Thursday, 13 February 2014
Saturday, 28 September 2013
Sunday, 11 August 2013
Thursday, 21 March 2013
Sunday, 3 March 2013
Monday, 12 December 2011
Monday, 7 November 2011
Aid for Women with AIDS
HIV infection has become an epidemic in the past few years with an estimated 61 million affected people worldwide, another 7 million are added every year as per UNAIDS, the United Nations watchdog for AIDS. With 27 million pregnancies every year in India, it is estimated that about 100,000 HIV infected women deliver every year. From infected pregnant women about 30,000 infants acquire HIV in India every year.
Human immunodeficiency Virus (HIV) belongs to a family of slow acting Lenti viruses that uses a special enzyme (a kind or protein) for replication. The virus binds to the immune cells (cells in the human body that protect it against infections) of the body and kills them. This leads to a progressive decline in the number and function of these immune cells, which in turn causes impairment of the immunity in the body. Low levels of immunity leads to an increased risk of infections and some type of cancers.
There is no evidence to suggest that pregnancy hastens the progression of HIV infection. However women who have HIV have a higher chance of abortion, small babies and an early delivery. The virus travels from the mother to the baby at three different times during pregnancy. Most commonly the baby gets infected while it is still in the womb, next commonly during delivery and least commonly after delivery by taking the infected mothers’ breast milk. More advanced is the mother’s disease, higher is the chance of the baby acquiring HIV from its mother.
Any pregnant women with HIV should be counseled about the nature of the disease, the need for long term treatment and general measures for HIV infection. She should be explained the risk to her and to the baby due to her infection. The option for termination of pregnancy should be discussed with her.
The primary mode of treatment of HIV positive women is administration of HAART (highly active antiretroviral therapy) started anytime after three and a half months of pregnancy. This consists taking oral medicines against HIV at home. It decreases the risk of the baby having HIV from 45% to around 8%. These medicines, which earlier had a very prohibitive cost are now available in generic versions at affordable prices, and can be taken at home.
The type of delivery is very important in decreasing the risk of HIV transmission from mother to child. It is recommended by the American College of Obstetricians and Gynecologists that Caesarean section should be done for all women to decrease the risk of infection to the baby further from 8% to 2%. Even women who have started having natural labor pains benefit from having a C section.
Centre for disease Control and Prevention, USA recommends avoidance of breastfeeding in HIV positive women. World Health Organization however recommends exclusive breastfeeding in women who do not have enough money to buy formula feed, but breastfeeding should be exclusive and should stop at four months of age of the baby. Giving a child a mixed diet of breast milk and formula feeds is worse for the baby as formula milk causes inflammation of the childs intestine from which the HIV virus can easily enter the body of the child.
All children born to HIV positive mothers should get Zidovudine (an antiHIV drug) and should be tested for HIV at birth and again at 6 weeks and 6 months and treated accordingly.
A good part of HIV transfer from mother to child is preventable through simple means. Women should be counseled for the same and helped in containing the virus.
How does AIDS spread?
Sexual mode is the major route of spread of HIV infection globally. Heterosexual intercourse accounts for 82% cases of HIV transmission in India. The risk of HIV infection with sexual intercourse is 1% per episode with an increased risk associated with female gender, presence of other sexually transmitted diseases and pattern of sexual behavior. There is a higher risk of male to female transmission compared to female to male transmission (8 times) due to the large surface area of the vagina, prolonged exposure to semen and trauma to the vagina during intercourse. Getting a blood transfusion with infected blood carries a 90- 100 % risk of contracting HIV infection. It is important to know that despite the strict control by the government on the screening of blood before transfusion and the crackdown of professional blood donors, there still exists a risk of 7 people accidentally getting AIDS through contaminated blood per every one million people getting a blood transfusion. This emphasizes the need for giving blood and its products only to those people who really need it. Infected needles are an important source of HIV infection for health care professionals like doctors and nurses and for intravenous drug addicts. Hollow bore needles are associated with 8 times increased risk of infection than a surgical needle. Needle prick with an infected hollow bore needle is associated with a 0.3% chance of HIV transmission.
