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No Baby Blues

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It’s difficult to believe but true that despite our 1.2 billion  population in India, many of our young adults have difficulty in producing children. They may be called “sterile, infertile or sub fertile”. But before a couple is labelled “infertile”, they should have had at least 12 months of regular contraception-free intercourse.

Worldwide, infertility affects 7-10 per cent of the population. Although women actually produce the babies, if the reasons for the infertility are investigated the woman is at fault in a third of the cases; in a third it is the man and in the remainder either both are responsible or no real cause can be found.

Before embarking on a planned pregnancy, the woman should have had immunisations for measles, mumps rubella (MMR) and hepatitis B (3 doses). She should also start folic acid supplements (5mg/day). Children born with physical or mental defects because these basic facts were forgotten are a human tragedy. Both partners need to keep their body mass index (BMI, or weight in kilograms divided by height in metre squared) at around 23 and be physically active for around 40 minutes a day. They also need to treat any existing underlying disease like diabetes, high blood pressure or thyroid problems.

Studies show that caffeine (found in tea, coffee and cola drinks) affects fertility. Women who drink alcohol can produce babies with “foetal alcohol syndrome”. It also reduces the sperm count in men. Smoking affects the quality of the sperms and inhaled passive smoke is bad for the growing baby. Sperm counts may be reduced by inhaling hazardous chemicals in the work place or by working in high temperatures.

Women ovulate cyclically and the egg is released 14 days before the next period. For a woman to conceive, intercourse must take place around this time and the sperm count must be optimal. Initially, if a menstrual calendar is maintained, the fertile days can be calculated. A semen analysis for sperm count is a non-invasive simple test. Also, after intercourse lie down, don’t douche, and avoid lubricants and cleansing agents.

If these simple methods fail in a couple where the woman menstruates regularly and the man has a normal sperm count, a visit to a reproductive medical unit is warranted. Further investigations to establish the patency of the tubes and quality of the sperm may be needed. Depending on the problem, medication or surgical correction of a specific defect may be needed.

Conservative medical treatments are usually tried for periods varying from 6 months to a year. If they fail, assisted reproductive technology (ART) techniques are started.

In IUI (intrauterine insemination) the woman is scanned during her most fertile period to determine ovulation. Healthy treated sperms from her partner are then inserted into the uterus. The technique is used when the sperm count is low, the motility unsatisfactory or if donor sperm is being used.

In GIFT (gamete intra-fallopian transfer), eggs and sperms are collected, mixed and then placed in the woman’s fallopian tube. Fertilisation takes place naturally in the body.

In IVF (in vitro fertilisation) the eggs are harvested and fertilised with sperm in the laboratory. The resulting embryos are then placed in the uterus. This is used in cases where the fallopian tubes are blocked, the fertility unexplained or when several attempts with the other forms of ART have failed. It can result in multiple pregnancies. Some clinics offer “natural cycle IVF”. This involves collecting and fertilising the one egg released during the normal monthly cycle. It avoids the side effects of fertility drugs and multiple pregnancies are less likely.

In ICSI (intracytoplasmic sperm injection) a single sperm is injected into the centre of an egg. This is used when the male partner has a very low sperm count or if other problems with the sperm have been identified.

Donor eggs from other women can be used if the woman has no eggs of her own, or if she is over 40 and the eggs are of poor quality. Sperm from donors can be used if the husband has a low count (oligospermia) or no sperms (azoospermia). Surrogate mothers can be hired to carry the baby to term.

There is no right time to seek medical help, but if sexual intercourse at least three times a week without contraception for a year has been unsuccessful, it is probably time for proactive action. If, however, the woman has periods at intervals less than 21 days or more than 90 days, the flow is unpredictable (if it starts it does not stop and if it stops it does not start) or if there has been pelvic infection in the past, an evaluation should be done at the earliest. In men, if the testes are not felt in the scrotum, or there is a hydrocoele (swelling) or a past prostate infection, investigation and treatment should be started sooner.

Sources:The Telegraph (Kolkata,India)

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IVF

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Introduction:
IVF or in vitro fertilization (IVF) is a process by which egg cells are fertilized by sperm outside the woman’s womb, in vitro. IVF is a major treatment in infertility when other methods of assisted reproductive technology have failed. The process involves hormonally controlling the ovulatory process, removing ova (eggs) from the woman’s ovaries and letting sperm fertilize them in a fluid medium. The fertilized egg (zygote) is then transferred to the patient’s uterus with the intent to establish a successful pregnancy.

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IVF was developed in the 1970s. The first British test tube baby was Louise Brown, who was born in 1978.Some 30,000 test tube babies have been born in the UK since then.
There are several different techniques, but the main process involves the women taking fertility drugs to help her produce more eggs.The eggs are then harvested and fertilised in the laboratory.
The woman is given hormone drugs to prepare her womb to receive the fertilised eggs. The fertilised eggs are placed inside the womb and a normal pregnancy follows.

