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Reproduction Health Feed

IVF Vs Tubal Ligation Reversal!

MD Gynaecology
IVF Specialist, Kolkata
IVF Vs Tubal Ligation Reversal!

There are many different modes of contraception available to women today. Tubal ligation is considered the most effective amongst these. This involves permanently blocking the fallopian tubes by clipping, cutting or burning them. The only downside to this form of contraception is its permanence. Conceiving a child after tubal ligation is difficult but not impossible. The two modes of treatment available to women who have undergone this procedure are tubal ligation reversal and IVF.

As the name suggests, a tubal ligation reversal procedure reconnects the fallopian tubes. This procedure involves making a 10-15cm incision in the lower abdomen. Tiny stitches are then used to reconnect the two blocked ends of the fallopian tubes. This procedure is usually performed while the patient is under general anaesthesia and could involve a few days of hospital stay. A tubal ligation reversal procedure can also be performed as a keyhole procedure. This procedure gives a woman a chance to conceive naturally. The younger the woman is, the higher are her chances of conception after this procedure. In the case of patients over the age of 40 years, the chances of a successful conception after this procedure are very slim.

IVF or In vitro fertilization involves harvesting the eggs from the patient’s ovaries, fertilizing them in a lab and then reintroducing the embryo into the patient’s uterus. When it comes to assisted reproductive therapy, IVF is more successful than a reverse tubal ligation. Another advantage of IVF over reverse tubal ligation is the fact that with IVF the woman will still have an efficient form of birth control even after the pregnancy. IVF also does not need any hospitalization. One of the downsides of a reverse tubal ligation is the high risk of tubal ectopic pregnancy. In this case, the fertilized egg is implanted outside the uterus. This type of pregnancy cannot usually be taken to full term and can be life-threatening for the woman.

On the flip side, IVF can often need repeat cycles which often works out to be quite expensive. These costs can be an issue for a woman who wants more than one child. In the case of reverse tubal ligation, the costs are a one-time investment.

One of the other common side effects of IVF is multiple pregnancies. For women who do not want more than one child, this can again be a problem. Thus, both forms of treatment have their advantages and disadvantages.

The best form of treatment for you can be decided only by a fertility expert.

4972 people found this helpful

Fertility - Best Ways Boost It!

MD Gynaecology
IVF Specialist, Kolkata
Fertility - Best Ways Boost It!

Pregnancy can be easy and smooth, while on the other hand, it might be time consuming, marred with conception difficulties all along the way. Pregnancy may seem exciting to some, whereas it can be stressful for others. Regardless of whether it is the first child you are planning or have had a successful pregnancy previously; there are some tips you need to keep in mind in order to improve fertility and give birth to a healthy child.

Some fertility boosting factors are:

  1. These fantastic swimmers are at the very root of male fertility. Some important components which need to be taken into consideration are sperm count, sperm motility (the ability of the sperm to swim around the female reproductive tract) and morphology (shape and size of a sperm). In order to have all these parameters in check and working fine, one needs to abstain from smoking and limit alcohol consumption among many other lifestyle modifications.

  2. Having unprotected vaginal intercourse during the woman’s fertile days in a month helps improve chances of conception.

  3. Fertility becomes a challenge when you are either overweight or underweight. The weight of a woman affects ovulation (The release of eggs from the ovaries) and causes hormonal imbalance; factors which make it very difficult to conceive. Keep your weight levels in check and that could prove primarily essential in bettering your fertility.

  4. Staying well nourished boosts your odds of conceiving! Make sure to include enough protein, iron, zinc, vitamin C, and vitamin D in your diet, because deficiencies in these nutrients have been linked to lengthened menstrual cycles (and therefore less frequent ovulation) and a higher risk of early miscarriage. Ask your gynaecologist if you should take a daily multivitamin supplement. And be sure to eat protein-rich foods, such as meat, fish, low-fat dairy products, eggs, and beans.

  5. Beware of STDs or Sexually Transmitted Diseases. One is the most prone to STDs of any kind if he/she happens to engage in unprotected sexual intercourse; having a number of sexual partners just ups the chances of getting afflicted by STD. Protected vaginal intercourse helps prevent STDs, thus enhancing fertility and subsequently, chances of conception.

  6. According to several studies, the lubricant one chooses surprisingly plays a significant role in determining fertility. Not all lubricants boost fertility and sperm motility (sperm count). Baby oil or egg whites are a few good examples of such lubricants.

