Are you losing eggs after 30?

It is true that the biological clock of a woman ticks faster and louder with each passing year. But another parallel truth is that women are born with about 100,000 eggs, so the length of a woman's cycle, whether longer or shorter, does not predict a woman's fertility. Women lose eggs while they are busy racking up life experiences in their 20s. But, what matters more is not the quantity of eggs a woman loses but the quality of eggs she is left with. It depends on variety of factors including the genetics, and the habits.

It is tough to determine the pivotal age of a woman when her child bearing years actually end, but the there is a steady decline in production of ovarian eggs with biological clock ticking fast at 30. For women, who value their professional mobility tend to forget bitter truth about natural fertility, which declines through a woman's 30s and 40s. Quality ovarian eggs deteriorate with age and women find it difficult to conceive in during late 30s. 

By the time a woman turns 40, she is left with only 3 per cent quality eggs. 90 per cent eggs are lost throughout the biological cycle, which starts the day she hits puberty. Women, who tend to shelve the idea of getting pregnant before their escalating career increase the risk of having complications in conceiving. But women above 35 do not need to abandon the hope of having children as there are chances of conceiving through IVF.

Potential decline in ovarian reserve is directly proportional to age. While most of the women continue to produce eggs throughout their 30s and 40s, the reservoir of potential eggs shrinks to produce eggs that might give them problems while conceiving. With the approach of menopause, sometimes at mid-40s, women experience rapid decline of store and production of eggs. Healthy 30-year-old woman has about a 20 percent chance per month of becoming pregnant, while a 40-year-old woman has about a 5 percent chance per month.  

Ways to slow the ticking of biological clock

Women are you nervous listening to the tick-tick-tick of biological clock but there are no scientific ways or pills to retain the fertility but certain controlling obesity, stress and smoking can control the harmful effects on fertility. Women who have more pregnancies are fertile for longer, and some women are born with more eggs than others, she said. The more eggs with which a woman is born, the longer she will be fertile and more time she will have until the onset of menopause. 

Women’s egg count

Other than some indirect methods like ultrasound to measure size and volume in ovaries or blood tests that checks the hormone levels, there are no methods to calculate exact number of eggs in a women.

It is important to know that women in the 19-26 age groups have double the chance of conceiving each menstrual cycle compared to women between 35 and 39 years old. Age is the most powerful predictor of fertility and women need to be more “fertility aware”, especially about the factors that reduce the ovarian reserve.

Dr Neeraj Pahlajani

 

Legal issues and Ethical considerations surrounding Egg Donation

Egg donation, embryo donation, semen donation and surrogacy was legalized in the country after the Government of India appointed Indian Council of Medical Research (ICMR) to form the decree to sketch legal issues and ethical considerations surrounding the infertility treatments. The practice of donation, creating of embryos outside the body and storage that was derived more than a decade ago revolves around some Ethical Considerations and Legal Issues and Chapter 3 of ICMR defines the Code of Practice for infertility treatment. Pahlajani IVF Clinic strictly follows the norms defined by ICMR and preserves the rights of donors under the law.

Throughout the egg donation process, Pahlajani IVF Clinic ensures confidentiality of both donor and recipient. Under the legal agreement of the hospital, the identities are veiled, unless unusual circumstances of medical emergency or orders of court. Secondly, the donors are kept abreast of the legal, ethnic and risks involved in the procedure. The donors are informed beforehand that the offspring (if any) will not know her identity. Also, the recipients are au fait on the limitations tagged with the proposed treatment, techniques and possible side-effects.  

Pahlajani IVF Clinic encourages no treatment without the consent of infertile couple throughout the stages of treatment via a standard consent form to be filed before the process. Before initiation of any kind of process, the donors are serviced with thorough counseling sessions to ensure psychological involvement, balanced decision and push the degree of positivity to higher levels. In case, the donated eggs are used for research purpose, the projects are first approved by the Institutional Ethics Committee.

Criterion to be an egg donor with Pahlajani IVF Clinic

There are few requirements that an egg donor should meet, including, the age criteria that should be between 21 and 35 years. The girl/woman should be free from HIV, Hepatitis B and C, Hypertension, Diabetes, sexually transmitted diseases, and common genetic disorders such as thalassemia. Secondly, the hospital records and determines the blood group and the Rh status, and other relevant information in respect of the donor, such as height, weight, age, educational qualifications, profession, colour of the skin and the eyes, and the family background in respect of history of any familial disorder.

Pahlajani IVF Clinic protects the anonymity of the donor except the child demands the information after becoming an adult. Also, the donor shall have no parental right or duties in relation to the child.Ethical ramifications gyrating around gamete donation sometimes creates a vacuum in fertility treatment. While donors are concerned about autonomy, justice, beneficence, and non-maleficence, the recipients need assurance of the clinical reproduction service. However, Pahlajani IVF Clinic believes in informed decision making and conserves the interests of the donors. 

