Understanding your fertility

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Female reproductive organs
Male reproductive organs
Understanding ovulation.

Knowledge is empowerment and the knowledge of fertility becomes more important especially if you are struggling with fertility. Getting pregnant is sometimes not easy and when you see everyone around getting pregnant, it only adds to your worries, however do not stress much as you are not alone, one in four couples is facing this problem. Most of these infertility issues can be solved, thanks to the rapidly developing IVF science.  

Female Reproductive Organs

  Female repro organs are:
  • A vagina
  • A cervix
  • A uterus
  • Pair of fallopian tubes
  • Pair of ovaries
All of these organs work together to help a woman menstruate (have monthly period), conceive, and carry a pregnancy.   Your vagina Is a tube like structure, connecting the uterus to external reproductive genitalia. This is where the sperms are deposited; from here the sperms travel upwards towards uterus.   Your cervix Is like an entrance to the uterus and it lies between vagina and uterus. Cervix secretes mucus that plays an important role in sperm movement up in the uterus.   Your uterus Right above cervix is Uterus; also referred as the womb, it is the organ which carries the pregnancy till term; it enlarges during pregnancy and reduces back after child birth. Once the egg is fertilized by sperm in the fallopian tubes, in few days it rolls down into uterus and gets implanted and grows in the nutrition rich layer of uterus called endometrium.   Your ovaries Most women have two ovaries, left and right. It stores eggs, in bag like structure called follicle. Each month a follicle matures and releases an egg in the fallopian tube. Every woman is born with fixed number of eggs ( about 2 million) and these eggs start decreasing with every passing month, so by the time a girl gets her first period she is left with around 400,000 eggs. An egg is fertilized by a single sperm in the fallopian tube.   Your fallopian tubes Just below both ovaries are two fallopian tubes, which catch the egg when it is released from the follicle in the ovary. The egg is known as a zygote after being fertilized by the sperm and then it moves down this fallopian tube to reach the uterus in several days. These tubes are like a pathway from ovaries to uterus and if these tubes are blocked then you might struggle to get pregnant without medical help.  

Male reproductive organs

  External organs: Penis, Scrotum and Testicles Internal organs: Epididymis, Vas Deferens, Urethra   Penis Penis is the external organ, used during sex. Blood flow through the muscles resulting in erection, semen ejaculates from the end of the penis. Semen is a natural fluid produced by male reproductive system that can contain sperm.   The scrotum Scrotum is the pouch of skin under penis, it contains the testicles.   The testis Testis produces sperms and testosterone hormone.   Epididymis The sperms are produced in testis but at that level they are not mature enough to fertilise an egg, this maturity is attained when the sperms pass gradually from the coiled tubes of epididymis, after which the sperms are ready to fertilise an egg.   Vas Deferens Once the sperm are mature, they move into vas deferens.   Urethra This is a tube from bottom of bladder till the end of penis. At the time of ejaculation of the sperms, urethra is the pathway used for semen ejaculation, however at this time a end of urethra is closed so that only semen is ejaculated in the right direction.  

Understanding pregnancy

In ovary every month a follicle matures and ruptures to eject its egg out into the fallopian tube, all these functions are controlled by hormones and receptors. Meanwhile when the egg is reaching the fallopian tube the sperms also have reached there traveling all the way from vagina through cervix and uterus to fallopian tubes. At that spot in the tube the sperm fertilizes the egg and the egg starts growing. While it grows, it moves gradually down the tube towards the uterus. When it reaches uterus it is closer to the stage of getting implanted in the endometrium. Once it gets implanted in uterus then the pregnancy is carried on further in coming months.  

Understanding ovulation

Ovulation is the process of the egg being released by the ovary. This egg is released (on an average) 14 days before the menstruation begins. If one can time the copulation, it can be helpful in getting pregnant.    
Don’t know your ovulation day? Don’t know the signs & symptoms of your body for ovulation? Not sure about your “Fertility Window”Give a call & gain knowledge

Female – Why am I not falling pregnant

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Common reason for infertility in women:

– Age
– PCOS
– Blocked or damaged tubes
– Endometrics
– Miscarriages

If you see around you’ll notice everyone is conceiving so easily whereas you might have a very opposite experience regarding this, however don’t stress because you are not alone as nearly 15 couples out of 100 need infertility treatment and the good news is 90% of them are treated.
In medical terms infertility is defined as a couple being unable to conceive after 12 months of regular unprotected sex, or if you can’t carry the pregnancy to term.
Female infertility factors:
The most common infertility factors in woman are:

  • Age
  • PCOS
  • Blocked or damaged fallopian tubes
  • Endometriosis
  • Miscarriage
  • Weight

Age

Your age is the single most important factor affecting your fertility.
Every woman is born with a finite number of eggs (1-2 million) and this number of eggs is all that she will ever have in her life. At Hope IVF we know that when she reaches her puberty she is left with three to four lakh eggs, chances of naturally getting pregnant starts declining gradually from 32 year of her age, 35 onwards this decline speeds up. Our research tells us that at 30, chances of conceiving naturally every month are around 20%, whereas at 40 it’s around 5 %.
The age is not only a hurdle in conceiving, it’s a major contributor in birth complications too like difficult labor, miscarriage and genetic abnormalities.
While there is no doubt that age is a factor, HOPE IVF has helped many couples to increase their chances of conceiving as the woman gets older.
Instead of waiting and loosing on precious time you should make the decision on having a baby now than later, for that discuss with our team at HOPE IVF so our fertility expert can find the best solution for you.

 

HOPE IVF SMART SCIENCE:
If you think now is not the right time to have a baby then you should discuss with your husband to freeze your eggs now to avoid the age related decline in egg quality and quantity. You should take advantage of the individualized fertility preservation program (egg freezing) at HOPE IVF.

PCOS

Polycystic Ovary Syndrome (PCOS) is a hormonal disorder, affecting woman of reproductive age. Its cause is not very clear so far, it can be genetic, lifestyle or environmental.
The woman suffers with infrequent, prolonged and irregular menstrual periods, often also has high male hormone (androgen) level along with other symptoms like:

  • Weight gain
  • Acne
  • Mood swings
  • Excessive hair growth (face, stomach and back)
  • Fertility issues

At HOPE IVF we have special interest in PCOS, to diagnose it we use a multiple diagnostic aids like ultra sound, blood tests and review of medical history.
To be categorized under PCOS most women need to be having atleast two of the following conditions:

  • One or both ovaries are enlarged, with 12 (or more) cysts visible in the ovaries.
  • Menstrual dysfunction (irregular or no periods).
  • High level of male hormones (androgens).

PCO & PCOS are two similar sounding terms however there is a significant difference. PCO refers to having polycystic ovaries that can be identified via ultrasound and it does not affect fertility the way PCOS does.
PCOS is a syndrome, where you experience 2 of the symptoms mentioned above.
PCO often goes undiagnosed as there are no symptoms, even though it affects up to a third of women of childbearing age.

 

How does PCOS affect fertility ?

If you are diagnosed with PCOS, then it might be difficult for you to conceive naturally.
Since PCOS disturbs the period timings, so it’s hard to know when to try to conceive.
With PCOS women the appetite controlling hormones are also not regulated, which leads to weight gain.

 

What should I do if PCOS is diagnosed ?

Treatment options to help you have a baby can include:

  • Reducing weight & reducing the BMI
  • Drugs to induce ovulation, such as Chlomid
  • Insulin-sensitizing medications
  • IVF or another assisted reproductive treatment

 

If you haven’t been diagnosed with PCOS, but you are concerned about it affecting your fertility, talk to your HOPE IVF specialist about the best way forward for you.

Blocked or damaged fallopian tubes

Fallopian tubes connect your ovaries to uterus, it has finger like structures close to ovaries which catch the egg as it is released out of ovary. The egg is fertilised by sperm in this tube and then it travels down this tube to reach the uterus to get implanted. Any damage or blockage in this tube will not let the sperm reach the egg to fertilise hence this tube has a very important role in getting pregnant.
Common reasons for damaged or blocked tubes:

  • Blockage since birth
  • Accidental damage by a surgery
  • Infection in and around the tubes
  • Tubes tied (tubal ligation surgery)

Diagnosing the state of fallopian tubes:

Team at HOPE IVF will determine the state of your fallopian tubes using following procedures:

  • X Ray
  • Atubal patency test (Dye test)
  • Laproscopic surgery (if needed)

 

TO KNOW ABOUT YOUR FALLOPIAN TUBES BOOK AN APPOINTMENT WITH OUR FERTILITY SPECIALIST

Endometriosis

Endometrium is the layer that lines the uterus and in some cases this tissue grows out of uterus near the ovaries, bowel etc. Sometimes women have it without any symptoms or mild symptoms. Investigation for diagnosis is often done when the symptoms become unbearable.
Common symptoms are:

  • Painful periods
  • Painful intercourse
  • Pain in lower tummy and pelvic area
  • Bleeding in between periods
  • Reduced fertility

How endometriosis causes infertility ?
Endometriosis can damage the fallopian tube or ovaries; this would have direct significant detrimental effect on the lady’s chances of conceiving. If the tubes and ovaries are not damaged, still endometriosis can hamper the movement of sperms, egg, fertilisation, embryo growth and implantation.