Clinical course of HIV in the body
Exposure to HIV is followed by an incubation period, which lasts for about 3-6 weeks followed by a period of rapid multiplication of the virus in the body called Acute HIV syndrome in 60-70% cases. This syndrome is similar to other viral illnesses with mild fever, body ache etc. This is followed by a period of immune response of the body, which reduces the virus levels in the body to very low counts. The diagnosis of HIV infection by lab tests may be missed by antibody based detection methods (the most commonly done lab test for AIDS) for up to 2 months following the HIV infection. This period is also known as the window period. The disease then lies low in the body for up to 6-8 years following which the virus again becomes stronger than the body and there comes the final stage of full-blown AIDS
Human immunodeficiency Virus (HIV) belongs to a family of slow acting Lenti viruses that uses a special enzyme (a kind or protein) for replication. The virus binds to the immune cells (cells in the human body that protect it against infections) of the body and kills them. This leads to a progressive decline in the number and function of these immune cells, which in turn causes impairment of the immunity in the body. Low levels of immunity leads to an increased risk of infections and some type of cancers.
There is no evidence to suggest that pregnancy hastens the progression of HIV infection. However women who have HIV have a higher chance of abortion, small babies and an early delivery. The virus travels from the mother to the baby at three different times during pregnancy. Most commonly the baby gets infected while it is still in the womb, next commonly during delivery and least commonly after delivery by taking the infected mothers’ breast milk. More advanced is the mother’s disease, higher is the chance of the baby acquiring HIV from its mother.
Any pregnant women with HIV should be counseled about the nature of the disease, the need for long term treatment and general measures for HIV infection. She should be explained the risk to her and to the baby due to her infection. The option for termination of pregnancy should be discussed with her.
The primary mode of treatment of HIV positive women is administration of HAART (highly active antiretroviral therapy) started anytime after three and a half months of pregnancy. This consists taking oral medicines against HIV at home. It decreases the risk of the baby having HIV from 45% to around 8%. These medicines, which earlier had a very prohibitive cost are now available in generic versions at affordable prices, and can be taken at home.
The type of delivery is very important in decreasing the risk of HIV transmission from mother to child. It is recommended by the American College of Obstetricians and Gynecologists that Caesarean section should be done for all women to decrease the risk of infection to the baby further from 8% to 2%. Even women who have started having natural labor pains benefit from having a C section.
Centre for disease Control and Prevention, USA recommends avoidance of breastfeeding in HIV positive women. World Health Organization however recommends exclusive breastfeeding in women who do not have enough money to buy formula feed, but breastfeeding should be exclusive and should stop at four months of age of the baby. Giving a child a mixed diet of breast milk and formula feeds is worse for the baby as formula milk causes inflammation of the childs intestine from which the HIV virus can easily enter the body of the child.
All children born to HIV positive mothers should get Zidovudine (an antiHIV drug) and should be tested for HIV at birth and again at 6 weeks and 6 months and treated accordingly.
A good part of HIV transfer from mother to child is preventable through simple means. Women should be counseled for the same and helped in containing the virus.
How does AIDS spread?
Sexual mode is the major route of spread of HIV infection globally. Heterosexual intercourse accounts for 82% cases of HIV transmission in India. The risk of HIV infection with sexual intercourse is 1% per episode with an increased risk associated with female gender, presence of other sexually transmitted diseases and pattern of sexual behavior. There is a higher risk of male to female transmission compared to female to male transmission (8 times) due to the large surface area of the vagina, prolonged exposure to semen and trauma to the vagina during intercourse. Getting a blood transfusion with infected blood carries a 90- 100 % risk of contracting HIV infection. It is important to know that despite the strict control by the government on the screening of blood before transfusion and the crackdown of professional blood donors, there still exists a risk of 7 people accidentally getting AIDS through contaminated blood per every one million people getting a blood transfusion. This emphasizes the need for giving blood and its products only to those people who really need it. Infected needles are an important source of HIV infection for health care professionals like doctors and nurses and for intravenous drug addicts. Hollow bore needles are associated with 8 times increased risk of infection than a surgical needle. Needle prick with an infected hollow bore needle is associated with a 0.3% chance of HIV transmission.
