Friday, 18 April 2014

Reasons Why Infertile Couples Do Not Opt for IVF Treatment


In Vitro Fertilization (IVF) or test tube baby technique was introduced in 1981 and till date millions of babies have been born using this treatment. Overwhelming figures speak volumes about IVF success rate. IVF might sound a cryptic medical terminology but is one of the lone treatments for infertile couples to have their own genetic babies through Assisted Reproductive Treatment. It has served as a boon for many infertile couples wanting to become parents.

However, many couples are resistant to undergo the treatment despite the high success rate. It was observed that while few couples unfortunately cannot afford the treatment, many are bound by orthodox beliefs.  

Infertile couples tussle to undergo go the test, based on the doubt factors-

  • Chances of success
  • Cost
  • Men are sometimes insecure and think that undergoing IVF might question their manhood.
  • Women consider themselves guilty partner for infertility.
  • Many consider IVF an artificial procedure.
  • Few feel that babies born through IVF are at increased risk of birth defects.


These reasons not only shield the couples from technology but also reduce their prospects of having a baby. The factors that increase the chances of success depend on how much the couple and the doctor are dedicated to make the process success. 

However, when the finances are concerned, IVF is indeed a treatment that might burn holes in the pockets. Sadly, the insurance companies do not consider infertility under a type of disease and do not cover this procedure.

Financial considerations are further strengthened by misconceptions and horror tales to resist the couples to opt for procedure. Also, men should understand that infertility is not uncommon, and men are not individually responsible for infertility nor women are but the contributing factors lead to infertility. So, resorting to IVF would not be an affront to their manhood.

Meanwhile, few couples who start believing IVF as an artificial procedure should understand that IVF is performing the natural process outside the body. In IVF, only forms embryos outside body and are later implanted in the uterus for natural pregnancy.

Knowing that IVF requires stimulation of ovaries, retrieving eggs from follicles which otherwise would have been discarded and performing the process in labs increases the doubts of couples, who start thinking that manipulating the natural process using hormonal injections might adversely affect the baby and become a cause of birth defects. They hear the stories from couples who have had failed IVF cycles and start considering IVF as a bane!

It is unfortunate that people with half-baked knowledge try to misguide the infertile couple who are already susceptible. Sometimes, even gynecologists refrain from suggesting the proper treatment and advise them against IVF specialists. These factors contribute to the reasons why patients are reluctant to undergo IVF.

Knowledge is power. Rather being susceptible to false claims and rumors, patients should grab the knowledge by consulting an IVF specialist. We at Pahlajani IVF Clinic counsel the patients before suggesting any kind of treatment. 

It builds a bridge of confidence between doctor and patient. Patients should read such informative blogs on internet and stay away from hurdles that give them only doubts not hopes to get have babies.


Dr Neeraj Pahlajani

Thursday, 17 April 2014

Blood AMH – a test that every young woman should undergo


Many physicians warn that though you may be enjoying good health, feeling healthy and being healthy are not always the same thing. Like most of the adults, you may be undergoing a regular annual medical examination to assure good health. One of the most common tests performed under the routine is Cholesterol, to calculate the risk of heart disease.

However, this test might be beneficial for men and women above 40 but for a woman in her late 20s, it is a futile to undergo this test. Generally, the chances of women at this age to be diagnosed with a heart disease are slim. 

So, instead of undergoing worthless tests, it is better to prioritize your test chart according to the need. Customizing the tests according to the age would help you find out the exact problem, rather than tests which are generally not recommended at your age.  

So, it is more valuable for women to undergo blood AMH level (a test to determine ovarian reserve) to check the quality and quantity of eggs she is left with. This is because, ovarian reserve declines with age and it is irreversible to achieve back the eggs that a woman has already lost during menstrual cycle. This is test is valuable for women who want to postpone child birth due to career or some other constraints. The AMH level testing provides a good index of ovarian function.

There is multiplicity of reasons why new age women tend to postpone childbearing. It might be because of career or the quest to find the right partner. While this can be a good sign towards social evolution, where women are taking independent decisions, it might be a biological hitch for some. 

Sometimes, in the race of life, women tend to forget that they might have extended the age of getting married but their ovary never stops to grow old. It constantly loses eggs and the quality and quantity declines tremendously with age. When a women strides towards her mid-30s and she might be satisfied to have a settled life, she already has reduced chances of pregnancy.  Much to her dismay, she might fail to achieve pregnancy without medical assistance.

Sometimes, women are baffled to hear this news! They are shocked to know about their ovarian functioning despite having regular cycles. They regret to have had known about such a situation much earlier to have avoided complexities at the young age.

So, if you are in your late 20s and have decided not to start family any time soon then it is recommended for you to undergo blood AMH level testing annually. It is an inexpensive test and demands no extra testing but blood test. This test would provide you a rough idea about ovarian reserve, specifically the quality and quantity of eggs you are left with. Therefore, how much time you have to actually start planning your family.

