What are the factors that make a woman fertile? + The most effective way to address infertility

Infertility is the inability to get pregnant after a year of unprotected intercourse. Both men and women can be infertile.

In about one-third of cases, the cause of infertility involves only the male.

In about one-third of cases, the cause of infertility involves only the female.

In the remaining cases, the cause of infertility involves both the male and female or no cause can be identified.

Women are born with a finite number of eggs. Thus, as the reproductive years progress, the number and quality of the eggs diminish. The chances of having a baby decrease by 3% to 5% per year after the age of 30 and this reduction is noted to a much greater extent after age 40.

Female infertility can also be caused by a number of factors including:

1. Damage to fallopian tubes

Damage to the fallopian tubes can prevent contact between the egg and sperm. Pelvic infections, endometriosis, and pelvic surgeries can lead to fallopian tube damage.

2. Hormonal causes

This can lead to ovulation disorders which prevent the ovaries from releasing eggs such as in polycystic ovary syndrome ,  hyperprolactinemia or disorders of the thyroid gland - hyperthyroidism / hypothyroidism, can interrupt the menstrual cycle and cause infertility.

3. Cervical causes

A small group of women may have a problem in which the sperm cannot pass through the cervical canal. Whatever the reason is , this problem may be treated with intrauterine inseminations.

4. Uterine causes

Abnormal anatomy and distortion of the uterine cavity due to the presence of polyps and fibroids or problem with the endometrial lining can lead to failed implantation of the embryo.

Endometriosis occurs when endometrial tissue grows outside the uterus - often affecting the function of the ovaries, uterus, and fallopian tubes.

5. Primary Ovarian Insufficiency:

Also called as Premature Menopause, when the ovaries stop working prematurely before the age of 40. Certain conditions are associated with early menopause like immune system diseases, radiation or chemotherapy and smoking.

Causes of male infertility may include:

1. Abnormal sperm production or function due to various problems, such as undescended testicles, genetic defects, health problems including diabetes, prior infections such as mumps, trauma or prior surgeries on the testicles or inguinal region.

2. Problems with the delivery of sperm, due to sexual problems, such as premature or retrograde ejaculation, certain genetic diseases, such as cystic fibrosis, structural problems, such as blockage of the epididymis, or damage to the reproductive organs.

3. Overexposure to certain chemicals and toxins, such as pesticides, radiation, tobacco smoke, alcohol, frequent exposure to heat can elevate the testicular temperature, impairing sperm production.

4. Damage related to cancer and its treatment, including radiation or chemotherapy for which timely cryopreservation can be done for future use.

5. Unexplained infertility, In approximately 20% of couples the cause cannot be determined using the currently available methods of investigation.

Why is IVF the best way to treat infertility in women?

Conception is a complicated process that depends on upon many factors:

On the production of healthy sperm by the man and healthy eggs by the woman

The sperm's ability to fertilize the egg when they meet.

The ability of the fertilized egg (embryo) to become implanted in the woman's uterus

IVF (or in-vitro fertilization) is a lab procedure where the sperm and the egg are combined in a dish (where fertilization takes place) and is followed by transferring the embryo (the fertilized egg) into the uterus. It is increasingly being used as a method to conceive as it has been established as a safe procedure that helps bypass a number of complications women may face while conceiving such as ovulation problems and issues with the fallopian tube.

Even women who face issues such as PCOS, endometriosis, and premature ovarian failure can conceive through this process. Moreover, IVF has been in practice since 1978 and has a safe track record. The success rates of IVF are high as well, making it a preferred procedure for couples who suffer from fertility problems. Unexplained infertility can also be treated with the help of this procedure.



What factors that  make a woman fertile? + The most effective way to address infertility

Contraceptives are generally drugs and devices, which are used to prevent pregnancy. A large number of contraceptives are available which allow the couple to enjoy sex without running the risk of unwanted pregnancies. The general categories of contraceptives are explained below:

Barrier Methods:
i. Male Condom: It is one of the most common forms of contraception. They are worn on the penis before sex is initiated. For safety purpose, a new condom should be used every time the person has sex.

ii. Female Condom: Much like male condoms, these are available at over-the-counter pharmacies without prescription. The condoms can be inserted to the vagina anytime within a period of 8 hours prior to sex.

iii. Diaphragm: This should be coated with a spermicide before sex and placed inside a woman's vagina so that the sperms are prevented from entering the uterus.

iv. Cervical Cap: These are used as replacements for diaphragms because some women may develop bladder infections such as cystitis while using it and these caps have lesser contact with the vagina.

Hormonal Methods:
The main implementation of hormonal changes to provide contraception is the pill. This is the most common form of female contraception available. It comes in two forms:
i. Combined contraceptive pill: Contains a combination of hormones such as progestin and oestrogen.
ii. Mini-pill: Contains only progestin: It is available only with the prescription of the doctor and should be used as per the prescription.

Intrauterine Devices
The intrauterine device (IUD) is a long-acting and reversible form of contraception for women. It is of two types: Copper IUD (contains copper) and Hormone-releasing IUDs (progestin hormone is released into the womb slowly). It is a small device that is fitted inside the womb and it provides contraception by facilitating the prevention of fertilization of the egg.

