How does thyroid dysfunction affect fertility?

Life can become miserable for couples who are trying to conceive but are not able to do so. It happens because it is not just the stress that plagues them, but also the nagging fear that they might never be able to bear their offspring. When results seem to be elusive after nearly 6 months of attempting to conceive, it is advisable to see a fertility specialist for help. The first step for infertility treatment is to focus on pinpointing the exact cause of infertility, and the possibilities are varied, with thyroid dysfunction being one of them.

The specialist has to look for all kinds of probabilities, which can include some major complications such as structural abnormalities, uterine fibroids, ovarian cysts, PCOD, endometriosis and so on. At the same time, something as simple as a thyroid dysfunction may be responsible too. It is hard to believe that improper function of a gland located near the throat can actually stop a woman from getting pregnant, but this does happen!

Thyroid Gland- Knowing it Better

Located at the front of the throat, the thyroid gland secretes hormones vital for regulation of various functions in the body. The hormones produced by the gland are T3 (triiodothyronine) and T4 (thyroxine), the former being synthesized in small amounts (T4 gets converted to T3) yet being the more active one.

Other key hormones which are to be studied for evaluating the thyroid function are TRH (Thyroid Releasing Hormone) and TSH (Thyroid Stimulating Hormone). TRH is released from hypothalamus (in the brain) and it is responsible for the stimulation of the pituitary gland (again in the brain) to secrete TSH, which in turn, stimulates the thyroid gland for producing T4 and T3. The importance of these hormones can be judged from the vital body functions they influence:

·         They have a direct impact on the metabolic function as they regulate the consumption and utilization of oxygen by the body and consequently influence the energy production too

·         Additionally, these hormones are also responsible for metabolism of fat, carbohydrate and protein and therefore, have an effect on weight maintenance too

·         Several other hormones related with brain function, growth, control of heart rate and blood pressure are also related with proper working of the thyroid

·         Thyroid hormones of the mother have a bearing on the growth and development of the fetus

Since thyroid hormones are of such great importance, any dysfunction of the gland can have serious implications. A variety of factors may be the reason of such an imbalance and these may range from nutritional deficiencies to high stress levels, infections, genetic causes and exposure to environmental toxins. Whatever may be the cause, thyroid dysfunction needs to be taken seriously, more so by infertile women and also the pregnant ones.

Thyroid Dysfunction- The Missing Link

In some cases, a battery of expensive tests for infertility may surprisingly yield negative results and the couple may end up spending a fortune, just to be told that they are suffering from something called “unexplained fertility”. The fact is that they may subsequently find out that something as common as underactive (or overactive) thyroid gland might actually have been the missing link. Then isn’t it better to study the thyroid function at the first instance and spare the couple the trauma and monetary burden involved in the expensive tests performed otherwise!

A comprehensive thyroid evaluation should actually be recommended for a woman who is battling infertility, particularly in the following cases:

·         When she has been trying to conceive and has been unable to do so despite regular, unprotected sex for the past 6 months

·         She has an erratic menstrual cycle

·         She has experienced recurrent miscarriages

·         There is a family history of thyroid dysfunction

Timely detection of the problem not only speeds up the treatment but also ensures that best results come fast for the couples undergoing the trauma as well as social stigma related to infertility.

How does thyroid dysfunction influence a woman’s fertility?

When it comes to studying the relationship between thyroid dysfunction and infertility, focus is on hypothyroidism or underactive thyroid, though both hypothyroidism as well as hyperthyroidism can be bad for women trying to conceive. Hypothyroidism implies that the level of hormones produced by the gland is below the normal and this can have an adverse impact on the fertility of a woman.

Low levels of thyroid hormones can lead to anovulatory cycles, which imply that ovulation is disturbed and the ovaries are not able to release the egg. Similarly, it can also cause disturbance in the balance of other reproductive hormones such as estrogen and progesterone as well as stem up certain autoimmune disorders, which have a negative impact on the woman’s ability to conceive.

