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The two-week wait after IVF is the time period between the day of embryo transfer and the day to find out if you are pregnant.  The IVF treatment itself was packed full with appointments with the doctor, ultrasounds, and taking hormonal injections. Also, other medications to be taken at set schedules, and undergoing procedures finishing with the embryo transfer. Then the 2 week wait being the culmination of all that hard work to see if it has all paid off.  Thus, this nail biting wait time can be filled with anxiety, doubts and fears which can in itself take an emotional toll on you. How do you deal with the wracked nerves along with the countless worries that continue to keep popping up in your mind during this period?

Tips to Overcome Anxiety During IVF Treatment

Here are some things which may help.

1. Try not to overthink any possible pregnancy symptoms. Sometimes even a small twinge in your body may make you very hopeful that you are pregnant or it may make you nervous that you have not had the implantation.  Try not to obsess over every symptom you feel.  Many of the so called “pregnancy symptoms” could be caused by hormones that are present during this time as well as the stimulation medications given throughout the IVF treatment especially if you have had a fresh embryo transfer rather than a frozen embryo transfer. 

Some of these symptoms can include cramps, slight twinges, breast tenderness, bloating and feeling very tired. Such symptoms are very common in pregnancy, but could also be the side effects of the progesterone treatment used to prepare your uterus lining for implantation.

Mild cramping and pelvic discomfort are very common symptoms during this time due to the various medications and the egg retrieval procedure itself and it doesn’t mean one way or the other that you are or are not pregnant. Light spotting is also relatively common after egg retrieval and embryo transfer.   Sometimes, spotting occurs due to the embryo implanting into the uterine wall. However, you should report any unusual bleeding to your doctor.  Also, many women do not have any symptoms at all when they are pregnant during this time. 

So do not read too much into anything, but rather take medications in time and stay positive.

• Keep yourself busy. in order to not dwell on any worries or negative thoughts.  It might help to have a goal in mind for what you want to achieve in 2 weeks.  Go out and relax with your friends, watch a movie, listen to music, read, take up a new hobby, clean out your closet, do a two-week course in something you are interested in, are all examples of things you can do.
• If you must, set aside only some “worry time”. If thoughts do come, breathe through the feeling and give yourself some time to feel it for a specific amount of time.  After this set amount of time has passed, you might feel relieved and be able to continue your other activities without worrying or being anxious.  
• Get support. You will need support from people close to you like your partner, friends or family or a therapist.  Discuss with your partner beforehand how to handle the news if you aren’t pregnant so that you have a set plan.
• Coping with emotions: Try to relax. Use techniques like yoga, breathing exercise, meditation, going for a walk or anything else that you know will relax you.  Try writing in a journal to sort out your thoughts.
• Know that you don’t have to walk on eggshells. Don’t feel that a hard sneeze, cough, laughing too hard, going to the bathroom or other things will dislodge your embryo once its implanted.
• Don’t test too early. Pregnancy tests work by measuring the levels of the hormone human chorionic gonadotrophin (hCG) in the urine or blood.  The embryo begins to release hCG hormone when you become pregnant.  However, during IVF treatment, before the eggs are retrieved, a trigger injection is given about 36 hours before the egg retrieval in order to mature the eggs.  This trigger injection has hCG and if you test too early, you can get a false positive.

These are some suggestions on how to deal with anxiety during the IVF two-week wait period.  It is important to be emotionally stable and calm throughout the whole IVF treatment especially near the end for positive outcome.  If you need some advice on how to go about this, feel free to talk to the fertility specialists in Pune at Xenith Advanced Fertility Centre.

After having had your first child, you may think that conceiving the next child will happen as easily.  But in some cases, this may not be true. Secondary infertility occurs when you are not able to conceive or carry a baby to full term after having at least one child. 

Secondary infertility shares many of the same characteristics as primary infertility which happens when couples have not able to conceive after trying for at least one year if you’re under 35 years of age, and after six months if you are older than 35. To be deemed as secondary infertility, the previous birth should have happened without the aid of fertility medications or other treatments like In Vitro Fertilization (IVF). 

Causes of secondary infertility

Secondary infertility could be due to issues with either or both partners. Here are a few of the common reasons why couples may experience secondary infertility:

∙       Age can affect the quality or quantity of available eggs because women are born with a limited supply of eggs.  As women get older, the number of eggs, as well as the quality of eggs, decrease. This is also true with men where sperm motility and sperm quality decrease with advancing age.

∙       Problems with the uterus. A previous Cesarean delivery can sometimes cause adhesions.  Adhesions form during post-surgery healing and consist of fibrous scar tissue that often abnormally connects to internal organs like the uterus.  Scarring could also occur due to dilation and curettage procedure done to remove tissue from inside the uterus to treat some uterine conditions or after a miscarriage.  It could also be due to the growth of fibroids or polyps inside the uterus can impair pregnancy.  

∙       Pelvic infections can block a fallopian tube preventing the egg and sperm from meeting.

