Category Archive In-Vitro Fertilization (IVF)

Effect of COVID on Fertility

Fertility Meaning

The natural capacity of the couple to conceive a child is called fertility. However, not every couple is able to conceive effortlessly due to various complications with respect to their fertility. About 11% of the couples will face infertility in Western countries – the inability to conceive naturally after one year of unprotected sexual intercourse.

It is a common belief that fertility is only a female issue. Both males and females are increasingly facing infertility and both men and women can take the steps to improve their fertility.

The process of pregnancy is a complex one and must be healthy so that the baby is born without any health complications. In order for the pregnancy to progress full term, the embryo must be healthy and the woman’s hormonal environment adequate for the development. Although it is a common belief that infertility can be primarily related to the woman, in reality, only one-third of the infertility cases are related to the woman alone. Statistically, one-third of the infertility problems are related to men and the remaining one-third is a combination of fertility factors, it involves both partners or unknown causes. Unknown causes account for approximately twenty percent of infertility cases. 

When you are desirous of conceiving a child, it is important to understand the meaning of normal fertility which is crucial to helping a person, or couple, to know when it is time to seek help. Most of the couples (approximately 85%) will achieve pregnancy within one year of trying, which has the greatest likelihood of conception occurring during the earlier months.

Signs of Infertility Among Men and Women

Signs of Infertility Among Men and Womens

The underlying conditions are often what lead to infertility. Numerous conditions can lead to infertility in men and women. The signs and symptoms of each can vary greatly. The common symptoms of infertility are as follows:

1. Irregular Periods

There is an average time duration of a woman’s cycle which is 28 days long but anything which is within a few days of the same can be considered normal. As long as these cycles are consistent, it is considered to be normal. 

For example, if a woman who has 33 day cycle one month, a 31 day cycle the next, and a 35 day cycle post that, is probably having ‘normal’ periods.

2. Painful or Heavy Periods

A woman whose cycles vary so greatly that she cannot even begin to estimate when her periods might arrive is experiencing irregular periods. It can also be related to hormone issues, or to polycystic ovarian syndrome (PCOS). Both of these can contribute to infertility.

3. No Periods

It is not uncommon for women to have a month without their cycle. Factors like stress or heavy workouts can cause the period to temporarily disappear. But if you haven’t had a period in months, it is time to get your fertility checked.

4. Symptoms of Hormone Fluctuations

Signs of hormone fluctuations in women could indicate potential issues with fertility. It is important to talk to the doctor once you experience the following:

  • Skin Issues
  • Reduced Sex Drive
  • Facial Hair Growth
  • Thinning of Hair
  • Weight Gain

5. Pain During Sex

Women have also experienced painful sex their entire lives, so they have convinced themselves that it is normal. But it is not. It is often related to hormone issues and to endometriosis. Other conditions can also be responsible for infertility.

Common Signs of Infertility Among Men

Maler-infertility-pronlem

1. Changes in Sexual Desire

A man’s fertility is also linked with their hormonal health. Changes in virility, often governed by the hormones, could indicate issues with fertility.

2. Testicle Pain Or Swelling

The several different conditions could lead to pain or swelling in the testicles, many of which could contribute to infertility.

3. Problems Maintaining Erection

A man’s ability to maintain an erection is often linked to hormone levels. If the hormone levels are decreased this could lead to trouble conceiving.

4. Issues With Ejaculation

Similarly, it is the inability to ejaculate which is a sign of the need to visit the doctor.

5. Small and Firm Testicles

The testes house a mans sperm, so testicle health is paramount to the male fertility. Small or firm testicles could indicate potential issues that should be explored by the medical practitioner.

Around 15 to 20 percent of the couples trying to conceive will have trouble with infertility. In case you have been diagnosed with infertility, or fear one may have trouble conceiving, it is immediately essential to consult the doctor

Factors Affecting Fertility Among Men and Women

Fertility issue Men and Women

One in every eight couples suffer from infertility. Since baby producing is a complex process, it is contingent upon four crucial steps:

  1. The woman and man each produces eggs and sperm.
  2. Healthy fallopian tubes that allow the sperm to easily get to the egg. 
  3. The sperm’s ability to fertilise the egg upon reaching it.
  4. A fertilised egg ability to attach to the uterus and continue developing normally.