Sterilization
This is a lifelong option that is available for both men and women. In males, the procedure is known as vasectomy which basically ties and cuts off the tubes that carry the sperm.

In women, two forms of sterilization are available; surgical and non-surgical. Surgically, the fallopian tubes are cut and tied using small cuts in the belly so that the ovaries and uterus are not linked. Non-surgically, coils are inserted into the fallopian tubes so the resultant development of scars leads to complete blockage of the tubes.

Other forms of contraceptives include contraceptive patches, vaginal rings, contraceptive injections, spermicides and contraceptive implants.

Different Types of Contraceptives and Its Uses

What You Must Know About ZIKA VIRUS

Introduction to the ZIKA VIRUS:

After the deadly Yellow Fever and Ebola pandemics, Zika Virus is yet another disease borne out of the African soil and spreading across the world right now. Named after the Zika forest in Uganda, where it originated, this virus spreads through a mosquito bite - that of ‘aedes aegypti’ mosquito. It can also be passed on from mother to child, blood transfusion and sex. 

What’s so deadly about ‘Aedes Aegypti’ Mosquito?

Zika Virus spreads via ‘aedes aegypti’ mosquito, same mosquito that also spreads Dengue and Chikungunya.These mosquitoes typically lay eggs in and near still water found in buckets, bowls, animal dishes, flower pots and vases.  They are aggressive daytime biters, prefer to bite people, and live indoors and outdoors near people.
These mosquitoes become infected when they feed on a person already infected with the virus. Infected mosquitoes can then spread the virus to other people through bites.

Symptoms of Zika Virus Attack
A person bit by an infected mosquito takes about 2-7 days to show symptoms like:
- Mild fever 
- Skin Rash
- Conjunctivitis
- Muscle and joint pain 
- Weakness and Fatigue

However, it lasts no more than a week and is usually milder than its cousins Dengue or Chikungunya. Although it is not a fatal disease, the real reason behind the panic is for the women who are pregnant. Zika is found to be a major cause of microcephaly – a birth defect due to which children are born with visibly smaller heads, severely limiting their mental and physical abilities. 

Should India Worry?

While it originated in the African continent, Zika has already taken South American countries like Brazil, and most others. Although the virus hasn’t reached Indian shores yet, we are very prone to mosquito borne diseases. The Dengue menace since last few years says it all. Since it is from the same family, we need to be all the more cautious. 

Preventions and Precautions:

Since no vaccine exists to prevent Zika virus attack, it’s best to act with caution to prevent the spread.

1. Mosquitoes that spread Zika virus bite mostly during the daytime. Stay in places with air conditioning or that use window and door screens to keep mosquitoes outside.
2. Use Mosquito Repellents during the day when exposed to areas prone to mosquitoes and cover yourself very well.
3. Never allow water to stagnate in or around your habitation. Avoid letting the water stand for long eg: puddles, or water in buckets or potted plants, sewage etc.



What is ZIKA VIRUS? Is it Deadlier than Dengue? Is India Ready To Face the ZIKA 

Caesarean section or C-section is fairly common today and most mothers do not realize that once their incision has healed completely, the scar tissue problems can still occur. Unfortunately, there are no instructions for how to heal and care for C-section scars after they go home. The general post-operative instructions from hospital include a list of activities to avoid like lifting heavy articles and driving.

Caesarean scars can cause pain well after they've healed. This happen at the site of incision, but in other areas as well. It's important to remember that the scar you see on a mother's lower abdomen is just one spot that scar tissue has formed. There are also internal scars which can spread throughout the body over a time period. This scar tissue can cause lingering pain and dysfunction well after delivery.

When our body tissue gets damaged, scar tissue forms. After a C-section, scar tissue forms along the abdomen and uterus as part of the natural healing process. Caesarean scars can be painful and mothers feel pain or tightness in their scars when they are reaching, leaning, lifting or standing up straight. The scar can cause muscle, connective tissue, and nerve damage in areas adjacent to scarred area. Over time this can lead to pelvic pain, bowel problems like constipation and irritable bowel syndrome and painful sex.

C-section scars are typically located in an area where they can entrap nerves. This can cause pain and also create an urgency or frequency to urinate. The best thing for a new mother is rest and recovery and doing too much, too soon, after a caesarean is a health risk. It is important that to keep incision clean, eat well and avoid lifting heavy articles to support healing. It is recommended that mothers have lymphatic and myofascial massage two days prior to surgery and as soon as possible post-surgery. Lymphatic massage is a light massage assisting in drainage and allows the collagen to align with the incision.

At three months post-caesarean mothers can begin scar tissue release therapy that involves massaging of the scar tissue so it becomes softer and more flexible like the surrounding skin and internal tissues. It needs to be done with three dimensional focus, slowly and gently separating the adhered tissues in all directions. The scar tissue release therapy painful with a burning sensation for some mothers, while some only feel mild discomfort or no pain at all.

