What is recurrent miscarriage?

If you have three or more miscarriages in a row, doctors call it recurrent miscarriage. If you have experienced recurrent miscarriage, your GP or midwife will refer you to a gynaecologist. Your gynaecologist will try to identify the reason for your losses.

Having miscarriage after miscarriage may leave you feeling utterly drained of hope. At times, it may be hard to keep trusting in the future. This experience affects every aspect of a woman s life from her mental and emotional health to her physical health and social well-being. 

If you can, try to draw comfort from the fact that most women who experience recurrent losses do go on to have a baby. This is especially the case if tests can find no reason for the losses. Six out of 10 women who have had three miscarriages will go on to have a baby in their next pregnancy.

Treatment of Recurrent Pregnancy Loss

Treatment for anatomic abnormalities of the uterus involves surgical restoration through removal of local lesions such as fibroids, scar tissue and endometrial polyps or timely insertion of a cervical cerclage (a stitch placed around the neck of the weakened cervix) or the excision of a uterine septum when indicated.

A thin endometrial lining has been shown to correlate with compromised pregnancy outcome. Often times this will be associated with reduced resistance to blood flow to the endometrium. Such decreased blood flow to the uterus can be improved through treatment with sildenafil (Viagra), Terbutaline and possibly aspirin.

Sildenafil (Viagra) Therapy Viagra has been used successfully to increase uterine blood flow. However, to be effective it must be administered starting as soon as the period stops up until the day of ovulation and it must be administered vaginally (not orally). Viagra in the form of vaginal suppositories given in the dosage of 25 mg four times a day has been shown to increase uterine blood flow as well as thickness of the uterine lining. To date, we have seen significant improvement of the thickness of the uterine lining in about 70% of women treated. Successful pregnancy resulted in 42% of women who responded to the Viagra. It should be remembered that most of these women had previously experienced repeated IVF failures.

Terbutaline this is a medication that relaxes the muscle in the uterine wall and so permits improved hormone delivery to the endometrium. The use of Terbutaline will often cause an increase in heart rate. It should not be prescribed to women who have irregular heart beats (arrhythmias), and women who have decreased cardiac reserve.

Aspirin this is an antiprostaglandin that improves blood flow to the endometrium. It is administered at a dosage of 81mg orally, daily from the beginning of the cycle until ovulation.

Selective Immunotherapy Using Intralipid, heparin, aspirin and corticosteroid

Many causes of pregnancy loss or failure can be treated with immunotherapy comprising combinations of aspirin and heparin and corticosteroids (dexamethasone or prednisone) and Intralipid (IL) to regulate increased NKa. Achievement of optimal success with Intralipid/corticosteroid therapy requires that the treatment be initiated well before ovulation takes place (about 7-14 days prior to anticipated implantation). Given the fact that only 10-15% of natural cycles (with or without the use of insemination and/or fertility drugs) will result in a pregnancy, it follows that repeated administration of Intralipid will be required in most cases before a pregnancy will occur. IVF achieves pregnancy rates that are often 2-3 times higher. This often makes IVF a treatment of choice in cases of immunologic recurrent pregnancy loss.

Role of IVF

Preimplantation genetic diagnosis (PGD) a procedure whereby the embryo can be tested for genetic or structural chromosomal abnormalities requires the use of IVF to select the best embryo(s) for transfer to the uterus. In cases of structural chromosomal (translocations) egg or sperm donation is often another option worth considering.

In those cases where due to intractable anatomical or alloimmune dysfunction IVF repeatedly is unsuccessful or is not an option, Gestational Surrogacy might represent the only recourse other than adoption.
If a couple with Recurrent Pregnancy Loss is open to all of the diagnostic and treatment options referred to above, a live birth rate of 70%   80% is ultimately achievable.

Recurrent Miscarriage - How to Deal With It?

Oral sex is a form of sexual activity, which involves the arousal of one's genitalia by his/her partner using the mouth (tongue, lips and throat). It is also called Cunnilingus (performed on a female) and fellatio (performed on a male). It is done before intercourse and during foreplay for sexual arousal. It is safe as compared to vaginal or anal sex, the rate of getting a sexually transmitted disease or HIV is comparatively lower. 

Oral sex can spice up your life and can also make your partner reach orgasm. It is also a safe way of getting sexual pleasure without getting pregnant. But necessary precautions must be taken in order to have safe oral sex.

Some of these necessary precautions are:

1. You can get throat cancer from oral sex: Human papillomavirus (HPV) is a cancerous virus found in the body of infected people. This virus can be transmitted to the person with whom you are engaging in oral sex. Studies show that people who engage with more than 6 sexual partners at once are more prone to get oral cancer. It is advisable to get your partner tested for HPV virus before engaging in oral sex.

