In vitro fertilization (IVF) is a process of fertilization in which eggs (ova) from a woman's ovary are removed. They are combined with sperm outside the body in a laboratory procedure, and then the fertilized egg (zygote) is transferred to the same or another woman s uterus for a successful pregnancy.

IVF is one of the several assisted reproductive techniques (ART) used to help infertile couples to conceive a child.

Causes of Infertility

Blocked fallopian tubes
Hormonal imbalance
Endometriosis
Women with ovulation disorder
Uterine fibroids
In the man, low sperm count or poor quality sperm
Genetic disorder
Procedures
Two procedures are done to gain access to ovaries

It involves inserting the needle through the vagina (transvaginally). With the help of an ultrasound machine, the physician guides the needle to the location of the ovaries
In the other procedure, called laparoscopy, a small thin tube with a viewing lens is inserted through an incision in the navel. This lets physician to see inside the patient, and locate the ovaries.
Method
Without additional techniques, the chances of pregnancy would be extremely small. The additional techniques used in IVF include-

Ovarian hyperstimulation- Stimulation to induce development of multiple follicles of the ovaries.
Final maturation induction- Induction of final oocyte maturation is performed, generally by an injection of human chorionic gonadotropin (HCG), when the ovarian follicles have reached a certain degree of development. This is known as the "trigger shot  
Egg and sperm preparation- Semen is prepared for fertilization by removing inactive cells and seminal fluid in a process called sperm washing. An oocyte selection may be performed prior to fertilization to select eggs with optimal chances of successful pregnancy. 
Co-incubation- Eggs are removed from the woman and placed in one of the fallopian tubes, along with the man's sperm. This allows fertilization to take place inside the woman's body. Therefore, this variation is actually an in vivo fertilization, not in vitro.
Embryo culture- The main durations of embryo culture are until cleavage stage (day two to four after co-incubation) or the blastocyst stage (day five or six after co-incubation)
Embryo transfer- The number to be transferred depends on the number available, the age of the woman and other health and diagnostic factors. Embryos are transferred to the patient's uterus through a thin, plastic catheter, which goes through her vagina and cervix.
Aftercare
After the IVF procedure is performed the woman can resume normal activities. A pregnancy test can be done approximately 12-14 days later to determine if the procedure was successful.

Risks

Multiple pregnancies
Ectopic pregnancy
Ovarian rupture, bleeding
Infections
Complications of anesthesia

In Vitro Fertilization - Quick Facts!

Vaginal bleeding is something that most women experience between their periods when they are not due for a menstrual cycle. It is considered as an abnormal occurrence when you bleed before you are expecting your menstrual period, or after you are done with your monthly cycle. It is usually characterised by bouts of spotting where a thick brown reddish discharge may be experienced. Also, this kind of bleeding is considered abnormal if it occurs during pregnancy or menopause.

Here are a few causes of abnormal vaginal bleeding:
1.  Hormones: An imbalance in the hormones like the estrogen and progesterone can lead to abnormal vaginal bleeding. These are the hormones that help in regulation of the monthly menstrual cycles. An imbalance can occur due to side effects caused by birth control pills that may not suit the individual, a contraceptive patch, or even contraceptive implants and injections. Further, an intrauterine device may also be the cause for this kind of bleeding. The hormonal balance can also get affected due to internal ailments like a dysfunctional thyroid gland and ovaries.

2. Pregnancy and Delivery: Some amount of spotting is considered normal in the first trimester of one's pregnancy. Yet, severe bleeding and persistent spotting must be reported to the gynaecologist immediately. Women also bleed for a while after the delivery of the baby, in the postpartum period. This may also happen when an abortion takes place as the uterus may not have come back to its original size and due to remaining foetal tissues within. Complications during the pregnancy like an ectopic pregnancy or a miscarriage can also lead to such kind of bleeding. An ectopic pregnancy is one where the egg gets implanted in the fallopian tube instead of entering and implanting itself in the uterus.

3.  Fibroids: Uterine fibroids are usually considered as non-malignant and non-cancerous growths within the uterus. These are common in many women who have gone through childbirth. These fibroids can also cause some amount of bleeding and spotting.

