Author: Sandeep Kulkarni

The festive season is almost upon us and most people around you are looking forward to enjoying their holidays being with family and friends.  But it could cause anxiety for those of you who are struggling with infertility.  You would rather not face the group and deal with the numerous questions like “It’s time you should look into having children” or “Your clocks are ticking and you should hurry up and have kids” or “Do you not want to have kids?” or “It’s time to take your focus away from your career and look into starting a family” and so on.  Also, the thought of seeing other young couples enjoying time with their kids sends your own thoughts spiraling down into a deep abyss and so you might be thinking that you may as well try to avoid the whole thing completely and just stay at home.  Isolating yourself could however feel very lonely.  So, what can you do?  Here are some suggestions.

1. Know that what you are feeling is completely normal and that what you are dealing with can be very difficult.  It’s hard to put on a happy face and be hurting inside.  It’s okay to feel sad.   Don’t feel obligated to go to every function or you could leave early or arrive late to the function so that it’s manageable for you. Feel free to stay at home if that’s how you feel or go away on a holiday with your spouse and spend some quality time together and just relax.  You could also do things that relax you like going to a spa, going to the movies, trying your hand at drawing/painting, writing in a journal or anything else that gives you joy.

• Have smart answers prepared beforehand so that you are not caught unawares.  You could tell them that you are happy and it’s your own personal choice or that you aren’t comfortable talking to them about this or that you have come to enjoy the festivities and not talk about your personal life with them.  Many of them are well meaning and might give you suggestions for various diets, certain clinics, or other ideas.  You could also be polite and answer with vague answers while slowly changing the topic.  Talk it over with your partner beforehand about your replies to these intrusive questions.  If they are being pushy and demand an answer, you could just be blunt and say that it’s none of their business.  You could also just tell them the truth if you are comfortable with that and jokingly ask them if they are willing to pay for your IVF treatment.  You could also just ignore/avoid them and walk away.  Whatever you say and do, know that there is no right or wrong answer and you need to look after your own physical and mental wellness while trying to be stress free. 

• Talk to someone close to you about what you are struggling with and how you are feeling.  It often helps to air out your struggles with a close friend or family.  Infertility is a taboo topic and people usually struggle with it by themselves.  You will be surprised to find out that it’s quite common and could get a lot of support from others who were also in a similar situation.  Surround yourself with people who are rooting for you and will stay with you through thick or thin and uplifting you in the process.  You could also join a support group or talk to a counsellor or psychiatrist.  Know that you are not the only one feeling this way and stop questioning yourself about why you aren’t able to have kids yet and if it’s because of something you did.  Sometimes the stress of not being able to conceive could affect your relationship with your partner.  Keep your communication lines open and be frank with each other about how you are feeling and why you are acting the way you are so that your relationship could grow stronger while going through this challenging time. 

• Don’t drown your sorrows in alcohol or binge eating because this could make it even more difficult to successfully conceive and have children.  Certain things in your lifestyle could affect your fertility like your diet, your health, your weight, stress and other things.  Read up about this and look into any changes you could make in your own lifestyle to bring about a successful pregnancy.

• Stay positive and take it one day at a time.  If you find your thoughts drifting to a negative place, be aware of this and move your thoughts toward all the positive things that you are grateful for.  Have a frank discussion with your partner about all the wonderful plans you could make for the future if you aren’t able to conceive so that it doesn’t seem so bleak.  Would you look at surrogacy or adoption or not having kids at all and come to peace with it so that you are not anxious about the what ifs.

• Try meditation or other simple exercises like walking or yoga.  Breathing exercises could help you calm down and bring your thoughts to a quiet place.

•  Volunteer at a charity to help take your mind off yourself and appreciate the fact that you have a lot of things to be thankful for. 

Just remember that you aren’t alone in this and that many others are also in the same situation as you.  Think positive and see if there is anything you can conceive successfully.  The experts at Xenith Advanced Fertility Centre are there to listen to your concerns and help you to successfully navigate your journey to have children.

Did you know that the human testicles normally produce millions of sperm every day?  A sperm is a male reproductive cell with an oval head and a long tail that is produced in the testicle.  It is mixed with semen and is ejaculated out.  It fertilizes a female egg cell to form an embryo which develops to become a baby.

Sperm anatomy

The sperm is made up of 3 parts which are the head, the midpiece and the tail which is called the flagellum.  The sperm head contains the DNA or the genetic material and it has 23 chromosomes which combine with the 23 chromosomes in the female egg to make up a total of 46 chromosomes of the human embryo. The tip of the sperm head has enzymes which can break down the protective layers of the egg’s surface in order to penetrate and fertilize it.  The midsection contains the energy or the mitochondria for the sperm to be mobile.  The tail propels and moves the sperm toward the egg.

Abnormal sperm

Various factors like age, lifestyle, genetics and medical conditions can affect the quality and quantity of sperm.  Abnormalities in sperm can reduce the chances of successful conception leading to infertility.  Semen analysis of the sperm looks at various things like its morphology or shape, volume of semen produced, total number of sperm, sperm concentration or the number of sperm per mL, its vitality or % that are alive, and its motility or how it moves.  After testing all these parameters and getting a prognosis of having abnormal sperm doesn’t mean that you won’t be able to have children.  Assisted reproductive technologies like in vitro fertilization are available to aid you.

There are different types of abnormalities of sperm.

1. Aspermia- occurs when no semen is released upon ejaculation
2. Hypospermia- where the volume of semen is low or less than 1.5mL
3. Azoospermia– where ejaculated semen doesn’t have any sperm.
4. Oligozoospermia- where the sperm count is low as well as there being issues with sperm shape and motility
5. Asthenozoospermia- where many sperm don’t move at all or don’t move in a straight line and move abnormally.  There also may be a low sperm count.
6. Teratozoospermia- where most of the sperm are shaped abnormally or have a double head or tail.  Thus they are not able to move properly.
7. Oligoasthenoteratozoospermia (OAT)- where the shape, size and movement are abnormal There also may be lower numbers of sperm present.
8. Necrozoospermia- where all the sperm in the semen are dead.
9. Leukocytospermia- where there are many white blood cells present in the semen.  White blood cells are often present to fight some infection.

