Signs of Infertility in Men

Infertility is as common in men as it is in women. If you have been trying to conceive for more than a year, it is just as likely to be a male problem as it is a woman’s problem. About 40% of infertility cases are related to male causes; another 40% can be related to female infertility causes; 20% of infertility cases are due to both male and female causes.

The essentials men need to achieve pregnancy

In order to have a successful pregnancy from the male perspective, there are a few things that are needed.

  • Healthy sperm. At least one of your testicles must be functioning correctly in order to produce sperm. But it is not enough just to produce sperm. Healthy sperm is needed for pregnancy. The body must produce testosterone and other hormones to trigger and maintain healthy sperm production.
  • Sperm needs to be transported. Sperm is produced in the testicles. It is then transported by tubes called vas deferens until they mix with semen and ejaculate out of the penis.
  • Enough sperm must be produced. If the sperm count is low, it can lower the odds of fertilizing an egg. A low sperm (oligospermia) is considered to be fewer than 15 million sperm per millimeter of semen.1 Sperm could be absent and this condition is known as azoospermia.
  • Sperm must have good motility. If sperm are not able to swim or have poor movement (motility), it is difficult for them to travel up to the fallopian tube to fertilize an egg.
  • Sperm must have a healthy shape (morphology). Normal sperm have oval heads and long tails that propel motion. This is nearly as important as the volume of sperm or motility, and more sperm with a normal structure can increase the chances of achieving pregnancy.

What could cause male infertility?

Male infertility could be due to various reasons including problems like the ones mentioned above. It could also be linked to several other causes such as:

  • An injury that prevents sperm from being released such as an injury to the spinal cord or testicles
  • Diseases or medical conditions such as varicocele, a common but reversible cause of male infertility
  • Hormonal imbalances can impact sperm count, sperm motility, or sperm morphology
  • medications
  • The National Institutes of Health lists the following lifestyle choices associated with male infertility: smoking cigarettes, alcohol intake, use of illicit drugs, obesity, psychological stress, advanced paternal age, dietary practices, and coffee consumption.2
  • Certain medications can affect sperm production, function and delivery. These may include medications for arthritis, depression, digestive issues, epilepsy, and infections.

What are the signs or symptoms of infertility in men?

Without a clinical diagnosis, it can be hard to tell if a man is infertile. There are no tell-tale signs unless there is a problem in the physiology of the male organs. In most cases, male infertility is often without symptoms and is not diagnosed until issues with conception arise. However, some of the common signs of male infertility could be:

Pain and swelling in the testicles

Testicular pain and swelling could be localized in one area or generalized around the groin. It can be caused by injury, infection, or a varicocele which is swelling of the veins within the scrotum.

Ejaculation and orgasm problems

Problems with reaching orgasm and ejaculating normally, could be a sign of male infertility.  There are 3 types of ejaculation problems: premature ejaculation, delayed ejaculation and retrograde ejaculation. These can be due to thyroid problems, injury, diabetes, depression, stress, anxiety, certain medication. Erectile dysfunction, the inability to achieve and maintain an erection, can also be an issue in such cases.

Low sexual desire

Over the course of life, sexual interest can wax and wane intermittently in men. In some cases, low libido, or low sexual drive, can be a temporary issue caused by relationship problems or stress at work. Persistently low sexual drive can put a strain on relationships and may be related to an underlying medical condition.

Being overweight or obese

Obesity in men is associated with lower testosterone levels, poorer sperm quality and reduced fertility as compared to men of normal weight.  However, this effect is often reversible by shedding the extra weight.

Smaller-sized testicles

Men with smaller than normal testicles suffer from a congenital disorder known as Klinefelter’s syndrome where instead of XY chromosomes normally found in men, there is XXY chromosomes.  Due to the smaller testicle size, they do not produce enough testosterone which is needed for the development of male characteristics. 

Undescended testicle

This occurs when the testicle hasn’t moved into the scrotum before or after birth.  Testicles need a cooler environment like the scrotum to function normally.  This can lead to fertility problems later on in life.

Most men have adequate and healthy sperm to fertilize their partner’s eggs even if they are unable to do so during sexual intercourse. In such cases, we employ other methods for the egg and sperm to meet such as assisted reproductive technologies like IUI, Intracytoplasmic Sperm Injection (ICSI) or Microsurgical Sperm Retrieval. In today’s modern age, infertility is mostly a thing of the past! If you suspect any signs of male infertility, visit us at Xenith Advanced Infertility.

Signs of Infertility in Women

It is an exciting time when a couple decides to start a family! The first few months are filled with exciting anticipation. Will I hear the good news this month? Will my pregnancy test be positive?  In most cases, good news is not too far away. But for some couples, disappointments can come as one home fertility test after another turns out to be negative. When should you seek help? If you are more than 35 years old and have been trying unsuccessfully for 6 months, or if you are younger than 35 years old and have been trying for more than a year, it is time to see a fertility specialist. 

Infertility can be caused by a number of factors and the good news for women who have not been able to conceive easily is that many of those factors can be easily resolved. See if you are experiencing any of these symptoms listed below.

1. Irregular menstrual cycles

A woman’s menstrual cycle is nature’s way of preparing her body for a possible pregnancy after she has ovulated. The average cycle is around 28 days long on average and there are hormones that work in concert during the entire cycle. Dysfunction in the rhythmic hormone regulation causes irregular menstrual cycles. There could be various reasons as to why the hormones are not being regulated and this needs to be determined if the periods have been irregular for more than 3 cycles.

Factors like stress or heavy workouts also can cause your period to temporarily disappear.  If you were on birth control and have stopped using them, sometimes your body will need a few months to regulate but if you don’t get a period even after 3 months, you should consult seek medical advice.

2. Intense cramps and pain during your period

If you are experiencing pain in the lower abdomen, lower back, pelvis, rectum, or vagina. If you have pain during sexual intercourse, irregular or painful menstruation you should check out why. These may be symptoms of endometriosis which may cause infertility in a small percentage of women. Most women who have endometriosis don’t have any symptoms, but if you are experiencing any one of these, we recommend seeing a doctor.

