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In today’s modern, fast paced society, it is easy for people to become stressed. In fact, one would almost think that being stressed is the “in” thing, and if you aren’t stressed it must mean there is something wrong with you! Realistically however, stress is not a good thing for our bodies in general, and has a very real impact on your fertility.
Can Stress Have an Effect on Your Fertility?
If your mind and body is under stress your body is signaled to release a hormone - Adrenalin. This is a stress relieving hormone and gives your body the rush to face the stress. This hormone inhibits the utilization of the hormone Progesterone, which is essential for fertility. Also during stress Prolactin, another hormone, is relapsed which also interferes with infertility. Hence to conceive its essential that your anxiety levels are under control.
How Stress Impacts Fertility?
Recent research tells us that stress boosts levels of stress hormones, such as adrenaline, catecholamines and cortisol, which can inhibit the release of the body’s main hormone, GnRH (gonadotropin releasing hormone), which is responsible for the release of sex hormones. Subsequently this may suppress ovulation in women, reduce sperm count in men and lower libido in both women and men.
Chronic Stress also decreases libido
Chronic stress may cause lack of libido as well as a decrease in general fertility. This has become such a common issue that they have created a name for it Stress Induced Reproductive Dysfunction. These facts are very important to consider if you have been trying to conceive with no results. It also shows that stress relief should be a part of every couple's conception plan even if they are going through IVF.
Ways to reduce stress & improve fertility:
If you are having difficulty to conceive, it's imperative that you get fertility tests done and also evaluate your life. Look out for the stress points that may be hindering a relationship. Remember defeating the stress may be the solution to your worries.
- Reduce stress in your life - The issues in your life may be work or result related. You need to learn to balance your personal and professional life. The sooner you do it the better; after all you are preparing yourself to welcome a new born in your life.
- Change your reactions - Get a hang of the situation and react accordingly. Over reaction to a situation can harm your body and mind. Stop bothering so much about the future.
- Let few things be the way they are - Stop getting bothered about people. Remember by nature everything will fall in place. Let few things be the way they are.
- Make it your habit to reduce stress - Call it an obsession or a practice, train your mind to choose options where there is less stress.
- Sleep well - A good rest is essential for a healthy mind and body. Meditate, do yoga or seek counseling. Go for facials if it sooths you.
Please note that if your fertility reports are normal, then it's just a matter of time. Give you, your partner and your body time. There are certain medical complications or disorders that can also be responsible for infertility. Be calm and composed so that you are able to face the rough waters clearly with your partner.
In vitro fertilisation (IVF) is a medical procedure followed for those women or couples suffering from infertility or for certain specific genetic problem. In the normal course, women or couples experience positive results within a few IVF cycles. However, in spite of reasonable pregnancy rates, some women may require few more cycles to achieve pregnancy. In such cases, in order to ensure a healthy pregnancy, the gynecologist may suggest the women undergo Endometrial Scratching before IVF.
Endometrium explained in brief
The uterus is located in the pelvic region and it is in the size and shape of a pear. The inner cavity of the womb or uterus is protected by the tissue lining called endometrium, also called endometrial. The endometrium plays a significant role in supporting the pregnancy.
The enhanced success of achieving pregnancy
The endometrial scratching procedure is a very simple one, which is resorted, so as to improve the results of IVF procedure. In this procedure, the gynecologist uses a very fine catheter and makes a small scratch on the endometrial lining. In fact, the scratch causes a kind of inflammatory reaction in the uterus. This inflammatory reaction induces the endometrium to be highly receptive to embryos during the successive menstrual cycle. This added receptivity enhances the success of pregnancy during the next menstrual cycle.
Considering the higher level of success in achieving pregnancy, the endometrial scratching procedure has gained popularity in the IVF procedure.
However, some of the other issues related to endometrial scratching may be as follows:
- Endometrial scratching optimises the uterine lining and thereby, makes it easier to continue the embryo implanting procedure. Normally, before the endometrial scratching procedure, the gynecologist may suggest endometrial biopsy.
- The endometrial procedure is usually suggested for those women who had two or more unsuccessful IVF procedures, despite having good quality embryos. However, in some cases, depending on the health of the patient and various other factors, the gynecologist may suggest this endometrial scratching at the very first IVF procedure. This procedure can be availed either for fresh embryos of the couple or frozen embryos or for the donor egg.