Abnormalities in sperm could be due to:

1. Low sperm count– means the ejaculated semen has fewer sperm than normal which is less than 15 million sperm per mL of semen.(1)  This could decrease the chances of conception and it may take longer to conceive.  Sometimes, there may be no sperm in the semen at all.  Low sperm count could be due to chromosomal errors, blockage of sperm passage, hormonal imbalances, obesity, trauma in the area around the testicles, varicoceles (which is a bulging of the veins within the testicle) or due to taking certain medications.
2. Poor sperm motility– would make it difficult for the sperm to swim towards the egg in order to fertilize it.  Normally they should be moving forward in large circles(progressively motile),  but decreased mobility might mean that they are moving in small circles and not forward (non progressively motile)or not moving at all(immobile).  The cause could be genetic, due to injury, health issues, infection, lifestyle or environmental factors.  Some lifestyle changes like stopping smoking, exercising, and maintaining a healthy weight could help resolve this issue.  Poor sperm motility is diagnosed if less than 32% of the sperm are moving properly.(1)  Symptoms might include swelling or pain in the testes, having issues with erection, and decreased sex drive.

• Abnormal sperm morphology – refers to the sperm’s shape, size and structure. A normal sperm would have a smooth, oval head, normal looking midpiece and tail.  Abnormal sperm might have too large, too small, a misshapen head or no head at all.  An abnormal tail could be coiled, crooked, have a stump, be of irregular thickness, have double, multiple tails or no tail at all.  Abnormal sperm morphology could be caused by toxins, poor diet, exposure to heat, stress, or alcohol/ drug use. It could lead to infertility and increased chances of miscarriage.  The DNA could also be damaged causing infertility, birth defects, miscarriages and it could be due to age, toxins in the environment, certain diseases or health problems.. 
• Sperm agglutination- occurs where sperm stick together and form clumps.  It is measured by the percent of sperm stuck together in a sample.  A higher amount of clumping causes more infertility issues because the mobility of clumped sperm could be impaired and make it difficult to fertilize the egg.  It could be caused due to infection, trauma, presence of anti-sperm antibodies.  Clumped sperm could be washed to remove the coating around it which makes it sticky and transferred back into the uterus to fertilize an egg in a procedure called intrauterine insemination (IUI).  It could also be fertilized in a laboratory setting and the fertilized egg is transferred to the uterus in a procedure called in vitro fertilization(IVF).

• Semen volume- is less.  WHO considers less than 1.5mL as abnormal. (1) This could be due to age, retrograde ejaculation where semen goes into your bladder rather than coming out of the penis.  It could also occur due to injury, some medications, or certain diseases. 

Symptoms

There may be no symptoms at all and it might only come to light when trying to conceive and having issues with infertility.  Some might have problems maintaining an erection, losing hair due to hormonal imbalances or have swelling and pain in the testicle area.  Other symptoms might include losing sex drive or having dry ejaculations, having blood in semen due to infections or previous surgery. 

Treatment

Treatment for abnormal sperm would depend on the cause.  Medications could be used to treat hormonal imbalances or infections.  Assisted reproductive technologies like IUI or IVF could be used for successful conception.  You also could change certain things in your lifestyle like eating a healthy diet, exercising regularly, getting enough sleep, staying hydrated, decreasing stress and stopping smoking.  Avoid hot places like hot tubs and wear loose, breathable clothing because sperm don’t like heat.  Surgery for treating varicoceles could help.  If the sperm abnormality cannot be treated, donor sperm could also be an option.  It is thus important to discuss various treatment options with your doctor.

Frequently Asked Questions

Q1.  Can I still become a father if I have abnormal sperm?

It depends on the type and severity of the abnormality but due to advances in assisted reproductive technologies, procedures like IVF could make your dreams of becoming a father come true.

Q2. Is there anything I can do to fix the abnormal sperm?

New sperm are being produced constantly.  As mentioned above you can follow a healthy lifestyle like eating healthy, exercising regularly, avoiding or learning to deal with stress, stop smoking or drinking excessively and also talk to the experts at Xenith Advanced Fertility Centre who can help improve your sperm quality and quantity to help you have a child. If you are struggling with infertility or think that you might have abnormal sperm, talk to the fertility experts at Xenith Advanced Fertility Centre who can listen carefully to all your concerns and do thorough testing to get to the root of the problem and help you successfully become a father.

Proper nutrition means eating healthy food and having a balanced diet which helps us to live and grow, protects us from illnesses, gives us energy and is even important for reproduction.  A balanced diet contains all the nutrients in the proper proportion that your body needs to grow and stay healthy. There is strong evidence that proper, balanced nutrition can affect fertility in both men and women. (1)  Because nutrition is important for reproduction, it is useful to form healthy eating habits to prepare your body for conception and throughout your pregnancy.  Fertility can be also affected by various other factors like certain diseases and disorders, genetics, older age, ovulation issues, abnormal sperm production, lifestyle and many other things.  Many of these factors like genetics are beyond our control but certain things like the way we live for example can be within our control.  Lifestyle factors include diet, exercise, sleep, smoking, stress and medications among other things.

How does nutrition affect fertility

Good nutrition can affect fertility in various ways:

It can help balance hormonal levels.  An imbalance of certain hormones could cause infertility.  Excessive eating, fasting, or eating foods that are high in sugars or are unhealthy can affect levels of certain hormones like insulin or thyroid hormone.  Since many hormones work together, they are interconnected and can throw off the balance of other hormones if one is out of sync.

Consuming foods high in unsaturated fats, whole grains, vegetables and fish are associated with improved fertility and too much saturated fats and refined sugars are linked to poorer fertility in various studies. (1)

Being obese or being underweight could affect ovarian function, cause ovulation issues, insulin resistance and lead to infertility.  Obesity has been linked to taking longer time to conceive and with higher rates of miscarriage.(2)

Nutrition could also affect maturation of the eggs, quality of the egg and its efficiency of implantation. (3)

A healthy diet improves sperm quality so that you can become pregnant quicker and can reduce risk of pregnancy complications.

A balanced diet can improve the receptivity of the endometrium to the fertilized egg. 

A healthy diet can also reduce inflammation, improve blood flow, decrease tissue damage so that the body can function well.  (4)

What I should and shouldn’t eat to improve my fertility

In order to prepare for pregnancy, it’s important to maintain a healthy weight.  It has been found that the Mediterranean diet could improve fertility.  The Mediterranean diet consists of consuming lots of fruit and vegetables, pulses, whole grains, olive oil, unrefined carbohydrates, low fat dairy, oily fish, and poultry with low consumption of red meat and simple sugars.  It has been associated with improving insulin resistance, metabolic disturbances and reducing obesity, which is all important for fertility. Moreover, studies show that healthy dietary patterns can also increase the chances of live birth among women using assisted reproductive technologies like in vitro fertilization (IVF) .   

