HIGH RISK PREGNANCY – No more a cause for worry

Pregnancy is one of the phases of life which is eagerly anticipated. The sheer joy of carrying a blessing inside you can be felt only by you

Taking a few precautions is what is needed to make this just the way it should be – wonderful.

Dealing with a high-risk pregnancy could be stressful but with expert medical care, it could be uneventful. Healthy mothers grow healthy babies so first and foremost enrol yourself for expert medical guidance for preparing yourself for pregnancy as soon as you plan one. Proper counselling regarding nutritional supplementation and achieving an ideal weight to prepare you for this event is necessary.

A high-risk pregnancy is one in which there is an increased probability of complications before or during pregnancy or after delivery. It is important therefore to understand the factors which may be responsible for this risk. Previous medical conditions like diabetes, high blood pressure, anaemia, fits, infections of any kind Rh-negative blood group along with lifestyle habits like smoking, consuming alcohol, advanced maternal age are contributors.

Care should be taken to note if there exists any family history of genetic defects in previous children or conditions like stillbirths, miscarriages. Certain medical conditions developing during pregnancy like high blood pressure, gestational diabetes, low or excessive fluid around the baby, multiple pregnancies, less growth of the baby, low lying placenta, may complicate your pregnancy.

Expert multidisciplinary care by a team of doctors would ensure that you are in perfect shape to initiate your pregnancy, well informed about the possible hiccups if any, enabling you to glide smoothly over the roadblocks.

Rekha Rani fertility centre for women, with expertise in all aspects of healthcare under one roof is the perfect destination to enjoy the joy of parenthood. Remember your pregnancy is the only blind date where you know you are going to meet the love of your life to be well prepared, well informed and well protected.



Ovarian cysts diagnosis and treatment

Diagnosis

During a pelvic exam, a cyst on your ovary can be recognised. A doctor will recommend the test examining its size and checks if it a fluid-filled, solid or mixed. Based on this there will be the prescription and they determine whether you need a treatment. The tests are as follows:


Pregnancy test: A positive test may suggest that you may have a corpus luteum cyst

Pelvic ultrasound :An image of your ovaries and uterus is displayed on the video screen by a transducer which sends and receives high-frequency sound waves. By seeing this video your doctor will analyze the presence of the cyst, identifies its location and determine

Laparoscopy :Laparoscope is a slim, lighted instrument which is inserted into your abdomen through a small incision. By this, your doctor can remove the ovarian cyst. A patient is given anaesthesia before performing

CA 125 blood test :Blood levels of a protein called cancer antigen 125 (CA 125) often are elevated in women with ovarian cancer. Your doctor prescribes this test if your cyst is partially solid and you’re at high risk of ovarian cancer.


Treatment

Treatment depends on the type and size of your cyst, your age and symptoms. Your doctor might suggest:

Watchful waiting : Wait and watch to re-examine if the cyst goes away. This is just an option regardless of your age. If there are no symptoms then it says that you have simple, small, fluid-filled cyst.

Medication : An image of your ovaries and uterus is displayed on the video screen by a transducer which sends and receives high-frequency sound waves. By seeing this video your doctor will analyze the presence of the cyst, identifies its location and determine its type.

Surgery : If your cyst is growing continuously through two or three menstrual cycles or if it causes pain then your doctor will suggest you the surgery.

In some cases, cysts can be removed without removing the ovary. Your doctor would suggest the removing of the affected ovary and leaving the other intact.

In some cases, cysts can be removed without removing the ovary. Your doctor would suggest the removing of the affected ovary and leaving the other intact.


Infertility counselling

Infertility is one of the most stressful life crises that a couple can face.

Among the top issues that contribute to the stress for couples in the towards infertility are:

      1. Physical tests
      2. Investigations and treatment procedures
      3. Relationship challenges
      4. Financial matters
      5. Emotional issues
      6. Decision making hormone treatments
      7. Exhaustion

They frequently bring a range of powerful feelings including anxiety, anger, stress, grief, humiliation, denial confusion, guilt, blaming and depression. Often their self esteem suffers too.

