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The big “C” word can be overwhelming but there is a brighter side. With modern science, medicine, and technology most people who catch malignancy in time are able to overcome it. However, what child-bearing women often neglect to ask their doctor is this: Will my cancer surgery and its treatment affect my ability to have children?

Unfortunately, the idea of fertility preservation for cancer patients or oncofertility as it is called is rarely offered or even discussed with the patient because they are so focused on their cancer treatment.  

Patients today have a much better survival rate and can also dream of having their own children. The use of assisted reproductive technologies like egg or embryo freezing and IVF, can offer a ray of hope for these women as they face this challenging time in their lives.  

How do various cancer treatments affect a woman’s fertility?

Egg freezing may be considered if you have been diagnosed with cancer and have 2-6 weeks’ time before you begin treatment. Below is a summary of treatment options cancer patients are likely to have and the impact it may have on a woman’s fertility.

Surgery: Sometimes surgery is required for some reproductive cancers which affect the uterus, ovaries, fallopian tubes, or other parts of the reproductive tract.  Removing tumors from these areas of the body can lead to scar tissue which can interfere with conception.  In some cases, treatment may require the removal of all or part of a reproductive organ, which can hinder a woman’s ability to become pregnant after the surgery.

Chemotherapy: Many chemotherapy drugs can damage the ovaries because they usually work by targeting cancer with medications called cytotoxins.  Even though this type of medication targets cancer cells, other fast-dividing cells in the body can also be affected.  

Women are born with all the egg cells they will ever have in their ovaries.  At any given time, a certain number of these follicles will become mature during each menstrual cycle when they ovulate and one egg will be released.  Chemotherapy can damage a woman’s eggs, particularly the ones which are closest to being released by the ovaries during ovulation.  

Radiation therapy: The high-energy rays in radiotherapy are targeted directly at the specific area of cancer in the patient’s body to destroy cancer cells but nearby healthy cells can also be damaged.  There is a greater likelihood of the radiation therapy affecting fertility if the cancer is closer to the reproductive tract and the abdomen or also near the pituitary gland in the brain which signals the hormone production.  

Fertility preservation techniques for cancer patients

Egg freezing offers many cancer patients the opportunity to safeguard their future in fertility before they enter cancer treatment by preserving their eggs for later use.  The procedure can be done at Xenith Advanced Fertility Clinic. Our doctors will first stimulate the ovaries by injecting hormones to boost the production of multiple eggs which are then retrieved using ultrasound and frozen at sub-zero temperatures using cryoprotectants to avoid the formation of ice crystals.  

These eggs can be stored up to ten years without any significant loss of quality. The eggs are protected and safe while the patient goes through cancer treatment and recovery, ready to be used for IVF when she is healthy again. When required, the frozen eggs are thawed and allowed to fertilize with the sperm in the lab and the resulting embryo is implanted via in vitro fertilization (IVF) in the womb.  

A ray of hope for women who may be impacted by infertility due to cancer and its treatment

Egg freezing could be a ray of hope for women diagnosed with cancer or other medical conditions that may affect their ability to conceive. After cancer is in remission, there is the potential to conceive.  Unfortunately, there are no guarantees.  We recommend you consult with your oncologist. Ask him if the surgery or treatment could negatively impact fertility? If you want to learn more about freezing your eggs before you enter treatment, don’t wait. Talk to us at Xenith. Choose the fertility clinic near you – Wakad or Koregaon Park. Life after cancer can be rich and fulfilling and can include creating your own family.

PCOS is short for Polycystic Ovarian Syndrome. It is a common endocrine and reproductive disorder in women characterized by hormonal imbalances, irregular periods, and the development of small cysts in one or both ovaries. PCOS can lead to metabolic disorders associated with insulin resistance and inflammation making it harder for women to lose weight.

PCOS Diet and Nutrition

Too much insulin in the body can turn your body into a fat storage facility. According to the National Institutes of Health, “Between 40% and 85% of women with Polycystic Ovary Syndrome (PCOS) are overweight or obese and obesity is closely linked to the development of PCOS.”¹

Losing weight is one of the first recommendations doctors prescribe to women with PCOS. The problem is: women with PCOS may find that they are always hungry. The hormonal imbalance, insulin resistance, and inflammation can make it even harder for women with PCOS to lose weight.

While achieving weight loss can be an uphill climb for women with PCOS, it can be done with a little willpower and consistency in maintaining a balanced exercise and diet regimen. Treatment for PCOS usually involves reducing insulin levels and this may involve making changes in your diet and lifestyle.

Diet Changes: Tips for losing weight for women with PCOS

This should encourage the women with PCOS who are struggling to lose weight: Studies have noted that even a 5% loss in body weight can improve insulin resistance, hormone levels, menstrual cycles, fertility, and overall quality of life in women with PCOS.²

Work toward achieving smaller goals and over time you’ll find weight loss success. Here are some tips that can help you lose weight.

Reduce your carb intake

Maintain what is called a low glycemic diet – a diet that is low in carbs, rich in fiber, and includes an adequate amount of protein at each meal. A low glycemic diet can improve the body’s use of insulin which in turn could lead to weight loss.

Refined carbs like white bread, pasta, as well as store-bought juices, and packaged foods can cause your blood sugar to rise and fall quickly making you only hungrier for more. Eat foods with complex carbs like vegetables (leafy greens, green beans, peas, carrots), fruits, whole grains, and legumes like dals because they take longer to digest due to their high fiber content. Keep snacks on hand like nuts and fruits sprinkled with seasonings like lemon juice, spices, and fresh herbs to spruce up your foods.  Avoid foods like cakes, cookies, candy, and fast foods.

