Month: March 2023

Conception: What is it and how does it happen?

Menstruation and conception are closely connected processes. The series of events that take place in your body each month as it gets ready for the potential of pregnancy is known as a menstrual cycle. Ovulation occurs during the menstrual cycle in both women.

Your ovary releases an egg for fertilisation during ovulation. Fimbriae, which resemble little fingers, aid in guiding the egg through your fallopian tubes and into your uterus. An egg may become fertilised by a sperm during this passage through your fallopian tubes.

In the testicles of men, sperm production begins. Millions of sperm cells are released during ejaculation with the sole intent of locating an egg to fertilise. Sperm cells swim up through your vagina and into your fallopian tubes during unprotected sex.

Only one sperm manages to fertilise an egg despite millions of sperm competing to reach and enter the egg. Eggs disintegrate if sperm cannot fertilise them.

A fertilised egg, also known as a zygote, continues to travel down your fallopian tube if a sperm is successful in its attempt to fertilise an egg. As it does so, it divides into two cells, then four cells, and then more cells as it travels. The zygote has arrived in your uterus about a week after the sperm and egg were fertilised. It has developed into a blastocyst, a developing collection of roughly 100 cells.

After that, the blastocyst attaches to the uterine lining (the endometrium). Implantation describes this process of attachment. Yet, only because conception takes place does not guarantee implantation. Occasionally, implantation fails, and the fertilised egg is passed during your subsequent menstrual cycle.

If implantation occurs, the cells keep dividing; some become your baby while others become the placenta. You start to exude hormones that alert your body that a child is developing inside your womb. These hormones also instruct the uterus to keep its lining in place as opposed to shedding it. This implies that you won’t get a period, which may be how you find out you are pregnant for the first time.

In a 28-day menstrual cycle, getting pregnant involves the following steps:

Day 1: your first day of menstruation.

Around day 14: Ovulation.

Within 24 hours of ovulation: An egg is fertilised by sperm (conception occurs).

About six days after fertilization: The ovum that has been fertilised grows inside your uterus.

Around day 21: You are pregnant if conception and implantation have been placed during this menstrual cycle. However, it can take a further five to seven days to get a positive pregnancy test.

A fertilised egg moves from conception through your fallopian tubes to your uterus. The fertilised egg, also known as an embryo, implants (attaches) to the uterine wall. The placenta begins to develop as a result. Human chorionic gonadotropin (hCG) starts to be produced by your placenta and released into your urine and blood. Around 11 days following pregnancy, HCG can be seen in a person’s blood. With home pregnancy tests, hCG takes a little longer to appear (that measure hCG in pee).

How does conception work with IVF?

The process of conception still requires the fertilisation of an egg by sperm. However, sperm fertilises an egg in a lab during in vitro fertilisation (IVF). A parent’s or a donor’s sperm is combined with an egg, either from the intended parent or a donor. When the sperm fertilises the egg, conception occurs.

After conception, your healthcare professional implants the embryo into the uterus.

What circumstances make it impossible to conceive?

Your ability to get pregnant may be impacted by specific medical issues. The mere contact of the sperm and egg does not guarantee fertilisation. Among the most typical ones are:

• you are not ovulating (this is anovulation).
• difficulties with sperm motility or low sperm count.
• an obstruction in the fallopian tubes, ovaries, or testicles.
• decreasing the supply of high-quality sperm and eggs.
• difficulty in the penetration of sperm into the egg.
• Thin endometrial lining or lining not being receptive.

Takeaway

Sperm fertilising an egg is known as conception. It’s one of several essential processes to becoming pregnant. Conception is a difficult process that is influenced by numerous variables. There are several options available to assist you if you’re having trouble getting pregnant. If you’re having trouble getting pregnant, talk to your doctor. In addition to describing the procedure, they can point out any obstacles to conceiving and becoming pregnant.

Ovarian Endometriomas: What are Chocolate Cysts?

“chocolate cyst,” also known as ovarian endometriomas, are cysts that contain menstrual blood. They are a sign of endometriosis, a disorder in which endometrium (cells from the lining of the uterus) spreads outside the uterus. Your doctor can assist you in managing any uncomfortable symptoms that these cysts may cause. Sometimes getting rid of them is the best course of action.

Must Read: The Vital Role of Psychological Support in the IVF Journey

What are the symptoms of Chocolate Cysts?

Some women may experience symptoms from chocolate cysts. Other ladies might not have any symptoms at all.

Moreover, the existence or intensity of symptoms is not always related to the cyst’s size. In other words, a woman with a little cyst might have symptoms, whereas a woman with a huge cyst might not. Cysts can be anywhere in size between 2 and 20 centimetres (cm).