∙       Endometriosis is a condition where tissue that normally grows inside the uterus grows somewhere else in the body like the ovaries or bowel surfaces.

∙       Polycystic Ovarian Syndrome (PCOS) is a hormonal disorder causing irregular menstrual periods.  A woman with this condition has an excessive male hormones and the ovaries fail to release eggs regularly.

∙       Weight problems. Being overweight as well as underweight can affect fertility.

∙       Stress can be one of the factors leading to infertility. 

Treatment options for secondary infertility

In order to assess the situation, the doctor may talk to you first about your current health, your medical history, and if anything has changed from your previous pregnancy.  They might then run some blood tests, and semen analysis, do a pelvic exam, carry out an X-ray to check for blocked fallopian tubes, and have a transvaginal ultrasound.  The main goal is to rule out any other male or female infertility issues.

Based on these results, a customized treatment is recommended which may include:

Medications. Oral or injectable fertility medications are prescribed to induce ovulation in women with an ovulatory disorder and normalize hormone levels.  Fertility-enhancing medications could also be used to help stimulate ovulation.  With more eggs available for fertilization per cycle, the hope is that at least one will result in a pregnancy.  

Surgery. If there is a physiological problem, doctors may recommend surgery. Surgery can be carried out on patients to repair uterine-related issues like the removal of fibroids, polyps, or scar tissue or on patients dealing with advanced endometriosis.  Surgery can also be done to repair testicular varicocele in men.

Advanced reproductive technology (ART). Intrauterine insemination (IUI) and In Vitro Fertilization (IVF) may be recommended as a treatment when other options have failed.

IUI is a procedure in which washed and concentrated sperm are placed directly into the uterus around the same time that the ovary releases an egg. This can increase the chance of fertilization as sperm need to travel less to reach the egg.

IVF is a more complicated procedure involving the removal of one or more eggs from a woman’s ovaries, allowing the sperm to fertilize it in a lab setting, and transferring the resulting embryo back into the uterus for implantation.

How to cope with secondary infertility

Coping with secondary infertility can take an emotional toll on a couple. It is often difficult for couples to understand why they are not able to conceive when the first pregnancy was non-problematic. It could also be tough with lots of doctor’s appointments, tests, and medications as well as time away from the other child. Staying positive will be a great benefit to couples struggling with secondary infertility. Avoid placing the blame on yourself or others.  Focus on things you can control like self-care, managing stress, having a support group, and living a healthy lifestyle.  Don’t put off getting help for secondary infertility. Usually, couples are older and the golden years of fertility may slip by. If you have concerns that you may be experiencing secondary infertility, get a full check-up done at Xenith Advanced Fertility Centre. We have helped hundreds of couples with infertility issues achieve their dreams to grow their family!

Polycystic ovary syndrome (PCOS) is a disorder of the endocrine system in women. It can lead to an imbalance in hormones which, in turn, may have implications on the metabolic, reproductive and psychological systems. 

Why is it sometimes difficult to get pregnant when you have PCOS?

The endocrine system is a set of glands and organs that regulate certain processes in the body using hormones which are chemical messengers that move through the bloodstream.  Due to the imbalance, the ovaries produce higher levels of androgens (male hormones like testosterone) than normal which then interferes with the development of the egg and its release.  Some of these unreleased eggs develop into cysts, which are little fluid filled sacs. Instead of being released during ovulation, these cysts build up in the ovaries which may even get enlarged and also could lead to irregularity in ovulation. 

How is PCOS diagnosed?

PCOS diagnosis, as per Rotterdam criteria, is characterized by two or more of the following: irregular or no menstrual periods, hyperandrogenism (excess of male hormones) and polycystic (multiple cysts) ovaries.  Some of the symptoms of PCOS may include irregular menstrual cycles, too much hair on face, chin, chest or other parts of the body where men usually have hair (hirsutism), acne, male pattern baldness, weight gain, darkening of skin along neck creases, in the groin and underneath breasts and presence of skin tags.

A pelvic exam, blood test for hormone levels, and an ultrasound can help diagnose PCOS.  PCOS affects each person differently and sometimes one may find out they have PCOS only after they have been unable to become pregnant.  There’s no cure for PCOS, but the symptoms could be managed by making some lifestyle changes which is something you can tackle yourself.

The Importance of Diet for Women with PCOS

Women with PCOS have been found to have a higher rate of weight gain and are more prone to obesity compared to women without PCOS.¹ Thus, it can be more challenging for women with PCOS to lose weight. 

Also, many women with PCOS have insulin resistance.  Insulin which is produced by the pancreas allows the body to use glucose for energy and helps balance the sugar levels in your body.  When the body doesn’t respond well to insulin due to insulin resistance, even more insulin is produced to compensate and this can in turn lead to weight gain and become more prone to diabetes. 

High fiber foods can deal with insulin resistance by slowing down digestion and reducing the effect of sugar on the blood.  High fiber foods include green leafy vegetables, beans and lentils, sweet potatoes, almonds and whole grains.