The term in vitro, from the Latin root meaning in glass, is used, because early biological experiments involving cultivation of tissues outside the living organism from which they came, were carried out in glass containers such as beakers, test tubes, or petri dishes. Today, the term in vitro is used to refer to any biological procedure that is performed outside the organism it would normally be occurring in, to distinguish it from an in vivo procedure, where the tissue remains insided the living organism within which it is normally found. A colloquial term for babies conceived as the result of IVF, test tube babies, refers to the tube-shaped containers of glass or plastic resin, called test tubes, that are commonly used in chemistry labs and biology labs. However in vitro fertilization is usually performed in the shallower containers called petri dishes. (Petri-dishes may also be made of plastic resins.) However, the IVF method of Autologous Endometrial Coculture is actually performed on organic material, but is yet called in vitro.

Around 6,000 babies a year are born in the UK to otherwise infertile couples as a result of in vitro fertilisation.

But the techniques used often arouse huge controversy and some say the process can falsely raise would-be parents’ hopes since it only has a success rate of around 15%.

There have also been cases of fertilised eggs being mixed up in the laboratory and the wrong embryo being transferred to the woman, leading to fears about how the process is carried out.

New techniques coming on stream:

One of the biggest and most controversial advances in IVF in recent years has been the introduction of a technique called ICSI – intra-cytoplasmic sperm injection.

This works by injecting a single sperm directly into an egg.

Some people fear the technique could increase the risk of genetic defects that make the donor infertile being passed on to babies.

ICSI was introduced during the 1990s, but new advances are helping men with a very low sperm count to benefit from it.

These include operations to search for sperm which can be retrieved and injected into an egg.

Another advance being developed at St George’s Hospital in London involves a 3D ultrasound device which helps to spot fertility problems before IVF begins.

For example, it can test whether there are any blockages in a woman’s fallopian tubes that could harm her chances of having a healthy pregnancy.

Other doctors at the hospital are pioneering a technique that could mean an end to hormone treatments and the painful retrieval of eggs from infertile women.

The technique involves collecting thousands of immature eggs from the ovary and developing them in the laboratory.

It works by removing a bit of the skin of the ovary which masks the place where immature eggs develop.

It takes five months to grow there properly and lots of nourishment.

The eggs can be frozen so that they can be used whenever the woman wants.

Again, the technique is controversial because it means a woman could store the eggs and use them at any age.

It is likely to be available in the next 10 years, say doctors at the hospital.

Dr Ian Findlay is also developing a test that can check for 10 genetic abnormalities in one go before a fertilised egg is placed in the womb. He said: “This could lead to a dramatic reduction in miscarriages as the vast majority of miscarriages are due to abnormalities.”

The politics of IVF

IVF is only successful in 15% of cases and a recent report from the College of Health shows that success rates vary widely across the country.

Only 18% of IVF treatment is funded by the NHS and waiting times can differ greatly.

It can cost up to £2,000 per cycle for a couple to go private.

Most couples have three cycles at an average cost of £3,420.

One way of getting free treatment is for women to donate their eggs to other infertile couples.

Opponents of IVF argue that it falsely raises would-be parents’ hopes that they will be able to have a baby when the chances are not that high.

They also argue that it can be a traumatic experience to go through repeated IVF attempts, only to find that the woman does not get pregnant.

Another possible drawback is the fact that IVF treatment increases the chance of having multiple births which the couple may not have planned for.

One to two per cent of pregnant women give birth to more than one child, but with fertility treatment the odds are raised to 25%.

Most of the babies born are twins, but bigger births are on the rise.

Many doctors are worried that they are being put under increasing pressure to use more of the fertility drugs to produce more eggs and so increase the chance of the woman getting pregnant.

Some believe fertility drugs could cause ovarian cancer.

Liz Tiberis, author of ‘No Time to Die’, believes her ovarian cancer was the result of nine attempts at IVF.

But fertility doctors say the link has not been proven.

The Cancer Research Campaign is investigating.

Who regulates the IVF process?

In the UK, the Human Fertilisation and Embryology Authority regulates and licenses fertility clinics under the 1990 Human Fertilisation and Embryology Act.

One area of controversy involves the processes clinics have for ensuring mix-ups do not occur over embryos.

This follows a US case where one woman wrongly received the fertilised egg of another.

Fertility experts say procedures in the UK are very tight and there is unlikely to be the same mix-up here.

But the Medical Protection Society recently reported the case of an expert who transferred three embryos from one woman into another by mistake.

However, he realised his error in time.