  7. While a limited amount of caffeine consumption is good, overdoing it might spoil and hamper fertility. Limit caffeine intake and keep it within a level of 200-250mg a day.

  8. Smoking, besides playing havoc with every organ in the body, affects the reproductive organs and thus fertility. In men, it leads to reduced sperm count and in women, it causes DNA damage. Stub the bud right now and never get back to it.

  9. Certain toxic chemicals can lead to female and male infertility. So it is advisable that you stay away from chemicals such as pesticides, organic solvents and lead, the primary toxins which pose a severe threat to fertility.

  10. Exercising regularly can never go wrong. It gives you the strength and stamina, boosting your overall health. However, vigorous exercises, especially when you are trying to conceive, will do you no good. It might adversely lead to the suppression of certain hormones such as progesterone (pregnancy stimulating hormone) and might affect ovulation, hence affecting fertility. Aim at a regular 20 minutes session of light exercises; mild cardiovascular exercises such as walking can work wonders, especially in such circumstances.
4782 people found this helpful

ICSI - Know Procedure Of It!

Dr.Pranay Shah 90% (73ratings)
MS - Obstetrics and Gynaecology
IVF Specialist, Ahmedabad
ICSI - Know Procedure Of It!

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 %
2654 people found this helpful

Third Party Reproduction - Is Ethical Or Unethical?

MBBS, MD - Obstetrics & Gynaecology
Gynaecologist, Thane
Third Party Reproduction - Is Ethical Or Unethical?

Third-party reproduction is a method in which a third person apart from the couple (intended parents) involves in reproduction procedure. This can be done by using donated sperm, eggs, embryos, or gestational carrier arrangements. In this process, the pregnancy is carried by the third individual other than the couple.

A gestational carrier is also sometimes referred to as Surrogacy, in which women carry the fetus and may also provide egg.

The third-party reproduction process gives an opportunity to those infertile couples who want to become parents. However, it can be ethically, socially, and legally complex. The egg or sperm donation, gestational carrier arrangement is controversial as it may not acceptable by law or society.

Third-party reproduction can be performed in the following ways: 

Egg Donation -

The first egg donation resulted in pregnancy was reported in 1984. After that, the egg donation becomes popular and helped many infertile couples to conceive. With the help of egg donation, infertile couples can have a genetic link to the child if a male partner contributes his sperm to fertilize with the donated egg. In this process, the eggs are removed from a fertile woman, fertilized in a laboratory, and transfer the resulting embryo to the recipient uterus.

Sperm Donation -

Sperm donation is practised and used for over a century. It was first reported in the year 1945. However, with the development of the HIV issue, Donor insemination (DI) has now only performed with quarantined and frozen sperm. This allows the time to test the sperm of the donor.

The process is beneficial for those who have any abnormalities with semen, or reproductive system that hinders them to have a child.

Embryo Donation -

In this process, the embryo is formed inside the body of a fertile woman and then transfer to an infertile woman for further development of the embryo. This process enables them to achieve pregnancy and conceive a child.

Embryo donation needs the recipient to undergo some medical and psychological screening for all gamete (Sperm and egg) donor cycles.

These are some of the ways for third-party reproduction.

Is Third Party Reproduction Ethical or Unethical?

Third-Party reproduction contains several legal issues. Both donor (s) (egg or sperm, or both) and intended parents should sign a legal contract that defines the rights of the donor and financial obligations with respect to the donated egg or sperm (gametes).

Apart from the legal perspective of third-party reproduction, there are some of the concerns of the process as well. The decision of undergoing this procedure may cause the expecting parents to face some dilemmas associated with community and society, as the pre-existing notion of building a family involves the natural process of becoming a parent.

As ethics of a society is an ever-transforming notion, the question of third-party reproduction being ethical or unethical depends on the progressive and collective psychology of the society.

2122 people found this helpful

IVC - Know Merits Of It!

Dr.Sameer Pahlajani 88% (27ratings)
MBBS
IVF Specialist, Raipur
IVC - Know Merits Of It!

INVO (intravaginal culture of oocytes), also called IVC (Intravaginal culture) is an abetted procedure of reproduction where early embryo development and oocyte fertilization are carried out inside a gas penetrable, air-free plastic tool or device that is placed into the maternal vaginal chamber for incubation. It is a device that helps the future mothers to participate in the evolution and growth of their own embryos present inside their body. The device is composed of an inner cavity with a protective outer rigid shell and a rotating valve.