There is infertility which may result when the above mentioned steps are not aligned.

COVID-19 Trends Over the Last 6 Months

In late 2019, a new coronavirus emerged in central China to cause disease in humans. The covid cases have been reported across the globe on January 30, 2020 and the World Health Organisation declared the virus which represents a public health emergency of international concern, and on January 31, 2020, the US Department of Health and Human Services declared it to be the health emergency for the United States.

Effect of COVID on Fertility

COVID Effect on Fertility

In our effort to answer the question of how does COVID-19 affects the fertility rate, let us take a look at its role in fertility for both men and women.

Effect of COVID on female and male fertility has been well researched by scholars and medical practitioners ever since the origin of the virus. COVID-19 may negatively affect the sperm quality and reduce the fertility factors in men, along with magnitude of the effect which may depend on the severity of the disease.

The female partners of men who are recovering from COVID-19 should not conceive until a specialist carefully examines and certifies their fertility status.

Even with the introduction of the vaccine, the health care providers should use the findings to counsel reproductive aged couples on the importance of properly following the CDC guidelines regarding social distancing, masking and hand washing. Many questions remain unanswered, and the larger scale studies with longer follow-up evaluating hormonal profiles and semen analyses are needed to know the long-term consequences after recovering from the COVID-19 on male fertility.

COVID-19 and Pregnancy

Apart from COVID-19 and the fertility rate, the pandemic has come as a health hazard for the world, with populations of all age groups being badly affected with various health complications. The protocols for testing and eligibility during the pregnancy vary depending on where one lives. WHO recommends that pregnant women with symptoms of COVID-19 should prioritise testing. If they have COVID-19, they may need specialised care.

If we begin to explore the genre has birth rate increased during COVID-19?, the key to understand this is to explore the trends of COVID and the reasons it is affecting pregnancy.

The birth rates during COVID in India – 

Although the pandemic has resulted in fewer baby births in the Unites States of America, the research shows this trend projects the biggest slump in a century. France has recorded its lowest birth rate since World War II and China has received 15% fewer registration for the babies.

The United Nations had projected last year that Indians would lead nations in the list of post pandemic baby boom. This was largely attributed to breakdown of contraceptive services during the lockdown. So the COVID impact on the birth rate in India has been quite evident, given the non evidence of the projected post pandemic baby boom. The gynaecologists across the country had projected a birth rate increase due to covid but the same did not happen.

Fewer deliveries are being conducted as compared to pre-pandemic days and instead several doctors have told that there has been an uptick in the requests for abortions.

There are many reasons for the same which include a continuing fear of COVID-19, pandemic restrictions which do not allow hospitals – especially government facilities – to admit patients. Lack of access to contraceptives during the lockdown has also resulted in fewer baby deliveries.

6 Suggestions How To Cope With Infertility – Vinsfertility.com

Having a child of your own might possibly be one of the biggest dreams of a couple. Yet, infertility crashes your dreams leaving you feeling despair and helplessness. Aside from that, there might be societal pressure to have kids or you might be judged for not being able to conceive. Some might also offer you advice about what to do and what not to, without any regards to your situations. 

Here are a few ways how one can cope with infertility-

1. Accept your feelings

It is understandable that dealing with infertility might feel like a roller coaster ride. During this time, one is flooded with emotions. There could be feelings of loss, anger, failure, guilt, jealousy, fear of rejection and many more. All these emotions cause stress which could harm you in a more severe way including physical side effects. The first thing to understand is that feeling these emotions is completely normal because infertility takes a toll on you. 

Almost every couple dreams of having a child of their own and infertility shatters that dream. So, take your time and gradually try to accept all that you feel, because only then you will be able to move forward in a positive way.