Researchers have shown that infertility and stress are related to each other and even though no hard evidence has been established as to whether stress causes infertility or infertility causes stress, it is well known that the infertility process can be overwhelming. The exhausting nature of infertility treatments and related issues can lead to battles with depression and anxiety.

This can affect the way in which one copes throughout the process. The most stressful stage in couples undergoing IVF treatment is the period when they are waiting for the outcome of the treatment. As the sense of failure intensifies, the infertile couple will become more isolated from everybody and are particularly vulnerable, the danger is that they become more isolated, losing confidence going into chronic depression with acute episodes. These are often triggered by events such as birth of someone else’s baby, the announcement of a pregnancy.

Dealing with infertility normally will put infertile couple in unstable emotions. It’s not easy to make good decision in this highly stressed state. It is difficult to continue one’s normal social life and work. The relationship between couples often is tested to the limit. To have successful IVF procedure patients should have a stable emotion. Hence every couple who decide to receive IVF treatments should attend an implication counselling with the counsellor first. In this implication counselling, the counsellor will briefly explain about the IVF treatment flow and stages, the importance of stability during the process, the cost and the risk that might occur. IVF counselling is an opportunity to get information and answer any questions that patients may have.

Counselling can be very beneficial, it can take the form of individual, couples or group support. Within a counselling relationship individuals can talk about what is important to them in an effort to gain some understanding which may bring clarity and perspective to their personal circumstances,

In general, counselling helps people, through which individuals and Couples are given the opportunity to explore their thoughts, emotions, reactions and beliefs with an impartial and sympathetic professional who understands the issues involved. Good counselling helps people better, it usually brings greater clarity, a broader perspective and some peace of mind. Decisions about what choice to make become less murky and are based on realism and self-knowledge. The whole process should be strictly confidential.

Therefore, it is imperative for the patients to be mentally free of all tensions before they start an infertility treatment


Male infertility

what is Male infertility

Having a baby is generally a simple and natural experience. However, for some couples it can be difficult to conceive a child. As a male, your fertility generally depends on the quantity and quality of your sperm. If the number of sperm you ejaculate is low, or if the sperm are of a poor quality, it will be difficult and in some cases impossible, to get pregnant.

If you’ve been trying to get pregnant without success for a period of 12 months, and you’ve been having sex at least twice a week, it’s worth visiting the doctor. If you’re aware of factors that could have an impact on your chances of conceiving a baby, it’s a good idea to seek help earlier on. Both you and partner should be tested for reproductive problems at the same time.

HOW COMMON IS INFERTILITY?

Infertility is a widespread issue. For about 20% of infertile couples, the problem is only in the male partner. For about 30% of couples the problem is in both partners. Therefore, the man contributes to infertility in around half of all cases.

About one in 20 men have low numbers of sperm, causing infertility. However, only about one in every 100 men has no sperm at all.

WHAT ARE THE SYMPTOMS OF MALE INFERTILITY?

In most cases, there are no obvious signs of infertility. You’ll usually have no difficulty with sexual activity, erections and ejaculation, and your semen will look normal to the naked eye. You’ll need medical tests to help find out the cause of the infertility.

WHAT CAUSES MALE INFERTILITY?

Infertility can be caused by problems that affect sperm production or how the sperm travels. There are medical tests that can help work out the cause.

About two-thirds of infertile men have a problem where they make low numbers of sperm and/or sperm that don’t work properly.

About one in five infertile men have other physical problems, including those who’ve had a vasectomy but now want to have children. Blockages (often called obstructions) in the tubes leading from the testicles to the penis can stop you ejaculating sperm.

Other less common causes of infertility include:

  • Sexual problems that affect whether semen is able to enter the vagina (one in 100 infertile couples)
  • Low levels of hormones made in the pituitary gland (a hormone controller in the brain) that affect the testicles (one in 100 infertile men)
  • Sperm Antibodies (proteins that fight against sperm, which are found in one in 16 infertile men) - In most men, sperm antibodies will not affect the chance of a pregnancy, but in some cases it can reduce your fertility
  • Sometimes, male infertility is simply genetic.

