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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!

Sleep plays a vital role in our lives because it helps to keep our bodies running optimally.  Getting a good night’s sleep helps to refresh and restore our brain and our organs as well as regulate important hormones in our body. 

Insomnia is defined as difficulty falling asleep, difficulty staying asleep throughout the night and/or waking up too early in the morning. Not getting enough sleep over a prolonged period of time can take a physical and mental toll on our body. But did you know that it could also affect your fertility?

How does sleep affect fertility?

Our bodies follow an internal clock or a sleep-wake pattern called the circadian rhythm and this will function properly if the body is exposed to a regular pattern of light and dark.  Even just a few nights of sleeplessness can affect hormone production.  The part of the brain that regulates the hormones involved in sleeping and being awake (cortisol and melatonin) is also responsible for triggering the hormones involved in reproduction. 

How does sleep affect men?

A high amount of daily hormone testosterone is produced in men in the night during sleep and these levels can be affected by changes in sleep cycle.  Testosterone is very important for healthy sperm production and thus men may have reduced semen quality and sperm count if they suffer from issues with proper sleep.  A study by Lauren Wise at Boston University found that there was 42% reduced probability of conception in any given month for men who slept less than 6 or more than 9 hours of sleep.¹ Another study from Denmark in The American Journal of Epidemiology found how men who slept poorly had lower sperm count and fewer sperm that formed correctly compared to other men.² The main explanation is most likely hormonal. 

How does sleep affect women?

In a woman, sleep deprivation can interfere with hormones that trigger ovulation and disrupt the menstrual cycle causing irregular periods.  Many hormones affecting fertility like thyroid stimulating hormone, progesterone, and estradiol which in turn regulates follicle stimulating hormone and luteinizing hormone could be affected by lack of proper sleep.  Women reporting sleep problems other than sleep apnea were 3.7 times more likely to be at risk for infertility than women with normal sleep patterns according to a large study of more than 16,000 women in Taiwan over a 10-year period.³ 

How much sleep is necessary?

As with most things, the key to sleep is balance.  In order to ensure that your personal sleep needs are met you should strive to get more than 6 hours of sleep but less than 9 hours.  Too much sleep can also interfere with fertility.  An optimal amount of sleep is about 8 hours average although this requirement can vary from person to person and somewhat from season to season.  Here’s a helpful chart with recommended sleep amounts based on age.

Credit: https://www.forbes.com/health/body/sleep-deprivation-health-effects/

How to treat insomnia

• Get some exercise to elevate your heart rate temporarily every day for 30 minutes.  Even a simple walk for half an hour will improve your sleep.
• Go to bed and wake up at the same time every day including weekends
• Keep your bedroom dark and cool
• Do not look at your screen for at least 30 minutes before bed.
• Unwind and relax before bed, like take a bath, drink some warm milk, read  a book, listen to relaxing music  or try some meditation or any other way that relaxes you
• Limit alcohol and caffeine consumption
• Try to reduce stress and don’t bring your work home.
• Don’t work odd hours like shift work or night shifts
• Get outdoors for an hour or more of sunlight each day
• Have your dinner early so that there’s enough gap between your dinner and bedtime
• Have a light dinner because if you are too full, falling asleep becomes difficult. 
• Have a good bed and pillow.
• Avoid supplements like melatonin because it can interfere with your body’s processes

Lastly, not getting enough sleep is detrimental to your emotional health and mood. If you are irritable and tired for an extended time, you may eventually run into problems of sexual intimacy with your partner. 

Almost all of us occasionally have a poor night’s sleep.  If you are a woman trying to get pregnant and have insomnia three times a week for more than three months, you might want to visit us at Xenith Advanced Fertility Clinic.  If your sleep and fertility problems continue, feel free to talk to us to find out if an underlying medical condition may be a factor.

Nowadays, more and more women are choosing to delay having children due to late marriages or career opportunities, or various other reasons.  However, fertility declines with age and it is important to make informed choices in order to have children at the appropriate time. Thanks to modern science and technology, fertility treatment makes it possible for most women who are having trouble getting pregnant, to succeed and enjoy motherhood.

