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If a couple is unable to conceive naturally despite having unprotected sexual intercourse for over a year, they may be diagnosed with infertility. IVF is one of the most common ways of dealing with infertility. This is a process where eggs from the female and sperm cells from the male are harvested and combined in a laboratory to form embryos. The embryos are then reinserted into the woman’s uterus. This is a crucial step of the IVF procedure. In order for the treatment to be successful, at least one embryo must attach itself to the endometrial lining of the uterus. This allows the embryo to receive nutrition from the mother. If the embryo is not attached successfully, it will be expelled from the body. In such cases, the woman is said to have an unreceptive uterus.
One of the ways to check the receptivity of the endometrial tissue is through an Endometrial Receptivity Array (ERA) test. This involves taking a biopsy sample of the endometrial tissue on a particular day of the woman’s menstrual cycle and sequencing the genes of the sample. Collecting the sample takes hardly any time but processing it can take up to 3 weeks. This is akin to a personalized genetic test. The results of the Endometrial Receptivity Array test help to determine the ideal time during the menstrual cycle when the embryos should be implanted.
This test is not always recommended for IVF patients. It is usually advised only if the woman is over the age of 37 years and the couple has had 2 or more failed IVF cycles. It may also be advised if the woman has healthy eggs but is still unable to conceive. This is a fairly simple procedure which may be performed in the doctor’s office. It is not painful and there are no serious risks associated with it.
Though this procedure can make IVF a little more expensive, there are a number of benefits associated with it. For starters, it helps reduce the risk of IVF failure and increases the chances of having a successful pregnancy. This helps save time by increasing the probability of a successful implantation in the first cycle of IVF itself. In the long run, it also helps save money. This is because each IVF cycle has a cost associated with it. Hence, undergoing an ERA once and finding the perfect window for implantation can negate the need for further IVF treatment.
The thyroid gland is a small butterfly-shaped gland located at the base of the neck. This is responsible for producing the thyroid hormone that in turn helps regulate metabolism and other bodily functions. The production of less than normal amounts of thyroid hormone is termed as hypothyroidism. Stress, food intolerance, an unhealthy lifestyle and immune system disorders are some of the factors that could contribute to hypothyroidism.
Symptoms of hypothyroidism include
In mild cases, there may be no visible effects on the person but in severe cases, it can reduce ovulation or cause the ovulation to stop completely. This can result in infertility. Hypothyroidism can also put a woman at a high risk of having a miscarriage.
Infertility can be treated in a number of ways. One of the most common amongst them is IVF or In Vitro Fertilization. This procedure involves stimulating the woman’s ovaries to produce eggs, harvesting them and combining them with sperm cells from the male partner in a laboratory. This increases the chances of forming an embryo. 2 or 3 of the healthiest embryos formed are then reinserted into the woman’s womb. When the embryo is successfully implanted, the woman may then carry the pregnancy to full term.
Many women who undergo IVF treatment give birth to twins or triplets. IVF typically has a very high success rate but when it comes to women suffering from hypothyroidism, this may not be the best course of treatment. This is because hypothyroidism can also prevent the embryos from being successfully implanted in the uterus.
For this reason, a thyroid test is essential before inserting the embryos into the uterus. This can be done with a simple blood test to measure the level of thyroid hormone in the blood. This test is known as a TSH test. Normal TSH levels range from 0.3 to 3.0 mIU/L. If the levels are unacceptable, medication will be prescribed to help regulate them. Dietary changes may also be required. Once the levels are within the normal range, the embryos can be inserted.
Women suffering from hypothyroidism must have regular checkups for the entire duration of their pregnancy. This will help doctors identify potential problems early and deal with them before they can affect the growing fetus. Even after giving birth, the woman should get her thyroid levels checked regularly while she is nursing the baby.
When we talk about infertility attention usually falls on treatment for women. However, infertility can affect men as well. The condition of infertility, can be described as the inability to become pregnant for a period of 1 year despite having unprotected, well-timed sexual intercourse. A low sperm count is one of the primary reasons for infertility in men.
Typically there should be fifteen million sperm per milliliter of semen. Low sperm count refers to the ejaculation of less than a normal amount of sperm in semen. This can also be termed as oligospermia. A complete absence of sperm in semen is known as azoospermia. Low sperm count does not mean that you cannot impregnate your partner but it reduces the chance of a successful conception. Thus, one of the most common ways to treat infertility caused by low sperm count is IVF.