- Although this is a part of a surgical procedure; endometrial scratching is very simple and painless and it is done without administering anesthesia. The procedure does not require any hospitalisation. In fact, the patient can go home soon after the procedure. Except for a few pain killers, this procedure does not require any extensive medication.
This is a safe and easy procedure. Neither does it lead to any side effects, nor is the procedure burdensome for your wallet. Many couples have been benefited by this endometrial scratching procedure.
Like most things in life, the uterus also has both good and bad sides to it. It is a symbol of womanhood and also carries the developing baby. The bad side is that it brings with it (and its appendages) many problems including dysfunctional uterine bleeding, endometriosis, fibroids, pelvic inflammatory disease, uterovaginal prolapse, adenomyosis, a pelvic pain of unknown origin, cancer of the uterine cavity and other obstetric complications.
Hysterectomy is one of the most commonly performed procedures and ensures complete relief from these symptoms. There are however, multiple procedures, which can be used to manage these conditions without having to resort to removal of the uterus. This can help in preventing complications from hysterectomy including prolonged recovery, infertility in women of childbearing age and loss of womanhood.
Read on to know some of the emerging conservative alternatives to hysterectomy:
Where there are fibroids, which are in the smooth muscles of the uterus and show symptoms like pain and discomfort. In these, it is advisable to go for a myomectomy. This removes only the fibroid, leaving the uterus in place. It can be done in one of the 3 ways traditional surgical process through an incision; laparoscopically through minute incisions; and then through vagina. In all these, only the fibroid is removed and sent for biopsy to confirm it is benign. It is less invasive, requires less recovery time and helps retain the uterus.
Uterine endometrial ablation
In cases of dysfunctional uterine bleeding or menorrhagia with no fibroids, the lining of the uterus could require removal. In these women, thermal balloon ablation, cryoablation, and radiofrequency ablation can be used. A small amount of extreme heat or cold or radio frequency waves are used to remove the uterine lining, thereby managing symptoms.
In women with fibroids, the feeding arteries could be cauterised to ensure blood supply is stopped so that fibroid growth is stopped. With very promising success rates, this is gaining popularity as a conservative method.
Laparoscopy and endometriosis excision
In endometriosis, where the uterine tissue is growing in areas outside the uterus, it could be removed laparoscopically after identifying the area of growth on ultrasound and laparoscopy.
In women with uterine prolapse, the uterus drops from its normal position, pushing against the vaginal walls. This can be due to vaginal childbirth, age, smoking and obesity. Vaginal pessary is where a removable device is placed into the vagina to prevent it from falling down. It is a temporary solution, but very useful in holding the uterus in place and relieve symptoms partially or completely.
How does the ICSI method in IVF treatment help manage severe male infertility?
Male infertility is a growing problem in India. According to a survey, almost 40 percent of all infertility cases occur due to male infertility. Severe male infertility is often treated with IVF, using the ICSI method. Here is a look at all you need to know about IVF with ICSI.
What is ICSI?
ICSI or intracytoplasmic sperm injection is a specialized method of IVF, where the sperm from the male partner is not allowed to fertilize the female egg normally. Instead, a single sperm is isolated and inserted into a mature egg, to get it fertilized. A hollow needle is used to extract the sperm from the male. Primary features of the ICSI-IVF include-
• The egg is fertilized inside a petri dish, as the sperm is not introduced inside the female’s body.
• Only one healthy sperm is selected from the sample and is injected into a single mature egg for the fertilization
• The fertilized eggs are monitored under laboratory conditions.
• Once the egg is fertilized, it can be introduced inside the woman’s body, similar to the ordinary IVF procedure.
Reasons why ICSI is used
Here is a look at some instances, when your doctor may advise you and your partner to undergo ICSI-IVF-
• Very low sperm count
• Sperm with abnormal shape
• Poor sperm motility
• Other IVF treatment has not yielded desired results
• If the sperm being used is frozen, the ICSI-IVF procedure may be required.
Risks involved in the IVF-ICSI method of fertilization
The ICSI procedure comes with all the risks involved in the normal IVF procedure. However, it does not introduce any new risk factors into the mix. This method of fertilization carries a slightly higher chance of the baby being born with defects when compared to a normal conception. However, it is still quite rare.
With the IVF-ICSI method, couples suffering from infertility have 50 to 80 percent chance of a successful conception.
