Natural Conception After IVF Treatment

Natural Conception After IVF Treatment

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By Femelife Fertility

IVF is used to overcome female infertility in the woman due to problems of the fallopian tube, making fertilisation in vivo difficult or due to problems in the partner like decreased sperm quality and quantity.

IVF is used to overcome female infertility in the woman due to problems of the fallopian tube, making fertilisation in vivo difficult or due to problems in the partner like decreased sperm quality and quantity. For IVF to be successful it typically requires healthy ova, sperm that can fertilise, and a uterus that can maintain a pregnancy. Due to the costs of the procedure, IVF is generally attempted only after less expensive options have failed. Pregnancy is a complex phenomenon and many things can change in due course of time. People who had a baby with IVF can get pregnant naturally later. Here are a few theories on what can impact natural success in pregnancies after IVF.

Endometriosis can subside after pregnancy

Sometimes, when a woman with endometriosis becomes pregnant through IVF, her body has time to recover from endometriosis, even if she doesn’t know she has it.

The disease is suppressed allowing the female environment to potentially be more favourable for subsequent pregnancies to occur during 9 months of childbearing.

Release of stress resolves the hormonal environment

For some women, after having their first child through IVF, the pressure of becoming pregnant significantly subsides and with decreased stress and lack of contraception, natural pregnancies may occur. Similarly, at many instances it is seen that women who have adopted a baby conceive naturally later.

Unexplained infertility may get better

About 20 percent of people who had a baby with IVF can get pregnant naturally later and this is more likely to happen if the cause of infertility was unexplained.

PCOS resolves with increasing age

PCOS patients often have regular cycles after a pregnancy, with increasing age the symptoms of PCOS reduce and the hormonal environment slowly returns to normal. This usually corrects defects in ovulation and improves quality of eggs and hence prepares the women for natural conception.

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Infertility : When to see a doctor ?

Infertility : When to see a doctor ?

What should I Know before meeting a Fertility Specialist?

  • WOMEN – A woman’s fertility gradually declines with age, especially in her mid-30s, and it drops rapidly after age 37. Infertility in older women may be due to the number and quality of eggs, or to health problems that affect fertility.

When to see a doctor if you are a female patient?


You probably don’t need to see a doctor about infertility unless you have been trying regularly to conceive for at least one year. Talk with your doctor earlier, however, if you’re a woman and:

  • You’re age 35 to 40 and have been trying to conceive for six months or longer
  • You’re over age 40
  • You menstruate irregularly or not at all
  • Your periods are very painful
  • You’ve been diagnosed with endometriosis or pelvic inflammatory disease
  • You’ve had multiple miscarriages
  • You’ve undergone treatment for cancer

When to see a doctor if you are a male patient?


  • You have a low sperm count or other problems with sperm
  • You have a history of testicular, prostate or sexual problems
  • You’ve undergone treatment for cancer
  • You have testicles that are small in size or swelling in the scrotum known as a varicocele
  • You have others in your family with infertility problems

What are General factors responsible for infertility?


  • Diabetes mellitus,
  • thyroid disorders,
  • undiagnosed and untreated coeliac disease,
  • adrenal disease

What are environmental factors responsible for infertility?


Environmental factors

  • Glues,
  • Volatile organic solvents
  • Pesticides.
  • Tobacco smokers are 60% more likely to be infertile than non-smokers.

 What is the effect of age on fertility? 


  • Age.
    • WOMEN – A woman’s fertility gradually declines with age, especially in her mid-30s, and it drops rapidly after age 37. Infertility in older women may be due to the number and quality of eggs, or to health problems that affect fertility.
    • MEN -Men over age 40 may be less fertile than younger men .
  •  What is the effect of tobacco on fertility? 


    Smoking tobacco –

    • reduces the chances of pregnancy.
    • reduces the possible benefit of fertility treatment.
    • Miscarriages are more frequent in women who smoke.
    • Smoking can increase the risk of erectile dysfunction
    • low sperm count in men is common in tobacco use.

 What is the effect of tobacco on fertility? 


  • WOMEN -Avoid alcohol if you’re planning to become pregnant. Alcohol use increases the risk of birth defects, and may contribute to infertility.
  • MEN – Heavy alcohol use can decrease sperm count and motility.

 What is the effect of Weight on fertility? 


  • Overweight- Inactive lifestyle and being overweight may increase the risk of infertility.
    • WOMEN -Ovulation Disorders .
    • MEN – A man’s sperm count may also be affected if he is overweight so a normal weight is always healthy for fertility.
  • Underweight. Women at risk of fertility who follow a very low calorie or restrictive diet.So eat healthy foods and develop healthy habits .

What is the effect of Exercise on fertility? 


  • Exercise- Insufficient exercise contributes to obesity, which increases the risk of infertility.
  • Heavy Exercise – Ovulation problems are associated with frequent strenuous  and  intense exercise in women who are not overweight.Hence , it is important to avoid heavy exercise when you want to be pregnant.

What are infections associated with infertility?


  • Sexually transmitted infections 
  • chlamydia,
  • gonorrhea
  • Adeno-associated virus might have a role in male infertility so it is important to have a screening for these infections.


  • WOMEN – A woman’s fertility gradually declines with age, especially in her mid-30s, and it drops rapidly after age 37. 
  • MEN -Men over age 40 may be less fertile than younger men .


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HOW TO REDUCE RISK OF BREAST CANCER

HOW TO REDUCE RISK OF BREAST CANCER

HOW TO REDUCE RISK OF BREAST CANCER



Healthy Habits and periodical screening can Prevent Breast Cancer.

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Healthy Habits Prevents Breast Cancer.

Screening mammography can be done every year for women starting from age  40 to reduce risk of breast cancer

What is the relation of breast cancer with alcohol drink?


The more alcohol you drink, the greater your risk of developing breast cancer. Hence ,  stop or reduce your alcohol quantity that reduces your risk of breast cancer.

What is the relation of smoking and breast cancer risk ?


Smoking increases breast cancer risk. Hence , Stop smoking that keeps you healthy.