The symptoms may consist of:

• painful periods
• pelvic pain
• irregular periods
• pain during intercourse
• Feeling the urge to pee more.
• Back pain.
• Vomiting.
• Bloating.
• Nausea.
• infertility 

What causes chocolate cysts?

Endometriosis and ovarian endometriomas have unknown exact causes, according to doctors. The most prevalent explanation contends that endometriosis arises from the backflow  of some endometrial tissue during menstruation from the uterus (retrograde menstruation). Some of the tissue makes its way back into your ovaries through your fallopian tubes rather than exiting your body through your vagina.

When your body releases the hormones that cause your uterine lining to bleed during each menstrual cycle, the abnormal tissue bleeds as well. It starts to swell up. Menstrual blood and the swollen tissue around it have the potential to develop into an ovarian endometrioma over time.

What effect do chocolate cysts have on fertility?

Chocolate cyst can penetrate, harm, and overtake healthy ovarian tissue. This may seriously threaten fertility. These cysts can be challenging to treat, and the pelvic treatments required to manage or remove them can impair fertility and leave ovarian tissue scarring.

Compared to women without chocolate cyst, these are the following problems women with chocolate cysts face:

• Fewer eggs.
• Eggs that are less likely to mature result in decreased fertilization rate
• Higher chances of unruptured follicle leading to anovulation
• The thickened outer shell of the eggs may impair fertilisation
• Higher follicle-stimulating hormone (FSH) levels may be a sign of ovarian issues.

Even while chocolate cyst harm ovaries, many women who have them can get pregnant naturally. If you struggle to get pregnant and have chocolate cyst, in vitro fertilisation (IVF) is an additional alternative.

How are chocolate cyst diagnosed?

Physical examinations and imaging tests can reveal signs of ovarian endometrioma. Your healthcare provider might find the cyst during a pelvic exam if it is particularly large. Your doctor can find out if you have a mass thanks to transvaginal ultrasounds, MRIs, and computed tomography scans (CT scans).

Laparoscopy is the gold standard for diagnosing endometriosis. Your doctor will do this procedure by making very small slits in your belly and inserting a laparoscope, which is a thin tube. Your doctor will be able to see the cyst through this tube and either completely remove it or extract a sample for testing (biopsy). Your doctor will identify endometrial glands and stroma cells in the sample if it is an ovarian endometrioma. Laparoscopy allows for simultaneous diagnosis and treatment. However, surgery for the removal of ovarian endometrioma is done according to symptoms. If a patient is having severe pain not responding to medicine and have completed the family then endometrioma can be removed as its removal will also result in damaging the surrounding healthy ovarian tissue leading to decreased ovarian reserve. That is why in patients with infertility with low ovarian reserve, removal of endometrioma if required, is preferably done after freezing of embryos.

Takeaway

Women with endometriosis frequently have chocolate cysts. Medication can frequently be used to treat symptoms. The cysts may need to be removed in some circumstances.

Unpleasant symptoms from ovarian endometriomas can interfere with your life. If you’re still in your reproductive years, it’s not particularly consoling to know that these symptoms typically improve after menopause. Ask your doctor about your treatment choices if you have an ovarian endometrioma. Based on your health and way of living, your doctor may suggest methods for treating your problems.

How Long Can Sperm Live Inside The Vagina After Intercourse?

A healthy sperm can survive for a few hours to five days following sexual activity. The sperm’s ability to survive inside the vagina is entirely dependent on its surroundings. The sperm’s longevity is influenced by the characteristics of the woman’s uterus, vagina, and fallopian tubes.

How Long Does Sperm Live?

Sperm is a crucial component of fertility and pregnancy, and its ability to survive after ejaculation entirely depends on its environment.

Inside the vagina: During three to five days, sperm inside the vagina can survive in cervical mucus or the upper vaginal canal, allowing fert lisation to proceed as long as the sperm is still alive. In order to account for the five days before ovulation and the actual day of ovulation, the fertile window is six days long. An egg has a 24-hour lifespan after being released.

Outside of the body: Sperm can survive in semen for up to a few hours outside the body because they need specific levels of warmth and humidity to survive. When semen is frozen, sperm can be kept for weeks or even years.

What role does sperm motility play in pregnancy?

The sperm enters the vagina during intercourse and travels via the cervix and into the uterus after ejaculation. After that, uterine contractions assist in directing the sperm towards your fallopian tubes.

In just a few minutes, the first sperm may enter your tubes. The sperm’s trip is made simpler the closer you are to ovulation.

Your cervical mucus needs to be favourable for pregnancy to happen. The ideal mucus has the consistency of an egg white. The trip is significantly more difficult if your cervical mucus is thick or dry.

When attempting to get pregnant, sperm count is a concern for many couples, although it only accounts for a portion of male fertility.