WHAT ARE THE GENETIC CAUSES OF MALE INFERTILITY?

Some changes to chromosomes or gene mutations can cause infertility because they harm sperm production or block the flow of sperm.

The most common genetic causes of infertility are chromosomal conditions that affect the way that sperm is produced. These include:

  • KLINEFELTER SYNDROME (a condition where you’re born with an extra X chromosome)
  • Y chromosome deletions (a condition where you have genetic material missing from your Y chromosome that is important for sperm production)
  • Other genetic problems, such as Down syndrome
  • Infertility can be due to mutations (DNA changes) in single genes, although it’s far less common.
We think that other genetic conditions will be discovered in the future that will help explain other sperm production problems with no known cause.

WHAT CAN I DO IF I’M WORRIED ABOUT MY FERTILITY?

If you’ve been trying for a pregnancy for 12 months without success, the best thing both you and your partner can do is visit your doctor or family planning clinic.

Infertility is a couple’s problem. Even if one partner has a child from another relationship, both partners should get tests done. Infertility can be a sign that you have other (possibly undiagnosed) health problems, so it’s important that you get it checked out.

HOW IS INFERTILITY DIAGNOSED?

Your doctor will usually ask for your medical history, conduct a physical examination and do a semen analysis. This will check the number, shape and movement of your sperm. They might also take a blood test to check the levels of hormones that control sperm production or for genetic testing. In some cases, your doctor will test your urine to see if sperm are present, which can occur when there is retrograde ejaculation. Sometimes your doctor will recommend an ultrasound, MRI, or a testicular biopsy, which is a small surgery to remove tissue for testing.

WHAT ARE THE TREATMENTS FOR INFERTILITY?

One in eight infertile men have a treatable condition, and after treatment, couples can become pregnant naturally.

In some cases, your doctor will recommend that you and your partner seek assisted reproductive treatment (used to achieve pregnancy), such as in vitro fertilisation (IVF). These methods don’t cure or treat the cause of infertility, but they can help you and your partner get pregnant, even if your sperm count is very low.

At this stage, there are no treatments to fix genetic causes of infertility. For those who can’t father children naturally, assisted reproductive treatment offer the best chance for you to have biological children.

CAN I DO ANYTHING TO PREVENT MALE INFERTILITY?

There are a number of things that can harm the production of sperm, so it’s best to avoid:

  • Smoking cigarettes
  • Drinking excess alcohol
  • Catching sexually transmitted infections
  • Heat stress from tight fitting underwear
  • Anabolic steroids taken for body building or sporting purposes

If you work somewhere that may affect your fertility, it’s important to wear protective clothing and to follow all occupational health and safety guidelines. We also recommended that couples trying to conceive stay away from harmful chemicals.

Because of the possible effects on fertility, it’s important to tell your doctor if you have had hormone treatment, or had surgery as a child to fix undescended testes.

CAN OLDER AGE CAUSE MALE FERTILITY PROBLEMS?

Healthy men in their 70s and beyond can still father children, although if you’re middle-aged or older, it usually takes longer for your partner to become pregnant. This might be because of less sexual activity, lower semen volume, changes to sperm movement, a lower number of properly working sperm, or possibly lower sperm function and DNA quality.

The chance of the child having some genetic or chromosomal problem also gets higher when you get older.

HOW TO COPE WITH INFERTILITY

Finding out that you’re infertile is often a shocking and upsetting experience. There’s still a common but incorrect belief that infertility is a woman’s problem. So men are often unprepared when they’re told there is a complication with their sperm.

Fertility problems can affect a man’s sense of masculinity, sexuality and potency.

It’s normal to have an emotional reaction to infertility. Talking with a doctor, a sexual therapist or counsellor can often help with any negative feelings you might be having.

Turning to family, partners and friends for support can also help.

WHEN SHOULD YOU MEET YOUR FERTILITY EXPERT?

