Month: October 2022

PCOS & Pregnancy Complications: What should be done?

Women with polycystic ovarian syndrome(PCOS) who are pregnant need to be more cautious about potential complications as compared to women without PCOS. It is widely known that women with PCOS are more likely to experience problems during pregnancy and delivery. An increased chance of early pregnancy loss and gestational diabetes are the two main side effects of PCOS in pregnancy.

However, maintaining a healthy weight and controlling weight gain before and throughout pregnancy can reduce the risk for several pregnancy problems.

What are the other pregnancy complications in women with PCOS?

Women with PCOS and their prenatal babies are more likely to face specific complications, such as:

• Miscarriage: Numerous studies indicate that women with PCOS have an increased risk of miscarriage, although some researchers link this risk to other elements such as obesity, advanced age, and the usage of fertility treatments. An increased risk of unexpected miscarriage may also occur in women taking ovulation-inducing medications as compared to those women who ovulate regularly. Some studies have shown that  intake of tablet metformin can lower the risk of miscarriage in pregnant women with PCOS.
• Gestational Diabetes: An increase in the mother’s blood sugar levels during pregnancy is known as gestational diabetes mellitus (GDM). This kind of diabetes typically develops in the second half of pregnancy and blood sugar levels return to normal after 12 weeks of pregnancy. However,if the blood sugar level remains high even after 12 weeks of delivery then the patient has Diabetes mellitus.These patients have increased chances of developing GDM in future pregnancies and also are at higher risk of suffering from diabetes in future. GDM-affected mothers frequently have larger-than-average babies and thus are at higher risk for cesarean delivery. Metformin usage before and during pregnancy lowers the rate of developing gestational diabetes in patients with PCOS.
• Preeclampsia: Pre-eclampsia is defined as a new onset of increase in blood pressure during pregnancy after 20 weeks of gestational age and proteinuria, that is protein in the urine, or a new onset of increase in blood pressure during pregnancy after 20 weeks of gestational age with end organ dysfunction with or without proteinuria. Patients may or may not have any symptoms  like swelling of legs and/or hands, excessive weight gain, headache etc. It is a serious disorder which can develop into eclampsia if untreated, which can lead to kidney and liver damage, seizures, and in rare instances, even death. The most crucial preventive step you can take is to keep your blood pressure within normal limits. Make sure to check in with your doctor if you experience any changes in your health while pregnant.
• Gestational Hypertension: Gestational Hypertension is a pregnancy-related high blood pressure after 20 weeks of gestational age. Unlike preeclampsia there are no proteins excreted in the urine. Twelve weeks following delivery, blood pressure frequently returns to normal. Your chance of developing gestational hypertension can be reduced by lowering your high blood pressure, losing at least 10% of your weight pre-conception  if you are overweight or obese, and engaging in regular exercise.
• Preterm Birth: Women with PCOS are more likely to deliver preterm babies, especially if their blood levels of androgen are high. This risk is increased in cases of multiple pregnancies. Multiple pregnancy, history of previous preterm delivery, incompetent cervix, and hypertensive disorders are a few of the factors that contribute to preterm birth.
• Cesarean Delivery: Women with PCOS have a higher risk of pregnancy and neonatal problems, which frequently requires cesarean or C-section delivery. 

What care do women with PCOS need during pregnancy?

