Why is Personalized Infertility Treatment Important?

At Xenith Advanced Fertility Clinic, we have a policy. We know that no two couples are alike in their infertility issues and therefore we offer each couple individualized or personalized infertility treatment plans. That’s because infertility can stem from a variety of causes such as age, lifestyle and issues related to the male and female reproductive system. Infertility issues can stem from disorders like diabetes, obesity, thyroid functions, or hormonal imbalance. It can be a single issue or it can be a combination of issues that can make it difficult for a couple to conceive.

Fortunately, in these modern times, the medical fraternity can now delve deeper into infertility issues thanks to advanced diagnostics, technology, and research. Many more childless couples can look forward to having a baby of their own than they could ten or twenty years ago. Personalization is now a growing trend within reproductive medicine that opens higher quality care to couples with a more individualized approach.

What Is Personalized IVF?

IVF is an expensive process and can be a physically and emotionally challenging experience for couples. Performing diagnostic tests – either some, or all – allows fertility specialists to determine the precise treatment to set couples up for the best chance of a successful cycle.

There is no one-size-fits-all approach to providing competent fertility care with consistent success rates. Personalized IVF includes tailoring treatments specific to each couple. This personalized treatment can be based on diagnostics, genetic testing, patient preferences, observed responses to treatment or specific symptoms.

At Xenith, our team will work with you to design an individual IVF protocol based on your diagnostics. We will take into consideration any financial constraints, lifestyle, need for counseling or alternative therapies, along with other factors. We are sensitive to your fertility needs, your comfort, and your personal preferences.

Personalized Fertility Assessment

The personalized infertility treatment begins with an accurate diagnosis of the root cause of infertility. Pinpointing the exact cause of why couples cannot get pregnant is the only way to treat infertility effectively. The assessment and testing process begins with a thorough medical history of each partner. This can include semen analysis, hormone tests, sperm DNA fragmentation tests, and more.

Personalized IVF Protocol

There can be a vast array of factors that impact fertility, implantation, and live birth. Some infertility issues such as tubal blockages can be treated even before a couple attempts to get pregnant. Others such as age (advanced maternal age) cannot be altered. Based on diagnostics, personalized IVF protocols can include minimal stimulation IVF and natural cycle IVF are chosen, and dose modifications are done case-to-case.

Screening for biomarkers or certain genetic signs can increase the chances of more positive outcomes.

Biomarkers are useful in determining a treatment path. Biomarkers like the anti-Mullerian hormone are used to screen for conditions like diminished ovarian reserve. Other biomarkers can help determine whether a patient is subfertile and infertile. They are useful in determining the extent of male infertility through a more detailed look at the sperm genome. Biomarkers give doctors a more definitive diagnosis of fertility issues and are useful even after pregnancy has been achieved.

Endometrial receptive array is used to determine the best timing for implantation. This is particularly useful for women who have experienced repeated implantation failures. Determining the precise time can increase the chances of implantation success.

Genetic testing of embryos is also an important part of personalized IVF treatment. The genetic testing of the embryo before implantation can help reduce the chances of miscarriages.

Benefits of a Personalized IVF Method

Approaching infertility with a highly personalized treatment plan can open up benefits for couples which can include:

  • Reduced patient physical stress
  • Reduced patient emotional stress
  • Reduced patient financial stress
  • Offers the highest chances of pregnancy
  • Produces the best overall patient trust
  • Produces the best overall patient satisfaction

IVF Success Rate in India

Due to more advanced screening and personalized IVF treatment plans, IVF success rates in India have been rising. India is now among the top five countries with the most IVF success rates, making it a prime destination for anyone considering undergoing fertility treatments. Xenith Advanced Infertility Clinic is your one-stop infertility clinic. We have everything you need under one roof right from advanced diagnostics to our own state-of-the-art IVF lab. If you are having problems conceiving, you can be sure you will receive the best infertility treatment at Xenith. We’ve quite friendly, too. Schedule a consultation.

PCOS and Infertility

PCOS is short for polycystic ovarian syndrome. It is a common disorder affecting 1 in 10 women who are of childbearing age. PCOS is usually caused by reproductive hormonal imbalances and problems with metabolism. Not only can PCOS affect the overall health and appearance of a woman due to hormonal imbalances, it is known to be one of the leading causes of infertility among women.

Symptoms of PCOS

How do you know you may have PCOS? Are there any tell-tale signs? There may not be any signs for women who are using contraceptive pills. The pill can make you have a period every month but it can be a false period because it is not related to egg production. Therefore, the pill can mask the condition for many years.