Questions to ask your doctor:-

  • If my semen analysis comes back normal, will you do some other tests?
  • Should I have a blood test of my reproductive hormones to make sure they are working properly?
  • What lifestyle changes could help improve my sperm quality?
  • Things to think about before your appointment
  • How long have you and your partner been trying to conceive? Have you been having sex at least twice a week during this time?
  • Do you and your partner focus sex on the fertile time of the month and how do you know when that is?
  • Did you have undescended testicles as an infant? Have you ever had pelvic surgery or treatments for cancer?
  • Are you taking any prescribed/non-prescribed medications, recreational drugs, androgenic steroids?


Obesity and Infertility

Being a healthy weight increases your chances of having a baby. If men or women are overweight, or underweight it can take longer to conceive.

WHY? Because it can cause problems with hormone levels, which can affect a woman’s menstrual cycle and the quality of her eggs.

Being overweight can also reduce the quality of a man’s sperm and cause erection problems. It can also affect men's and women's libido (sex drive).

HOW CAN I TELL IF I’M A HEALTHY WEIGHT?

One way to measure whether you're in a healthy weight range is using the Body Mass Index or BMI. You can enter your height and weight into this BMI calculator to find out your BMI number.

  • A BMI between 18.5 and 24.9 is considered a ‘healthy weight’
  • A BMI below 18.5 is considered ‘underweight’
  • A BMI between 25 and 29.9 is considered ‘overweight’
  • A BMI over 30 is considered ‘obese’
You can also measure your waist to indicate whether you have a healthy weight.

THE FACTS ABOUT WEIGHT AND FERTILITY

Most of us carry more weight than our parents and grandparents did when they were our age.

In 2014-15, nearly one-third (33 percent) of Indian adults are overweight or obese, and obesity is on the rise.

A healthy diet and regular exercise improve your health and your chance of pregnancy and having a healthy baby.

WEIGHT AND MEN'S FERTILITY

Overweight and obese men have worse sperm quality than men who are a healthy weight. Being underweight can also reduce a man’s sperm quality and therefore his fertility.

Being overweight or obese can cause hormonal changes that reduce fertility and make men less interested in sex. Men who are very overweight are also more likely to have problems getting and keeping an erection. Together, these factors reduce the chances of fathering a child.

Weight, women's fertility and pregnancy health

Being a healthy weight increases the chances of getting pregnant and reduces the risk of complications during pregnancy.

Women who are obese take longer to get pregnant and have a higher risk of:

  • miscarriage
  • hypertension (high blood pressure)
  • pre-eclampsia
  • gestational diabetes
  • infection
  • blood clotting
  • the need for medical intervention to bring on labour (induced labour)
  • caesarean birth
  • premature birth
  • stillbirth

Babies born to women who are obese are more likely than babies born to mothers in the healthy weight range to:

  • be larger than normal at birth
  • need intensive care after birth
  • have a birth defect
  • become obese and have health problems in childhood and later in life

WHAT YOU CAN DO

The good news is that by making some changes – eating healthy meals and doing some regular exercise, you can work towards a healthier weight to improve your chance of pregnancy and having a healthy baby

If you and/or your partner are overweight or obese, losing even a few kilos can improve your chances of getting pregnant.

Losing weight is not easy, and it takes commitment and time. But for most people, it is possible. Research shows that if partners get healthier together, there’s a better chance of success. Having support from a partner, family or friend can help you set up healthy lifestyle habits for the future.

Men who start healthy eating and exercise more often can increase the quality of their sperm. See How to get ready to be a dad and Your Sperm and how to look after them.

WAYS TO MAKE HEALTHIER CHANGES

  • Avoid short-term fad diets or changes that you are unlikely to continue in the future.
  • Set small achievable goals that you can manage (e.g. taking the stairs rather than the lift, using a pedometer to count your steps each day, swapping juice or soft drinks for water).
  • Be realistic and build your goals up slowly over time.
  • Everyone is different. Find a way that works best for you, and fits into your lifestyle


PCOS and infertility

WHAT IS PCOS?

Polycystic ovary syndrome (PCOS) is a very common endocrine condition in reproductive-aged women. It affects approximately 5-10% of young women and often leads to difficulty conceiving. Women with this condition can experience irregular periods, abnormal hair growth, acne, and can have ovaries containing multiple small cysts.