3. Sudden weight gain

If you have sudden unexplained weight gain, even if you did not change your eating habits or your level of activity, it could be a sign of infertility.  Unexplained weight gain can be related to a number of causes and some of these can affect fertility.

4. Excessive hair growth

This is a sign of hormonal imbalance in the body. Your body is producing an excess of male hormones.  You may see excessive hair growth in unusual places where women don’t usually have a lot of hair like the face, chest, back or arms.

5. Hair loss

Thinning hair could indicate a thyroid disorder, or anemia, or polycystic ovaries.  Thyroid disorders affect the level of production of certain reproductive hormones which, in turn, can interfere with the release of the egg from the ovary. Thyroid disorders could also cause dry skin conditions and unexplained fatigue.

6. Severe acne breakout

If you experience a sudden breakout of severe acne as an adult, it may be an early sign of Polycystic Ovary Syndrome (PCOS). In about 25% of the cases, PCOS has been associated with ovulation problems that can make pregnancy difficult to achieve.

7.  Bleeding between periods or after intercourse

Bleeding between periods, having heavy periods or bleeding after intercourse could be a sign of a reproductive issue. Irregular spotting one to two weeks apart may indicate that ovulation is not happening at all. We recommend you consult with a fertility specialist to find out the underlying causes.

8. Pain in the pelvic area

Pain in the pelvic area can be caused by a number of disorders. It could be a urinary infection, a gynecological problem, even a musculoskeletal problem. Studies suggest that gynecological problems constitute only 20% of chronic pelvic pain.

However, if you have pelvic pain along with fever and an abnormal discharge, it could be a sign of infection which may lead to scarring and tubal blockage. This needs attention as it could lead to reproductive issues.

If you suffer from any of them, come visit us. Even if none of the symptoms relate to you, but you have not conceived after actively trying for some time, consult the experts at Xenith Advanced Fertility Centre. As we said, most infertility issues can be resolved with the right treatment. We recommend you don’t put it off. Early treatment and diagnosis has better outcomes than ones that are delayed.

Low Sperm Count: Symptoms, Causes, and Treatment

It happens in 30% to 50% of the cases where couples have been actively trying to get pregnant and yet not able to succeed. Low sperm count is often the problem. The technical term for this is an odd-sounding word called oligospermia. Low sperm count is a condition when men do not have adequate quantity or quality of sperm to fertilize the egg.

What exactly is oligospermia or low sperm count?

A man’s reproductive system is responsible for making sperm. Sperm is produced in the testicles along with testosterone, a male hormone that controls the making, storing, and transporting of sermon. During ejaculation, sperm get mixed with fluid from the prostate and seminal vesicles to form semen. Semen travels through the urethra out of the penis and into the vaginal canal. Sperm then travel upwards into the uterus and further up into the fallopian tube of a woman where an egg may be waiting to be fertilized.

When fertilization happens successfully, the union of an egg with a sperm creates a zygote or a fertilized egg. The zygote begins as a single cell containing 23 chromosomes from the egg and 23 chromosomes from the sperm. In the days following fertilization, a zygote multiplies rapidly.

The fertility of a man is dependent on sperm count as well as the quality of sperm and its ability to be motile (capable of motion). Only a few thousand of the millions of sperms present in the semen reach the tube and the oocyte even when sperm counts are normal. Hence a low count can cause inadequate numbers of sperms reaching the tube for fertilization of the egg. Thus the process of fertilization is impeded when a man suffers from low sperm count.

What can cause low sperm count?

There could be many reasons why men have low sperm count. Some reasons are related to environmental factors, genes, as well as lifestyle habits. The reasons below are informative, but not exhaustive:

  • Genetic disorder
  • Physiological problems with the male reproductive system
  • Hormone imbalance
  • Certain medications
  • Being overweight
  • Stress
  • Previous infections
  • Varicocele ( engorged blood vessels around testes)
  • Consumption of alcohol
  • Cigarette smoking
  • Overheating of testicles due to tight innerwear
  • Idiopathic
  • Consumption or exposure to toxins (hazardous work environment)
  • Chronic illness or tumours that affect reproductive organs/functions
  • Cancer treatments

Symptoms of Low Sperm Count

Men who have low sperm count may not be aware of it. Most men can engage in normal day-to-day activities without any tell-tale signs or symptoms of male infertility. Low sperm count usually becomes apparent when pregnancy does not happen and both partners undergo investigations to determine fertility.

Apart from an inability to conceive, men and their spouses may notice the following signs or symptoms that could indicate low sperm count. Ask yourself these questions:

  • Do you have a healthy appetite for sex? Do you shun away from having sex and how often?
  • Do you have problems achieving an erection?
  • Do you have any lumps or swelling in the testicle area?
  • Do you think you have abnormally less facial or body hair for a man?

A “yes” to any one of these questions, especially over a period of time could indicate that you need to consult your fertility specialist.  If you suspect you may have this condition and would like to confirm the presence of adequate sperms in the semen, visit Xenith Advanced Fertility Clinic for a fertility test for men that includes a sperm analysis. An analysis is done under a microscope where sperm is counted and also checked for motility (movement) and morphology (shape). Sperm count is also referred to as sperm concentration – the number represents how many sperm can be found in one milliliter (ml) of sperm.

The important thing couples need to understand is that evaluation of the semen MUST be done by an Embryologist trained to pick up problems in the sperms. Incorrect assessment is common and leads to delay in diagnosis and treatment outcome. 

If your semen analysis shows a low sperm count, we may ask you to undergo further investigations to determine the reason for your low sperm count. Xenith has an Andrology Clinic and one  of the best success rates in Male factor infertility. Our team of Andrologists, Urologists and Embryologists provide accurate diagnosis and treatment related to Male infertility issues. 

