertility

According to Ayurveda; A Cheerful mind forms the basis of pregnancy; so relaxing panchakarma procedures like massage, steam, head massage, Shirodhara are done to reduce stress and its impact on infertility treatments.

Diet:
Like other fertility treatments, Ayurvedic treatment does not depend only on medicines. In fact, it ensures that patient follows a strict diet rules as per Ayurveda and avoids spicy and salty food. The proper food can help to provide proper nutrition to reproductive organs.

Lifestyle modification:
Nowadays infertility has become a part of lifestyle diseases. Ayurvedic Doctor can guide you to modify lifestyle according to your body constitution (Dinacharya) and seasonal variations (Rutucharya). It is always better to avoid cigarette smoking, tobacco and alcohol as they reduce fertility. Exercise is an inevitable part of lifestyle. One should learn exercise, yogasana (e.g. Surya Namaskara, Gomukhasan, Sarvangasan, Pavanmuktasan, Ardhamatsyandrasan, Naukasan, Dhanurasan, Shalabhasan etc.) and Pranayam from an experienced teacher.  

Infertility is a condition where a couple trying to conceive in a natural way is not able to do so even after one year of trying. It is also a matter of worry for patients who are over the age of 35 years and those who are not able to conceive naturally even after 12 months of trying constantly. So here are the causes, risks and treatment for this condition.

* Causes: There are many causes of infertility. It may be down to a condition present in one or both partners. As per a medical study, 20% of the cases of infertility are due to males, while 40% to 50% cases are due to problems in the female partner. 30% of the cases suffer from infertility due to problems in both males and females. Ovulation and fertilisation are the main elements of the conception process, and any condition in the female or male can upset either function which can make it difficult to conceive. While abnormal sperm production and transport may be a common condition that leads to infertility in males, other factors like side effects of cancer treatments and too much exposure to toxins and chemicals can also play an important role in this regard. For females, the causes of infertility may range from ovulation disorders, uterine and fibroid tumours, uterine and cervical anomalies, damage to or blockage of the fallopian tubes, endometriosis, primary ovarian insufficiency and pelvic adhesions. Also, factors like thyroid, cancer and medication leading to temporary infertility may be at play. 

* Risk: There are a number of factors that put a male or a female at risk of infertility. Being in your mid 30s usually has an adverse effect on the ovulation and production of well functioning sperm. Further, smoking and tobacco are among the main causes of infertility in either partner. Excessive alcohol consumption may also lead to this problem. Being overweight or underweight can also make a person infertile. Further, not getting enough exercise and routine activities out of your day, can lead to this condition as well. 

* Treatment: Male patients can go through treatment for any existing infections, hormonal injections and medication, surgical options like vasectomy reversal, and ART or assistive reproductive technology. Female patients can turn to medication that will stimulate ovulation, Intrauterine Insemination, and surgical processes to correct a uterine septum and remove endometrial polyps, or even a hysteroscopy surgery. 

If these methods fail, the patient or the couple can always turn to methods like In Vitro Fertilisation. For other mild reasons, lifestyle changes along with a stress free environment can help in increasing the chances of conception.
 

Diabetes alters the metabolism and functioning of almost entire body system. The most important targets are the circulatory and nervous system, leading to peripheral vascular disease and neuropathy. Diabetic foot is the result of a combination of these two factors in the feet – altered/reduced blood flow to the feet combined with reduced sensation.

1. Neuropathy: When the sugar levels are poorly controlled, then the nerves in the legs are damaged, leading to reduced or absence of sensation. The patient cannot feel pain/heat/cold. Sensory neuropathy causes loss of protective sennsation leaving the foot at risk to repetative unnoticed trauma.
2. Peripheral vascular disease: The blood vessels which are away from the heart are affected, leading to poor blood flow from the legs to the heart. Proper blood flow is essential for overall health, and when this is affected, the peripheral foot health is affected.