2. Communicate with your partner/spouse

Repeatedly trying and failing to conceive can strain the relationship of a couple. Infertility can either bring the couple closer or could cause them to drift apart. Feelings of anger, inadequacy, hopelessness, pressure to have a child- are often left unspoken, which causes tension between the couple. Both, the man and woman might respond differently to infertility. Men tend to become emotionally distant whereas women are openly distressed. The relationship might go more downhill if the couple gets intimate only for the sole purpose of conceiving, as it may affect the sexual performance and lead to decline in overall sexual satisfaction. 

Try to reconnect with your partner. To overcome the gap, you can go for couple therapy or try to bring back the intimacy via both non sexual or sensual ways. Allow each other to cope differently, if that makes it easier. Don’t let go of each other, you are in this together. Share how you feel with each other and don’t fear asking what you want. Stay strong and act as a team in this entire journey.

3. Talk to your loved ones

Infertility is stressful, you might want to isolate yourself. However, it will do you more harm than good. Don’t shut them out, instead stay connected with them. Support from friends and family, especially at this time can help reduce the emotional stress. Talking about how you feel aloud will make the weight on your heart feel less heavier. If your loved ones are uninformed about infertility, you can tell them about it or recommend some readings so that they can understand your feelings in a better way and comfort you in the best way possible. But make sure that you choose these people wisely as even one negative comment could stress you more than you already are.

4. Explore other options for building your family

Infertility might make you feel helpless and lost. If you feel so, you can explore other options to have a child. Your doctor can help you understand these options and help decide the best alternative for you. This might revive your dream of parenthood. Other options could be- Assisted Reproductive Techniques (ART) like- IVF, ICSI, Donor programmes, Surrogacy and adoption, etc. 

Understand these options well, as it will help you in making your decision and hopefully result in a positive outcome. But before choosing any alternative, grieve properly, because only then you will be able to fully embrace the idea of trying other methods. 

5. Seek professional counselling

For a couple going through infertility, seeking help from a counselor will help you deal with the situation in a better way. Along with providing mental support, coping techniques, the fertility counselor will help answer all your questions and help you in making decisions which are beneficial for you. They understand your fears and concerns and you should not at all feel ashamed in asking for help because overcoming infertility is not an easy job.

6. Take care of yourself

Infertility causes a turmoil in your life, during this time it is very important to stop blaming yourself and practice self-care. Because you being infertile is not your fault; it is caused due to genetics and other factors. Blaming yourself will not lead to anything, instead, focus on yourself during this time. Spend time alone, get enough sleep, exercise regularly and talk with others about how you feel. If you are healthy and happy during this time, this journey of infertility will become much easier to navigate through. Take part in activities which help you alleviate your stress, like go for a run, a walk, paint, a parlour session, whatever relieves your mind.

Focus on taking positive steps which help you achieve your goals. Even when you think that everything is especially hard on you, take time, take breath, think and do what’s best for you.

5 Common Myths Busted Associated with IVF

IVF or In Vitro Fertilization has become the most common answer to infertility and is also a boon to couples with fertility issues. Since IVF has become known to people, millions of children have been born worldwide using IVF and other assisted reproduction techniques. But still, people don’t have complete knowledge about IVF, which has given rise to a number of myths associated with it. 

In this article, we aim to bust the most common myths related to IVF and other assisted reproduction techniques. 

Myths take birth from unawareness and ignorance. So, before anything, it is required to gain knowledge about IVF.

WHAT IS IVF?

In simple words, IVF or In-Vitro-Fertilization is a type of Assisted Reproductive Technology that provides the gift of parenthood to the intended parents by assisting them in conceiving a baby. 

The process involves the joining of a woman’s egg and a man’s sperm in a laboratory dish. It is a complex process with multiple steps involved including fertilization, embryo development, and implantation. IVF can be done using the couple’s own eggs and sperm or eggs, sperms, or embryos from an anonymous donor.

BRIEF HISTORY OF IVF

The history of IVF  goes back to the prior 1800’s, which could be surprising for many people. but due to lack of research, this phase of IVF is not noticeable in the history of IVF. The golden period in the time of IVF is stated back in the 1900s when Patrick Steptoe and Robert Edwards initially introduced In vitro fertilization (IVF) in the 1970s to treat female infertility caused by damaged or blocked fallopian tubes. years of research and hard work in the field of IVF resulted in the birth of the world’s first baby conceived through IVF in 1978. By 1986, over 1,000 children were born via IVF. The 40-year journey of developing IVF brought the challenge of infertility into public conversation and changed millions of lives around the world.

