Infertility is a condition where the woman is unable to get pregnant due to pressing problems persisting in her reproductive organs. This includes her inability to ovulate due to conditions such as polycystic ovaries that causes irregular menstruation, damaged or blocked fallopian tubes, or a condition called endometriosis due to which an extra tissue develops outside the uterus. (This condition can be cured through surgery). Defects related to reproduction equally exist in men and this happens when the man has low or poor sperm-count.
Though there are treatments available for both men and women, the couple has to make sure that they do not procrastinate, as post 35, a woman gradually loses her ability of becoming pregnant. Treatment for women includes the consumption of fertility drugs which induce ovulation. Artificial Insemination is another process and in some cases surgeries are also recommended for women before conception.
Costlier treatments are available for those who do not obtain success from the regular methods. The umbrella term under which such procedures are constituted is called Artificial Reproductive Technology (ART). In vitro fertilization is the most common type of ART. Techniques that constitute in vitro fertilization include Intracytoplasmic sperm injection, assisted hatching and surrogacy.
Infertile men may be asked to alter their life-style to stimulate a surge in sperm-count; some might have to undergo a surgery while for others sperm-count stimulating medicines might work. In such cases where the level of sperm found in the ejaculated fluid is zero, a technique called sperm retrieval can be implemented where sperm is retrieved from the testis through surgery.
Modern methods do encourage the process of reproduction but neither of them vouches for the fact that the woman will get pregnant. However, in recent times improved technology has caused inflation in the rates of success.
Reproduction is a major component in the entire spectrum of a human life and the inability to procreate often takes a toll on a person’s emotional health. But there are lots of treatments that a couple can consider to overcome infertility.
Fertility drugs that might come in the form of injection shots or pills are the most common measures that help a woman to reproduce. These medicines encourage egg production and make the uterus fit for the artificial placing of embryo. In many cases these drugs are enough to make a woman pregnant. They are cheaper in price when compared to other reproduction-inducing treatments.
Artificial Insemination or Intrauterine Insemination is another process that goes hand in hand with the consumption of fertility pills. Washed or purified sperms are injected into the woman’s uterus via a catheter. It is best for those women whose partners suffer from low-density sperm count. It is also a good option for those women whose cervical mucus is too dense or acidic to allow sperm to travel. In most cases pregnancy occurs after the sixth cycle of treatment.
Other formats of fertility treatments where the physiological (reproductive) samples of either of the parents or both are replaced by samples of someone other than the biological parent(s) include Donor Eggs, Donor Sperm, Donor Embryos and Surrogacy. These are best for those who suffer from unexplained infertility or anomalies that they do not wish to pass on to the children.
In vitro fertilization is the most talked-about and expensive among all the fertility treatments. In this the egg of a woman is retrieved and it is practically incubated in a lab with the help of a healthy sperm. Once it develops into an embryo it is placed in either the uterus or the fallopian tubes.
A woman who suffers from the inability to become pregnant after a couple of trials is fit for undergoing fertility treatments. Similarly a man who is affected by low-density sperm count, owing to which his partner fails to conceive, might consider fertility treatment.
Women post the age of 35 are usually dissuaded from undergoing fertility treatments as with age women lose the ability to become pregnant. Despite the existence of various methods cases of unexplained infertility are not uncommon. For these people nothing might work. Those women who are disinclined toward conceiving multiple babies shall not go for fertility treatments, as, multiple birth is a common side effect of these treatments.
The most common side effect of infertility treatments is multiple births resulting in premature delivery. Other factors include fatigue, nausea, bloating and development of ovarian cysts that could result from the intake of fertility drugs. Insertion of developed embryos into the fallopian tubes could be a risky process and recovery time might be longer than usual. Processes like surrogacy, donor embryo and donor eggs entail a lot of legal miscellanies, not to mention the personal stress. Apart from that these treatments often come with a rigorous regimen that patients need to follow in order to attain success. Moreover, fertility treatments do not warrants positive result. In some cases they just fail to work.
Women undergoing fertility treatments face higher chances of giving birth to premature babies. In such cases the baby needs to be kept under special care, often, under the guidance of the obstetrician for quite a few days before it is handed over to the parents. Even the mother can face certain problems after undergoing fertility treatments, like she can develop ovarian cysts or unexplained bloating. To combat these conditions dosages of medicines might continue for long even after pregnancy. To get proper post-pregnancy guidelines the concerned doctor(s) who have performed the fertility treatment need to be consulted.