Another implication of hypothyroidism is that it can lead to luteal phase problems, which could cause an early miscarriage. Luteal phase refers to the second half of a woman’s menstrual cycle, when a hormone called luteinizing hormone prepares the uterus for implantation of the fertilized egg by thickening the endometrial lining. Hypothyroidism interferes with this process and the fertilized egg fails to implant, being shed off by the body and deemed to be a regular period.

This happens in very severe cases, while pregnancy is quite possible in milder cases and with proper management. However, timely diagnosis and treatment are crucial to prevent infertility and a likely miscarriage, in case a thyroid patient does get pregnant. Those undergoing treatment with artificial reproductive technique are also comprehensively tested, with thyroid function tests making an important part of the diagnostics.

Gaudium IVF is a trusted infertility clinic which provides complete testing, effective treatment and support counseling to couples struggling with a variety of infertility issues. Here, patients can get a free second opinion from the award winning fertility specialist, Dr Manika Khanna, who has helped fulfill the parenthood dreams of many.

Gaudium IVF Centre Delhi http://www.gaudiumivfcentre.com

Can embryo fall out of the uterus after its transfer?

IVF is a complicated assisted reproductive technique, which not only has the patients spend a lot but also takes an emotional toll. The two week wait period after the implantation of the embryo seems to be like a roller coaster ride time for the couples, as it seems to decide the fate of the cycle. As the embryo is transferred into the uterus by artificial means, the biggest fear that plagues the couple is that it might fall out of the uterus after the transfer.

The fear might be so great that normal activities like standing up, walking, having sex, peeing, coughing, sneezing and laughing might be seen as sinful ones by the prospective parents. Though people without medical background are justified in thinking that embryo can make its way out from the same route it went in, thankfully, the apprehension is baseless. For understanding why you need not be scared of such a possibility, it is necessary to comprehend how things actually work when the embryo implants itself into the uterus and what happens after that.

What happens during and after embryo transfer?       

The primary step of IVF is embryo culture, during which eggs are combined with sperms in a lab dish and made to reach the embryo stage (a 3 day or 5 day culture depending upon the clinic protocol). The best amongst the cultured embryos is selected for uterine transfer. The embryologist first takes out the chosen embryo from the incubator and then transfers the same into the uterine cavity with the help of a thin and soft catheter. The right placement of embryo is ensured by using ultrasound guidance as the catheter is threaded through the cervix.

Once the embryo is transferred into the uterus, the patient is generally made to lie on her back for an hour or so. Since the process is ultrasound guided, the same is done with full bladder as a protocol of the scanning procedure. This means that the patient would need to urinate at the end of the transfer. Scary as it may sound, peeing after the transfer would not flush out the embryo from the uterus.

Though the doctors would not stop you from standing and doing all normal activities after the transfer, strenuous workout and lifting heavy objects need to be avoided and so do hot baths and Jacuzzis. During the two week wait, the woman needs to abstain from smoking, alcohol, caffeine and all other potential threats to the pregnancy. 

Though best efforts are made for choosing the healthiest amongst the embryos and ensuring its proper placement during the IVF, nature takes its course once the transfer has been done. Nothing can be done to influence the implantation of the embryo in the uterus, as it takes some time to develop and stick to the uterine walls and will do it successfully if it is meant to.

Is it possible for the embryo to fall out of the uterus?

The uterus can be pictured as a cavity, an empty space, within which the embryo(s) would be deposited and would roll around as the woman would stand up and walk around. In fact, it is quite possible for the woman to be obsessed about taking bed rest to maximize the chances of the embryo settling down and sticking to the uterine walls. The truth, however, is that the uterus is a potential cavity rather than a true one. It is a muscular organ, which originally has its walls touching each other and it increases in size as the embryo grows.

So practically, the tiny embryo would have a snug fit within the uterine walls and there is no chance that it would get dislodged and fall out. For a woman with receptive endometrial lining and healthy embryo, there is hardly a reason why pregnancy would not take place. No external influence such as exercise, walking or sneezing can interfere with the process of the embryo sticking to the wall. This is the miracle of nature which cannot be matched even by the most amazing innovations in science and technology.

