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Uterine Fibroids: Symptoms & Diagnosis

Leiomyomas, or uterine fibroids, are growths of muscle and connective tissue from the uterus’s wall. Often, these growths are not malignant (benign). In your pelvis, your uterus is an organ with a pear-shaped shape on its side. During pregnancy, the baby develops and grows inside the uterus.

Who is at risk for uterine fibroids?

Your likelihood of having fibroids may be influenced by a number of risk factors. They may consist of the following:

• Increase in body weight and obesity
• Family history of fibroids.
• Menopause at a late age.
• Getting your period at a young age.
• Not having children.

What are the symptoms of uterine fibroids?

Most fibroids are symptomless and don’t need any treatment beyond routine monitoring by your healthcare provider. Usually, these are little fibroids. Asymptomatic fibroids are those that do not cause symptoms. You may have a number of symptoms from larger fibroids, including:

• Excessive or uncomfortable menstrual bleeding.
• Bleeding in between menstrual cycles.
• Bloating or a lower abdominal fullness sensation.
• Frequent urination.
• Pain during sex.
• Low back pain.
• Constipation.
• Chronic vaginal discharge.
• Inability to totally empty your bladder or urinate.
• Increased abdominal enlargement.

How are uterine fibroids diagnosed?

Frequently, fibroids are initially identified during a routine visit with your doctor. These can be detected during prenatal care or a gynecologic exam and felt during a pelvic exam. Quite frequently, your description of severe bleeding and other relevant symptoms may prompt your doctor to think about including fibroids in the diagnosis. Several tests can be performed to identify the size and location of fibroids as well as to confirm their presence. These tests might be:

• Ultrasonography: This non-invasive imaging examination uses sound waves to paint a picture of your inside organs. Transvaginal or transabdominal ultrasonography procedures can be used.

• Magnetic resonance imaging (MRI): This examination produces finely detailed images of your interior organs using magnets and radio waves.

• Computed tomography (CT): Using X-ray imaging, a CT scan creates a detailed view of your inside organs from various angles.

• Hysteroscopy: A scope is a small, flexible tube with a camera on the end that your doctor will use during a hysteroscopy to view the fibroids inside your uterus. The scope is inserted into your uterus after passing through your cervix and vagina.

• Hysterosalpingography (HSG): In order to get a clear image of the uterus, a contrast substance must first be injected. This is more frequently applied to those who are also having infertility testing.

• Sonohysterography: In this imaging procedure, a tiny catheter is inserted transvaginally, and saline is administered into the uterine cavity via the catheter. With the help of the additional fluid, your uterus can be seen more clearly than during a typical ultrasound.
• Laparoscopy: Your doctor will create a tiny cut (incision) in your lower abdomen to do this test. To take a close-up look at your inside organs, a little, flexible tube with a camera on the end will be inserted.

 Best IVF Center in Mauritius

Pristyn Care Ferticity IVF & Fertility Clinics is the best IVF centre in Mauritius. Because of its reduced IVF costs, the cost of the best IVF Treatment in Mauritius is now affordable. The centre offers comprehensive fertility solutions to couples and parents who are having trouble getting pregnant. In vitro fertilisation is offered there for the lowest possible cost. With the assistance of our experts, more than 16,000 healthy infants from all over the world have been born, and the centre has assisted more than 50,000 families.

What is IVF (in vitro fertilization)? Which is the best IVF centre in Mauritius?

A type of assisted reproductive technology (ART) called in vitro fertilisation, or IVF, helps individuals or couples who are having difficulty conceiving a child naturally. It is possible to fertilise an egg with sperm outside of the body, in a laboratory setting, through a process called in vitro fertilisation (IVF). If you’re looking for the best IVF hospital in Mauritius, your search ends here.

What is the process of IVF?

The steps involved in IVF are as follows:

Estrogen or contraceptives: 

Before starting IVF treatment, your doctor may advise oestrogen or birth control pills. This controls the start of your menstrual cycle and stops the development of ovarian cysts. It makes it easier for your doctor to monitor your care and retrieve more mature eggs during egg retrieval. Others simply receive oestrogen, while some are prescribed birth control pills that include both oestrogen and progesterone.