Is there a relation between weight of a person and breast cancer risk ?


Overweight is a risk factor for breast cancer. Overweight women has increased  risk of breast cancer.

How physical activity helps to reduce breast cancer risk ?


Physically active people maintain a healthy weight, which helps to reduce the risk of breast cancer.

What is the type of physical exercise helps to maintain a healthy weight and decrease the breast cancer risk ?


For a healthy life healthy weight is essential . Hence , You can observe the following for a healthy weight :

  • At least 150 minutes a week of moderate aerobic activity  or
  • 75 minutes of vigorous aerobic activity weekly

One of the above with  strength training at least twice a week keeps you healthy.

Is there a role of breast feeding in prevention of breast cancer?


Breast-feeding play a role in breast cancer prevention. The longer you breast-feed, the greater the protective effect. So breast feeding to the baby reduces the risk of breast cancer too.

What is the effect of hormone therapy on risk of breast cancer?


Combination hormone therapy for more than three to five years increases the risk of breast cancer. Hence be careful while on long term hormone therapy. Is it really necessary ?

You should screen yourself for breast cancer by consulting the doctor.

What is the role of radiation exposure/CT Scan in Breast cancer?


Some studies showed relation between between breast cancer and radiation exposure so it is better to reduce your exposure to radiation.

Which diet reduces risk for breast cancer?


Mediterranean diet with extra-virgin olive oil and mixed nuts may  reduce the risk of breast cancer in women.

Fruits ,vegetables, whole grains, legumes and nuts are healthy for your body and also reduces the risk of breast cancer.

Hence , healthy diet including vegetables, fruits and nuts with loads of antioxidants reduces the risk of breast cancer.

Is there a relation between birth control pills and breast cancer?


Birth control pills and intrauterine devices (IUDs) increases the risk of breast cancer due to the hormone in it. Risk is  estimated to be very small . The risk decreases after the medicine is stopped . As there is a small risk of breast cancer for people taking hormone therapy, you should be vigilant about breast cancer screening. If you find any mass oin breast then immediately consult the doctor.

What is the role of family history in Breast cancer ?


Genetics is  the primary cause of 5–10% of all cases. So women with family history of breast cancer to the mother should be vigilant about breast cancer detection.

When you should suspect breast cancer ?


Appearance of new lump or mass in the breast needs a screen and consultation of doctor. If you develop some skin changes over breast always consult the doctor.

Mass or lump in the breast , is it always indicates cancer?

No.

There are a number of benign conditions which can cause mass or lump in the breast and these issues can be solved by medicines or may need a small surgery. Hence , never get scares if you find a mass or lump in a breast, consult the doctor.

SCREENING FOR BREAST CANCER


What is the common screening for breast cancer?


Mammograms are the commonly used for  screening for breast cancer and early diagnosis too.

What is mammography ?


Mammography is a specific type of breast imaging that uses low-dose x-rays to detect cancer in early stages .This can detect the breast cancer before women experience any symptoms . At this point the disease is mostly treatable  so  the patient can have a healthy life further .

When I should have a screening mammogram ?


Mammography helps in early detection of breast cancers .

Mammography can show changes in the breast up to two years before it can be detected clinically.

Current guidelines from the U.S. Department of Health and Human Services (HHS) and the American College of Radiology (ACR) recommend screening mammography every year for women, beginning at age 40.

Research has shown that annual mammograms lead to early detection of breast cancers, when they are most curable and breast-conservation therapies are available.



Current guidelines from the U.S. Department of Health and Human Services (HHS) and the American College of Radiology (ACR) recommend screening mammography every year for women, beginning at age 40.

Healthy Habits Prevents Breast Cancer.

Screening mammography: every year for women starting from age  40  reduce risk of breast cancer . Healthy habits including breast feeding reduces the risk of breast  cancer .

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Gender Assignment at birth, A Challenge For Parents

Gender Assignment at birth, A Challenge For Parents

Biggest Assignment as a Parent- Raising a child with Genital Ambiguity

The decision to have a baby is the first step in a lifelong commitment of love, time, and financial resources and dealing with a baby with sexual ambiguity is devastating and painful .

Sexual ambiguity is a complex issue. An accurate diagnosis is essential and may take some time. Sex of assignment must be based not only on the underlying diagnosis and karyotype but also on the potential for adult sexual function, fertility, and psychological health. For these reasons, input from several specialties, including endocrinology, genetics, neonatology, psychology, urology, and an ethicist, is important. All members of the team must communicate adequately with each other. Parents must fully understand the medical recommendation for sex assignment and required therapy. They must wholeheartedly agree and support the assigned sex to avoid ambivalence, which can lead to gender confusion and psychological trauma for the child.

Parents may be dealing with two major categories of children presenting with this problem:

  • Virilized 46, XX females –females look like male
  • Under virilized 46, XY males- males look like female

The most common cause of sexual ambiguity in newborns is congenital adrenal hyperplasia secondary to 21-hydroxylase deficiency. Adrenal gland is situated above the kidneys and secretes several hormones.

As a general rule, gonadal tissue containing Y chromosomal material is at higher risk for development of malignancy.

When infant is born with ambiguous genitalia, and the sex of the infant is uncertain, what next ?

Accept the truth, cooperate with medical professionals as further testing is necessary to determine the infant’s sex. Explain all the relevant history during pregnancy that may help in a diagnosis.

 

Reference to more commonly understood birth defects may be useful. Several days may be necessary to complete the testing and a team will participate to make an accurate diagnosis and a considered recommendation.

 

Completion of the birth certificate should not be postponed, and sex assignment should not be delayed. Accept the sex assigned by Medical team.

What can cause genital ambiguity in newborn? Is it preventable?

Drug ingestion, alcohol intake, and ingestion of hormones during pregnancy can lead to such a situation. Hence Maternal history is particularly important. Progestational (androgenic) therapy used for threatened abortion or androgens for endometriosis during pregnancy should be avoided as far as possible. If the mother has signs of excessive androgen or parental family history for occurrence of ambiguity, neonatal deaths, consanguinity, or infertility it can lead to sex disorders.