1. Folic acid- is a B vitamin that’s very important during pregnancy.  It’s needed for cell growth and repair.  It can reduce the risk of the fetus developing neural tube defects.  The brain and the spinal cord form from the neural tube and this develops at the very early stages of pregnancy before the woman even knows she is pregnant.   It is recommended to take 400 micrograms of folic acid each day at least 3 months before conception.  It is found in eggs, leafy green vegetables, broccoli, and lentils like chickpeas. 
2. Iron- is a mineral for helping in red blood cell production, delivering oxygen throughout the body and for optimal thyroid function. Women with less iron are said to be anaemic and have issues with ovulation, failure to implant and increase in miscarriage rates. The demand for iron increases during pregnancy and it could improve the chance of conception. Iron is found in foods like meat, fish, green leafy vegetables like spinach, legumes and beans. To improve iron intake, eat a balanced diet and try to eat Vitamin C rich foods like citrus fruits because Vitamin C helps the body to better absorb iron.  Talk to your doctor before taking iron supplements because taking too high doses could be detrimental to your health.
3. Omega 3 fatty acids- improve fertility by improving egg quality, reduce inflammation, regulate hormones, and improve blood flow in the uterus.  It helps in growth of fetal brain.  It could also improve sperm quality.  It is found in certain fish, flaxseed, spinach and walnuts.  
4. Antioxidants support egg and sperm health and are important for fertility and conception. Coenzyme Q10 is an antioxidant which could reduce oxidative stress on tissues and improve endometrial thickness.  Antioxidant-rich foods include all fruits and vegetables, nuts, seeds, legumes, dry fruits and whole grains.
5. Vitamin B12- could improve sperm count and sperm quality in men.  It also helps in ovulation, improves egg quality and decreases chances of miscarriage.  It  supports the baby’s central nervous system along with folic acid. Foods rich in vitamin B12 include fish, meat, poultry, eggs and dairy products. Because Vitamin B12 isn’t readily available in plant foods, you should speak with your doctor about getting supplements, if you don’t eat animal products.
6. Low glycemic index (GI) and high fibre carbohydrates- GI is a measure of how certain foods affect your blood sugar levels.  Foods high in refined sugar and carbs have a high GI, whereas foods high in protein, fiber and fats have a low GI.   Foods with low GI and high fibre carbs improve fertility and affect ovulation positively.  It also regulates blood sugar levels.  Foods in this category include oats, whole grains, fresh fruits, vegetables like carrots, legumes like chickpeas and lentils.  Try to avoid high GI foods like white bread and rice, starchy vegetables like potatoes, baked goods and juices or drinks sweetened with sugar.
7. Saturated and trans fats- Reducing the amount of saturated and trans fats in your diet is important for general health because they increase the levels of bad cholesterol in your body.  So try to reduce eating fried and processed foods and eating leaner meat like fish or chicken. Trans fats can negatively affect sperm morphology, and egg quality. (5)
8. Avoid alcohol- some studies have shown that consuming too much alcohol could increase the time it takes you to become pregnant as well as affect ovulation, sperm production and hormone levels. (6)

Some other factors to improve fertility

Try to eat earlier as it could improve fertility.  Drink lots of water and stay hydrated to improve sperm and egg health, hormone regulation, and blood supply to the endometrium. Talk to your doctor about taking prenatal vitamins.

If you have other medical issues like diabetes, endometriosis or PCOS, it would be useful to get advice from your doctor about how to improve your fertility through your diet. Nutrition can play an important role in successful conception and its important to have a balanced diet to improve your fertility and prepare your body for a healthy pregnancy.  If you have any questions about the role of nutrition in your fertility, feel free to contact the experts at Xenith Advanced Fertility Centre.

Laparoscopy is a surgical procedure to look inside the abdomen or pelvis through small cuts in the abdomen instead of making a large incision in the belly to help the doctor determine the cause of the problem.  It is done using a laparoscope which is a thin fiber optic tube with a light and a camera and other surgical instruments might also be used if treatment is needed at the same time.  When laparoscopy is done for infertility purposes, the woman’s reproductive system like the uterus, fallopian tubes and ovaries are observed and then diagnosed and treated.  Sometimes the cause of issues like pelvic pain or other issues with the reproductive system cannot be ascertained or might prove to be inconclusive via physical exam, ultrasound or other methods.  Then, laparoscopy might be carried out to diagnose the problem.

Laparoscopy procedure

Laparoscopy is done under general anaesthesia and a small cut is made near the belly button.  Carbon dioxide gas is passed through a needle to expand the abdominal area, allowing the surgeon to see more clearly and thus make their work easier.  The laparoscope is inserted through the hole to inspect the organs to determine the cause of infertility. The camera in the laparoscope will transmit the image of the abdominal/pelvic cavity onto a monitor.  If the cause is found, sometimes treatment might be also done at the same time by inserting other surgical instruments.  Upon completion, the instruments as well as the gas are removed and the cuts are closed and sealed with a bandage.  They will keep you under observation for a few hours and usually send you home on the same day depending on what procedure was done. 

You will need to rest and avoid strenuous activity for a few days following the procedure.  You may feel tired and may be sore around the incision areas after the laparoscopy.  You may have pain in the back or shoulder due to some gas still remaining in your abdomen and this pain will go away in a day or so.  You may also feel nauseated due to the anesthesia and also from all the probing that was done in your abdominal area.  You can get back to doing your normal activities in a day or two, if it was a minor procedure or longer, depending on what was done. 

Diagnostic laparoscopy for infertility

Diagnostic laparoscopy for infertility uses laparoscopy to find the cause of the problems like infertility or pelvic pain.  Why might the doctor recommend diagnostic or operative laparoscopy for infertility?  Here are some possible reasons:

1. having severe menstrual cramps
2. having pelvic pain or pain during sexual intercourse
3. Endometriosis– is a disorder where tissue that is similar to the uterus lining is found outside of the uterus, usually on the ovaries, fallopian tubes, and other pelvic structures and it bleeds just like the uterine lining.  This could cause pain, scarring, lesion formation and lead to infertility.  So, the surgeon will look for any signs of scarring or other growths that might be causing pain or infertility.
4. Pelvic inflammatory disease- is a sexually transmitted infection of the reproductive organs by bacteria like Gonorrhea or Chlamydia that could cause inflammation and cause scarring if not treated in time eventually leading to infertility, ectopic pregnancy and chronic pain in the pelvis.  The surgeon will look for signs of inflammation and scarring.
5. Previous Ectopic pregnancy is a pregnancy that occurs outside the uterus, usually in one of the fallopian tubes and this could have dangerous consequences if not treated immediately.  If there is a history of previous ectopic pregnancy, it could mean unhealthy tubes for which a Laparoscopy may be suggested.
6. Blocked fallopian tube– the fallopian tube is the structure which brings the sperm to the egg and then the fertilized egg goes back to the uterus for implantation for a successful conception.  A blocked fallopian tube could lead to issues with infertility and could be caused by endometriosis, pelvic infection or other reasons. If the tube is partially blocked, it could allow the sperm to go through but not the fertilized egg to go back to the uterus for implantation and thus, it could cause an ectopic pregnancy.  Laparoscopy is the most accurate way to diagnose this
7. Fibroid – A fibroid is an abnormal growth in or around the uterus causing pain, distorting the uterine cavity, or blocking the fallopian tubes. Even though they are usually non cancerous, it could make it hard to conceive. 
8. Polycystic ovary syndrome (PCOS)-is caused due to hormonal imbalances and its symptoms could be the presence of fluid filled sacs or cysts in the ovaries, irregular periods, abnormal hair growth and other symptoms.   An ovarian cyst could be suspected to cause pain or block the fallopian tubes. The PCOS ovaries might look like ping pong balls. 
9. Abnormality of uterus