Ovarian stimulation:

In a healthy person of reproductive age, a batch of eggs begins to mature once a month according to the natural cycle. Just one egg typically matures to the point of ovulation. The group’s remaining immature eggs began to break apart.

Throughout your IVF cycle, you will be given injectable hormone medications to enable the batch of eggs to mature all at once and completely. This means that instead of just one egg, you can have several (as in a natural cycle). The type, amount, and frequency of medications administered to you specifically will be determined by your medical history, age, AMH (anti-mullerian hormone) level, and response to ovarian stimulation during prior IVF cycles. The other steps in the ovarian stimulation process include:

• Monitoring: In order to monitor how your ovaries are responding to the medications, ultrasounds and blood hormone levels are employed. Monitoring might happen daily or every few days over the course of two weeks. Stimulations typically last eight to fourteen days. Ultrasound is used by medical practitioners to inspect your uterus and ovaries during monitoring appointments. Eggs cannot be spotted with ultrasound due to their small size. Nevertheless, your medical professionals will measure the size and number of ovarian follicles that are developing. One egg should fit inside each of the small sacs found in your ovaries, which are known as follicles. The size of each follicle indicates the stage of development of the egg it contains. A completely formed egg is present in the majority of follicles longer than 14 mm. Unfertilized immature eggs are more likely to be present in follicles with a diameter of less than 14 mm.
• Trigger shot: When your eggs are ready for final maturity, which is determined by your ultrasound and hormone levels, a “trigger shot” is administered to finish the maturation process in order to become ready for egg retrieval. You must give the trigger injection exactly 36 hours before the time of your planned egg retrieval, as directed by your doctor.

Egg retrieval:

Your doctor will use an ultrasound to guide a tiny needle into each of your ovaries through your vagina. Your eggs are extracted from each follicle using the suction tool that is coupled to the needle. Your eggs are placed in a dish with a special mixture. The dish is then kept in an incubator (controlled environment). Using medicine and a light level of anaesthesia, discomfort is minimised throughout this procedure. 36 hours later, the final hormone injection before egg retrieval—the “trigger shot”—is administered.

Fertilization:

The afternoon following your egg retrieval procedure, the embryologist will attempt to fertilise all mature eggs using intracytoplasmic sperm injection, or ICSI. This suggests that sperm will be injected into each mature egg. Immature eggs cannot be used in ICSI. sperm and food will be placed in a dish with undeveloped eggs. Seldom do immature eggs finish growing in the dish. If an immature egg ultimately matures, the sperm in the dish can try to fertilise the egg.

Usually, 70% of mature eggs will fertilise. For instance, if 10 mature eggs are found, seven of them will fertilise. If fertilisation is successful, the egg will grow into an embryo.

You can freeze some of the eggs before fertilisation if there are too many eggs or if you do not want all of the eggs fertilised.

Embryo development:

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

Your embryo must overcome a number of challenges before it is prepared to be implanted into your uterus. Every day, the cells must divide and grow. Usually, 50% of fertilised eggs develop into blastocysts. This is the stage that is most suitable for transfer to your uterus. Three or four of seven fertilised eggs, for instance, might develop into blastocysts. The remaining 50% are typically unsuccessful and discarded. However, depending on the patient’s medical history and a number of other circumstances, day 3 stage embryos may also be transferred.

All viable embryos will be stored in anticipation of upcoming embryo transfers on days three, five, or six following fertilisation.

Embryo transfer:

The two types of embryo transfers are fresh and frozen embryo transfers. Your doctor can assist you in deciding if using fresh or frozen embryos is best for you to have given your unique circumstances. Both fresh and frozen embryo transfers follow the same protocol. The primary distinction is already apparent from the name.

The embryo is implanted into your uterus three to five days after the egg retrieval procedure during a fresh embryo transfer. This embryo has not been frozen, making it “fresh.”

Frozen embryos from an earlier IVF round or donor eggs are thawed and implanted into your uterus during a frozen embryo transfer. This method is more common since it is more practicable and there are more live births. Frozen embryo transfers can happen years after egg retrieval and fertilisation.