 

What causes endometriosis ?
Cause of endometriosis is not yet clearly understood and it varies from woman to woman. One theory is that the uterus cells are spilled out backwards into abdominal cavity via fallopian tubes when the lady gets her periods.

 

Is endometriosis treatable ?
Yes, depending on the type and severity the treatment may include some simple medication. A laparoscopic surgery to remove the patch of endometriosis, many women conceive naturally after this removal but IVF is also a common option if infertility continues.

 

If you have been diagnosed or you are concerned about endometriosis, book a free discussion with HOPE IVF patient care coordinator.

Miscarriage

Its defined as loss of pregnancy before 24 week of gestation.
It’s most likely to happen in the very early stages of the pregnancy and is uncommon after 10 weeks.
Many women who have a miscarriage go on and have a baby naturally.
If a woman has 2 or more miscarriages, without any successful pregnancies in between, than it is termed as recurrent miscarriage. If you have experienced recurrent miscarriage, its important to talk to a fertility specialist about potential causes.

Often no cause is found but common recognised causes include:

  • Advanced female age
  • Abnormal fetal development
  • Genetics related
  • Uterine or cervix in competency or abnormality
  • Hormonal disorder
  • Placental failure
  • Multiple pregnancy
  • PCOS
  • Infections
  • Poorly controlled diabetes and thyroid disease

 

What next

For recurrent miscarriage at HOPE IVF your specialist, depending on your individual case, may recommend advanced embryo selection treatment or tests for natural killer cells.

 

To find your reason for recurrent miscarriage give a call to book an appointment with fertility specialist at HOPE IVF.

Male – Why we are not falling pregnant

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Major causes of male infertility:
Sperm production
Absent sperm
Blockages
Sexual difficulties
Age

Male infertility factors

If you see around you’ll notice everyone is conceiving so easily whereas you might have a very opposite experience regarding this, however don’t stress because you are not alone as nearly 15 couples out of 100 need infertility treatment and the good news is 90% of them are treated.
In medical terms infertility is defined as a couple being unable to conceive after 12 months of regular unprotected sex, or if you can’t carry the pregnancy to term.

Male factor infertility is the most common reason for infertility after the female age factor.
Major causes of male infertility are:

  • Lack of Sperm production
  • Absent sperm
  • Blockages
  • Sexual difficulties
  • Age

 

Sperm production

Lack of enough sperm, sperm with low motility, low morphology (formation) and sperms with antibodies are the most common cause of male infertility.
Absent sperm (azoospermia)
Azoospermia is a condition when there is total absence of sperm in ejaculate. Common causes for this condition are genetic abnormalities, lack of sperm production or after a vasectomy.

 

Blocked vas deferens or other tubes

Blockages can be present from birth (congenital), as a result of surgery (like a vasectomy) or due to severe trauma or infections. Some cases can be fixed or reversed, or sperm can be retrieved and used in IVF treatment.

 

Sexual difficulties

Some men experience difficulties having regular ejaculatory sex. Men with diabetes, spinal cord injuries, who take certain medication or with psychosexual problems may have trouble ejaculating during penetrative sex. IVF is an effective option.

 

Age

Although it doesn’t affect fertility to the same extent as female age, sperm quality does decrease with age. The risk of miscarriage in women is higher if the male is over 45. Older males also have a greater chance of conceiving children with autism, mental health problems and learning difficulties.
Male infertility is often diagnosed by a semen analysis test,a physical examination or testicular biopsy by your fertility specialist.

 

If you are concerned about any issue related to male fertility, contact our IVF specialist for a confidential couple discussion session.

We at HOPE IVF have special interest in male infertility, and a well tested program where male infertility is easily diagnosed and treated with fertility treatment, such as IVF with Intracytoplasmic sperm injection (ICSI) or other advanced treatments like Physiologically selected Intracytoplasmic sperm injection (PICSI), Elective sperm cryo preservation (ESCP) and MICROTESE.

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