While sexual intercourse may also be deemed as a peril to the transferred embryo, it has been proved that even orgasm cannot change the fate of a transferred egg. Though there are uterine contractions during orgasm, they cannot dislodge the embryo because the hormone called progesterone synthesized during the luteal phase ensures otherwise. Therefore, whether pregnancy is natural or assisted, there are hardly any reasons to be scared that you may lose the embryo to a free fall. If anything like that was possible, pregnancy would have been a rare event.

Should the woman take bed rest after embryo transfer?

As it has been clarified that the embryo cannot fall out of the uterus, it would be wise to know that bed rest is not necessary after the embryo transfer. In fact, it can make the woman physically uncomfortable and emotionally stressed out, as she has to be confined for no feasible reasons. And there is no reason that the woman should blame herself if the IVF cycle fails because not taking bed rest cannot be the reason behind it.  

Surprisingly, even a little spotting and mild cramping during or after the IVF is not seen as a reason to worry because it could happen as a result of the embryo burrowing into the uterine lining and getting implanted therein. It is important for the patients to be aware of the implications of IVF so that they do not lose their sleep over trivial issues and rather try and concentrate on the joy that the coming days might have in store for them.

At Gaudium IVF, patients not only get comprehensive evaluation and best treatment for diverse infertility issues, but are also educated about the procedures and precautions needed after them. Also, visit the clinic to get a free second opinion from the award-winning fertility specialist, Dr Manika Khanna.

Ovulation Tracking: Beneficial or not

When a couple comes across infertility issues and attempts to conceive fail to yield results month after month, they are likely to become somewhat obsessed with the idea of getting pregnant. Not only do they seek medical help, but also make countless efforts at their end to know more about improving their chances. One thing that comes up as an issue of major importance is the timing of the attempt to conceive, which is greatly influenced by the ovulation cycle of the woman.

Ovulation tracking, as the name suggests, refers to keeping a track of the ovulation cycle, which is a useful way to know the time when the chances of conception are the brightest. Whether a woman is trying to conceive naturally or is undergoing an infertility treatment, ovulation tracking is regarded as a vital parameter for improving her chances of conception, natural or assisted.

Understanding Ovulation: The Role of Hormones

The fertility of a woman is determined by her ability to ovulate, a process greatly influenced by her hormones. Defined scientifically, ovulation is the process of release of a mature egg from either of the ovaries, followed by its movement down the fallopian tube where it can be fertilized by the sperm. From here, the fertilized egg moves into the uterus, where it gets implanted if pregnancy does take place. The fertilization is dependent upon the timing as the sperm must meet the egg at the precise moment when it is prepared for the same.

The uterus gets ready to receive the fertilized egg by thickening its walls. In case, the egg fails to get fertilized, the uterine lining as well as the fertilized egg, gets shed and this is the time when the woman has her menstrual period. Understanding ovulation requires a comprehensive understanding of the hormones which work behind the proper running of the reproductive function in the body of the woman.

The first day of the menstrual period marks the beginning of the menstrual cycle. This is the time when the hormone levels are low. The level of estrogen starts rising towards the end of the period, as it plays the role of thickening the uterine lining. After this, the level of Follicle Stimulating Hormone (FSH) starts going up and it drives the egg towards maturity.

Next in the picture comes the Luteinizing hormone, which makes the egg able to leave the ovary. There is a considerable increase in its level during the period of 12 to 36 hours before ovulation. Now as the ovulation takes place, the egg is released by the ovary and this leads to a rise in the level of another hormone called progesterone. This hormone is responsible for a rise in the Basal Body Temperature as it generates heat and this indicates that ovulation has taken place.

The progesterone level has to be maintained so that the uterine lining stays intact and this is done by corpus luteum (a ball of cells formed as the ovary released the egg). This structure lives for a 14 day period, known as the Luteal Phase and dies if implantation fails to take place. In this case, the hormone levels drop again and a fresh menstrual cycle begins. On the other hand, if conception does happen, a hormone called Human Chorionic Gonadotrpin (HCG) comes into play and maintains the uterine lining.

