Aging and Fertility Issues

 Advanced age and Fertility !! Age is not just a number game but when we think about fertility its the main factor.More so the age of the female partner.Definitely we cannot reverese the things but we can think about the ways which can help to give us the best outcome. Various criteria are correlated with age when a couple visits doctor while planing baby-Like FSH,LH,E2,AMH,AFC if we talk in medical terms. As we are aware the number and quality of eggs decline with the adavncing age irrespective whether one had any pregnancy or undertook any fertility treatment prior and so far no ways to reverse or improve that. If we talk about ART (Assisted Reprodcutive techniques), the success rate declines with age While it is true that the ideal age to opt for IVF is late 20s and early 30s because the quality of eggs is robust at that time, even women in their late 30s and early 40s can savour the joy of motherhood through IVF. .But it is a lot better and wiser to give IVF a go in your late 30s and early 40s than regret not taking the plunge for the rest of your lives. The chances of success might be lesser, or even minuscule in some cases, but they certainly are not non-existent. There have been plenty of cases when women over 40s have become mothers by dint of IVF. Moreover, the rigours of undergoing the IVF treatment are completely worth for fulfilling the dream of motherhood. For a woman, nothing can match the happiness of being a mother of a child. They can also look at a brighter side of being mothers at 40 or above. Women in their 40s are more prudent, mature and sensitive than they are in their younger days. Hence the older mothers are more likely to give a well-rounded and holistic upbringing to their children. Another fact of being a mother in 40s is that one is well-settled and established in her professional life and hence more financially secured. So be it emotionally or financially, women in late 30s and 40s are more secured and mature. Hence chances of them providing wonderful upbringing to their children are quite salutary.

Intrauterine Insemination- All You Need To Knkw

 Intrauterine Insemination- All You Need To Know !!

Intrauterine insemination (IUI) — a type of artificial insemination — is a procedure for treating infertility. Sperm that have been washed and concentrated are placed directly in your uterus around the time your ovary releases one or more eggs to be fertilized. Older types of artificial insemination placed the sperm in the vagina. While this was easier, it was not as successful as the current procedure.

The hoped-for outcome of intrauterine insemination is for the sperm to swim into the fallopian tube and fertilize a waiting egg, resulting in a normal pregnancy. Depending on the reasons for infertility, IUI can be coordinated with your normal cycle or with fertility medications.

Indications-

A couple's ability to become pregnant depends on many different factors. Intrauterine insemination is used most often in couples who have:

1) Donor sperm- Frozen donor sperm specimens are obtained from certified labs(as per ICMR) and thawed before the IUI procedure.

2) Unexplained infertility- IUI is often performed as a first treatment for unexplained infertility along with ovulation-inducing medications.

3) Endometriosis-related infertility. Like unexplained infertility, the combination of medications to obtain the best egg and IUI is the first treatment.

4) Mild male factor infertility (subfertility)-Your partner's semen analysis, one of the first steps in the medical assessment of infertility, may show below-average sperm concentration, weak movement (motility) of sperm, or abnormalities in sperm size and shape (morphology). IUI can overcome some of these problems because preparing sperm for the procedure helps separate the highly motile, normal sperm from those of lower quality. This works best if the sperm have only one abnormality, such as only a motility problem.

5) Cervical factor infertility- Your cervix is at the lower end of the uterus and provides the opening between your vagina and uterus. The mucus produced by the cervix around the time of ovulation is supposed to provide an ideal environment for sperm to travel from your vagina to the fallopian tubes. However, if the cervical mucus is too thick, it may impede the sperm's journey. IUI bypasses the cervix, depositing sperm directly into your uterus and increasing the number of sperm available to meet the awaiting egg.

6) Semen allergy-Rarely, women have an allergy to proteins in their partner's semen, so ejaculation into the vagina causes redness, burning and swelling where the semen has contacted the skin. A condom can protect you from the symptoms, but it also prevents pregnancy. If your sensitivity is severe, IUI can be effective, since many of the semen proteins are removed before the sperm is inserted.

 Risks Of IUI-

Intrauterine insemination is a relatively simple and safe procedure, and the risk of serious complications is low. Risks include:

1) Infection-t fewer than 1 percent of women experience infection 

2)Spotting-Sometimes the process of placing the catheter in the uterus can cause a small amount of vaginal bleeding. This does not usually have an effect on the chance of pregnancy.

3)Multiple pregnancy 

 Steps Followed in IUI procedure-

Once the Eggs are ready with medicines and ovulation trigger given and IUI timed then the semen sample is prepared and patient shifted to IUI room

Its generally done in full consciousness with exceptions as per Clinical situation !

While lying on an exam table, you'll put your legs into stirrups and a speculum will be inserted into your vagina — similar to what you experience during a Pap test. During the procedure, the doctor or nurse:

Attaches a vial containing the small sample of healthy sperm to the end of a long, thin, flexible tube (catheter)

Inserts the catheter into your vagina, through your cervical opening and into your uterus

Pushes the sperm sample through the tube into your uterus

Removes the catheter, followed by the speculum

Post IUI-

After insemination you'll be asked to lie on your back for a brief period. Once the procedure is over, you can get dressed and go about your normal daily activities. You may experience some light spotting for a day or two after the procedure.

Interpretation Of IUI results-

Better see you treating doctor with report in clinic than self analysis and e-consults as there may be many grey areas which can be cleared with face to face discussion only.

Wait two weeks before taking an at-home pregnancy test. Testing too soon could produce a result that is:

False-negative. If your hormone levels are not yet at a measurable level, the test result may be negative when, in fact, you really are pregnant.

False-positive. If you're using ovulation-inducing medication such as HCG, the medication that's still circulating in your body could indicate a pregnancy when you really aren't pregnant.

Your doctor may instruct you to return about two weeks after your home kit results for a blood test, which is more sensitive in detecting pregnancy hormones after fertilization.

If you don't become pregnant, you might try IUI again before moving on to other fertility treatments. Often, the same therapy is used for three to six months to maximize chances of pregnancy.