Female infertility is considered as the inability of conceiving. As per WHO it is described as the inability to be pregnant, maintain and carry forward a pregnancy to its full term. It is often of two types:

    Primary Infertility: This is the inability to give birth to a baby either due to the inability to become pregnant or maintain a pregnancy, which includes stillborn and miscarriage.
    Secondary Infertility: This refers to the inability to give birth when there is already a live birth or the woman was pregnant.

The causes of infertility can vary from being acquired or genetic. However, following factors are largely responsible for infertility:

    Genetic: Some genes can lead to mutation leading to infertility like, in case of BMP15 gene there is a hypergonadotrophic ovarian failure which causes infertility.
    Acquired: This is caused by factors like age, smoking, sexually transmitted diseases, obesity, body weight, eating disorders, diseases like diabetes, thrombophilia and also radiation and chemotherapy.

The treatment for infertility usually depends on the cause, age, duration of time for which a person has been infertile and preference of the patient. Infertility is believed to be a complex disorder and the treatment involves a huge amount of physical, financial and psychological commitments. All this also requires a lot of time. Some women might need just a minimum of two therapies to attain fertility while others might require different treatment before they can conceive.

Treatment is largely aimed to restore the fertility either by means of medication and surgery or help in reproduction with the help of some procedures.

Fertility Restoration through medication

This is the main treatment for women who are infertile because of ovulation disorders. These drugs include:

    Gonadotropins: These are injected to stimulate the ovaries. Drugs like Menopur, Repronex, Follistim AQ, Gonal-F, Bravelle restore the production of eggs, while Ovidrel and Pregnyl are used for maturing the eggs and for their release.
    Clomiphene citrate: This is taken orally and stimulates ovulation by releasing more Follicle Stimulating Hormone and Luteinizing Hormone from the pituitary gland.
    Metformin: This is used in females who have PCOS and also when insulin resistance plays a major role in infertility.
    Bromocriptine: Used when the infertility is caused due to excess prolactin production.
    Letrozole: This also induces ovulation

Fertility Restoration through surgery

Surgical procedures can amend the problem of infertility. However, these treatments are very rare these days owing to the success of other fertility treatments. These include:

    Tubal ligation reversal surgery: In case a tubal ligation has been performed it can be reversed by reconnecting the tubes again through surgery.
    Hysteroscopic surgery: This corrects or removes the abnormalities that cause infertility. This surgery can correct the shape of the uterus, remove endometrial polyps and improve chance of getting pregnant.
    Tubal surgeries: In case of blocked fallopian tubes laproscopic surgery can be performed to dilate the tubes, removed blockages or create a new opening.

Assistance in Reproduction through techniques

The most common used techniques for reproduction assistance are:

    Intrauterine insemination or IUI: In this about million healthy sperms are put in the uterus at the time of ovulation.
    Assisted reproductive technology: In this mature eggs are retrieved from a woman and this is then fertilized with sperms in a dish in the lab. Once the fertilization is done the embryo is placed in the uterus for further development. IVF is the most common and effective assisted reproductive technology. This procedure takes place over weeks with several blood tests and hormone injections.

Dealing with infertility is not easy and can be emotionally and physically draining. To cope with the various tests and treatments of infertility one should be fully prepared, eat a healthy diet, exercise reach out for help and support of family and friends and look for other options like a donor egg, adoption or no children.

Treatments of Infertility

Thyroid disorders are conditions that affect the thyroid gland, which is a butterfly-shaped gland in front of the neck. There are specific kinds of thyroid disorders that include:

Hypothyroidism
Hyperthyroidism
Goiter
Thyroid Nodules
Thyroid Cancer
Epidemiology, Incidence, and Prevalence
It has been estimated that about 42 million people in India suffer from thyroid diseases.

Hypothyroidism

Hypothyroidism occurs when the thyroid gland produces an insufficient amount of thyroid hormone. It can develop from problems within the thyroid gland, pituitary gland, or hypothalamus. 