Get enough protein intake

Eating protein-rich foods can help stabilize blood sugar levels and reduce cravings. Protein has a way of making you feel fuller, for longer. Healthy high protein foods include dals, beans, yogurt, eggs, nuts, white meat, and seafood. Eat about with 1.5 grams of protein per kilogram of your ideal body weight.

Up your fiber intake

When you feel hungry, snack on cucumbers and carrots – these are high-fiber foods that can help to stabilize your blood sugar and keep you fuller longer. Vegetable smoothies with a protein powder is a great way to get fiber and protein into your daily diet and kill those hunger pangs. According to the American Heart Association, women should eat at least 21 to 25 grams of fiber per day.

Lifestyle Changes: Tips for losing weight for women with PCOS

Practice mindful eating

Mindful eating means actually sitting down at specified meal times, savoring your food and thinking about what you are putting in your body without distractions like the television so that you are more aware of cues from your body which helps in portion control and prevents overeating.  It may help with eating issues like binge eating and emotional eating

Reduce inflammation

Inflammation is your body’s natural response to infection or injury. But chronic inflammation is linked to obesity and is common in women with PCOS. Sugar and processed foods may contribute to inflammation. A diet like the Mediterranean diet which is high in fruits, vegetables, whole grains, olive oil, and omega 3 rich foods such as fatty fish may protect against inflammation.

Don’t undereat

Don’t go overboard in your diet. Eating too few calories can negatively affect the hormones that control your appetite and in the long term may slow down your metabolism eventually leading to weight regain after initial weight loss. So don’t restrict caloric intake but focus on eating whole foods and cutting out unhealthy products. Eat a healthy breakfast high in protein, healthy fats as well as fiber which in turn can help decrease your appetite throughout the day. Try eating smaller more frequent meals.

Exercise regularly

Exercise first, and eat later. Exercising just before a meal can help boost your metabolism so that you are storing carbs for energy, and not fats. Exercise can also help your body use up extra glucose stores bringing your insulin levels down. Exercising at least 30 minutes every day to get your heart rate up can help and help you lose calories faster. A regular, consistent exercise pattern trains your body to utilize glucose properly.

Get enough sleep

If you have PCOS, you may experience sleep disturbances. You may feel very sleepy during the day if you have not had adequate sleep. Poor sleep has been linked to obesity because it can increase the activity of certain hormones which cause you to eat more throughout the day. It’s good to have 6 to 8 hours of sound sleep every night. 

Manage your stress

Stress increases levels of the hormone cortisol. High levels of this hormone for long periods of time are linked to insulin resistance and weight gain. Find a way to cope with stress. Take time to do whatever it is that can help you relax. For some women, it is reading a good book or watching a good movie. For some, it can include practicing meditation, doing yoga, or spending time gardening. Women with PCOS need to watch their calorie intake. Any excess in calories can lead to more storage of fat in the body. If you have PCOS and are struggling to lose weight, visit us at Xenith Advanced Fertility Clinic. PCOS can also be one of the primary for not being able to conceive so treating PCOS early can lead to more successful chances of getting pregnant. Consult with one of our dieticians who specialize in PCOS weight loss.

The success rate of In Vitro Fertilization (IVF) in India has been steadily improving with advanced science and technology. It is giving hope to millions of couples who otherwise would not have had the chance to hold their baby in their arms. At Xenith Advanced Fertility Clinic we are happy to see many of the couples under our care have their dreams come true.

What is IVF? 

IVF is a process where a woman’s ovaries are stimulated to produce mature eggs. These eggs are then retrieved, fertilized with the sperm in a specialized IVF lab to create an embryo which is then transferred back into the uterus for implantation in the uterine lining. 

Once the embryo is transferred, the nail-biting wait is on for about two weeks to find out if this led to a successful pregnancy. 

IVF success rate is measured as the percentage of live birth per embryo transfer and this can differ from couple to couple, from clinic to clinic, from one specialist to another and can also depend on the type of IVF procedure being performed.

Multiple tests and diagnostics are done before the IVF are used to determine a customized course of action for the IVF procedure to yield the best results in the first IVF cycle.

What factors can impact IVF success rates?

The success rate of an IVF procedure can be affected by various factors like:

Age: Globally, the average IVF success rate is 40%. This can be higher in women under 35 years of age. After the 35, IVF success rates begin to decline. It goes down to 19% for women between the ages of 40-42.  Women aged 45 and above, have a much lower chance of IVF success. Doctors recommend that women who are struggling to conceive should seek at the earliest, as age is a determinative factor for IVF success. (1)

Endometrium receptivity:  A successful embryo implantation is very important for a positive outcome of in vitro fertilization. There is only a short period of time during which the endometrium is receptive for the embryo and this can be detected by a test called Endometrial receptivity analysis(ERA) which studies the endometrium at a molecular level.  The thickness of the endometrium is important for implantation and it can be artificially prepared with supplementation of various hormones or drugs if the endometrium is too thin or too thick. An experienced and well-qualified embryologist can help couples improve their chances of IVF success, even after multiple IVF failures. 

Other factors that can impact IVF success include:

• The quantity and quality of the eggs/embryo
• The quantity and quality of sperm
• The stimulation protocols and the timing of ovulation
• The ease of the embryo transfer process
• Certain issues like fibroid tumours or uterine abnormalities
• Certain lifestyle issues like smoking, drug/alcohol use
• Obesity

Is there hope after a failed IVF?

The world of IVF is advancing every day. IVF success rates are climbing higher and more couples are able to achieve IVF success today than ever before. With specialized treatments that are customized for each couple, doctors are able to perform highly advanced techniques that can increase the chances of IVF success.