IVF IN THE MODERN ERA

IVF is no longer an alien word for people now. Continuous enhancements in the IVF technique have been in the process by doctors and scientists. Thousands of births take place through IVF every day. People with fertility issues consider IVF nothing but a blessing to fulfill their dreams of a baby. IVF has become the most common assisted reproduction technique. Earlier not many people could afford IVF being it an expensive treatment. But now it can easily be afforded by the middleman. 

IVF has come a long way from being an alien concept to the most preferred solution for infertility treatments. 

5 COMMON MYTHS ABOUT IVF

1. IVF – An answer to all infertility issues.

People believe that IVF can resolve all the issues related to infertility. Undoubtedly there are multiple assisted reproductive procedures available to cure many infertility issues today and IVF is just one of them. But still, there are multiple issues that cannot be cured with IVF. There are other techniques that can be used for treating infertility other than IVF.

2. A 100% success rate

IVF is expected to have a 100% success rate by the people. Although in reality, IVF has a success rate of about 60% in couples below the age of 35. At most the IVF centres can provide a success rate of 70-80%, but it can never be more than that. Also, there are multiple factors over which the success rate of IVF depends such as age, cause of infertility, and biological and hormonal conditions.

3. Babies born with defects

This is the most common myth associated with IVF-born babies.  People widely believe that IVF babies are born with birth defects and malformations. In reality, the absolute risk of delivering an IVF baby with malformations is low. IVF is a complex and sensitive technique involving many procedures that are performed very precisely. The risk of an anomalous fetus in spontaneous or IVF babies is the same as in the general population. 

4. IVF not a safe procedure

People with no or minimal knowledge about IVF consider it an unsafe procedure. On the contrary, it is a safe procedure with only about 2% of patients standing the risk of becoming unwell from ovarian hyperstimulation syndrome and few other risks. It is important to choose a doctor and center for IVF precisely after collecting entire knowledge about the doctor performing IVF and the IVF center.

5. IVF pregnancies result in cesarean births

IVF pregnancies are just like naturally conceived ones and do not indicate birth through cesarean section. Couples who have tried to conceive for many years or those with higher chances of multiple pregnancies can opt for elective cesarean delivery. A very normal vaginal delivery is possible following IVF. 

IVF WITH VINSFERTILITY

Vinsfertlity comes with the best solution where you can get involved in the low-cost IVF treatment. We make sure to provide the parents with the joy of parenthood. We also ensure to associate you with the top IVF centres with a high success rate. Vinsfertility provides you with a team of in-house consultants and doctors to provide you with the full knowledge about the process and answer all your queries. We help you to choose the best centre and doctor to provide the best infertility treatment as per your concern in your city. It is made sure that the treatment is top-notch and personalized care is provided to the intended couple through Vinsfertility.

To book your free appointment or to know more about IVF or other infertility treatments through our trusted doctors and counselors, contact us on +91 9643264509

Or mail us at: info@vinsfertility.com

Step-by-Step through an IVF cycle

IVF is a boon for those who are not able to conceive there baby and looking for there biological child. Below mention steps will describe the actual process followed for this procedure. For egg donation, either self egg or donor egg are used. Below mention graph will explain the rate of decrease of conceiving with self egg and this result also let you know why to freeze your own egg earlier.

Men younger than 40 have a better chance of fathering a child than those older than 40. The quality of the sperm men produce seems to decline as they get older. Their food habits and living also determines there sperm quality. When you include healthy diets on day to day life then it increases fertility to a massive level.

Most men make millions of new sperm every day, but men older than 40 have fewer healthy sperm than younger men. The amount of semen (the fluid that contains sperm) and sperm motility (ability to move towards an egg) decrease continually between the ages of 20 and 80.