In vitro fertilization (IVF) includes empowering the woman with medicines, taking various eggs from her ovaries, fertilizing them with her partner’s sperm, and inserting a portion of the subsequent embryos into her uterus with the trust that one will form into a fetus.
Tubal ligation reversal, on the other hand, requires a laparotomy, which needs a much bigger entry point on the abdomen, usually around four to six fingers long. Since the skin, each of the muscles, and different tissues of the stomach must be sliced through, there is extensively more uneasiness and a longer recovery time required after the surgery, when compared with a laparoscopic surgery, for example, with a tubal ligation.
Here are a few common differences:
- Sperm quality - The male partner needs a sperm test before basic procedures of either of the two. In case that the sperm quality is great, then the couple could consider proceeding. In case that the sperm quality is poor, in vitro treatment is the better alternative. With IVF, poor sperm quality is effectively overcome.
- Tubal status - The length of the remaining tubal stumps after tubal ligation is an important aspect. The more extended the two remaining stumps are on each side, the better and more effective is the pregnancy. The shorter the stumps, the lower are the odds for pregnancy.
- Status of other pelvic conditions - Pelvic endometriosis or any scar tissue in the range of the tubes or ovaries would diminish the chance for accomplishment after tubal ligation reversal. Although, IVF pregnancy achievement rates are usually not influenced by these conditions. Along these lines, in vitro fertilization is most likely a superior alternative in women with noteworthy endometriosis or pelvic scar tissue.
- Female age - Chances for pregnancy with either tubal ligation or IVF decrease in the mid to late thirties and significantly reduce at the age of thirty-eight. By age forty-three or forty-four, not many women will have the capacity to have a baby using either approach.
- Egg amount and quality - A few women have a decrease in either egg amount or quality prior in life than anticipated. In this manner, the woman’s ovarian capacity needs to be tested before a choice is made in regards to whether to continue with either tubal ligation or in-vitro fertilization. AMH levels, ovarian antral follicle number, and day 3 FSH levels are generally done to evaluate ovarian capacity or hold.
- Doctor intervention - The greatest favorable position of tubal ligation reversal over IVF is that once the woman has experienced the surgery she ideally will not require any medication through the doctor, for example, medications or systems, keeping in mind the end goal to get pregnant.
PGS or Pre-implantation Genetic Screening is a test conducted to decipher the chromosome count of the embryo. Today, if you are planning to get pregnant or using alternative technologies for pregnancy; there are several tests that need to be conducted so that the child is born healthy and stable. One such test is the PGS, it determines whether or not the count of chromosomes is normal, which is forty six, is present in the embryo. If there are abnormal numbers of chromosomes present in the embryo then it might lead to additional problems in the future. In such cases, special treatments and procedures are conducted.
There are several advantages of PGS. Some of them are highlighted in details below :
- Healthy pregnancy: Interestingly, a man can produce sperms throughout his lifetime. But a woman is born with the eggs already created. The chances of producing a healthy baby with those eggs decrease as the age of the woman increases. It is seen that those women who think of delivering a child in their older ages are often found with chromosome deficiencies in the embryo. Thus, to avoid such a situation, it is best to perform PGS.
- Reduces the chance of miscarriage: Pregnancies which occur without having performed any prior tests like the PGS have high chances of resulting into a miscarriage at the slightest of carelessness. But research has found that those pregnancies which take place after considering the chromosomal health of the embryo have reduced the risk of being abnormally terminated.
- Time reduction between two IVF Circles: For those who do not know IVF stands for In-Vitro Fertilisation. It is a process which aids a woman in becoming pregnant. It is often opted by those who are having issues in naturally conceiving a child. PGS here plays an important role. If the test detects abnormal embryo, then the next IVF circle can be started right away without wasting any time. But if the PGS detects a normal embryo then the IVF circle is deemed to be successful and the woman can continue with the pregnancy.
Thus, these are some of the main advantages of Pre-Implantation Genetic Screening. This helps to determine whether the embryo is of the desired choice or not and whether the baby born out of it would be healthy and normal. It is one of the tests which need to be conducted preceding implantation to provide better results after the implantation process is carried out.
Having a child is one of the most profound experiences in a woman’s life. The joy of being a mother and welcoming a new life is unparalleled. In the midst of such expectation, an inability to conceive can take a serious toll on any woman’s health. The mental scars from such an event can never be obliterated.