Weak sperm may need to be retrieved using a procedure called the Intracytoplasmic Sperm Injection or Microsurgical Sperm Treatment used when sperm needs to be retrieved from the testes surgically. In a couple with advanced age, chromosomal abnormalities are the likely cause of IVF failure where we would recommend a Preimplantation Genetic Screening (PGS) to increase the chance of implantation. Advanced procedures such as laser-assisted hatching where the outer layer of the embryo is slightly broken to increase the chances of implantation of a healthy embryo can be conducted at Xenith.

IVF offers hope for women of all ages.The NICE fertility guide released by the National Institute for Health Care and Excellence in the U.K., recommends that “women under 40 who have been trying to get pregnant for two years, should be offered 3 full cycles of IVF. For women aged between 40 and 42, who have been trying for 2 or more years, and have not previously received IVF or shown evidence of low ovarian reserve, NICE recommends 1 full cycle of treatment.”1

With every failed cycle, doctors are able to assess the cause of failure and improvise their treatment for the next cycle.

Having the right team to support you can improve IVF success rates

The right experts: Choose the best experts for your case so that your chances of success are optimized.  A higher success rate can often result in an IVF clinic that has more experience and more qualified doctors. At Xenith Advanced Fertility Clinic, we take on tough cases. Couples often come to us after experiencing repeated IVF failures in other clinics. Many of them are able to achieve pregnancy success with us because of our expertise, experience, and state-of-the-art equipment in our clinic.

The right clinic: IVF success rates are dependent upon the entire clinical and laboratory team. There are multiple levels of emotional and financial stress on the family going through IVF cycles and this stress can be compounded by multiple failures. At Xenith, our entire team works toward making the journey smooth and less stressful for every couple. Along with the best of doctors, we have a supportive staff with counseling and therapeutic communication at each stage of a couple’s IVF journey.  To find out more about the team at Xenith Advanced Fertility Clinic, schedule an appointment!

Going to a fertility clinic for the first time can be both exciting and nerve-wracking at the same time.  You don’t know what to expect. So many questions are running through your mind.  What are the right questions to ask?  What do I need to take with me? What kind of questions will the doctor ask me? Every couple wants to understand the fertility journey they are about to take.

Your fertility journey will begin with a doctor’s consult which would include an in-depth evaluation of your medical history and once this is established, the doctor can outline a customized treatment plan.

Xenith Advanced Fertility Clinic is one of the best centers for IVF treatment in Pune. We make couples feel as comfortable as possible. We believe it’s important that couples relax and are able to open up about their lives. Seeking the help of a fertility specialist is the first step toward the journey of making your sweet dream come true!

To help you as you begin this adventure, we’ve gathered a few tips for couples to better face their first consultation with a fertility doctor.

What to bring for your first doctor’s consultation

Medical records are a must

The doctor will want to understand your medical history. Are there any prior illnesses she should know about? Does either partner have diabetes; is it under control? Has the couple been to other doctors or have had any medical examination or taken any medication for fertility? Do you know of any hormonal problems? Have you had any miscarriages? Bring as many supportive documents as you can.  Make sure you tell the doctor about any medication or supplements you are taking.

Bring your notebook

Before you come to the clinic, write down all the questions you’d like to ask the doctor. This should include any doubts and fears you might have, as well as pertinent questions about your chances of having a baby. Be forthright with the doctor, even about finances and the costs involved.

The notepad will also help you jot down things as the doctor explains your journey ahead. The first visit is often overwhelming for couples so it helps to take notes.

Bring your partner!

Take your spouse with you for the first consultation with the doctor. You can lean on each other for emotional support. You’ll both become aware of what will be involved in the treatment and be able to ask questions together. This is a choice that both partners need to make. Also, infertility is a couple of problems and needs evaluation and history from both partners.

What kind of questions to expect from the doctor?

• The doctor will ask couples questions such as:
• How long have you been trying to get pregnant?
• What is your home environment like?
• Are there any menstrual problems or issues related to intercourse?
• Do you become easily anxious and whether either partner is prone to depression?

Other questions may be related to weight, age of menstruation, details about your cycle, lifestyle choices – whether you lead a sedentary life, exercise, drink, or smoke.

What kind of questions should you ask the doctor?

Ask everything that is on your mind, for sure, but don’t forget to ask these pertinent questions as well.

Ask: How qualified is your doctor?

There is a difference between a fertility specialist and a board-certified fertility practitioner. There are many who are called “fertility specialists” but are not fully qualified. At Xenith, Dr. Mamta Dighe is one of the first few doctors in India to receive a Fellowship in Reproductive Medicine. Once you meet her, you’ll know why her patients call her the best IVF doctor in Pune!

Ask: What are the fertility success rates in the clinic? How do they compare with other clinics?

When you ask, be more specific. Ask about the fertility success rates for a couple in your age group and with similar problems as yours. Some fertility clinics take only younger patients as the fertility success rates are higher in such cases. They can appear to be wonderful but couples can get a truer picture by knowing the age group of such couples. Ask about the difference in success rates for achieving pregnancy vs IVF success rates.

At Xenith, we hold a record for achieving more than 70% pregnancy for infertile couples! We specialize in taking couples who have experienced repeated IVF failures.

Ask: Does the clinic provide counselors to provide emotional support?

Most couples are facing the disappointment of not being able to conceive naturally when they enter a fertility clinic. Going through diagnostic examinations, hormone treatment, the ups and downs of treatment can be an exhaustive emotional experience. Make sure the clinic has counselors available when counseling is needed.