What is the  treatment for low sperm count?

In today’s modern era, low sperm can be successfully treated. Here are some treatment options we might recommend but a more tailored-made approach will depend on your specific condition:

  • Minor lifestyle changes
  • Medication
  • Surgery to resolve structural problems with the penis or testicles
  • Intrauterine insemination (IUI) – if your sperm count is low or low quality, we may recommend this procedure to deposit sperm directly into the uterus
  • Intracytoplasmic Sperm Injection (ICSI) is a procedure that is performed in an IVF lab. The egg is retrieved from the spouse and a selected sperm is injected into the egg. The fertilized egg is then allowed to multiply in a petri-dish for 3 to 5 days. This is then placed in a catheter and transferred to the uterus of the woman for implantation.

While having a low sperm count can decrease the odds that your sperm will fertilize your partner’s egg, there’s still hope. At Xenith Advanced Fertility Clinic, there are several treatments available to treat low sperm count leading to a successful pregnancy. Schedule an appointment and begin your journey to parenthood!

Things to Know About Blocked Fallopian Tubes

When sperm is deposited into a woman’s vagina these little swimmers immediately begin to travel upwards. Their destination? Either one of the two fallopian tubes  found in a woman’s reproductive system. During the fertilization period in the ovulation cycle, the fallopian tube is the place where the egg waits for the sperm to come and fertilize it. The fertilized egg then travels down the fallopian tube and into the uterus for implantation to the uterine wall.  

This makes fallopian tubes a very important, almost magical, part of a woman’s reproductive system.

What could go wrong with the fallopian tubes?

The fallopian tubes are two thin tubes on each side of the uterus. Sometimes an obstruction in the tube prevents the sperm from reaching the egg and the egg from traveling down the tube.  The condition is called tubal infertility or tubal occlusion. This blockage can lead to infertility issues or an ectopic pregnancy where the fertilized egg may attach to fallopian tubes or other areas rather than the uterus.  It’s also possible that the tube could only be partially blocked or only one of the tubes is blocked and fertility might be difficult, but still possible.

What are the different causes of blocked fallopian tubes?

The fallopian tubes can be partially or totally blocked due to scarring on the walls of the tubes, abscesses, or damage due to surgery that may have involved the pelvic area. Scar tissue can also be formed due to an abortion or miscarriage, a ruptured appendix, abdominal surgery, or an ectopic pregnancy.

The pelvis is the lower abdominal area including the fallopian tubes, ovaries, cervix and uterus. Pelvic inflammatory disease (PID) can cause damage to the fallopian tubes especially if an infection is not treated in time. The bacteria can first enter the vagina and over time this infection can move to the pelvis. PID can also be caused by sexually transmitted infections like chlamydia or gonorrhea. 

During menstruation, the uterine lining or endometrium is shed and released.  Endometriosis is when cells from the uterus lining or the endometrium begin to grow outside the uterus.  Tissue growing outside the uterus is not shed and causes inflammation and could lead to scar tissue development. 

How do you know if your fallopian tubes are blocked?

Many women with blocked fallopian tubes might not experience any symptoms at all because they still get their periods are regular. They might only find out they have blocked fallopian tubes when they aren’t able to conceive and go to a gynecologist for a check-up.

Symptoms of endometriosis and pelvic inflammatory disease can include pain in the pelvis and during sexual intercourse, foul-smelling vaginal discharge, and sometimes even fever, nausea, and vomiting.

A condition called hydrosalpinx may cause lower abdominal pain and vaginal discharge. This happens when a blockage causes the tube to dilate or increase in size and fill up with fluid.

How do blocked fallopian tubes get diagnosed?

Hysterosalpingogram (HSG) is a test done by putting a dye through the cervix and then taking a special X-ray to see if the dye travels through the uterus, the fallopian tubes, and around the uterus, and into the pelvic cavity.  When the dye doesn’t go through the tubes there may be a blocked fallopian tube.

Other tests could include ultrasound, laparoscopic surgery, or blood work to check for any sexually transmitted infection.

What is the treatment for blocked fallopian tubes?

Treatment depends on the type and location of the blockage and the general condition of the tube. Tubal cannulation is done for blockages closest to the uterus.  A catheter is guided through the vagina and uterus until it reaches the blockage.  With the help of X-ray or ultrasound and most often during laparoscopy, the exact place of blockage is determined and a  thin wire is used to remove the blockage.

If only one tube is blocked, you might still be able to get pregnant or your doctor could give you some fertility drugs to increase the chances of ovulation on the open side to become pregnant.  However, if both tubes are blocked, then you might need laparoscopic surgery to open the blocked tubes or remove scar tissue.  Its success depends on various factors like age, length of the fallopian tubes, where the blockage is, and the cause of the blockage.  It was also found that about a third of the opened tubes subsequently reocclude. Also, it is important to understand that just opening the tubes is not the solution. Unhealthy and damaged tubes will cause hinderance to pregnancy even if patency is restored by some means.

IVF is preferred to surgery if tubes are unhealthy or scarred, there are severe adhesions, in older women and also if other factors of infertility are present. It is also recommended for women where there is significant scarring, severe endometriosis, or where surgery to unblock fallopian tubes has failed.  IVF treatment bypasses the requirement for fallopian tubes. The eggs are retrieved directly from the ovaries and then fertilized with your partner’s sperm in our IVF lab.  The fertilized ovum is allowed to grow for 3 to 5 days and is then transferred to the uterus directly for implantation.  As you can see, blocked fallopian tubes do not spell doom for women who desire to have babies of their own. Come visit us at our clinic and let us help you start your family. The Xenith Advanced Fertility Clinic is one of the best in Pune with top-notch doctors who are recognized in this field. Feel free to set up a consultation. We keep a friendly environment in our clinic and you can rest assured you are under capable care.

What Is Fibroid Surgery and When Is It Required?