Regardless of the age of the scar, one could get benefits from scar tissue release therapy from injuries to burns to surgical scars. Surface and internal scarring from surgeries could be contributing to many of the issues. Sometimes scarring is just a piece of the puzzle of your pain and so a pelvic floor physiotherapy in addition to scar tissue release therapy is recommended. The scar tissue release therapy reduces the appearance of C-section scars. It softens tissues and increases circulation, which all lead to a lightening in colour of the C-Section scar.

Tips to Deal with Caesarean Section Stiches

When you are pregnant, your body is at a very delicate stage as you are carrying another individual inside you. While you are pregnant, there are many restrictions and regulations you must follow to ensure the birth of a healthy child. Bad habits such as smoking and consuming alcohol are strictly prohibited. It is also advised that you should not be in any kind of stress.

When it comes to travelling, it depends on the stage of your pregnancy. You should consult your doctor before travelling and know well about the restrictions that would be imposed, even if you are allowed to travel. The ideal time for you to travel during pregnancy is after the second trimester, when you will be less fatigued.

Here are some tips you should follow if you choose to travel when you are pregnant.
Travelling by car, train
1. You should always put your seatbelt on while travelling in a car when you are pregnant. Wear both the lap belt and the shoulder belt to keep yourself and your baby inside, safe and static.
2. The airbags should always be turned on for safety purpose.
3. Buses are narrow and should be avoided when you are pregnant. If you are availing a bus, avoid getting up when the bus is moving. In case you have to move, take the support of the railings.
4. When you are travelling by train, always hold on to the railings and seats while moving about in motion.
5. Avoid long hour journeys in cars or trains. The maximum travel duration should be not more than six hours, when you are carrying a child.
6. Make it a point to halt at points to take a walk. This would enhance your blood circulation.

Travelling by air, sea
1. This mode of travel is safer than any other travel modes for pregnant women.
2. Pregnant women can fly until eight months or nine months, after consulting a doctor.
3. Moving about in an airplane, which is flying is a bad idea for pregnant women and should be avoided.
4. Always choose an aisle seat while travelling by air. It will make moving convenient in case you need to visit the restroom.
5. Choose to travel on trustworthy, major airlines with a pressurized cabin and avoid small airplanes or private jets. Do not travel above a height of 7000 ft.
6. Travelling by sea should be strictly avoided as it causes motion sickness and pregnant women might have nausea.

Travel for pregnant women is restricted in many ways, and all the instructions should be followed.

Is It Safe for Me to Travel During Pregnancy?

Nutrition for you will never be as important to you as it is during pregnancy, because while eating you have to think not only about you, but also the development of your unborn child. However, merely eating is not enough you have to eat right. Here is your guide of what to eat and what to avoid, during pregnancy, so that your child gets the best nutrition.
Things to eat: 
1. Whole grains- whole grains, which can be found in food items like cereals, whole-wheat breads and pastas, are rich in folic acid, iron and fibers. Make sure you incorporate ample amount of whole grains in your diet to remain healthy during pregnancy.
2. Beans- beans are extremely nutritious for pregnant women, as they contain protein, fiber, iron, folate, zinc and calcium, which are much needed for the development of a healthy baby.
3. Fish- incorporate enough fish in your diet because they contain healthy omega-3 fatty acids. Salmon, for example, is exceptionally good for health since it contains less mercury than other fish.
4. Eggs- eggs are rich in protein, and is also a good source of other nutrients like amino acids, vitamins and minerals, including choline which is crucial for the baby's brain development.
5. Berries- berries contain vitamin c, calcium, folate and fiber, which is important to your diet, besides being a delicious addition to your meal.
6. Low fat yogurt- sweetened yogurt is extremely bad for your health, but a cup of plain, low fat yogurt contains copious amount of calcium and is also a good source of proteins.

Things to avoid: 
1) soft cheese- soft cheese, like feta, blue cheese, brie, etc. Are made of unpasteurized milk, which contain listeria bacteria which might be fatal for you and your child. Hence, they are best to avoid.
2) undercooked or raw food-raw meat may contain toxoplasma and other bacteria. Raw eggs in sauces like mayonnaise, uncooked dough, desserts like tiramisu and salad dressings are also harmful for you. Fish in sushis or self caught fish may also contain harmful bacteria and parasites or chemicals released from nearby factories. Do ensure that your meat and fish are thoroughly cooked while dining out as well.
3) unpasteurized juices- there is always a risk of juices, which are squeezed and unpasteurized, being contaminated with e-coli or salmonella, which can be very harmful for you.
4) pre-dressed poultry- poultry that has been dressed and stuffed at the market often run the risk of being contaminated by the juices of slaughtered poultry, proving to be best breeding grounds for bacteria.
5) unwashed fruits and vegetables- toxoplasma can breed on unwashed raw foods, which also cause harm to your health, mainly in the prenatal period.
6) alcohol, coffee and unpasteurized milk- these beverages have been deemed unsafe for pregnant ladies since they can cause severe health damages.

Nutrition Tips for Pregnant Women

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