Ask: Are diagnostic tests and procedures done in the clinic?

Having all the diagnostics done under one roof means that couples are not running to other centers to get tests done. It also means that the results are reliable. Having an in-house IVF lab with full-time embryologists can assure couples that the lab environment, room temperature, and procedures are well under control – these are important factors for IVF success. If you have not been able to conceive after 6 months of actively trying, come see us at Xenith Advanced Fertility Clinic. Some of the best embryologists in the country are working with us, along with nutritionists and complementary care physicians, fully equipped to support couples in the IVF treatment process. Schedule an appointment with us today.

“It’s the most painful thing I’ve ever been through…after three failed cycles I’m not sure I can take any more,” said a patient who came to us with wide eyes full of expectant hope. The news that an IVF cycle has failed – whether it’s the first one or the third – can be heartbreaking, but not without hope, as we shall see for this couple and many more like them, at the end of this article.

Many couples are overwhelmed with a sense of uncertainty when an IVF cycle has failed. After repeated failures, couples begin to wonder what to do. What next? How do I deal with this? Should we give up? Should we wait a year and try again? Under the circumstances, these questions and more are bound to arise.

Before we get into understanding IVF cycle failures, let’s start with…

What can you do to increase your chances of IVF success?

Turn to the best IVF clinic in Pune

The likelihood that you will achieve pregnancy and go through full term in the first cycle itself is largely dependent on the quality of the IVF program. IVF clinics are not equal – some have a higher rate of success than others. Going to the best IVF fertility clinic in Pune will certainly increase your IVF success rate. At Xenith, we have a Board Certified Reproductive Endocrinology and Infertility specialist and can boast of some of the highest rates for IVF success in Pune.

Freeze your eggs or embryos in the first IVF cycle

Collecting viable eggs in your first IVF cycle saves you from having to go through the entire hormonal treatment again. This can make the next few IVF cycles a little bit easier since all that the embryologist has to do is fertilize them if eggs are frozen, or implant an embryo if embryos are frozen.

How many IVF cycles should you go through before you see IVF success?

According to the National Institute of Health, it takes an average of 3.6 IVF cycles to achieve pregnancy.  Many clinics believe that after 3 to 4 unsuccessful IVF cycles, one is less likely to benefit from future cycles. However, according to a study done in the United Kingdom, the greatest percentage of IVF success occurs in 6 cycles but success is also age-related as this six-cycle regimen works best for women under the age of 35.¹ The famous singer, Celine Dion, had to endure 6 failed IVF cycles before having a successful pregnancy. 

What are some of the common causes for IVF failure?

There can be myriad reasons why an IVF cycle fails. Each couple is different and while it is not possible to pinpoint the exact reason, there are some common causes.

Chromosomal abnormalities

A failed IVF cycle could be due to the presence of too many or too few chromosomes or structural abnormality in the chromosomes.  You can opt for preimplantation genetic testing to be done. A sample of cells from the embryo is taken and examined in our IVF lab for chromosomal abnormalities. This will ensure our embryologists implant an embryo that is not abnormal. This will increase the chances of success.

Endometrial receptivity

Sometimes, the embryo cannot attach to the membrane lining in the uterus also called the endometrium due to various factors like the thickness of the lining, presence of too much fluid, polyps or if there’s an infection.  A bacterial infection could be treated by antibiotic therapy.  Other factors like a history of fibroids, anatomical abnormality, and having PCOS may influence successful pregnancy.  Some of these issues are corrected before the IVF procedure begins to encourage successful pregnancy.

Lifestyle factors

To help the success of the IVF cycle, we recommend that couples lead a healthy lifestyle. There is some indication from studies that show factors such as body weight, smoking, drinking, diet, exercise, and stress can all influence chances of becoming pregnant. Before starting an IVF cycle, it may help to reach an optimal weight through diet and exercise.

Next steps

Have a detailed discussion with your doctor

It is important to understand the recurrent causes of IVF failures. The doctor will be able to evaluate whether the causes can be corrected and the modifications that need to be made for the next cycle.

Couples can have several options even after IVF cycles have failed. If maternal age is a factor, think about using donor eggs which can increase your chances of having a successful outcome.  There is also the opportunity to adopt a child to consider.  These are personal decisions each couple must make for themselves.  It’s also okay if a couple decided to stop the IVF journey.

Take time to pause and grieve, rely on your support group

It is important to seek support through your family, friends, and other support groups, even a psychologist — wherever you feel comfortable to vent your feelings and find a constructive way to heal.  Feel free to ask for help and don’t be so hard on yourself.  Don’t let yourself feel alone or isolate yourself.

No medical expert or scientist has been able to exactly figure why that magical moment happens and why other attempts have failed. We have experienced some couples succeed in spite of all odds and that gives us all joy. Some couples go through a harder time when there is apparently nothing wrong. Like the couple at the beginning of our article. They were blessed with a baby boy following treatment with us after the previous 5  failed attempts.IVF is still one of the best opportunities infertile couples have to succeed in having children of their own. Visit us at one of our Xenith fertility clinics near you – either at Wakad or Koregaon Park.

Parenthood is considered an important milestone in a couple’s life. When “good news” seems to have passed you by, couples have the next “good news” – the chance to be able to conceive with the help of a fertility specialist. Thanks to science and advanced technology, couples can look forward to having their dreams come true.

However, IVF treatment can be a stressful experience for some couples. There is a link between mental health and fertility. It is important for couples to recognize the need for psychological support during this time to make the journey as comfortable as possible.

