Daljindar Kaur's inspiring story of motherhood: How IVF became her savior

The success of In vitro fertilization continues in India as a septuagenarian woman gives birth to a baby boy. Even after 46 years of marriage, the couple from Amritsar was childless. Daljinder Kaur, along with her 79-year-old husband, Mohinder Singh Gill, had been visiting National fertility and the Test Tube Baby Centre in Hisar since 2013 and did not give up even after two failed IVF cycles. They had faced ridicule for their inability to have a baby and yet they kept their hopes up.
On the 19th of April, the couple was blessed with a baby boy who is nothing less than a miracle. The groundbreaking achievement of the embryologists from Hisar has been an inspiration and a beacon of hope for couples all across the country. Once again, IVF has proved to be one of the most successful procedures to have babies for couples with fertility issues. Following are some of the advantages of In vitro fertilization, which you should know about-
1. It can be used by anybody
In-vitro fertilization is not necessarily used by the going to be a mother. It can be used by gestational carriers or by a surrogate as well. So it depends on whether the parents want to take the help of a surrogate or themselves want to be involved in the pregnancy. IVF gives an opportunity to single women and same-sex couples to become parents.
2. Use of donated eggs and sperms
There might be circumstances when the doctor can recommend using donated sperms or eggs. In that case, the eggs can be fertilized manually in the lab and the fetus developed can be used for in vitro fertilization. This increases the chance of pregnancy by a fair amount.
3. Control over timing
In vitro fertilization is a solution for couples who have a very engaging professional life, and can be an option for people who want to have babies after a certain point of time. Eggs and embryos can be preserved for future use. It is also helpful for couples who already have a child and plan to have another later.
4. Decreases chances of miscarriage
Genetic abnormality is one of the primary causes of miscarriage. The technique of preimplantation genetic diagnosis (PGD) is used to ensure the viability of the embryo much ahead of time so that the mother can have an uncomplicated pregnancy and carry her baby full term.



Daljindar Kaur's inspiring story of motherhood: How IVF became her savior

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.

Endometrial Scratching and IVF - Can it Help You Get Pregnant?

Egg Freezing, which is also known as mature oocyte cryopreservation, refers to the method through which reproductive potential is restored among women. Eggs get harvested from the ovaries, frozen and in an unfertilized manner and are stored for purpose of using them later on. The egg freezing procedure is recommended for those women, who would like to delay conceiving baby due to various kinds of reasons.

Before the freezing of eggs, it is important to first retrieve the eggs. Let us look at how the eggs are retrieved, followed by the procedure of egg freezing through two different ways.

Retrieval of Egg

Egg Retrieval takes place just like it is done in case of in vitro fertilization (IVF). Women would need to be put under medication for hormones or through injections, which shall lead to the stimulation of ovaries, leading to more eggs getting matured. After this women would receive the necessary medication to stimulate ovulation and then the extraction of eggs takes place through the use of a needle. Specialists perform this whole procedure by putting women under the effect of anesthesia and are also guided by ultrasounds. Once the extraction is completed, the freezing takes place.

There are two different techniques involved in the egg freezing process. They include:

Slow Egg Freezing Method

A substance called cryoprotectant is used in order to protect the biological tissues from getting damaged out of freezing. This slow freezing method of getting eggs freezed relies on low initial concentrations of crytoprotectant. The cryoprotectant in low concentration is introduced when the egg is at a relatively warm temperature and still continues to experience the usual functions of a living cell. Then the cryptoprotectant would spread all throughtout thus fill the egg, hence replacing most of the water inside the egg. The egg is then inserted into a small container made of plastic and ultimately get placed inside a cooling chamber. The lowering of temperature, to around -6 degree centigrade, takes place through injecting very tiny amounts of liquid nitrogen into the cooling chamber. The cooling process is controlled by a computer.

The main purpose of these techniques is to avoid ice crystals from getting formed in the egg. During the spreading of the cryoprotectant, if the ice crystals are still present, they can cause damage to the egg and hence the egg may not survive the process of thawing. Then the temperature is lowered further to around -32 degree centigrade. By this time, the egg s metabolic rate become slow. The container where the egg was placed, is then dipped inside the liquid nitrogen, forming a solid.

Rapid Egg Freezing Method or Vitrification

At the time of rapid freezing method, there is high concentration of initial cryoprotectant whereas the cell remains at room temperature. The egg is unable to stay for long in this temperature and thus gets poured immediately onto the liquid nitrogen. Cryoprotectant spreads at a rapid rate so as to avoid ice-crystal from getting damaged. Vitrification is a very new method for freeing eggs. Recent research has shown that vitrification of eggs largely improves the possibility for survival after thawing and the rates of pregnancy.