Pregnancy:

Pregnancy happens as a result of the embryo’s implantation in the uterine lining. Your doctor will conduct a blood test to determine your pregnancy nine to fourteen days after the embryo transfer.

Why is IVF done?

In vitro fertilisation is used to treat infertility or genetic conditions (IVF). Before starting IVF, you and your spouse may be able to try less intrusive treatments such as fertility drugs to increase egg production or intrauterine insemination (IUI), in which sperm is directly injected into the uterus just before ovulation.

IVF is sometimes suggested as the first course of treatment for infertility in women over 40. IVF may still be an option if you have particular medical issues. IVF, for instance, might be a choice if you or your spouse have:

• Blockage or damage to the fallopian tube: When the fallopian tube is damaged or obstructed, it is difficult for an egg to mate or for an embryo to migrate to the uterus.
• Ovulation Disorder: If ovulation is irregular or absent, fewer eggs are available for fertilisation.
• Endometriosis: This condition, which usually affects the ovaries, uterus, and fallopian tubes, arises when tissue that resembles the uterine lining implants and extends outside of the uterus.
• Uterine fibroids: Fibroids are benign tumours that develop in the uterus. These are typical in women in their 30s and 40s. The proper implantation of the fertilised egg may be hampered by fibroids.
• Previous tubal sterilisation or removal: During a technique known as tubal ligation, the fallopian tubes are cut or plugged to end a pregnancy permanently. If you wish to become pregnant after having your tubes shut, IVF can be a better alternative than tubal ligation reversal surgery.
• Impaired sperm production or function: Sperm with low concentration, weak movement (poor mobility), or abnormalities in size and structure may have problems fertilising an egg. If abnormalities in the semen are found, a consultation with an infertility specialist may be necessary to establish whether there are any treatable disorders or underlying medical conditions.
• Unexplained infertility: Unexplained infertility is the absence of a cause despite testing for common causes.
• A genetic disorder: If either you or your spouse run the risk of passing a genetic issue to your child, preimplantation genetic testing, which requires IVF, may be a possibility for you. Certain genetic problems, but not all of them, maybe discovered after the eggs have been fertilised and removed. Embryos with no known abnormalities are able to be transferred to the uterus.
• Fertility preservation for cancer or other health conditions: If you are going to start cancer treatment that could damage your fertility, such as radiation or chemotherapy, IVF for fertility preservation may be a possibility. Women’s ovaries can be removed to obtain eggs, which are then frozen unfertilized for later use. The eggs can also be fertilised and kept as embryos for later use.

IVF with a different individual carrying the pregnancy may be an option for a woman if her uterus isn’t working or if the pregnancy poses a serious health risk (gestational carrier). The sperm and the woman’s eggs are fertilised in this case, but the resulting embryos are then implanted in the gestational carrier’s uterus.

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

In-vitro fertilisation (IVF) is a type of assisted reproduction technique (ART) that involves a predetermined sequence of procedures beginning with the surgical removal of eggs from the ovaries, fusing those eggs with the retrieved sperm in a lab, and implanting the resulting embryo in the woman’s uterus. Technological techniques help the entire fundamental process and always have an impact on cost. The IVF cost in Mauritius is quite affordable s compared to others.

Takeaway

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

To ensure you receive the finest care possible at every stage of your journey, our team of doctors, fertility specialists, and counsellors works together. Whether it be at your initial consultation or post-pregnancy care, we are dedicated to helping you realise your dream to start or grow your family.

Best IVF Treatment in Andaman

In vitro fertilisation, also known as IVF, is a reproductive procedure in which sperm and eggs are combined in a lab outside the body. It is a method followed by those who require assistance getting pregnant. IVF is a successful sort of assisted reproductive technology that entails numerous steps. Are you looking for the best IVF Treatment in Andaman?

IVF Treatment in Andaman

At Pristyn Care Ferticity IVF & Fertility Clinics, we have state-of-the-art facilities to deliver best-in-class infertility to every patient treated by professionals and consults with us. We’re committed to giving you the top care you need and deserve. We put a lot of effort into making it possible for you to become a parent since we comprehend your desire.

With our many years of experience, we have been giving every patient the high-quality care they expect. Tens of thousands of our patients have benefited from our assistance in becoming pregnant, and we are ready to add countless others to that list.