 

What is the extent of problem?

The most common cause of a virilised female is congenital adrenal hyperplasia (CAH). Virilisation may also be caused by maternal ingestion of androgens or synthetic progesterone during the first trimester of pregnancy. The measurement increased ACTH in blood is useful for making a diagnosis. These babies have female chromosomes with male outlook, however they do have ovaries and uterus like any other female child.

 

An undervirilized male (previously called male pseudo hermaphroditism) refers to a male with female external genitalia. The abnormality may range from various grades of feminisation to a completely female phenotype. Such disorders result from deficient androgen stimulation of genital development and most often are secondary to testosterone biosynthetic defects. These boys have male chromosomes with female outward looks.

How the condition is diagnosed? What are the tests done?

The diagnosis of the origin of sexual ambiguity can rarely be made by examination alone, it is always combined with a series of tests. Tests are directed to determining the presence or absence of palpable gonads (presumably testes), the presence or absence of a uterus, and the karyotype to allows classification of the infant as a virilized female, an under virilized male, having a disorder of gonadal differentiation, or having one of the

unclassified forms. Certain forms of CAH may cause dehydration, hypertension, or areolar or genital hyperpigmentation. Turner’s stigmata may be present, including webbed neck, low hairline, and edema of hands and feet.

Radiographic studies are necessary to find out structural abnormalities like the presence of gonads and other reproductive structures. Pelvic ultrasound examination by qualified and experienced personnel should be performed as soon as

possible to look for a uterus. The presence of gonads, fallopian tubes, and a vaginal vault may also be determined. If necessary, a genitogram may be performed to see the lower reproductive organs like presence of vagina and its extent.

Because 21-hydroxylase deficiency is a common cause of sexual ambiguity, the level of 17-hydroxyprogesterone (17-OHP) should be assessed in all such infants who do not have palpable gonads. Screening of newborns for CAH with measurement of a 17-OHP level is now mandated in all 50 of the United States and in many countries throughout the world. A karyotype is essential and must be obtained expeditiously. Buccal smears are absolutely contraindicated because they are inaccurate. In many laboratories, a karyotype can be completed within 48 to 72 hours.

Defects in testosterone synthesis can be diagnosed by low testosterone levels with defect in its synthesis pathway (from the level of enzymes block either in the adrenal or in testicular pathways).

What is the role of parents in upbringing?

The decision about sex assignment must be carefully made, taking into consideration each “level” of sex determination. Sex assignment also depends on fetal sex hormone exposure, the potential for adult sexual function, and psychological and cultural considerations. It is vital that parents completely understand and support the decision because ambivalence about sex of rearing may result in gender confusion and psychological trauma.

Virilized females are usually assigned a female sex. They have normal ovaries as well as uterus and vaginal structures and, with surgical correction and steroid replacement, can have normal sexual function and achieve fertility. However, severely virilized females should be assigned a male sex.

Undervirilized males are often infertile, and sex assignment has usually been based on

phallic size. Adult social and fulfilling sexual function should be the primary goals of gender assignment. If male sex assignment is contemplated, a trial of depot testosterone (25 mg every 3-4 weeks) for 1 to 3 months indicates whether phallic growth is possible.

In patients with gonadal dysgenesis and Y chromosomal material, gonadectomy is necessary, and fertility is not possible. Internal duct structure is also frequently deranged. Small phallic size usually leads to a female sex assignment.

True hermaphrodites who have a unilateral ovary and uterine structures may have spontaneous puberty and normal fertility and may be raised as females. External genital size and structure may allow male assignment, but more commonly, external genitalia are poorly virilized, and affected infants are assigned a female sex.

 What are the future prospective regarding marriage, child bearing etc.?

Parents must understand that having normal sexual performance does not correlate with reproductive ability. However, physicians always give preference to sexual ability than childbearing probability. Our aim in parenting is to give the child a sexual identity which may contradict the genetic makeup and at places may force us to sacrifice the gonads for future life.

We have much to learn about gender identity and must consider which decisions may be made later than previously thought (e.g., surgery). Some surgical interventions are cosmetic, and some affected patients have expressed the wish to make the decisions in adolescence or adulthood. This field challenges many of our perceptions of sex and gender and our role as physicians. Although the infant with genital ambiguity presents a medical and social emergency, decisions should be made carefully, cautiously, and with all necessary biochemical and anatomic information available. Most important, the multidisciplinary team approach must involve the parents in an open and honest

discussion of the options. In the end, it is the parents who come first in decision making on sex assignment.

A male child be with complete androgen insensitivity should be raised female. Complete androgen insensitivity usually does not have suspicion of ambiguity in the new born period or early childhood. Affected children grow as normal females until puberty. They feminize with normal breast development at puberty because high levels of testosterone are aromatized to oestrogen, but they have no pubic or axillary hair and no menses because they lack uterus and ovaries. Gender identity is usually female. Patients come to medical attention because of lack of menses in adolescent period.

The diagnosis is therefore frequently made when patients are in their middle to late teens. If diagnosed early the testes should be removed to prevent cancer and oestrogen therapy should start early. This therapy helps in developing the vagina and performance as a female is not compromised.

Undervirilized males traditionally, infants with 5-alpha-reductase deficiency were raised as females until puberty, then continued life as males, and, in some cases, achieved fertility. More recently, however, the condition has been recognized early in life, and affected males are now raised from infancy as boys.

Virilized females are usually assigned a female sex. They have normal ovaries as well as

Uterus and ovaries and, with surgical correction and steroid replacement, can have normal sexual function and achieve fertility.

However, severely virilised females should be assigned a male sex. They can perform sexual function as a male but cannot reproduce as they don’t  have male gonads.

Patients with Y-related chromosomal or genetic disorders that cause mal development of one or both testes are said to have gonadal dysgenesis. They present with ambiguous genitalia and may have inadequate virilisation, uterus and vagina may be present in such children. The Y-containing dysgenetic testes are at risk for developing cancer and must be removed better reared as females.