Step 1: Control Ovarian Hyperstimulation (COH)

COH is done using different protocols. The most common one is a long GnRH-Agonist (Lupron) protocol where the secretion of gonadotropin hormones is suppressed to prevent premature ovulation. Once optimal suppression is achieved, the next step is the recruitment of multiple follicles by daily injections of gonadotropins. Ultrasound imaging and hormone assessments are used to monitor follicular development. When the lead follicles have reached the appropriate size, the final maturation of eggs is completed by HCG administration. Egg retrieval is scheduled 34 – 36 hours after HCG injection.

Step 2: Egg Retrieval

It is a very important procedure as different doctors have the different condition for retrieval ( From egg donor). Many doctors don’t work with virgin egg donors. Since the sharing of egg donor profiles is not legal so we will only share their details if there will be assurance and after donor price paid. Egg retrieval is performed in a surgical suite under intravenous sedation. Ovarian follicles are aspirated using a needle guided by transvaginal ultrasonography. Follicular fluids are scanned by the embryologist to locate all available eggs. The eggs are placed in a special media and cultured in an incubator until insemination.

Step 3: Fertilization and Embryo Culture

  • If sperm parameters are normal, approximately 50,000 to 100,000 motile sperm are transferred to the dish containing the eggs. This is called standard insemination.
  • The ICSI technique is used to fertilize mature eggs if sperm parameters are abnormal. This procedure is performed under a high-powered microscope. The embryologist picks up a single spermatozoon using a fine glass microneedle and injects it directly into the egg cytoplasm. ICSI increases the chance that fertilization will occur if the semen sample has a low sperm count and/or motility, poor morphology, or poor progression. If there are no sperm in the ejaculate, sperm may be obtained via a surgical procedure. ICSI is always used to achieve fertilization if the sperm is surgically retrieved.
  • Fertilization is assessed 16 – 18 hours after insemination or ICSI. The fertilized eggs are called zygotes and are cultured in a specially formulated culture medium that supports their growth. They will be assessed on the second and third day after retrieval. If sufficient numbers of embryos exhibit good growth and development, they may be selected to grow to the blastocyst stage in a specially designed culture medium. Blastocyst culture has several advantages. Embryos at this stage have a higher potential for implantation, therefore fewer embryos can be transferred on day 5 to reduce the chance of multiple pregnancies. Low numbers of embryos and poor embryo quality reduce the chances for good blastocyst development. A day 3 embryo transfer is recommended for cycles with low numbers and/or poor quality.

Step 4: Embryo Quality

Embryo fertility is determined by PGS ( Pre-implantation genetic screening. After PGS testing we freeze the most fertile embryos and after first fresh embryo if the process failed then we use the remaining frozen embryos. There are several criteria used to assess the quality of the embryo. This is especially important when trying to decide which embryos to choose for embryo transfer. Early in the morning on the day of your transfer, the embryos are evaluated and photographed by the embryologist. The embryologist and your physician will decide, based on the rate of development and appearance of the embryos, which and how many embryos are recommended to be transferred. Typically, embryos are transferred at the cleavage stage (day 3 after oocyte retrieval) or at the blastocyst stage (day 5). In the lab, a grading system is used to asses the quality of the embryos.

 Cleavage Stage: Day 3 Transfers

Day three embryos are called cleavage stage embryos and have approximately 4 – 8 cells. When analyzing these embryos, we not only look at the number of cells but also how symmetrical they are and whether there is any fragmentation. Fragmentation occurs when the cells divide unevenly, resulting in cell-like structures which crowd the embryo. No fragmentation is preferable but some is acceptable. In our lab, we classify embryos into grades 1 through 4. Grade 4 represents the best quality embryos.

Day 5 Blast: Day 5 Transfers

Day 5 embryos are called blastocyst embryos. At this stage, the embryos have increased in size and are even more developed. They resemble a ball of cells with fluid inside. One of the things we look for at this stage is how expanded these embryos are. The more expanded, the better the quality of the embryo. These embryos are also classified by a number scale, 1 through 6. Grade 6 represents the best quality blastocyst.