Clinical course of HIV in the body
Exposure to HIV is followed by an incubation period, which lasts for about 3-6 weeks followed by a period of rapid multiplication of the virus in the body called Acute HIV syndrome in 60-70% cases. This syndrome is similar to other viral illnesses with mild fever, body ache etc. This is followed by a period of immune response of the body, which reduces the virus levels in the body to very low counts. The diagnosis of HIV infection by lab tests may be missed by antibody based detection methods (the most commonly done lab test for AIDS) for up to 2 months following the HIV infection. This period is also known as the window period. The disease then lies low in the body for up to 6-8 years following which the virus again becomes stronger than the body and there comes the final stage of full-blown AIDS
Age and Infertility
What is the relation between my age and my chances of getting pregnant?
Most fertility patients are aware of the term "biological clock". Women are born with all their eggs and with each month passing, some of these eggs are used up. A woman’s reproductive potential declines, especially as she approaches her fourth decade of life. The total eggs that are left in a woman’s body is called her “ovarian reserve”.
Because women in our society are marrying later, and consequently attempting pregnancy later in life, evaluation of ovarian reserve is critical to understanding a patient’s reproductive potential. Unfortunately, there is no perfect test and it is difficult to answer with certainty the question that is often asked by anxious patients. How much time do my ovaries have left? And; How long can I wait to have a baby?
Can I get pregnant even if I am in my forties?
A little assistance is needed if you are in your fourth decade of life but definitely, a pregnancy can happen. The assistance might be in the form of IUI or IVF/ ICSI.
How to get pregnant if I have gone through menopause?
If you are postmenopausal, it means that you have finished with your supply of eggs. However with egg (ova) donation, you can borrow an egg from a young donor, get it fertilized with the sperm of your husband and then the embryo transfer is done to your uterus. You then carry the pregnancy to term in your own uterus. This is what is called egg donation or Donor Egg IVF
What infertility tests will tell me how good are my chances of getting pregnant at my age?
The infertility tests to determine your fertility potential are called tests of Ovarian reserve.
Follicle Stimulating Hormone (FSH). This is a blood test that measures the negative feedback from the ovary to the pituitary gland, which makes follicle stimulating hormone. It is done preferably on the third day of your periods (the first day being the day the periods began). FSH is the hormone that causes follicular recruitment and development in the ovary.
As ovarian function declines, and premenopause approaches, the negative feedback to the pituitary is decreased and the FSH level rises as the pituitary tries to drive the ovary harder. Commonly accepted values for a reassuring day 3 FSH value are less than 10 iu/ml. A slightly higher level may be compatible with development of an ongoing pregnancy with the use of appropriate therapy.
Unfortunately, this test is not a perfect predictor of reproductive potential because it is only one measurement in one cycle, and because ovarian function varies from cycle to cycle. Some cycles provide more fertility potential than others, especially in premenopausal patients. Sometimes it is possible to successfully treat a patient who has had a previously high FSH in a cycle that is more optimal by using hormonal medications to reduce the basal FSH level and then administering fertility medications.
These patients may become pregnant, especially if other markers of ovarian reserve are normal. In summary, one elevated FSH level on day 3 is not necessarily a steadfast indicator of an impossible case but should be interpreted in the light of further testing. Treatment should be started immediately if ovarian reserve is diminished as the ovarian function declines with age.