This does not mean you should give up. Consult a doctor to find the cause and rectify it. With advances in medical science and technologies like IVF in the market, no fertility challenge is insurmountable.
One of the most common cause of infertility is ovarian cysts. According to research conducted by the American Society For Reproductive Medicine, ovarian cysts resulting in ovulation abnormality and infertility has been recorded among 25% of women.
There are two types of cysts that are produced as byproducts of ovulation-
2. Corpus Cysts or luteal cysts is a condition when after the egg has bronek free, the follicles seal itself rather than shrinking and the fluid builds up inside.
Ovarian cysts are mainly caused due to hormonal imbalance, abnormal cell growth where the cells overgrow and develop into cysts, pelvic infections that spread to the ovaries and fallopian tubes and causes severe harm to them, and endometriosis when the tissue attaches to an ovary and forms cell growth.
Ovarian cysts that generate complications during pregnancy include-
1. Endometriomas - This is the condition when the tissues lining your uterus or endometrium grows outside the uterus or the fallopian tubes and is largely associated with fertility problems. Endometriomas can differ in sizes from the range of less than an inch to over 6 inches. They are filled with dark coloured blood.
Some studies have demonstrated that women suffering from mild endometriosis develop a lower (2%-4%) chance of getting pregnant each month when compared to women who are healthy and have a 15%-20% chance. Another research states that 40% of unexplained infertility results from endometriosis through anatomical distortion or inflammation.
2. Polycystic Ovary Syndrome - PCOS is the condition where small cysts form inside your ovaries which prompts irregular periods, excessive stomach cramps and large hormonal imbalance. Connected to immature ovaries, they do not assist in ovulation and thus produces complications infertility. The immature follicles with an immature egg cause the ovary to be politic.
This chronic lack of ovulation also alters the hormonal levels in your body that assists in ovulation. Women with PCOS develop high levels of androgen or male hormones in your body, which gets converted to estrogen. As a result, they do not ovulate.
Does the treatment of ovarian cysts also affect fertility?
This usually depends on the kind of treatment you receive. Hormonal birth control doesn’t have a long-term effect on fertility. Although surgeries can invariably damage some healthy eggs inside your body, the doctors recommend that the ovaries be removed before you have more complications. However, in both the situations, the egg count in your body decreases significantly.
In–vitro fertilization of IVF is a medical process through which a woman’s egg is fertilized with the sperm in a test tube, petri dish in a laboratory. IVF is not just useful for getting pregnant, it also helps in curing a lot of other conditions as well.
Conditions which can be treated by IVF
IVF may not be able to completely cure certain medical conditions but they can treat these conditions to a huge extent. Such medical conditions are:
• Treatment for people with genetic deformities - There are a lot of people out there who suffer from a huge risk of having genetically deformed babies but IVF can help prevent that. In such circumstances, the concerned people can choose the embryos, which do not contain such deformities, and the process through which this is done is called preimplantation genetic diagnosis. This treatment can also be performed on people who have consistent miscarriages.
• Ovulation problems - Women whose ovaries have difficulties in producing eggs on a normal basis can be helped by the IVF treatment.
• Vaginal and cervical complications - Sometimes, certain surgeries can cause injuries and extreme scarring on top of the vagina and also cervix problems. IVF can solve this problem by placing the embryo straight in the uterine cavity, avoiding the cervix.
• Multiple factors causing infertility - Sometimes both male and female infertility can be caused by several factors. In case there is a slight scarring of the fallopian tubes accompanied by a sperm problem, IVF can be used to remedy this and hikes up the chances of conception and fertilization.
• Damage in fallopian tubes or tubal damage - When a woman’s fallopian tubes are extremely damaged that surgery also cannot remedy it, IVF comes into play. This is because IVF circumvents the fallopian tubes and does the job. But before considering this treatment, consult your gynaecologist because if the fallopian tubes are slightly injured then the IVF treatment is not necessary.
• Endometriosis - Endometriosis is a type of condition in which the uterine lining develops outside the uterus. Even though it is not the only option for dealing with this condition, IVF does help in remedying it to some extent.
• Unclear reasons for infertility - When it becomes very difficult to find the reasons causing infertility, IVF helps in diagnosing it. In this matter, the success rates are quite high for IVF.