It can be used for IVF (In Vitro Fertilization) cycles; whether with the mother's own eggs or any donor's eggs. It provides the same successful results as conventional treatments. It works in a very simple way:- when the requisite samples to produce embryos have been acquired or when the eggs have been impregnated in the laboratory, they together with culture medium are placed into the INVOcell device and then the device is inserted into the vagina of the mother and there it is kept for two to three days (for 72 hours culture period). Throughout this time, the mother can lead a practically normal life but she needs to elude taking bath, having intercourse or flying during those days on which she is wearing it.

When fertilisation takes place, it will be the mother's own heat which will supply the best conditions for the proper development of the embryos. Once they are set and ready, the doctor will remove the INVO from the mother's vagina to recover the embryos. The embryos are then evaluated under the microscope to choose the healthiest-looking ones to transfer them into the uterus. Within the uterus, they will be embedded in order to begin developing.

Advantages of INVO are:

  1. It is one of the most cost-effective assisted conception treatments.
  2. In this method, the embryo incubation is more natural.
  3. Since in this whole process embryo incubation in the laboratory isn’t required, the possibility of stumbling at the laboratory is diminished.
  4. In this method, the couple experiencing the treatment is involved more.
  5. This method has similar efficacy as the IVF treatments.

Disadvantages of INVO are:

  • Since the device has to remain for three days in the mother's vagina, it causes some discomfort.
  • The patient has to spend much time in the assisted reproduction clinic and visit it more often.

The studies suggest that it could be a useful alternative choice for assisted reproduction.

5581 people found this helpful

Andrology - What Should You Know?

Dr.Chitra Reddy 87% (44ratings)
Karnatak University, India, J J M M C, DAVANAGERE, JJM Medical College, Davangre(Mysore University)
Gynaecologist, Bangalore
Andrology - What Should You Know?

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.

  1. Vasectomy: One of the most effective methods of birth control, vasectomy is ligating the tubes so that the sperm does not enter the urethra. It is a definitive surgical contraceptive technique and is very simple, as compared to the other contraceptive measures.
  2. Circumcision: Surgical method of removing the foreskin, which may be done for medical or elective reasons, at birth or later in life. This is one of the most widely performed surgical procedures across the world.
  3. Prostatitis: The prostate gland is a walnut-sized gland located between the bladder and the penis. It can get inflamed as a result of infection, often bacterial. This can be acute or chronic and presents with painful urination and change in color of urine. The patient never has the feeling of having emptied the bladder fully, and there is a constant fullness. Urge to urinate is increased, especially at night. A course of antibiotics often helps in treatment.
  4. Impotence: The most common reproductive problem in males, impotence or erectile dysfunction is now known to have strong psychological and physiological components. In addition to male organ problems, there can be unhealthy relationships and performance anxiety which also could lead to impotence. In most cases, counselling will help in managing impotence.
  5. Epididymitis: In sexually active males, the epididymis which is located behind the testicles can get inflamed as a complication of gonorrhea or chlamydia. There can also be swelling of the testicles, frequent urination, and a burning sensation when urinating. Treatment includes pain killers and antibiotics.
  6. Phimosis: In a patient with phimosis, the foreskin cannot be pulled back beyond the glans. There could be a balloon-like swelling with urination under the foreskin. It is often painless, but with the erection, may be slightly painful. Seen in young children, usually resolves by the age of 7 years.
  7. Peyronie's disease: This is a connective tissue disorder, where fibrous plaques form in the soft areas of the penis. The penis develops a curvature which does not easily go away. It becomes common with age and interferes with urination and sexual intercourse. Though it resolves with time, there is no definitive treatment for this condition.

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.

1351 people found this helpful

Things You Should Know About Adolescence!

MBBS, MS - Obstetrics and Gynaecology, Fellowship In IVF
Gynaecologist, Faridabad
Things You Should Know About Adolescence!

What is puberty?
Puberty is the phase in life when the body of the child matures to become an adult. This change is mainly influenced by the developing reproductive system and it makes them capable of sexual reproduction. It a progressive change and happens over a span of few years. Girls start to develop breasts and might start menstruating whereas boys notice changes in body hair growth pattern with their voices beginning to crack.
The average age for a girl to attain puberty is found to be 11, whereas in boys, it is longer and the average age is somewhere around 12. Puberty also marks the onset of emotional maturity in kids as well.
Sometimes puberty can be seen at a very young age such as 7 or 8; this is called precocious puberty. This can make it physically and mentally taxing for a child and can be a sign of health issues.