Inhibin B- Inhibin B is a specific hormone secreted by the ovarian follicle and is the most specific marker assessing ovarian reserve. The test appears to be more reliable than just a day 3 FSH blood test and is more consistent from cycle to cycle offering a more reliable evaluation of the true state of ovarian reserve. It is a marker of how the ovaries will respond to fertility drugs. The mean value at 95% confidence limits for day 3 inhibin evaluations is 33-45 pg/ml in normally fertile women. Since inhibin is a messenger hormone secreted by a healthy ovary to influence the pituitary gland, a low inhibin less than 30 pg/ml is a bad prognosticator of future reproductive potential. But a normal inhibin, even in the face of a slightly elevated day 3 FSH, can be encouraging and compatible with the initiation of a successful ongoing pregnancy.
Anti Mullerian hormone (AMH) is another new accurate marker of ovarian reserve. The advantage with AMH is that it can be done anytime during the women’s cycle.
The Clomiphene Challenge test provides an additional measurement of ovarian reserve. The principle of the test is to measure the basal FSH and estradiol levels on day three of the patient’s cycle. In order to evaluate the ovarian response to fertility drugs, 100 mg of Clomid is administered between days 5-9 of the cycle. The ovarian response on day 10 is further evaluated by checking the response to Clomid and measuring the FSH and estradiol. The test is abnormal if the day 3 or day 10 FSH is elevated above 10 iu/ml.
Stimulating the ovary with gonadotropins to see how they respond. An ovulation study is done and the number of eggs produced in response to the gonadotropins is evaluated. This is the ultimate test of ovarian reserve.
Most fertility patients are aware of the term "biological clock". Women are born with all their eggs and with each month passing, some of these eggs are used up. A woman’s reproductive potential declines, especially as she approaches her fourth decade of life. The total eggs that are left in a woman’s body is called her “ovarian reserve”.
Because women in our society are marrying later, and consequently attempting pregnancy later in life, evaluation of ovarian reserve is critical to understanding a patient’s reproductive potential. Unfortunately, there is no perfect test and it is difficult to answer with certainty the question that is often asked by anxious patients. How much time do my ovaries have left? And; How long can I wait to have a baby?
Can I get pregnant even if I am in my forties?
A little assistance is needed if you are in your fourth decade of life but definitely, a pregnancy can happen. The assistance might be in the form of IUI or IVF/ ICSI.
How to get pregnant if I have gone through menopause?
If you are postmenopausal, it means that you have finished with your supply of eggs. However with egg (ova) donation, you can borrow an egg from a young donor, get it fertilized with the sperm of your husband and then the embryo transfer is done to your uterus. You then carry the pregnancy to term in your own uterus. This is what is called egg donation or Donor Egg IVF
What infertility tests will tell me how good are my chances of getting pregnant at my age?
The infertility tests to determine your fertility potential are called tests of Ovarian reserve.
Follicle Stimulating Hormone (FSH). This is a blood test that measures the negative feedback from the ovary to the pituitary gland, which makes follicle stimulating hormone. It is done preferably on the third day of your periods (the first day being the day the periods began). FSH is the hormone that causes follicular recruitment and development in the ovary.
As ovarian function declines, and premenopause approaches, the negative feedback to the pituitary is decreased and the FSH level rises as the pituitary tries to drive the ovary harder. Commonly accepted values for a reassuring day 3 FSH value are less than 10 iu/ml. A slightly higher level may be compatible with development of an ongoing pregnancy with the use of appropriate therapy.
Unfortunately, this test is not a perfect predictor of reproductive potential because it is only one measurement in one cycle, and because ovarian function varies from cycle to cycle. Some cycles provide more fertility potential than others, especially in premenopausal patients. Sometimes it is possible to successfully treat a patient who has had a previously high FSH in a cycle that is more optimal by using hormonal medications to reduce the basal FSH level and then administering fertility medications.
These patients may become pregnant, especially if other markers of ovarian reserve are normal. In summary, one elevated FSH level on day 3 is not necessarily a steadfast indicator of an impossible case but should be interpreted in the light of further testing. Treatment should be started immediately if ovarian reserve is diminished as the ovarian function declines with age.