Even though IVF is hardly used as the first mode of treatment in case of fertility complications, you can consider it as your next best option. IVF is known all around the world for it’s benefits and usage. But before going for any IVF treatments, make sure to go and consult your doctor and take his opinion about whether you really need it or not.
The concept of egg quality of a woman is derived from the belief that the embryo implantation probability is powerfully related to the age and ovarian reserve of the woman. Thus, it is regarded that the quality of the egg is almost synonymous with the chances of embryo implantation. Its quality cannot be assessed merely by looking at the egg or measuring its ability to receive the fertilization by sperm or simply observing the initial embryo division.
There are a few important factors that contribute to the success or failure of the embryo implantation and some of them are:
- Diminished ovarian reserve: A woman with an increased FSH level on the third day of the menses is regarded as having diminished reserve of ovary. This implies that her ovary is not competent in sending feedback signals to the pituitary gland and the body responds by producing an increased amount of FSH for stimulating the ovary. For more than 10 years, it has been found that in over thousands of fertility treatment cycles, women with an increased FSH level have a lower egg quality.
- Advanced age of maternity: Even though the FSH level is normal, the age of the mother who provides the eggs plays an important role to determine the quality of the egg. Quite like women with increased FSH levels, eggs obtained from women aged more than 40 years can have some problems at a later stage of fertilization. Normal FSH levels are not considered a reassuring factor, owing to the lower implantation rate in females aged over 45 years.
- Diminished quality of egg: With an increase in age, the capacity of the mitochondria in producing energy slowly decreases. The egg is linked to the circulation before ovulation, and it is linked again after the embryo implantation. But during the one week time ranging from ovulation to implantation, the egg and the resulting embryo are contained in the zona pellucida and function on the basis of mitochondrial energy supply. The older age of the woman doesn’t cause any problem at the initial stage of ovulation. Its fertilization and embryonic development are also normal. But soon, it runs out of energy and stops dividing before reaching the stage of implantation.
Therefore, it is important to have the eggs tested to find out any sort of chromosomal abnormality. In case the mother is deficient of producing high quality eggs, the best option is to have donor eggs.
In case you have a diseased uterus, which makes you infertile, you can undergo a procedure known as uterus transplant or uterine transplant to get pregnant. In the process of sexual reproduction, a diseased uterus does not allow embryonic implantation. This factor is referred to as uterine factor infertility or UFI. As a result, you will not be able to get pregnant.
Who requires a uterus transplant?
This procedure involves women who have UFI and women who had their uterus removed by hysterectomy. Women who have a damaged uterus on account of an injury or infection, which does not function anymore, can also undergo a uterus transplant procedure. Women from the age of 21 to 45 are eligible for this procedure. Many women are born without having a uterus. This condition is called Mayer-Rokitansky-Küster-Hauser syndrome.
Uterus transplantation begins with undertaking a uterus retrieval surgery on the uterus donor. The uterus, which is recovered has to be stored and transported to the location of the patient undergoing the transplant. An ischemic tolerance may last over 24 hours. Three major surgeries have to be carried out with the recipient. Firstly, a transplantation surgery is required in which the donor’s uterus gets transplanted. In case pregnancy develops, a caesarean section surgery has to be performed. The patient is given immune suppressive therapy. After childbirth, a hysterectomy is done in order to terminate the immune suppressive therapy.
Will the women be able to get pregnant after having sex?
Women receiving a uterus transplant will not be capable of becoming pregnant without undergoing fertility treatments. The transplanted uterus is not connected with the fallopian tubes, which is the location of the normal fertilisation process. The women will require to carry out IVF or in vitro fertilisation to become pregnant after a uterus transplant. IVF is a process in which the eggs are removed from the ovaries and get fertilised in a laboratory. Then, they are implanted in the uterus. After undergoing the uterus transplant procedure, a woman has to wait for a period of one year. The uterus requires time for healing and after recovery, the embryo may be implanted for pregnancy. After giving birth successfully, a woman will be able to keep the transplanted uterus.
She has the option to get pregnant again. However, after giving birth twice, a hysterectomy must be carried out for the removal of the uterus. This is done so that the woman can stop using the immune suppressant drugs, which are associated with major risks. Uterus transplant is a relatively new technology. In October 2014, the first healthy baby was born to a woman who had undergone a uterus transplant. This surgery is kind of experimental in nature and is usually the last option for getting pregnant.