How to deal with infertility in such cases?

Fertility potentiality is decided by karyotyping, presence of gonads and presence of uterus and vagina. Accordingly, they can go for gamete donation programme or surrogacy. The decision has to be taken after discussion with the couple.

 

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Noise pollution : Health Hazards

Noise pollution : Health Hazards

noise pollution

noise pollution

What is noise?

Noise is unwanted unpleasant sound which is loud or disruptive to hearing. From definition of physics, noise is same as any form of sound but it is perceived in the brain in a different way.

What is noise pollution?

Noise pollution is environmental noise and the propagation of noise which cause  harmful impact on the activity of human or animal life.

What are the health issues associated with noise pollution?

Exposure to noise is associated with adverse health outcomes.

Examples:

  • Hearing loss
  • High blood pressure
  • Ischemic heart disease
  • Sleep disturbances
  • Injuries
  • Peptic ulcer
  • Decreased work performance

What are the Psychological effects of noise pollution?

Noise has following psychological effects –

  • Annoyance
  • Psychiatric disorders
  • Adverse psychosocial well-being

What is the noise levels allowed for residential areas?

WHO recommends value of 50 dB allowed for residential areas.

How noise pollution affects cardiovascular health?

High noise levels can result in cardiovascular effects. Exposure to moderately high levels during a single eight-hour period causes a statistical rise in blood pressure of five to ten points and an increase in stress, and vasoconstriction leading to the increased blood pressure as well as increased incidence of coronary artery disease.

Can we reverse noise induced hearing loss?

Noise-induced hearing loss is permanent. But this is very much preventable.

What is the acceptable noise levels in India?

The Central Pollution Control Board of India has set the safe limit for ambient noise at 55 dB for residential areas and 65 dB for commercial areas.

What is the average city noise ?

Average city traffic noise corresponds to 70 dB.

  What is the heavy city noise ?

Average city traffic noise corresponds to 90 dB.

What are examples of very loud noise and its measure?

Very loud noise spans 90 to 110 dB. Examples of 100 and 110 dB respectively are a farm tractor and a jet plane flying 310 meter overhead.

Which is the most nosiest city in India?

A study by the National Physical Laboratory indicated that Mumbai is ‘the noisiest city in India’, the biggest source of noise for a person there being vehicular traffic .

What is the noise level that can drive the person insane?

A noise of 140 decibels is sufficient to drive a person insane.

Which noise can make a permanent hearing loss?

Prolonged  exposure to noise levels greater than 85 decibels can impair hearing permanently.

How to avoid noise pollution?

Ear plugs and ear muffs can be used for this purpose. The workers in noisy environment should be rotated to avoid prolonged exposure. Education about noise pollution and its health hazards are important steps.

Health Tips

Healthy Habits

 

HDL : THE GOOD CHOLESTEROL

HDL : THE GOOD CHOLESTEROL

What is cholesterol?

Cholesterol is a  lipid or  fat-like substance that’s found in all the cells in your body. Your body needs some cholesterol to work properly. But having too much cholesterol in your blood raises your risk of coronary artery disease.

What is the function of cholesterol?

Cholesterol is an essential structural component of all animal cell membranes and is essential to maintain both membrane structural integrity and fluidity. It is helpful in synthesis of vitamin D and all steroid hormones.

What are the types of lipoproteins?

Types of lipoproteins in the blood. In order of increasing density, they are –

  • Chylomicrons,
  • Very-low-density lipoprotein (VLDL),
  • Intermediate-density lipoprotein (IDL),
  • Low-density lipoprotein (LDL),
  • High-density lipoprotein (HDL).

Whatis good Cholesterol?

HDL particles are thought to transport cholesterol back to the liver, either for excretion or for other tissues that synthesize hormones, in a process known as reverse cholesterol transport (RCT ) .  So HDL  is called good cholesterol.  HDL is called the “good” cholesterol because it carries cholesterol from other parts of your body back to your liver.Liver then removes the cholesterol from  body.

 

How do I know what my HDL level is?

A blood test called LIPID PROFILE  can measure your cholesterol levels, including HDL.

How frequently we should check blood lipid profile?

For people who are age 19 or younger:

  • The first test should be between ages 9 to 11
  • Children should have the test again every 5 years
  • Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack, or stroke

For people who are age 20 or older:

  • Younger adults should have the test every 5 years
  • Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years

What is normal level of HDL ?

HDL cholesterol, higher values are better for health. High HDL level can lower your risk for coronary artery disease and stroke. How high your HDL should be depends on your age and sex:

  • Age 19 or younger                                 – More than 45mg/dl
  • Men age 20 or older                                 – More than 40mg/dl
  • Women age 20 or older                 – More than 50mg/dl

 

How to increase blood HDL level?

Lifestyle changes help to increase HDL levels and gives protection against cardiovascular diseases.

  • Eat a healthy diet. To raise your HDL level, you need to eat good fats instead of bad fats .
  • Stay at a healthy weight. You can boost your HDL level by losing weight, especially if you have lots of fat around your waist.
  • Getting regular exercise can raise your HDL level, as well as lower your LDL. You should try to do 30 minutes of moderate to vigorous aerobic exercise on most, if not all, days.
  • Avoid Smoking and exposure to smoke can lower your HDL level.

Why HDL is called good cholesterol?

Large numbers of HDL particles correlates with better health outcomes,whereas low numbers of HDL particles is associated with atheromatous disease progression in the arteries. High HDL levels gives protection against cardiovascular diseases. So HDL is called good Cholesterol.

What are the drugs that can affect HDL level?

Certain medicines can lower HDL levels .

  • Beta blockers
  • Anabolic steroids
  • Progestins
  • Benzodiazepines

Which food is advised to avoid for a favourable lipid profile?

Avoid  trans fats –  they can increase LDL cholesterol and lower HDL cholesterol levels. Foods such as cakes and cookies , fried foods , some margarines.