Symptoms of hypothyroidism can include:

Fatigue
Poor concentration or feeling mentally "foggy"
Dry skin
Constipation
Feeling cold
Fluid retention
Muscle and joint aches
Depression
Prolonged or excessive menstrual bleeding in women
Common Causes of Hypothyroidism

Hashimoto's thyroiditis (an autoimmune condition that causes inflammation of the thyroid gland)
Thyroid hormone resistance
Other types involving inflammation of the thyroid, such as acute thyroiditis and postpartum thyroiditis
Hyperthyroidism

Hyperthyroidism refers to the excessive production of thyroid hormone, a less common condition than hypothyroidism. Symptoms of hyperthyroidism are usually related to increased metabolism. In mild cases, there may not be apparent symptoms.

Signs and symptoms of hyperthyroidism can include:

Tremors
Nervousness
Fast heart rate
Fatigue
Intolerance for heat
Increase in bowel movements
Increased sweating 
Concentration problems
Unintentional weight loss
Common causes of hyperthyroidism

Graves' disease
Toxic multinodular goiter
Thyroid nodules that overexpress thyroid hormone (known as "hot" nodules) 
Abnormal secretion of TSH
Thyroiditis (inflammation of the thyroid gland)
Excessive iodine intake
Goiter: A goiter is an enlargement of the thyroid gland, regardless of cause. A goiter may be associated with hypothyroidism, hyperthyroidism, or a normal thyroid function. 

Thyroid Nodules: Nodules are lumps or abnormal masses in the thyroid. Nodules can be caused by benign cysts, benign tumors, or less commonly, by cancers of the thyroid. If nodules are excessively large, they may cause symptoms related to compression of nearby structures. 

Thyroid Cancer: Thyroid cancer is more common among adult women than men or youth. About 2/3rd of cases occur in people under age 55. There are different kinds of thyroid cancers depending upon the specific cell type within the thyroid that has become cancerous. Most cases of thyroid cancer have a good prognosis and high survival rates, especially when diagnosed in its early stages.

Investigations

Blood tests are done to measure levels of thyroid hormones. Blood tests are also done to identify antibodies against thyroid tissue, such as titers of antithyroglobulin, antithyroperoxidase, or TSH receptor-stimulating antibodies.

Treatment

Thyroid disorders can be treated with medications or, in some cases, surgery. The treatment will depend on the particular disease of the thyroid.Medications can be given to replace the missing thyroid hormone in hypothyroidism. Synthetic thyroid hormone is given in pill form by mouth. When hyperthyroidism is present, medications can be used to decrease the production of thyroid hormone or prevent its release from the gland. 

Thyroid Disorder - What All Should You Know 

When the thyroid gland is affected, leading to the thyroid disorder of an underactive nature, it is termed as hypothyroidism. The thyroid gland which is found in the lower portion of the neck is critical to the proper functioning of the human body s metabolism. In simple words, the thyroid hormone being released by this gland has to travel throughout the body to help in the use of energy gained from the food consumed and to keep the vital parameters such as the heartbeat in the right condition. When some antibodies attack the thyroid gland, and don t permit it to release adequate amounts of hormones into the system, the hypothyroid condition results.

The Causes for Hypothyroidism
An inflammation caused to the thyroid gland can result in this condition. This is an auto-immune disorder, in the sense that some internal factors can trigger this inflammation. Medically, the inflammation is termed  thyroiditis . There are also other factors that can cause hypothyroidism. These include radiation therapy. If the therapy has been administered near the neck area and the rays have penetrated to the thyroid gland, the inflammation can occur. Even those suffering from hyperthyroidism, the overactive form of thyroid and given radioactive iodine treatment can suffer from this condition due to the damage caused to the gland. Lastly, certain specific medications, if consumed regularly, can cause the condition.

Particular Sections of the Community at Risk
While there is no strict division among the population on vulnerability to be affected by hypothyroidism, research has indicated that women, and that too older women, may be more at risk. Men may be at a lower risk. Besides this, there are other profiles such as race and age which can also have a bearing on the level of risk. Of particular significance is that people who already suffer from autoimmune disorders are more likely to suffer from hypothyroidism than others.