What is AMH and what does it have to do with fertility

Anti-Müllerian Hormone (AMH) is a hormone that is secreted by the granulosa cells in the ovarian follicles and its levels can be determined by a simple blood test which is less expensive and takes less time. The blood test can be done at any time of the woman’s cycle. 

Why take the AMH test?

One of the main advantages of this test is that it can determine when a women’s fertility may start to decline. The AMH test can give women the option of making an informed decision about when to get pregnant. 

Couples are able to plan parenthood. If the results of the AMH test are good, couples can consider postponing their decision to start a family if that is what they desire. This could be for medical reasons or other career decisions that may impact the decision of starting a family. If the AMH results are not so good, couples can consider trying to get pregnant sooner rather than later.

The AMH test also gives couples the option of freezing eggs or embryos if ovarian reserves are low and they prefer to wait to start a family.

What the results of an AMH test show

AMH test (popularly known as the Ovarian Reserve Test) is used as a marker for the quantity of eggs but not quality.  AMH levels usually peak in women aged 20-25 years and tend to gradually decline until menopause is reached. 

Á higher AMH level means that there is a higher ovarian reserve or egg count and it thus gives an idea of how many eggs are present in the ovary at a certain time.  An exception to this rule is women with many small follicles, like those with polycystic ovaries (PCOS), who tend to have high AMH hormone values.

Lower levels of AMH values generally indicate a woman with diminished ovarian reserve. 

However, it must be noted that a good AMH level does not always ensure higher fertility.  Even though high AMH levels may indicate good fertility rate, it does not reflect the quality of the eggs produced which can diminish with age and other factors.  Alternately low AMH levels do not mean that a woman cannot get pregnant naturally because it takes only one good egg along with sperm to get pregnant. 

Poor ovarian reserves – one of the leading causes of infertility in Indian women

A study in the Journal of Human Reproductive Sciences found that there is a more rapid decrease in AMH levels with age in Indian women compared to their Caucasian counterparts. It is not clear why this trend is prevalent in Indian women – it could be due to a number of factors such as diet, genetics, or pollution.¹

Another study conducted by a diagnostics centre in Mumbai found that 1 out of 2 women visiting infertility centers had low AMH values.  Over 29,500 samples from women aged between 20 and 55 years were analyzed. Low or extremely low levels of AMH were found in:²

• Over 54% of the women aged 30 to 35
• Over 38% of the women aged 26 to 30

For this reason alone, it is important that women become aware of their ovarian reserves and get themselves tested. For more information, please watch Dr. Mamta Dighe’s video on this subject here.

Low AMH levels? What next?

Having low AMH levels might explain why it might be more difficult to get pregnant, but it doesn’t mean that you cannot get pregnant naturally because it only takes one healthy egg to combine with a sperm and form an embryo in order to become pregnant.  Schedule a consultation with us at Xenith Advanced Fertility Clinic. There’s a fertility specialist near you at either Wakad or Koregaon Park in Pune. Despite low AMH levels, women have a higher chance of starting a family than they did even a decade ago. Reach out, let’s talk about it!

One way of improving fertility outcomes while undergoing fertility treatment is by practicing yoga. Fertility yoga has been gaining popularity as a tool for helping to boost fertility. Yoga is known for preserving and maintaining physical and mental health.

Does yoga increase fertility?

Certain yoga poses can reduce stress levels, cleanse the body of toxins as well as improve circulation and flexibility especially in the hip and pelvic area. It is also known to help keep hormonal imbalances in check which in turn can boost fertility.

According to a study published in PubMed, the success of Artificial Reproductive Technology (ART) can be affected by a patient’s psychological, social, and physical status. The study examined the effects of yoga-including asanas (yoga poses), pranayama (proper breathing), shavasana, and meditation-on male and female fertility and ART outcomes. They study found that “yoga can help couples overcome infertility and increase the ART success rate by improving the physiological and psychological states of both men and women.”¹

Another study by Dr. Alice Domar at Harvard has proved that women who took fertility focused yoga courses were almost three times more likely to conceive than those who did not.²  

Yet another study published in 2012 states, “Yoga for fertility improves both female and male infertility by minimizing stress, which consecutively balances the hormones of the body with improvement in mental health; thereby increasing a couple’s ability to conceive. However, persuasive research in this scientific field is still unmapped.”³

Couples can do fertility yoga together to help them overcome stress related to the strenuous IVF procedure. 

