Fertility Health Feed

Some tips for couples facing fertility issues during COVID pandemic
1. Stay connected with family, friends and relatives
2. Excercise regularly, keep watch on weight and diet
3. Maintain regular schedule for daily routine, eat and sleep on time
4. Reduce exposure to media if that adds to your stress levels
5. Reduce smoking. Remember smokers are at high risk due to covid complications
6. Read books, listen to music, take out time for hobbies
7. Yoga, meditation, breathing exercises will help to calm down 
Everyone is going through difficult time, stay positive. We will surely come put of this successfully.

One of the major milestones in a woman’s life is the entry into motherhood. For most women, when this does not happen in the natural logical sequence of things, there is anxiety and a lot of pressure from family and friends.

However, with advancements now, there are options like intrauterine insemination and in vitro fertilization (IUI and IVF) available, which can help increase the chances of conception and pregnancy. IVF is where the egg is retrieved from the woman’s womb, fertilized externally and then transplanted back into the uterus where it grows to full term. However, there are always unanswered questions like how long to wait before going for IVF, is it the right procedure for me, etc.

Read on to know to find answers to some of these. 

1. Maternal age: As a woman reaches 35 and a man reaches 40, the fertility rates drop significantly. The chances that a woman at 35 will conceive is about 20%, which goes down to 5% if the woman is 40. However, this rate can be significantly increased by using IVF. The quality of the egg would gradually deteriorate, and so if a woman is nearing 40, it is better to consider IVF as the ovarian reserve would be optimal with IVF.
    
2. Failed intrauterine insemination: In couples who have problems with the sperm reaching the uterus, intrauterine insemination (IUI) is first attempted. However, if 3 or more attempts of fail, it is time to consider IVF.
    
3. Duration of inability to conceive: While some couples conceive quite promptly in a month or two, most take about 6 to 8 months of unprotected sex to conceive. Therefore, IVF can be an option if you are failing to conceive even after a year. Less than a year, don’t fret. Take it easy and it might just do the trick.
    
4. Medical health: Both the partner’s medical health should be taken into account. Lifestyle changes like smoking, alcohol abuse, drug abuse should be considered, which can account for poor sexual performance and therefore lead to an inability to conceive. Health conditions like diabetes and heart disease can also lead to infertility. Hypothyroidism in women is another thing that must be ruled out, as it often leads to an inability to conceive.
    
5. Sexual problems with the partner: One of the first things to do before going for IVF is to check that the male does not have any issues. Be it erection issues or ejaculation issues or sperm issues, they need to be ruled out. Sperm quality, quantity, and motility have to be analyzed, and if they are optimal, IVF can be considered.

Pregnancy and motherhood are the beautiful yet crucial phases of a woman's life. When to become pregnant or start family is merely personal and the decision may vary from woman to woman. Now days, women are becoming more independent financially and socially as well. Their priorities are also changing. Before getting pregnant and starting family what they want is the best for their babies from all point of view and therefore most of the women have their first pregnancy after 35 years of age.

The science of the right age to get pregnant:
But what is the scientific approach regarding the right age for conception? According to the American College of Obstetrics & Gynecology (ACOG), the chances of conceiving are highest in 20 - 30 years of age. After 32 years of age the fertility in the women starts decreasing as they have fixed number of eggs in the ovary and the number of eggs decreases with advanced age. The eggs are also not that much fertile as compared to younger women. Problems that can affect the fertility becomes more common with increasing age as well. The older women are more likely to have pre-existing health problems as compared to younger ones. There is increased risk of miscarriages, different complications and birth defects in older age. According to ACOG, the risk for miscarriage for women aged 20 to 30 years is between nine and 17 percent; this rate increases sharply from 20 percent at age 35 years to 40 percent at age 40 years and 80 percent at age 45 years. In between 20 -30 years of age, the fertility rate is high among this age group. The chances of complications, chromosomal abnormality, preterm deliveries and birth defects are minimal. Pregnancy is often physically easier for women in their 20s because there's a lower risk of health complications.

The most important aspect in pregnancy is - YOU
Whatever may be the age of the women during pregnancy, the thing which matters most is the health of the baby and the mother. In advanced age also, mothers need to stay fit and healthy by optimum exercise, healthy nutritional diet and positive approach.

There are many reasons leading to infertility, but one of the main causes is the inability of the sperm to travel all the way up to the uterus to fertilize an egg. This is caused by defective sperms and could be due to poor sperm quality, poor motility, etc. There are multiple reasons for this, and even smoking, obesity, diabetes, hypertension, etc. could be reasons.

Many technical advancements in fertility treatments are being done, and they try to keep the natural process of fertilization intact, at the same time improving the chances of success. Intracytoplasmic sperm injection (ICSI, often used as a standalone term iksee) improves the rate of fertilization in that the sperm is directly injected into the egg. The environment of this artificial fertilization is completely controlled, and the fertilized egg is then placed into the womb for further growth. It is one of the recent methods of improving fertility, a part of ART (assisted reproductive technology).

