Recurrent Miscarriage: Treatment & Diagnosis

Recurrent Miscarriage: Treatment & Diagnosis

When a woman experiences two or more successive clinical pregnancy losses, this condition is known as recurrent miscarriage. It is also known as chronic abortion or recurrent pregnancy loss. Clinical pregnancy is defined by doctors as having visible or detectable signs of a gestational sac (a cavity of fluid around an embryo), or foetal pole (thickening on the yolk sac edge of a foetus) in an early ultrasound.

Clinical pregnancies are different from chemical pregnancies, which result in a miscarriage before any physical signs of pregnancy other than a positive pregnancy test or blood test are present. 15 to 20 per cent of clinical pregnancies result in miscarriages.

How to diagnose recurrent miscarriage?

An obstetrician/gynaecologist or fertility specialist will examine the patient’s medical history and previous pregnancies to identify the reason for recurrent miscarriages. Typically, a doctor would advise getting a full physical exam, which includes a pelvic check.

A karyotype test of the embryo, which identifies and assesses the size, shape, and number of chromosomes in a sample of body cells, may be used by the doctor if repeated miscarriages are considered to be the result of a genetic defect.

Imaging tests, such as an MRI or sonogram/ultrasound, are probably performed if a doctor feels a uterine anatomical issue is the root cause of a recurrent miscarriage. If a woman has a problem with the shape of her uterus, it can be detected with an ultrasound or a hysterosalpingogram (HSG), which is an X-ray of the fallopian tubes and uterine cavity. Blood testing can be used by doctors to identify immune system issues like Antiphospholipid syndrome or thrombophilia which is the tendency of the body to form blood clots.

About half of the patients who are assessed for recurrent miscarriage have a specific diagnosis. The diagnosis of recurrent miscarriage in the remaining cases lacks a clear reason.

Depending on the patient’s maternal age, the likelihood of a positive outcome among those patients who are unsure of the origin of their diagnosis can reach up to 70%.

What is the treatment for recurrent miscarriage?

Recurrent miscarriages can be treated with lifestyle changes, medications, surgery, or genetic testing to improve the likelihood of a healthy pregnancy. Medical or surgical therapies can reduce a woman’s risk for subsequent miscarriages in certain circumstances including recurrent miscarriages.

A woman still has a 60 to 80% probability of conceiving and carrying a full-term pregnancy even after three miscarriages. The majority of the time, women choose to continue their natural pregnancy attempts. Still, in some cases, a doctor may recommend medication to assist in lowering the risk of suffering another loss.

Surgery can correct issues with a septate uterus and remove certain fibroids or anomalies caused by scar tissue etc. Since surgical repair increases the live birth rate, it is frequently the preferred treatment for anatomical problems.

A doctor may recommend blood-thinning drugs like heparin or low-dose aspirin if the patient has an autoimmune condition like APS or thrombophilia. Although a patient can use blood-thinning drugs to reduce the risk of miscarriage while pregnant, she should consult a doctor before doing so due to the increased risk of life-threatening bleeding issues.

Treatment for medical conditions like thyroid, hormone abnormalities, and abnormal blood sugar levels might increase the likelihood of a healthy, full-term pregnancy. Progesterone supplements or drugs that stimulate the brain’s dopamine receptors can help with this process.

A doctor might advise genetic counselling if a chromosomal issue like a translocation is discovered. Even though many couples with translocations can conceive normally, a doctor may advise fertility treatments such as in vitro fertilisation (IVF), which is a procedure in which a reproductive specialist combines eggs and sperm in a lab. Preimplantation genetic diagnosis (PGD) allows for the genetic testing of the embryos after which only healthy ones are delivered to the uterus. This enhances pregnancy results.

Making healthy lifestyle decisions like giving up smoking or using illegal drugs, consuming less alcohol and caffeine, and maintaining a healthy weight may reduce the risk of recurrent miscarriage.

Best IVF Center in Maldives

Best IVF Center in Maldives:

Pristyn Care Ferticity IVF & Fertility Clinics provides the best IVF treatment in Maldives. Because of its reduced IVF costs, the cost of IVF Treatment in Maldives is now affordable. Couples and parents who struggle with infertility can receive complete fertility options from the centre. It is providing in vitro fertilisation at the most affordable price. More than 16,000 healthy babies from around the world were born with the help of our experts and more than 50,000 families have been served by the centre.

Read More: Successful IVF: Tips for a Healthy Pregnancy after IVF Treatment

What is IVF (in vitro fertilization)?