Fibroids are muscular tumours that develop in the myometrium or the muscular layer of the uterus. . These tumours are usually non-cancerous, or what we call benign tumours. About 25 per cent of women of childbearing age will develop fibroids and upto 30-40% of women over the age of 40 have fibroids. They are most common in women in their forties and fifties. After menopause, fibroids usually shrink.

Fibroids can grow as a single tumour or there may grow as multiple tumours. They can be small, big, or grow to be very large. Some women who have fibroids don’t even know they have them. They do not experience any symptoms. However, there are women who have severe pain and heavy bleeding due to fibroids. Such women may find fibroids hard to live with.

Why do fibroids grow?

Doctors and researchers have not yet fully understood why fibroids grow. We do know that hormone levels of estrogen and progesterone affect the growth of fibroids. If you have fibroids when you are pregnant, they can grow fairly quickly because of the rise of hormone levels during this time causing complications. Some studies show that women are at more risk of having fibroids when:

  • Family history – If your mother had fibroids, your risk of having fibroids is likely to be three times higher than the average
  • Obesity – Women who have a higher BMI run a risk of having fibroids that is two to three times higher than the average

How do I know if I have fibroids?

As mentioned earlier, some women may have fibroids and not have any symptoms. There is usually no need to treat women who do not have any symptoms unless these fibroids are big or are impeding pregnancy. Women who do have symptoms may experience:

  • Painful and heavy menstruation. The loss of blood can lead to anaemia.
  • A feeling of heaviness in the lower stomach area (pelvic area)
  • Lower back pain
  • The need to frequently urinate because fibroids putting pressure on the bladder
  • Fibroids can cause discomfort due to pressure on the rectum
  • When fibroids are very large they can make a woman appear pregnant
  • Pain during sexual intercourse

Sometimes, fibroids can be the cause of infertility.

How do I know for sure if I have fibroids?

Fibroids can be diagnosed through imaging tests such as ultrasound  or magnetic resonance imaging (MRI). A sonohysterogram can also be used to determine fibroids which are present in the cavity of the uterus that is submucosal fibroids.  

Sonohysterogram is a harmless no-radiation procedure to look at the inside of the uterus. It uses sound waves and a computer to create images.

Hysterosalpingography can be used to diagnose fibroids but is most commonly used for evaluating the fallopian tubes and the reasons for infertility. It is also performed in recurrent early pregnancy loss and pre-term delivery.

A good Ultrasound and especially a 3D ultrasound is the best tool to diagnose fibroids and determine its type and location.

What are the treatment options for fibroids?

Our doctors at Xenith will help you determine the type of treatment you will need to treat  fibroids. The decision will be based on factors like:

  • Severity of symptoms
  • If you have plans to grow your family in the future
  • The size of the fibroids
  • The location of the fibroids
  • Your age and proximity to menopause

Treatment can involve over-the-counter medication for pain relief as well as iron supplementation.

  • Hormone treatment to control fibroid symptoms
  • Drugs can help shrink fibroids but these drugs have side effects and can be used temporarily (six months). Usually, they are given for a short duration before surgery. Shrinking tumours makes them easier to remove surgically.
  • Women who have moderate to severe symptoms may be advised surgery. There are several surgery options and many of them can be done through laparoscopy:
    • A myomectomy is a type of surgery that removes the fibroids without taking out any of the healthy tissues in the uterus. This type of surgery is used when women are younger and want to have the ability to get pregnant.
    • A hysterectomy is usually recommended with fibroids that are large, cause heavy bleeding, and when the woman is nearing the age of menopause. The entire uterus is removed.

Some other treatments available but not very commonly used are

  • Myolysis uses a needle guided by laparoscopy to conduct an electric current. This destroys the fibroids.
  • Fibroid or artery embolization is a process that cuts off the blood supply to fibroids causing them to shrink. This process can be used for women who do not want to have children, but not all women can qualify for this treatment.

Fibroids and Infertility-

Fibroids which are large in size, those that are present inside the uterine cavity and those that are at locations which hamper pregnancy, may need to be removed as they impact the chances of pregnancy. A thorough evaluation of any fibroid is needed before taking any decision to operate, as when not indicated it is better to leave the fibroids as they are. However, evaluating when a removal would be beneficial, is key to enhancing pregnancy chances. A woman does not have to live with the severe symptoms of fibroids, neither suffer from infertility due to them. There are many fibroid treatment options available to restore quality of life. Fibroids are just one among many of the reasons why pregnancy is often delayed. If you have been trying to start a family for six months or more and have not succeeded, come visit us at Xenith Advanced Fertility Clinic. We have had the joy of helping hundreds of happy couples fulfil their dreams of having children.

The Best Time to Freeze Your Eggs

Today, you don’t have to say goodbye to your dreams even though your biological clock is ticking away.  Cryopreservation or the process of freezing your eggs for later use is an option that women have thanks to modern technology.

All this is great news! But when should you freeze your eggs? When is the right time? How long can you keep them frozen? And does cryopreservation of eggs work all the time? If you are considering cryopreservation or if you want to know more about this fascinating process, this article will shed some light. But first …

Why would you freeze your eggs?

There are many reasons why a woman would choose to freeze her eggs.

Medical reasons

Surgeries that are related to the pelvic area can sometimes affect the reproductive organs in that cavity and their function as well. Before undergoing such surgeries, share any concerns you might have about how the surgery or treatment and how it might affect your ability to have children.

Cryopreservation can be a good option for women who are diagnosed with cancer and are due to undergo treatments like radiation or chemotherapy. These types of treatments can affect a woman’s fertility. Sickle cell anemia or autoimmune disorders like lupus could also be reasons to look into freezing your eggs.

Personal reasons

Some women might also feel that they haven’t met the right partner yet and would like to have this option in the future when they feel ready. Freezing eggs can also be a good choice for women who want to focus on establishing a career before considering parenthood. They do not need to run the risk of it being too late to get pregnant. 