Some of the common foot problems encountered in diabetics are listed below:

1. Fungal infections: Whether a person wears shoes regularly or not, they become more prone to fungal infections. The nails become discoloured, brittle, and break off. They are difficult to treat and may require oral medications.
2. Ulcers: Diabetic ulcers are very common. The combined effect of reduced sensation and reduced blood flow leads to ulcers, which are not painful (due to lack of sensation) and therefore are ignored and not treated promptly. They can progress and become severe, even sometimes leading to amputation. Fungal ulcer are most common in between toes and in creases of a diabetic patients
3. Corns: Diabetics are more prone to develop corns which are thick masses of skin near the bony area of a toe. This could be in areas where the shoes rub against the toes or between the toes where there is a lot of friction. Home care includes smoothing it with a pumice stone. The person should not try to remove them on their own.  Warts, bunions, ingrown toenails, hammertoes, etc., are also very common in diabetics.

Prevention/Treatment:

1. The first and most important step is to monitor and regulate the blood sugar levels within ranges ideal for you.
2. Warm water to be used for washing feet, and then to be dried well, to not leave a moist area between toes
3. Regular feet care to check for blisters, ulcers, wounds, etc.
4. Check toenails for overall health
5. Preferably wear closed toe shoes
6. Wear stockings or socks and shoes that fit well
7. Moisturise the skin well to avoid drying
8. Avoid exposing feet to extreme weather
9. Quit smoking
10. Ensure blood flow is maintained by not standing or sitting for prolonged periods and with regular exercise

Diabetic neuropathy is a nerve disorder caused by diabetes. The high blood sugarfrom diabetes affects the nerves and over time increases a person's risk for nerve damage. Keeping blood sugar levels within the target range recommended by your doctor helps prevent diabetic neuropathy.

Types of Diabetic Neuropathy:
Diabetic neuropathy can be classified as Peripheral, Autonomic, Proximal, or Focal. Each affects different parts of the body in various ways...

Peripheral neuropathy, the most common type of diabetic neuropathy, causes pain or loss of feeling in the toes, feet, legs, and hands.

Autonomic neuropathy affects the nerves that control involuntary body functions such as digestion, bowel and bladder function, sexual response, and perspiration. It can also affect the nerves that serve the heart and control blood pressure, as well as nerves in the lungs and eyes. Autonomic neuropathy can also cause hypoglycemia unawareness, a condition in which people no longer experience the warning symptoms of low blood glucose levels.

Proximal neuropathy causes pain in the thighs, hips, arms, or buttocks and leads to weakness in the legs and hands, resulting in difficulty in walking, standing, picking up objects, buttoning your clothes, etc.

Focal neuropathy results in the sudden weakness of one nerve or a group of nerves, causing muscle weakness or pain. Any nerve in the body can be affected.

How Diabetes Causes Damage to the Nervous System?
There are several factors that are likely to contribute to nerve damage through diabetes...

• High blood glucose, a condition associated with diabetes, causes chemical changes in nerves. These changes impair the nerves' ability to transmit signals. 
• High glucose levels affect many metabolic pathways in the nerves, leading to an accumulation of a sugar called sorbitol and depletion of a substance called myoinositol. These changes are the mechanism that causes nerve damage. Nitric oxide dilates blood vessels. In a person with diabetes, low levels of nitric oxide may lead to constriction of blood vessels supplying the nerve, contributing to nerve damage.
• Presence of mechanical injury like carpal tunnel syndrome in a diabetic patient worsens its symptoms and prognosis
• inherited traits increase susceptibility to nerve disease
• lifestyle factors, such as smoking or alcohol use

Symptoms:

1. Numbness, burning sensations, tingling, or pain in the toes, feet, legs, hands, arms, and fingers
2. Either hypersensitivity to touch or insensitivity, even to hot and cold temperatures
3. Weakness in muscles and loss of reflexes
4. indigestion, nausea, or vomiting
5. diarrhea or constipation
6. dizziness or faintness due to a drop in blood pressure after standing or sitting up
7. problems with urination
8. Changes in gait and balance
9. Injuries that are taking longer to heal and are more prone to infections

Prevent Diabetic Nerve Damage:
Keeping your blood sugar levels in your target range, set with your doctor, may help prevent nerve damage from ever developing. The best way to do this is by checking your blood sugar and adjusting your treatment. It is also important to get to and stay at a healthy weight by exercising and eating healthy foods.