2. Oral sex also causes stress: Oral sex is generally related to hygiene, therefore the partner can be self conscious and worried about his/her genital hygiene. If oral sex is performed on a daily basis, some people prefer to wax their pubic hair often. This is harmful because it can cause red bumps and burning sensation occurs. It is advisable to trim your pubic hair and wash it properly before engaging in oral sex.

3. A condom should be worn by the male during oral sex so that there is no risk of male fluid entering the woman's body.

4. A latex, which is made into a thin sheet called dental dam can be used on the vagina or anus. This creates a thin barrier between the mouth and the genitalia. Hence, chances of getting infected by sexually transmitted diseases are greatly reduced.

Oral sex can be pleasurable and fun, but the risks of getting sexually transmitted diseases like herpes, gonorrhea and crabs is not altogether misplaced. So it is advisable to use proper protection and to maintain hygiene before engaging in oral sex.

4 Ways to Have Safe Oral Sex - Necessary Precautions

Although most women experience menopause between the age of 45 and 55, but when women experience the menopause before they reach 40, it is termed a premature or early menopause. It is also known as premature ovarian failure.
This may be due to primary ovarian insufficiency in which there is decreased activity in ovaries and the periods spontaneously stops. It may be result of chemotherapy treatment for cancer or it can be surgically induced menopause when the ovaries are removed. Premature menopause can also be caused by treatments for cancer or other conditions that involve chemotherapy or radiation therapy for the pelvis. These treatments can damage the ovaries and result in ovarian failure. The chances of premature menopause depend on the type and amount of chemotherapy as well as the age of the patient

Removal of both ovaries by surgery causes menopause right away. Menstruation stops after this surgery, but the hormones of women facing such condition drop quickly. They experience strong menopausal symptoms such as hot flashes and diminished sexual desire.

Chromosome defects like Turner s syndrome can lead to premature menopause. In this condition, the female is partly or completely missing an X chromosome due to which the ovaries does not form normally leading to early menopause. Women with a family history of premature menopause are more likely to have the same themselves. Autoimmune diseases like Thyroid disease and rheumatoid arthritis that attack the body's immune system may mistakenly effect the ovaries thus preventing them from making hormones.

One should visit agynaecologist, if the period stops or changes before the age of 40. Menopause is confirmed when a woman does not have her period for 12 months in a row. Blood tests for measurement of oestrogen and related hormones, like follicle-stimulating hormone determines if one has reached premature menopause

Women have premature menopause can be observed as physical problems, emotional disturbances or problems associated with sexual functioning. Women experience sudden waves of mild or intense body heat commonly known as hot flashes and can also experience profuse sweating called as night sweats and have difficulty in sleeping. They experience vaginal dryness and the sexual drive or the libido also decreases. The bone density decreases leading to osteoporosis and fractures. In addition to physical symptoms, there are emotional symptoms like anxiety, mood swings, loss of focus and difficulty in concentration. Women who want to conceive and go through premature menopause may feel extremely upset. The sexual symptoms include dryness and thinning of walls of vagina, thus causing pain or discomfort during sexual intercourse.

Premature Menopause - Signs and Causes

What are the latest advancements in male contraceptions?

The drawback of surgical approaches (such as vasectomy), especially patient compliance and the low success rates with condoms has spurred research on hormonal contraceptive dosage forms. There is a dearth of investigations in the development of pharmaceutical preparations. Evolving technology in the 21st century as well as improvement in living standards further underline the need for new male contraception approaches, especially those that entail new drug delivery methods.

Here are few areas where male contraception is being researched and used in some countries

Hormonal contraception for men is possible, and we are at the threshold of an important breakthrough. Combined testosterone plus progestin administration is more effective and safer than testosterone alone. Combination of testosterone plus an anti-androgenic progestin has several advantages over other formulations. In combined therapy, single injection formulation may have better compliance. 

Conventional male contraception 
Abstinence (doesn't work well)
Masturbation
Male condom
Vasectomy
There are other methods being developed but not sure they are there yet. But for guys? Their options are stuck in a time warp. If a man wants to take pregnancy prevention into his own hands, his choice basically comes down to condoms, a vasectomy, withdrawal, or abstinence. That s why it's so amazing that scientists are finally developing some real advancements when it comes to male contraception.

Researchers writing in the April issue of the Open Access Journal Contraception published a rundown of the top emerging options. A few hold real promise, particularly a daily or weekly pill that would deliver a dose of artificial hormones to a guy s bloodstream, which would then act on reproductive hormones to stop sperm from being produced. Like the female hormonal pill, the male hormonal pill would be reversible. But also like the female hormonal pill, there appear to be side effects, among them acne, weight gain, and even trickier to work around, changes in testosterone levels that trigger a plunge in libido.

