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

Diabetes during pregnancy is known as gestational diabetes. It is interesting to note that the chances of getting gestational diabetes, is one of the most common complication of pregnancy. It has increased by almost 40%. Also, gestational diabetes not only affects the health of the mother, but also the health of the baby. What usually happens with gestational diabetes is that the blood sugar level, of both the mother and the baby go above the normal level. Ayurveda can help treat this disease. Here are the most common Ayurveda remedies for gestational diabetes.

1. Gurmaar
Gurmaar, called "The Sugar Killer" is also known as Gymnema sylvestre in medical jargon. Gurmaar also contains gymnemic acid molecules, which are crucial because they have an anti-diabetic effect. They work by combining with glucose molecules, which are in the blood stream. These stop the glucose from entering the bloodstream. 

2. Karela
Karela is commonly known as bitter gourd and its biological name is Momordica charantia. It has anti-diabetic properties and also contains many other micronutrients, which are crucial in preventing the complications which arise from gestational diabetes.

3. Vizaysaar
Vizaysaar comes from the bark of a tree whose biological name is Pterocarpus marsupium. It is very useful for diabetes. If you immerse the wood of Vizaysaar in water overnight and then drink it, your blood sugar levels are expected to fall.

4. Saptrangi
Saptrangi is biologically known as Salacia oblonga. Just like Vizaysaar, it is a tree whose bark is immersed in water and then drunk by the patient suffering from diabetes. You will know that the water is ready for drinking when it turns brown, which usually happens overnight. It is also being studied in Western herbal schools in addition to Ayurveda nowadays.

5. Tulsi
Tulsi is a holy plant in Hindu mythology and is known as Ocimum sanctum in biological terms. It is worshiped as a holy plant because it has tremendous medicinal properties including treating many types of cancers, cough, cold, sore throat as well as reducing blood sugar.

6. Ashwagandha
The medical name for ashwagandha is Withania somnifera. It is another great remedy for diabetes.

Ayurveda and Gestational Diabetes

There are two types of abortion, namely medical and surgical. In case of medical abortion, pills are taken to terminate the pregnancy; whereas, surgical abortion is done if the pregnancy has reached an advanced stage when pills are ineffective. While generally there are no health risks or negative effects of abortion on fertility, there are rare cases of complications, which can give rise to severe symptoms post abortion. Following is the information you need to know about abortion and its effects on fertility:

When to seek medical assistance
It is advisable to seek medical help if you have the following symptoms post abortion:
1. Persistent pain in the lower abdomen, which lingers even after taking medication
2. Excessive bleeding
3. A high temperature

Possible effects of surgical abortion on fertility
1. Infection after abortion: infections post abortion like pelvic inflammatory disease (pid), if left untreated for long can spread and harm your reproductive organs, thereby impacting your fertility. It can cause complications like infertility or ectopic pregnancy.

2. Damage to the cervix during abortion: damage to the cervix during an abortion can cause cervical incompetence and consequently increase the risk of miscarriage.

3. Damage to the womb during abortion: there are chances of damage of the womb (uterus) during abortion, resulting in scarring, which can cause fertility issues if not corrected. This is more likely in case you had multiple abortions.

Apart from the above mentioned complications there are a number of other complications, which can happen due to abortion, preterm birth, vaginal bleeding during pregnancy and low birth rate, etc. Further, infertility can also be a possible side effect of abortion pills, which happens due to scarring of the uterus during the procedure of forcible elimination of the fetus. In all such cases it is advisable to schedule regular check up with your gynaecologist.

Can Abortion Affect Fertility?

Insulin is the most common treatment prescribed for people affected with diabetes. Diabetes is condition where high amounts of glucose prevail in the blood for an extended period of time. However, there are some drugs that offer an alternative to insulin in treating diabetes, which are:

1. Liraglutide: Liraglutide is a glucagon-like peptide-1 (GLP-1) drug that causes the body to release greater amounts of insulin so as to facilitate the movement of glucose from the blood to the cells. People with type 2 diabetes generally use this treatment. It slows the digestion process and can cause symptoms of headache and nausea. 