• Regular Exercise: Walking for 10 to 20 minutes after eating can help manage postprandial hyperglycemia, which in turn helps manage blood pressure and insulin resistance. Additionally, yoga has been proven to be particularly useful in enhancing PCOS and fertility. It’s essential to remember that while yoga won’t treat PCOS, it will make you feel closer to your body, help you get your hormones back in check, and possibly even improve blood flow to your pelvis.
• Balanced diet : A nutritionist can be consulted for a balanced diet. This personalised healthy eating plan makes sure you obtain the nutrients you need, put on the proper amount of weight, and keep your blood sugar under control. The most crucial thing is to make sure your diet is full of foods rich in essential nutrients, and has balanced carbohydrates, fat and  protein. Your best bet is to stay away from processed and junk food.
• You may require frequent visits to the doctor during pregnancy so that if needed timely diagnosis and treatment of complications can be made.As discussed above, intake of tablet metformin plays an important role in preventing complications secondary to PCOS in pregnancy. Thus, it is important to take this medicine regularly along with other medication in the prescribed dose by your doctor.
• Blood sugar: Glucose tolerance test is recommended for all pregnant females who are at risk of developing diabetes in pregnancy for example patients with obesity, history of GDM in previous pregnancy or family history of diabetes. Even if the glucose tolerance test comes within normal limits, it is important to check blood sugar values regularly if you are at high risk for developing GDM. Ask your doctor what your blood glucose readings should be. 
• Blood Pressure: Your blood pressure is usually checked at every visit to the hospital. However, it is better if you can monitor your blood pressure if you are at high risk of developing hypertension in pregnancy or preeclampsia for early diagnosis and treatment. Consult your obstetrician if the readings at home are coming higher than normal range.

It’s crucial to prepare your body and maintain its health before getting pregnant. Although it may be challenging, making additional efforts to enhance your health will have a positive impact on both the result of your pregnancy and the wellbeing of your unborn child.

While PCOS may affect your fertility and pregnancy, conception and a healthy pregnancy is still possible with the correct care and treatment!

How can male infertility be treated?

If a man and a woman have regular unprotected sex for over a year and the woman doesn’t get pregnant then either one, or both of them may have infertility issues. Male infertility is a common issue and the process of conception could be challenging. Fortunately, having infertility problems does not prevent you from having a child of your own. There are procedures and medications that can increase the likelihood of conception.

Must Read: 10 Ways to Support Baby’s Brain Development in the Womb

How common is male infertility?

One in eight couples experience difficulties conceiving or maintaining a pregnancy. One-third of infertility causes are generally attributed to the female partner, one-third to the male partner, and one-third to a combination of issues affecting both couples.

High amounts of environmental contamination, such as pesticides, herbicides, and water pollutants, are likely to cause male infertility. While infertility has not significantly increased recently, several studies claim that sperm levels have been dropping globally.

What causes male infertility?

• Genetic diseases: For example, Klinefelter’s syndrome, myotonic dystrophy, microdeletion etc.
• Drugs: Including a few prescription medications, anabolic steroids, alcohol, and marijuana, as well as certain antibiotics.
• Chronic Disease: Such as diabetes, cancer, some autoimmune disorders, cystic fibrosis, malnutrition, anemia or history of mumps in childhood.
• Varicocele: A condition where the veins in the scrotum enlarge which may affect the number and motility of sperm.
• Diseases of the male genital tract: Includes  cancer, infection, or injury.
• Surgery on the male genital tract: Inguinal hernia or a testicle-removal operation.
• Hormonal disorders: Male infertility may be impacted by conditions that affect your hypothalamus or pituitary gland.

What are the symptoms of male infertility?

Being unable to conceive is the only symptom of male infertility.

How is male infertility diagnosed?

Male infertility issues are typically diagnosed by:

• Medical history and examination: Your doctor will inquire about any hereditary disorders, ongoing health issues, illnesses, injuries, or surgeries that may have an impact on your fertility. Your doctor will examine your genital area to look for any undiagnosed problems. Additionally, your doctor might inquire about your sexual behaviours and how those changed as you approached puberty.
• Semen analysis: There are several techniques to collect samples of semen. You can submit a sample by masturbating and ejaculating into a special container provided at the clinic. In certain circumstances, semen can be obtained by using a unique condom during sexual activity.

After that, the semen sample is examined in a lab to see if their number, motility and morphology are normal. Your semen will also be examined in the laboratory for signs of issues including infections.

Which males are most likely to have infertility?