Avoid high sugar foods and foods high in refined carbohydrates like white bread, pasta, cakes, sugary snacks and drinks, fast foods, fried foods and processed meats. 

Research has shown that chronic inflammation is common in women with PCOS.²  Anti-inflammatory foods include fish high in fatty acids, tomatoes, berries, dark chocolate, olive oil as well as spices like turmeric.  The Mediterranean diet emphasizes a high intake of vegetables, fruits, seafood, legumes, nuts, whole grains fermented dairy like yoghurt and olive oil. It is low in saturated fat and rich in other components like vitamins and minerals, unsaturated fatty acids and other compounds with antioxidant and anti-inflammatory properties as well as low glycemic index for regulating glucose metabolism.  It was found in one study that a Mediterranean diet combined with a low carbohydrate diet was an effective treatment for overweight PCOS patients.³ In India, an equivalent of a Mediterranean diet can be formulated by a nutritionist depending on the food you typically eat. Speak to one of our nutritionists for a recommendation on an eating plan right for your individual needs.

Exercise and Fitness

Exercisehas a positive effect on polycystic ovary syndrome.  It not only helps with weight loss but may also reduce the testosterone concentration in your blood.  Researchers say vigorous exercise has the highest impact on body mass index (BMI), fitness and insulin resistance in women with PCOS.  At least 120 minutes of vigorous intensity exercise each week is recommended.⁴  The best type of exercise is one that you will do regularly like brisk walking, biking, swimming, running and more.  Gentle low impact exercises like yoga, or Pilates can be practiced for longer durations.  Talk to your doctor about what type of exercise would be the best for you.

Don’t underestimate the rest you need

Sleep can affect your stress levels and can help balance your hormone levels.  Sleep disturbances are twice as common for women with PCOS.⁵ Aim for 8-10 hours of sleep, establish a regular bedtime routine and avoid stimulants and rich fatty foods before bedtime. 

Stress reduction and emotional well-being

Mind body exercises can help to reduce stress, improve your mental health and calm your mind with techniques like yoga, tai chi, Pilates and meditation.  Women with PCOS are sometimes dealing with depression and anxiety maybe due to feelings of helplessness or other factors.  It helps to talk to a professional or have a support group to deal with this.  Take time out for walks and learn how to relax. 

Watch out for chemicals in your food

Avoid endocrine disruptors which are chemicals or ingredients that interfere with or block your body’s natural hormonal reactions.  They can mimic female and male sex hormones causing confusion in your reproductive system which may increase your risk of PCOS symptoms.  They are often found in canned foods, soaps, makeup, pesticides, and bisphenol A(BPA).⁶ The International PCOS Guideline 2018 strongly recommends healthy eating and physical activity in women with PCOS to improve general health and quality of life.  If you have any questions about PCOS and how to combat it, feel free to contact the fertility specialists at Xenith Advanced Fertility

Cigarette smoking has been associated with many health risks impacting respiratory and cardiovascular health. 

While there are 600 ingredients that can be used in cigarettes, when burned, they produce over 7,000 chemical compounds of which at least 69 are carcinogenic¹.  The three major ingredients of a cigarette are tar (which coats your lungs), nicotine (which is highly addictive, causes a rush of adrenaline and makes you feel less hungry) and carbon monoxide (which is a by-product of burning cigarettes and is highly poisonous because it tries to replace oxygen).

But did you know that it is also detrimental to your reproductive health and may have an impact on our ability to conceive? Infertility is defined as the inability to conceive following 12 months of regular, unprotected sex if you are 35 years old or younger or following 6 months if you are older than 35.

Smoking affects fertility in both men and women. Here’s how.

Effects of smoking on men

A study found that cigarette smokers had lower semen volumes, sperm counts and motility as well as DNA damage in sperm compared to men who did not smoke.  Also, it was found that it is dose dependent or it gets more worse the more cigarettes you smoke per day.  The study found that men who smoked more than 20 cigarettes per day had a 19% decrease in sperm concentration compared with non-smokers.^2-3  Many other studies have also found similar results.  Smoking may also reduce the success of assisted reproduction techniques such as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). 

Paternal smoking could also expose the mother to second hand smoke which can also in turn affect her fertility.⁴ Second hand smoke is the smoke that one exhales as well as the smoke made by the lit cigarette.  Second hand smoke has more than 4,000 irritants, toxins and substances that cause cancer.  Since lot of the second-hand smoke is invisible and odourless, it can still affect the people around you to breathe in all these toxins. 

Smoking can also cause erectile dysfunction which is defined as the inability to maintain an erection for sexual performance. Cigarette smoke affects the blood flow needed for an erection, and smoking interferes with the healthy function of blood vessels in erectile tissue.⁵

Effects of smoking on women

Women who smoke don’t conceive as quickly and infertility rates are about double in smokers as compared to non-smokers.  When conception does occur, the likelihood of giving birth to a low-birth weight baby is higher for smokers. Smoking before and during pregnancy also increases miscarriage rates as well as birth defect rates (like Down syndrome), as smoking increases the chance for an egg to have chromosomal abnormalities.