Pahlajani IVF Clinic walks on few defined principles of ensure health benefit and preventing harm to donors. Donors are well-versed about the longitudinal effects of the ovulation drugs and recoil of the process. 

Dr Neeraj Pahlajani

Egg Donation Programmes at Pahlajani Test Tube Baby Center

Egg donation is a marvel of creating lives through modern technology. Considering the need of few women, who are unable to produce their own eggs or do not want their genetic conditions to pass on to their children, Pahlajani Test Tube Baby Center has been organizing several egg donation camps in Raipur.

It is important to donate eggs as some women, who are unable to produce their own eggs require donations for healthy pregnancy. Multiplicities of reasons are attached to infertility and requirement of donated eggs. Some women might have gone through the menopause early – as young as 20, few women are left infertile after chemotherapy or radiotherapy for cancer, while other women have genetic conditions that resist to be transferred to their offspring.

During the egg donation camp organized at Pahlajani Pregnancy Care, the donors are provided the medical care throughout the process to diminish the risk involved in the process. Eggs of women usually between 21 to 35 years of age are accepted. In the standard egg donation process, the donors might be prescribed a medication for one or more weeks to temporarily halt ovaries' normal functioning to ensure controlled response to fertility drugs.

The egg donation procedure aims to obtain several mature eggs through egg stimulation procedure. The process of stimulating the ovary to produce more eggs than normal is called ‘hyperstimulation’. Donors are suggested to abstain from intercourse or use contraception during the donation cycle to avoid pregnancy with sometimes twins, triplets or quadruplets. The donors need to undergo frequent blood tests and ultrasounds to monitor the periodical development of eggs in response to the hormones. The eggs are removed from the ovaries through minor surgical procedure called transvaginal ovarian aspiration. Hence, the donated eggs are transferred into recipient for in vitro fertilization (IVF). The extracted eggs are first incubated then used in IVF or frozen to be used later.

It is important to for a donor to know that the eggs may go to more than one recipient. Also, one or more women may conceive or no pregnancies may occur. Sometimes, the donated embryos are used by another couple, or used for research, or are left frozen indefinitely. It depends on the need of the situation. At Pahlajani Pregnancy Care, the donors are given medical assistance since the inception of donation cycle. Along with the medical assurances, the donors are helped to ease their inhibitions related to the process. Till date, several donors have donated the gift of parenthood to childless couples through their eggs. 

Dr Neeraj Pahlajani     

Are you too old to get pregnant?

Gradient in the age and fertility graph of a woman takes steep rise during mid-20s and steady decline with approaching late-30s. Before a woman actually starts considering idea of getting pregnant, it sometimes is too late. A woman’s fertility clock starts ticking at its strongest pace, when she hits puberty and it gradually declines much earlier than thought. Although, the male fertility declines leisurely, but for couples with huge age difference face trouble when a partner five years older or more as sperm quality declines with age.

The most fertile time of a woman is between the ages of 19 to 26-years, as the chances of conceiving two days before ovulation are 50 per cent higher. With time, women become 10 per cent less fertile at 27 and the fertility rate starts sharply declining in the mid-30s. Sometimes, a late decision leaves a vast barren ground of infertility before the couples. However, most of the women were seen giving birth to a healthy baby at 35 without real complications in conceiving but after 35 the proportion of women experiencing infertility or miscarriage increases as the rate of fertility drops by nearly 40 per cent between the age of 27 and 34.

After 35, the fertility rate starts depending on the ages of both the partners. If the age difference is less, then two out of five women conceive with 30 per cent chances but couples with larger age difference experience infertility issues as the chances of conceiving remains less than 20 per cent. It is not that women stop conceiving, it just takes longer time and more complications. By the age of 40 only two in five of those who wish to have a baby will be able to do so.

On the other hand, male fertility starts declining at the age of 35. Many men remain fertile into their 50s and beyond, the proportion of men with sperm disorders increases with age. The decline in male fertility is more gradual for men than women. The decline in male fertility can affect the health of the children they may go on to have. Men can remain fertile for much longer than women. Even though male fertility also declines with age, it tends to happen gradually for men.

The reason behind decline of fertility in women is considered as ovulation problem and blockages to the fallopian tubes. When a woman hits 30s, she is left with less number of quality eggs that makes her ovarian reserve decline. And with the approach of menopause that comes usually around 40s, women are left with meager number of eggs. In fact, the chances of conceiving non-identical twins are seen mostly in older women. This is because the struggles to produce more Follicle Stimulating Hormone (FSH) to make women ovulate at the older age. The hormone is called follicle. Body produces FSH to fight the fewer viable eggs left in your ovaries. But the over-production of FSH can result in more than one follicle ripening and releasing an egg and multiply pregnancies.

