The Road to Fertility

Secondary infertility is inability to conceive or carry ahead the pregnancy again after a woman has once conceived earlier. There are broadly two type of couple here, one who already have a baby and fail to achieve a pregnancy second time around, and secondly, couple who conceive but the pregnancy does not carry forward for any medical reason. These couples suffer for a trauma and emotional stress not very well appreciated. Difficulty in conceiving a second child may come as a shock to the couple, particularly if no problems were experienced before. The reaction that some couples face “ be happy you have one” can be very depressing for a couple desperately trying for a child. The average incidence of secondary infertility is 20-30 percent of the general infertility population. The main causes for secondary infertility are similar to those of Primary infertility like tubal block, endometriosis, fibroid uterus, altered sperm parameters with the added burden of age and lifes...

There was a subject called economics that we science students frowned upon religiously in college days. What could possibly be the attractions of a dry number driven complex topic for the pursuers of life and living beings and the forces that drive them, we asked! The answers came by, albeit a bit delayed, in the years of practise. For the health care is also driven by something we learnt as Demand and supply theory! Especially the optional treatment branches.  Fertility is such a branch, which is catering to healthy couple who are not suffering from a disease (infertility is yet listed as a condition and not as a disease) and is availed of as an optional, even boutique therapy. Only couple under the clutches of infertility realise what can be the devastating effects of the condition. Because is not an emergency or life threatening condition, usually couple have enough time and resources to choose the place of treatment. The question is, are our couples seeking fertilit...

Geoffrey Chaucer said "Time and tide wait for no man”. I would like to put an addendum with due respect to Chaucer, "Time, Tide and Biological Clock wait for no woman". Women mature with age, become more mellowed and beautiful and confidant after the twenties, but does her fertility follow this graph too? Sadly, no! Each month a bunch of eggs, start their journey towards ovulation. Only one best egg is selected and the rest are discarded by a natural selection.  By the age of 37 years there is a sharp decline in the egg reserve and the number steeply declines till the age of 40+ when there are but few good eggs left to come to the aid ofthat persistent sperm and make a living of their own!  Thanks to the advents of science, we now have a way forward with egg freezing or Ooocytecryopreservation as we call it.The American Society of Reproductive Medicine has removed the "experimental" label from oocyte cryopreservation in 2012 and it has been included in ...

We pace through the daily life in an unending rush, especially so in the metropolis. Like a coin, life in a big city has its pro's and con's. Do we stop to think about the effect on life and it's quality and more importantly, fertility and it's quality? lets do the exercise for a moment here! Lifestyle modifications go a long way in improving and improvising the way we live our days and also the number of days we live! The concept has to be drilled into us from the childhood because firstly the foundations built in young age decide how our future shapes up and secondly, because we as a species are in love with that which is easy! Our kids grow chubbier, our adults grow obese and our doctors grow busier! The wholesome effect of an unprocessed diet, hours in open air and away from the addictive screens cannot be overstressed. However, those who live in pigeonhole high rise apartments can but dream of those days which we have taken for granted in our childhood. We can...

What am I talking about? Negativism? Not at all! I am just changing the perspective here from the literary meaning. We would all hope and love to loose some weight, wouldn't we? Barring some extremely lucky individuals who actually can eat to their hearts content and still look fit as a fiddle. One may ask, how does this co relate with the fertility issues. It does, because the basic essential for good fertility is a healthy body. For women AND men. Obesity in men has been known to affect sperm count and motility. And if the background leads to the entire spectrum of diabetes, hypertension,  type A personality and a unhealthy stressed corporate lifestyle, well that's all the ingredients there to adversely effect the well being of the sperms. The high cholesterol, high sugar levels, neuropathy associated with diabetes and the stressed lifestyle which allows for little or no physical activity. For women the problems of weight gain can st...

So, you have been at it, been there, done that and to your utter frustration, "that" has not helped..What now! For the medical jargon junkies, it translates to having done the investigations, been through the ovulation induction, planned the act for the anticipated pregnancy, tried the laparoscopy and still its back to square one. the strip on the pregnancy card never tickled you pink! Your doctor has advised insemination..after the first reservations, it does seem simple enough and quicker perhaps? Hold your horses, for it may not be as simple as it seems. The essential criteria to undergo an insemination, more specifically  an intrauterine insemination is that the fallopian tubes should be patent, the sperm count should not be below a cutoff value and yes, the follicles should grow well and rupture.these are some things you have to make sure are in place before proceeding for an IUI. IUI if done without stimulating the ovaries minimally, usual...

Laparoscopy has come in the fertility management as a boon..or so I thought. It was once a simple minimally invasive way to have a look at the woman's reproductive organs, treat the disease if any and get out safely, without causing the mayhem of an open surgery. But as they say, too much of anything is not good. Along came the enthusiastic laparoscopic surgeons who took up a diagnostic laparoscopy as the first line management of any couple seeking help with their fertility issues. And the brunt was born by the poor ovaries! Drilling of ovaries, a term that you may see on the surgery summary of your papers has a lot of explaining to do. Drilling means making small points with some form of heat, cautery, laser etc. This is essentially done for women with PCOS who DO NOT , I repeat DO NOT ovulate with routine drugs in from of tablets and injections. Apart from the fact that drilling is a surgical intervention, it can cause long lasting irreversible effects if done in the wro...