If you are not on the pill, women who are likely to have PCOS will show some of the symptoms mentioned below:

  • Missed or irregular menstrual periods
  • Higher level of male hormones can show as more facial or body hair
  • Acne or oily skin
  • Thinning hair on scalp resembling male pattern baldness
  • Unexplainable rapid weight gain and difficulty losing that weight

Symptoms can vary from women to women. Some experience more severe symptoms while for others, the symptoms are mild and may not be noticeable.

However, the only sure way to know that you have PCOS is to get a test done under the supervision of a doctor. The doctor may request a transvaginal scan that sends a probe inside the pelvis to enable a view of the ovaries. Other blood tests may be ordered such as thyroid, prolactin and metabolic workup.

PCOS can make it tough to get pregnant… treatment can help

It is possible for women who have PCOS to get pregnant. But with that said, most women will need the help of a fertility specialist. Because cases vary and different treatments have different outcomes, treatment for PCOS is individualized and depends on a number of factors such as weight, health of the ovaries, severity of anovulation, and more.

Something to keep in mind: Fertility tends to decline with age so if you are over 30 years of age, we would recommend you seek the assistance at Xenith Advanced Fertility Clinic, sooner rather than later.

The good news for women with PCOS is that with treatment the chances of getting pregnant are very good. Here are a few treatments options:

The first line of treatment usually involves making lifestyle changes. This can include following a healthy diet, getting adequate exercise and taking folic acid supplements.  By a good diet we mean low-carb, low-sugar, adequate amount of protein, and high in fibre. Load up on fruits, vegetables, and whole grains. Get at least 30 minutes of moderate exercise daily or at least 3 times per week.  About 70% of women who have PCOS may struggle with insulin resistance so it is important than you maintain a low glycemic diet leaning toward more protein than carbohydrates.1

Experts say that by losing 10% of your body weight your menstrual cycle may become more predictable. This first line of treatment alone may help your body to start ovulating, increasing your chances of getting pregnant.

Fertility medication can assist women with PCOS. Clomifene citrate or letrozole is the standard medication to start with. It stimulates the ovaries to release eggs.  Gonadotropins may be used as the next step to stimulate egg production. The effect of both these medications are closely monitored by ultrasound and at times blood tests to determine hormone levels and to make sure that the ovaries are not being overstimulated. Metformin may be prescribed to control sugar levels. Medication along with lifestyle changes can increase your chances of having a baby.

Laparoscopic ovarian drilling can restore ovulation but it is important that it is done only in indicated patients. This helps to decrease the excess of testosterone being produced in the ovarian stroma helping to restore hormonal balance.

Ovarian stimulation with IUI (Intrauterine Insemination )- An intrauterine insemination is done after good ovarian stimulation or combined if an additional mild male factor is present.

In vitro fertilization (IVF) can help achieve pregnancy. This is the last option we would recommend if none of the above procedures work.In this process, after ovarian stimulation eggs are retrieved from the ovaries, fertilized with the partner’s sperm in an IVF lab, and then transferred into the uterus.

Early diagnosis of PCOS can lead to early treatment. Your chances of getting pregnant become a lot higher when it is diagnosed well in time. If you suspect you may have PCOS, visit us at Xenith Advanced Fertility Centre. Our friendly environment as well as the experience and expertise of our medical staff will put you at ease as we work with you to fulfill your dreams!

Signs of Infertility in Men

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

The essentials men need to achieve pregnancy

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

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

What could cause male infertility?

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

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

What are the signs or symptoms of infertility in men?

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

Pain and swelling in the testicles

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

Ejaculation and orgasm problems

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

Low sexual desire

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

Being overweight or obese

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

Smaller-sized testicles

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

Undescended testicle

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

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

Best Season for an IVF Treatment

Is summer the best season for IVF treatment? It is true that some research studies have shown that summer is the best time for IVF cycles. However, these studies were conducted in countries where there are distinct seasons – summer, winter, spring, and autumn. In India we have plenty of sunshine in most parts of the country, all year round. 😊

Here are a few reasons why some (not all) studies have suggested that summer may be the best season for IVF treatment.

Vitamin D production increases in summer

Vitamin D is called the sunshine vitamin because sunlight aids in Vitamin D production.  Vitamin D maintains the body’s calcium levels and also increases immunity but a little-known fact is that having Vitamin D sufficiency could help improve the chances of Assisted Reproductive Therapy (ART), according to a study published in Reproductive Health (July 2019).1 

In India, a large population of women are Vitamin D deficient despite the sun shining on us practically the whole year. An August 2019 article in India Today, revealed a study that showed “70-90% of Indians including 88% urban Mumbaikars are Vitamin D deficient. It also showed that pregnant women in India have up to 84 percent Vitamin D deficiency.”2 

Melatonin production increases in summer

Melatonin is a neurohormone that plays an important role in the circadian rhythm or sleep cycle.  It also has anti-inflammatory and anti-oxidative properties.  Its secretion is stimulated by darkness and inhibited by light.  According to research, melatonin regulates fertility in women and shown to prime the fertility of women apart from determining their sleep-wake cycle.3 

A study featured in the January 2021 issue of Frontiers in Bioscience Research suggests that “melatonin improves the egg quality and increases the chance of success of in vitro fertilization (IVF).” Melatonin may directly act on the reproductive tissues leading to increased fertility in women.4 

The best season concept for IVF treatment is more likely a myth

The success rate for IVF depends on various factors like age of both the male and female patient, egg and sperm quality, cause of infertility among various other reasons. 