Laparoscopy Treatments for Infertility

When the cause for infertility is diagnosed, it might be easier to treat it right away if possible.  If the fallopian tubes are blocked partially with scar tissue, it could be removed.  However, if it is blocked by large amounts of scar tissue, it might not be possible to remove the blockage.  Issues with the shape of the uterus could also be rectified with laparoscopy.  Fibroids, cysts, endometrial tissue or scar tissue could also be removed for biopsy purposes or taken out completely if they are small and fewer in number or they may need to cut the fibroids into smaller pieces before removal. For treating PCOS, they might first ask you to lose weight and try fertility medications in order to ovulate regularly.  If this doesn’t work, they might resort to a procedure called ovarian drilling where a few holes are drilled into the ovaries to try to restore regular ovulation.  Ovarian drilling is rarely done because it destroys part of the ovaries and reduces your ovarian reserve or the number of eggs you have left, if the drilling is excessive.

Advantages

Some of the advantages of laparoscopy include it is minimally invasive with smaller scars, shorter hospital stays, less pain and greatly reduced recovery time compared to open surgery.  There is also a lower risk of infection, less trauma to organs and fewer complications.  One can also diagnose and treat the issue in one go. 

Frequently Asked Questions (FAQs)

1. What are the risks?

Sometimes problems might occur with laparoscopy like internal bleeding or bleeding at the incision site, infection or damage to an organ.  Laparoscopy might take longer than an open surgery and so you could be under anesthesia for a longer period of time.  Surgery could relieve the pain but its also possible for the pain to return after a few years.

• What should I watch out for after laparoscopy?

Contact your doctor immediately if you have severe pain, fever, heavy bleeding, or if you aren’t able to empty your bladder.

• What are the chances of the procedure being successful in treating infertility?

The success rate depends on what issue was, the patients age and varies from individual to individual.  Speak to your doctor about this. Laparoscopy could thus play an important role in diagnosing and treating some causes of infertility so that you can improve your chances of getting pregnant either naturally or with fertility treatments.  If you are dealing with infertility and have questions on how to deal with it, talk to the experts at Xenith Advanced Fertility Centre.

When conception has not occurred after 1 year of having regular, unprotected sex, which is defined as infertility, then people approach for treatment and some of them also need  assisted reproductive technologies like in vitro fertilization (IVF) for helping them to have a child.  IVF is a series of procedures where the woman’s ovaries are stimulated to produce more than one egg and these eggs are retrieved, combined with sperm in a laboratory setting and the resulting embryo is transferred back to the woman’s uterus for implantation potentially leading to a successful pregnancy.

The role of embryo transfer

Going through IVF could increase your chances of having twins or multiples because sometimes more than one embryo is transferred to the uterus to increase the chance of conception with the hopes that at least one will survive to full term.  However, if all the embryos survive, it could lead to twins or multiples.  Nowadays, the conception of multiples is getting less common due to improved technology and the healthiest embryo is selected and transferred into the uterus.  This transfer of only 1 healthy embryo into the uterus is called elective single embryo transfer (eSET).  eSET should be considered for patients who have a good likelihood of getting pregnant with IVF which is usually women younger than 35 and who produce good quality embryos.

There are different types of embryo transfer.  In fresh embryo transfer, the eggs that have just been fertilized in the lab are cultured for a few days and the best embryos are transferred back into the woman’s uterus with the remaining good embryos being frozen.  In frozen embryo transfer, the frozen embryos are thawed and transferred to the woman’s uterus.  The success rates of both frozen and fresh embryos are almost similar, with frozen embryo transfer giving slightly better pregnancy rates. .  The embryo can be transferred to the uterus at two different times of the embryo growth which are the cleavage stage and blastocyst stage.  Cleavage stage embryo transfer occurs 2 to3 days after fertilization occurs.  A blastocyst is a cluster of dividing cells about 5 to 6 days after fertilization by sperm and can be transferred at this time.  This gives more time for the embryo to develop in the lab and also gives time for the embryologist to grade the embryo and pick the healthiest ones to implant.  The embryo could also be tested for any genetic defects at this time.  The uterus also has to be the proper thickness so that it is receptive to the embryo and this timing or implantation window is when the embryo needs to be introduced into the uterus. 

Factors affecting multiple pregnancies

Some reasons for transferring multiple embryos into the uterus include being older (more than 35 years old), fewer embryos were produced, lower quality embryos produced, having had repeated IVF failures, the patient’s health, and following the country’s regulations and guidelines. An educated decision is made by the patient after consulting with the doctor and following the doctor’s recommendations.

Risk of IVF Twins and Multiple Pregnancies:

Having twins or multiples may seem ideal to couples dealing with infertility where you get 2 babies for the price of one IVF procedure.  But delivering twins or multiples comes with its own risks to both baby and mother.  There is a higher risk of the baby being born prematurely and this could lead to a number of health complications to both babies and mother.  Babies could be born with low birth weight, respiratory issues, cerebral palsy, other health problems and delays in development.  Mothers might have higher risk of getting gestational diabetes(diabetes that develops during pregnancy causing larger sized babies and other complications), anemia, haemorrhage (severe bleeding) after delivery due to more stress on the uterus, hypertension(high blood pressure) and preeclampsia (high blood pressure, general swelling, increased protein in urine and possible kidney damage or damage in other organs).  There is also higher risk of miscarriage and stillbirth.  So, both mother and baby have to be monitored closely before and after birth.  They are also more likely to have a caesarean section delivery.  Twin to twin transfusion syndrome could occur if the twins share a placenta where one twin receives more supply of blood than the other causing more growth in one fetus with higher blood supply and could lead to death of the undersupplied fetus.  It could also lead to abnormal growth and heart problems during development. A twin pregnancy could go all well also, however the risks are higher compared to a singleton pregnancy.