As a patient-focused network, Pristyn Care Ferticity supports you during treatment. We have long believed that having a thorough understanding of the diverse conceptions of fertility and its treatment can enable you to make informed decisions about your care and treatment. We guarantee that Pristyn Care Ferticity is a reliable resource for details about fertility and fertility-related goods and services.

So, if you’re looking for the Best IVF Hospital in Andaman, your search ends here at Pristyn Care Ferticity IVF & Fertility Clinics.

How common is IVF?

IVF is a treatment option for about 5% of infertile couples. Since 1978, IVF has resulted in the birth of more than 8 million children. One of the best assisted reproductive technologies (ARTs) now accessible is this one.

How is IVF different from IUI?

In contrast to in vitro fertilisation (IVF), intrauterine insemination (IUI) involves fertilisation inside the patient’s body. A sample of sperm is taken and cleaned to remove all except the best sperm. A catheter (a tiny tube) is used to introduce this sample into your uterus during ovulation. In the hopes that fertilisation will take place, this technique makes it easier for the sperm to reach the egg.

The sperm and egg are fertilised outside of your uterus (in a lab) via IVF, and the resulting embryo is then implanted within your uterus.

Compared to IVF, IUI is less expensive and less intrusive. IUI has a lower cycle success rate.

What do you do to prepare yourself for IVF treatment?

Before beginning IVF treatment, you must undergo fertility tests and a comprehensive physical examination. Also being inspected and tested will be your partner. You’ll go through the following preparation steps, for example:

1. IVF counselling.
2. A uterine exam.
3. A semen analysis.
4. Screening for sexually transmitted infections and other infectious diseases.
5. Ovarian reserve testing, blood and urine tests.
6. Genetic carrier screening.
7. Sign consent forms.
8. Uterine cavity evaluation.

What medications are used for IVF?

A cycle of IVF may involve the use of several drugs. Others are injected, applied to the skin, or inserted in the vagina. Some are taken orally. Depending on the course of your treatment, your doctor will specify the precise dosage and time.

Injectable hormones will likely be administered to you during the ovarian stimulation phase:

• Follicle-stimulating hormone (FSH): These hormones encourage the release of eggs from your ovaries. During your therapy, you can receive one or a combination of the two. This is carried out for roughly 14 days.
• Human chorionic gonadotropin (hCG): Often administered as a last-ditch effort to cause your eggs to develop and initiate ovulation.

Before starting IVF, you might be given birth control pills or injections. This gives you some control over your cycle and enables all of your eggs to begin at the same time. Most often, oestrogen pills are prescribed for consumption both before and after embryo transfer. The lining of their uterus becomes thicker because of this hormone. 

Furthermore, progesterone is administered to increase the likelihood that an embryo will implant and develop into a healthy pregnancy. The majority continue doing this for the entire first trimester. These medicines can be taken orally, intravenously, topically, or vaginally.

How much does IVF costs in Andaman?

It’s challenging to estimate the cost because it depends on your health history, the treatment plan, insurance coverage, etc. However, at Pristyn Care Ferticity IVF & Fertility Clinics, we provide the best treatment at the most affordable cost.

Potential factors influencing the Cost of IVF in Andaman

The modern diagnostic tests, ICSI, aided hatching, PGD/PGS, and surgical aspiration of sperms can be incorporated to change the treatment process and to achieve a successful conception, therefore it’s crucial to understand this before learning the precise cost of IVF in Andaman.

You may choose the best IVF treatment plan from the finest IVF treatment in Andaman by being aware of all the elements that affect prices, the several advanced processes IVF uses, the price of each of these techniques, additional procedure fees, and all potential expenditures before the IVF begins.

As every IVF is unique, a separate set of protocols might need to be followed. One’s chances of becoming a parent can be increased with a minor alteration in the process and the addition of support with cutting-edge IVF treatments. The following determining factors that affect IVF can alter the overall cost of implantation.

