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?

Diabetes is something which has become so common over the past few decades and this is said to be a cause of worry as most people don't understand how to prevent and manage it. This has led to some myths, gaining more than their fair share of popularity. So, wouldn t it be a good idea to get to know a little more so as to separate the myths from the facts?

Weight & watch: One of the most common myths when it comes to diabetes is the belief that a person is going to have his or her life adversely affected if he or she is overweight. While it is true that being overweight happens to be one of the risk factors related to diabetes, it is important to keep in mind the fact that there are other risk factors which are responsible, as well. Some of these factors are age and family history, as well as the ethnicity of the person. Taking this into account, it should not come as too much of a surprise to know that there are quite a few people who are not overweight, but are still fighting diabetes.
Packaged tricks: Considering the rise in the number of people who are suffering from diabetes, this has led to food being marketed specifically for their consumption. However, in reality, whatever represents a healthy diet is sufficient for a person who is diabetic. So a diet which does not have a high amount of saturated fats and trans fats and does not go overboard with starch and sugar, but features a fair amount of lean protein works well too. All the fancy diabetic food, which a person buys, is only likely to drive a great hole in the wallet and not have any additional health benefits. Therefore, the extra spending is nowhere close to being worthwhile and should be avoided.
Fruits punch: Many people are of the opinion that it is the processed and sugary food items, which cause diabetes and this is true to a significant extent. However, some people are of the view that since fruit is natural, diabetics can eat as much of it as they like. This is where the thinking gets dangerous. Some fruits are rich in carbohydrates and so it should be consumed in a reasonable quantity, as part of the daily meal plan. After all, too much of any good thing is bad!

Diabetes - 3 Myths Decoded!

It is not easy to deal with labor pains. According to scientists and doctors, labor pain is a very strong sensation that a woman experiences in her lifetime. Therefore, it is important to know some tips that will help you deal with the intense pain during labor. There are some practical tools, which will help you survive labor pains on both emotional and physical levels. 

You just need to implement these tools during your labor.

Focus on the current contraction: When you get a contraction, focus on it solely. Do not agonize on the contractions you had or do not feel scared thinking about the contractions that are yet to come. You just need to focus on the present contraction without thinking about anything else. Many women think about how long they have to push before they can meet the baby. The over thinking can worsen the pain. Therefore, you should be in the present moment.
Breathe: A great tip of resisting labor pains is breathing. Various kinds of breathing techniques have been invented for labor. You can try some of those breathing techniques during your labor. If you don t remember any particular breathing technique, you can also try everyday breathing during the contractions. Breathing lets your abdominal muscles relax and helps the baby descend faster.
Try to relax: Whenever you encounter pain or stress, you tense all the muscles of your body, especially your abdominal muscles. It is important to relax during your labor pain. Although it is difficult, you should try to relax instead of getting tensed. It will make your labor smooth.
Be in a comfortable place: You should be in a place where your labor must be comfortable for you. If you are not comfortable, you will be stressed and anxious, which in turn, will make it difficult for you. When you are in a comfortable place, you will be happier and your muscles will be more relaxed.
Don t worry: Instead of worrying about your entire labor experience, focus on the task at hand. When you don t worry, you can process the contractions without being stressed. As a result, your body will also get less tired and your baby will come out faster. You need to channel your energy into pushing the baby rather than worrying and stressing.
If you follow these simple tips, you will be able to survive labor pains and give birth to a healthy baby. Nature has given women all the tools so that they can give birth to a baby naturally. You just need to trust your body and empower yourself by keeping these tips in your mind.

Labor Pain - 5 Tips to Help You Survive

4 Dietary Changes that can Increase Your Chances of Getting Pregnant

At times being able to conceive becomes a challenge due to certain biological reasons. Feeling positive and eating healthy naturally takes you a step nearer to getting pregnant. In case of no medical condition acting as an obstruction, consuming the right food can increase your chances of getting pregnant.

Here?s a list of supplements you can include in your diet to maximise your chances of getting pregnant.

1. Choose whole grains over refined carbohydrates: Reducing the intake of refined carbohydrates (found in milk, potatoes, corn to name a few) can reduce inflammation of the genitals, which will help increase fertility. You can still continue to have your favourite foods, but ensure they are low gi (glycaemic index- a figure used to represent the ability of carbohydrate to increase glucose in blood) carbohydrates.

You can consume whole grains, which help in reducing insulin levels that in turn reduce the risk of heart diseases and diabetes and also help lower cholesterol levels. Try having whole grain bread instead of white bread and porridge instead of sugary processed cereals to reduce your gi ingestion.

2. Harness the power of proteins: Proteins are an important part of your diet and the type of proteins you require careful consideration as they help make new hormones. Try having 25gms of vegetable protein like seeds, legumes and nuts instead of animal protein.

Add dairy foods to your diet as they are also a rich source of protein. They provide vital minerals and nutrients like magnesium, calcium and vitamin b12 to the body and at the same time are low in calories. Include milk, yoghurt and cottage cheese to your meals so that you have a minimum of three servings of dairy products a day, which is essential to meet your nutritional needs and increase your chances of having a baby.