Yoga and Fertility for Women

An article that reviewed 87 studies concluded that yoga could help relieve stress in women with infertility issues.⁴ The following benefits were perceived:

• reducing their anxiety and depression
• improving their sleep
• helping them manage the stresses of pregnancy, labor, and birth
• improving their quality of life during pregnancy or after stillbirth for women.

The article also reported benefits for stress management in patients with infertility Yoga may help to

• manage ovulation and oocytes improvement for fertility
• decrease depression, anxiety, and stress

Yoga and Fertility for Men

The benefits of regular yoga practice were not limited to women with infertility. Men with infertility also benefited may be able to experience improvements in sperm count, sperm motility, and prostate secretion showed improvement in men who practiced yoga.

Top Yoga Poses to Boost Fertility

Warm up by sitting in the lotus position, taking a few deep breaths and then rotating your head in one direction and then the other way.  Straighten your legs and rotate your feet in one direction and then the other as well as stretch your foot away from you and towards you alternately.  Stretch your arms as well by moving them in a circular motion a few times.

Dandasana: This position helps with correcting posture and strengthening the back muscles, the hamstrings and the core which in turn energizes the body and leads to decreased stress.  Remain in this position for at least a minute and repeat this asana 3 to 5 times.⁵

Paschimottanasana: Also known as seated forward fold stretches the muscles on your lower back, hips and hamstrings.  It is said to improve fertility in women by vitalizing important organs like the ovaries and stomach and stretching the spine improves the blood flow toward the pelvis and head while reducing mental stress.  Hold this position for two minutes.⁶

Janu Sirsasana: It is the one-legged forward bend or the head to knee pose.  It stretches the calves and the hamstrings of your body while relaxing the muscles of the abdomen.  Hold this pose for 30 seconds and repeat with the other leg.⁷

Sarvangasana: Also known as shoulder stand helps treat thyroid conditions and relieves stress.⁸

Bhramari Pranayama: Also called the humming bee breath asana is done by placing your thumb over your ears, closing your eyes with the rest of your fingers and making a humming bee sound in a high pitch tone while exhaling for as long as you can.  It calms the body.  Do 6 to 7 times.⁹

Setu Bandhasana: Also known as the bridge pose, improves body circulation and helps expand the pelvic region while having a calming effect on the brain.¹⁰

Shavasana: This is a simple posture, also known as the corpse posture. It is done at the end of each yoga posture to normalize the heartbeat and also relax strained muscles.  It is basically lying flat on your back and breathing normally for 3 to 4 minutes.  It can give you a peaceful rest.¹¹

Other fertility yoga poses may want to try include:

• Viparita Karani
• Marjaryasana
• Balasana
• Kapalbhati Pranayama
• Anulom vilom

Practice these moves regularly to help you relax and de-stress.  However, make sure you have mastered the correct posture and breathing techniques by learning from a certified yoga instructor in order to avoid any injury.  Contact us at Xenith Advanced Fertility Centre if you would like to learn about how to boost your fertility through yoga!

Endometriosis is a debilitating condition that affects about 10% of women at reproductive age, according to the World Health Organization. The pain can be chronic affecting the quality of life and in some women, it can result in losing ten hours a week from work or study, per reports. Endometriosis is one of those things that women often don’t talk about, suffering in silence, but the earlier it can be diagnosed the better the treatment outcomes.

What is the endometrium?

The endometrium is the tissue lining the uterus. Every month to prepare for the ovulation cycle, the endometrium gets thicker and it is at its thickest right before ovulation. An environment is created within the womb that is ripe for fertilization. In the IVF process, this is the time to prepare for embryo implantation. If fertilization does not take place at this time, the outer tissue lining is shed through menstruation.

What is endometriosis?