• Assisted Hatching: The success of implantation is significantly influenced by embryo quality. Zona pellucida, a protective protein layer, provides excellent protection for the embryo. The embryo must rupture its protective coat to effectively implant. To aid implantation, embryologists carefully modify these protein layers under the microscope during assisted hatching. This extremely sophisticated procedure’s fees are separate from the base price.
• Intracytoplasmic sperm injection (ICSI): By directly injecting a single sperm into the egg, ICSI can help with male reproductive difficulties such as low sperm count, poor sperm quality, or less mobile sperm. Unfortunately, there is an additional expense associated with this process.
• Preimplantation genetic screening or diagnosis (PGS/PGD): This genetic testing method checks the embryos for any chromosomal abnormalities such as aneuploids (chromosomes missing or added), chromosomal aberrations, translocations, and single-gene diseases. PGS/PGD can be considered for patients who have a high chance of developing inherited illnesses with the additional cost included.
• Testicular sperm extraction (TESE): If a man has no problems with sperm retrieval or ejaculation, TESE can be used to remove sperms directly from the sperm-producing organs. The cost of this minimally invasive surgical treatment increases.
• Donor eggs and sperm may be necessary in some cases; treatments using donor eggs or sperm will result in higher prices to cover the costs associated with donation.
• Surrogacy: When an embryo transfer is carried out on a surrogate mother, the price will increase due to additional fees for the surrogate mother’s care and needs.

How long does it take to know you are pregnant after IVF?

After embryo transfer, it takes fourteen days to do a pregnancy test. Depending on the procedure or fertility clinic, the precise timing could change. To determine whether you are pregnant, your doctor will most likely do a blood test. Human chorionic gonadotropin (hCG), a hormone made by the placenta during pregnancy, is measured by blood tests.

What is assisted hatching in IVF?

A procedure utilised in IVF is assisted hatching. Before the embryo is transferred into your uterus, a hole must be made in its shell. Your embryo can more easily “hatch” from its shell thanks to this opening. Your embryo must hatch and cling to the lining of your uterus for you to become pregnant.

Consider assisted hatching as a way to give your embryo a head start and raise the likelihood that it will hatch and implant in your uterus. The majority of people who use assisted hatching have had numerous unsuccessful IVF cycles.

What are the common side effects of IVF?

The fertility drugs used in the IVF ovulation stimulation phase sometimes have side effects. They consist of:

• Nausea
• Vomiting.
• Hot flashes.
• Headaches.
• Abdominal pain.

You should be able to get back to your regular activities after the embryo transfer. You could feel a little uncomfortable when your ovaries grow. Typical negative effects following embryo transfer include:

• Constipation.
• Bloating.
• Cramping.
• Breast tenderness.
• Spotting.

IVF can be challenging, both mentally and physically. Several IVF patients experience anxiety and despair. People may experience disappointment or overwhelming feelings as a result of IVF or infertility issues. We are one of the Best IVF Clinics in Andaman and thus, provide all the necessary support to our patients.

How successful is IVF in conceiving a child?

One of the most important factors affecting IVF success is your age. If you’re under 35 years old, your chances of getting pregnant with IVF are substantially higher, and if you’re over 40, they’re a lot lower. A variable factor closely related to age is the live birth rate. For instance, the live birth rate when the pregnant parent is under 35 and using their eggs is roughly 46%, whereas the live birth rate when the pregnant parent is 38 and using their eggs is approximately 22%.

Is there anything you can do to increase your chances of pregnancy with IVF?

The success of IVF might depend on a number of factors, some of which are under your control and others not. These elements consist of:

• age.
• BMI 
• the number of prior births.
• total number of births.
• utilising donor or your eggs.
• quantity of IVF rounds.
• The fertility clinic’s success rate.
• health problems.
• the root of your infertility.

What is the difference between IVF and ICSI?

The method by which the sperm fertilises the egg is the main distinction between IVF and ICSI. The egg and the numerous sperm used in IVF are left in a lab dish to fertilise on their own. The chosen sperm is directly inserted into the egg during ICSI.

ICSI produces acceptable fertilisation outcomes and aids in reducing issues with aberrant fertilisation brought on by eggs and sperm, such as multiple sperm fertilisation and the sperm’s failure to penetrate the eggs and fertilise, among other issues.