This test is recommended because a number of women experience infertility and sometimes it is too late to know about it. However, it is important to know that for a woman with unproven infertility with a low AMH level might conceive and have baby without any complications, while AMH level testing in an infertile woman is completely different. 

The test is useful to know about the declining ovarian reserve, so that your doctor can warn you before it is too late. If a woman knows about her eggs beforehand, then it would be much easier for her to determine the right age to plan her family. With the data about AMH level, it will be easy for even your doctor to counsel you about making the right choice.

With AMH levels, women in their late 20s, who have enough time to have babies, can make well-informed decision. If a woman is young and has low AMH level, then she can decide whether she has to have baby or may freeze her eggs when their quality is good, so that the frozen eggs can be used when she wants to get pregnant few years later.

It is recommended for young women to undergo blood AMH level test annually to avoid facing unforeseen results in future. All the best!


Dr Neeraj Pahlajani

Wednesday, 16 April 2014

Dr. Pahlajani Test Tube Baby Center Raipur: Does IVF cause premature menopause?

Dr. Pahlajani Test Tube Baby Center Raipur: Does IVF cause premature menopause?: Women are born with a certain number of eggs and IVF  stimulation of ovaries to produce extra eggs in single menstrual cycle might logic...

Does IVF cause premature menopause?


Women are born with a certain number of eggs and IVF  stimulation of ovaries to produce extra eggs in single menstrual cycle might logically let your ovarian reserve exhaust and push you enter early menopause!

Normally, women with menstrual cycle length between 28 to 30 days ovulate 12 times/year producing one egg for every cycle. So, she uses only 12 eggs per year. However, one IVF cycle demands the harvest at least 15 eggs or more for one IVF cycle through stimulation of ovaries with hormones, so as to make use of best few eggs. 

Now, multiple IVF cycles (in case of recurring failure) might make use of dozens of eggs. Mathematically, the ovarian reserve of women undergoing the above process should deplete than normal and she should find herself standing on the last leap of her menstrual cycle, staking her long-term fertility.

However, the laws of medical logic annul all such absurd facts. Scientifically, ovaries are the pair of egg reservoirs situated in pelvic region of women. Eggs are the cells which are also called genetic blue prints that create babies with male sperm. Ovaries have specialized structures called follicles to store, protect, and nourish eggs.

Between 18-22 weeks of gestation, a female fetus contains about 2,000,000+ follicles in its ovaries and each follicle contains one egg. However, the fetus loses 80 % of its eggs at the time of birth and it is left with only approx 3,00,000 eggs in her ovaries. From puberty to menopause, she loses almost all her follicles. During her lifetime menstrual cycle, a woman normally ovulate around 400 eggs, releasing one mature egg each month.

Most of the immature follicles inside ovary do not mature to release eggs. So, around 99.99 % follicles do not serve any biological purpose by not releasing eggs.

How ovary functions during menstrual cycle?

With the start of menstrual cycle, the pituitary gland secretes Follicle Stimulating Hormone (FSH) to stimulate the ovarian follicles. In response the follicles start growing and out number of follicles one follicle (called dominant follicle) carries the mature egg. This mature egg is released during ovulation. Meanwhile, the other follicles which fail to mature are lost in the process. These follicles die in a natural process called atresia.

How ovary functions during IVF?

During IVF, women are injected with high amount of FSH, higher than the body normally produces. High FSH matures higher number of follicles to produce potential eggs in single cycle. This is done to retrieve maximum number of eggs in one cycle for embryo formation. 

This is the reason why IVF treatment will not deplete your ovarian reserve because, the stimulation matures the follicles which would otherwise die. This is why the IVF treatment does not cause premature menopause. Even if you have multiple IVF cycles, it would not affect your ovarian reserve.

However, the other parallel truth is infertile women have higher risk of early menopause because of already poor ovarian reserve. It is due to the biological functioning of their bodies and it has nothing to do with IVF or number of IVF they are subjected to. So, if you are infertile and you enter menopause after IVF then please understand that it was not IVF which exhausted your ovarian reserve. You would have entered early menopause anyway, even without undergoing IVF.

Dr Neeraj Pahlajani

Tuesday, 15 April 2014

Embryo Transfer - Do’s and Don’ts during 2ww


Generally, patients find themselves wedged in a situation, where it is difficult to decide what is good or bad for them. Sometimes, they restrict themselves to function normally and allow unnecessary stress to permeate their lives. Below is a list of do’s and don’ts that would help you through 2ww,

Do’s

  • Eat healthy
  • Avoid complete bed rest
  • Follow medications routinely
  • Follow simple yoga regime
  • Do things to keep yourself happy and relaxed
  • Avoid self-blame if the IVF cycle does not succeed
  • Read good books.
  • Be a part of surrounding that makes you happy.