Women who undergo such treatments where the embryo or embryos are placed in the fallopian tubes utilizing laparoscopic surgery have higher chances of facing assisted medical problems and often the recovery time in such cases become longer than usual. In many cases fertility treatments just do not work. In a circumstance like that recovery in terms of getting back ones psychological integrity and stability become more of a challenge than recovering health-wise. Therefore, couples must look in to both the advantages and downsides of fertility treatments before stepping out.
The cost of In Vitro Fertilization starts from Rs. 65,000 and can go up to Rs. 3, 00000 based on the kind of facility and the reputation of the facility. Artificial Reproductive Technologies are often assisted by the prescription of fertility drugs which can be as low as 415 Rupees or as high as 6000 Rupees depending upon the requirement of the patient. Procedures such as surrogacy, donor sperm, embryo eggs etc could be of any range and is subject to the demands of the donor.
If the fertility treatment works and everything goes fine with the health of the baby secured, the result will have permanency. However, in some scenarios it has been observed that children born out of fertility treatments have developed anomalies in their later lives. But the argument has no valid ground as this can occur in anyone, naturally born or otherwise.
To be precise, the result of fertility treatments could be either positive and enduring, or negative, bringing about no result at all.
There are many alternatives that may work to ease up the process of pregnancy; however, they are not foolproof methods assuring a positive result. Acupuncture is a very popular therapy and it can produce positive result when assisted with IVF treatment. Popular singer Celine Dion sought the help of acupuncture beside undergoing IVF treatment after a failed pregnancy and she gave birth to twin healthy babies as a result of it.
Rs . 2000 - Rs 2,50,000
The In-vitro-Fertilization method has revolutionized reproductive technology and has made natural conception possible for so many expectant families. Despite its popularity, many individuals still fail to see to their well-being during treatment. Not only does it affect the probability and success of conception, it can also lead to further mental stress that can only be destructive towards your psychological health and perhaps your upcoming pregnancy. Here are a few ideas on how you can best take care of yourself during the treatment period:
1. Proper Sleep
A sufficient amount of sleep every night goes a long way to ensuring a peaceful state of mind. As you are anticipating conception, you should schedule your timings such that you can sleep for at least 8 hours every night. Additionally, adopt a nightly ritual so you can ease yourself into bed at a regular time every night. This allows your body clock to be standardized through the treatment period and provide you with optimal energy for the day.
2. Keep Hydrating
Fluids are ideal for flushing out the negative toxins from your body. As a result of the treatment, your body is going through a number of chemical and biological changes. Thus water and other fluids like vegetable and fruit juices help your body maintain a healthy count of blood cells and ward off side effects that may arise during the IVF treatment.
Clinical tests have proven that certain acupuncture procedures strengthen the flow of blood into the uterus and the ovaries. Most specialists recommend that you undergo a session of acupuncture the day of the embryo transfer so that you do not activate your stress hormones. As IVF treatments often become quite trying for the couple in question, you might want to try this method to release anxiety.
4. Take Walks
Though it is not recommended that you exert yourself too much physically, engaging in light walks should only help you ease into your IVF cycle. Not only will it maintain your balance and coordination, it can also improve your mood and help you maintain an appropriate weight for conception.
Even if you may not realize it at the time, this period could turn out to be one of the most significant periods of your life. Becoming a mother is a complex challenge yet a wonderful privilege and you might want to document your experiences while you are going through the treatment. Not only is it incredibly soothing, it might help you prepare for your upcoming journey by letting you recognize and accept your emotions.
Andrology is the male equivalent of gynecology, which refers to the study of the female reproductive system and sexual health. Unlike its female counterpart, andrology is not very widely used. Urology is a more popular known specialty for male urinary and reproductive issues.
Read on to understand some of the common issues and procedures that come under the purview of andrology.
These are the major conditions encountered by andrologists. This specialty has gained popularity over the last few decades and is only set to get more popular in the coming years.
Surrogacy is a boon for couples who cannot conceive naturally or give birth to a child. Surrogacy is a process in which a woman's unfertilized eggs are implanted into the uterus of another woman who is called the surrogate mother. The egg is fertilized in the surrogate mother's uterus with the biological father's sperm. The surrogate mother lets the child develop in her womb and gives birth. Although, there are various medical treatments available, but not all of them have a high success rate.