Fertility treatments like IVF are still not able to bypass the effects of smoking.  Women undergoing assisted reproduction treatment and who smoked during their treatment cycle had approximately a 50% reduction in implantation rate of the embryo in the uterus and ongoing pregnancy rate compared with women who had never smoked.⁶ Female smokers need more ovary-stimulating medications during IVF and still have fewer eggs at retrieval time.

They also found that increasing the number of cigarettes smoked per day led to more issues with fertility.

Chemicals in cigarette smoke can also speed up the number of eggs lost and since each woman is born with only a limited number of eggs, they cannot be replaced.  Due to this, menopause can occur 1 to 4 years earlier in women who smoke compared with non-smokers leading to a smaller window of opportunity for conception.⁷

Ectopic pregnancies and preterm labor can also occur more often among female smokers. Ectopic pregnancy is a condition in which the fertilized egg fails to move to the uterus for implantation and instead attaches to other organs outside the womb leading to fetal death and puts the mother at high risk.  Each stage of reproductive function is targeted by components of cigarette smoke:

• Folliculogenesis (maturations of the follicle)
• Embryo transport
• Endometrial receptivity (how well the endometrium will allow for embryo implantation)
• Endometrial angiogenesis (formation of new blood vessels)
• Uterine blood flow and various other processes

Smokers vs. non-smokers: However, women who quit smoking before their treatment cycle had the same pregnancy rate as non-smokers. This is why some health professionals recommend you try to stop smoking about two to three months before trying to conceive to get the full benefits of quitting.  For optimal results for conception,  it is recommended that you have a cigarette smoking cessation plan and cut out smoking from your life. If you need help with how to do this or what to do, please feel free to contact the fertility specialists in Pune at Xenith Advanced Fertility Clinic – either at our centre in Wakad or Koregaon Park.

Everyone knows about the importance of nutrition during pregnancy.  But a healthy diet can also be beneficial for conception.  Even if we eat the healthiest of meals, our food will likely fall short of several crucial vitamins that are important for the various stages of conception all the way through to pregnancy and giving birth.  The role of vitamins and fertility is complicated to understand because each person’s body is unique and may require different needs.

What are vitamins and fertility supplements?

Vitamins are organic substances needed in small amounts by the body for normal growth and metabolism.  Multivitamins may contain several vitamins along with supplements of minerals, herbs, amino acids, and fatty acids depending on their purpose. 

Fertility supplements contain micronutrients which include vitamins, minerals, and other micronutrients that the body needs in small amounts that may help people increase their chances of pregnancy.  Fertility supplements like nutritional supplements are not regulated and that means no one is keeping track of the content in those supplements and there might not be much scientific research or factual evidence backing their claim. 

Prenatal vitamins are taken during pregnancy to support the growth and development of the fetus and the mom.  They don’t necessarily improve fertility but they are recommended for IVF patients because it’s best to start them about 3 months prior to pregnancy. Women who have found it hard to conceive are reported to have lower than recommended levels of certain micronutrients. Taking a prenatal vitamin at least one month before conception helps because it may take time for the vitamins and minerals to get to optimal levels in your body.  Make sure the purchased vitamins are from a reputed pharma company.

The most effective way to support fertility is to accurately analyze which nutrients you are deficient in and optimize those levels specifically for you.  It is best to consult with your doctor before taking any vitamins or supplements for your own safety to avoid any adverse reactions with other medications you might be taking and get their advice. 

List of vitamins and minerals that may aid in female fertility

1)      Folic acid, also called vitamin B9 is needed for the development of red blood cells and DNA production.  Folate is the natural form of the B9 vitamin in food and folic acid is the synthetic form.  It also plays an important role in cell division.  Studies found adequate folate levels are important for oocyte quality, maturation, fertilization, and implantation. Females who consume folic acid had fewer issues with ovulation, conceive faster, and may increase the chances of live birth when using assisted reproductive technology.^1,2,3 Take it at least a month before conception to support fetal neural tube(brain and spine) development.  For women trying to conceive, the recommended intake is 400 micrograms daily.

2)      Vitamin B12, also known as cobalamin helps in the proper functioning of the brain and nervous system and for forming red blood cells and producing the genetic components DNA and RNA of the egg as well as the sperm.  Deficiency can lead to anemia, infertility, higher chances of fetal loss and could possibly contribute to abnormal ovulation, disruption in cell division, impaired development of egg, and implantation issues.  The recommended dosage is 2.4 micrograms daily.

3)      Omega 3 fatty acids are found in fish, vegetable oils, nuts, and leafy vegetables.  Fish oil-omega3 fatty acids have been shown to improve female fertility, and egg quality.  They are an important part of cell membranes and for preventing heart disease.  In one study, women taking omega 3 supplements were 1.5 more likely to conceive compared with those not taking omega 3 supplements.⁴ However other studies have found no change in fertility.  So more research needs to be carried out.  Consider taking 1000mg of omega 3 fatty acids daily.