The capacity of the sperm to swim correctly is referred to as “sperm motility”. When it comes to getting pregnant, motility can be just as important as sperm count. Pregnancy cannot occur if the sperm cannot reach the egg.

Couples have a number of options to consider if motility is a contributing issue in infertility. IUI decreases the requirement for sperm to swim from the vagina via the cervix as the motility is increased after the semen sample is prepared for IUI and the travelling distance is reduced as the semen sample is placed directly within the woman’s uterus.

With IVF-ICSI, the sperm is injected into the egg and the embryo is grown in the lab before inserting it in the womb.

What’s the role of frozen sperm in IUI and IVF?

Both IUI and IVF are compatible with both fresh and frozen sperm. For these procedures, frozen sperm may be used for a variety of reasons, including the use of donor sperm and the preservation of fertility for a male with cancer.

Even while sperm that has been frozen can last for a very long period, some people think that when it is thawed, its integrity may be damaged. Although, research suggests that at least when utilising IVF and ICSI, frozen sperm may be equally as effective at generating conception as fresh sperm.

What is Hydrosalpinx (Fallopian Tube Blockage)?

When fluid builds up in one or both fallopian tubes, it causes hydrosalpinx, which results in a blockage. Your uterus and ovaries are connected by fallopian tubes. Your ovaries release an egg each month as part of your menstrual cycle, and the egg travels through your fallopian tubes. An open channel is provided by healthy fallopian tubes for the union of an egg and a sperm (fertilisation).

Must Read: The Vital Role of Psychological Support in the IVF Journey

The fertilised egg or embryo passes through the same clear channel to reach your uterus. An embryo can then implant in your uterine wall and grow into a foetus from there. Fluid accumulation obstructs this route in a hydrosalpinx. Sperm may not be able to reach your egg if your fallopian tube is blocked. If fertilisation does take place, the fallopian tube obstruction may stop the embryo from implanting in your uterus. Also, if the embryo reaches to uterine cavity the fluid may harm the embryo leading to implantation failure.

What are the signs and symptoms of a hydrosalpinx?

Rarely does a hydrosalpinx show any symptoms. When your doctor looks into why getting pregnant is challenging, you might not discover your tubes are blocked. When symptoms exist, they consist of the following:

• Pelvic pain that could get worse during or right after your menstruation.
• Sticky or stained vaginal discharge.

What causes a hydrosalpinx?

The most frequent cause of a hydrosalpinx is an untreated infection. Your fallopian tubes might become irritated and damaged by harmful germs. Your fallopian tube’s fimbriae, which are located close to your ovaries, are frequently irritated. Your fallopian tubes’ fimbriae are finger-like extensions that sweep an egg out of your ovaries.

Your fimbriae may fuse together during the healing process, closing your fallopian tubes. Your tubes expand as a result of fluid becoming trapped inside of them. Causes of hydrosalpinx include:

• Sexually transmitted diseases (STIs), such as chlamydia and gonorrhoea, that have previously gone untreated.
• Endometriosis-related tissue growth.
• Pelvic inflammatory disease (PID), frequently brought on by untreated STIs.
• Scar tissue that remains after pelvic surgery, particularly after the fallopian tubes were operated on.
• Certain tumours.

How does hydrosalpinx affect your body?

It might be challenging to get pregnant and raise your risk of miscarriage and pregnancy issues if you have an untreated hydrosalpinx. In addition to making it challenging to conceive through sexual activity, a hydrosalpinx can:

• Reduce your likelihood of conceiving via in vitro fertilisation (IVF): You can conceive via IVF even without fallopian tubes. With IVF, your doctor removes your eggs from your body and fertilises them with sperm from your partner or a donor outside of you. Your medical professional will then insert the embryo into your uterus, where it can grow. Once the embryo implants into your uterine wall, a hydrosalpinx may cause issues. According to research, the fluid from a hydrosalpinx can flow backwards into your uterus, creating an unfavourable environment for embryonic development.
• Increase your risk of ectopic pregnancy: An ectopic pregnancy can occur when an embryo implants in your fallopian tubes after being unable to reach your uterus due to a blockage. Without treatment, these pregnancies can be fatal and are not viable. 

What tests will be done to diagnose a blocked fallopian tube?

Tests to determine whether your fallopian tubes are blocked include:

• Ultrasound: On an ultrasound, your fallopian tubes are typically invisible. However, they will appear as such if they are enlarged due to fluid buildup. They can occasionally have a sausage-like form. To ensure that a hydrosalpinx is indeed the source of the alteration, your doctor may request more tests.