Step 5: Embryo Transfer

Embryos are transferred on day 3 when they are at the cleavage stage (6 – 8 cells) or on day 5 when they have reached the blastocyst stage. Embryo transfer is a simple procedure that does not require any anesthesia. Embryos are loaded in a soft catheter and are placed in the uterine cavity through the cervix.

Source : 1. https://www.urmc.rochester.edu/ob-gyn/fertility-center/services/infertility/ivf/ivf-step-by-step.aspx
2. https://academic.oup.com/humrep/article/20/2/433/603283

How much IVF is useful with self EGG

Each month in a natural menstrual cycle, your body withdraws one gumball (egg) from the machine (your ovaries). That egg is either healthy or unhealthy. As you age, you have fewer gumballs in the machine, and a higher percentage of the gumballs are unhealthy, lowering the chances that the one you get in a given month will be able to result in a healthy baby. That’s why it can take much longer—many more menstrual cycles—for older women to get pregnant.

Even when fertility medicine comes into play, the relationship between age, fertility, and egg quality affect chances of success. Fertility treatments like in vitro fertilization use hormone medications to prompt the ovaries to produce multiple eggs in one cycle, but some of those eggs will still be abnormal (how many are abnormal will depend on your age). So while IVF can help increase the chances of finding some healthy eggs, it can’t make more of your eggs healthy. If a woman in her 40s retrieves 10 eggs in an IVF cycle, it’s likely that only 10–20% of those eggs will be normal. If she retrieves 20 eggs in two IVF cycles, still only 10–20% of those eggs will be normal—but she’ll have more to work with because she retrieved more.

That’s why we see declining success rates as women age, even when using advanced reproductive technology like IVF. If there are very few healthy eggs to work with, the chance of success is low.

What happens during IVF

IVF involves 6 main stages:

  1. suppressing your natural cycle – the menstrual cycle is suppressed with medication
  2. boosting your egg supply – medication is used to encourage the ovaries to produce more eggs than usual
  3. monitoring your progress and maturing your eggs – an ultrasound scan is carried out to check the development of the eggs, and medication is used to help them mature
  4. collecting the eggs – a needle is inserted into the ovaries, via the vagina, to remove the eggs
  5. fertilizing the eggs – the eggs are mixed with the sperm for a few days to allow them to be fertilised
  6. transferring the embryo(s) – 1 or 2 fertilized eggs (embryos) are placed into the womb

Once the embryo(s) has been transferred into your womb, you’ll need to wait 2 weeks before taking a pregnancy test to see if the treatment has worked.

Read more about what happens during IVF.

Chances of success

The success rate of IVF depends on the age of the woman undergoing treatment, as well as the cause of infertility (if it’s known).

Younger women are more likely to have a successful pregnancy. IVF isn’t usually recommended for women over the age of 42 because the chances of a successful pregnancy are thought to be too low.

Between 2014 and 2016 the percentage of IVF treatments that resulted in a live birth was:

  • 29% for women under 35
  • 23% for women aged 35 to 37
  • 15% for women aged 38 to 39
  • 9% for women aged 40 to 42
  • 3% for women aged 43 to 44
  • 2% for women aged over 44

These figures are for women using their own eggs and their partner’s sperm, using the per embryo transferred measure.

The Human Fertilisation and Embryo Authority (HFEA) has more information on in vitro fertilization (IVF), including the latest success rates.

Maintaining a healthy weight and avoiding alcohol, smoking and caffeine during treatment may improve your chances of having a baby with IVF.

What are the risks?

IVF doesn’t always result in pregnancy, and it can be both physically and emotionally demanding. You should be offered counselling to help you through the process.

There are also a number of health risks involved, including:

  • side effects from the medications used during treatment, such as hot flushes and headaches
  • multiple births (such as twins or triplets) – this can be dangerous for both the mother and the children
  • an ectopic pregnancy – where the embryo implants in the fallopian tubes, rather than in the womb
  • ovarian hyperstimulation syndrome (OHSS) – where too many eggs develop in the ovaries

Source: https://www.nhs.uk/conditions/ivf/

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