- IVF involves harvesting eggs from the woman’s uterus and sperm from the male partner and combining them in a laboratory to form a zygote. When IVF is used to treat male infertility, a semen analysis is the first step. This helps determine the patient’s sperm count, sperm motility, volume, pH levels, white blood cell levels etc.
- The ejaculated semen is then processed so as to separate the sperm cells from the plasma. In this process sperm cells with higher motility are identified and segregated. These cells have a higher chance of fertilizing the egg.
- Sperm cells are then injected into the harvested egg. Some techniques may require the injection of 50,000 or more sperm cells while others such as intracytoplasmic sperm injection (ICSI) can be effective with a single sperm cell. Once the egg is fertilized, it is allowed to develop for a few days in the laboratory.
- Two or three embryos are then selected to be reintroduced into the woman’s uterus with the help of a catheter. The remaining fertilized embryos are preserved in an embryo bank in case the pregnancy is not successful. If these need to be used later, the woman does not have to go through the initial stages of IVF treatment to stimulate the follicles and harvest eggs from the ovaries.
When it comes to IVF, the success rates are very high. However, one of the most common side effects is the birth of twins or triplets. This is because multiple embryos are inserted into the uterus. The number of babies born then depends on the number of embryos that are implanted successfully.
There are two tubes on either side which connect the ovaries to the uterus. These are the fallopian tubes, and in the majority of the cases, this is where the fusion between the egg and the sperm happens. If there is any problem in either of the fallopian tubes, then the egg cannot travel down into the uterus and there cannot be fusion. Tubal infection or salpingitis and blocked fallopian tubes are some of the most common causes of infertility. In some cases, the sperm may travel up the fallopian tube halfway till the area of blockage and fuse with the egg. This is known as ectopic pregnancy, which is out of place.
Tubal infection is often a result of sexually transmitted diseases including trichomonas, gonococci, and chlamydia. Other general bacteria like strep and staph also produce salpingitis. In most cases, tubal ligation per se is not an issue. However, it can cause problems like blocked tubes or hydrosalpinx. In these cases, the complications arise. In some women, treating these could be the cure for their infertility itself. Blocked fallopian tubes can stop the eggs from traveling down the ovaries and fuse with the sperm. If the block is removed, then infertility is solved. Similarly, if the tubes are filled with pus as a result of the infection, then it does not produce a conducive environment for fertilization.
With IVF being used as a treatment for infertility, the tubes need to be cleared for infection or blockages. These might continue to pose problems and reduce the overall success rate of IVF. These are easy to diagnose so that the infection can be completely cleared and pus drained if required. Surgical debridement can also be done if required so that the tubes are cleared. In some cases, a part of the tube may be removed so that the issue is addressed completely. A course of antibiotics is often required to completely clear the infection. After that, once ovulation is stimulated, then the eggs can travel down so that they can be retrieved and frozen for further use.
Undetected blocked fallopian tubes of silent infection (chronic salpingitis, which does not present with any symptoms) can be one of the causes of failure to conceive with IVF. This can be quite demotivating for both the couple and the medical team. With IVF, there is no clear role for the fallopian tubes, as the eggs can be retrieved from the ovaries and placed directly in the uterus. So, in severe cases of infection, the tube(s) may be even completely removed to improve chances of fertility.
With infertility on the rise, more and more couples are turning to IVF as a definitive solution. Though there are some inherent risks with IVF, the success rates have gone up significantly over the last couple of decades. This has made it extremely popular for a couple facing infertility. IVF is no longer just a physical issue but also a hugely emotional one.
There are various factors which determine the success rate of IVF, and a thin endometrium is one of them. This is the inner lining of the uterus which should facilitate transfer and growth of the embryo throughout the course of pregnancy.
Ideally, the endometrium should be about 7 to 8 mm thick and have a 3-layered structure on ultrasound. If it is too thin, it may not be able to support the implantation of the fertilized egg. Further, even if it supports initially, as the embryo continues to grow, it may not be able to support the weight, leading to possible miscarriages.