Types of Psychological Support

Emotional issues during fertility treatment are common. This is in part due to the hormonal treatment administered to women during the treatment process. Generally, there are three types of psychological support couples can receive during this time.

Education support for emotional wellbeing

This can be as simple as getting the answers you need to common questions you may have. We also recommend that couples go through documentary resources on stress coping, audiovisual information of IVF processes and treatments. It is important to receive support after negative pregnancy tests, and abandoned cycles. We believe that the patient-centric care we offer helps to improve emotional wellbeing and also increases a couple’s acceptance and preparation of fertility treatments.

Support counseling

Couples who come for infertility treatment are already saddened by the fact that they have not been able to conceive naturally. Infertility is associated with anger, depression, anxiety, marital problems, sexual dysfunction, and social isolation. There is a sense of loss and social stigma that many childless couples face. We, at Xenith Advanced Fertility Clinic, understand the issues. All members of our infertility team are trained to provide emotional support. The main aim of such counseling is to help couples use their resources to cope with situations in and outside the clinic.

Professional counselors

Professional counselors can help couples address specific needs at different stages of the IVF journey. Some couples are particularly anxious because of the unfulfilled desire to get pregnant, the repeated cycles of interventions with IVF treatment, long-lasting wait that often creates frustration, disappointment that can put an additional marital, familial, and interpersonal strain on relationships.

Professional counselors are qualified and have a working knowledge of reproductive psychology and infertility. They can help couples handle complex issues, assisting couples to accept the situation and develop coping strategies. Such counselors can also help couples deal with specific issues they are facing in their marital life.

Tips for couples

IVF can impact a couple’s life in different ways – socially, financially, emotionally, and physically and all of these factors can lead to psychological issues.  Here are a few tips to help you make it through the IVF journey.

Look after your relationships.  Have open, honest communication with your partner before starting the IVF cycle so that you can be strong together throughout the procedure.  Discuss what you expect of each other during the treatment like whether you want to go together for all the appointments, what to do if you need to undergo unexpected procedures.

Find support from friends and family. It’s important to have an extended circle of support apart from your spouse. This extended circle should consist of people who understand and know you. Studies have found that a good support group can decrease stress and in turn increase positive pregnancy outcomes. (1)

Identify what causes you stress and consider ways to cope. Think about solutions to these stressors and anticipate ahead.  You and your partner may deal with stress in different ways. It is important to recognize those differences and have a good discussion with your partner. Learn to support each other and reduce conflict.

Exercise is a good way to reduce stress. Other ways to de-stress can include listening to music, relaxation tapes, meditation, and humour to lighten your mood.  Try yoga or breathing techniques to calm your mind and body.  Express your feelings in a journal if you think it helps.

Eat healthy nutritional meals, cut out smoking or excessive drinking. 

Don’t make major changes in your life like taking on a big project at work or moving to a new place or changing jobs.  Avoid anything that can add to the stress levels. 

Don’t hesitate to seek professional counseling

Everyone is different but there are some common signs that show professional psychological support may be required. Here are just a few:

• You are constantly thinking about your fertility treatment and struggling to cope with daily routines
• Strained relationships make you want to isolate yourself from others.
• You are experiencing strong feelings of guilt, anxiety, or depression
• Persistent sadness and tearfulness

At Xenith Advanced Fertility Centre, we can assure couples that they will receive the psychological support needed during any kind of infertility treatment with us. Maintaining mental health during fertility problems translates to having a calm, joyful spirit – this is really half the battle won! Let’s work together to make your experience as comfortable as possible. Visit or schedule an appointment at Xenith.

One of the hardest things couples have to deal with after IVF is a failed pregnancy. Failed IVF treatments can be painful and traumatic taking an emotional and financial toll. It is normal to feel sadness and a sense of frustration.

Possible reasons for pregnancy failure after IVF treatment

It is true that some research suggests that there is a slightly elevated risk of failed pregnancy for women who use IVF and get pregnant with a single embryo. This risk is not associated with the IVF procedure but rather with the underlying causes that have led to infertility treatment. A couple of possible reasons are described below:

Advanced age: Women who go through IVF treatment tend to be older and this in itself is associated with a higher risk of miscarriage.

Underlying health problems: Women undergoing IVF treatment are more likely to have had some previous health problems or chronic health conditions like being overweight, diabetes, or thyroid issues.

Implantation issues:  The chances that an embryo will implant in the uterine cavity even after using top-quality embryos is about 60%. This means that even after transferring good quality embryos implantation is not guaranteed. At the same time since the eggs, sperms or the endometrial lining could be compromised in patients going through IVF, these factors could also be a factor resulting in an unsuccessful pregnancy.More than one attempt at IVF may be needed for couples to conceive. However, a failed cycle causes disappointment, and here are a couple of suggestions to help you get back on track after a failed attempt.

How to take care of yourself after a failed attempt

Whatever the reasons are, couples need to take special care after a failed pregnancy. It is important that women take care of themselves after an unsuccessful attempt to ensure fast recovery of the body and mind. Here are a few tips:

Recouping physically- It is important to take a rest for the body and let menses set after all hormonal medication has been stopped.

Avoid doing very heavy work: Don’t engage in heavy-duty work that may make you overtired and strain our muscles. Avoid intense workouts at the gym to help your body recover from any physical exertion. Try some mild exercises like doing some breathing techniques or yoga which can relieve stress.

Take any medications that may have been advised: These should be taken under the doctor’s advice and at the proper time. Follow the complete course as may be advised and continue taking folic acid supplements.

Give yourself time and space to grieve: Take it slow. Some days will be better than others. Focus on getting through one day at a time. 