In vitro fertilisation, or IVF, is a sort of assisted reproductive technology (ART) that helps people or couples who are having trouble conceiving a child naturally. In vitro fertilisation (IVF) is a process that involves several medical treatments intended to help fertilise an egg with sperm outside of the body, in a laboratory setting. If you’re looking for the best IVF hospital in Maldives, your search ends here.

What is the process of IVF?

The steps involved in IVF are as follows:

Estrogen or contraceptives: 

Your doctor can recommend oestrogen or birth control medications before you begin IVF treatment. This is used to regulate the time of your menstrual cycle and prevent the growth of ovarian cysts. It enables your doctor to manage your care and increase the number of mature eggs collected during the egg retrieval operation. While some people are prescribed birth control pills that include both oestrogen and progesterone, others only receive oestrogen.

Ovarian stimulation:

A group of eggs starts to mature each month during the natural cycle in a healthy person of reproductive age. Normally, only one egg develops to the point of ovulation. The rest of the group’s immature eggs break apart.

Ovarian Stimulation TreatmentYou will receive injectable hormone drugs throughout your IVF cycle to encourage the batch of eggs to mature all at once and fully. This indicates that you might have numerous eggs instead of just one (as in a natural cycle). Your medical history, age, AMH (anti-mullerian hormone) level, and reaction to ovarian stimulation during prior IVF cycles will all be taken into account when determining the type, dosage, and frequency of drugs that will be given to you specifically. The other steps in the ovarian stimulation process include:

  • Monitoring: Ultrasounds and blood hormone levels are used to track how your ovaries are responding to the drugs. Over two weeks, monitoring can take place every day or every few days. Usually, stimulations endure for eight to fourteen days. During monitoring visits, medical professionals utilise ultrasound to examine your uterus and ovaries. Because of their small size, eggs cannot be seen with ultrasonography. Nonetheless, the size and quantity of ovarian follicles in growth will be counted by your healthcare professionals. Your ovaries contain tiny sacks called follicles, each of which should hold one egg. Each follicle’s size reveals the developmental stage of the egg it holds. Most follicles longer than 14 mm (mm) contain a fully developed egg. Less than 14 mm follicles are more likely to contain immature eggs that won’t fertilise.
  • Trigger shot: A “trigger shot” is given to complete the maturation of your eggs to prepare for egg retrieval when they are ready for ultimate maturity, which is assessed by your ultrasound and hormone levels. Precisely 36 hours before the time of your intended egg retrieval, as per your instructions, you must administer the trigger shot.

Egg retrieval:

A tiny needle is inserted into each of your ovaries through your vagina by your doctor using an ultrasound as guidance. The suction tool attached to the needle is used to extract your eggs from each follicle. Your eggs are put in a dish with a unique solution. An incubator is then used to house the dish (controlled environment). During this treatment, discomfort is minimised using medication and moderate anaesthesia. The “trigger shot,” the final hormone injection before egg retrieval, is given 36 hours later.

Fertilization:

The embryologist will attempt to fertilise all mature eggs using intracytoplasmic sperm injection, or ICSI, the afternoon after your egg retrieval operation. This implies that each developed egg will get a sperm injection. ICSI cannot be conducted on immature eggs. The undeveloped eggs will be put in a dish with sperm and food. Seldom do immature eggs complete their development in the dish. The sperm in the dish can then attempt to fertilise the egg if an immature egg eventually matures.

70% of mature eggs will typically fertilise. For instance, seven out of ten ripe eggs will fertilise if ten are recovered. The fertilised egg will develop into an embryo if it is successful.

If there are too many eggs or you don’t want all of the eggs fertilised, you can freeze some of the eggs before fertilisation for later use.

Embryo development:

Your embryos’ growth will be closely watched during the ensuing upto five to six days.

Before it is ready to be transferred into your uterus, your embryo must clear many obstacles. The cells must divide and grow every day. 50% of fertilised embryos typically reach the blastocyst stage. The stage best suited for transfer to your uterus is this one. For instance, three or four of seven fertilised eggs may progress to the blastocyst stage. Usually, the remaining 50% are not successful and are eliminated. However, day 3 stage embryos can also be transferred depending on past history and several other factors.

On day three, five or day six after fertilisation, all viable embryos will be preserved in preparation for upcoming embryo transfers.

Embryo transfer:

Fresh and frozen embryo transfers are the two different types of embryo transfers. Depending on your particular circumstances, your healthcare practitioner can help you determine if using fresh or frozen embryos is ideal for you. The identical transfer procedure is used for frozen and fresh embryo transfers. The name already makes the primary distinction clear.

