Doctor in Milann : The Fertility Centre
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Pregnancy loss could be devastating. Not only does it affect a woman mentally, but it also often takes a huge toll on her confidence. Post miscarriage trauma is a common phenomenon in this case. The range of emotion a woman might go through include denial, guilt, anger, depression, envy and yearning. Although the process of grieving takes a lot of time, the first step towards post miscarriage trauma is to accept the inevitable and move on.
Here is a list of tips that will greatly help a woman to cope up with the loss:
- Take time: While listening to friends and family seems to be the best course of action around this time, your loved ones need not get priorities at this time. If you believe that clearing your baby’s belongings is causing pain to you, take the time to prepare yourself. Clear away the stuff only when you are emotionally ready to do so.
- Create memories: While a lot of people suggest to completely get rid of all the memories that are attached to the baby, it may not be a great thing to do. Studies have shown that creating a memory about your loss helps to heal faster. So go ahead and take a picture with your baby, plant a tree, take a footprint or christen the baby. Good memories attached to your baby will not haunt you about the loss.
- Take care: Do not neglect your personal health and well-being. Eat well, take enough rest, quit smoking and drinking and seek pleasure in your loved one's company. The more you embrace life, better are your chances to get back to the grooves. Following an old hobby or working out one hour per day goes a long way in the process of healing.
- Get your partner’s help: Being open about your emotions is a good thing to do. Express your feelings about the baby to your partner. The process of coping up can be entirely different from each other. What matters is to let each other’s feelings known. Your partner’s broad shoulder is your best bet to come out of your loss.
- Set the expectations right: Women often get cranky and irritated after a miscarriage. Speak to your loved ones and let them know about your feelings. This will help you to get your loved ones support you and let you heal quickly from your loss.
- Support group: It is very comforting to share your feelings with people who have already experienced the kind of loss you have faced. Sharing in person can reduce your pain a great deal. A spiritual healer or a professional psychiatrist can also play a crucial role in your recovery.
In vitro fertilisation (IVF) is a medical procedure followed for those women or couples suffering from infertility or for certain specific genetic problem. In the normal course, women or couples experience positive results within a few IVF cycles. However, in spite of reasonable pregnancy rates, some women may require few more cycles to achieve pregnancy. In such cases, in order to ensure a healthy pregnancy, the gynecologist may suggest the women undergo Endometrial Scratching before IVF.
Endometrium explained in brief:
The uterus is located in the pelvic region and it is in the size and shape of a pear. The inner cavity of the womb or uterus is protected by the tissue lining called endometrium, also called endometrial. The endometrium plays a significant role in supporting the pregnancy.
The enhanced success of achieving pregnancy:
The endometrial scratching procedure is a very simple one, which is resorted, so as to improve the results of IVF procedure. In this procedure, the gynecologist uses a very fine catheter and makes a small scratch on the endometrial lining. In fact, the scratch causes a kind of inflammatory reaction in the uterus. This inflammatory reaction induces the endometrium to be highly receptive to embryos during the successive menstrual cycle. This added receptivity enhances the success of pregnancy during the next menstrual cycle.
Considering the higher level of success in achieving pregnancy, the endometrial scratching procedure has gained popularity in the IVF procedure. However, some of the other issues related to endometrial scratching may be as follows:
- Endometrial scratching optimises the uterine lining and thereby, makes it easier to continue the embryo implanting procedure. Normally, before the endometrial scratching procedure, the gynecologist may suggest endometrial biopsy.
- The endometrial procedure is usually suggested for those women who had two or more unsuccessful IVF procedures, despite having good quality embryos. However, in some cases, depending on the health of the patient and various other factors, the gynecologist may suggest this endometrial scratching at the very first IVF procedure. This procedure can be availed either for fresh embryos of the couple or frozen embryos or for the donor egg.
- Although this is a part of a surgical procedure; endometrial scratching is very simple and painless and it is done without administering anesthesia. The procedure does not require any hospitalisation. In fact, the patient can go home soon after the procedure. Except for a few pain killers, this procedure does not require any extensive medication.
This is a safe and easy procedure. Neither does it lead to any side effects, nor is the procedure burdensome for your wallet. Many couples have been benefited by this endometrial scratching procedure.
In vitro fertilization (IVF) includes empowering the woman with medicines, taking various eggs from her ovaries, fertilizing them with her partner’s sperm, and inserting a portion of the subsequent embryos into her uterus with the trust that one will form into a fetus.
Tubal ligation reversal, on the other hand, requires a laparotomy, which needs a much bigger entry point on the abdomen, usually around four to six fingers long. Since the skin, each of the muscles, and different tissues of the stomach must be sliced through, there is extensively more uneasiness and a longer recovery time required after the surgery, when compared with a laparoscopic surgery, for example, with a tubal ligation.
Here are a few common differences:
- Sperm quality: The male partner needs a sperm test before basic procedures of either of the two. In case that the sperm quality is great, then the couple could consider proceeding. In case that the sperm quality is poor, in vitro treatment is the better alternative. With IVF, poor sperm quality is effectively overcome.
- Tubal status: The length of the remaining tubal stumps after tubal ligation is an important aspect. The more extended the two remaining stumps are on each side, the better and more effective is the pregnancy. The shorter the stumps, the lower are the odds for pregnancy.