Don’ts

  • Do not doubt yourself.
  • So not use sauna, hot tubs, or any activity that might increase your body temperature.
  • Do not exhaust yourself mentally or physically.
  • Stay away from negative surrounding
  • Avoid watching or reading stressful things.
  • Do not change your diet completely. If you want to switch to healthy eating habit, do it slowly. 

Dr Neeraj Pahlajani

Embryo Transfer FAQs


How long is the process of embryo transfer?
Few minutes, before you are done with embryo transfer in your uterus.


Can I take a long journey back to home immediately after embryo transfer?
Yes, air travel or any mode of transport has no affect on embryo. It will do no harm to the pregnancy. The precautions are to keep yourself hydrated, move frequently and not sit for long.


Is bleeding normal after embryo transfer?
Bleeding after transfer is not usual. Most of the time, the embryo transfer does create trauma to your cervix or endometrium, so the patients should not experience bleeding or spotting after an embryo transfer.

However, some patients with narrow cervical opening (called cervical stenosis) may experience bleeding after the transfer. But there is no reason to panic because the blood is not from uterus. Your embryos are completely safe. We, at Pahlajani IVF clinic show our patients the embryos before they are transferred to your uterus.


What does embryos look like before and after transfer? 
Embryos are the minute microscopic cells which one could not see through naked eyes. You need a microscope to view them. Since, the embryos are living cells, so they constantly divide and look different with each passing day after fertilization. Doctors identify and compare the size of embryos with each day. 


Is wet discharge normal after the embryo transfer?Wet discharge is not from inside your body rather it is the sterile fluid used by doctors to cleans your vaginal canal and the cervix. So, it is normal that you experience a little wet discharge after embryo transfer but do not worry your embryo is safe inside your uterus and the wet discharge did not wash it out.


Do I need to adhere with some eating rules before embryo transfer?
No, you can have normal food as embryo transfer is not done using general anesthesia. So, the patients are not given any diet chart before the transfer. They simply need to follow normal guidelines provided by the clinic.  


Dr Neeraj Pahlajani



Monday, 14 April 2014

What you need to do immediately after Embryo Transfer?


Do you fear walking around, or standing up after embryo transfer through IVF? Women tend to worry about purge out of their embryos through the channel of implantation. After all, if the embryos are transferred through the uterus through the cervix, then it is reasonable for a woman to think that the embryo might slip out through the same route. 

Understandably, women are protective about the to be fetus and tend to feel, if they sit stiff in one position the embryo might stick to the wall of uterus and if they walk or do some physical activity, the embryo might get disturbed. 
Few women fear to go to the toilet, they think if they pee the embryo might get removed.  However, if women understand the construction and properties of the uterus, it would be easier for them to feel normal after embryo transfer.

ANATOMY OF UTERUS

Uterus is a muscular of organ about the size of a fist. The walls of the uterus are in close contact with each other with no gap of hollow space. So, when an embryo is implanted, it is protected between the walls like a seed when sowed is buried inside the soil. It is an interlocking, where the walls hold the embryo between the contractions like when we hold a small seed inside our pressed palms. 

The palms create a suction area around the seed and hold it even if we move or jerk our hands. The seed will not get dislodged in any direction you move your hands. Similar is the function of uterus, it holds the embryo between the walls. The embryo, when implanted is small and microscopic and through the weeks it makes its own space by adjusting inside the walls.

Also, the 'uterine cavity' is a medical reference; it does not mean that the uterus is a cave like structure with a void inside. There is no real ‘space’ between the walls. So, nothing can disturb the embryo inside the uterus once implanted, neither jumping nor going to pee. Any kind of external physical activity cannot disturb the embryo. 

So, it is SAFE to walk, pee or even dance. Human body has its own structural complexities to handle the inside environment, so without worries allow the organs to work according to their intelligence.

Even the belief about weeks of bed rest after embryo transfer is completely wrong. Bed rest has not been scientifically proven to improve pregnancy rate in embryo transfer. Bed rest would in turn harm you physically and emotionally. No work or physical activity would give you additional complications like back ache, decrease uterine blood flow by reducing pelvic circulations, laziness or gastric issues. 

When you rest and do absolutely nothing, then you may start thinking about negative aspects, become pessimistic and the whole IVF cycle might turn out a stressful process because a body rests but the mind starts working in double pace. Women should be energetic, follow their normal routine, eat healthy, little workout or brisk walk would make a perfect healthy environment for a fetus to develop.

Do not be scared to sneeze or cough, do not hold the pee in fear. Even if you have orgasm while sleeping (it usually happens during 2ww), don’t worry, your embryo will not be dislodged in any case even if you have intercourse. Feel normal and stay calm, allow the organs to perform their functions. 

Wash the old myths out of mind that bed rest and house arrest would keep your baby healthy. Your fetus needs fresh air, healthy environment inside. So, if you rest for the whole time and do not allow your body to function, then how will your fetus get a healthy environment?

A couple, and most importantly the family members should understand that bed rest would not improve the pregnancy. All the best! 

Dr Neeraj Pahlajani