A fresh embryo transfer occurs three to five days following the egg retrieval operation when the embryo is put into your uterus. This embryo is “fresh” because it hasn’t been frozen.

A frozen embryo transfer entails the thawing and implantation of frozen embryos (from an earlier IVF cycle or donor eggs) into your uterus. Due to practical considerations and the higher likelihood of live birth, this approach is more widespread. Years after egg retrieval and fertilisation can pass before frozen embryo transfers take place.

Pregnancy:

When the embryo embeds itself in the uterine lining, pregnancy results. Between nine to 14 days following embryo transfer, your doctor will perform a blood test to see if you’re pregnant.

Why is IVF done?

Infertility or genetic issues are treated by in vitro fertilisation (IVF). If intrauterine insemination (IUI) is used to treat infertility, you and your partner may be able to try less invasive treatment options before attempting IVF, such as fertility medications to boost egg production or IUI, in which sperm are placed directly in the uterus close to the time of ovulation.

IVF is occasionally recommended as the first line of therapy for infertility in women over the age of 40. If you have certain medical problems, IVF may still be an option. IVF, for instance, might be a choice if you or your spouse have:

  • Blockage or injury to the fallopian tube: It is challenging for an egg to become fertilised or for an embryo to move to the uterus when the fallopian tube is damaged or blocked.
  • Ovulation Disorder: Fewer eggs are accessible for fertilisation if ovulation is infrequent or nonexistent.
  • Endometriosis: Endometriosis develops when tissue resembling the uterine lining implants and spreads outside of the uterus, frequently impairing the ovaries’, uterus’, and fallopian tubes’ functionality.
  • Uterine fibroids: In the uterus, fibroids are benign tumours. In women in their 30s and 40s, they are typical. Fibroids may prevent the fertilised egg from implanting properly.
  • Previous tubal sterilization or removal: The fallopian tubes are cut or blocked during a procedure known as tubal ligation to permanently end a pregnancy. best IVF treatment in Maldives may be a better option than tubal ligation reversal surgery if you want to become pregnant after having your tubes tied.
  • Impaired sperm production or function: Sperm may have trouble fertilising an egg if they have low concentration, weak movement (poor mobility), or abnormalities in size and form. A consultation with an infertility specialist may be required if abnormalities in the semen are discovered to determine whether there are any treatable issues or underlying medical problems.
  • Unexplained infertility: Despite testing for typical causes, unexplained infertility refers to the absence of a cause.
  • A genetic disorder: Preimplantation genetic testing, which involves IVF, may be an option for you if you or your partner are at risk of passing a genetic condition to your kid. It is possible to find some genetic issues after the eggs have been fertilised and extracted, but not all genetic issues. Transfer to the uterus is possible for embryos without known defects.
  • Fertility preservation for cancer or other health conditions: best IVF treatment in Maldives  for fertility preservation may be an option if you are about to begin cancer treatment that could affect your fertility, including radiation or chemotherapy. Women can have their ovaries harvested for eggs, which are then frozen unfertilized for future use. Alternatively, the eggs can be fertilised and preserved as embryos for later use.

If a woman’s uterus isn’t functioning or pregnancy offers a major health risk, she may opt for IVF with another person carrying the pregnancy (gestational carrier). In this instance, the sperm and the woman’s eggs are fertilised, but the resulting embryos are then implanted in the uterus of the gestational carrier.

How Much Does it Cost to Get an IVF Treatment in Maldives?

In-vitro fertilisation (IVF) uses an assisted reproductive technique (ART) that entails a planned series of actions starting with the surgical removal of eggs from the ovaries, a fusing of these eggs with the retrieved sperm in a laboratory, and implanting the embryo in the woman’s uterus. Modern methods that always affect cost aid the entire fundamental process. The IVF cost in Maldives is quite affordable s compared to others.

Takeaway

Visit the best IVF clinic in Maldives right away to book an appointment. At Pristyn Care Ferticity IVF & Fertility Clinics, we work hard to provide the best IVF treatment in Maldives with an emphasis on giving our patients individualised care and support.

Our team of fertility specialists, doctors, and counsellors collaborates to make sure you get the best treatment possible at every stage of your journey. We are committed to assisting you in realising your desire to start or expand your family, whether it be through your initial consultation or post-pregnancy care.

Ovarian Stimulation: Process & Risks

Ovarian Stimulation: Process & Risks

The second step in the IVF fertility process is ovarian stimulation. From the woman’s ovaries, the intention is to remove all mature eggs formed with ovarian stimulation. Collecting many eggs increases the likelihood that one of them will be fertilised, returned to the uterus, and develop into a healthy child.