Personalised Decision-Making:

You would need to discuss with a fertility expert the pros and cons of having twins or multiples and make an educated decision after learning about the risks and dangers of going through with this.  A counsellor could help you make a decision that’s best suited uniquely for you.  The couples age, previous reproductive history, health issues, and other factors would need to be taken into consideration before making a decision on the number of embryos to be transferred to the uterus for conception to occur.

IVF Technique Advances:

Many technological advances have been made in IVF to improve the chances of conception and decrease the need for multiple embryo transfers.  Some of them include:

1. Embryoscope- is an incubator with a camera that monitors the growth of the fertilized egg and takes images at regular intervals.  It allows the embryologist to keep track of the embryo without having to disturb its growth and bring it out to analyse it compromising its viability.  It could also mimic the same conditions as the fallopian tube. The time lapse feature allows the embryologist to select the ones that are growing well and seem healthier for improved chance of conception. However many studies have shown that use of Embryoscope does not necessarily increase clinical pregnancy rates.
2. Embryo vitrification- is a process of flash freezing the embryo for later use and its outcome is very similar to using fresh embryo.
3. Preimplantation Genetic Testing-is used to identify genetically abnormal embryos and thus  helps in selecting the healthiest embryos for transfer.  It is an important tool for people who are at greater risk of having babies with some genetic disorders like if a certain genetic risk runs in your family or if you are older or have had multiple failed IVF cycles. 
4. Laser assisted hatching- is used to help in implantation of the embryo to the uterus by using laser to make a small crack in the outer shell of the embryo to aid in attaching to the uterus.  It was found that embryos of women older than 35, frozen embryos, or other unknown reasons have a harder outer shell making it difficult for the embryo to implant.  It has to be done very precisely without affecting the contents inside the embryo.
5. Blastocyst culture-In the past, 2 or 3 day embryos were usually transferred to the uterus but now due to better technology, one can culture a 5 or 6 day blastocyst and only the healthy ones survive up to this period. With blastocyst culture, only one healthy blastocyst will need to be transferred to the uterus to prevent multiple pregnancies.  But not all labs have the capability of growing blastocysts and also there is a chance that none of the embryos may develop into blastocysts in the lab environment.  So it might be easier to transfer day 3 embryos and the doctor might need to decide whether to choose a 3 day or 5 day embryo.

Conclusion

Many infertile couples have been granted the gift of becoming parents due to IVF.  However, multiple pregnancies can be risky.  So, the patients need to be educated on the pros and cons of going through multiple embryo transfers and the decision has to be made together with the doctor as to what would be best for their unique circumstances.  The goal is to have a healthy pregnancy and a healthy baby and mother.  If you are interested in how to go about successfully and safely having a child, come talk to the experts at Xenith Advanced Fertility Centre.

Frequently Asked Questions (FAQs)

1)Is eSET less risky than transferring multiple embryos?

Elective single embryo transfer (eSET) selects the healthiest embryo of the lot and has very good chance of successful conception with a single fetus especially if you are young and healthy.  Transferring multiple embryos could lead to twins or multiples which is more risky for the health of both mother and babies. 

2)Can I choose to have twins when going through IVF? It is important to discuss with your fertility specialist about your wishes because it could be risky depending on your age and your health.  Having twins is also more risky to the health of both the mother and the babies.  Thus, it would have to be monitored very closely by the doctor.

Menstruation, also known as period, is the release of blood and tissue from the uterus lining through the vagina.  The egg is released from the ovary every 28 days on average and if the egg isn’t fertilized by sperm, the uterus lining is shed through the vagina for 2 to 8 days marking the beginning of your period. 

Sometimes women have irregular periods which could mean that the period comes unpredictably, they are heavier or lighter or they last longer or shorter than average.  Irregular cycles could also mean the frequency of periods is longer than 38 days or shorter than 24 days.  Premenstrual syndrome (PMS), which are the physical and mental symptoms that occur just before the period begins until a few days after the period begins, could also affect women negatively. Women might have to physically deal with menstrual pain which could include cramps, lower abdominal pain, tender breasts, nausea, exhaustion, headaches, or other symptoms.   It could also cause irritability, food cravings, anxiety, sleeplessness and sadness and thus affect a woman’s quality of life on a monthly basis.  Menstrual health could be affected due to various reasons like infections, pelvic inflammatory disease (PID), endometriosis, polycystic ovarian syndrome(PCOS), thyroid disease, fibroids, stress, excessive exercise, hormonal imbalances or diet.  Treatment for the pain could range anywhere from using a heating pad to medications or even surgery.  However, something that could help alleviate many of these issues naturally without medications is yoga.  Yoga is an ancient Indian practice that focuses on various body poses (asanas), mind (meditation) and breathing (pranayama) all working together to make you more healthier and making you more aware of your own body.  It could be used to deal with irregular cycles, relieving menstrual pain and discomfort and could also help with hormonal imbalances.  It has a way of calming one’s brain and body.  It improves strength, flexibility, respiratory and heart function, reduces stress, anxiety and depression, improves sleep patterns, decreases chronic pain, and improves the overall well being and quality of life in general. 

One study found that in some women, practicing yoga 5 days a week for 6 months decreased the levels of some hormones that cause irregular periods. (1)  Many other studies have found similar results with decreased pain symptoms (2,3).  Being overweight or being a smoker could also increase the risk of encountering various PMS symptoms. 

Here are some yoga poses that could help you to have more regular menstrual cycles, ease menstrual pain and balance hormonal levels. (4)  Please do these under the guidance of a trained yoga instructor so that proper breathing and body positioning is done without harm to your body.