Recommended during IVF cycles

Doctors will recommend egg freezing when hyperstimulation of the ovaries produces a number of viable eggs. If an IVF cycle fails, a woman does not need to undergo intensive hormone therapy again if the eggs/embryos are frozen. The “extra” viable eggs produced in the first IVF cycle can be frozen and used for the second or third IVF cycle. More commonly women who have a low ovarian reserve may need more than one cycle of ovarian stimulation, and oocyte pooling can be done to obtain a larger number of oocytes for IVF.

You may also have to freeze your eggs or embryos during the IVF process if uterine receptivity is not ideal. Doctors will advise freezing the embryo or the egg till such time the uterus is more receptive.

What is involved in the process of freezing your eggs or oocyte cryopreservation?

Before the actual procedure is carried out, a test is done to check the quantity and quality of the eggs.  The woman is also screened for infectious diseases like HIV, Hep B, and other diseases.  Drugs will be used to stimulate the ovaries so that more eggs are produced.  The woman’s eggs are harvested from the ovaries and are carried out under anesthesia.  The doctor would use an ultrasound probe in the vagina to locate the follicles and then use a suction device connected to a fine needle to remove the eggs. 

After the eggs are harvested, the eggs are flash-frozen to -196oC by using liquid nitrogen in a process called vitrification to stop any biological activity.  Cryoprotectants are used to prevent harmful ice crystal formation within the eggs cellular structure during freezing.  The eggs can be stored in a temperature-controlled environment for as much time as the woman would like. The survival rate of the eggs is about 70 percent to 80 percent.  

When you are ready for pregnancy, the cryopreserved eggs will be carefully thawed and checked.  The best eggs will be used for fertilization. Doctors will usually use a technique called intracytoplasmic sperm injection (ICSI) to directly insert sperm into the egg. The newly formed embryo is allowed to grow in the petri-dish for 3 to 5 days and then implanted in the womb.

When is the best time to freeze your eggs?

Oocyte cryopreservation has the highest chance of success when performed at an earlier age.  According to some research done in the Journal Fertility and Sterility, the optimal age range for egg freezing is between ages 30 and 34.  There was not too much of a higher benefit to freezing eggs between the ages of 25 and 30, though earlier the eggs are frozen when indicated the oocyte quality would be better.  However, for a woman who was 37 years old, oocyte cryopreservation has the largest benefit when compared with someone who tried to conceive naturally later.

The quality of eggs is one of the main reasons for IVF failure and if you preserve eggs while you are still young, your chances of achieving a successful pregnancy using those eggs later in life are much higher.

What is the difference between freezing eggs and freezing an embryo?

An embryo is a fertilized egg. This fertilized egg is then frozen. The frozen embryo will be 3 to 5 days old when it is frozen. When needed, they are thawed and then directly inserted into the uterus so that implantation can take place. However, when women are not married or do not have a partner to fertilize the egg with, or would like to postpone childbearing and just freeze the oocytes in the meantime, egg freezing is the choice.

Women need to be informed about this option

With increasing age at marriage, delay in childbearing, hectic work schedules and laying down a good career foundation, pregnancy is pushed back by many women and couples. In such cases knowing that oocyte freezing can be a very good option to have your own biological child is important. Women should give this a real thought as an early decision will greatly enhance chances of success whenever they decide to plan for motherhood. Time is of the essence as oocyte quality will continue to decline with age. Also, for women who have to go through surgeries, chemotherapy, or radiation due to cancer treatments, freezing their eggs before these procedures is a crucial consideration

It’s important to remember

While cryopreservation technology is available, we recommend that it be used when necessary, but also that women discuss this option so as not to lose out on their chance of having their biological child. There are several issues to consider such as ethics, emotional risks, and costs involved and can be discussed with your fertility doctor.  Though there is no sure-proof guarantee for future parenthood, success rates using frozen oocytes have been constantly getting better with pregnancy rates nearing those of fresh oocytes. According to the Mayo Clinic, “The chances of becoming pregnant after implantation are roughly 30 to 60 percent, depending on your age at the time of egg freezing. The older you are at the time of egg freezing, the lower the likelihood that you’ll have a live birth in the future.” Visit us at the Xenith Advanced Fertility Clinic and we’ll help you see whether egg freezing would be the right choice for you.

Diabetes and Its Impact on Fertility & Reproductive Health

Meet Anita – a type 2 diabetic who has been more than eager to become a mother. With India having the highest number of diabetics in the world, Anita’s story is not unlike some other women. Having diabetes has made it that much harder for Anita to conceive, although not impossible. And Anita is on the path to becoming a mother through IVF.  

If you or someone you love has diabetes and are finding it difficult to get pregnant, read on. There’s hope for even the toughest cases thanks to science and the understanding it has given us of diabetes, as well as Assisted Reproductive Treatment (ART).

First, what exactly is diabetes?

Diabetes is a condition that can be described as the mismanagement of blood sugar in the body. When we finish a meal, the carbohydrates that we consume are broken down into glucose. Glucose is the primary source of energy for our bodies. Glucose enters the bloodstream prompted by insulin, a hormone produced by the pancreas. Insulin allows glucose to enter the cells in our bodies to provide energy.

Excess glucose is converted to glycogen and is stored in the liver. In between, when insulin levels are low in the body, glycogen is converted back to glucose and released in the cells.

 In the case of diabetics, the body has a resistance to the action of insulin and later does not produce enough insulin (type 2 diabetes) or produces extremely little or no insulin at all (type 1 diabetes). There are several health complications associated with diabetes. It is a progressive disease that can be controlled through a proper diet and exercise. However, if diabetes is not properly treated, the high and low blood glucose levels can silently cause damage to the organs of the body.

Diabetes can interfere with fertility and reproductive health. How much diabetes has impacted your fertility can depend on a number of factors such as the number of years you’ve been a diabetic, and how well you have your diabetes under control, including what type of diabetes you have – type 1 or type 2, as well as many other factors. No two cases are alike.

Here’s how diabetes may affect men and women differently impacting procreative health.