Ovarian stimulation is difficult since the normal female reproductive cycle is complex. An IVF cycle can be stressful, mainly if it’s your first time.

Related: Top IVF Myths People Need To Stop Believing

How does Ovarian Stimulation work?

During ovarian stimulation, follicle-stimulating hormones (FSH) and luteinizing hormones (LH) are administered to aid in the development, maturation, and release of more eggs. These hormones are injected to begin the procedure during a two-week period.

FSH is used to boost oestrogen levels and drive follicle growth because some naturally die when the body’s FSH levels fall. It is essential that these levels stay high to encourage higher egg production. Estrogen levels must be high since this hormone aids at the beginning of ovulation. It should be mentioned that the IVF procedure necessitates the retrieval of the eggs before ovulation.

What is the process of Ovarian Stimulation?

The timing of the ovarian stimulation procedure must be exact to coincide with the patient’s body’s normal cycle. To understand how the body is responding to the medicine being administered, it is important to carefully observe each step of ovarian stimulation.

To administer the medication for the subsequent stage, it is also crucial to understand the progression of the follicle maturation as well as what is occurring. The ovarian stimulation that causes the follicles in the ovaries to mature occurs in three stages specifically. The three stages are:

  • Stimulate the growth of follicles.
  • Prevent the egg release.
  • Final maturation.

The medicine, time and dose are decided according to the above stages.

What are the risks of Ovarian Stimulation?

Ovarian Hyper Stimulation Syndrome (OHSS) is a known side effect of ovarian stimulation. However, due to new medicine and protocols of IVF, this is very rarely seen these days. A few days after the eggs have been collected, this complication may occur. A significant amount of hormone therapy is what leads to OHSS. The ovaries become painfully enlarged as a result. Most women with OHSS typically have a moderate disease which is self-limiting, but in rare instances, the raised hormones may have a serious negative impact on the patient and may require hospitalization.

Takeaway

If you’re looking for the best IVF centre to start your parenthood journey or you still have questions regarding this, you can always reach out to us. Pristyn Care Ferticity IVF & Fertility Clinics is one of the best IVF centres in South Delhi. 

 

Non-obstructive Azoospermia: Causes & Treatment

Azoospermia is the medical term for an ejaculate that contains no sperm at all. According to the presence or absence of obstruction, it is divided into obstructive azoospermia and non-obstructive azoospermia.

What are the causes of Non-Obstructive Azoospermia?

Non-obstructive azoospermia can be caused by many things, such as:

  • Genetic Causes: Male infertility can have a number of hereditary origins, some of which can lead to non-obstructive azoospermia. They include karyotypic anomalies and Y-chromosome microdeletions. When a male has an extra X chromosome, they have Klinefelter Syndrome, the most prevalent karyotypic anomaly. 
  • Varicoceles: Varicoceles, which are enlarged varicose veins in the scrotum, can potentially have an impact on sperm production. Blood pooling in the scrotum brought on by varicoceles has a detrimental effect on sperm production.
  • Medications: The generation of sperm may potentially suffer from exposure to some drugs. For instance, taking testosterone supplements can interfere with the reproductive system’s operation.
  • Causes of Non-Obstructive Azoospermia by Hormone: The pituitary’s hormones must stimulate the testicles to make sperm. Sperm formation cannot take place if these hormones are lacking or absent. The hormones required for sperm production may have been impacted in men who currently use or have used steroids.
  • Radiations and Toxins: The production of sperm can be hampered by harmful chemical exposure, such as that caused by chemotherapy and radiation therapy. For this reason, sperm banking is advised before chemotherapy or radiation therapy.

What is the treatment for Non-Obstructive Azoospermia?

Hormone replacement therapy (HRT) effectively addresses hormone shortages in males with non-obstructive azoospermia. Aromatase inhibitors, which increase sperm concentration and motility, can treat men with an abnormal testosterone-to-estradiol ratio (T/E2). However, HRT works in patients with low hormones. Patients with high hormone values are difficult to treat and often require donor sperm for IVF. 

Data on whether to surgically repair varicoceles are inconclusive. By tying off the afflicted veins and redirecting blood flow through healthy veins, varicocelectomy can help diminish the enlarged varicose veins, but it is often only used in severe cases.

Pregnancy with Non-Obstructive Azoospermia

In the past, fertility specialists believed that men with sperm production issues could only start a family via donor sperm or adoption. Testicular biopsies, however, frequently reveal sperm in males with non-obstructive azoospermia. In vitro fertilisation (IVF) can use testicular sperm, which frequently have reduced motility, for intracytoplasmic sperm injection (ICSI).