- Status of other pelvic conditions: Pelvic endometriosis or any scar tissue in the range of the tubes or ovaries would diminish the chance for accomplishment after tubal ligation reversal. Although, IVF pregnancy achievement rates are usually not influenced by these conditions. Along these lines, in vitro fertilization is most likely a superior alternative in women with noteworthy endometriosis or pelvic scar tissue.
- Female age: Chances for pregnancy with either tubal ligation or IVF decrease in the mid to late thirties and significantly reduce at the age of thirty-eight. By age forty-three or forty-four, not many women will have the capacity to have a baby using either approach.
- Egg amount and quality: A few women have a decrease in either egg amount or quality prior in life than anticipated. In this manner, the woman’s ovarian capacity needs to be tested before a choice is made in regards to whether to continue with either tubal ligation or in-vitro fertilization. AMH levels, ovarian antral follicle number, and day 3 FSH levels are generally done to evaluate ovarian capacity or hold.
- Doctor intervention: The greatest favorable position of tubal ligation reversal over IVF is that once the woman has experienced the surgery she ideally will not require any medication through the doctor, for example, medications or systems, keeping in mind the end goal to get pregnant.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Infertility is a condition that can be caused due to a variety of reasons, for both males as well as females. Yet, it also comes with plenty of emotional baggage because there is a great deal of social stigma attached to childless parents, especially in the developing countries like India, where we still hold on to traditional thinking which does not really justify modern day realities.
Understanding Infertility in the Developing World: As per medical science, infertility is defined as a problem that is faced by couples who do not manage to conceive even after a year of trying without any birth control measures. In countries like ours, there is a great social stigma that is attached to being childless. As per many studies by the World Health Organization (WHO), about 15% of couples the world over are affected by infertility. Also, such cases go undetected because there is a great social stigma attached to the same. Further, there may be underlying conditions like Tuberculosis which may have been undiagnosed because people do not like to talk to doctors about the symptoms. The main problem in countries like India, and others areas is that people do not open up about such problems and they consider doctors and other medical practitioners as strangers.
Still in the Dark Ages: Even though we have made the transition from an agricultural country where we would pray to the elements and wait for signs for all our everyday activities from harvesting to childbirth, to an industrial country we are still in the dark ages as far as our social setup goes. There are many educated and well-heeled families where being childless is considered as an issue. And many people tend to go to astrologers and temples to change their fate, where a simple visit to a doctor and procedures like IVF, or adoption as the last resort, can also work out.
Infertility Stigma for Males and Females: For an infertile couple, the problem may stem from the male, or the female or both partners. There are still many social stigmas that are attached to this and many people in countries like India tend to call the woman barren, if she is unable to bear a child. In many cases, the male partner does not even go in for a check up as it is not even considered as an option that the problem might lie with him. Male erectile dysfunction, ejaculation problems, and general infertility can cause a range of issues for the couple when it comes to conception. So it is imperative to have the same checked by the doctor so that a sperm test can also be conducted and the treatment can carry on accordingly with the help of IUI or IVF. In case you have a concern or query you can always consult an expert & get answers to your questions!
Of a million sperms released in one ejaculation, a single sperm manages to fertilize the egg, which grows into an embryo and then a baby. Due to various reasons, when this does not happen, it is termed as infertility and is currently on the rise.
With IVF, couples sometimes go through multiple sessions to ensure fertilization. ICSI or intracytoplasmic sperm injection improved this chance of fertilization. It is where a single sperm is used to fertilize an egg in an artificially controlled environment and then injected into the uterus where it grows further.
The next step in this technique is IMSI, where the chances of successful pregnancy are further enhanced and also promises improved quality of the embryo. IMSI, as it stands for, has “morphologically selected” which means under a highly powerful microscope, the best sperms are selected and then used to fertilize the egg. Morphology stands for shape, and the shape of the sperm is a direct indicator of the sperm quality. This not just ensures good success rate but also ensures the sperm which is used produces a high-quality embryo.
- High success rate of fertility
- Reliable and efficient method of ART (assisted reproductive technology)
- More expensive than traditional IVF methods or ICSI
- Requires complex equipment, training, and set-up
- Useful in couples who have failed IVF previously
- Male infertility with unidentifiable cause
- Poor sperm quality
What to expect?
Both partners are prepared both physically and mentally prior to IMSI.
Before the procedure - men:
- A screening is first done to decide if the sperms can be used directly
- In case of hereditary diseases, a donor is preferred
- The first technical step involves sperm collection, either directly or through a donor
- Sperms are collected either through masturbation or through a small incision in the testicles
- Sperms used could be fresh or frozen; fresh ones may be stored for later use also
Before the procedure – women:
- The woman is put on some ovulation therapy to ensure the release of multiple eggs, so a good one is picked. These high doses of hormones ensure multiple eggs are released.
- Egg release is monitored through blood and urine tests
- They are collected within after 36 hours of release
During the IMSI procedure:
- A healthy egg is chosen and placed in a glass container containing hyaluronidase
- Sperms are placed in a medium which will slow their movement, which enables picking a good sperm for fertilization
- The dual advantage of this is that in addition to a high success rate of fertilization, the quality of the embryo is also assured
In case you have a concern or query you can always consult an expert & get answers to your questions!