Indications:

1. Poor sperm perms motility
2. Semen where sperm concentration is low
3. Male infertility with unidentifiable cause
4. Poor sperm quality, with sluggish sperms
5. Ejaculation issues, such as retrograde ejaculation (semen is ejected into the bladder)
6. Useful in couples who have failed IVF.

What to expect? 

The following outlines some of the steps for both male and female before and during the procedure.

Before the procedure - males:

1. First step is the sperm collection; a screening is first done
2. Sperms collection happens through either masturbation or directly from the testicles via a small incision
3. Sperms could be collected fresh or collected and frozen for later use

Before the procedure – women:

1. In the normal menstrual cycle, only a single egg is released. However, prior to ICSI, the woman is given ovulation drugs, which are high-dose hormone injections prior to ovulation. This ensures multiple eggs are released, which are then retrieved for fertilization in the external environment.
2. Blood and urine are monitored regularly to identify the ovulation time, and eggs are collected within 24 to 36 hours of release

During the procedure - How ICSI happens:

1. A healthy egg is chosen and placed in a glass tube, and sperm is introduced to ensure fertilization
2. This could be repeated in multiple tubes, and the most healthy one could be chosen to be implanted into the uterus
3. Some of the fertilized ones could be frozen for later use, in case the implanted embryo fails to grow as expected
4. The success rate for this procedure is quite high as the fertilization rate is almost 80 - 85 %

Ever wondered how your body releases an egg each month or how the uterus wall thins and thickens at different times of the month? It is the job of your body’s chemical messengers – hormones, which manage the various processes involved in preparing your body for fertilization.

Hormones and Fertility
A subtle balance of different hormones, involved in managing the reproductive organs, enables and maintains fertility. These hormones regulation changes like the discharge of an egg from the ovary and thickening of the uterine wall lining (endometrium). Infertility results if this balance is disrupted.

Roles of hormones in making a woman infertile

Knowing the role of a hormone in making a woman infertile will be easier if you know its role in making the same woman fertile. Here is the role of the five most important hormones that encourage fertility in women-

1. FSH or Follicle-stimulating hormone - The pituitary gland in the brain releases the Follicle-stimulating hormone. The major role of this hormone is to allow a woman to have better control over her menstrual cycle and production of an egg in her ovary. The levels of this hormone designate the proper functioning of the ovary as well as the quality of the produced egg. When there is an imbalance in this hormone, the ovary of the woman will not function properly to produce eggs, thus creating infertility in women.
2. LH or Luteinizing hormone - The pituitary gland releases this hormone. It plays a vital role in stimulating the ovary of a woman to discharge eggs. It instigates the manufacturing of progesterone to prepare the uterus of a woman to accept a fertilized egg. When the level of this hormone is disturbed, it will not stimulate the ovary to release eggs.
3. Estradiol Hormone - This is a vital form of the oestrogen hormone. When the levels of this hormone become irregular, it will reduce the chances of making a woman conceive.
4. Thyroid hormones - This hormone assists greatly in making the ovulation as well as the ovary of a woman to function normally by interacting with the progesterone and oestrogen hormones.
5. Progesterone hormone - This hormone plays an important role in making a fertilized egg to continue as well as to develop in the uterus of a woman. Any imbalance in the level of this hormone will not allow the egg in the uterus to grow.

Pregnancy and motherhood are the beautiful yet crucial phases of a woman's life. When to become pregnant or start family is merely personal and the decision may vary from woman to woman. Nowadays, women are becoming more independent financially and socially as well. Their priorities are also changing. Before getting pregnant and starting family what they want is the best for their babies from all point of view and therefore most of the women have their first pregnancy after 35 years of age.

The science of the right age to get pregnant:
But what is the scientific approach regarding the right age for conception? According to the American College of Obstetrics & Gynecology (ACOG), the chances of conceiving are highest in 20 - 30 years of age. After 32 years of age the fertility in the women starts decreasing as they have fixed number of eggs in the ovary and the number of eggs decreases with advanced age. The eggs are also not that much fertile as compared to younger women. Problems that can affect fertility becomes more common with increasing age as well. The older women are more likely to have pre-existing health problems as compared to younger ones. There is increased risk of miscarriages, different complications and birth defects in older age. According to ACOG, the risk for miscarriage for women aged 20 to 30 years is between nine and 17 percent; this rate increases sharply from 20 percent at age 35 years to 40 percent at age 40 years and 80 percent at age 45 years.In between 20 -30 years of age, the fertility rate is high among this age group. The chances of complications, chromosomal abnormality, preterm deliveries and birth defects are minimal. Pregnancy is often physically easier for women in their 20s because there's a lower risk of health complications.

The most important aspect of pregnancy is - YOU
Whatever may be the age of the women during pregnancy, the thing which matters most is the health of the baby and the mother. In advanced age also, mothers need to stay fit and healthy by optimum exercise, healthy nutritional diet and positive approach.