4)      Coenzyme Q10 is an antioxidant and was found to increase fertility, especially for women over 40.  It optimizes egg quality, thickens uterine lining, and improved fertility rates for women with PCOS.  It plays important role in energy production inside cells.  Its levels decline with age and this is thought to contribute to poorer egg quality.   A study of infertile women undergoing ART indicates that CoQ10 supplementation increases clinical pregnancy rates.   However, more studies need to be done to prove this theory.⁵

5)      Vitamin D is also called the sunshine vitamin.  Its role is to keep bones healthy and strong by helping the body absorb calcium.  Vitamin D deficiency has been found to lead to reduced fertility and higher Vitamin D levels were associated with IVF success.  However, more research needs to be done to confirm these findings.⁶ Vitamins and micronutrients have a positive impact on fertility.  Many supplements claim they promote natural fertility, improve ovulatory performance or improve your pregnancy chances. But that evidence might not exist and can bring a false sense of hope. So, before you take any supplements or vitamins, consult with your doctor about their implications on your fertility and health. The fertility specialists in Pune at Xenith Advanced Fertility Centre are more than willing to answer any questions you might have about vitamin supplementation for fertility. Xenith is the best fertility clinic in Pune with a high success rate for couples who have been trying to have a baby but have not succeeded.

Stress can be defined as any type of change that causes physical, emotional, or psychological strain or tension.  Everyone experiences stress to some degree or other and the way we respond to it can affect us in various ways.  Stress can be short term or long term or it could be experienced in low, moderate or high levels.  Some common signs of stress include mood swings, difficulty sleeping, digestive problems, headaches, racing heartbeat, and low energy amongst other things. 

The relationship between stress and infertility has been debated for years. Anyone who is dealing with infertility is tired of hearing “Just relax and it will happen automatically.”

Relationship between infertility and stress

Research suggests that infertility can lead to anxiety and stress.¹ Many studies have been carried out to see if stress can lead to infertility but are inconclusive because of the complexity of this kind of study.^2,3 During extremely stressful situations, anything that isn’t needed for survival shuts down which includes the reproductive system, and it could lead to irregular or absent periods.  Stress can also affect implantation in the uterine lining.  Stress in males can also reduce sperm quantity and quality.

Stress can also affect fertility negatively in indirect ways.  In trying to cope with stress, one could lead to smoking or drinking too much alcohol or caffeine.  It could affect one’s sex drive or cause you to eat unhealthy or copious amounts of food. Stress could deter you from exercising or prod you to exercise too much or affect your sleep patterns.  Each of these things, in turn can affect fertility.  Each person also reacts to stress differently which could also affect fertility. 

Eliminating things that cause stress before trying to become pregnant might shorten the time needed to conceive.  Women will know which stress reduction strategy works best for them because it’s not a one size fits all strategy. Improved mental health and learning how to cope with stress can help the fertility process.

How to deal with stress due to infertility

1. Educate yourself. Understand and learn about infertility and its effects.  Talk to your doctor about what to do and how to cope.  Be aware of what stresses you and recognize the signs in yourself and how you deal with it.
2. Improve your work-life balance. Work from home has caused stress levels to rise as both partners struggle to integrate work and responsibilities at home. Most people end up spending more time on their job leaving little time for work-life balance.
3. Speak frankly with your partner, close family, friend, an infertility support group, or a therapist about your feelings.  Keep your communication lines open and don’t isolate yourself.
4. Keep your body healthy. Eat well balanced, healthy meals like our elders used to eat before fast food came along! 
5. Engage in moderate exercise for at least 30 minutes like walking or any exercise you enjoy to get your heart rate up.  Get enough sleep.
6. Learn to relax by listening to music or motivational talks, expressive writing, going to the spa, practice yoga and deep breathing and meditation.  Learn to turn off your negative thoughts and self-blame and appreciate all the positive things in your life. 
7. Make sex fun. After long periods of not being able to conceive, sex might seem more like work and monotonous.  You can take a break or try different things to make it more interesting.

So even though, how stress affects fertility is not yet fully understood but being aware of what causes you stress and learning how to deal with it will bring about the best outcome for you.  If you have questions about how to deal with stress while trying to conceive or have issues with infertility, feel free to contact Xenith Advanced Fertility center for answers to any questions you might have.

Trying to conceive can sometimes be a stressful and disheartening process especially if even after a year of trying there has been no success.  It often leads couples to look at natural ways to improve the chances of conception like trying to go on a diet to attain optimal weight, exercise, quitting smoking or drinking, cutting back on caffeine, trying to decrease stress and other ways. 

Couples suffering from infertility can be vulnerable and are sometimes willing to try many things in order to have a baby.  One of the things couples might consider is a fertility massage. Before trying it out, couples should do a good amount of research to know what the benefits of a fertility massage are and also protect themselves from any misleading. 

What is a fertility massage to get pregnant?