Ovulation Tracking

Ovulation tracking is done by studying the hormonal levels during the menstrual cycle and it helps the woman know which stage of ovulation she is actually going through. The key hormone studied in this regard is Luteinizing Hormone, which is measured by ovulation predictor kits. Another medical procedure recommended for ovulation tracking is through vaginal ultrasound scans, which determine the exact status of the egg during those crucial days.

Other natural methods of tracking fertility involve measuring the basal body temperature and keeping a tab on the cervical mucus. Basal body temperature is studied using a basal thermometer and it predicts the beginning of ovulation as there is a rise in body temperature. On the other hand, the anatomy of cervical mucus (a slippery liquid found in the cervix and which helps the sperm to travel inside) indicates the onset of ovulation. Right from the start of ovulation till its end, the cervical mucus looks like egg-whites.

Some women even experience symptoms like mild abdominal cramps and spotting during ovulation. It becomes possible for them to gradually start reading these signals and become aware when they are ovulating.

Whether a woman makes use of an ovulation tracking kit or takes a more natural approach, ovulation tracking actually helps her be more aware about her body’s natural rhythm. In  simple words, she can come to know the most fertile days of her cycle, an information which can help her increase her chances of conceiving (or to avoid pregnancy, for that matter).

Is ovulation tracking actually beneficial?

The primary purpose of ovulation tracking is to know the best days for a couple to have sexual intercourse so that they can conceive, and the same applies to those couples undergoing fertility treatment. In addition to helping couples plan (or avoid) conception, ovulation tracking can help women get a fair idea of their overall reproductive health and detect any irregularities in their initial stages.

In fact, ovulation tracking is recommended as one of the first treatment procedures for couples who seek the advice of a fertility specialist. They have patients undergo vaginal ultrasound scans to pinpoint the exact day when ovulation occurs, so that the attempt should be made bang on target. But to be realistic, the couple might still fail to conceive, despite making all the efforts and choosing just the exact moment for the intercourse. It is so because the human body is programmed for a 10% success rate of conception, even if conditions are perfect.

Seeing the flip side of the coin, ovulation tracking can have its share of downsides too, as the couple has to bear a great deal of stress during the process, in addition to the financial costs. The woman might find it taxing to take out time from her personal and professional commitment for getting the scans done. At the same time, some couples may find sex becoming a little to mechanical, as they have to time it according to the doctor’s advice, rather than make it a spontaneous, relaxed event.  

As a result, it can be said that ovulation tracking with vaginal scans can be a stressful and even, useless test if advised cycle after cycle. The natural techniques like cervical mucus study, basal body temperature and ovulation predictor kits make better and cost effective ones for the infertile couples.

If your doctor advices you to opt for ovulation tracking cycle after cycle, taking a second opinion from the expert fertility specialist, Dr Manika Khanna would be of great help. Get in touch with Gaudium IVF, a fertility clinic trusted for giving the best advice to its patients.

For more click here: http://www.gaudiumivfcentre.com/

I have low AMH level: What needs to be done

Female fertility is dependent on a variety of factors and hormone level is the key one amongst these factors. There was a time when FSH or follicle stimulating hormone was regarded as the parameter for hormonal testing, but the latest in the hormonal brigade is Anti Mullerian Hormone, more popularly known as AMH. Medically, AMH is defined as a hormone produced by the follicles, during the primordial (earliest) stage of the follicular development.

AMH level has a direct influence on the fertility of a woman as it determines the number of follicles which will be produced by her ovaries, which in turn would determine her available egg supply. Low AMH level is responsible for a lesser number of ooytes (eggs) left with the woman and thus, reduced fertility. Therefore AMH level is now seen as a more reliable way of determining the fertility of a woman (in terms of egg quantity and quality) and then deciding the line of treatment that has to be followed in infertility cases. 

Why is AMH testing considered more accurate than FSH testing?