Non-hormonal techniques are also being developed, particularly a vaccine that immunizes men with antibodies to halt sperm production. This so-called male birth-control shot is encouraging, because it targets sperm directly (rather than targeting other hormones in the body) and doesn t have the testosterone-lowering side effects of a hormonal pill. Each injection would last for long intervals (experts aren t yet sure how long), but the pregnancy-preventing effects would be reversible, if and when a guy decides he s ready to be a dad.

So when can you expect to see men rushing out to the pharmacy counter to pick up their new birth control Rx?  I think we may see a novel male contraceptive within 10-12 years, That may seem far off, but hey at least it s finally within sight.

Male Contraception - An Insight!

Disregarding genital tract infections and issues including the symptoms of the same can lead to problems when it comes to fertility. It may also cause problems in your sexual life. Genital problems can also lead to infertility. These days, infertility is a noteworthy and very important occurrence that plagues many couples.

Common Infections: A large portion of these genital tract diseases occurs because of infections. Salpingitis happens in close to 15% of ladies in their reproductive age and 2.5% of all ladies get to be infertile as an aftereffect of salpingitis by age 35. Many times, symptoms of conditions and STDs like Chlamydia trachomatis are usually nonexistent. The real rate of ladies with upper genital tract infections is presumably underestimated.

Infection and Infertility: Infectious agents can hinder different vital human functions, including reproduction. Bacteria, fungi, infections and viruses can meddle with the reproductive capacity in both genders. Diseases of male genito-urinary tract represent around 15% of the instance of male infertility. Diseases can influence distinctive areas of the male regenerative tract, for example, the testis, epididymis and male sex organs and glands. Urogenital diseases at various levels of their advancement, development and transport can affect the sperms themselves in this manner. Among the most widely recognized microorganisms required for sexually transmitted diseases, meddling with male fertility are Chlamydia trachomatis and Neisseria gonorrhea.

Symptoms: If the following symptoms of a genital tract infection are ignored, it can definitely lead to the person being infertile in some stage of life or immediately. These are as follows:

The signs and symptoms in males are

Changes in the way you discharge
Bleeding while urinating or discharge
Thick white, yellow or green release from the tip of the penis along with pain in urethra or pain while urinating
A hard but painless sore on the penis along with swelling of the lymph hubs in the crotch
Pain or uneasiness while urinating or discharge from the urethra
Difficult or irritated red spots and small blisters on the penis
Chestnut bits on the hair around the penis
Gentle delicacy around one of the testicles
Delicate swelling in the scrotum on one or both sides
Extreme pain after injury to your penis
The signs and symptoms in women are as follows:

Irregular vaginal discharge with a pungent smell
Burning sensation while urinating
Tingling or itching in the outer area of vagina
Uneasiness and pain during sex
Sore vagina
Foamy greenish-yellow discharge with a foul smell
Light bleeding after intercourse
Warts in the vagina
Regular check-ups and visits to the gynecologist are very essential. One should always keep the partner updated about their sexual health problems to practice a healthy and honest relationship and to avoid further contagious infections from occurring.

Can Genital Tract Infections Lead to Infertility?

Pelvic inflammatory disease (PID) refers to the infection that occurs in the female reproductive organs. It happens when sexually transmitted bacteria infect the uterus, ovaries or fallopian tubes on spreading from the vagina. Generally, the cervix plays the role of preventing the bacteria from entering the vagina and infecting the reproductive organs. But when the cervix becomes exposed to an STD, it loses its power to put a stop to the spread of these microorganisms to the reproductive organs.

What causes this condition?
STDs like gonorrhea and chlamydia have been found to be responsible for about 90% of PID cases.

Some of the other causes include
- Abortion
- Childbirth
- Pelvic procedures

The condition is only detected later in life when you face difficulty in getting pregnant or have chronic pelvic pain complaints. If you experience symptoms like vomiting, high fever, pain in the lower abdomen and instances of fainting, you should immediately seek a doctor.

What puts you at risk for PID?
Certain factors may put you at a higher risk for PID and these are:

- Instances of sexually transmitted diseases like Chlamydia (an STD that can occur from anal, oral or vaginal sex) and gonorrhea (a condition that causes discharge from the vagina or urethra) can make you prone to developing PID.

- Douching on a regular basis can increase your risk of PID as it disrupts the equilibrium of good and bad bacteria in your vagina, and may hide the symptoms of the condition as well.

- Even a previous history of PID can increase your chances of having another episode of PID.

- Compared to older women, teenagers who are sexually active are more prone to developing PID.

- Having multiple sexual partners can also put you at a greater risk for PID and STDs.

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