Let go of personal blame: Sometimes women begin blaming themselves and go through the “What if…” process thinking that could have avoided a failed pregnancy “if only they had not ….” There is no way to avoid a failed pregnancy.  Women should not blame themselves.

Seek support when ready: Talk with your partner because he might not cope with grief the same way you do.  So be open and honest with each other.  Talk to close friends or family for support or if you don’t feel comfortable talking to them, speak to a counselor or a spiritual adviser.  Join a support group because sharing with others who are also dealing with failed pregnancy might help you deal with your own sense of loss.  If feelings of depression seem prolonged or you are having trouble completing your normal routine or have trouble dealing with feelings of loss, consult your doctor, mental health provider for professional support.

Eat a healthy diet: Consume warm nourishing foods, drink lots of water and take an iron supplement or iron-rich foods and multivitamins.

Keep a journal: Some women find a sense of relief by writing in a journal. It can be thoughts, prose or even poetry — express your feelings on paper to let go of the pain. 

Listen to music: Music can be a therapy in itself and can help some women keep their spirits up.

Contact your doctor: It is best to consult your doctor to discuss what the possible reasons could have been. A detailed PreIVF evaluation and assessment to rule out conditions that may lead to failure of the IVF treatment is important and is always done at Xenith. Talking to your doctor and understanding possible causes and options will help.

What next?

Couples need to remember that one or two failed cycles don’t mean that pregnancy will never happen. A failed pregnancy can indicate that you need more time or a different treatment plan. Discuss with your doctor the next steps you need to take. You may want to ask questions like:

What could the possible reasons be?

Will another IVF cycle results in success?

What are the different treatment options open?

What are the additional tests that may be required? Coping with infertility is not easy for couples. A failed pregnancy after IVF makes it even more difficult. Xenith Advanced Fertility Clinic has some of the highest success rates for IVF treatment. With proper diagnosis and attention to detail before starting the cycle itself and using the right treatment option, we give couples a greater chance to succeed. Contact us at Xenith Advanced Healthcare to schedule an appointment.

Infertility affects millions of people of reproductive age worldwide and impacts their families and communities. Estimates suggest that between 48 million couples and 186 million individuals live with infertility globally.

For some couples, infertility issues may arise after having their first child. This is known as secondary infertility – a failure to conceive following a previous pregnancy. Clinically, infertility is a reproductive system disease defined by failing to achieve a clinical pregnancy after 12 months of regular unprotected sexual intercourse. But in the case of secondary infertility, we recommend that couples visit an infertility specialist after 6 months of unprotected sex because of the age factor. Women between the ages of 35 and 40 have the highest rate of unexplained infertility because of problems in the quality and quantity of eggs in the ovarian reserve.

Unexplained secondary infertility can have a lot of causes and this article will help you understand a few of them and the treatment options available.

What is Secondary Infertility?

Secondary infertility is the inability to conceive a child or carry a pregnancy to full term after a previous childbirth. The previous delivery must have occurred without help from fertility medications or treatments, like in vitro fertilization, to classify as secondary infertility. 

Secondary infertility is typically diagnosed after trying unsuccessfully to conceive for six months to a year. A related condition is recurrent pregnancy loss, where patients and couples can conceive but cannot carry to term.

Causes of Secondary Infertility

Infertility may be caused by several different factors in either the male or female reproductive systems. However, it is sometimes not possible to explain the causes of infertility.

In the female reproductive system, secondary infertility may be caused by:

• Tubal disorders such as blocked fallopian tubes
• Uterine infections which could be inflammatory
• Disorders of the ovaries
• Disorders of the endocrine system cause imbalances of reproductive hormones

In the male reproductive system, secondary infertility may be caused by:

• Obstruction of the reproductive tract causes dysfunctionalities in the ejection of semen
• Hormonal disorders lead to abnormalities in hormones produced by the pituitary gland, hypothalamus, and testicles.
• Testicular failure to produce sperm
• Abnormal sperm function and quality

Environmental and lifestyle factors such as smoking, excessive alcohol intake, and obesity can affect fertility. In addition, exposure to environmental pollutants and toxins can be directly toxic to gametes (eggs and sperm), resulting in their decreased numbers and poor quality, leading to infertility.

In many cases, however, the exact cause of secondary infertility cannot be determined. According to the Obstetrics and Gynaecology Reviews, “Approximately 15% to 30% of couples will be diagnosed with unexplained infertility after their diagnostic workup.”¹  Couples may be asked to take further investigations and tests to assess ovarian reserve, semen analysis, ovulation testing, imaging to assess for tubal and uterine factors before a diagnosis of unexplained infertility is made.

Treatment Options for Unexplained Secondary Infertility

Treatment for unexplained infertility can include expectant observation with timed intercourse and lifestyle changes, clomiphene citrate and intrauterine insemination (IUI), controlled ovarian hyperstimulation with IUI, and in vitro fertilization (IVF).

For Women:

• Laparoscopy

Laparoscopy, a female infertility treatment, is a key-hole surgical procedure to reconstruct reproductive organs and treat conditions like endometriosis, blocked tubes, or ovarian cysts.

• In Vitro Fertilization (IVF) 

The IVF infertility treatment involves carefully using ovarian stimulating hormones, which cause multiple follicles to grow in the ovaries to increase the number of eggs. 

• Intrauterine Insemination

IUI, Intrauterine insemination, is a relatively simple treatment that increases the number of sperm cells placed in the uterus.

• Egg Freezing

Egg preservation or freezing is a suitable option for couples who are not ready to start a family immediately but want to conceive later.