A woman battling with infertility has to be evaluated extensively for finding out the exact reason of the condition. The latest amongst the diagnostic tests recommended for such patients is AMH testing. Currently, AMH testing has become a more accurate evaluation as compared to FSH testing. The reason is that FSH levels keep fluctuating during the menstrual cycle and can bring reliable results when checked only at particular time during the cycle.

Conversely, AMH levels remain steady during the entire menstrual cycle, which makes it a much more reliable parameter for judging the ovarian reserve of the woman. Moreover, AMH level is the direct indicator of the oocyte production, which means that it is a better way to check the fertility of the patient. In fact, a woman may have optimal FSH levels but still may not be able to conceive because her AMH is low.

Normal AMH level and chances of conception

AMH levels are tested using a blood test, which indicates the level of the hormone in the blood. This, in turn reflects the size of the ovarian reserve of the woman (in layman’s language, the size of the remaining egg supply in the ovaries of the woman). As the woman progresses in age, the AMH level starts falling as this reserve keeps on diminishing, which is the reason why fertility deteriorates in advanced maternal age.

For women under 35 years of age, the range between 1.5 ng/ml and 4.0 ng/ml is regarded as the normal AMH level. Those who are nearing menopause have very low AMH level, lesser than 0.5 ng/ml, a reading which indicates that their chances of conception are bleak. On the other hand, high readings of AMH (in the range of more than 4.0 ng/ml) show that the woman has numerous follicles of very small size, as seen in the patients of polycystic ovarian disease.

What if your AMH level tests bring very low readings?

Typically, low AMH levels mean that the woman does not have many eggs available for conception. But there is no reason to panic when tests bring very low readings. When something like this happens, the specialist would first confirm the reports by recommending a repeat test from another lab and then some ultrasound scans. Another advanced blood test called clomid challenge test can also be done.

At the same time, it is important to be aware that low AMH levels do not necessarily mean that the woman cannot have a baby at all. Women of younger age have good chances in particular, if they get the right kind of treatment. A course of DHEA (dehydropiandrosterone) has shown proven results as a treatment option for women with poor ovarian reserve. But the medicine should not be taken by the patient without being assessed by an expert fertility specialist.

How do your AMH levels influence the chances of IVF success?

If you are a potential candidate for IVF, you need to know how your AMH levels are going to influence the chances of success of the procedure. Obviously, those with higher levels are likely to be better off because they will respond to the ovarian stimulation in a better manner and produce more eggs for retrieval. The greater the number of eggs retrieved, the better are the chances of getting that one high quality embryo which can be implanted in the uterus for a successful pregnancy to take place.

However, this in no way implies that women with low AMH levels should lose hope because they do have chances of getting pregnant naturally or with artificial reproductive techniques, however few these maybe. In fact, IVF gives such women better chances to conceive because it makes the optimal use of the few eggs which are left in their ovarian reserve. In cases where even IVF brings no hope for such patients, donor eggs may be considered as the next option.  

If you have very low AMH levels, you can still get pregnant with the right treatment. You can seek a free second opinion from Dr Manika Khanna, the expert fertility specialist at 

Gaudium IVF CENTRE

My embryos stopped growing in IVF lab: how can I prevent it in subsequent attempts

Embryo culture can be seen as one of the most crucial steps of the IVF cycle, because it is the one which determines whether the cycle will be a success or not. The embryologists work on getting multiple embryos during the process but it is not necessary that all of them will mature for successful implantation in the uterus. Perhaps, this is the reason why focus is laid on fertilizing multiple eggs to obtain multiple embryos.

During an IVF attempt, it is common for the embryos to stop growing in the lab during various stages of embryo culture. This condition is known as embryonic arrest and can happen at any stage; while some embryos do not reach past the single cell/zygote stage, many others succumb to embryo arrest during the cell division process, the cleavage stage, before they reach the stage of implantation.

What could be the probable reasons of embryo arrest?

The embryos might stop growing the IVF lab due to a variety of reasons, some of which could be natural while others could be the result of human error in the IVF lab.