1. Bow pose or dhanurasana- could stretch and strengthen your back and stimulate the reproductive organs.  It could also help ease menstrual pain.  Lie on the ground on your stomach.  Lift your legs backwards and grab hold of it with your hands as you raise your body up backwards. 
2. Garland pose or malasana- could help ease cramping and back pain.  Keeping your feet hip distance apart, squat down.  Spread your knees wide and hold hands in namaste position
3. Reclined butterfly pose or suptabhadrasana- could open up your hips and help ease back pain and could relax your mind.  Lie flat on your back and then bend your knees and bring the soles of the feet together.
4. Reclining twist pose or jathara parivarthanasana- stretches your back and hips, could help deal with menstrual pain and stimulates digestive organs.  Lie down on your back and then bend your left knee and tilt it over your right knee and hold the left knee with your right hand while facing the left side.  
5. Inverted leg pose or viparita karani- is very relaxing physically and mentally.  It could help with blood circulation, digestion, and lowering blood pressure.  Lie down with your back perpendicular to the wall and put the legs straight up on the wall with back straight on ground like the shape of an L. 
6. Bridge pose or setu bandhasana- could help control thyroid function especially for women dealing with PCOS and could stimulate the reproductive organs.  Lying on the back with bent knees, feet flat on the floor hip width apart, and lift the hips and spine up with the weight on your shoulders and palms facing down. 
7. Locust pose or salabhasana- could help stimulate ovaries and uterus and could help people with diabetes.  Lie on your stomach and hands alongside your body.  Without bending your knees, lift your legs up backwards along with your head in the shape of U.
8.  Kapalbhati pranayama- could help reduce stress, reduce pain intensity, improve respiratory system, strengthen abdominal muscles, improve digestion, and improve brain function. It is a breathing technique with powerful forced exhalation followed by short, automatic inhalation and it involves contracting your stomach muscles while seated cross legged or on a chair.
9. Child’s pose or balasana- is thought to relax your body, stretches your back, shoulders and hips and helps you to focus on your breathing.  It begins by kneeling and sitting on your heels while spreading your knees.  Then bend forward bringing the head to touch the ground and stretching the arms in front with palms facing downward
10. Corpse pose or savasana- relaxes your body and mind and helps you be aware of your breathing and ease menstrual cramps.  Lie down on your back with hands to the sides and feet slightly apart.  Close your eyes and relax. 

Yoga could be beneficial in improving menstrual health naturally.  If you would like to learn more about this, please feel free to contact the experts at Xenith Advanced Fertility Centre.

Every woman is born with all the eggs she will ever have in her whole life and they lie dormant in the ovaries.  During each menstrual cycle, some of these immature eggs will mature with usually only one egg being eventually released each month during ovulation while the rest of those eggs disintegrate.  If one of these eggs is fertilized by a sperm, it could form an embryo and get implanted in the uterus lining resulting in a pregnancy.

What is AMH?

AMH stands for Anti-Müllerian Hormone and it is a hormone that is secreted by the granulosa cells in the ovarian follicles which are fluid filled sacs containing an immature egg in the ovary.  Ovarian reserve is the number of eggs you have left in the ovary at that particular time.  The level of AMH hormone is directly proportional to the number of eggs remaining in the ovary.  So, a higher AMH level means you have a higher ovarian reserve and vice versa.  AMH levels tend to peak around the age of 20 to 25 in women and then decline until menopause when no eggs are remaining.  A simple, inexpensive blood test can be used to determine the AMH levels at any time of the woman’s cycle. 

Significance of AMH testing

As fertility declines with age and as more women are choosing to delay having children, it’s important to have an idea of how fertile you actually are, so that you can make an informed decision about when to have kids.  Low AMH levels do not mean that a woman cannot get pregnant naturally because it takes only one good egg along with sperm to become pregnant. If you don’t plan on having kids for a while, but your ovarian reserve is low, then freezing your eggs could be an option although these options should be discussed with your doctor.  However, it must be noted that a good or higher AMH level does not always ensure higher fertility because it does not reflect the quality of the eggs produced which can diminish with age, genetics, your environment, your lifestyle like smoking, under certain health conditions like endometriosis, when taking certain toxic medications like the ones used for treating cancer and few other factors. Age is a major factor for fertility and as you age, the cell division of the immature eggs are more prone to errors.  The eggs in the ovaries of different women mature at different rates and so some women could hit menopause much earlier.  An AMH test could tell you if your ovaries are aging too quickly for example.  Premature ovarian failure or aging means the ovaries have fewer eggs in them than they normally would in women of similar age. So, if there is a woman who is born with lesser number of eggs or a lower ovarian reserve compared to what we consider as normal, or if she is losing more number of eggs every month, then this woman is going to have a lesser number of eggs in her ovary compared to what we would expect as normal at that particular age. It has been found that Indian women have a lower ovarian reserve compared to caucasian women of the same age. There is a more rapid decrease in AMH levels with age in Indian women of reproductive age group compared to healthy Caucasian women. (1,2)

When is AMH testing recommended for women?

1. If you are having problems conceiving-You might need to find out if you have low ovarian reserve which could explain issues with infertility.
2. If you are undergoing an in vitro fertilization (IVF) procedure- During IVF, the woman’s ovaries are stimulated to produce multiple eggs at one time and these eggs are retrieved, fertilized with sperm in a laboratory setting and the fertilized embryo is transferred back into the woman’s uterus for implantation which could lead to a successful pregnancy.  Higher AMH levels could suggest that you might respond well to fertility drugs and might not need as much whereas lower AMH levels could suggest that you might need higher doses of fertility drugs to respond well.
3. If you are suffering from Polycystic ovarian syndrome (PCOS)- which is a hormonal issue sometimes causing multiple cysts to form on your ovaries, and/or high levels of male hormones and/or having irregular or skipped periods.  Women with PCOS often have higher levels of AMH. 
4. If you are undergoing treatment for ovarian cancer- a decrease in AMH usually means that your treatment is working. If AMH increases, it may mean your treatment isn’t working or cancer has returned.

So, is AMH testing necessary for women?  AMH testing can only give you partial answers to the big picture of fertility.  Having low AMH levels might explain why it’s more difficult to conceive.  Age plays a big role and the quality of the eggs cannot be tested until it is fertilized by the sperm and a genetic analysis is done on the resulting embryo.  Other tests might need to be done concurrently like a transvaginal ultrasound, levels of other hormones etc. to get a more accurate picture of any issues with fertility.  Low AMH levels could mean a declining fertility but all it takes is one healthy egg for pregnancy to occur and this could be more easily attainable by going through an IVF procedure.  This is why its important to do a complete and proper assessment for fertility.  The experts at Xenith Advanced Fertility Centre can give you knowledgeable advice on where you stand now in terms of your fertility, how to understand your test results and what can be done to boost your chances of having a baby.  After evaluating your unique circumstances, they could provide a tailored treatment to improve your odds of successfully having a baby.

Often, living a healthy lifestyle usually begins once a woman finds out that she is pregnant.  Preconception is the time before the sperm fertilizes the egg and so preconception age is usually the period of time between the decision to try to have a baby and when conception actually occurs.  The time before conception is important because your lifestyle, diet and various other things could affect conception, going through a successful pregnancy, and affect the future physical and mental health of the mother and baby.  So, during this time, you might need to make changes in your lifestyle or do other things in order to improve your chances of conception and also ensure a healthy pregnancy.  Men should also be included in this because the quality of sperm could be affected by their lifestyle and various other factors.  Ideally, this plan should be looked at least 3 months before conception and the plan is different for each person.  The doctor could counsel and educate you on the risks involved and also make up a preconception plan for you to follow depending on your unique circumstances.  Counseling and education is important to know about the potential risks that might be involved in your particular circumstances and what you could do to optimize the chances of conception.