4. Infections: When there is an infection in the reproductive organs like the ovaries and uterus of the patient, there may be some amount of bleeding. An infection in this area can also cause inflammation, which is one of the primary causes of abnormal bleeding. This can also occur due to a sexually transmitted disease or STD, as well as painful intercourse and sexual abuse which can lead to scarring as well.

5. Cancer: One of the least common causes includes cervical, ovarian and other forms of cancer. 
Stress and diabetes can also cause abnormal vaginal bleeding in rare cases. It is best to see a doctor as soon as such bleeding takes place.

Causes of Abnormal Vaginal Bleeding

Polycystic ovarian syndrome or PCOS is a condition in which a woman experiences fluctuation of hormone levels, estrogen, and progesterone which causes cysts in her ovaries, dysfunctional menstrual cycle, cardiac problem, fertility and changes in appearance. Hormones are chemical messengers that can trigger a number of issues in the body. Long term problems due to PCOS can be avoided with an early diagnosis and a proper treatment.

Causes
- Genetics and hormonal imbalance have been identified as the main causes of PCOS although the exact reason has not been discovered.
- Overproduction of androgen, a male hormone in a woman can cause small lumps in the ovaries, irregular development of eggs and abnormal insulin level.

Symptoms
The severity of the symptoms depends on the constitution of the person but the most common one is irregular periods. PCOS occurs when there is a decrease in sex hormones which can lead to the development of certain male features like:

- Deeper voice
- Growth of hair on face, toes, stomach, chest and back
- Reduction in breast size
- Loss and thinning of hair

There are other symptoms as well which can help one to determine the syndrome including:
- Oily skin leading to acne
- Irregular egg formation causing fertility problems and miscarriages
- Depression, anxiety and mood swings
- Hyperinsulinemia, that refers to the presence of too much insulin in the body which can cause obesity
- Difficulty in breathing while sleeping

The severity of the symptoms varies but if you are experiencing any of these problems, it is advisable to seek a professional consultation. A healthy lifestyle, regular exercise, nutritious diets are some of the preventive measures you can take. There are hormone regulating medicines and treatments that attempt to curb the condition but there is no permanent cure.

What is Polycystic Ovarian Syndrome?

Roti vs. Rice- What should you have your meals with?

The nutritional conflict between rice and roti is age-old, as primary staples of every Indian cuisine.  White rice and wheat chapattis are both infused with considerable amounts of protein, calorie, fat as well as fibre. This overlap makes it tougher to choose just one as an accompaniment with your meals.
The health-conscious can take a sigh of relief with this list of effective benefits of the two. Let’s pit them against each other!

#1: If you opt for a lighter meal…Choose rice!
Boiled white rice is easier to chew and digest as it is low in fibres. For those with issues of diarrhoea, colitis, an upset stomach or morning sickness, rice is a favourable choice. If you are suffering from chronic gastrointestinal distress, rice is recommended for you.
Tip- You can consume a bowl of steamed rice with sautéed vegetables for a wholesome meal!

#2: If you are looking for muscle growth…Choose roti!
Rotis is the best food accompaniment for vegan and vegetarian bodybuilders. At home, you can mix variants of whole grains to harness the benefits of calcium and other minerals. Wheat chapattis made of whole grain consist of complex carbohydrates that boost your energy.
Tip- For reducing your portions, have two servings of roti (without ghee) with a large bowl of home-cooked yellow dal.

#3: If you have a heart condition… Choose rice!
For you to keep your heart healthy, the consumption of rice is vital. Brown as well as white rice is full of fibres and high in magnesium, niacin, phosphorus that can prevent heart problems.  Rice helps you in lowering bad cholesterol levels.
Tip- Substitute your regular white rice in the khichdi or biryani recipe with brown rice. (Contains fibrous bran and germ layer)

#4: If you want to feel fuller… Choose roti!
For weight watchers, who want the feeling of satiety for longer period should include rotis in their meal. Wheat rotis take longer to digest which helps in maintaining blood sugar levels. This quality also makes it a good alternative for diabetic individuals. Wheat rotis are nutritious and contain vitamins B1, B2, B3, B6 and B9 that help in keeping you strong.
Tip- While kneading the wheat dough for the rotis, you can add soya powder to increase its protein content.
To escape the dilemma of choosing between these two healthy and tasty staple sides, try switching to whole-wheat rotis and brown rice. Savour both, guilt-free!