What causes puberty?
The stimulation of the hypothalamus in the brain leads to the production of a hormone called Human Gonadotropin-releasing hormones (GnRH) which signal the Pituitary Gland to produce luteinizing hormone (LH) and follicle-stimulating hormone (FSH). This is responsible for sexual development.
Signs that may indicate the onset of puberty in girls:

The telltale signs of puberty in girls are:

  1. Development of breasts
  2. Growth of hair in areas such as armpits and genitals
  3. A growth spurt, i.e., rapid growth in height
  4. Start of menstruation or her periods
  5. Increase in body fat in certain areas of the body
  6. Development of acne
  7. “Mature” body odour

Signs that may indicate the onset of puberty in boys:
The usual signs of puberty in boys are:

  1. Enlargement of the testicles or penis
  2. Pubic, underarm, or facial hair development
  3. Rapid height growth — a growth "spurt"
  4. Deepening of voice
  5. Acne
  6. "Mature" body odor
  7. Increase in hair growth in other parts of the body such as the arms and legs

Along with these signs and symptoms, other signs can be changes in mood. Boys and girls may develop sexual urges wherein you will notice an unexplained attraction to the opposite sex.

1443 people found this helpful

IVF - Know Steps Of It!

Dr.Pranay Shah 90% (73ratings)
MS - Obstetrics and Gynaecology
IVF Specialist, Ahmedabad
IVF   - Know Steps Of It!

What is IVF?

IVF stands for In Vitro Fertilization and is a method of artificial insemination that dramatically increases the chances of pregnancy. It is one of the assisted reproductive technologies methods used as fertility treatment across the world where other methods have had drastic results.

In simpler terms, a man's sperm is inserted in a woman's egg using controlled laboratory environment to proceed with fertilization. These embryos are then carefully put back into the mother's uterus after 4 to 5 days of fertilization in an incubator in hopes that the embryo would grow in a full baby. The embryo transfer process needs to be carefully done in order for successful fertilization in the mother's womb.

There are many reasons why IVF is conducted:

  1. Poor sperm quality - Males having poor sperm quality are unable to achieve fertilization and increase the chances of conception with their female partners. This is male factor infertility due to which people move towards IVF.
  2. Fallopian tube problems - This is female factor infertility, in which fallopian tubes either get blocked or damaged making it complicated and stressful for the embryo to travel to the uterus.

One must approach IVF treatment with patience and a willingness to comply with all the tenets that the treatment is built upon. IVF clinics may vary the treatment a little according to what the patient's condition demands and different clinics may have different methods. The basic methods of IVF treatment, however, remain the same. The first step to the treatment is to find the right clinic which complies with factors like availability of resources, cost and quality of treatment. After deciding the clinic, the next step is to understand that IVF treatment happens in cycles and the success rate of conception varies. Patients must also be ready to face any disappointment.

Here’s the short version of the steps involved in an IVF treatment cycle:

  1. Ovarian stimulation. Your doctor prescribes a course of drugs for you to take to stimulate your ovaries into hopefully producing 12 to 15 mature eggs.
  2. Monitoring of your drug response. To monitor the progress of your ovarian stimulation you undergo an ultrasound examination and blood tests.
  3. Egg maturation. Two days before your eggs are due to be collected you have a hormone injection, which triggers maturation of the eggs.
  4. Egg collection. You receive a light general anaesthetic for this simple, short procedure, and your doctor retrieves your eggs using an ultrasound-guided technique.
  5. Sperm production. On the day of egg collection, your partner provides a sperm sample.
  6. Fertilisation. The embryologist puts sperm and eggs together in the lab and, if all goes well, the eggs fertilise and early embryo development begins.
  7. Embryo transfer. Two to five days after egg collection, your doctor places one or two embryos in your uterus. Frozen transfer can be planned after a gap of 1 month.
  8. Embryo freezing. If you have additional embryos suitable for use, they can be frozen and kept for future transfers. Also, frozen embryos are available.
  9. Pregnancy test. About two weeks after embryo transfer you have a blood test to find out whether the treatment worked.
    • If the test is positive, you have your first pregnancy scan two weeks later.
    • If the test is negative, you and your partner need to talk to your doctor and decide whether to try the treatment again.
2385 people found this helpful

Ovarian Cancer - All You Should Know About It!

