Thursday, 15 August 2013

Fertility Concerns



Some of the most common questions regarding female infertility have to do with miscarriages and also the effects of alcohol on fertility.
What Are The Effects of Alcohol on Fertility?

The data regarding the effects of moderate alcohol intake on fertility is inconclusive at this time. The largest prospective studies conducted in Europe indicate that high levels of alcohol consumption are associated with greater difficulty conceiving. One small Danish study identified a slight delay in conception even with alcohol ingestion of 5 drinks or less per week. However, this research relies on self-reporting of alcohol consumption which may be inaccurate. In many cases, the studies do not fully account for other factors that could be affecting fertility.

Don’t Overdo It

When you are attempting to conceive, taking a moderate approach to alcohol consumption is the wisest course of action. If having an occasional beer or glass of wine once or twice a week is part of your normal lifestyle, this is unlikely to have a significant effect on your ability to conceive. Drinking every day or consuming several drinks at one sitting is behavior you should avoid. High levels of alcohol can negatively affect many aspects of your health and is probably not good for eggs or sperm development either.

Alcohol and Pregnancy 
If you think you might be pregnant, it’s time to stop consuming alcohol. Fetal harm from exposure to alcohol in the womb can lead to lifelong health problems. In fact, Fetal Alcohol Syndrome (FAS) caused by maternal alcohol consumption is the leading identifiable cause of neuro-developmental disorders and birth defects in babies. No “safe level” of prenatal alcohol exposure has been identified, so pregnant women are advised to abstain from alcoholic beverages altogether.
 
How Common Is Miscarriage?

A high percentage of fertile women who have unprotected sex will experience loss of a pregnancy at some point. According to the American Society for Reproductive Medicine, 25% of recognized pregnancies end in miscarriage. The total number of miscarriages (including cases where the woman is unaware of the pregnancy) is estimated at about 50%. Pregnancy losses occurring within the first 8 weeks are most common. Few women experience miscarriage after the 12th week.  

What You Should Know about Recurrent Miscarriage

A single miscarriage is not usually a cause for concern from a medical standpoint. However, consecutive miscarriages are rare, occurring in less than 5% of women.  If you experience two or more miscarriages of in a row, you may wish to seek assistance from a reproductive specialist.

In some situations, there is an identifiable, medically treatable factor contributing to the loss of pregnancies. Many pregnancies simply end because of random chromosomal abnormalities in the egg or the developing embryo.

Recurrent miscarriage or early pregnancy loss can be physically taxing and emotionally devastating. Not knowing why this problem is happening can be especially distressing. Patients may experience feelings of self blame, failure, or desperation. It is important for patients to seek emotional support during this time. Professional mental health support may also be beneficial for patients coping with recurrent loss.

Pregnancy after Miscarriage 

Fortunately, most women trying to conceive do go on to carry a healthy pregnancy to term after a miscarriage. This includes 60-70% of women who have experienced recurring pregnancy loss with no identifiable cause. Following a healthy lifestyle including good nutrition, diet, weight control, prenatal supplementation, exercise, rest, and general self care is the best course of action for women who wish to increase their chances of a normal pregnancy in the future.
 
Can Recuring Miscarriage Be Prevented?

Because the underlying cause of most miscarriages is chromosomal abnormalities, the various therapies and techniques typically promoted for prevention are not proven and are unlikely to be useful. This includes over the counter, herbal, and alternative treatments.

Treatable Causes

Occasionally, a patient is diagnosed with a medical condition that may cause or contribute to recurrent miscarriage. Treatment or correction of the underlying disease, deficiency, or abnormality may reduce the chance of future miscarriage for some patients.
Here are a few examples:

Problem: Identifiable genetic abnormalities in one or both parents or advanced maternal age increasing the risk of chromosomal abnormalities in the embryo.
Treatment: During an In Vitro Fertilization cycle, preimplantation genetic diagnosis (PGD) may be used to identify a chromosomally normal embryo for implantation.

Problem: Uterine problems including polyps, fibroids, or a uterine septum (distortion of the interior of the uterus by abnormal tissue formation).
Treatment: Surgery may be suitable for some patients to restore a normal uterine surface to enable implantation and ongoing support of future embryos.

Problem: Diabetes or insulin resistance (such as found in patients with PCOS)
Treatment: Management of blood sugar through lifestyle changes and/or with appropriate medications to consistently maintain blood sugar at normal levels.

Problem: Antiphospholipid antibody syndrome which may cause excessive blood clotting and an antibody reaction to the placenta.
Treatment: Blood thinning therapy with aspirin and heparin may help prevent clotting. According to the American Society for Reproductive Medicine, medical treatments such as leukocyte (white blood cell) immunization and intravenous immunoglobulin (IVIG) therapy for preventing miscarriage have no proven benefit at this time.