·         More often than not, genetic factors may be responsible for embryo arrest. The oocytes(eggs) of an older woman have a high risk of developing into embryos with chromosomal defects, when they do get fertilized. In such cases, the embryo growth gets arrested as a natural defense mechanism to prevent the birth of a baby with a genetic defect.

·         Another possible reason of embryonic arrest in the lab is mitochondrial defect, a condition which is again common in older women. Mitochondria are the cellular power units, which fulfill the energy needs of developing embryo. Since the embryos get the mitochondria from the oocyte of the mother, the ones which come from older women may not provide enough energy to carry out the cell division effectively, thus resulting in the arrest of the embryo growth.

·         The genetic material from the mother as well as the father is carried by the embryo, the formation of which takes place when the egg is fertilized by the sperm. It is this genetic information which is responsible for the single celled embryo growing into a baby. In the beginning stages (up to 4-8 cell stage), it is only the genetic information of the egg which is responsible for the cell division. Only after reaching this stage does the embryo genome (the first cell of human life) get activated and the further development takes place. In some embryos, development is arrested when the genome activation fails.

·         The other major reason of embryonic arrest in the IVF lab is the absence of optimal culture conditions therein. For instance, the culture medium might be infected or there is may be a malfunction in the incubator. When the embryo gets sub optimal conditions in the lab, the process of cell division is hindered and it stops growing. When the patient suspects lack of lab care, they have a right to question the embryologist about the growth arrest

Once the embryo stops growing in the lab, nothing can be done about it, though it can be taken as a lesson. The key lies in finding the actual cause of the embryonic arrest. Any of these reasons could be responsible for the stopping of embryo growth in the lab and if it happens due to the human error, the patient has all the rights to demand a reason and switch over to another IVF clinic for a subsequent attempt.

What can be done to reduce the chances of embryonic arrest in the subsequent IVF attempt?

The problem of embryonic arrest during IVF is more prevalent in older women because the egg quality deteriorates with the maternal age. Here, use of donor eggs may be seen as a feasible way to increase the success rate of the embryo growth in the IVF lab. Similarly, a new technique called cytoplasmic transfer (a process in which the cytoplasm of a younger woman’s oocyte is transferred in an older woman’s oocyte) is being recommended for restoring the developmental ability of the embryo.

In case the embryo growth is arrested for a younger woman, the problem could definitely lie in the lack of competence of the IVF clinic. The answer here lies in trying out a different and more trustworthy IVF clinic for the subsequent cycle. Here again, if the next attempt fails despite opting for the best clinic, cytoplasmic transfer may have to be considered as the next alternative. However, this technique is not very popular at present because it is still in its developmental stages.

Couples who have experienced embryonic arrest in their previous IVF cycle can take the second opinion of Dr Manika Khanna, the renowned fertility specialist at Gaudium IVF and improve their chances in the next cycle.

Precious Pregnancy: Precautionary Guidelines for Couples

We have heard of thousands of couples complaining about accidental pregnancies but there are countless others who continually face the disappointment of not being able to conceive month after month. The experience can become a physical, emotional and financial ordeal, particularly if the couple is undergoing a taxing fertility treatment. At the end of the day, even if they are able to conceive, there is a constant phobia that something might go wrong, till the baby actually comes to the world.

Only a couple undergoing this trauma can value such a pregnancy, which rightly gets the name of a precious pregnancy. Any pregnancy which comes following a long wait, carries a major risk factor or has been induced by medical treatment, falls in the category of precious pregnancy. What makes a precious pregnancy different from the normal one is, not only the complications involved, but also the fact that the couple is under huge stress in this one.

Though nothing might go wrong during those difficult nine months, there is a lurking fear for the couple and they are not able to enjoy that special feeling of the impending parenthood. In fact, such a couple tends to go in an overprotective mode as they are constantly concerned about the baby and medical intervention is greater as compared to a normal pregnancy. Most of the times, these fears are baseless, yet certain precautions can be observed to ensure a smooth sail for the mommy carrying a precious baby.