Diabetes and Male Fertility

Prolonged and uncontrolled diabetes may impact men’s reproductive health in the following ways: 

  • The ability to maintain an erection. Diabetes can cause damage to the nerves leading to decreased flow of blood which can result in sexual dysfunction.  
  • Low libido. Uncontrolled glucose levels can lead to less energy levels. Men may feel too tired to have sex or lose interest.  
  • Premature ejaculation. Several studies show that premature ejaculation is more prevalent in men with diabetes than in men who don’t have diabetes.

In type 2 diabetes, men may have low sperm concentration in semen. Diabetes can also affect the motility of sperm making it more difficult for sperm to travel to the fallopian tube for conception to take place. Both type 1 and type 2 diabetes are associated with structural damage to the sperm and its DNA.

Diabetes and Female Fertility

Women may experience the following complications which may lead to infertility issues or the ability to carry a baby to full term. 

  • Irregular menstrual cycles due to the metabolic effects of type 1 and type 2 diabetes on the hypothalamus, pituitary gland, and ovaries. 
  • Higher susceptibility to infections in the genitourinary tract can lead to problems in the fallopian tubes. 
  • Pregnancy complications may arise due to high blood glucose levels in the mother’s body. Chances of miscarriage and congenital defects are higher in women with diabetes. 
  • Loss of interest in sex. As in the case of men with diabetes, women too may experience tiredness and lose their appetite for sexual intimacy.

Women with type 1 diabetes may also experience an absence of ovulation. According to a study published in Fertility and Sterility (2012), a large majority of women with Polycystic Ovary Syndrome (PCOS) – about 65% to 70% — are insulin resistant. PCOS usually co-exists with obesity and diabetes. All three conditions together can make fertility even more difficult.1

What can be done to improve fertility when you have diabetes?

If couples have tried unprotected sex for more than six months to a year, we usually recommend they undergo comprehensive fertility tests. Some tests will monitor your sugar levels, some will monitor your hormones while others may be diagnostic. Based on the results, our doctors will prescribe a tailor-made plan to resolve infertility issues. Some of the individualized procedures we may recommend are:

  • Medications to treat infections, stimulate the ovaries, and treat problems like erectile dysfunction and premature ejaculation.
  • Corrective procedures such as surgery to remove ovarian cysts or uterine fibroids or tubal disease.
  • Assisted Reproductive Treatment (ART):
    • Intrauterine Insemination (IUI)
    • In vitro fertilization (IVF)

How can diabetics prepare for IVF treatment?

If blood glucose levels are not in the normal range, the first line of treatment for both men and women is better diabetes management. Getting your blood sugar under control is key. This means stringent monitoring, smart eating, and plenty of exercise. This is extremely important to facilitate conception/implantation and carry a foetus to full term. Schedule an appointment with Xenith Advanced Fertility Clinic if you or your partner have diabetes. Early intervention can help achieve more successful results.

An Indian Diet Plan to Promote IVF Success

An Indian Diet Plan to Promote IVF Success

Diets have evolved over the years. The elderly among us will recall the days when food had more taste, there were no preservatives or chemicals in the food they ate. Making atta involved a trip to the granary. People walked more or cycled. Lifestyles were healthier.

Today, the easy availability of processed foods, modernization of agricultural methods, the use of food formulation techniques that destroy natural nutrients, sedentary lifestyles, and the temptation to eat out regularly make it that much harder to get the nutrients we need in our diets!

It was only as recently as the 20th century that scientists discovered vitamins and their essential role in supporting good health. Attention was given to sugar, fats, chemicals, preservatives, and the protein gap in our diets.  Scientists suggested a connection between nutrient-deficient diets and chronic diseases, and hence came the need for supplementation.

In the case of IVF, there is still no conclusive proof from science to prove that a certain diet can help promote IVF success. But studies have attempted to study the correlation between nutrition and lifestyle. Lifestyle includes diet and physical activity, stress, socioeconomic factors, BMI, smoking, alcohol, and caffeine which can all impact fertility.

Start making changes early

A growing body of evidence has suggested that changing preconception nutrition and lifestyle factors should be considered a first-choice treatment, particularly for unexplained subfertility. These are important steps to take to support the process of IVF. An ideal time to start is 3 to 6 months before your IVF treatment. What changes should you make?

Maintain a healthy weight prior to IVF. Obese women tend to have higher complications, but being underweight can also lead to infertility issues reducing the success rate of IVF.

Exercising regularly has many health benefits which include helping the body to better regulate insulin as well as hormonal levels that can affect ovulatory cycles. Try to aim for 3 to 5 hours of moderate exercise per week like going for a brisk walk or going to the gym. 

Adopting the “fertility” or the “preconception” diet. Data shows that a diet high in trans fats, refined carbohydrates, and added sugars can negatively affect fertility The term “fertility diet” or “preconception diet” may go under different names but the pattern is generally the same. These diets tend to be high in healthy fats. Healthy fats include monounsaturated and polyunsaturated such as ghee and oils from vegetables, nuts, seeds, and fish.  Studies from Harvard have suggested that a healthy diet can improve the chances of conceiving and having a successful pregnancy. Certain foods can also increase the quality of semen in men. 

Here’s what a “fertility” diet can include with examples of everyday Indian foods:

Complex carbohydrates

  • Beans and whole grains
  • Whole grains like wheat used in chappatis, millet or ragi, oats, and brown rice are better alternatives than white rice.

Fruits and vegetables – chose a variety of colours

  • Green leafy vegetables are rich in folic acid and Vitamin C.  It includes spinach, methi, broccoli.  Vegetables like beets and sweet potatoes are high in iron.  Colorful vegetables like tomatoes and red pepper are also beneficial.
  • Fruits are packed with Vitamin C, potassium, calcium, and folate and are good antioxidants as well as anti-inflammatory. This may include citrus fruits like oranges, lemons, avocados, apples, pears, strawberries, grapes, figs, pomegranates, bananas, and coconut.  Eating too much pineapple is not recommended.