MCh (Surgical Oncology, MBBS
Oncologist, Guwahati
Ovarian Cancer - All You Should Know About It!

Ovarian cancer is referred to as the cancer of the ovaries. The ovaries are a component of the female reproductive system. There are two ovaries located on either side of the uterus in a woman's body. Ovaries which are the organs responsible for producing egg cells also produce the hormones estrogen and progesterone.

Ovarian cancer is a type of cancer which often goes undetected until it has spread all the way to the pelvis and the abdomen. However, it is also very difficult to treat the condition in its later stages which is why diagnosing ovarian cancer quickly is quintessential. Here is everything you need to know about ovarian cancer;

Symptoms:

  1. No symptoms at first: Usually, in its early stages ovarian cancer does not cause any symptoms.
  2. Abnormal bloating: Bloating is when your abdomen swells due to excess fluid or gas inside. Abnormal bloating is more frequently associated with irritable bowel syndrome or even constipation is a common symptom of ovarian cancer.
  3. Feeling full quickly: This is also an associated symptom which has often been mistaken for constipation or irritable bowel syndrome.
  4. Weight loss: This is one of the more common signs of ovarian cancer.
  5. Discomfort in the pelvis area: This symptom occurs towards the later stages of ovarian cancer after it has already spread.
  6. Constipation: Constipation is a symptom of ovarian cancer as well.
  7. Frequent urination: This is yet another symptom which is a sign of ovarian cancer.

The symptoms of ovarian cancer are often mistaken with that of irritable bowel syndrome and constipation.

Causes: As with other forms of cancer, it is still very unclear what exactly causes ovarian cancer.

Treatment:

  1. SurgerySurgery most commonly involves removing large parts of the female reproductive system which includes the ovaries, the fallopian tubes, the uterus as well as the lymph nodes. The surgeon will also try and remove as many cancer cells as possible from the abdomen and pelvic areas.
  2. ChemotherapyChemotherapy is usually done after surgery. It is usually performed so that the rest of the cancer cells are killed off. Chemotherapy drugs can be injected directly into the vein, abdominal cavity or sometimes even both.
2355 people found this helpful

IVC - Know Merits Of It!

Dr.Pranay Shah 90% (73ratings)
MS - Obstetrics and Gynaecology
IVF Specialist, Ahmedabad
IVC - Know Merits Of It!

INVO (intravaginal culture of oocytes), also called IVC (Intravaginal culture) is an abetted procedure of reproduction where early embryo development and oocyte fertilization are carried out inside a gas penetrable, air-free plastic tool or device that is placed into the maternal vaginal chamber for incubation. It is a device that helps the future mothers to participate in the evolution and growth of their own embryos present inside their body. The device is composed of an inner cavity with a protective outer rigid shell and a rotating valve.

It can be used for IVF (In Vitro Fertilization) cycles; whether with the mother's own eggs or any donor's eggs. It provides the same successful results as conventional treatments. It works in a very simple way:- when the requisite samples to produce embryos have been acquired or when the eggs have been impregnated in the laboratory, they together with culture medium are placed into the INVOcell device and then the device is inserted into the vagina of the mother and there it is kept for two to three days (for 72 hours culture period). Throughout this time, the mother can lead a practically normal life but she needs to elude taking bath, having intercourse or flying during those days on which she is wearing it.

When fertilisation takes place, it will be the mother's own heat which will supply the best conditions for the proper development of the embryos. Once they are set and ready, the doctor will remove the INVO from the mother's vagina to recover the embryos. The embryos are then evaluated under the microscope to choose the healthiest-looking ones to transfer them into the uterus. Within the uterus, they will be embedded in order to begin developing.

Advantages of INVO are:

  1. It is one of the most cost-effective assisted conception treatments.
  2. In this method, the embryo incubation is more natural.
  3. Since in this whole process embryo incubation in the laboratory isn’t required, the possibility of stumbling at the laboratory is diminished.
  4. In this method, the couple experiencing the treatment is involved more.
  5. This method has similar efficacy as the IVF treatments.

Disadvantages of INVO are:

  • Since the device has to remain for three days in the mother's vagina, it causes some discomfort.
  • The patient has to spend much time in the assisted reproduction clinic and visit it more often.

The studies suggest that it could be a useful alternative choice for assisted reproduction.

3749 people found this helpful
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