 

Health Tips

Cholesterol and Heart

Surrogacy In India – A Technology Impasse

Surrogacy In India – A Technology Impasse

Surrogacy is a method of assisted reproduction that helps biological parents start families when they cannot conceive naturally or by artificial methods. Couples pursue surrogacy for several reasons and come from different backgrounds.

There are two types of surrogacy arrangements: gestational surrogacy and traditional surrogacy. In gestational surrogacy, an egg is removed from the biological mother or an anonymous donor and fertilized with the sperm of the biological father or anonymous donor. The fertilized egg, or embryo, is then transferred to a surrogate who carries the baby to term. The child is thereby genetically related to the woman who donated the egg and the father or sperm donor, but not the surrogate. In a traditional surrogacy arrangement, a surrogate becomes pregnant with the use of her own eggs. Indian government legalised surrogacy in 2002 and from then gestational surrogacy is practiced in India.

GUIDELINES FOR SURROGACY –

  • The ART clinic or Fertility Hospital must not be a party to any commercial element in donor programmes or in gestational surrogacy.
  • A surrogate mother carrying a child biologically unrelated to her must register as a patient in her own name. While registering she must mention that she is a surrogate mother and provide all the necessary information about the genetic parents such as names, addresses, etc.
  • She must not use/register in the name of the person for whom she is carrying the child, as this would pose legal issues, particularly in the untoward event of maternal death (in whose names will the hospital certify this death?).
  • The birth certificate shall be in the name of the genetic parents. The clinic, however, must also provide a certificate to the genetic parents giving the name and address of the surrogate mother.
  • Surrogacy by assisted conception should normally be considered only for patients for whom it would be physically or medically impossible/ undesirable to carry a baby to term.
  • Payments to surrogate mothers should cover all genuine expenses associated with the pregnancy. Documentary evidence of the financial arrangement for surrogacy must be available. The ART centre should not be involved in this monetary aspect.
  • A third-party donor and a surrogate mother must relinquish in writing all parental rights concerning the offspring and vice versa.
    A child born through surrogacy must be adopted by the genetic (biological) parents unless they can establish through genetic (DNA) fingerprinting (of which the records will be maintained in the clinic) that the child is theirs.
  • A prospective surrogate mother must be tested for HIV and shown to be seronegative for this virus just before embryo transfer. She must also provide a written certificate that (a) she has not had a drug intravenously administered into her through a shared syringe, (b) she has not undergone blood transfusion; and (c) she and her husband (to the best of her/his knowledge) has had no extramarital relationship in the last six months.
  • No woman may act as a surrogate more than thrice in her lifetime
  • A relative, a known person, as well as a person unknown to the couple may act as a surrogate mother for the couple. In the case of a relative acting as a surrogate, the relative should belong to the same generation as the women desiring the surrogate.
  • A surrogate mother should not be over 45 years of age. Before accepting a woman as a possible surrogate for a particular couple’s child, the ART clinic must ensure (and put on record) that the woman satisfies all the testable criteria to go through a successful full-term pregnancy.

Surrogacy Rules and Regulations in India

2002 – gestational surrogacy allowed in India

2008- Commercial surrogacy allowed

2012- India bars foreign gay couples, singles from surrogacy

2016-Bill to Ban Commercial Surrogacy Introduced In
Lok Sabha, Bill is still under discussion.

No Visas to Foreigners Wanting to Visit India For Surrogacy

Surrogacy Should Be Allowed Only for Indian Couples, Government Says

2018- Central government’s women employees, whose children are born through surrogacy, will now be entitled to maternity leave, according to an official order of the personnel ministry.

Discussion on surrogacy bill

In August 2017, the Parliamentary Standing Committee submitted its 102nd report on the Surrogacy Regulation Bill, 2016.

The report gives a clause by clause analysis of the Bill. In it, the Committee has pointed out certain pertinent observations which clearly indicate the draconian nature of the Bill, which is based on impractical and paternalistic presumptions.

Traditional surrogacy or gestational surrogacy?

One of the biggest and most prominent drawbacks is the contradiction in the Bill with respect to whether traditional surrogacy is allowed or gestational surrogacy. Traditional surrogacy is one where the egg of the surrogate mother and the intended father’s sperm is used to conceive the child with the help of IVF technology. It is the most widely practised forms of surrogacy.

However, it has been widely criticised due to the genetic link with the surrogate mother, which can lead to several emotional complications for the parents. On the other hand, gestational surrogacy – also referred to as “full surrogacy” – is the case where the egg and sperm are of the commissioning parents and the surrogate mother carries the fertilised egg of the intended parents. Thus, all of the genetic material involved originates either from the intended parents or donors.

The Surrogacy Regulation Bill, 2016, under Section 4 (iii) (b) (III) lays down: “No women shall act as a surrogate mother or help in surrogacy in any way, by providing gametes or by carrying the pregnancy, more than once in her lifetime.”

The effect of this provision under the bill is that the surrogate mother can provide her gametes and be a surrogate as well. On this, the Standing Committee opined that, “… on the one hand the Department asserts that only Gestational surrogacy is permitted under the Bill, whereas clause 4(iii)(b)(III) advocates the concept of Traditional Surrogacy. Thus, there is an apparent contradiction between the Department assertions and provisions of clause 4(iii)(b)(III). The Committee, therefore, recommends that the infirmity in clause 4(iii)(b)(III) be rectified and the clause be amended suitably so as to spell out in unambiguous terms that the surrogate mother will not donate her eggs for the surrogacy.”

The object of the Bill is to prevent exploitation, PREVENT COMMERCIAL SURROGACY-

However, this very basic provision if not rectified can lead to the opening of a Pandora’s box, especially since the current Bill provides that surrogacy can only be performed by a “close relative”. The emotional stress and complications of having a close relative as a surrogate, on the life of the surrogate child, surrogate mother and the commissioning parents, is immeasurable.

Close relative as a surrogate

The Committee has very beautifully dealt with the issue of “close relative” being a surrogate. The object of this provision was to curtail exploitation of the surrogate; however, it would be unrealistic and very complex. The provision can be analysed from two perspectives. First and foremost, infertility is a taboo in India and for couples to come forward and undergo Artificial Reproductive Technique (‘ART’) procedures and surrogacy procedures is frowned upon. In such a situation, to force couples to only be able to have close relatives as surrogates is arbitrary and violative of their basic reproductive rights.