How do you plan for a healthy pregnancy

1. Optimize your reproductive health- It allows you to look at any medical conditions you might have like blood pressure, diabetes, endometriosis, polycystic ovarian syndrome(PCOS), celiac disease, depression, kidney, heart or thyroid issues and discuss with your physician about how this could affect your fertility or your pregnancy journey.  If you have certain diseases like HIV and other sexually transmitted diseases, it could be passed on to the baby and the medications you take might cause miscarriages or affect the fetus and so you need to discuss with your doctor about what to do under these circumstances.   If there are any genetic disorders that run in your family, you need to understand the risk of passing this disorder to the baby.  If you are on certain medications, talk to your doctor about its effects on conception and having a healthy pregnancy.  Diabetes should be well under control to prevent chances of miscarriage, and other complications to both mother and baby.
2. Getting proper nutrition – is very important in improving your fertility and your chances of conception.  So, you should follow a well balanced diet which is rich in whole grains, fruits, vegetables, fish, nuts, and avoid processed, sugary and fried foods.  Prenatal supplements like folic acid and iron  or prenatal vitamins may be needed to make sure all your nutritional requirements are met.  Folic acid should be taken at least 3 months before conception to prevent neural tube defects.  The quality and quantity of sperm in men could be affected by nutrition as well as other factors like heat, chemicals like pesticides, radiation and various other things. (1)
3. Lifestyle factors– or how you live your life could affect your chance of conceiving successfully and having a healthy baby and mother.  Try to get enough exercise, enough sleep, decrease stress, stop smoking, stop drinking alcohol or drinking excessive caffeine, maintain proper weight, and avoid being exposed to toxins or other chemicals that could be harmful like pesticides, X Ray etc.  Obesity could increase risk of gestational diabetes, hypertension, stroke, congenital heart problems for the fetus and various other issues.  Being underweight could also cause low birth weight, decrease chances of conception causing both mother and fetus being nutrient deficient and along with various other issues. 
4. Age – can affect the chances of conception because with increasing age, comes more issues with infertility.  More and more couples are delaying having children due to continuing education, achieving career goals, not having financial security or various other reasons leading to increased use of assisted reproductive technologies like IVF.  So, if you are planning to have children, try to plan it while you are younger or below 35 years of age.
5. Counseling- talking to a professional counsellor about the risks involved especially if you are dealing with depression or certain infections like Hepatitis B or HIV where vaccinations or medications might be crucial and how to cope with this successfully. (2)

In conclusion, it is very critical to plan ahead before conception in order to have a healthy and successful pregnancy.  You can learn to be proactive to improve your chances of conception.  Speak to your doctor about giving you a risk assessment in your particular case and how to go about doing this and also get more educated about the consequences of your actions.  This could give you more confidence to embark on this parenthood journey and navigate through conception and pregnancy successfully.  If you are interested in learning more about this, come talk to the experts at Xenith Advanced Fertility Centre.

Breastfeeding involves feeding a baby human milk from the breast.  Breast Milk provides the ideal nutrition with proper combinations of fat, protein, carbohydrate, vitamins, antibodies and various other things.  The breast milk could be fed directly from the breast or pumped from the breast, stored and later fed through a bottle.  Most doctors recommend breastfeeding the baby for at least the first 6 months after their birth. 

There are 3 types of breast milk produced at different stages after the baby’s birth.  The milk content changes gradually over time.  The milk composition and its quantity varies with the baby’s needs because as the baby grows, they need more food and different levels of nutrients.  The first milk produced is colostrum, also called liquid gold, which lasts for the first few days and is usually yellowish in color and thicker than the other milk. After this comes the transitional milk which is thinner in consistency and lasts for the next few weeks.  Transitional milk is a mixture of colostrum and mature milk and eventually becomes mature milk after some time.  After about 2 to 4 weeks, mature breast milk will be produced for the rest of the time the breast milk is produced. 

There are many benefits to breastfeeding not only for the baby but also for the mother.

Benefits for the baby

1. Nutrition– the colostrum, which is easily digestible by the newborn, is low in fat but high in protein especially whey.  Colostrum helps develop the immature digestive tract of the newborn. It also works as a laxative to help pass the newborn’s initial stools and remove any excess bilirubin in order to prevent jaundice.  The mature milk which has higher levels of fat and lactose amongst other things provides all the nutrients needed to help the baby grow and remain healthy.  The breasts also start producing larger amounts of milk as the baby grows and needs more milk.  Breast milk also keeps the babies hydrated.  So human breast milk provides optimal nutrition for the baby’s growth and development and mothers need to eat a balanced diet to make sure the baby gets proper nutrition.  Here’s a breakdown of the various nutrients present in breast milk:

Carbohydrates-Babies, whose gastrointestinal tract are not very developed, ingest carbohydrates in the form of lactose rather than glucose. 

Protein- which is needed for growth and development, is present in the form of mostly whey and casein in human breast milk. Caseins are the main source of calcium and phosphate and it turns into solid curds when it is exposed to the acid in the stomach and may help the baby feel fuller. Whey remains as a liquid and is thus easier to digest. These proteins also aid in digestion, provide hormones and other growth factors. 

Fat-is also present although the mature milk contains more fat than colostrum and it provides energy for the infant.  The fat content can vary depending on the mom’s diet and change in weight during pregnancy.  Fats help develop the baby’s brain and nervous system. 

Vitamins- are needed for normal growth and there’s enough of it in breast milk.  However, the levels of Vitamin D and K might not be enough and might need to be supplemented from external sources. 

• Immunity- breast milk, especially the colostrum, contains antibodies which can help fight off infections from bacteria, viruses and other pathogens.  Antibodies are used to fight germs that the body comes in contact with.  Breast milk also contains white blood cells, lactoferrin, lysozyme, oligosaccharides, probiotics and prebiotics.  It has been found that babies who are not fed breast milk are more susceptible to various health issues like ear and throat infections, common cold, gut infections, various allergies, asthma, eczema, pneumonia, type 1 diabetes, and diarrhea to name a few.  Recovery time is also improved and the severity of the illness is reduced in babies who are fed breast milk.  Not drinking breast milk is sometimes associated with sudden infant death syndrome (SIDS) where a baby sometimes dies in their sleep.  Colostrum has a high level of immunoglobulin A (IgA) which is an antibody made by white blood cells.  IgA forms a protective layer in the internal surfaces of the body like the baby’s nose, mouth, throat, lungs and digestive system and binds the germs that come across it, thus preventing them from infecting the body and causing an illness.   IgA is small enough to pass into the breastmilk and therefore is passed onto the baby whereas most other antibodies are too big to be passed from mother to baby via breast milk.  Since the baby and the mother are generally exposed to the same germs, the mother’s breast milk can thus protect the baby. Baby formula lacks these antibodies.  Lysozyme inhibits the multiplication of pathogenic bacteria.  Lactalbumin is needed for making lactose in the mammary gland and it helps in absorption of essential minerals like calcium and zinc.  Lactoferrin aids in absorption of iron into the body from the intestine and prevents the harmful bacteria from growing in the gastrointestinal tract.  Oligosaccharides in milk support the growth of beneficial gut bacteria (probiotics) preventing pathogens from attaching to the intestine.  Prebiotics are basically foods like fiber for these probiotics.