A study published in the Public Library of Science (July 2018) states, “It might be speculated that the complete pharmaceutical control of the ovarian and endometrial function, as well as the homogeneous treatments, procedures and laboratory equipment used during the study period have lowered the influence of seasonal effect on IVF treatment outcome.”5

Scientists in China conducted a study of both IVF and ICSI cycles, as well as fresh and frozen transfers in 38,476 patients undergoing IVF/FET between 2014 and 2017. The study was designed to seek an answer to the question: Do seasonal variations have an impact on IVF outcome? They came to the conclusion that there was no significant difference of seasonal variations in the outcome of IVF with fresh embryo transfer and frozen embryo transfer.6

We encourage women undergoing IVF treatment to maintain a healthy weight by eating well-balanced meals along with at least 30 minutes of moderate exercise daily, using prenatal multivitamins and supplements which include folic acid and Vitamin D, getting enough sleep each night, avoiding chemical products, reducing stress, quitting smoking, drinking alcohol in moderation and partnering with excellent fertility specialists at Xenith Advanced Fertility Clinic. It seems like quite a to-do list but our motto is do what you can, don’t stress out!

What is the best season for IVF treatment?

There is no best season to have babies! While IVF technology helps in bringing the sperm and egg together for conception, conception  still remains a mystical process. Couples who have not been able to get pregnant now have a greater possibility with advanced science to get pregnant but while the success rate is high, the entire process is still a mystery in many ways. 

The IVF cycle can be done any time. In fact, we recommend that you do not wait for any particular season thinking it might bring you success. Age is an important factor to consider in IVF success outcomes and the sooner you start treatment the more likely it is to succeed. Statistics show that women under 35 have higher success IVF rates.

The success rate for IVF in India averages around 45-48%. More advanced reproductive techniques and technologies continue to raise the success rates each year, and these success rates are independent of seasonal variations. At Xenith Advanced Fertility Clinic, we’ve IVF success rates up to 75%. Contact us at Xenith today if you don’t know why you are unable to conceive after trying for more than 6 months. We can help you make your dreams come true in any season!

Signs of Infertility in Women

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

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

1. Irregular menstrual cycles

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

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

2. Intense cramps and pain during your period

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

3. Sudden weight gain

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

4. Excessive hair growth

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

5. Hair loss

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

6. Severe acne breakout

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

7.  Bleeding between periods or after intercourse

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

8. Pain in the pelvic area

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

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

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

Low Sperm Count: Symptoms, Causes, and Treatment

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

What exactly is oligospermia or low sperm count?

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

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

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

What can cause low sperm count?

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

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

Symptoms of Low Sperm Count

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

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

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

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

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

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

What is the  treatment for low sperm count?

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

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

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

Things to Know About Blocked Fallopian Tubes

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

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

What could go wrong with the fallopian tubes?

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

What are the different causes of blocked fallopian tubes?

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

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

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

How do you know if your fallopian tubes are blocked?

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

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

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

How do blocked fallopian tubes get diagnosed?

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

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

What is the treatment for blocked fallopian tubes?

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

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

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

What Is Fibroid Surgery and When Is It Required?

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

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

Why do fibroids grow?

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

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

How do I know if I have fibroids?

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

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

Sometimes, fibroids can be the cause of infertility.

How do I know for sure if I have fibroids?

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

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

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

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

What are the treatment options for fibroids?

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

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

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

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

Some other treatments available but not very commonly used are

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

Fibroids and Infertility-

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

The Best Time to Freeze Your Eggs

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

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

Why would you freeze your eggs?

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

Medical reasons

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

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

Personal reasons

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

Recommended during IVF cycles

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

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

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

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

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

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

When is the best time to freeze your eggs?

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

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

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

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

Women need to be informed about this option

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

It’s important to remember

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

Diabetes and Its Impact on Fertility & Reproductive Health

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

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

First, what exactly is diabetes?

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

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

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

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

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

Diabetes and Male Fertility

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

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

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

Diabetes and Female Fertility

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

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

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

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

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

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

How can diabetics prepare for IVF treatment?

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

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