2. Pramlintide: It's an artificially produced version of amylin. It is taken by both type 1 and type 2 diabetic patients, facilitates slower digestion of food and therefore, controls release of sugar in the blood. It can cause tiredness and nausea.

3. Dulaglutide:This treatment is for people affected with type 2 diabetes and it is administered once a week. It causes more insulin to be released and pass the glucose to the cells. It can cause loss of appetite, nausea and abdominal cramps as side effects.

4. Albiglutide: This treatment facilitates pancreas to release insulin and limits the glucagon hormone production. It is used by type 2 diabetes patients who have not taken well to other treatments. The side effects are skin reaction, respiratory tract infection and nausea.

5. Exenatide: It is a drug that causes pancreas to release insulin that facilitates movement of glucose to cells. It is a treatment for type 2 diabetes and it restricts release of glucagon in the body. The possible side effects are acidity, constipation and vomiting.

Common Insulin Alternatives

The average blood sugar rises gradually and as it rises there is damage occurring throughout the body. Out of control blood sugar levels can lead to serious short term problems such as hypoglycemia, hyperglycemia, or diabetic ketoacidosis.

In the long run, uncontrolled blood sugar can also damage the vessels that supply blood to important organs, like the heart, kidneys, eyes, and nerves. This can occur even when you feel OK. That's why it's so important to take action as soon as you're diagnosed with diabetes. Our bodies are amazing, but unfortunately once you have a heart attack or stroke, or your kidneys fail, or you become blind, the damage cant be undone.

The good news is that paying attention to blood sugar control can help keep you healthy and prevent health problems from happening later. Some tips - 

1) Keep your blood glucose within your goal range as much as possible. Work with your diabetes team to develop and maintain a plan.

2) Take your diabetes medication as prescribed. If you're on insulin, ask to see a diabetes educator to learn how to adjust your dose.

3) Increase physical activity. If you aren't physically active, talk to your health care provider about suitable activities. If you haven't exercised in a while, consider beginning with five to ten minutes of daily physical activity and gradually increase your activity to at least 30 minutes of physical activity most days of the week.

4) Achieve and maintain a healthy weight. Even a 5 percent to 7 percent weight loss will help you better manage your blood glucose.

The quality of your future life depends on the decisions and actions that you take today.

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Why Managing Blood Sugar Levels Is Extremely Important

One of the most important decisions a couple takes is to start a family. It fills them with hope and joy of new future, but if the attempts have been unsuccessful for more than six months, it can take a toll on the relationship and the mental health of the couple. This is the time to seek fertility specialist who will be appropriate to analyze the situation and provide proper guidance. Read on to find out the exact indications to see a fertility specialist:

1. If a woman who is under the age of 35 is unable to get pregnant even after a year of having regular unprotected sex
2. A woman who has had more than three miscarriages
3. Someone who has suffered from blocked fallopian tubes and is in need of surgery
4. One who experiences irregular ovulation
5. A couple who has suffered from genital infections
6. A pregnant woman who has consumed an estrogen derivative
7. A man who has been diagnosed with low semen count, also known as poor motility
8. A couple who has not been diagnosed with any irregularity but is infertile

Which specialist should you visit?

If you or your partner or both have shown signs of infertility, then visiting the following specialists can be helpful:

Specialists for men

Urologists and Andrologists are specialists who treat men for infertility. Urologists conduct an analysis of semen quality, semen count, hormone levels, reproductive organs and abnormalities in bladder and kidneys. Andrologists are medical professionals who specialize in hormonal conditions and physiology of male infertility.

Specialists for women

Hormonal imbalance is one of the potent obstacles to pregnancy. If a general obstetrician/gynecologist has not been able to successfully treat a woman then she can visit a reproductive endocrinologist who specializes in hormonal disorders. Depending upon the nature of the problem, she can also visit a reproductive surgeon who deals with uterine abnormalities, endometriosis, and reproductive organ surgery.

When Should a Couple See a Fertility Specialist?

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