• Weight gain- occurred in babies in a healthy way due to components in breast milk which support healthy gut bacteria which, in turn, could affect storage of fat.  The hormone leptin in milk can control appetite and satiate hunger.  It could also prevent childhood obesity and help develop healthy eating patterns. 

• Improves brain development- It has been found that breast feeding improves cognitive development like improved memory, greater language and motor skills and intelligence in early childhood and sometimes even into adulthood. It also helps in the social and emotional development in children.  (1)

For the mother

1. Breastfeeding helps the uterus contract- Oxytocin is a hormone which aids in bringing the uterus back to its original size after pregnancy.  During labor, the body produces high amounts of oxytocin by encouraging contractions to help deliver the baby and reduce bleeding. A breastfeeding mother has higher levels of oxytocin which leads to faster involution of the uterus and less bleeding after delivery. 
2. Increased emotional and physical bonding- Being in close physical contact and eye contact with the baby during breastfeeding could make you feel more connected to your baby and this could also help decrease behavioural issues. Breastfeeding could reduce anxiety, stress and negative moods in mothers.  They were also found to have reduced blood pressure, and higher quality sleep patterns and better social interactions and relationships than mothers who fed their babies infant formula. (1)
3. Lose baby weight faster- than mothers whose babies are fed formula because breastfeeding could burn more calories.   Also, nursing moms are often more conscious of what they eat.
4. Decreased risk for postpartum depression (PPD)- which could develop shortly after childbirth and those with PPD are more likely to have trouble breastfeeding and do so for a shorter period.
5. Breastfeeding reduces your risk of breast and ovarian cancer- They also have lower risk for high blood pressure, arthritis, high cholesterol, heart disease, and type 2 diabetes.  The risk of ovarian cancer decreases if the mother breastfeeds for at least 8 to 10 months. (2)
6. Breastfeeding saves time and money- because it is free and you don’t have to spend money on baby formula, bottles and other accessories.  It also saves you time in preparing the formula as well as cleaning and sterilizing the nipples and bottles. It is easier to travel when you are breastfeeding because you don’t have to take the baby formula and bottles with you everywhere you go and breastmilk is always at the right temperature.

Human breast milk is thus thought to be the gold standard for infant feeding. As well as its nutritional benefits, other advantages include social, psychological, improved health, economical and so much more for both the baby and the mother.  If you have any questions, feel free to contact the experts at Xenith Advanced Fertility Centre.

A vaginal yeast infection is a common fungal infection in the vagina and vulva (tissue in the vaginal opening) and is also called vaginal candidiasis.  It is most often caused by a type of yeast called Candida albicans. 

What causes vaginal yeast infections

In the vagina, there is normally a balanced growth of bacteria and yeast.  Some bacteria like the Lactobacillus keep the growth of yeast in check.  But sometimes, this balance can be disrupted leading to an excessive multiplication and growth of the yeast cells causing a yeast infection.  This could be caused by various reasons like taking certain antibiotics which can kill some healthy bacteria, pregnancy which causes hormonal changes, uncontrolled diabetes which causes high blood sugar levels, birth control pills, weak immune system, menstruation, stress or wearing moist, tight clothing which could provide a breeding ground for yeast.  

Symptoms

Some of the symptoms of vaginal yeast infections could include an itching or burning sensation when urinating or having sex.  It could also cause redness and swelling in the vulva, thick white vaginal discharge, and a vaginal rash.  Some of these symptoms are similar to having a sexually transmitted disease and so you should get it checked by your doctor although it is not considered to be a sexually transmitted infection.   However, mild infections might have no symptoms at all.  If you often have yeast infections, it could be an indication of an  underlying health condition like diabetes. 

Treatment

Vaginal yeast infections could be treated by antifungal medications which could be oral medications or topical in the form of a cream or a vaginal suppository which is inserted into the vagina where it dissolves to deliver medications into the vagina.  Cotton underwear could be worn to absorb any moisture.  You could take some probiotics which are made up of good bacteria in the form of supplements or certain foods like yoghurt, buttermilk or some fermented foods.  Most medications will work quickly within a week’s time.  However, if it’s a severe case, it might take longer to resolve. 

Does it affect fertility

A vaginal yeast infection does not directly affect fertility.  However, it can indirectly affect it because sex might be painful and uncomfortable and the woman might be put off from having sex.  However, if you are often getting vaginal yeast infections, it could affect the consistency of the cervical mucus and also the pH of the vagina and prevent the sperm from getting past the vagina into the uterus and reaching the egg. If you have a severe case of vaginal yeast infection, it may take longer to treat up to a few months.  Just be aware that these same symptoms could also be due to more serious conditions like gonorrhoea and chlamydia which could cause scarring and blockage of the fallopian tubes causing infertility.  So, make sure to get it checked out by a doctor.  If a yeast infection remains untreated, it could cause additional health problems like infection in the blood.  Also repeat infections or if treatment doesn’t affect the infection, it could point to diabetes which is poorly controlled or rarely other diseases like HIV.

Prevention

Some things you can do to prevent infection include following a healthy diet like fruits, vegetables and yoghurt and getting regular exercise.  Try to avoid consuming excessive sugary foods.  Keep the vaginal area clean and dry and try to avoid using scented soaps and douching which can affect the natural pH balance of the vagina.  If you have to take antibiotics, you should also take probiotic supplements or other foods like yoghurt which have healthy bacteria.  Try not to wear tight clothes, wet swimsuits or sweaty clothes for long periods of time, wear cotton underwear and keep the vaginal area dry. During your time of menstruation, try to change pads and tampons often and use chemical free pads preventing any infection.  So, in conclusion, yeast infections are treatable and it cannot directly affect your fertility.  If you want to know more about vaginal yeast infections, feel free to talk to the experts at Xenith Advanced Fertility Centre.