The two primary methods of surrogacy are:
Process involved in surrogacy:
Here are the several processes and procedures, which need to be undertaken, after you have chosen a surrogate mother for carrying your child.
This method of having a child has become very popular in the recent times. It is a great blessing for people who cannot conceive due to medical conditions or otherwise. If you wish to discuss about any specific problem, you can consult an IVF Specialist.
Fibroids are the most frequently seen tumors of the female reproductive system. Fibroids, also known as uterine myomas, leiomyomas, or fibromas, are firm, compact tumors that are made of smooth muscle cells and fibrous connective tissue that develop in the uterus. It is estimated that between 20 to 50 percent of women of reproductive age have fibroids, although not all are diagnosed. Some estimates state that only about one-third of these fibroids are large enough to be detected by a doctor during a physical examination.
In more than 99 percent of fibroid cases, the tumors are benign (non-cancerous). These tumors are not associated with cancer and do not increase a woman's risk for uterine cancer. They may range in size, from the size of a pea to the size of a softball or small grapefruit.
Causes: While it is not clearly known what causes fibroids, it is believed that each tumor develops from an aberrant muscle cell in the uterus, which multiplies rapidly because of the influence of estrogen.
Some women who have fibroids have no symptoms, or have only mild symptoms, while other women have more severe, disruptive symptoms. The following are the most common symptoms for uterine fibroids:
Heavy or prolonged menstrual periods
Abnormal bleeding between menstrual periods
Pelvic pain (caused as the tumor presses on pelvic organs)
Low back pain
Pain during intercourse
A firm mass, often located near the middle of the pelvis, which can be felt by the doctor on examination
Diagnosis: Fibroids are most often found during a routine pelvic examination. This, along with an abdominal examination, may indicate a firm, irregular pelvic mass to the physician. In addition to a complete medical history and physical and pelvic and/or abdominal examination, diagnostic procedures for uterine fibroids may include:
Transvaginal ultrasound (also called ultrasonography). An ultrasound test using a small instrument called a transducer, that is placed in the vagina.
Magnetic resonance imaging (MRI). A non-invasive procedure that produces a two-dimensional view of an internal organ or structure.
Hysterosalpingography. X-ray examination of the uterus and fallopian tubes that use dye and is often performed to rule out tubal obstruction.
Hysteroscopy. Visual examination of the canal of the cervix and the interior of the uterus using a viewing instrument (hysteroscope) inserted through the vagina.
Blood test (to check for iron-deficiency anemia if heavy bleeding is caused by the tumor).
Treatment: Since most fibroids stop growing or may even shrink as a woman approaches menopause, the doctor may simply suggest "watchful waiting." With this approach, the doctor monitors the woman's symptoms carefully to ensure that there are no significant changes or developments and that the fibroids are not growing.
In women whose fibroids are large or are causing significant symptoms, treatment may be necessary. Treatment will be determined by the doctor based on:
Your overall health and medical history
Extent of the disease
Your tolerance for specific medications, procedures, or therapies
Expectations for the course of the disease
Your opinion or preference
Your desire for pregnancy
In general, treatment for fibroids may include:
Hysterectomy. Hysterectomies involve the surgical removal of the entire uterus.
Conservative surgical therapy. Conservative surgical therapy uses a procedure called a myomectomy. With this approach, physicians will remove the fibroids, but leave the uterus intact to enable a future pregnancy.
Gonadotropin-releasing hormone agonists (GnRH agonists). This approach lowers levels of estrogen and triggers a "medical menopause." Sometimes GnRH agonists are used to shrink the fibroid, making surgical treatment easier.
Anti-hormonal agents. Certain drugs oppose estrogen (such as progestin and Danazol), and appear effective in treating fibroids. Anti-progestins, which block the action of progesterone, are also sometimes used.
Uterine artery embolization. Also called uterine fibroid embolization, uterine artery embolization (UAE) is a newer minimally-invasive (without a large abdominal incision) technique. The arteries supplying blood to the fibroids are identified, then embolized (blocked off). The embolization cuts off the blood supply to the fibroids, thus shrinking them. Health care providers continue to evaluate the long-term implications of this procedure on fertility and regrowth of the fibroid tissue.