In general, a massage is a term for pressing, rubbing, and manipulating the skin, muscles, tendons, and ligaments in order to provide relaxation or for therapeutic purposes.  It can range from light stroking to deep pressure on specific parts of the body. 

A fertility massage is a type of massage that is aimed at improving the fertility and health of the reproductive organs.  It is all natural with supposed benefits that include improved abdominal health, reproductive health and menstrual cycle.  A fertility massage may include a deep tissue massage of the abdomen intended to increase circulation which, in turn, is considered to boost fertility.

There are different types of massages some of which include the use of certain acupressure points around the feet called reflexology to benefit the organs.  A Swedish massage involves actions like kneading, tapping and rolling to energize the body. A self-fertility massage is a type of massage you give yourself and is intended to boost fertility.

Benefits of a Fertility Massage

1. Decrease stress and increase relaxation. Studies show that massages may decrease the levels of stress hormones like cortisol in the body while increasing dopamine and serotonin levels, which are thought to improve mood and well-being.¹ In women, stress can increase the cortisol levels which then inhibits estradiol production which in turn leads to deterioration of the egg quality. Stress may also reduce uterus blood flow and it can lead to miscarriage.  In men, stress and anxiety can lower the number and motility of sperm in semen as well as percentage of normally shaped sperm.
2. Hormonal balance. A regular massage could improve blood flow to the organs and deliver the hormones present in the blood to its destination.  It is also thought to release the feel-good hormones like oxytocin which may lead to a healthy hormonal balance.
3. Improved circulation. When you increase the blood flow and improve circulation, more oxygenated blood will get to the tissues.  This is supposedly good for successful egg transfer during IVF and for endometrial lining.
4. Reduce pain and muscle soreness. The release of endorphins which are natural pain killers and also lessen painful periods.  It can help people with headaches, muscle pain, sports injuries, and back pain.

There is good evidence that stress can affect the reproductive system and thus the ability to conceive and it can affect both men and women.^2-3 A massage could reduce stress and make you more relaxed which can help you conceive because women dealing with infertility often are more stressed and anxious.  Fertility issues often involve multiple factors of which stress is just one aspect. 

Massages shouldn’t be painful and beware of any overly deep abdominal massage which can cause harm like a ruptured cyst.  If it’s painful, ask the masseuse to stop.  Also avoid massages if you are pregnant, have an infection, have a fracture, are suffering from burns or wounds that are healing, or deep vein thrombosis. 

However, there is very little to no research to prove that fertility massages directly improve fertility.⁴ In general, massage therapy can be relaxing and with few risks involved, it can be worth trying if just to relieve stress.  If you are trying to conceive and are anxious, consult with the best fertility specialists in Pune. Schedule an appointment with Xenith Advanced Fertility Clinic.

IVF treatments can feel overwhelming physically, financially, and emotionally when you are going through it.  There are numerous doctor’s visits, lab tests, ultrasounds, hormone injections and it can seem very chaotic and unorganized.  It can also take a toll on your body physically with all the poking and prodding as well as dealing with some side effects like bloating and discomfort due to various medications and their effects on the body.  It might seem to be out of your control because you have to go along with what the specialist asks of you.  But there are some things that are within your control in order to make this IVF journey more pleasant.

Clear your calendar of any unnecessary things for the period of time that you will be undergoing IVF treatment.  Try to be realistic as to what you consider to be essential and what is optional.  Make time for lots of rest and downtime because you might feel overwhelmed during this period.  Be aware of your diet and what are appropriate exercises to do during this period.  It would also be helpful to do this together with your partner so that your schedules would be synced and you are aware of each other’s schedules.

Get your paperwork in order.  As you go through treatment, you will get a lot of paperwork.  It might be useful to keep a 2 or 3 ring IVF binder that can hold all the paperwork that you have received so far with separate tabs for categorizing them.  Try not to just stuff it all in a folder because it might then take a lot of time to find specific paperwork and it could all fall out if kept loose.  In it, you could keep your calendar with the various appointments in there as well as any special instructions, payment receipts, and information about the medication. You could also do it all on your mobile by scanning your receipts and various information as well as add your appointments to your calendar and add contacts for who to call if you have a question or an emergency.  You could also set timers on your mobile for when to take medication next as well as keep notes of any questions you might need to ask the doctor.

Organize your medications as there will be a lot of them to keep track of and it can get confusing.  They will need to be administered at various intervals or times in specific ways and some may need to be refrigerated.  You could use a pill organizer and have all of them sorted out for morning, afternoon, and evening so that an empty spot in the box means you have taken them for sure.  Have a specific storage place so that they are all kept together along with their appropriate syringes and needles.  Keep a diary of what medications you have taken so far along with notes in case you experience any side effects.

1)      Expect the unexpected in that you will not have control over how your body reacts.  Read up on the IVF process and all that it entails.  Be aware of what could happen due to medications and discuss them with your specialist so that you won’t be caught unawares.