Inhibin B- Inhibin B is a specific hormone secreted by the ovarian follicle and is the most specific marker assessing ovarian reserve. The test appears to be more reliable than just a day 3 FSH blood test and is more consistent from cycle to cycle offering a more reliable evaluation of the true state of ovarian reserve. It is a marker of how the ovaries will respond to fertility drugs. The mean value at 95% confidence limits for day 3 inhibin evaluations is 33-45 pg/ml in normally fertile women. Since inhibin is a messenger hormone secreted by a healthy ovary to influence the pituitary gland, a low inhibin less than 30 pg/ml is a bad prognosticator of future reproductive potential. But a normal inhibin, even in the face of a slightly elevated day 3 FSH, can be encouraging and compatible with the initiation of a successful ongoing pregnancy.
Anti Mullerian hormone (AMH) is another new accurate marker of ovarian reserve. The advantage with AMH is that it can be done anytime during the women’s cycle.
The Clomiphene Challenge test provides an additional measurement of ovarian reserve. The principle of the test is to measure the basal FSH and estradiol levels on day three of the patient’s cycle. In order to evaluate the ovarian response to fertility drugs, 100 mg of Clomid is administered between days 5-9 of the cycle. The ovarian response on day 10 is further evaluated by checking the response to Clomid and measuring the FSH and estradiol. The test is abnormal if the day 3 or day 10 FSH is elevated above 10 iu/ml.
Stimulating the ovary with gonadotropins to see how they respond. An ovulation study is done and the number of eggs produced in response to the gonadotropins is evaluated. This is the ultimate test of ovarian reserve.
How Does Pregnancy Happen?
Pregnancy is the result of a process that has many steps. To get pregnant—
· A woman’s body must release an egg from one of her ovaries (ovulation).
· The egg must go through a fallopian tube toward the uterus (womb).
· A man’s sperm must join with (fertilize) the egg along the way.
· The fertilized egg must attach to the inside of the uterus (implantation).
Infertility can happen if there are problems with any of these steps.
What is a regular menstrual cycle?
A regular menstrual cycle is an important element of successful conception. The menstrual cycle refers to the maturation and release of an egg as well as the preparation of the uterus to receive and nurture the fertilized egg (embryo). The hormones released during the menstrual cycle control the sequence of events that lead to pregnancy. On the first day of the cycle, when menstruation (or your "period") begins, the uterus sheds its lining from the previous cycle. The typical menstrual cycle lasts for about 28 days and is divided into the following three distinct phases.
1) Follicular Phase - Days 1 to 13
During this phase, the hypothalamus and pituitary glands in the brain release a hormone known as follicle stimulating hormone (FSH). FSH stimulates the development of a follicle, which is a tiny fluid-filled sac in each ovary containing a maturing egg. The follicle also secretes estrogen, which produces mid-cycle changes in the cervical mucus. These changes help prepare the cervical mucus to receive and nourish sperm.
2) Ovulatory Phase - Approximately 14 Days Before Your Next Cycle Starts
The ovulatory phase begins when the level of luteinizing hormone (LH), also release by the pituitary gland, drastically increases or surges. LH causes the follicle to break open and release the mature egg into the fallopian tube. During her reproductive years, a woman usually releases a single mature egg each month. This process is known as ovulation. Cervical mucus is most receptive to sperm around this time and a woman has the best chances of conceiving right before and during ovulation.
3) Luteal Phase - Days 15 to 28
During this phase, the follicle that produces the egg becomes a functioning gland called the corpus luteum. The corpus luteum produces progesterone, which prepares the endometrium (lining of the uterus) for the implantation of the fertilized egg.
I want to know more about Fertilization
The ovulatory phase of the menstrual cycle is the optimal time for fertilization. When a couple has intercourse during this time, sperm swim through the cervical mucus, into the uterus and along the fallopian tube, where they meet the egg. Although millions of sperm are released, only one sperm can fertilize an egg. The egg has the capacity to be fertilized for about 24 hours after it is released from the follicle. (If fertilization does not occur, the egg passes through the uterus, and the corpus luteum ceases to function on about day 26. The uterine lining then breaks down and is shed several days later as the next menstrual cycle begins.)