Different Techniques That Can Be Used For Egg Freezing!

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?

To work out on IVF failures, we should focus on causes of failure.
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.
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. 
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.
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.  

IVF Failure: Hope In Ayurveda!

Frozen Embryo Transfer or FET is an extremely effective method to conceive a pregnancy. Recent studies have proved that there is a increased chance for pregnancy when the embryos, which get used are frozen and get placed inside the uterus at a time right after the ovaries are stimulated. Still, certain issues can arise with the transfer of frozen embryo, such as:

A Thin Lining of the Uterus
Research has shown that there are not many women who get pregnant if the lining in their uterine does not tend to thicken enough. It is not clear exactly why this problem occurs in most women and moreover there is no sure shot treatment to make the lining of the uterine thick. The experts on fertility would try out different methods like increasing the amount of estrogen or change the way how estrogen is given. There are other instances when women might be given supplemental medicines, while for some, the problem will continue to exist.

What Should Be Done In Case The Problem Persists?

In case the problem continues for some women, then there are certain approaches which experts might look to adopt. The first one is to cancel the transfer of embryo and try once again at any later stage, that too with a different treatment method.
The second option which they could think of is to go ahead with the transfer, wherein they might feel that a thin lining does not necessarily mean that it is impossible for a woman to get pregnant but definitely the efficiency would be reduced.
One last option is to make use of the opportunity for undergoing additional tests which would help them to assess the ability of the uterus to allow implantation of the embryos.
Unexpected Ovulation
For enabling the embryos to get implanted into uterus, placing them very precisely and at the appropriate time is important. This is regarded as the window of implantation. The time taken, is based on the time frame since progesterone reaches the lining of the uterine.

Doctor knows the exact time to place the embryos, right from the time he or she instructs a woman to start having progesterone supplements. In case a woman was to ovulate, the production of progesterone would begin earlier than the normal time and would lead to the shift of the window of implantation. As identifying the correct time of ovulation is almost impossible, so that would lead to some sort of uncertainty into the timing.

Due to this reason, there are doctors who would use medication in order to prevent unexpected ovulation from occurring. Generally an injection called Lupron is usually used as medication.

Timing for the Embryo Transfer is Inappropriate
This is a problem related to early ovulation. There are case when the implantation window is shifted, still the timing of the transfer becomes accurate. Recent studies have shown that quite a nominal percentage of women might have a window of implantation, which could be either earlier or later than normal time. A test called the Endometrial Receptivity Array can help determine at what time is the window of implantation open.

Frozen Embryo Transfer - Complications Associated With It!

If you are trying to get pregnant through IVF, then you must be receiving a lot of suggestions from people close to you. You get suggestions about lifestyle changes, changes in your diet and much more. You will definitely get to hear about the Mediterranean diet in that list. This is one of the best diets that can ensure a healthy pregnancy.

There are so many studies conducted on the right diet for women to achieve a healthy pregnancy. A diet which is rich in vegetables, fruits, high fibre, whole grains and fish is good and the Mediterranean diet has just what a woman requires.

What is the Mediterranean diet?
The Mediterranean diet includes eating fresh fruits and vegetables. It also includes good fat, proteins and carbohydrates. When you are opting for IVF treatment, your overall lifestyle plays an important role such as the food you consume. You need to add more proteins to your diet as that can help in the production of eggs. You need to consume vegetable protein and not just animal protein.

How can the Mediterranean diet influence the results of an IVF?

Your body should be able to absorb the nutrients from the food that you eat. This will help in the production of quality sperm, egg and hormones. So, the Mediterranean diet can help you with that.
The Mediterranean diet helps manage blood sugar levels. Most women crave sweets or experience mood swings caused by hormones good food can help control these. When you are able to manage your blood sugar with the help of this diet, then you will be able to produce good quality or healthy eggs.
You will have to make sure that the food you are eating is protecting the cells from radical damage. When the cells in the body are damaged, then they will impact the quality of the sperm and egg produced. The Mediterranean diet is high in antioxidants that protect the cells.
The Mediterranean diet contains good fats. Fats from fish are very good as they boost the cell membranes. Inflammation is also prevented with the help of this good fat.
Apart from that, you will also find the Mediterranean diet useful in reducing obesity, heart diseases and diabetes.
Being overweight can also be one of the reasons for not getting pregnant. This diet will help you maintain a good weight. People with sleeping disorders are also able to overcome the problem. So, overall the Mediterranean diet is the best diet for maintaining overall health. Overall good health will guarantee a good and healthy pregnancy. 

Mediterranean Diet - How Can It Influence The Results After IVF?

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