Calls have been made for procedures for matching eggs with mothers to be tightened, for example, by stipulating that doctors have to do a DNA test before implantation goes ahead rather than relying on written records.

You may click to learn more about IVF

BBC NEWS:31 March , 1999

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Health Quaries

Some Health Questions And Answers

Q: I have a paunch. How can I reduce it?….CLICK & SEE

A: Spot reduction of a paunch alone is not possible. You have to attempt all-round weight reduction and toning exercises. This can be done with a judicious combination of diet and exercise. Either alone will work only in the short term.

Men tend to accumulate weight around their middle. It will probably be the first place you gain weight and the last place you lose it. The risk factors associated with a paunch are diabetes, hypertension and heart disease. In men the risk increases once the waist measurement crosses 102 cm.

No surgery
Q: My eight-year-old son has frequent attacks of tonsillitis when the weather changes or if he drinks or eats refrigerated things. The doctor says I should wait and not have them operated. Is that correct?

A: Years ago many children had their tonsils removed as they were considered a useless troublesome organ. Today, we know that the tonsils filter out harmful viruses and bacteria and prevent them from entering the body and causing disease. Surgery is seldom necessary. It is recommended if there are seven or more episodes of tonsillitis in one year, the swollen tonsils interfere with breathing or swallowing, or an abscess develops in the tonsils.

Infection occurs with bacteria and viruses. These are usually spread with close contact. The number of infections increases when the child starts school. The refrigerator probably has little to do with the frequent attacks.

The tonsils tend to decrease in size as the child grows older. Waiting and watching instead of rushing into surgery seems like a sensible option. Your doctor is right.

Safe period
Q: We are a newly married couple and do not want children. My wife dislikes condoms and refuses to take the pill. My friend advised natural family planning and the safe days. I was too embarrassed to find out the details. How do we go about it?

A: First, you have to calculate the length of your wife’s menstrual cycle. This can vary in different women and can be anywhere from 26 to 45 days. The first day of bleeding is taken as day one.

Pregnancy occurs if there is sexual intercourse around the time the egg is released. This is usually 14 days before the next period starts. The safe period is thus seven days before and seven days after menstruation. It is not a very reliable method though.

Some couples practice coitus interruptus. In this method, ejaculation takes place outside the vagina.

Medication and sterility
Q: My wife and I have been trying to have a baby for the last 20 years. She is now nearing 40. She has had two miscarriages in the past. I was given methotrexate on and off for my medical condition of psoariasis. I now think this may be the cause of our problem.

A: Gonadotoxins are substances that interfere with sperm formation and quality. They may be chemicals, medication (both prescription and non-prescription), tobacco, alcohol and illicit drugs. The severity and reversibility of the problem depend on the duration and amount of exposure. Methotrexate is one of the medicines that can do this if taken long term.

Consult a reproductive medicine unit in a hospital near you. They will be able to work with your physician to determine the best course of action.

Memory loss
Q: I am preparing very hard for my exams. My marks used to be very good. Now the more I study the less I remember. My marks are decreasing. All these late nights are making me irritable.

A: Sleep deprivation leads to memory loss, irritability and a decline in reasoning. All the three would work against good academic performance.

Most people need around eight hours of sleep a day. Your brain automatically knows how tired you are. If you are consistently using an alarm clock to wake up, it means that you are forcing your brain to function when it is not ready. This decreases efficiency and impairs memory.

Perhaps your marks will be better if you put in 30 minutes of physical activity a day and also got rid of your alarm clock.

Source:The Telegraph (Kolkata, India)

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News on Health & Science

‘High temp leads to infertility’

NEW DELHI: Researchers recorded the temperature changes to the scrotum caused by laptop use among 29 healthy male volunteers aged between 21 and 35 and found that just sitting with thighs pressed together, caused scrotal temperatures to rise by 2.1 degrees C.

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The AIIMS study also found that majority of men who were exposed to high temperature at their work places welders, dyers, blast furnace workers, cement and steel factories are also more prone to infertility. All this happens because even small changes in temperature have a negative effect on sperm production.

Testes are located outside of the body, suspended by the spermatic cord within the scrotum. This allows for more efficient and fertile sperm production.

The temperature of the testes is usually three degrees lower than the core body temperature (37 degrees C or 98.6 degrees Fahrenheit). Even one degree elevation in testicular temperature leads to 14% depression of spermatogenesis.

“Not only has quantity of sperm production declined in males across the world, there has been a decrease in mortility (sperm movement) and morphology (shape and structure) of the sperms.

“There has been a 2% decrease in quality of male sperm annually. Also, 40% men in the reproductive age group are at present recording a quantitative and qualitative decline in sperm quality,” Dr Dada said. The study also found that nearly 20% of infertile men with low sperm count, or oligospermia, harboured genetic abnormalities.