Second, in the context of the surrogate mother, it would be unfair for her to have to see the child repeatedly, and the effect the same would have on the child is a different matter of concern altogether. The Committee has recognised these factors and suggested that “limiting the practice of surrogacy to close relatives is not only non-pragmatic and unworkable but also has no connection with the object to stop the exploitation of surrogates envisaged in the proposed legislation.

“The Committee, therefore, recommends that this clause of “close relative” should be removed to widen the scope of getting surrogate mothers from outside the close confines of the family of the intending couple. In fact, both related and unrelated women should be permitted to become a surrogate.”

Waiting period 5 years before commissioning surrogate-

ART and surrogacy procedures have emerged essentially due to increasing infertility in the society. The current Bill defines infertility as the inability to conceive after five years whereas the previous draft Bills, of 2008 and 2014, defined it as the inability to conceive after one year.

The Committee has compared this definition of infertility with that given by the WHO and suggested that “since conception has many interplay functions, a five-year time bar would add to the misery of already distressed intending couples. The five-year waiting period is therefore arbitrary, discriminatory and without any definable logic. The Committee, therefore, recommends that the definition of infertility should be made commensurate with the definition given by WHO. The words ‘five years’ in clause 2(p) and 4 (iii) (c) II, be therefore, replaced with ‘one year’ and consequential changes be made in other relevant clauses of the Bill.”

This suggestion by the Committee is based on the basic fundamental Right to Reproduction and the Right to Privacy. How and when individuals wish to reproduce is their own personal discretion. The government can impose limitations and set criteria, however, the same should be rational and not arbitrary.

Other suggestions

The Committee makes several other laudable suggestions, some of which take root from the previous ART Bills and some which are based on reasonable analysis of the current social-medical scenario. It suggested that ‘compensated surrogacy’ should be allowed and that single parents and live-in partners should be allowed to commission surrogacy.

Provision of breast milk banks

The Committee also recommended that there should be a provision of breast milk banks for the surrogate child, and a tripartite surrogacy agreement should be entered into between the parties instead of separate agreements, to make the process easier.

The Committee has analysed the bill in a very comprehensive manner and put forward suggestions which if not incorporated would have a domino effect and push the entire surrogacy industry underground, which in turn could lead to the exploitation of the all the members of the surrogacy arrangement. Surrogacy is undertaken by individuals to procreate and to found a family; the essence of that needs to be understood and retained.

COMMERCIAL SURROGACY

The parliamentary standing committee on health after examining the Surrogacy (Regulation) Bill 2016 has made a case to allow surrogacy on payment of money on the grounds that “economic opportunities available to surrogates through surrogacy services should not be dismissed in a paternalistic manner”.
The committee observed that if many impoverished women are able to provide their children with education, construct home, start a small business, etc. by resorting to surrogacy, there is no reason to take this away from them. While it is mandated that organ, donation should be altruistic, the committee has held that altruistic surrogacy was “extreme and entails high expectation from a woman willing to become a surrogate without any compensation or reward”.

The Union Cabinet, chaired by Prime Minister Narendra Modi, on 21 st March 18 gave approval for amending the Surrogacy (Regulation) Bill, 2016 to provide for rights of child born through surrogacy to that of a natural child or biological child and mandate for surrogacy clinics to be registered with the appropriate authorities in the states.

The amendments also seek 16 months of extended insurance coverage for the surrogate mother to cover all complications besides a strict clause to safeguard the surrogate mother from exploitation, the Union Health Ministry said.

Also, Assisted Reproductive Technology (ART) now has been kept out of the purview of the Bill, it added.

The proposed legislation ensures effective regulation of surrogacy, prohibit commercial surrogacy and allow altruistic surrogacy to the needy Indian infertile couples, as per an official statement.

Once it becomes the Act, it will regulate the surrogacy services in the country, control the unethical practices in surrogacy and prevent its commercialization of surrogacy. It will also prohibit potential exploitation of surrogate mothers and children born through surrogacy.

HOW EVER THE FERTILITY CONSULTANTS AND PROSPECTIVE CUSTOMERS ALL OVER INDIA ARE EAGERLY WAITING FOR THE LEGALISATION OF SURROGACY BILL ,AS FOR THE TIME BEING THE TECHNOLOGY IS AT STANDSTILL.

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START CARDIO TODAY . CARDIO  KEEPS YOUR HEART HEALTHY

START CARDIO TODAY . CARDIO KEEPS YOUR HEART HEALTHY

What is Cardio?

Cardio is a type of  aerobic exercise. This  is physical exercise of low to high intensity that involves or requires utilisation of  free oxygen to meet energy demands during exercise through aerobic metabolism.

What are the different types of exercises?

Isotonic  Exercise – increase your breathing and heart rate. They keep your heart, lungs, and circulatory system healthy and improve your overall fitness. Examples : brisk walking, jogging, swimming, and biking.

Isometric  exercises make your muscles stronger. Some examples are lifting weights and using a resistance band.

Balance exercises – help prevent falls. To improve your balance, try tai chi or exercises like standing on one leg.

Flexibility exercises stretch your muscles and can help your body stay limber. Yoga and doing various stretches can make you more flexible.

What are the aerobic exercises?

Examples of aerobic exercises are

Indoor :Stair climbing , Elliptical trainer , Stationary bicycle,Treadmill , Aerobic gymnastics

Outdoor: Walking , Cycling, Running

Does Cardio help to reduce weight?

Health guidelines recommends:

Continuous moderate exercise  should be performed for at least 30 minutes five times a week. This will reduce obesity by 19% versus no activity at all.

What are the health benefits of doing cardio or aerobic exercise  ?