Anti-inflammatory painkillers. This type of drug is often effective for women who experience occasional pelvic pain or discomfort. In case you have a concern or query you can always consult an expert & get answers to your questions!
Endometriosis is an often painful disorder in which tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus. Endometriosis most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis. Rarely, endometrial tissue may spread beyond pelvic organs.
With endometriosis, displaced endometrial tissue continues to act as it normally would — it thickens, breaks down and bleeds with each menstrual cycle. Because this displaced tissue has no way to exit your body, it becomes trapped. When endometriosis involves the ovaries, cysts called endometriomas may form. Surrounding tissue can become irritated, eventually developing scar tissue and adhesions — abnormal bands of fibrous tissue that can cause pelvic tissues and organs to stick to each other.
The primary symptom of endometriosis is pelvic pain, often associated with your menstrual period. Although many women experience cramping during their menstrual period, women with endometriosis typically describe menstrual cramp that's far worse than usual. They also tend to report that the pain increases over time.
Common Signs and Symptoms of Endometriosis may include:
Pain with intercourse. Pain during or after sex is common with endometriosis.
Pain with bowel movements or urination. You're most likely to experience these symptoms during your period.
Infertility. Endometriosis is first diagnosed in some women who are seeking treatment for infertility.
The severity of your pain isn't necessarily a reliable indicator of the extent of the condition. Some women with mild endometriosis have intense pain, while others with advanced endometriosis may have little pain or even no pain at all.
Endometriosis is sometimes mistaken for other conditions that can cause pelvic pain, such as Pelvic Inflammatory Disease (PID) or ovarian cysts. It may be confused with irritable bowel syndrome (IBS), a condition that causes bouts of diarrhea, constipation and abdominal cramping. IBS can accompany endometriosis, which can complicate the diagnosis.
When to see a doctor
See the doctor if you have signs and symptoms that may indicate endometriosis.
Endometriosis can be a challenging condition to manage. An early diagnosis, a multidisciplinary medical team and an understanding of your diagnosis may result in better management of your symptoms.
Although the exact cause of endometriosis is not certain, possible explanations include:
Retrograde menstruation. In retrograde menstruation, menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of out of the body. These displaced endometrial cells stick to the pelvic walls and surfaces of pelvic organs, where they grow and continue to thicken and bleed over the course of each menstrual cycle.
Transformation of peritoneal cells. In what's known as the "induction theory," experts propose that hormones or immune factors promote transformation of peritoneal cells — cells that line the inner side of your abdomen — into endometrial cells.
Embryonic cell transformation. Hormones such as estrogen may transform embryonic cells — cells in the earliest stages of development — into endometrial cell implants during puberty.
Endometrial cells transport. The blood vessels or tissue fluid (lymphatic) system may transport endometrial cells to other parts of the body.
Immune system disorder. It's possible that a problem with the immune system may make the body unable to recognize and destroy endometrial tissue that's growing outside the uterus.
Several factors place you at greater risk of developing endometriosis, such as:
Never giving birth
Starting your period at an early age
Going through menopause at an older age
Short menstrual cycles — for instance, less than 27 days
Having higher levels of estrogen in your body or a greater lifetime exposure to estrogen your body produces
Low body mass index
One or more relatives (mother, aunt or sister) with endometriosis
Any medical condition that prevents the normal passage of menstrual flow out of the body
Endometriosis usually develops several years after the onset of menstruation (menarche). Signs and symptoms of endometriosis end temporarily with pregnancy and end permanently with menopause, unless you're taking estrogen.
The main complication of endometriosis is impaired fertility. Approximately one-third to one-half of women with endometriosis have difficulty getting pregnant. Endometriosis may obstruct the tube and keep the egg and sperm from uniting. But the condition also seems to affect fertility in less-direct ways, such as damage to the sperm or egg. Inspite of this, many women with mild to moderate endometriosis can still conceive and carry a pregnancy to term. Doctors sometimes advise women with endometriosis not to delay having children because the condition may worsen with time.
Ovarian cancer does occur at higher than expected rates in women with endometriosis. Although rare, another type of cancer — endometriosis-associated adenocarcinoma — can develop later in life in women who have had endometriosis.