• Laparoscopy: A minimally invasive procedure called laparoscopy enables your doctor to examine your abdominal cavity. To get a better look at your fallopian tubes, they create very small slits in your belly and insert a laparoscope, a small camera. Sometimes, a catheter will be inserted into your cervix and vagina to inject dye into your uterus and fallopian tubes to look for obstructions. A laparoscopy can be utilised to validate the HSG’s findings.
• Hysterosalpingogram (HSG): A fallopian tube obstruction test using X-ray dye is called an HSG. It is the most typical test for identifying hydrosalpinx. Your doctor will put a dyeing medium within your uterus and use an X-ray to observe how it moves. Your tubes are open if the dye leaks through them and into your pelvic area. Your tubes are obstructed if the dye abruptly ceases.

How is hydrosalpinx treated?

You can increase your chances of getting pregnant by treating a hydrosalpinx. Various variables, including your age and the degree of your obstruction, will affect how you are treated. If you have an illness that is still active, your doctor will recommend medications to treat it. Surgical procedures consist of:

• Salpingectomy: removes either one fallopian tube or both (bilateral salpingectomy).
• Clipping of tubes: To stop the backlog of fluid in the uterine cavity, tubes are clipped with the help of laparoscopy. 

What happens if hydrosalpinx is left untreated?

Your chances of getting pregnant are reduced if you have hydrosalpinx, and your risk of miscarriage and problems like ectopic pregnancy is increased. You have a far better chance of having a safe pregnancy if you receive treatment.

Infertility: Causes & signs in men & women  

Are you trying to get pregnant but it just isn’t working out? You might be concerned about whether you or your partner need to get checked out for a medical issue. Let’s learn what infertility is and the possible causes and symptoms in women and men.

What is infertility?

Infertility is the inability to become pregnant after engaging in frequent, unprotected intercourse for anywhere between six months and a year, depending on your age. Not all cases of infertility result in “sterility”—the inability to ever produce a child. A child can eventually be born to half of couples who receive medical assistance.

Obstacles to conception can affect both men and women. 20% of infertile couples have issues with both partners’ fertility. After conducting all necessary testing, no cause is identified in 15% of couples. We refer to this as unexplained infertility.

What are the causes of infertility in men?

Causes of infertility in men may include:

• Abnormal sperm development or function as a result of undeveloped testicles, genetic flaws, medical conditions like diabetes, or infections like chlamydia, gonorrhea, the mumps, or HIV. Varicocele (enlarged veins in the testes) can also lower sperm quality.

• Sperm delivery issues due to sexual problems such as structural issues such as a blockage in the testis, early ejaculation, genetic conditions such as cystic fibrosis, or damage or injury to the reproductive organs.
• Excessive exposure to radiation and other environmental elements such as pesticides and other chemicals, and radiation.
• Fertility can also be impacted by cigarette smoking, alcohol consumption, marijuana use, anabolic steroids, and intake of drugs for depression, high blood pressure, and bacterial infections.

What are the causes of infertility in women?

Causes of infertility in women may include:

• Ovulation disorders, which impede the ovaries ability to release eggs. Conditions like polycystic ovarian syndrome, hyperprolactinemia that is increased prolactin hormone, abnormal thyroid hormone may impact ovulation. Too much exercise, food disorders, or malignancies may also be underlying factors.

• Abnormalities in structure of uterus or cervix, growth of polyps in uterus or cervix, all such conditions can lead to recurrent miscarriages or implantation failure. Uterine fibroids, which are benign (noncancerous) tumors of the uterine wall, can prevent a fertilised egg from implanting in the uterus or block the fallopian tubes, both of which can result in infertility.

• Inflammation of the fallopian tube is frequently the cause of fallopian tube injury or obstruction (salpingitis). This may be the outcome of pelvic inflammatory disease, sexually transmitted infection, tuberculosis or any other infection affecting reproductive system.
• The ovaries, uterus, and fallopian tubes may all be affected by endometriosis, which develops when endometrial tissue spreads outside of the uterus. It may lead to formation of adhesions which may hamper the normal functioning of the fallopian tube. Endometriosis also has adverse effects on the ovarian reserve and on implantation.

What are common signs of infertility in men and women?

Unable to conceive is the only sign for infertility. There may be no sign or symptom of infertility in both males and females.

Takeaway

An estimated 15 to 20 percent of couples who are attempting to get pregnant will experience infertility issues. Infertility due to female factors often accounts for 40% of problems, whilst infertility due to male factors accounts for 30% to 40% of problems. 20 to 30 % of the time, a combination of these variables results in infertility.

You’re not alone if you’ve found out that you’re infertile or think you could have difficulties becoming pregnant in the future. Schedule a consultation with your doctor and discuss your worries there. Even if you have been given an infertility diagnosis, you might still be able to get pregnant if you consult the doctor at earliest.