Endometriosis is a female disorder in which an abnormal tissue resembling the endometrial tissue, but growing outside the uterus. This tissue behaves similar to the endometrium in that it also responds to the hormones that affect the menstrual cycle.  It too thickens before ovulation and during menstruation, it bleeds into areas where it shouldn’t, but there is nowhere for the waste tissue and blood to go.  

This rogue tissue can develop anywhere in the body, but it usually affects the pelvic area including the ovaries, fallopian tubes, tissues that support the uterus, and outside of the uterus.  Endometrial tissue can also develop in other areas including the abdominal cavity, digestive tract, urinary bladder, lungs and even around the heart.  

How can endometriosis cause infertility?

Even though this tissue is not cancerous, it can lead to scarring and adhesions where the tissue binds the pelvic organs together.  It can block the fallopian tubes making it harder for the sperm to reach the egg or grow into the ovaries affecting egg growth and can also prevent the embryo from implanting.  Formation of cysts due to trapped blood can cause chronic inflammation in the pelvis which can result in pain.  Tissues could also fuse together, leading to changes in the reproductive organs.  As tissue decomposes, scar tissue can form and it can gradually worsen over time.    

What are the symptoms of endometriosis?

In many cases, women may not experience any signs and symptoms but when they do, common symptoms can include:

• Pelvic and abdominal pain and cramping especially during menstruation and sex
• Heavy bleeding and painful periods lasting longer than 7 days or bleeding between periods
• Pain during bowel movements and urination (especially during periods)
• Fatigue, diarrhea, constipation and bloating
• Blood in the stool or urine
• Nausea and vomiting
• Difficulty becoming pregnant if left untreated
• Chronic lower back and pelvic pain

How can endometriosis be diagnosed? 

It can be difficult to diagnose because the symptoms are very similar to many other disorders and they vary so much from person to person depending on the severity.  It can be diagnosed by having a pelvic exam, going through imaging tests such as an ultrasound or MRI scan, laparoscopy, or getting a biopsy.  Surgical laparoscopy is a procedure where the doctor inserts a laparoscope through a small incision to look at the tissue and is a sure fire way to confirm a diagnosis as well as treatment for endometriosis.  

What are the different stages and types of endometriosis?

There are four stages to describe the severity of endometriosis ranging from minimal to severe.

Stage 1: Minimal-few shallow implants or tissue growths and no significant scar tissue

Stage 2: Mild- more implants that stage I and also may have some scar tissue

Stage 3: Moderate-multiple, deep implants, both superficial and deeply invasive.  Adhesions or thick bands of scar tissue may be present on the tubes and ovaries

Stage 4: Severe- multiple deep implants and adhesions as well as large cysts

The stages of endometriosis are not specifically linked to levels of pain.  But the risk of infertility appears to increase as the stages progress. 

What is the treatment for endometriosis?

There is currently no cure for endometriosis but various treatment options may help manage symptoms like pain management through hormonal treatments.  Women with Stage 1 and 2 endometriosis may be able to conceive naturally. Cysts or scar tissues may be surgically removed, to improve your chances of getting pregnant.  

Other treatment options will first need to consider a few factors in order to determine the best treatment for you specifically.  Some of these factors include your age, the severity of your symptoms, the severity of endometriosis itself and whether you want to have children.

What options do women with endometriosis have to conceive? 

To improve fertility for females who have mild or moderate endometriosis, our doctors at Xenith Advanced Fertility Clinic will usually recommend a laparoscopy to remove or vaporize the growths followed by an IUI.

If pregnancy still doesn’t happen, In Vitro Fertilization (IVF) could be the best option for couples desiring to have children of their own.  IVF involves using hormones for the woman to produce more than one mature egg at a time after which the eggs are collected, fertilized with your partner’s sperm in a lab setting. Fertilization takes place and the resulting embryo is transferred back to the woman’s uterus for implantation.  

During pregnancy, the symptoms of endometriosis could disappear since there is no menstruation during this time.  If endometriosis is affecting your fertility, please don’t lose hope of having a baby.  Reach out to a fertility specialist at Xenith Advanced Fertility Clinic near you – in Wakad or Koregaon Park.