Symptoms and Diagnosis
Many symptoms might not be unique to the hypothyroidism condition and can be misleading. Constipation, depression, hair loss and fatigue are some of them and an experienced medical practitioner will weigh the other factors, including the profiles explained above to reach the proper conclusion. The conventional TSH (thyroid-stimulating hormone) and T-4 (thyroxine) blood tests will be advised by the physician and the results should provide a reasonable confirmation of the condition. If doubts still persist an ultrasound or scan can also be ordered.

Hypothyroidism Treatment
As mentioned, for the body s metabolism to function normally, it is essential that the thyroid gland releases the thyroid hormone in sufficient quantities. Treatment of hypothyroidism is therefore very essential. The most frequently followed treatment is to prescribe regular intake of the synthetic thyroid hormone called T4. It is usually available in the form of a pill and has to be taken daily. The physician will know the concentration and dosage to be advised. Periodically testing your blood is necessary to monitor the levels.

Inflammation Of The Thyroid Gland - Can It Be Safely Controlled & Treated?

Top 5 things all diabetics must do

As you are aware, diabetes is an increasingly common problem not only in adults but with children and young people too. Preventing or delaying diabetes is possible with a few lifestyle changes. And for those who have been diagnosed with type-2 diabetes, changes in lifestyle can prove beneficial to keep it under control. This is important and should not be taken lightly as diabetes can lead to other serious health complications. There are few simple things which if done regularly can keep you safe and absolutely fine.

5 ways to combat diabetes.

1) exercise - do minimum 45 to 30 minutes of exercise like brisk walking (for people with heart ailments make sure that you have done stress test/tmt). Keep yourself physically active all the time this will help you in losing weight, controlling blood sugar, blood pressure, cholesterol. It will also improve insulin sensitivity in your body. 
2) high fiber diet - include high fiber foods like fruits, vegetables, leafy vegetables, beans, nuts, seeds, and whole grains, cinnamon, green tea in your diet. This will improve your blood sugar level and also reduce your risk of developing diabetes and helps you to lose weight. Do not get into fad diets and tv commercials as they are often misleading.
3) reduce stress - tension and worry releases certain chemicals (stress hormones) which can increase your blood sugar level. Try relaxation therapy like meditation, yoga, music and soundful sleep.
4) restrict intake of alcohol - alcohol increases body weight, triglyceride (cholesterol) level and blood pressure. They may make you unaware of symptoms of hypoglycemia (low blood sugar which may be dangerous). They are empty calorie with no nutritional value. Permissible limit is 2 drinks (60ml) a day for men and 1 drink (60ml) for women, it is also not advisable to smoke.
5) regular check-ups - make sure that you regularly check your blood sugar levels and modify treatment from your diabetologist doctor (if required.) your body and your friend/ relative / colleague's body are different, so is your need of medicine for diabetes as well. What works best for them may not be right for you. So it is my sincere request is to avoid any self medication as it can be dangerous. Regularly undergo screening for early detection of diabetes complications like eye, nerve, heart, foot, kidney.

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Top 5 Things All Diabetics Must Do

While cold and cough are common, diseases like Addison s disease are rare. It is also known as chronic adrenal insufficiency or hypocortisolism as it is a result of insufficient production of hormones like cortisol and aldosterone by the adrenal glands. This disease can affect men and women of any age.

There are two types of Addison s disease. These are:

    Primary adrenal insufficiency: In this case, the adrenal glands themselves have a problem.
    Secondary adrenal insufficiency: If the hormone production in the adrenal glands is restricted by a problem that has started somewhere else like the pituitary gland, for example, it is known as secondary adrenal insufficiency.

Primary adrenal insufficiency is more common of the two. This could be triggered as a result of autoimmune diseases or a long lasting infection such as HIV, tuberculosis and some fungal infections. Cancer can also cause this type of Addison s disease.

Secondary adrenal insufficiency is usually caused by a problem with the pituitary gland or the hypothalamus as they are responsible for the production of hormones that stimulate the adrenal glands. Damage caused to the pituitary gland by tumors or radiation and surgery can also interfere with hormone production. Prolonged and improper use of steroid hormones can also trigger this condition.