Causes of the thin endometrium:
- Reduced blood supply to the uterus
- Reduced levels of estrogen
- History of endometriosis
- Scar tissue from prior uterine infections or surgery
While blood tests can help identify reduced estrogen levels, ultrasound can be used to measure blood flow to the uterus. The cause of thin endometrium needs to be addressed before going ahead with IVF so that the chances of success are increased.
- Estrogen supplements can be given if there is estrogen deficiency. This is essential to promote overall uterine health, which can sustain a healthy pregnancy.
- Surgically, uterine scraping where the top layers of the uterus are stimulated to produce a thicker lining. This is an outpatient procedure and produces excellent results in most women.
- Increased intake of L-arginine is another way to improve uterine health. It promotes blood flow, thickens the uterine lining, and improves the success rate. About 500 mg per day for about a month is considered beneficial.
- Uterine cleansing with for instance castor oil is another way to improve uterine lining.
- Uterine massage where herbal oils are used to massage the pelvis has also shown great results. It helps improve circulation to the uterus and surrounding reproductive organs and improves their overall health. This should be done about 2 to 3 months before IVF and stopped after IVF (can result in dislodgement!!)
- Acupuncture: Another well-established method to improve uterine lining and health is the use of acupuncture, as it improves circulation.
- Eating healthy, vitamin supplements if required, getting adequate rest, moderate workout, and quitting smoking all go a long way in improving uterine health.
IVF is one of the most common ways to treat infertility. This procedure can be described as one where the woman’s eggs and the man’s sperm are harvested and combined in a laboratory to form an embryo. Two or more embryos are then inserted into the woman’s womb where they will develop during the pregnancy. IVF has a high success rate but there are a number of factors that could interfere with this. Issues with the woman’s uterus such as the presence of scar tissue or polyps could be one such factor. Thankfully, this issue can be identified and treated before undergoing IVF so as to increase the chances of its success.
- A hysteroscopy is a procedure through which the doctor can take a look inside the woman’s uterus. This is an invasive procedure that is performed while the woman is under general anesthesia. It involves inserting a narrow tube with a telescope at one end into the uterine cavity.
- The cavity may or may not be filled with a gas or a fluid. The telescope then captures and transmits images of the uterus to a screen where it can be viewed by the doctor. Any malformations such as polyps, scar tissue, fibroids etc. will be made visible through this procedure. If any such issues are seen, the doctor will then proceed to remove them. In this case, the procedure is not only diagnostic but operative as well.
- The fertilized embryos are then inserted into the woman’s uterus. Since all the scar tissue and uterine abnormalities have been addressed, the embryos then have a higher chance of being successfully implanted. This boosts the chances of a successful IVF pregnancy.
- A hysteroscopy may not be very effective for a patient with recurrent IVF failures but for a woman who is undergoing IVF treatment for the first time, this could be quite helpful. It is rare for a hysteroscopy to have side effects. Infection caused by this procedure is very rare. In some cases, women may experience temporary bloating or cramps after the procedure. This does not affect her fertility in any way. A hysteroscopy is not a typical part of the IVF procedure and hence there are additional costs associated with it. However, in the long run, by increasing the chances of having a successful pregnancy, these costs may be offset by negating the need for a second round of IVF treatment. In the end, the choice is a personal one.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Infertility is becoming an increasingly common problem. With maternal ages advancing and lifestyle turning unhealthy, infertility is affecting many couples. The problem is that it is not just a physical issue but a hugely emotional one too. For many couples, failure to conceive is devastating news. With recent advances in medicine and technology, in-vitro fertilization or IVF is becoming a highly recommended procedure to treat infertility. Frozen Embryo Transfer or FET is the step where the retrieved frozen eggs are implanted in the uterus. This could be done as a part of regular IVF or when the previously transferred egg ends up with a miscarriage.
This requires some amount of preparation, though not as much as IVF, as there are not too many medications to take to boost egg production. However, preparing for FET about a couple of months ahead of the transfer can up your success rates to a great degree.
- Eat well and leave out junk, processed, oily, and packaged foods. Switch over to multiple grains, cereals, dairy products, omega-3 fatty acids, vitamins, and minerals so that your body turns healthy. Drink a lot of clear water and herbal drinks. Avoid alcohol and quit smoking. This will help it go through the rigors of IVF or FET.
- Fertility cleansing is aimed at cleaning up the toxins and ensure there is an adequate hormonal balance that is so essential for a healthy pregnancy. This takes about a month and so talk to your doctor about timing it. There are various natural options available for this, castor oil being an example.