If you would like to consult with me privately, please click on 'Consult'.

 Roti vs. Rice- What should you have your meals with?

4 Things that Cause Vaginal Dryness

Vaginal dryness is an uncomfortable and painful condition that usually occurs during or after menopause. The estrogen level in your body gets reduced during this time which eventually leads to vaginal dryness. However, there are other factors that can trigger this condition including certain medications and immune disorders. This is a problem that can affect women at any age but it is visible more frequently in older women.

Here are some common factors that may lead to vaginal dryness:

1. Hormonal changes - A decrease in estrogen level that occurs during menopause is one of the most common causes of vaginal dryness. The decrease in estrogen may also occur during perimenopause, during breastfeeding or after childbirth. Radiation and chemotherapy for cancer treatment may also result in a decrease in vaginal lubrication.

2. Irritants - Chemicals present in soaps, dyes, hygiene products and perfumes may cause allergy in some women. Irritants present in underwear or towels and other allergens like objects and lubricants that are placed in the vagina may also cause vaginal dryness.

3. Insufficient arousal - Low libido or other sexual problems may also lead to vaginal dryness. Poor sexual performance and early ejaculation may also contribute to it.

4. Anxiety - Sexual desire can be affected by emotional and psychological factors such as anxiety and stress that may eventually lead to vaginal dryness. High anxiety level in women results in insufficient flow of blood, causing vaginal dryness.

How can vaginal dryness be treated?

Topical estrogen therapy is a common method of treating vaginal dryness caused by low estrogen level. Topical estrogen helps in inserting some hormone that your body is no longer producing. This controls the vaginal symptoms to a certain extent but it does not replace as much estrogen as oral hormone therapy, in your blood stream. Lubricants and moisturizers may also be applied to reduce vaginal dryness and make sex less painful and uncomfortable.

Word of Caution

Please get a PAP Smear done before starting local estrogen and keep a follow up with your doctor.



4 Things that Cause Vaginal Dryness

Miscarriage basically refers to the phenomenon, when a developing embryo or the foetus in a pregnant woman dies a natural death, before it can manage to survive on its own. The common signs of miscarriage are vaginal bleeding accompanied with pain. It leads to depression, anger and guilt. The reasons for miscarriage are manyincluding use of tobacco, smoking, diabetes, extreme obesity, drug or alcoholic addiction. Here are some important signs that indicate you might be miscarrying:

 Bleeding: recurrence of bleeding, which keeps on starting and stopping indicates the downfall of your hormonal balance. You must get your pregnancy hormone levels checked. Very intense bleeding, which accounts for soaking your pad within an hour is an indication of the beginning of a miscarriage. However, bleeding is a common factor in normal pregnancy as well.
 Cramps: severe cramps in the vaginal region, accompanied by very heavy breathing and suffocation are other signs that you might be headed for a miscarriage. Sometimes, bleeding occurs along with the cramping.
 Disappearance of pregnancy symptoms: if you are pregnant, but the signs and symptoms of pregnancy start disappearing, a miscarriage may be indicated. However, it might not be the first major signal. For normal pregnant women, the signs of pregnancy do not appear for many days. You may not feel nauseated or your breasts do not get sore. For ten to fourteen weeks, this phenomenon is a normal one. However, in case it continues for a more prolonged duration, it might be an early sign of miscarriage.
 Pregnancy test results vary between positive and negative: results of a pregnancy test done very early may vary between positive and negative. This is completely normal. In case of obtaining the same results when you are already over two weeks pregnant, it may indicate a miscarriage. You might be having an ectopic pregnancy. Spotting is also noticed in the vaginal region. If you had a pregnancy test showing positive results, but the results come negative after re-taking the test a few weeks later, it is high time for you to consult a gynaecologist. You have to deal with ectopic pregnancy before choosing a surgical path. Varying results signify that something is wrong. The urine produced by the body is less concentrated.

A case of miscarriage is very painful for the pregnant woman as well as her family. You should keep healthy, and avoid all bad habits to keep away from miscarriage.

5 Signs That You Might Be Miscarrying

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