Addison s disease has a very slow progression and its symptoms develop gradually over time. Some of these symptoms are:

    Weight loss and loss of appetite
    Extreme fatigue
    Hyperpigmentation
    Low blood pressure
    Craving for salt
    Nausea and diarrhea
    Pain in the abdomen and joint pains
    Irritability
    Depression
    Loss of body hair and sexual dysfunction in women

Treatment for Addison s disease involves hormone replacement therapy. This aims at correcting the hormone levels in the body. Hormone replacement therapy includes oral corticosteroids and corticosteroid injections. The dosage of these steroids could vary depending on the situation. For example, the doctor may suggest a temporary high dosage when the patient is in a stressful condition. Along with this, sodium is also recommended especially during the summer months and while exercising. This medication must be taken regularly as skipping a single dose can be dangerous.

In some cases this condition can become life threatening. An addisonian crisis causes a drop in blood pressure, sugar and a spike in potassium levels in the body. This requires immediate medical attention and can be treated with intravenous injections of hydrocortisone, saline solution and sugar.

Addison's Disease - What You Should Know About it

 Thyroid is a small gland situated in front of the neck and secretes hormones like thyroxine (T4) and tri-iodothyronine (T3). These hormones control various functions of our body like heart, blood pressure, digestion, metabolism, growth, blood formation, brain function etc. Any fluctuation in the functioning of the thyroid gland can have a great impact on health. The thyroid gland is primarily responsible for energy and metabolism. This gland triggers the genes that make all the cells in the body conduct their specific jobs. But over a period of time, the optimum functioning of the thyroid may reduce because of specific reasons. The gland may start to under-produce or overproduce the thyroid hormone, which may lead to conditions known as hypothyroidism or hyperthyroidism, respectively. 

Patients with hypothyroidism may feel extreme tiredness and fatigue even though they may be sleeping more than before. An unexplained gain in weight, constipation, inability to stand cold temperatures, and constant pain in muscles and joints are some of the other symptoms of hypothyroidism. 
Hyperthyroidism, or overactive thyroid, is an endocrine disorder. Patients with this disorder may experience excessive sweating, fatigue, and intolerance to heat. They may even experience restlessness, puffy or protruded eyes, hair loss, and muscle weakness. Such patients may lose weight and are unable to sleep properly at night. In some cases, palpitations or abnormal heart rhythm may also be experienced. 
Complications of Thyroid Disorder 

Hypothyroid and hyperthyroid can cause a number of complications if patients don t take medications. It is important for you to not to ignore any of the aforementioned symptoms and speak to your doctor as soon as possible. 

Hypothyroid complications

Myxedema: This condition is characterized by slowed thinking, swelling of tissues, and accumulation of fluid around major organs like brain, lungs and/or heart. This condition may prove life-threatening if not treated on time. 
Enlarged goiter: This is characterized by enlargement of the thyroid gland because of a constant increase in the TSH levels. High cholesterol and triglycerides: This may eventually pave way for heart disease and stroke. 
Sleep apnea: Sleep apnea is a disorder that affects nighttime breathing where the brain that temporarily stops sending signals to the muscles that control breathing, or by an obstruction in the airway. This may prove fatal if left untreated. 
Low blood pressure: This means not enough blood is getting to capillaries and tissues, particularly in your hands, feet, and brain. You may have chronic nail fungal infections and cold hands and feet if so. 
Hyperthyroid complications 

Heart disorders (cardiac arrest): If left untreated, excess thyroid hormones can lead to congestive heart failure and heart rhythm disorders. 
Osteoporosis: Too much thyroid hormones interfere with the body s ability to use calcium to build bone. This may lead to brittle bones and osteoporosis. 
Thyrotoxic crisis: This is a rare yet life-threatening complication characterized by high fever, vomiting, irregular heartbeat, and agitation. 
Hypertension or high blood pressure: It is a condition in which a patient has high blood force striking the walls of the artery An early diagnosis can help make the treatment of this disorder easier. 
Depending on the condition of the thyroid condition, it requires different ways to manage it. The conventional TSH (thyroid-stimulating hormone) and T-4 (thyroxine) blood tests will be advised and the results should provide a reasonable confirmation of the condition. If doubts still persist an ultrasound or scan can also be ordered. In case you have a concern or query you can always consult an expert & get answers to your questions!

Is Your Thyroid Gland Working Against Your Body? 

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