Lean protein

  • Beans, lentils, and sprouts are packed with lean protein and iron.  It includes chickpeas, black-eyed peas, sprouted lentils as well as all types of dal. 
  • Protein sources for non-vegetarians include eggs, chicken, fish like salmon, and bhangda. Some fish like tuna can have high mercury and should be avoided. 

High-fat dairy foods

  • Dairy products are rich in calcium and are a good source of fats as well as Vitamin D.  Drink full-fat milk and curds, eat malai paneer, and other dairy products with high fat and less sugar.

Nuts

  • Nuts and dry fruits are great sources of good oils, vitamins, and minerals like selenium.  It includes walnuts, almonds, hazelnuts, dried raisins, dates, and figs.  Dates are high in iron.

#IndianDiet Plan

Our dieticians at Xenith Advanced Fertility Clinic can help you chalk out a tailor-made diet plan that is right for you. Choose organic foods, as far as possible. Chemicals like insecticides and pesticides can have adverse effects on reproductive systems.

Don’t stress out

For some women, the stress of doing everything “right” to get pregnant may actually make things worse.  Sarika’s story is a typical example.

“When trying to get pregnant, I found myself scrutinizing every detail of anything I was eating, every exercise I was doing, and how it could adversely affect my fertility.  I became hyper-aware of my surroundings like when someone was smoking near me.  I checked and double-checked the ingredients in the food cartons to see if there were any unhealthy food groups like trans fats.  I even looked critically at the type of soap I was using and tried to go organic all the way” remembers Sarika who had already gone through 2 miscarriages and was trying IVF.” 

Being hypersensitive to adhere to lifestyle changes and the “fertility diet” created a lot of stress for Sarika. She had to learn to relax and just let it happen.  After learning to de-stress through meditation, walking, and just eating as healthy as was possible for her, Sarika did get pregnant and has a healthy baby boy.

At Xenith, we’ve seen better IVF results when men and women prime their health before beginning the IVF process. Schedule a consult if you would like further help on “preconception” diet, nutrition, and lifestyle. Or, if you’ve been trying to get pregnant for some time, but need a little help from us.

Conceiving with Sperm and/or Egg Donors: 7 Things to Consider

Couples tend to have children later on in life and sometimes don’t realize that while they put off parenting, the fertility clock is ticking. After the age of 35, the eggs in a woman’s ovaries begin to decline not just in number, but in quality as well. Healthy eggs are required for fertilization to take place. That goes for sperm, too. A man is fertile for most of his life but recent research shows a worrying trend toward declining sperm health in Indian men over the last 40 years.

Infertility issues may arise because of an age factor or due to other physiological reasons. But there is good news. There are so many wonderful options available today for parents who are unable to conceive using their own sperm or eggs.

Egg and sperm donation is on the rise all over the world giving childless couples much hope. However, the choice of using donor sperm/egg is a very personal one and each couple must decide what is right for themselves.

Your options may depend on the issues related to infertility. Here are some scenarios:

1. A woman’s eggs are not viable for fertilization

Women can still experience pregnancy, childbirth, and breastfeeding by using donor eggs.

What you should consider

Couples who want to use donor eggs :

  1. Using eggs from a donor.  Oocyte donors can be commercial donors who donate their eggs for compensation of their time and effort or from women who are undergoing their own IVF cycles and have excess eggs to donate.  However due to the option of oocyte and embryo freezing  where excess eggs or embryos can be stored for future use, either after a failed IVF cycle or even for a second pregnancy, most of the times couples do not wish to donate their eggs when they are first retrieved. Commercial egg donation hence is usually a faster and more reliable option for couples. A profile of the egg donor regarding their medical history, educational qualifications, personality, appearance, physical height and weight, profession, is shared with the couple.

Using eggs from someone you know is not allowed by law in India. The oocyte donor has to be anonymous and cannot be an acquaintance, friend, or a family member.

2. There is no sperm in the male partner or the sperm is not healthy enough for fertilization

If a woman’s eggs are viable, couples have the choice of using donor sperm.

What you should consider

The same option is available for choosing a sperm donor. Donor sperm is usually taken from Sperm banks, where the semen of donors has been cryopreserved for a minimum of 6 months. A similar kind of profile as in oocyte donors is shared with the couple.

3. Both the eggs and sperm of the couple are not viable for fertilization

Fertilization takes place through IVF and the newly formed embryo is placed in the uterus of the female partner. The child that will be born is not biologically related to either parent. Here the oocyte as well as the sperm comes from a donor. There are multiple reasons why a donor embryo may be used by a couple. Complete evaluation and counseling is required before going ahead with donor gametes or donor embryo treatments.

4. Bonding with your baby

A question that is commonly asked when considering donor eggs/sperm is: If my baby is not biologically mine, will I be able to bond with the baby? It is perfectly normal to feel anxious or doubtful. At Xenith, we’ve seen hundreds of babies being born through sperm/egg donation and we can tell you that when you hold that child in your arms, every couple “knows” this is “their” child. Bonds of love and affection are instinctive.

5. Coming to terms

To begin the process of using donor eggs/sperm, both partners have to come to terms and perhaps overcome the sadness that comes with not being able to have your own biological children. This is an important step in the journey toward having a baby using donated sperm/egg.

6. What is a family and who’s in it?

We suggest couples take some time to consider their idea of “family”. How would you feel about the baby not being genetically related or only partially related to either partner? An important aspect is also to understand the effects of “nature vs nurture”. Egg or sperm donation does give the couple a chance of being able to have at least 50% of their own genetic material and several couples are enjoying the bliss of parenthood with these options.

At Xenith we do complete counseling and give the couple time to assimilate their feelings regarding this option and guide them to take an informed decision.

7. Legalities of using donated sperm/eggs

And lastly, consider all the legal implications. Our counselors are there to guide you every step of the way.