Ovarian Cysts: Symptoms & Treatment

An ovarian cyst is a fluid- or semisolid-filled sac that develops on, inside of, or near one or both of your ovaries. Your ovaries are tiny organs in your pelvis that store egg cells and produce oestrogen and progesterone, among other hormones. 

Ovarian cysts come in a variety of forms, and the majority are painless and benign. Ovarian cysts typically don’t have any symptoms. Unless your doctor discovers one while doing a standard pelvic exam or imaging treatment, you probably won’t be aware that you have one.

What are the types of ovarian cysts?

The majority of ovarian cysts are functional cysts. They develop in response to the changes in your body that occur during the menstrual cycle. Ovarian cysts can develop for reasons unrelated to menstruation, however, this is less common. 

The most typical type of ovarian cyst is a functional cyst, which is unrelated to any disease. They are brought on by ovulation (the release of an egg from the ovary). These cysts may indicate that your ovaries are working properly. Without specialised therapy, functional cysts often decrease with time—typically within 60 days.

• Follicular cysts: Each month as part of your menstrual cycle, an egg is released from a tiny sac in your ovary called a follicle. A follicular cyst develops when a follicle fails to release an egg. Instead, the follicle enlarges and becomes more fluid-filled.
• Corpus luteum cysts: The corpus luteum is a cluster of cells that produces hormones after the follicle releases an egg. When fluid builds up in the corpus luteum, it grows and creates a cyst.

Ovarian cysts do not always develop in response to your menstrual cycle. Although they don’t usually indicate a sickness, your doctor may want to keep an eye on them to make sure issues don’t arise. They consist of the following:

• Cystadenomas: These cysts develop on your ovary’s surface. They may be filled with thin, watery or thicker, mucous-like fluid.

• Endometriomas: Endometrial tissue, which is the same tissue from which you bleed each month during your period, fills these cysts.

• Dermoid cysts: Dermoid cysts are made up of cells that make up many different kinds of bodily tissue, including skin, hair, teeth, and even brain tissue.
• Ovarian cancer: Ovarian cancer cysts (tumours) are solid masses of cancer cells, in contrast to the symptoms mentioned above.

What causes an ovarian cyst?

The primary cause of ovarian cysts is ovulation. Additional factors include:

• Endometriosis: When endometriosis is developed, these cysts frequently develop on the ovary.

• Abnormal cell reproduction: Dermoids and cystadenomas are examples of cysts that can develop due to atypical cell proliferation.
• Pelvic inflammatory disease (PID): Cysts can develop in your ovaries as a result of severe pelvic infections.

What are the signs and symptoms of an ovarian cyst?

The symptoms of certain smaller cysts are absent. You might not even be aware of having a cyst in these circumstances. Bigger cyst size may result in:

• Bloating or a sense of fullness in your lower belly that may be more noticeable on one side of your body.
• Backache or pain in the pelvis.
• Pain during intercourse.
• Painful periods.

How is an ovarian cyst diagnosed?

• Ultrasound: In this imaging method, sound waves are used to produce images of the internal organs in your body. It can locate and determine the predominant fluid or solid nature of cysts on your ovaries.

• A pelvic exam: Your doctor or nurse will check your pelvis for abnormalities or changes.
• Laparoscopy: Your medical doctor can see your reproductive organs and pelvic cavity by inserting a camera through an abdominal incision (cut). Your doctor can remove a cyst if one is identified at this time.

What are the treatment options for ovarian cysts?

Your age, as well as the kind and size of your cyst, will affect your treatment. Your symptoms will also play a role. Your doctor might advise you to:

Medicine: Birth control tablets and other hormonal contraceptives prevent you from ovulating. This could prevent the development of ovarian cysts. But, using contraceptives won’t make an existing cyst go away.

Surgery: In cases where a cyst is huge, doesn’t appear to be a functional cyst, is expanding, or hurts, your doctor may advise removal. Without removing the ovary, some cysts can be treated (cystectomy). Sometimes, the ovary containing the cyst is removed (oophorectomy).

Takeaway

If you’re looking for the best hospital to get treated, you can always reach out to us. Pristyn Care Ferticity IVF & Fertility Clinics is one of the best IVF & fertility centres in Delhi. 

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:

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.

You 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

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. 

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 

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!

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.