Diagnosis: To diagnose endometriosis and other conditions that can cause pelvic pain, the doctor will ask you to describe your symptoms, including the location of your pain and when it occurs.
Tests to check for physical clues of endometriosis include:
Pelvic exam. During a pelvic exam, the doctor manually feels (palpates) areas in your pelvis for abnormalities, such as cysts on your reproductive organs or scars behind your uterus. Often it's not possible to feel small areas of endometriosis, unless they've caused a cyst to form.
Ultrasound. A transducer, a device that uses high-frequency sound waves to create images of the inside of your body, is either pressed against your abdomen or inserted into your vagina (transvaginal ultrasound). Both types of ultrasound may be done to get the best view of your reproductive organs. Ultrasound imaging won't definitively tell the doctor whether you have endometriosis, but it can identify cysts associated with endometriosis (endometriomas).
Laparoscopy. Medical management is usually tried first. But to be certain you have endometriosis, the doctor may advise a surgical procedure called laparoscopy to look inside your abdomen for signs of endometriosis.
While you're under general anesthesia, the doctor makes a tiny incision near your navel and inserts a slender viewing instrument (laparoscope), looking for endometrial tissue outside the uterus. He or she may take samples of tissue (biopsy). Laparoscopy can provide information about the location, extent and size of the endometrial implants to help determine the best treatment options.
Treatment for endometriosis is usually with medications or surgery. The approach you and the doctor choose will depend on the severity of your signs and symptoms and whether you hope to become pregnant.
Generally, doctors recommend trying conservative treatment approaches first, opting for surgery as a last resort.
The doctor may recommend that you take an over-the-counter pain reliever, such as the nonsteroidal anti-inflammatory drugs (NSAIDs) ibuprofen (Advil, Motrin IB, others) or naproxen (Aleve, others), to help ease painful menstrual cramps.
If you find that taking the maximum dose of these medications doesn't provide full relief, you may need to try another approach to manage your signs and symptoms.
Supplemental hormones are sometimes effective in reducing or eliminating the pain of endometriosis. The rise and fall of hormones during the menstrual cycle causes endometrial implants to thicken, break down and bleed. Hormone medication may slow endometrial tissue growth and prevent new implants of endometrial tissue.
Hormone therapy isn't a permanent fix for endometriosis. You could experience a return of your symptoms after stopping treatment.
Therapies used to treat endometriosis include:
Hormonal contraceptives. Birth control pills, patches and vaginal rings help control the hormones responsible for the buildup of endometrial tissue each month. Most women have lighter and shorter menstrual flow when they're using a hormonal contraceptive. Using hormonal contraceptives — especially continuous cycle regimens — may reduce or eliminate the pain of mild to moderate endometriosis.
Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists. These drugs block the production of ovarian-stimulating hormones, lowering estrogen levels and preventing menstruation. This causes endometrial tissue to shrink. Because these drugs create an artificial menopause, taking a low dose of estrogen or progestin along with Gn-RH agonists and antagonists may decrease menopausal side effects, such as hot flashes, vaginal dryness and bone loss. Your periods and the ability to get pregnant return when you stop taking the medication.
Progestin therapy. A progestin-only contraceptive, such as an intrauterine device (Mirena), contraceptive implant or contraceptive injection (Depo-Provera), can halt menstrual periods and the growth of endometrial implants, which may relieve endometriosis signs and symptoms.
Danazol. This drug suppresses the growth of the endometrium by blocking the production of ovarian-stimulating hormones, preventing menstruation and the symptoms of endometriosis. However, danazol may not be the first choice because it can cause serious side effects and can be harmful to the baby if you become pregnant while taking this medication.
If you have endometriosis and are trying to become pregnant, surgery to remove as much endometriosis as possible while preserving your uterus and ovaries (conservative surgery) may increase your chances of success. If you have severe pain from endometriosis, you may also benefit from surgery — however, endometriosis and pain may return.
The doctor may do this procedure laparoscopically or through traditional abdominal surgery in more extensive cases.
Assisted reproductive technologies
Assisted reproductive technologies, such as in vitro fertilization (IVF) to help you become pregnant are sometimes preferable to conservative surgery. Doctors often suggest one of these approaches if conservative surgery doesn't work. If you wish to discuss about any specific problem, you can consult a gynaecologist.