 A male may have a higher chance of being infertile if:

• He is obese or overweight.
• He has been exposed to radiation.
• He has been exposed to toxins found in the environment, such as lead, calcium, pesticides, or mercury. 
• He is currently using a number of drugs, such as cyproterone, flutamide, spironolactone, bicalutamide, cimetidine, or ketoconazole.
• He has a history of undescended testicles.
• He has a history of varicoceles, which are widened veins in your scrotum.
• He has been exposed to testosterone.
• He uses tobacco, marijuana or alcohol.
• He has a history of mumps

How is male infertility treated?

There are now more treatment options available for male infertility. Infertility treatments might vary depending on the underlying cause, such as:

Medications:

• Hormone therapy can help to boost sperm production.

Lifestyle changes:

• Keep your weight within a healthy range.
• Give up smoking.
• Give up drinking.
• Abandon marijuana use.
• Stop using drugs recreationally.

Surgeries:

• Sperm Retrieval: If the semen analysis shows no sperm in ejaculate, then sperm must be found through a testicular biopsy. There are various surgeries which can be performed like Percutaneous epididymal sperm aspiration (PESA), Testicular sperm aspiration (TESA), Testicular sperm extraction (TESE),  Testicular sperm aspiration (TESA ) and Microsurgical testicular sperm extraction (Microdissection TESE). The sperm found through these methods can be used with the spouse’s egg for fertilization through intracytoplasmic sperm injection (ICSI) or can be frozen for future if conception is not planned immediately. 
• Vasectomy reversal: This common surgery is used in patients with a history of vasectomy to undo the procedure. The vas deferens, the scrotal tube through which your sperm travels, is reconnected by the surgeon. The surgeon delicately stitches the ends of the vas deferens back together while using a high-powered surgical microscope to observe it so that the sperm may travel back into ejaculate.
• Vasoepididymostomy: A similar method is used to clear blockages in your epididymis. The blockage is surgically removed, the ends of the tube are rejoined.

Other methods:

• Intrauterine insemination: This method can be used in patients with erectile dysfunction or with below average sperm count or mild motility or morphology issues. In this method semen sample is collected in a sterile container, prepared in the iui lab and transferred into the  female partner’s uterus using IUI cannula after her follicle is ready egg is matured and released, which is monitored through ultrasound.
• In vitro fertilization: In vitro fertilisation (IVF) is the treatment of choice for some couples coping with male infertility. Injectable fertility drugs are used during IVF to stimulate the ovaries and enhance the maturation of eggs. When the eggs are ready, a day care oocyte retrieval  procedure is carried out to collect them.  The eggs are exposed to sperm in a culture plate. After that embryos are grown in the lab for three to five days, then a tiny catheter is inserted through the cervix to transfer the embryo/embryos into the uterus.
• Intracytoplasmic sperm injection: This treatment is known to have helped even the most severe cases of male factor infertility. Similar to IVF procedure the female is prepared  using injectable fertility drugs followed by oocyte retrieval.  One sperm is directly injected into each mature egg, through a procedure known as intracytoplasmic sperm injection. Then the embryos are grown in the lab for three or five days and transferred to the uterus. 

With advancement of medical science there are chances of conception even in patients with severe male factors to have an offspring of their own. If you are facing any difficulties in conception then it is better to approach fertility specialists and discuss your problems as early as possible.

Are you trying to Conceive? Here are the best tips to increase your chances 

A woman trying to conceive typically has a low probability of getting pregnant each month. However, the majority of women become pregnant within the first year of trying, and others may require medical assistance.

Mentioned below are some of the best tips, techniques and other factors that can help improve your chances of getting pregnant.

Track your menstrual cycle

A woman who wants to become pregnant should keep track of the time between her cycles to see if it is regular—that is, if the first day of her period usually occurs the same number of days apart each month. 