What is Implantation?
After fertilization, the embryo travels through the fallopian tube toward the uterus. Inside the uterus, the embryo implants itself into the lining on about the 20th day of the cycle and continues to grow into an embryo and eventually a fetus. The corpus luteum continues to produce progesterone to preserve the uterine lining and help maintain pregnancy.
What and when is the ‘fertile period’?
Fertile period is the time period during a womans menstrual cycle when there are maximum chances of the woman getting pregnant. This is the time when the woman is ovulating. The ovulatory phase, in a woman with a regular 28 day cycle is around the 14th day of her cycle. In women with irregular periods however, predicting the fertile period is tricky.It is a common misconception that the ovulatory phase begins around day 14 of your cycle; in fact, it can more easily be determined by 14 days prior to the start of your cycle, which may not be an exact 28 days. Your cycle begins in the first day that you experience regular flow. Once you determine how long your personal cycle lasts, subtract 14 days from the predicted end of the cycle to determine time of ovulation.
· A woman’s body must release an egg from one of her ovaries (ovulation).
· The egg must go through a fallopian tube toward the uterus (womb).
· A man’s sperm must join with (fertilize) the egg along the way.
· The fertilized egg must attach to the inside of the uterus (implantation).
Infertility can happen if there are problems with any of these steps.
What is a regular menstrual cycle?
A regular menstrual cycle is an important element of successful conception. The menstrual cycle refers to the maturation and release of an egg as well as the preparation of the uterus to receive and nurture the fertilized egg (embryo). The hormones released during the menstrual cycle control the sequence of events that lead to pregnancy. On the first day of the cycle, when menstruation (or your "period") begins, the uterus sheds its lining from the previous cycle. The typical menstrual cycle lasts for about 28 days and is divided into the following three distinct phases.
1) Follicular Phase - Days 1 to 13
During this phase, the hypothalamus and pituitary glands in the brain release a hormone known as follicle stimulating hormone (FSH). FSH stimulates the development of a follicle, which is a tiny fluid-filled sac in each ovary containing a maturing egg. The follicle also secretes estrogen, which produces mid-cycle changes in the cervical mucus. These changes help prepare the cervical mucus to receive and nourish sperm.
2) Ovulatory Phase - Approximately 14 Days Before Your Next Cycle Starts
The ovulatory phase begins when the level of luteinizing hormone (LH), also release by the pituitary gland, drastically increases or surges. LH causes the follicle to break open and release the mature egg into the fallopian tube. During her reproductive years, a woman usually releases a single mature egg each month. This process is known as ovulation. Cervical mucus is most receptive to sperm around this time and a woman has the best chances of conceiving right before and during ovulation.
3) Luteal Phase - Days 15 to 28
During this phase, the follicle that produces the egg becomes a functioning gland called the corpus luteum. The corpus luteum produces progesterone, which prepares the endometrium (lining of the uterus) for the implantation of the fertilized egg.
I want to know more about Fertilization
The ovulatory phase of the menstrual cycle is the optimal time for fertilization. When a couple has intercourse during this time, sperm swim through the cervical mucus, into the uterus and along the fallopian tube, where they meet the egg. Although millions of sperm are released, only one sperm can fertilize an egg. The egg has the capacity to be fertilized for about 24 hours after it is released from the follicle. (If fertilization does not occur, the egg passes through the uterus, and the corpus luteum ceases to function on about day 26. The uterine lining then breaks down and is shed several days later as the next menstrual cycle begins.)
What is Implantation?
After fertilization, the embryo travels through the fallopian tube toward the uterus. Inside the uterus, the embryo implants itself into the lining on about the 20th day of the cycle and continues to grow into an embryo and eventually a fetus. The corpus luteum continues to produce progesterone to preserve the uterine lining and help maintain pregnancy.