For men with non-obstructive azoospermia, a method called testicular sperm extraction (TESE) and microscopic testicular sperm extraction ( micro TESE) with ICSI has been used. A local or general anaesthetic may be used during testicular sperm extraction. This method can be used to obtain sperm for IVF treatments.

Genetic testing and counselling are advised before IVF if a man has been diagnosed with a hereditary explanation for his non-obstructive azoospermia.

Blocked Fallopian Tubes: Symptoms, Causes & Diagnosis

Blocked Fallopian Tubes: Symptoms, Causes 

Fallopian tubes are part of the female reproductive system attached to the uterus from one side and ovaries on the other. Every month, an egg is transported from an ovary to the uterus by the fallopian tubes during ovulation, which takes place around the middle of a menstrual cycle. The fallopian tube is where conception also takes place. If a sperm fertilises an egg, the fertilised egg travels via the tube to the uterus where it will be implanted.

A blocked fallopian tube prevents sperm from reaching the eggs and the fertilised egg from returning to the uterus. Scar tissue, infections, and pelvic adhesions frequently cause fallopian tube blockages. 

What are the symptoms of a blocked fallopian tube?

Contrary to anovulation, which may be indicated by irregular menstrual periods, obstructed fallopian tubes rarely result in symptoms. Infertility is frequently the first “symptom” of obstructed fallopian tubes. In addition to regular routine fertility testing, your doctor may order a special X-ray to check your fallopian tubes if you haven’t been pregnant after a year of trying (or after six months if you’re age 35 or older).

Lower abdomen pain and unusual vaginal discharge are possible indications of a particular type of obstructed fallopian tube termed a hydrosalpinx. However, not all women may experience these signs. When a blockage causes the tube to expand (grow in diameter) and fill with fluid, the condition is known as hydrosalpinx. Fertilization and pregnancy are prevented because the fluid inhibits the sperm and egg.

Blocked fallopian tubes can have a variety of causes, some of which may also have unique symptoms. For instance, painful menstruation and painful sexual activity may be brought on by endometriosis and pelvic inflammatory disease (PID).

What are the causes of a blocked fallopian tube?

PID most frequently brings on fallopian tube blockages. Although not all pelvic infections are associated with STDs, pelvic inflammatory disease results from a sexually transmitted illness. A history of PID or a pelvic infection also raises the chance of blocked tubes, even if PID is no longer present.

Here are some more factors that could result in obstructed fallopian tubes:

  • Having chlamydia or gonorrhoea currently or in the past is an STD infection.
  • An abortion or miscarriage-related uterine infection history.
  • Previous fallopian tube surgery, including tubal ligation.
  • History of an appendix rupture.
  • History of abdominal surgery.
  • Previous ectopic pregnancy
  • Endometriosis

How to diagnose a blocked fallopian tube?

It can be challenging to recognise blocked fallopian tubes. It is sometimes difficult to determine if the tubes are obstructed or closed because they can open and close.

  • a hysterosalpingogram (HSG), an X-ray examination: Injecting a safe dye into the womb should cause it to flow into the fallopian tubes and the pelvis. On an X-ray, you can see the stain. The fallopian tubes may be blocked if the fluid does not enter them or does not spill put freely into the pelvic cavity.
  • a sonosalpingography (SSG), a type of ultrasound examination: Fluid is pushed through the cervix into the uterine cavity to see if it comes out in the pelvic cavity. While doing an ultrasound this fluid can be seen flowing into the cavity and out into the pelvis to determine if the tubes are opened.
  • laparoscopy, often known as keyhole surgery: A small incision is made in the body, and a tiny camera is inserted to obtain images of the fallopian tubes from within. Dye is pushed into the uterus to see if it flows out in the pelvic cavity.

How to treat blocked fallopian tubes?

Fallopian tubes that are obstructed may be surgically opened. However, this depends on the degree of scarring and the location of the blockage. 

What are the possible complications caused by a blocked fallopian tube?

The same risks are involved with surgery to open the fallopian tubes. These consist of:

  • development of more scar tissue.
  • bleeding.
  • infection.
  • ectopic pregnancy.

Takeaway

Even while blocked fallopian tubes can lead to infertility, it is still possible to become pregnant. Oftentimes, laparoscopic surgery can clear the obstruction and help fertility. IVF can assist you in getting pregnant if surgery is not an option. Pristyn Care Ferticity IVF & Fertility Clinics is one of the best IVF facilities in Delhi which has a cutting-edge laboratory and a competent staff of specialists in both fertility and medicine. Book an appointment with us today!