PCOS AND INFERTILITY

PCOS negatively impacts fertility because women with the condition do not ovulate, or release an egg, each month due to an overproduction of estrogen by the ovaries. Because ovulation does not occur regularly, periods become irregular and increased levels of hormones such as testosterone can affect egg quality, inhibit ovulation, lead to insulin resistance, and increase the risk disorders such as gestational diabetes.

PCOS AND FERTILITY TREATMENT

For those women trying to conceive a pregnancy, the first step in treatment of PCOS is lifestyle modification, including a healthy diet and exercise. The diets shown to be most successful in PCOS patients include those with lower carbohydrates, a reduced glycemic load. Recommended exercise in PCOS patients is at least 30 minutes of moderate exercise three times per week, with daily exercise being the ultimate goal.

Women who still have infrequent ovulation despite lifestyle modifications may require fertility medications to assist with the release of an egg from the ovary. Typical initial therapy for patients with PCOS who do not ovulate and are trying to conceive includes administration of either a tablet


Stress and Infertility

It is not clear how exactly stress impacts fertility. It is not known whether high levels of stress can prevent pregnancy or affect a woman’s chance of conceiving. We do know that reducing stress provides a better quality of life during times of intense personal challenge.

WHAT IS STRESS?

Stress is often defined as an event that a person sees/feels is threatening. In order to protect itself, the body responds with a “fight or flight” response.

HOW CAN STRESS IMPACT A FERTILITY PATIENT?

Sometimes, infertility patients respond to the stress of being unable to conceive by aggressively pursuing treatment and procedures. Other patients withdraw and isolate from family, friends, and community. Neither of these extremes is ideal for patients who seek to treat their infertility and build a family.

HOW CAN I REDUCE MY STRESS?

Having less stress in your life while pursuing fertility treatment may not, in and of itself, result in a pregnancy. However, developing better coping strategies to manage stress related to an infertility diagnosis and treatment can help you feel more in control and improve your overall well-being.

It has been shown that stress does interfere with making rational and well-thought-out decisions. Reducing stress can allow patients to research, explore, and consider all the options available with a clearer mindset. By reducing stress, the pros and cons of one treatment course over another can be more effectively weighed and considered.

Reduced stress is good for your health. While no one expects patients to approach fertility treatment stress-free, finding ways to minimize stress while pursuing treatment can help. It is

helpful for patients to look for ways to reduce the burden of infertility treatments and medical protocols.

There are many stress-reducing techniques; some of the more popular methods recommended to fertility patients are:

  • Acupuncture
  • Aerobic exercise
  • Experts guidance for stress reduction
  • Journaling
  • Listening to music
  • Massage therapy
  • Meditation
  • Mind-body groups
  • Mindfulness
  • Progressive muscle relaxation
  • Psychotherapy and cognitive behavioural therapy
  • Self-help and motivational books
  • Support/educational groups
  • Visualization
  • Walking/hiking
  • Yoga

HOW CAN I HELP MY FRIEND/LOVED ONE?

Friends and loved ones are facing a challenge. Telling patients to be less stressed can make them feel more responsible for “causing” their own infertility and feel blamed. Telling someone to relax can cause greater stress. However, asking how couples/friends are doing and suggesting concrete and pragmatic ways to reduce stress will enhance quality of life and give the patient back some sense of control. For many struggling with infertility, just having friends/loved ones available for listening is greatly appreciated.

The goal of stress reduction is to minimize, not eliminate stress, by finding the technique that serves the patient’s needs the best.


Infertility Treatment for foreign Patients in India

India is well-known for its medical treatments associated with infertility for many years going manner back to 1978 once the world’s second tubing baby was born in Republic of India country simply 67 days after the primary test tube baby was born in European nation.

There has been a gradual increase within the number of international patients returning to India for infertility treatment within the recent times. Generally, Asian nation sees an out sized proportion of foreigners from kingdom, Afghanistan, Africa, Iraq, Iran, Saudi Arabia, Russia, Australia, New Zealand and also the North American country for fertility treatments. Within the last 2 years, the proportion of individuals from foreign countries returning to India for Infertility treatments has been doubled.