For Men

• Antibiotics for Genital Tract Infection

Antibiotics are prescribed to treat genital infections.

• ICSI (Intracytoplasmic Sperm Injection) 

This process is used in severe male infertility. Sperm is extracted surgically from the testes or epididymis. ICSI involves the injection of a single, carefully selected sperm directly into a mature egg. Xenith is the only single speciality IVF Centre in Pune, to conduct surgical sperm extraction under a high magnification microscope thus helping the couple achieve a much higher pregnancy rate.

• Microsurgical Sperm Retrieval

This procedure is conducted when men have no sperm in their semen.

• Gonadotropin Therapy

Gonadotropins are injectable fertility medications used in the infertility treatment of men. 

Unexplained Secondary Infertility Success Stories

At Xenith, we determine the optimal treatment for unexplained secondary infertility based on individual patient characteristics. Factors such as age, treatment efficacy, side effect profile, as well as cost considerations are discussed with the couple before creating a treatment plan. We have had high success rates for our patients. Here are two of our very own success stories – couples who came to us and were delighted with the treatment they received! If you have had a child and are wondering why conceiving for your second child has been so difficult, visit us at Xenith Clinic.

Unlike women who are born with all the eggs they will inside their ovaries, a man’s body creates sperm every day.  Sperm is produced in the testicles and hormones such as testosterone stimulate the production of sperm.  As per WHO guidelines, normal sperm count can range anywhere from 15 million to more than 200 million sperm count per ml of semen. Shape of sperm is also important. Sperm must also have an oval shaped head, a midpiece and a tail.  Motility is the ability of sperm to swim in a straight forward direction to reach the egg and measured as the percentage of moving sperm cells in a sample of semen.

Factors that Affect Sperm Production

In order to improve fertility, there are certain things you can try at home, some of which include eating the right diet, exercising regularly, getting enough sleep, quitting smoking, and avoiding stress amongst other things.

There are a number of factors that can affect sperm count. Some of them include certain medical conditions, genetic disorders, infections and even stress. Sometimes nutritional deficiencies can be the cause of low sperm production. Men are often able to boost their sperm quality and quantity by meeting the nutritional gap in their diet.

Which Vitamins Boost the Production of Sperm?

After consulting your doctor, include the following vitamins and supplements in your diet. Studies have shown that it may be able to boost male fertility.

Vitamin C is commonly known to boost the immune system because of its antioxidant properties.  A study has shown that taking 1000mg vitamin C twice a day for up to 2 months increased sperm motility by 60% and sperm count by more than 100%. It also increased the normal morphology of sperm cells by 67%.¹

D-aspartic acid (D-AA) is a type of amino acid present in the testicles, semen and sperm cells. D-AA levels are much lower in infertile men than fertile men and it has been shown that D-AA supplements may increase testosterone levels as well as sperm count and motility.²  

Vitamin B12 is involved in cellular energy production and is important for sperm production. It is also needed for red blood cell formation, normal functioning of the brain and nervous system and for DNA production.  Vitamin B12 is a water-soluble vitamin and many vegetarians are likely to have a dietary B12 deficiency since it is mostly found in meat, fish and dairy products.  Vegan men also receive little vitamin B12 in their diets.  Studies show that sperm count in men who have B12 deficiency may be improved with supplemental doses of Vitamin B12.³

Zinc has been shown to raise testosterone levels, promote fertility and help in muscle growth.  Zinc is found in meats, eggs, nuts, seeds, lentils, yoghurt, oats and mushrooms.  However, too much zinc in semen may damage sperm.  Studies have shown that taking zinc supplements may increase testosterone levels and sperm count in those who are low in zinc.⁴

Vitamin D is also known as the sunshine vitamin. This vitamin affects many physiological functions including male fertility.  One study found that men with higher Vitamin D levels had improved overall fertility and sperm count.  Close to 40% of Indians are vitamin D deficient even though most parts of the country get abundant sunlight throughout the year.⁵

Folic acid is a B vitamin that’s important for the development of red blood cells, DNA production and cell division.  One study found that combined supplementation of folic acid and zinc for a period of 26 weeks increased total sperm count in men.  However other studies have found no effect of taking folic acid and zinc supplements on male fertility. A natural way to get more folic acid into your diet is by regularly including green leafy vegetables.⁶

Vitamin E is an antioxidant.  A combination of antioxidants such as vitamin C, E and CoQ10 intake can improve semen parameters in infertile men according to one study.⁷

Selenium is important for normal testicular development, sperm formation, motility and function and is also an antioxidant.  There was a 52% improvement in sperm motility, morphology as well as 10% increased rate of pregnancy in a study which used selenium and Vitamin E.⁸

Botanicals and Other Nutrients that May Boost Male Fertility

Ashwagandha (Indian ginseng) is a shrub found in India and North Africa and used in Ayurvedic medicine.  It may improve male fertility by boosting testosterone levels. One study has found that Ashwagandha use caused a 53% increase in semen volume, a 57% increase in sperm motility and a 167% increase in sperm count.⁹

Shilajit is also used in Ayurvedic medicine. It is a sticky substance produced by the slow decomposition of plants and is found mainly in Himalayan rocks. In one study, a group of 60 infertile men took shilajit twice a day for 90 days after meals. More than 60 percent of the study participants showed an increase in total sperm count and more than 12 percent had an increase in sperm motility.  It can also increase testosterone levels.¹⁰

Omega 3 fatty acids are associated with male fertility because sperm contains a lot of omega-3 fatty acids and they influence sperm morphology, count, motility as well as improved antioxidant activity.  However, it takes some time for it to come into effect.  Avoid eating products with transfats like potato chips and processed baked goods which are deleterious for sperm and testosterone levels.  Try supplementing your diet with fish oils, flax seeds or walnuts.¹¹

Lycopene is a natural pigment found in many fruits and vegetables that give them their bright yellow, orange and red colors.  It is believed to improve sperm count by as much as 70%.¹²

Fenugreek extract used in a study showed that it improved testosterone levels, sexual function and sexual frequency.¹³

Coenzyme Q10 is an enzyme and is found in semen.  Higher concentrations are correlated with high sperm count and better motility.¹⁴

How long should men take vitamins to boost sperm production?