However, with advancement of technologies, the couple need not worry. The upward trend of IVF has preserved the excitement of couples wanting have babies at any age. It is suggested to see a doctor after the age after regular failed attempts of getting pregnant.

Dr Neeraj Pahlajani

Medical Tourism – No more a Taboo in Raipur

Even as the institutions like IIM and AIIMS has anointed Raipur among one of the rapidly developing cities in country, the burgeoning idea of medical tourism parallelly has caught the imagination fertility tourists living in geographically dispersed cities towards the state.

Away from the cacophony of fast moving metropolitans, Raipur is situated in the heart of Chhattisgarh, a tribal heartland in Central India. With rare combination of state-of-the-art medical infrastructure and potential IVF and surrogacy options in Raipur, it has gradually fueled the international demand. Raipur can be termed as a bastion for couples wanting to ply their gametes at cheaper rates. With low traffic frequency rates, uber medicinal and infrastructural at hospitals, Raipur has become one of the favorite destinations for foreigners wanting to undergo fertility treatment.

It was observed that medical tourists were more liberal than ever for undergoing treatment in Raipur, after several infertile couples from USA, Europe, Africa and even neighboring countries like Bangladesh and Afghanistan came here it to find the cure. Success stories of the IVF and surrogacy in Raipur has put the doubts of couples to rest, who are otherwise skeptical about the treatment because of the obvious complications associated to it. Also, the cheap IVF treatment offered in Raipur has warded off the discomfort of pocket burning fees demanded in the first world countries. Visit counts of tourists tripping Raipur has multiplied in past one decade, with most of them returning with assured pregnancy results. The city has won an international recognition after high ratio of infertile couples was blessed with children.

The day commercial surrogacy was declared legal in India it also opened the flood gates of all the inhibitions related to surrogacy and IVF in the country. After facing a tough rebound from less liberal countries, medical tourism has emerged as a successful intersection of inexpensive and medical infrastructure in Raipur. In years, the city has witnessed high influx of tourists seeking medical care willing to travel the tribal land. Skewed population distribution in metros, and commercialized health care has locomoted the infertile tourists towards Raipur. The infertility hospitals have been able to preserve their appeals for assuring best treatment to patients. A taboo associated with IVF and surrogacy is dying a fast death after Raipur was appended to the list of best known IVF and surrogacy destinations.

Dr Neeraj Pahlajani

Medical Tourism In India

With India becoming a mecca for infertile couples, medical tourism has clearly laid an offshore pipeline for the global fertility tourists to fish for cut-price generic material from country’s pool. Though, medical tourism stumbles onto few legal and ethical obstacles in many countries like Canada, France and UK, where laws and statutes cover the legal issues of fertility treatment. 

In India, without real ethnic or legal implications, medical tourism has opened new avenues for couples seeking IVF treatment in pocket friendly rates. Couples wanting to undergo IVF treatment tend to churn out leads from internet to get best, assured and cheap fertility help. India, with its fascinating culture, also has impressive IVF with less than lesser implications and more chances of fertility. Beyond border quest for babies has globalised the surgical procedures, giving multiplicity of options to infertile couples before actually undergoing the life changing procedure.

While some countries have shortage of women donors, some actually restrict the doctors with legal implications. However, the scenario is rather more flexible in India. With higher rate of IVF successes, India has ace on its sleeves to have magnified its presence on world map. Easing the paramount concerns of infertile couples, hassle-free treatment and more chances of getting pregnant has anointed the country as one of the favorite destinations for medical tourism. Also to add, commercial surrogacy is completely legal in India, increasing international confidence on the country for treatment. It is one of those countries where legal issues around fertility treatment are left to official guidelines. For example, many countries have strict single embryo transfer policies, while in India will leave the number of embryos implanted up to the discretion of the fertility specialist. Where implantation of single embryos dims the chances of conceiving, it also reduces faith on the entire procedure. 

Apart from legal regulations, the fragile cord of ethnic inference has rarely affected the surrogacy procedure as anonymity of the donor is maintained. Boasting its large pool of skilled doctors and low treatment prices, healthcare balances the global brain drain of IT and medicine. Medical tourism has clearly shrunk the borders and brought countries closer to resolve medical issues over a wider spectrum.

With population of humongous proportion, need of availability, accessibility and affordability to reduce exacerbating health insecurity would be the pressing concern in few decades. However, the IVF successes have seeded the hope of infertile couples to experience the bliss of parenthood, with such procedures becoming bold predictions of reckoning.

Dr Neeraj Pahlajani

Dr.Malpani's Blog: How do I interpret my ovarian reserve test results ?

Dr.Malpani's Blog: How do I interpret my ovarian reserve test results ?