3. Welcome good fats: Processed foods, fatty meats and takeaways are high in saturated fats including trans fats. These lead to inflammation and an increase of oxygen free radicals in the body, which decrease fertility. So, incorporate good fats in your diet in controlled quantities. Try having avocado and tomato on a whole grain toast, for instance.

4. Make folate an integral part of your diet: Folate is an essential nutrient that helps in decreasing the incidence of birth defects in the babies, while ensuring a healthy conception. Along with the prescribed supplements, try to increase its intake in its natural form. The best way to do this is by having green leafy vegetables, which are a rich source of folate. You can also have veggie sticks and vegetable soup along or green vegetable dishes to increase your folate intake.


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4 Dietary Changes that can Increase Your Chances of Getting Pregnant

Egg Freezing, which is also known as mature oocyte cryopreservation, refers to the method through which reproductive potential is restored among women. Eggs get harvested from the ovaries, frozen and in an unfertilized manner and are stored for purpose of using them later on. The egg freezing procedure is recommended for those women, who would like to delay conceiving baby due to various kinds of reasons.

Before the freezing of eggs, it is important to first retrieve the eggs. Let us look at how the eggs are retrieved, followed by the procedure of egg freezing through two different ways.

Retrieval of Egg

Egg Retrieval takes place just like it is done in case of in vitro fertilization (IVF). Women would need to be put under medication for hormones or through injections, which shall lead to the stimulation of ovaries, leading to more eggs getting matured. After this women would receive the necessary medication to stimulate ovulation and then the extraction of eggs takes place through the use of a needle. Specialists perform this whole procedure by putting women under the effect of anesthesia and are also guided by ultrasounds. Once the extraction is completed, the freezing takes place.

There are two different techniques involved in the egg freezing process. They include:

Slow Egg Freezing Method

A substance called cryoprotectant is used in order to protect the biological tissues from getting damaged out of freezing. This slow freezing method of getting eggs freezed relies on low initial concentrations of crytoprotectant. The cryoprotectant in low concentration is introduced when the egg is at a relatively warm temperature and still continues to experience the usual functions of a living cell. Then the cryptoprotectant would spread all throughtout thus fill the egg, hence replacing most of the water inside the egg. The egg is then inserted into a small container made of plastic and ultimately get placed inside a cooling chamber. The lowering of temperature, to around -6 degree centigrade, takes place through injecting very tiny amounts of liquid nitrogen into the cooling chamber. The cooling process is controlled by a computer.

The main purpose of these techniques is to avoid ice crystals from getting formed in the egg. During the spreading of the cryoprotectant, if the ice crystals are still present, they can cause damage to the egg and hence the egg may not survive the process of thawing. Then the temperature is lowered further to around -32 degree centigrade. By this time, the egg s metabolic rate become slow. The container where the egg was placed, is then dipped inside the liquid nitrogen, forming a solid.

Rapid Egg Freezing Method or Vitrification

At the time of rapid freezing method, there is high concentration of initial cryoprotectant whereas the cell remains at room temperature. The egg is unable to stay for long in this temperature and thus gets poured immediately onto the liquid nitrogen. Cryoprotectant spreads at a rapid rate so as to avoid ice-crystal from getting damaged. Vitrification is a very new method for freeing eggs. Recent research has shown that vitrification of eggs largely improves the possibility for survival after thawing and the rates of pregnancy.

Different Techniques That Can Be Used For Egg Freezing!

An often painful condition usually involving the bowel, ovaries or the tissue lining the pelvis, endometriosis is characterized by the abnormal growth of the endometrial tissue beyond the premises of your uterus or your pelvic region. The endometrium, in fact, functions perfectly normal with each menstrual cycle, but because of it being displaced, it cannot exit the body and consequently gets trapped.

Besides causing severe pain and distress, endometriosis can also adversely affect fertility. When the ovaries get involved, certain cysts known as endometriomas tend to develop which often result in the formation of scar tissues and adhesions.

Complications associated with it

Infertility: Impaired fertility is the most common kind of complication arising from endometriosis, with approximately one-third to one-half women having problems with pregnancy. During endometriosis, the fallopian tube gets obstructed, thereby restricting the union of the egg and sperm.
Ovarian cancer: Women with endometriosis are more likely to suffer from ovarian cancer. Moreover, they are also more susceptible to acquiring endometriosis related adenocarcinoma, which is another variant of cancer, but a comparatively rarer phenomenon.
How best to treat it?

Depending upon how severe your symptoms are, endometriosis can be treated via the use of medications or through the advent of surgery.

Pain medications: Certain medications, including pain relievers and anti-inflammatory drugs, are particularly useful in providing relief to painful menstrual cramps.
Hormone therapy: Undergoing hormonal therapy can help ward off or reduce the pain of endometriosis, but it should be kept in mind that it is only a temporary fix and that symptoms might reoccur. Hormonal therapies include:
Hormonal contraceptives
Medroxyprogesterone
Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists
Danazol
Conservative surgery: This can either be done through laparoscopy or, in more extensive cases, through traditional abdominal surgery.
Assisted reproductive techniques: These include in-vitro fertilization, and are sometimes more preferable over conservative surgery.
Hysterectomy: This is usually done in more severe cases of endometriosis whereby ovaries are also removed with uterus and cervix

Complications and Treatment of Endometriosis

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