What and when is the ‘fertile period’?
Fertile period is the time period during a womans menstrual cycle when there are maximum chances of the woman getting pregnant. This is the time when the woman is ovulating. The ovulatory phase, in a woman with a regular 28 day cycle is around the 14th day of her cycle. In women with irregular periods however, predicting the fertile period is tricky.It is a common misconception that the ovulatory phase begins around day 14 of your cycle; in fact, it can more easily be determined by 14 days prior to the start of your cycle, which may not be an exact 28 days. Your cycle begins in the first day that you experience regular flow. Once you determine how long your personal cycle lasts, subtract 14 days from the predicted end of the cycle to determine time of ovulation.
What is Infertility?
What is infertility?
Infertility means not being able to get pregnant after one year of trying, or, six months, if a woman is 35 years of age or older.
How does pregnancy occur?
Pregnancy is the result of a process that has many steps. To get pregnant—
· A woman’s body must release an egg from one of her ovaries (ovulation).
· The egg must go through a fallopian tube toward the uterus (womb).
· A man's sperm must join with (fertilize) the egg along the way.
· The fertilized egg must attach to the inside of the uterus (implantation).
Infertility can happen if there are problems with any of these steps.
When Should I Get Help for Female Infertility?
It can take up to a year for a woman to get pregnant. This is considered normal. Most health care providers suggest a woman try for a year before seeking infertility testing. It is a good idea, though, to go to a health care provider to discuss pre-pregnancy health before starting to try to get pregnant.
Certain health problems can make getting pregnant more difficult. Don’t wait a whole year of trying to get pregnant before talking with your health care provider if you have a history of
· ectopic pregnancy
· irregular periods
· pelvic inflammatory disease
· repeated miscarriages
· thyroid problems
What is Secondary Infertility?
Secondary infertility is defined as infertility affecting couples who have had at least one child previously. Unfortunately, couples suffering with secondary infertility don't often get the help and support they need from doctors, friends and family because they aren't perceived as truly infertile since they've already had children.
What are the causes of Secondary Infertility?
There are many reasons that may explain why a couple is suffering with secondary infertility. A woman's fertility can change or be affected after having a child, even if she had no problem becoming pregnant the first or second time. Infection such as pelvic inflammatory disease (PID) can cause damage to the fallopian tubes, making it difficult for fertilization to occur, or increasing the risk of ectopic pregnancy.
Weight gain and an unhealthy diet can also affect your fertility. Gaining even a small amount of weight can throw your hormones off balance, affecting your menstrual cycles. If you are not ovulating, or ovulating irregularly, it may also be difficult to get pregnant. Endometriosis and fibroids are also contributing factors to secondary infertility.
Age can contribute to secondary infertility as well. With more women waiting to have their first child until well into their 30s, your fertility may have decreased significantly in the years between your first pregnancy, and attempting your second. Research shows that a woman's fertility begins a steady decline even in your late 20s and early 30s. (See age and Infertility) While this doesn't mean that you can't get pregnant, you may have a harder time conceiving and have an increased risk of miscarriage due to aging eggs. In addition to your fertility, your partner's fertility is also affected by age, thus contributing to secondary infertility.
When should I seek treatment?
If you are under 35, you aren't considered to have fertility problems until you've tried unsuccessfully for at least a year to get pregnant. This means that you've been having regular, unprotected sex for at least 12 months. If you're over 35, you should seek the treatment of a doctor after six months of trying. Repeated miscarriages, infection and irregular cycles are all reasons to speak to a doctor earlier. You will require an assessment of your current health, as well as tests to assess your reproductive status. (See Investigations for Infertility). Depending on the cause of the secondary infertility, you might be recommended a variety of fertility treatments.
If you feel that you are having trouble, or you may have trouble getting pregnant, don't hesitate to speak with your doctor at anytime.
What is the first step in seeking treatment?