2)      There will be a lot of time spent waiting for the appointments in the IVF clinic.  Use this time wisely to get work done if you are able.  If you aren’t able to focus on work during this time, maybe listen to some relaxing music to calm and soothe your mind and body because this too could be helpful for a positive outcome for IVF.

3)      It’s very helpful to have the support of your partner or other family or friends or a therapist who will help you through this process.  Keep them aware of what you are going through and they could help you destress when doubts start creeping in.

4)      Set one day to organize things like your medications for the week and look over what coming over the horizon so that you might be better prepared for what’s to come.  Try to be open and positive about whatever comes your way.   

5)      Carve out some time to do fun, relaxing things like a day at the beach or the spa.  Practice self-care during this period.  Make sure you get lots of rest and have peace of mind.  You will definitely need some time for destressing because the IVF journey can be filled with a lot of questions, anxiety, and stress.  Be kind to yourself and don’t berate yourself if something didn’t happen the way you might have imagined.  Try to be positive and do things that bring you joy.

By being organized, the whole IVF process could be a little smoother.  If you have any questions about how to be better prepared for the IVF journey, please feel free to contact us at Xenith Advanced Fertility Centre.

Unexplained infertility is when standard infertility testing hasn’t found a cause for infertility.  All the diagnostic tests that were done still don’t reveal any answers to your burning question: why am I not able to have children? 

But this doesn’t mean that you have no options left. You still have reason to hope.   

Possible explanations for diagnosis of unexplained infertility

There could be underlying reasons which doctors will delve into when they cannot find an explanation for infertility. Some of these reasons are explained below:

• Having an undiagnosed medical condition like diabetes, thyroid disorder, or autoimmune problems could affect fertility.
• The fallopian tubes which appear patent, could be unhealthy and non functional.
• Mild endometriosis is not easily diagnosed but can cause scarring or cysts to form that might decrease the chances of conception without any obvious symptoms. 
• A hostile vaginal environment could be due to the issues with the mucus being too sticky or dry or acidic or due to the presence of antibodies or inflammatory cells which could prevent the sperm from surviving and fertilizing the egg.
• Poor quality eggs could be due to advanced age or some other reason that is hard to diagnose.
• Issues with DNA fragmentation in the sperms.
• There could be issues related to the endometrium that make it hard for embryo implantation.  The endometrial lining has to be a specific thickness for successful implantation for example.

In addition to physiological issues, there are emotional issues at play and even stress can take its toll and make it harder for couples to conceive. Couples may just need to just relax and not be so anxious. And then, there are times when absolutely nothing is wrong and it reminds us all that conception (the power to germinate life) still remains a mystical process which cannot always be controlled.

Treatment for unexplained infertility

When infertility cannot be explained, doctors may ask you to take some of the following steps:

Lifestyle changes. Follow a healthy diet, cut out smoking or excessive alcohol and caffeine consumption, keep a healthy weight, exercise at least 30 minutes each day, and reduce stress.

Timed intercourse to make sure sperm is introduced only when an egg is released.  Timing of intercourse is crucial for conception and doctors can counsel couples on how to calculate the woman’s ovulation so that the intercourse is timed accordingly. 

Use of clomiphene citrate, gonadotropins or other medications to stimulate the ovaries (superovulation) to produce more than one egg

IUI (Intrauterine insemination) is a procedure where the washed sperm is placed right into the uterus around the time of ovulation bypassing the vagina.  Usually IUI is done in conjunction with superovulation for better outcomes.

IVF (In vitro fertilization) is a procedure where healthy sperm is introduced to the egg (retrieved from the woman) in a lab environment, leading to embryo production and this embryo is then transferred back into the uterus for implantation. 

IVF is the most successful treatment for unexplained infertility. IVF can be both diagnostic and therapeutic, because during the IVF process, they may be able to find out the unexplained reason for infertility while also significantly improving chances of pregnancy.  

When endometriosis is minimal without tubal damage, IUI with superovulation may be a reasonable option. For mild endometriosis, surgical removal, using laparoscopic laser treatment, of endometriotic deposits has been shown to be more effective than natural conception. 

In conclusion, a thorough but time-efficient investigation of the infertile couple is needed before the diagnosis of unexplained infertility. It is a diagnosis of elimination because the doctor could not find a specific cause for the failure to conceive. While one doctor may diagnose your case as unexplained, another fertility specialist may say you just haven’t been fully evaluated and this is where Dr.Mamta from Xenith Advanced Fertility Centre comes in.  Dr. Mamta has ensured successful pregnancy outcomes for many patients dealing with unexplained infertility. Just keep in mind that being diagnosed with unexplained infertility doesn’t mean you won’t be able to conceive.  Don’t give up.  Schedule an appointment with Xenith Advanced Fertility Centre if you have any questions regarding unexplained infertility.

Exercise can have a positive impact on our body including brain health, bone and muscle strength and weight management. Exercise can also help reduce risk of cardiovascular disease.  But too much exercise without enough caloric intake can have a detrimental effect on your body in ways you may have not considered. An energy deficit occurs when you don’t have enough energy for your body to complete its basic functions. The reproductive system is very sensitive to energy deficit.