- Taking about 500 mg of L-arginine is another way to create a healthy environment for the fetus. This also improves blood flow and creates a thick uterine lining.
- A fertility massage also helps to improve the uterine lining, so it is better prepared to receive and sustain the embryo throughout pregnancy. The massage improves circulation to the uterus and other reproductive organs and improves the ability of the uterus to hold the fetus. This should be done 2 to 3 months ahead of the FET and stopped after transfer.
- Surgically, the uterus could be scratched to clear it of debris and enhance its ability to receive and sustain a pregnancy.
- FET is an emotionally tense moment for a couple going through it. There is anxiety about the procedure per se and the results. So keep calm and be there for each other. Having a close family or friend also helps whom you can openly express your concerns to. Meet up with people who are also into IVF or FET so you don’t feel alone.
Vaginal bleeding is a common phenomenon in women. Sometimes it is due to cyclical changes in the cycle, while other times, it may be indicative of something unnatural and perhaps severe.
Abnormal vaginal bleeding includes:
- Heavy periods: This is a very common phenomenon. Bleeding during periods cannot be measured with optimum accuracy but periods can be considered heavy if it lasts over 7 days, if you need double protection, or if you seem to pass too much clots. It is recommended to consult your doctor if it starts to affect your lifestyle and causes hindrance in your day to day activities. The cause of heavy bleeding during menses is often unclear, but it may be indicative of uterine fibroids or cysts.
- Post coital bleeding: Post coital bleeding happens when you bleed after sex. The most likely reason for this to happen is if there is inflammation in the neck of the cervical opening or it is sore. The common cause of this can probably be sexually transmitted diseases such as Chlamydia.
- Inter menstraul bleeding: Bleeding between your periods is also a possibility. There can be several causes for this. It can be broadly indicative of uterine polyps or infections. Polyps are fleshy masses of cells which are basically an abnormal growth in the uterus or cervix.
- Break through bleed: These bleeds happen very suddenly and spontaneously in the middle of the cycles or close to the menstrual cycles. These can happen when you start contraceptive pills and usually settle down in a matter of few months.
- Post menopausal bleeding: Bleeding or spotting post menopause can be indicative of something more serious. The common causes can be uterine or cervical cancer. Often, it may also happen that the uterus starts to degrade, and small fibrous bleeding or spotting may be visible.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Cervical cancer refers to the type of cancer that spreads through abnormal cells, which may be found in the lining of the cervix. This affects the lower part or the womb of the body. This may also be medically known as the uterine cervix. This kind of cancer is considered one of the most preventable ones. There are various kinds of screening tests that can help in early detection so that the symptoms become clear and the problem can be treated before the cancer spreads or malignancy sets in.
Read on to know more about the various screening measures that can help in treating and preventing the same.
- Pap smear test: This is one of the most recommended and easiest tests conducted for cervical cancer screening. The pap smear test is recommended for all women who have been through child birth. In this form of screening, the doctor usually takes a sample from the cervix of the patient. This will be then be put through a lab test to find any kind of anomalies in the cells of the cervix. This test is also strongly recommended on an annual basis for women who are going through menopause, as this is the time when the cells undergo maximum changes.
- HPV test: The HPV test can be conducted along with the pap smear test so as to find out if the HIV virus is active as well.
- Pelvic exam: In order to conduct screening for cervical cancer, the doctor may also ask the patient for a pelvic exam. In this test, the doctor checks the various areas like the uterus, the cervix and ovaries so as to ensure that there are no anomalies and irregular changes in these areas or organs of the body. This exam can help the doctor in finding any changes that may point at the risk of developing cervical cancer.
- Reading the test results: The doctor will usually take a look at the test results before making a clear diagnosis and recommending a course of medication or other kinds of treatment so as to prevent the spread or onset of cancer. For cases where this type of cancer has already progressed to a great degree, the doctor will usually recommend chemotherapy as well as radiation and sometimes, even surgery.
When should you get a screening test done?
Once you are above 21 years of age or have had a baby, it is imperative to get a screening test done at least annually. It is also important to get this done once a year if you are going through menopause. The doctors may ask you not to go through a test, if your previous three tests have been clear.
In case you have a concern or query you can always consult an expert & get answers to your questions!