Benefits of  regular aerobic exercise are:

  • Strengthening the muscles involved in respiration, to facilitate the flow of air in and out of the lungs
  • Strengthening and enlarging the heart muscle, to improve its pumping efficiency and reduce the resting heart rate, known as aerobic conditioning
  • Improving circulation efficiency and reducing blood pressure
  • Increasing the total number of red blood cells in the body, facilitating transport of oxygen
  • Improved mental health, including reducing stress and lowering the incidence of depression, as well as increased cognitive capacity.
  • Reducing the risk for diabetes. One meta-analysis has shown, from multiple conducted studies, that aerobic exercise does help lower Hb A1Clevels for type 2 diabetics.
  • It prevents Depression and keeps a good mood.

Click here to Read How Exercise Prevents Depression

 

What are the limitations of cardio ?

Limitations of  aerobics or cardio  include:

  • Overuse injuries.
  • Doesn’t help for building muscle.
  • Only effective for fat loss when used consistently.

 

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Successful IUI programme

Successful IUI programme

Intrauterine insemination (IUI) is  a  simple and cost effective fertility treatment.In this procedure healthy sperm is placed into a woman’s uterus when she is ovulating. This procedure is used for couples with unexplained infertility, minimal male factor infertility, and women with cervical mucus problems. IUI success is improved when it is done in conjunction with ovulation-stimulating drugs. It can be performed using the husband’s sperm or donor sperm. Before the procedure, the woman should be evaluated for any hormonal imbalance, infection or any structural problems.

Factors for a successful IUI programme :

  • Healthy sperm (Sperm count, motility and morphology should be good)
  • Timing of IUI – for a healthy pregnancy the sperm and egg should meet within 24 hrs. of ovulation. An aged or degenerated egg cannot yield a healthy pregnancy.
  • Fallopian tubes should not have any blockage or obstruction.
  • Similarly, the quality of egg should be good, an egg with thick covering(zona) does not allow sperm to enter inside the egg.
  • The uterus should be prepared well to receive the embryo otherwise implantation does not happen.

When is IUI used?

The most common conditions where IUI is recommended :

  • Low sperm count or decreased sperm mobility.
  • Unexplained infertility
  • A hostile cervical condition, including cervical mucus problems
  • Cervical scar tissue from past procedures which may hinder the sperms’ ability to enter the uterus
  • Ejaculation dysfunction

Success rate in  IUI :

The success of IUI depends on several factors. If a couple has the IUI procedure performed each month, success rates may reach as high as 20% per cycle depending on variables such as female age, the reason for infertility, and whether fertility drugs were used, among other variables.

Pregnancy rate :

Approximate pregnancy rate as a function of total sperm count (may be twice as large as total motile sperm count). Values are for intrauterine insemination. (Old data, rates are likely higher today)

The pregnancy or success rates for artificial insemination are 10 to 15% per menstrual cycle using ICI, and 15–20% per cycle for IUI. In IUI, about 60 to 70% have achieved pregnancy after 6 cycles.

However, these pregnancy rates may be very misleading, since many factors, including the age and health of the recipient, have to be included to give a meaningful answer, e.g. definition of success and calculation of the total population.For couples with unexplained infertility, unstimulated IUI is no more effective than natural means of conception

 

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COST OF IVF TREATMENT

COST OF IVF TREATMENT

Cost of fertility treatment is the single most deciding factor to have a baby

 

 

Why IVF treatment is costly?

IVF cost

IVF cost

 

IVF treatment is a programmed procedure extending from 4 to 6 weeks of time. It includes treatment for both the couples simultaneously. Initial investigations for both the couple may vary from 5000 -50 000 INR depending on the extent of problem. Pre-IVF treatment includes corrections of any underlying disorder which may hamper success of IVF. These include any chronic medical disorders like hypertension, diabetes, autoimmune diseases, heart disorders, skin diseases, infections and inflammatory diseases.

IVF programme starts with daily hormone injections to the female partner which are costly. These fertility medications may cost around one lakh rupees. Along with these injections continuous monitoring of follicular growth is required. Duration of the injections depends on the protocol decided by the IVF specialist. The protocol may be of long or short duration depending on the patient profile. Once the follicular growth is satisfactory the patient is take for collection of eggs. Oocyte retrieval or egg collection is usually done in an operation room under sedation. This procedure cost will be around 30,000 -50,000 INR.

IVF or ICSI procedure is carried out inside a laboratory with advanced microscopes and hi-tech equipment. It usually takes 3 to 5 days to grow the embryos in the laboratory. There are various optional procedures carried in the laboratory apart from IVF/ICSI depending on the need of patient. Some of them are sperm freezing, freezing of oocytes and embryos, IMSI, PGD/PGS, Assisted hatching. Total IVF laboratory cost may vary from 50,000 to 1,50,000 depending on the various steps taken for the couple.

IVF/ICSI is not a sure success treatment. It depends on the patient profile, the expertise of IVF specialist and Embryologist. It also depends on the quality of drugs used, culture conditions which varies among Fertility clinics and IVF laboratories. Due to the repeated failures IVF packages become very costly for the trying couple.

Cost of IVF in India

Cost of IVF in India

The decision to have a baby is the first step in a lifelong commitment of love, time, and financial resources. At Femelife Fertility we understand the long-term implications of the couple’s decision and wish to lessen the financial burden from the beginning. Our attention to quality, coupled with innovations in the treatment of infertility, has led to our excellent success rate.

What are the alternative to IVF Treatment?

Like many aspects of our health, fertility is improved by adopting a healthy lifestyle. Maintaining an ideal weight, a diet rich in antioxidants (found in fruits and vegetables), as well as multi-vitamins may improve the quality of egg and sperm. Avoiding pollution, smoking, junk food, reducing stress and controlling chronic medical conditions such as high blood pressure and diabetes may also improve a couple’s chances of fertility. Couples with underlying medical or genetic conditions should see a doctor so that they can increase their overall health before conceiving. Dr Nabaneeta Padhy at Femelife Fertility evaluates all aspects of the couple and gives suggestions for improving natural fertility.

Is low cost IVF Successful?