Identifying the Risk Factors

As said before, a pregnancy is deemed as precious if it comes after a long wait and/or is achieved after a fertility treatment. The primary precaution in such a pregnancy is to identify the risk factors:

·         Age: If the mother is past 40 years of age, the pregnancy becomes precious as the chances of genetic defects and miscarriage increase in direct proportion to the woman’s age

·         General medical complications: Another matter to be taken care of in case of a precious pregnancy is to pay attention to the general health of the mother. For instance, women suffering from conditions like diabetes, hypertension, heart disease, genetic disorders, sexually transmitted diseases and kidney disorders become candidates of precious pregnancy

·         Gestational complications: When the pregnancy is precious, the woman has to take extra care and monitoring to identify gestational conditions (conditions which are induced during pregnancy) such as gestational hypertension and gestational diabetes. Such conditions can be tackled by timely medical intervention and management.

·         Fetal complications: Extra precaution is to be taken with regard to the condition of the fetus in precious pregnancy. Regular tests and ultrasound scans can help the doctors to be prepared for conditions such as multiple births, premature labor, developmental problems or structural complications such as placenta previa (a condition in which the cervix is covered by the placenta).

When the pregnancy is precious, special precautions are needed with regard to the timely identification of the above mentioned issues. This is possible only with the help of certain diagnostic tests.

Precautionary Diagnostic Testing for Precious Pregnancy

Though certain diagnostic tests are recommended for every pregnant woman, they become all the more important in case of precious pregnancies so that complications are identified at the earliest. Besides the routine urine and blood analysis and regular ultrasound scans, certain additional tests may be recommended for specific conditions.

Some tests like chronic villus sampling, amniocentesis and cordocentesis are used to evaluate genetic problems. Similarly, a specialized ultrasound test can be done to measure the cervical length, in order to identify the risk of premature labor. Regular fetal heart monitoring is also recommended for precious pregnancies.

General Pregnancy Precautions

In addition to identifying the risk factors and some extra diagnostic tests, a precious pregnancy requires all general precautions that need to be taken in normal pregnancy.

·         A healthy, balanced diet comprising of all important nutrients is a must. Supplements of folic acid, calcium, iron and some other nutrients may be recommended by the doctor

·         Certain food items like some kinds of fish are to be avoided as they may have high mercury levels. Salmon, tuna and swordfish are an absolute no-no. Fresh and organic fruits and veggies should be preferred

·         A healthy lifestyle is of equal importance in pregnancy, whether it is precious or normal. The woman should take sufficient sleep and rest, and at the same time, staying active and maintaining the right weight is also vital. Meditation and light exercise can be done to do away with stress, but the woman should consult her doctor before doing the same

·         It is recommended for a pregnant woman to stay away from smoking and drinking. Caffeine intake also needs to be minimized

·         The woman needs to protect herself and the fetus from food preservatives as well as environmental toxins

·         No medication should be taken without consulting the gynecologist as some medicines can actually cause harm to the fetus

Mode of Delivery

It is common to see that precious pregnancies are subjected to C-section deliveries, particularly when there are risk factors like preeclampsia (a condition caused by high blood pressure), multiple pregnancies, fetal complications and gestational diabetes. Moreover, when the pregnancy is an assisted one and the woman is past the age of 40 years, the doctor is likely recommend a cesarean delivery.

On the other hand, there are some doctors who believe that a baby conceived using IVF is just like any other baby and vaginal delivery is a safe option. The decision should be taken on the basis of comprehensive condition of the mother, rather than being biased by the fact that the pregnancy is a precious one.

Gaudium IVF is a reputed infertility clinic which has dealt with a number of complicated cases and helped numerous couples handle their precious pregnancies successfully. For getting a free second opinion from Dr Manika Khanna, visit Gaudium IVF Centre. 

Male fertility testing: Beyond semen analysis

When it comes to infertility problems in couples, the reasons might be diverse and unlike the popular belief, male factor infertility comes up as common a cause as female factor infertility. Male factor infertility can plague any man, who otherwise looks and feels healthy. Even someone who already has been a father before can combat it at a later stage. Fertility clinics focus on testing both males and females for addressing infertility at the earliest, so that no time is wasted for starting with the right treatment plan based on the accurate diagnosis.