If your doctor finds other medical conditions such as low levels of progesterone hormone or other hormonal irregularities, these may be treated as well. The efficacy of such treatment for preventing recurring miscarriage is not yet known.




Thursday, 1 August 2013

Fertility Treatment for PCOS



Polycystic ovarian syndrome (PCOS) is caused by an excess of testosterone and is the most frequent cause of infertility in reproductive-aged women. Conception is difficult for women with PCOS, as most experience irregular menstrual periods, often having only a few per year. High insulin levels are another symptom that can further contribute to menstrual irregularities. Additionally, Polycystic Ovary Syndrome may increase the risk of miscarriage because of the hormonal imbalance.

Polycystic Ovary Syndrome is the most common hormonal abnormality causing infertility in women. It affects fertility by suppressing ovulation. Egg follicles may begin to mature but do not ovulate or release the egg into the fallopian tube. These follicles remain as cysts in the ovaries. In women with PCOS, the ovaries also produce excessive amounts of testosterone (male hormone) that can lead to acne and hair growth. In the fat cells, testosterone is converted to estrogen, leading to excessive buildup of the uterine lining which may contribute to heavy or irregular bleeding.

Like most medical problems that are referred to as “syndromes”, Polycystic Ovary Syndrome is made up of a cluster of signs and symptoms.  Women with polycystic ovary syndrome may have some or all of the following features:

    Irregular or skipped menstrual periods
    Obesity and difficulty controlling weight gain
    Male pattern hair growth
    Acne and other chronic skin conditions
    Dark brown or black patches on the skin

Other symptoms are oily skin, acne, facial hair growth and weight problems.

Polycystic Ovary Syndrome is diagnosed based on a patient's history, blood testing and ultrasound examination during which doctors may identify multiple small cysts on the ovaries. Diagnosis is made by evaluating the presence of multiple symptoms and ruling out other conditions.


High levels of insulin associated with obesity interfere with ovulation and also worsen PCOS symptoms. Minimizing insulin resistance via a healthy, safe weight loss regimen is a common first step for patients with Polycystic Ovary Syndrome who want to make conception more likely. Insulin regulating medications may also be prescribed. Some women are able to begin ovulating more normally at this point and may be able to conceive naturally.

Fertility enhancing drugs such as Clomid, Metformin and gonadotropins may be used to stimulate ovulation. This approach is tried after other potential causes of infertility have been ruled out. In Vitro Fertilization can also be used for some women with PCOS.

For women who are not trying to get pregnant, birth control pills can regulate the menstrual cycle and control the hormonal imbalance. If necessary, other medications can also be used in combination with oral contraceptives. For women who are trying to conceive, we use medications to induce ovulation and to reduce the risk of miscarriage. Weight loss also plays an important role in treatment, as it can help restore regular menstrual periods.

See more at: www.pregnancymiracle.com


Fertility Process and Testing



Nine out of ten couples with a female partner under the age of 35 who are actively trying to get pregnant succeed within one year. The chance of a pregnancy is about 25% per month. For couples who fail to achieve pregnancy after one year (and for women over the age of 35 after 6 months) fertility testing is recommended to identify any obstacles that could prevent pregnancy.

A full medical history and physical examination can reveal problems related to pelvic surgery, cancer treatment, or menstrual disturbances that cause infertility.

Fertility testing is done to rule out specific problems in four areas:


Sperm Testing
For approximately one out of four couples, the quality or quantity of the male partner's sperm is the underlying cause of infertility. Semenalysis can reveal issues with the sperm count, the motility of sperm (its ability to swim), and the morphology (shape) of the sperm.

Ovulation

For women with a history of irregular menses who do not ovulate regularly, underlying medical conditions may be the cause of low fertility. Common problems include thyroid imbalances, high levels of a hormone called prolactin, or polycystic ovarian syndrome (PCOS). Blood tests and ultrasound exams are used to diagnose these conditions.

Uterus and Fallopian Tubes
Fallopian tubes that are closed can interfere with fertility by making it impossible for an embryo to reach the uterus. Causes of blockage may include previous pelvic surgery or complications from STDs. The uterus may also contain fibroids or polyps that limit the chances of pregnancy. An exam called a hysterosalpingogram (HSG) is used to detect structural problems with the fallopian tubes and uterus. It involves the injection of a contrast dye into the cervix to make the patient's internal reproductive organs visible in x-rays.

Eggs

The quality and quantity of a woman's eggs plays a vital role in fertility. Egg quality cannot be determined with fertility testing, but it is strongly correlated with age. The quantity of eggs can be estimated using blood tests such as the FSH (follicle stimulating hormone) and AMH (anti-mullerian hormone). AFC (antral follicle count) is an ultrasound test that can also assist in estimating the number of eggs available.

See more at: http://www.pregnancymiracle.com