If your periods are regular, you will ovulate about two weeks before your next period. This indicates that you will have a fertile window of seven days prior to your anticipated ovulation. If your periods are irregular, it could be a little trickier to anticipate when you’ll ovulate and what your fertile window will be.

However, you can try a variety of methods to determine your ovulation and fertile window like:

• Ovulation predictor kit: Ovulation predictor kit can be easily used at home. However, it may have some false negative results.
• Follicular monitoring: Follicular monitoring documents follicle but you have to go to the clinic for this.

Take a Preconception Checkup

Get a checkup before you start trying to conceive. Being in good general health is important for both partners before trying for pregnancy. Visit your primary care physician for a checkup to make sure you don’t have any hidden health problems that might cause problems in your pregnancy. Females over the age of 35 years should get themselves checked as the chances of getting pregnant decreases with age.

Take a prenatal vitamin

One of the simplest ways to help in conception is by taking a prenatal vitamin every day. It can also be a standard multivitamin as long as it contains essential components like folic acid. Prenatal vitamins with a high folic acid content can aid in embryo development and lowers the risk of neurological birth abnormalities. Your partner can either consume a male fertility supplement free of additions to testosterone or daily multivitamin and a supplement containing Coenzyme Q-10.

Maintain a healthy body weight

Being overweight or underweight may lower a woman’s chances of getting pregnant. Body Mass Index (BMI) is a useful measure that can help you determine what weight is healthy for your height, but it’s not perfect because it loses accuracy when it accounts for factors like muscle mass or those who are very tall or short. When you begin attempting to conceive, try to be within 15% of your ideal body weight.

Have sex at the right time

Make sure you have intercourse during the fertile window, which is five days prior to ovulation, on the day of ovulation and a day after ovulation when you are most likely to become pregnant. By having intercourse during these days, you increase the likelihood that sperm will be present in your body when your egg is released, giving you the highest chance of becoming pregnant. 

Quit your smoking habits

Both men and women who smoke can experience issues with conception. Nicotine and carbon monoxide, two substances present in cigarette smoke, have effects on both eggs and sperm. However, exposure to passive smoke has also been related to an increase in pregnancy problems. Similarly, research suggests that marijuana use may have a deleterious effect on female fertility.

Quit alcohol consumption

When a woman is trying to get pregnant, it is best for her to completely avoid alcohol. If a woman decides to stop using birth control because she wants to get pregnant, she should also give up drinking. According to some research, having just two drinks per day can cause a 60% reduction in fertility. Alcohol is also associated  with birth defects of the baby. 

Limit your caffeine intake

According to some research, drinking more than 500 mg of caffeine per day, or roughly five cups of coffee, has a bad impact on fertility. Limit your daily caffeine intake to 200 milligrammes or roughly two cups of coffee. Also keep in mind that foods like soda, tea, energy drinks, chocolate, and supplements may also contain caffeine which is why you should carefully read your labels.

Eat healthy food

There isn’t one special food that will help you get pregnant. You should prioritize consuming a range of fruits, vegetables, complex carbs, and lean proteins. There are also certain foods that you must avoid while trying to get pregnant like refined carbs, processed meats like hot dogs, too many carbohydrates, and fish that are high in mercury including canned tuna, frozen swordfish, tilefish, and shark.

Exercise 

Exercise or yoga can lift your mood, tone your muscles and skin, support heart health, and also raise your chances of getting pregnant. Even making the effort to walk rather than drive or use public transportation, taking stairs instead of using the lift will help if you don’t have time for the gym. While exercising is said to be good for a woman trying to conceive, however, excessive exercise can also harm fertility.

Takeaway

The most important factors while trying to conceive are knowing your cycle, having a healthy lifestyle and observing your most fertile days. When you don’t get pregnant right away, it can be difficult, but try not to be stressed and follow the tips mentioned above. 

However, if you don’t get pregnant after 1 year of trying, you should consult a fertility specialist to identify the cause and for treatment of individualized guidance to increase your chances of getting pregnant.