Primarily, semen analysis is regarded as the basic test for identifying male factor infertility. As the name suggests, the test involves testing of the sperm to check out its ability to fertilize an egg successfully. The analysis includes the study of an array of parameters such as the sperm count, motility, volume, pH level, morphology (appearance), consistency and maturity.

When sperm analysis turns out normal results, the specialist looks for other reasons of infertility. On the other hand, when this test shows some abnormality, further testing has to be done to establish the exact cause of male infertility and proceed with the right treatment.

Male Fertility Testing: Beyond Semen Analysis

After the basic semen analysis turns up with something amiss, the specialist has to adopt a more aggressive approach for diagnosing the problem. For this purpose, a number of advanced tests have been devised and these will now be discussed in detail.

Physical Examination

Before approaching towards advanced testing, a simple physical examination by an expert urologist is done to identify a condition known as varicoceles. It refers to a vein abnormality (enlargement) in the scrotum, which is one of the most common causes of male factor infertility. Fortunately, it can be easily treated with a simple surgery. Another parameter that is checked out during a physical exam is the testicular size.

Hormonal Testing

Another thing that the specialist might want to rule out as a cause of male infertility is hormonal imbalance. Sperm production is influenced by a number of hormones such as testosterone, the male hormone as well as FSH (follicle-stimulating hormone), LH (luteinizing hormone), prolactin and TSH (thyroid stimulating hormone), all of which are both male and female hormones. Any abnormality in these hormone levels can lead to male infertility, though this can be rare phenomena.

Genetic Testing

Genetic testing refers to a blood test which has a closer look at the DNA, with the purpose of detecting a chromosomal defect. It is recommended for men whose sperm count is extremely low or sperm is non-existent in the semen. Men with some congenital problems such as small testicular size and absence of vas deferens (in simple language, the pipeline for sperms), are considered as candidates of genetic testing. Similarly, couples combating multiple miscarriages can be made to take genetic tests.

Testing for Antibodies and Sexually Transmitted Diseases

In some cases, certain antibodies are produced in the body and these attack the sperms produced by the man, hindering their ability to fertilize the egg. Blood tests are used to identify these anti-sperm antibodies and treat the issue effectively. Other tests such as those for sexually transmitted diseases like HIV, hepatitis B and hepatitis C are also used to study male factor infertility in a comprehensive manner.

Testicular Biopsy

Testicular biopsy is an advanced test which involved removal of a small piece of tissue from the testicles. The test determines whether the sperm is being produced normally and in case, it turns out normal, it indicates some kind of obstruction.

Ultrasonography

An ultrasound test can help the specialist locate a blockage or damage in the male reproductive system, as in the seminal vesicles, scrotum, prostate, ejaculatory ducts and other support structures of the tract.

Vasography

Vasography refers to an x-ray, which is done to identify an obstruction in vas deferens or a leakage of sperm from it.

Post-ejaculation Urinalysis

Post-ejaculation urinalysis is a specialized urine test performed to check out the condition called retrograde ejaculation. It is characterized by the sperm travelling backward into the urinary bladder instead of being ejaculated through the penis. A previous surgery could be the possible cause of retrograde ejaculation.

Advanced Sperm Function Tests

Certain advanced sperm function tests are performed to address more complicated issues related to the sperm quality. These tests relate to the ability of the sperm to swim through the cervical mucus and penetrate the egg, its potential of survival after ejaculation and whether it can successfully attach to the egg to form an embryo. These tests are suggested only in very rare cases.

All these tests have become a part of the diagnostic and treatment plan for couples these days, and they are as important as female fertility testing. Timely and accurate diagnosis ensures that the treatment is carried out in a speedy and effective manner.

Gaudium IVF is a reputed infertility clinic which provides all kinds of advanced diagnostic tests for male and female infertility. Contact here for a free second opinion from Dr Manika Khanna, the renowned fertility specialist at Gaudium IVF.