The first step for many couples seeking medical treatment for infertility is to discuss their inability to conceive with an Infertility Specialist. The Infertility Specialist will review the couple's medical history and conduct a complete physical examination of the female. The evaluation of the male's medical history includes a discussion of previous pregnancies, developmental problems, surgeries, testicular trauma or infections and environmental exposure. The female medical history includes review of previous pregnancies, painful periods or pelvic pain, infections and previous surgeries.
Infertility means not being able to get pregnant after one year of trying, or, six months, if a woman is 35 years of age or older.
How does pregnancy occur?
Pregnancy is the result of a process that has many steps. To get pregnant—
· A woman’s body must release an egg from one of her ovaries (ovulation).
· The egg must go through a fallopian tube toward the uterus (womb).
· A man's sperm must join with (fertilize) the egg along the way.
· The fertilized egg must attach to the inside of the uterus (implantation).
Infertility can happen if there are problems with any of these steps.
When Should I Get Help for Female Infertility?
It can take up to a year for a woman to get pregnant. This is considered normal. Most health care providers suggest a woman try for a year before seeking infertility testing. It is a good idea, though, to go to a health care provider to discuss pre-pregnancy health before starting to try to get pregnant.
Certain health problems can make getting pregnant more difficult. Don’t wait a whole year of trying to get pregnant before talking with your health care provider if you have a history of
· ectopic pregnancy
· irregular periods
· pelvic inflammatory disease
· repeated miscarriages
· thyroid problems
What is Secondary Infertility?
Secondary infertility is defined as infertility affecting couples who have had at least one child previously. Unfortunately, couples suffering with secondary infertility don't often get the help and support they need from doctors, friends and family because they aren't perceived as truly infertile since they've already had children.
What are the causes of Secondary Infertility?
There are many reasons that may explain why a couple is suffering with secondary infertility. A woman's fertility can change or be affected after having a child, even if she had no problem becoming pregnant the first or second time. Infection such as pelvic inflammatory disease (PID) can cause damage to the fallopian tubes, making it difficult for fertilization to occur, or increasing the risk of ectopic pregnancy.
Weight gain and an unhealthy diet can also affect your fertility. Gaining even a small amount of weight can throw your hormones off balance, affecting your menstrual cycles. If you are not ovulating, or ovulating irregularly, it may also be difficult to get pregnant. Endometriosis and fibroids are also contributing factors to secondary infertility.
Age can contribute to secondary infertility as well. With more women waiting to have their first child until well into their 30s, your fertility may have decreased significantly in the years between your first pregnancy, and attempting your second. Research shows that a woman's fertility begins a steady decline even in your late 20s and early 30s. (See age and Infertility) While this doesn't mean that you can't get pregnant, you may have a harder time conceiving and have an increased risk of miscarriage due to aging eggs. In addition to your fertility, your partner's fertility is also affected by age, thus contributing to secondary infertility.
When should I seek treatment?
If you are under 35, you aren't considered to have fertility problems until you've tried unsuccessfully for at least a year to get pregnant. This means that you've been having regular, unprotected sex for at least 12 months. If you're over 35, you should seek the treatment of a doctor after six months of trying. Repeated miscarriages, infection and irregular cycles are all reasons to speak to a doctor earlier. You will require an assessment of your current health, as well as tests to assess your reproductive status. (See Investigations for Infertility). Depending on the cause of the secondary infertility, you might be recommended a variety of fertility treatments.
If you feel that you are having trouble, or you may have trouble getting pregnant, don't hesitate to speak with your doctor at anytime.
What is the first step in seeking treatment?
The first step for many couples seeking medical treatment for infertility is to discuss their inability to conceive with an Infertility Specialist. The Infertility Specialist will review the couple's medical history and conduct a complete physical examination of the female. The evaluation of the male's medical history includes a discussion of previous pregnancies, developmental problems, surgeries, testicular trauma or infections and environmental exposure. The female medical history includes review of previous pregnancies, painful periods or pelvic pain, infections and previous surgeries.
Subscribe to:
Posts (Atom)