Note: Xenith only uses sperm/eggs derived from anonymous donors and a legal sperm bank which complies to Indian laws and regulations. Childless couples are on the rise. Couples should not think they are alone in this type of situation. Many couples at Xenith have found their dreams come true using donated eggs and/or sperm. There is some effort you need to take to understand all the issues involved so that you can make the right decision – a decision that is right for you and your partner.

6 Ways to Maximize Pregnancy Success with IUI Treatment

Intrauterine Insemination (IUI) is one of the most commonly used techniques for couples who are experiencing difficulty in conceiving a child. It is a relatively easy, non-invasive and inexpensive treatment. For some couples who have not been able to conceive, it can help speed up the time it takes to get pregnant.

This article will discuss why IUI is sometimes necessary, who is eligible for such treatment, how it is conducted, and more importantly, what steps you can take to improve pregnancy success through IUI.

Special note: The IUI process should be supervised by a reproductive endocrinologist. Applying the term “fertility specialists” randomly without the right credentials and qualifications should be scrutinized. Your greatest chances of success lie under the direct governance of a doctor who is a well-qualified.

Why is IUI necessary?

Conception is often not as easy as it seems! Conception takes place 12 to 24 hours after ovulation, and therefore the timing must be exact. For the timing to be right, it is important to figure out when your partner ovulates.

During natural intercourse, sperms have a hard journey ahead of them. Even if the timing is right, most sperm is killed in the vagina due to the fluids present there. Some sperm will reach the cervix which contains a sticky mucous. Not many sperm make it through the sticky mucous of the cervix and into the uterus. The few that do make it to the uterus need to climb their way up the fallopian tube where conception actually takes place. Some couples may just need a little help. IUI is usually the first line of fertility treatment for couples unable to conceive.

Who is eligible for IUI?

Not everyone is eligible for IUI. The IVF clinic will conduct a series of tests which will include blood tests, an ultrasound, an HSG test for women. Men will need to get a sperm analysis. IUI is usually recommended for couples when:

  • Women have abnormalities in their cervical muscles
  • Men suffer from ejaculation dysfunction
  • Unexplained infertility
  • Minimal to moderate Endometriosis
  • Mild problems with sperm count and motility
  • The woman has had a history of pelvic infections

Certain conditions must be prevalent for the IUI process to work:

  • The female must ovulate on her own or with the help of fertility medication
  • At least one fallopian needs to be open
  • Sperm must be of fairly good quality. IUI works well with normal or subnormal sperm count. If a man has very low sperm count, the doctor may recommend IVF instead of IUI

How is IUI conducted?

The IUI process bypasses the vagina and the cervix by injecting sperm directly into the uterus. This way, more sperm is able to make it to the fallopian tube raising the chances of pregnancy. In fact, the chances of getting pregnant with IUI is much higher than natural intercourse.

IUI is performed at the time of ovulation. The timing needs to be precise, even more, precise than intercourse. Because the timing needs to be so perfect, we usually call the couple to our clinic to determine the time of ovulation. Monitoring ovulation with ultrasound is always done to assess the follicular growth, number of follicles and ovulation time.  We do not recommend that couples time their ovulation using an app or temperature charting during the IUI process.

Sperm must be prepared for IUI process

Sperm is separated from seminal fluid in this process which is often called “sperm washing”. Seminal fluid contains many chemicals which can be harmful to a woman if injected into the uterus. The sperm is separated very carefully from the seminal fluid in a special IVF lab. The sperm is then collected in a catheter and ejected inside the uterus.

Steps You Can Take to Improve Pregnancy Success with IUI Treatment

IUI success can depend on a lot of factors such as the age of the woman and fertility medicine used during the treatment. A high majority of couples will likely achieve success after 3 to 4 IUI treatments.

1. Improve your diet

Diet can influence the success of your IUI treatment. You should include a diet that is rich in protein. If you are a vegetarian include lentils (daal), dairy products such as low-fat paneer or curds. Lower your intake of carbohydrates such as rice and potatoes. Replace these with good carbs such as brown rice, whole wheat grain, oatmeal, and beans. Avoid syrupy desserts and junk food! For more on this, read this article.

2. Exercise

Exercise is recommended to improve IUI success. Exercise in moderation.  Live an active lifestyle. Avoid sitting in one place for long periods of time. Take a brisk walk every day for at least 30 to 45 minutes.

3. Don’t stress

Many couples are tense and anxious during the IUI process. The clinical tests and atmosphere of an IVF clinic can add to the stress. Here at Xenith, we provide a friendly environment. We want to put you at ease during the entire process. A relaxed, positive approach will achieve better results!

4. Acupuncture may help

Acupuncture treatment is recommended 1 to 3 months prior to the IUI, whenever possible. A study conducted in Israel and reported by the Tennessee Reproductive Health Center showed that acupuncture can help to significantly raise IUI success. Benefits include reduced stress, increased egg quality, improved blood flow to the uterus and ovaries, decreased side effects of medication, and supporting early pregnancy.

5. Take supplements prescribed by the doctor

Take supplements that the doctor has prescribed. Depending on your health, the doctor may prescribe certain supplements that can help support good health. Make sure you take these as prescribed by the doctor. It seems a simple step but so many forget to take their supplements regularly.

6. After the IUI, enjoy sex

Sex after IUI is often recommended to couples. During the act, the uterus contracts and expands helping to push the injected sperm in the uterus to the fallopian tube. It is also a way to bond intimately with your partner, relieving stress and expressing unity. However, in certain cases, your doctor may advise waiting at least 48 hours after the procedure.

To summarize

Years ago, couples who had difficulty conceiving had no options available to them. It was not an easy road for them. Thanks to science and technology, having your own children is now more than a possibility for childless couples. There is much hope so keep a positive, happy outlook!

Xenith Advanced Fertility Clinic has qualified doctors and is the best IVF clinic in Pune. We provide all the treatment couples need under one roof in a comfortable, friendly environment. Schedule a consultation today!

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