 

The costs of fertility treatment depend on individual needs. Treatment options range from intrauterine insemination (IUI), which is the least expensive, to in vitro fertilization (IVF) with donor egg, which is the most expensive. Often there are less expensive options than IVF that may work for the couple. The only way to find out how much treatment will cost is to set up an initial consultation. Cost of IVF treatment in India is expensive but at Femelife Fertility infertility treatment is cheaper with high IVF success. Hence Femelife Fertility is the best IVF centre in INDIA.

Wide network of IVF clinics of Femelife makes IVF treatment easily accessible for patients from all regions of the world.

What are IVF packages?

 

Is it wise to go for IVF packages?

 

Femelife Fertility has designed several discounted packages to meet the varying needs of patients.  Many centres charge for each service individually, and these pays can significantly increase the total IVF cycle costs paid by the patient. Femelife Fertility prefers discounted fees, which are designed as a single price that is paid prior to starting of IVF cycle.

Stress Management

Stress Management

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What is stress?

Stress is a feeling of strain and pressure. Also this is one type of psychological pain.

Is stress always harmful?

No , It is not always harmful . Small amounts of stress may be desired, beneficial, and even healthy.

What is positive stress?

Positive stress helps improve athletic performance. It also plays a factor in motivation, adaptation, and reaction to the environment. It helps to improve the quality of a person.

What can be the bad effects of stress on health ?

Excessive amounts of stress, however, may lead to bodily harm. Stress can increase the risk of strokes, heart attacks, ulcers, and mental illnesses such as depression.

What is ‘Eu stress’ and ‘Distress’ ?

Eu stress is when a person perceives a stressor as positive.  Distress is when stress gives discomfort and pressure. When  demand vastly exceeds a person’s capabilities he fells discomfort and dis stress.

What are the behavioral changes  seen with stress?

Behavioral changes can be smoking and eating habits and physical activity.

What is ‘Chronic stress’ and how it comes?

When stress is constantly present and not avoidable body starts adapting to it. This is a chronic stress. Example : Living in a unfriendly environment . Working in a place with high levels of discomfort.

What are relaxation techniques  and how to practice them ?

Relaxation techniques include some activity that takes you away from the world of stress. Some activity that helps you is best for you .Some examples of relaxation technique are : meditation, progressive muscle relaxation, tai chi,listening to music  and yoga.

More-active ways of achieving relaxation include walking, jogging, outdoors games that interests you or participating in sports activities.

Select a technique that works for you and practice it regularly.

What are steps to be corrected to avoid stress in daily life?

Take care of your Health – Stay healthy .

Good Sleep – Regular sleep of 8 hours keeps you stress free .

Deep Breathing , yoga , Meditation are some techniques to be practiced to avoid stress.

Eat Healthy and Stay Hydrated : Read about healthy foods and try to take healthy foods which includes fruits and vegetables.This gives you a lots of anti-oxidants and vitamins.

Have a positive attitude to analyse the events . Negative attitude brings more stress.

Get some free time for yourself and your relaxation. Practice some Stress relieving techniques like Yoga , Meditation , walking and sports activities .

Is depression related to stress?

Yes, it gives more stress. Stay healthy and happy.

Read about depression.

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Cholesterol and Heart

Cholesterol and Heart

What is cholesterol?

Cholesterol is a fat-like substance that’s found in all the cells in your body.

Where Cholesterol comes from?

Cholesterol occurs naturally in the blood. It stays in a limit. It is essential for the body within normal limits.  If the cholesterol level exceeds normal limits then it causes harmful effects.

Liver makes cholesterol in the body. It is present in some foods, such as meat and dairy products.

What are the foods that increase  cholesterol levels in blood ?

Your body needs some LIPIDS  or Cholesterol to work properly. But if you have too much in your blood, there is  a higher risk of atherosclerosis and coronary artery disease.

Eating large amount of saturated fat increases cholesterol levels. This is why it is better to avoid foods   that are high in saturated fats .

Foods that are high in cholesterol are:

Butter, Ghee, Hard margarines ,Fatty meat and meat products such as sausages

Full fat cheese, milk, cream and yogurt , coconut and palm oils .

How do you measure cholesterol levels?

A blood test called a lipid profile can measure your cholesterol levels. Before the test, you’ll need to fast (not eat or drink anything except water) for 9 to 12 hours.

What are the tests included in lipid profile?

The test of lipid profile gives information  about –

Total cholesterol – a measure of the total amount of cholesterol in your blood. It includes the two types – low-density lipoprotein (LDL)  and high-density lipoprotein (HDL) cholesterol.

LDL (bad) cholesterol – the main source of cholesterol buildup and blockage in the arteries

HDL (good) cholesterol – HDL helps remove cholesterol from your arteries

Non-HDL – this number is your total cholesterol minus your HDL. Your non-HDL includes LDL and other types of cholesterol such as VLDL (very-low-density lipoprotein).

Triglycerides – another form of fat in your blood that can raise your risk for heart disease, especially in women.

 What are the foods that naturally help to lower cholesterol?

Oatbran , oat breakfast cereals , bread made with 50% oat flour or oat bran , baked beans , black beans, black-eyed peas, chickpeas , red lentils, green lentils .

Vegetables rich in soluble fibre such as citrus fruits, turnip, sweet potato and mango , Soya alternative to milk , Tofu , Almonds, pistachios, walnuts, pecans, cashews, peanuts (always unsalted).

Should I take Egg?

There is no reason to limit the egg intake . Eggs contain medium amounts of fat.  However the white contains hardly any.  One average egg (60g) contains around 4.6g fat; about a teaspoon. But only one quarter of this fat is saturated fat, which is the type of fat that increases cholesterol levels in the body.

Eggs are packed full of high quality protein.  The protein in eggs is not only easy to digest it also contains all the building blocks of essential proteins (amino acids) and in the right proportions.

Eggs are a good source of many important vitamins and minerals including the B vitamins riboflavin, vitamin B12 and folate and vitamin D.

Most of the people don’t require to limit or stop egg intake . If you are diagnosed as FH (familial hypercholesterolaemia) then you should restrict egg intake and consult the doctors for further management.

 

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