The abnormality either involved sex chromosomes or autosomes or micro deletions in the ‘Y’ chromosome, said Dada. The ‘Y’ chromosome harbours the gene critical for germ cell development and differentiation, without which a person will have no sperms or will have very low sperm count.

Related Stories :

Tight jeans could reduce fertility

Male infertility on the rise

Infertility strikes in the 20s

In Audio: Wanna be a dad? Beware of...

Source:The times of India

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Ailmemts & Remedies

Endometriosis

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Many women suffer from the pain and heavy bleeding of endometriosis. In the past, they often were told their complaints were “just cramps” or “all in your head”. Today, doctors take this condition more seriously, but conventional medicine offers little to ease its symptoms.

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Symptoms

*Intense menstrual cramps that begin before your period starts and reach their peak after it ends.
*Abnormally heavy menstrual bleeding, often with large clots.
*Nausea and vomiting just before a menstrual period.
*Sharp pain during sexual intercourse at any time of the month.
*Diarrhea, constipation, or pain during bowel movements.
*Blood in the stool or urine during menstrual period.
*Infertility.

When to Call Your Doctor

If you have any of the above symptoms.
Reminder: If you have a medical condition, talk to your doctor before taking supplements.

What It Is

In endometriosis, bits of the uterine lining (endometrium) migrate out of the uterus and embed themselves in other abdominal tissues, often the ovaries, uterine ligaments, or intestines. Each month, as estrogen and other hormones cause the lining of the uterus to thicken with blood, the wayward cells also expand. The uterine tissues then slough off normally. But the stray cells have nowhere to release the blood they’ve amassed, leading to cysts, scarring, or adhesions (fibrous tissue that binds parts of the body that are normally not attached to each other). Although not all women with endometriosis have symptoms, the condition can cause severe pain. Endometriosis is a leading cause of female infertility.

What Causes It

No one knows why endometriosis develops, but speculation abounds. According to the reflux menstruation theory, menstrual blood travels backward through the fallopian tubes, funneling endometrial cells into other abdominal areas where they seed and grow. Another hypothesis suggests that endometriosis is congenital — meaning that some endometrial cells have been outside the uterus since birth. Still another idea is that endometriosis is caused by a faulty immune system, which neglects to destroy the out-of-place cells.

How Supplements Can Help

All of the supplements listed can be used together and with any medications prescribed by your doctor. Begin by taking the traditional combination of chasteberry and dong quai. These herbs aid in correcting the hormonal imbalances that can intensify the pain of endometriosis. They also relax the uterus, as does wild yam. In addition, take a lipotropic combination, which stimulates the liver to clear excess estrogen from the body. Use these supplements throughout your menstrual cycle for best results. If menstrual cramps are painful, take the high doses of calcium and magnesium listed, but only during your period. These minerals help to lower the body’s production of prostaglandins, substances made by endometrial cells that cause menstrual cramps.

What Else You Can Do

Eat soy products, which contain phytoestrogens (plant estrogens) that may offset the effect of estrogen on symptoms of endometriosis.
Exercise. In several studies, it has been shown to suppress symptoms and may actually prevent endometriosis.

Supplement Recommendations

Chasteberry
Dong Quai
Wild Yam
Lipotropic Combination
Calcium/Magnesium
Vitamin C
Vitamin E
Flaxseed Oil
Evening Primrose Oil

Chasteberry
Dosage: 225 mg standardized extract 3 times a day.
Comments: Also called vitex. Should contain 0.5% agnuside.

Dong Quai
Dosage: 200 mg, or 30 drops tincture, 3 times a day.
Comments: Standardized to contain 0.8%-1.1% ligustilide.

Wild Yam
Dosage: 500 mg twice a day.
Comments: Take with food to minimize stomach upset.

Lipotropic Combination
Dosage: 1 or 2 pills 3 times a day.
Comments: Should contain milk thistle, choline, inositol, methionine, dandelion, and other ingredients.

Calcium/Magnesium
Dosage: 500 mg calcium 4 times a day; 500 mg magnesium twice a day.
Comments: Use this dose only during menstruation.

Vitamin C
Dosage: 1,000 mg 3 times a day.
Comments: Reduce dose if diarrhea develops.

Vitamin E
Dosage: 400 IU twice a day.
Comments: Check with your doctor if taking anticoagulant drugs.

Flaxseed Oil
Dosage: 1 tbsp. (14 grams) a day.
Comments: Can be mixed with food; take in the morning.

Evening Primrose Oil
Dosage: 1,000 mg 3 times a day.
Comments: Can substitute 1,000 mg borage oil once a day.

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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.

Source:Your Guide to Vitamins, Minerals, and Herbs(Reader’s Digest)

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