Why Foreigners prefer India for Infertility Treatments?

Affordability

The treatment prices in India are a lot of lesser than in most countries which is one strong reason that motivates individuals to cross oceans and mountains for his or her fertility treatments. the typical treatment value for IVF in the US is around Rs. 11,10,000 and in the UK, it's around Rs. 8,50,000 whereas in Asian nation, it's around Rs. 4,00,000 as well as the medication prices. Albeit we have a tendency to think about the value of the keep and also the travel, the whole cash they pay for his or her treatment in India is much lesser than what they need to pay in their own country.

Less waiting Times

In a few developed nations, there square measure long waiting periods of months or perhaps years to induce a donor for a sperm or an egg because it is incredibly troublesome to seek out one. However in India, it's very simple to find a donor egg or a donor spermatozoon at intervals a short time therefore infertility treatment for international patients get done quicker in India. In some countries, there is a month long waiting period even to get a meeting to check a fertility specialist that isn't the case in India wherever you'll get a meeting in an exceedingly day or two. Some specific hospitals have separate fertility business choices through that infertility treatment for international patients may be organized and prepared beforehand even before they land in India.

High-quality treatment and efficient doctors

The success rate of infertility treatment for international patients by Indian doctors is high and most of the fertility clinics within the railroad line cities have progressive instrumentality and facilities for fertility treatments that are at par with the hospitals in alternative countries. There is plenty of success stories of foreign couples obtaining formed in India after several unsuccessful IVFs in their own countries. This speaks to the effectiveness of the treatment and also the ability of Indian doctors.


Diabetes and fertility

Have you tried each medicine and check for your infertility problems however with no results? It’s time to see if you are diabetic.

Yes, it's true that diabetes in each men and ladies will influence the fertility. The speed of diabetes in India is increasing at Associate in Nursing dreaded rate that the International diabetes Federation has declared that 79.4 million people in is predicted to possess diabetes by the year 2030. Diabetes is caused because of irregularities related to the extent of hormone in the body. Because the issues with hormone will increase, it conjointly more aggravates the problems of infertility.

Diabetes could be a chronic sickness. Usually, blood sugar levels are controlled by hypoglycaemic agent that could be a secretion created by the exocrine gland. After we eat food, the aldohexose blood sugar glucose} level rises when that the hypoglycaemic agent is discharged to decrease the glucose level. Basically, diabetes is caused once the exocrine gland doesn't manufacture sufficient hypoglycaemic agent to the body or once the insulin produced isn’t being properly absorbed by the cells of the body. Either way, it elevates the blood sugar level in the body.

When the glucose levels are too high,
It will have an effect on secretion levels in the body as well as the essential steroid, progestin and androgen levels that are required for a maternity to occur. It causes conjointly stop conceiving or current maternity resulting in miscarriages.

Diabetes and Male Infertility

One-third of the infertility problems square measure diagnosed in men. Though there are several reasons attributed to the causes of infertility in men, unrestrained blood sugar levels in the body might produce to fertility problems and once it goes unrestrained, it will any irritate the infertility in men. Though it hasn’t been a lot of talked regarding, sugar and male infertility is one sturdy reason to explore.

Can diabetes Cause infertility In Men?

Due to the high glucose level, there are many bodily disorders that arise that cause men to face infertility problems.

The DNA of the sperm could also be broken due to the high glucose level that will cause the natural death of the sperms, thereby creating it troublesome for the relation to become pregnant. Diabetes may also lower the sexual drive in men by lowering the extent of testosterone present in the body.

Retrograde Ejaculation is another major result due to diabetes. By Retrograde Ejaculation, men wouldn't be able to perform a full-fledged ejaculation of sperms which results in the seed going into the bladder rather than being ejaculated usually during sex. In these cases, though the sperm count could look healthy, the ejaculated sperm count is lesser and so this decreases the probabilities of pregnancy. Due to the high glucose level, the nerves and blood vessels can’t be controlled properly due to that it results in dysfunction and should any cause impotence.


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