Sperm take 72-90 days to develop and most fertility experts recommend taking supplements for 90 days or longer to see the best results. Taking these supplements for 30 days can also make a difference.

Vitamins, minerals and antioxidants have been shown to improve fertility and if getting these from foods is hard, then consider taking supplements according to each individual’s deficiency.  In general, improving health will also boost fertility.  There’s no guaranteed fix but if the reason for infertility is due to nutrient deficiencies, then these tips may help.  Visit Xenith Advanced Fertility Clinic and let us help you diagnose the cause of your infertility. Things may change as you focus on a healthy diet that meets the nutritional gaps in your life. After a thorough diagnosis, the team at Xenith will offer an array of treatment options. Early diagnosis and treatment are advisable.

Human Immunodeficiency Virus (HIV) is a virus that attacks the body’s immune system, specifically the CD4 cells, which are a type of white blood cells, weakening a person’s immunity against opportunistic infections. It can be transmitted through blood (unclean needles or unscreened blood), by having unprotected sex, or from mother to baby.  

Once infected with HIV, it is there for life because there is currently no effective cure. However, with proper medical care and antiretroviral treatment, HIV can be controlled and people can live long healthy lives. The antiretroviral treatment works by decreasing the viral load or the amount of virus in the blood. About 38 million people in the world were living with HIV in 2020. Since many young HIV-infected patients are living longer and healthier lives, they can now contemplate having children.

Does HIV Infection Affect Fertility?

Fertility can be affected by HIV infection through biological and psychosocial factors. The virus affects the white blood cells and therefore can lower the body’s immunity making it prone to various other illnesses. It can also cause weight loss which in turn can result in infertility. Drug abuse may also impact fertility.

HIV in Men

In men with HIV, sperm functions like motility, morphology, and quantity are impaired along with decreased semen volume. Inflammation of the testicles and production of insufficient testosterone levels might occur in HIV-infected men leading to infertility issues. Such people also experience decreased sex drive and erectile or ejaculatory dysfunction.  

HIV in Women

Women living with HIV tend to have lower birth rates than the general population. HIV-positive women could also have some issues with their menstrual cycle where it is sometimes absent or no egg is released during ovulation. In addition, stress, a weakened immune system, weight loss, and the presence of various other sexually transmitted diseases may cause infertility in HIV-positive women. 

Using antiretrovirals before pregnancy may protect women from having a miscarriage.  

Psychosocial conditions can also affect fertility because issues like fear can decrease the frequency of sexual intercourse, and cause stress. People with HIV may have limited access to medical care in terms of reproduction, and lack the knowledge of how to conceive safely. There is also a stigma attached to being HIV positive from their community. The fear of transmitting HIV to the child could be a deterrent to fertility although with rigorous testing this can be minimized. The desire for motherhood and the decision to have a child can also be affected by family support.

Infertility Treatment for HIV Patients

Assisted reproduction options like IUI, IVF, and ICSI can serve as a blessing for people facing fertility-related issues and can be a safe choice for couples where one partner is negative and the other is positive for HIV. With the development of antiretrovirals, a growing number of HIV-positive women can opt to have safe vaginal deliveries. However, a completely separate area and unit catering to HIV positive couples needs to be considered during ART treatments to avoid the risk of contamination and transmission to other couples, though this risk is very low.

Antiretroviral therapy followed by fertility treatment can enable female HIV-positive patients who desire to become mothers to have a healthy pregnancy. To reduce the chance of infection transfer to the child, the woman is kept on medication throughout her pregnancy. Preexposure prophylaxis is an oral daily pill for people who don’t have HIV but are considered high risk to protect themselves.  

Before starting the treatment cycle, one would undergo HIV viral load test to measure the number of HIV particles present in the blood and do a blood test to look at the number of CD4 cells in the body to check the immunity. Thus, infection is minimized with the use of antiretroviral drug combinations during pregnancy, neonatal prophylaxis, elective Caesarean delivery, and avoidance of breastfeeding.  

If the male partner is HIV positive, the sperm is washed and motile sperm are separated from the rest of the ejaculation and inseminated into the egg. Sperm washing eliminates seminal plasma and the majority of immotile sperm and is then tested for the presence of HIV RNA.  A special method of sperm preparation is used for washing semen of affected men.

Hope for Those with HIV to Start a Family

In the past, pregnancy was discouraged among women living with HIV because of the risk of infecting the baby by the mother. Presently, however, this risk is negligible if the people living with HIV achieve viral suppression by taking combination antiretroviral therapy before planning pregnancy.

Evidence indicates that fertility treatments can be a safe option for couples where one or both are HIV positive, although the potential risk of viral transmission cannot be eliminated it may be safer than attempted natural conception. According to a report by WHO, the transmission rates of HIV from mother to the offspring can be reduced to below 5% with effective treatment during the cycle of pregnancy, delivery, and breastfeeding.   Feel free to contact Xenith Advanced Fertility Clinic for any questions on infertility treatment for those with HIV. We would be happy to guide you in your desire to start a family.