How do you interpret weight?

Body Mass Index (BMI) is tool used to measure the amount of excess fat the body and it is based on a person’s height and weight. 

BMI	Interpretation
<18.5	Underweight
18.5-24.9	Healthy weight range
25.0-29.9	Overweight range
>30.0	Obese

A BMI of 18.5 or less (underweight) or a BMI in the obese range often causes irregular menstrual cycles and ovulation.  However, ovulation isn’t the only issue. A doctor can help identify other disorders related to obesity that impact pregnancy such as thyroid disease, insulin resistance, and diabetes.¹

Vigorous exercise and fertility in women with normal weight

Vigorous exercise may decrease fertility in women with normal weight.  If there is an energy deficit, the body will try to conserve energy by suppressing the reproductive hormones.  Estrogen and progesterone concentrations will decrease affecting menstruation.  Progesterone levels, which are usually high because it allows the fertilized egg to attach itself to the uterine lining, may decrease interfering with its implantation. 

The luteal phase, which is the period between ovulation and the next menstruation (about 2 weeks), is also affected due to this.  It can also suppress growth of the follicles and maturation of the egg as well as lead to poor quality of the endometrium leading to infertility. 

Another reason could be due to change in levels of the hormone leptin which regulates appetite and metabolism and you may not eat enough. Yet another reason could be the hormones responsible for regulating the female reproductive system like GnRH, LH, FSH and estradiol levels are changed to interfere with ovulation.  All this could lead to disturbances in the menstrual cycle making it irregular or completely absent. 

Vigorous exercise and fertility in women with overweight women

However, the effect of vigorous exercise on overweight/obese women or those suffering from polycystic ovary syndrome (PCOS) or anovulatory infertility, showed that exercise, with or without diet, can lead to resumption of ovulation.   So vigorous exercise may improve fertility in women who are obese because it will help you lose weight but may decrease fertility in women who are at their normal weight. Studies suggest that losing body weight can boost your health and fertility if you are currently obese.² However, it is important to understand the type and extent of exercise and doing it under supervision may be a good idea.

Vigorous exercise and fertility in men

There’s not much data when it comes to male infertility and exercise but constriction of testicles like wearing bike shorts reduces sperm count and impairs sperm motility.  Also, any exercise that causes overheating of scrotal region could decrease fertility.  Performance enhancing steroids reduce the amount of male reproductive hormone secreted in the brain and reduce testosterone concentration in the testes which affects sperm quality, quantity and motility and morphology.  In men, being overweight can also affect the quality and quantity of their sperm.

How much and what type of exercise is beneficial or detrimental

Regular exercise can improve fertility and lower stress, especially in women who are overweight. 

Moderate exercise

Moderate exercises can include brisk walking, swimming, bicycling, dancing, and yoga or other activities that need moderate effort and speed your heart rate and breathing but don’t make you out of breath.  With moderate exercise, you feel like you are breathing more deeply than normal but are not breathless.  Another measure is talk test.  If you can talk throughout your workout without pausing for breath, you are likely doing a moderate intensity workout. Research shows that moderate exercise is beneficial to everyone and could improve fertility.³

Vigorous exercise

Vigorous activity means any exercise that makes you breathe hard and fast. If you’re working at this level, you won’t be able to say more than a few words, without pausing for breath. One study showed that women engaged in extreme exercise for over 60 minutes per day may be at higher risk of problems with ovulation.  But women who exercised vigorously for 30 to 60 minutes may actually reduce anovulatory infertility.⁴

Tips for exercising when trying to conceive

When trying to conceive, try replacing some of your more intense workouts with gentler forms of exercise like yoga or walking leisurely.  Weight training can be moderate depending on the amount of weight you lift, the number of repetitions or the type of exercise.  Examples of intense exercise include CrossFit, powerlifting, marathon training, high intensity interval training, and racquetball.  IVF success rates may also be reduced by exercising too much. 

If you have been struggling to get pregnant and/or do not have regular periods it may help to bring down your level of activity to a moderate level as well as making sure you eat enough food to replace the energy used during exercise.  Some of the ways you can avoid overtraining is by simply listening to your body, getting enough rest, consuming enough calories for your level of exercise, drinking enough water, get enough sleep each night, not exercising in extreme heat or cold, taking a break if you aren’t feeling well, resting at least 6 hours between periods of exercise and take a full day off every week. 

Conclusion

The good news is that fertility issues due to overexercise could be reversed if you are vigilant about consuming enough calories to account for your levels of exercise. If you suspect that your weight might be connected to your inability to get pregnant, talk to a fertility consultant.

Enjoy the exercise you are doing so that you are more likely to continue it and discuss your individual issues and consult with an expert at Xenith Advanced Fertility Clinic, near you, about how much you should work out and how you can improve your chances to conceive.  Schedule an appointment today!