A medical procedure is a course of action intended to achieve a result in the delivery of healthcare
Ask anything about medical procedures
Medical tests to learn your baby's gender
Medical tests to learn your baby's gender All in all, it’s no wonder that many people believe in these myths. After all, they always have a 50% chance of being right. But how can you determine your baby’s gender without any doubts? These are some of the tests that your doctor can use to determine your baby’s gender: Blood tests Special blood tests can determine your baby’s gender. These tests are usually only carried out on women over the age of 35, or those with an increased risk of chromosomal disorders. Amniocentesis This tests is also carried out mostly on high-risk pregnancies. Using a sample of amniotic fluid, it can detect genetic abnormalities and your baby’s gender. Chorionic villus sampling (CVS) This test uses a sample of placenta to diagnose Down syndrome or another chromosomal abnormality. It can also determine the baby’s gender as early as week 10 of pregnancy. Ultrasound This is the most common way to determine your baby’s gender. And it’s what most women carrying low-risk pregnancies will experience. An ultrasound technician could see your baby’s gender as early as 15-16 weeks, but most women will find out during their second trimester ultrasound. Final note It’s normal to want to know your baby’s sex, but having a healthy mom and a healthy baby are always more important. Maintain a healthy nutrition during pregnancy, keep an eye out for the fluids you consume during pregnancy, keep your water intake high, stay active, and pretty soon you’ll find out whether you’re pregnant with a boy or a girl!
Can anybody tell what is process of c section delivery ? Anesthesia kaha diya jata ? N anesthesia ka asar khatam hone k baad cramping hoti h kya is it painful?
What is male infertility?
Male infertility is any health issue in a man that lowers the chances of his female partner getting pregnant. About 13 out of 100 couples can't get pregnant with unprotected sex. There are many causes for infertility in men and women. In over a third of infertility cases, the problem is with the man. This is most often due to problems with his sperm production or with sperm delivery. What Happens Under Normal Conditions? The man's body makes tiny cells called sperm. During sex, ejaculation normally delivers the sperm into the woman's body. The male reproductive system makes, stores, and transports sperm. Chemicals in your body called hormones control this. Sperm and male sex hormone (testosterone) are made in the 2 testicles. The testicles are in the scrotum, a sac of skin below the penis. When the sperm leave the testicles, they go into a tube behind each testicle. This tube is called the epididymis. Just before ejaculation, the sperm go from the epididymis into another set of tubes. These tubes are called the vas deferens. Each vas deferens leads from the epididymis to behind your bladder in the pelvis. There each vas deferens joins the ejaculatory duct from the seminal vesicle. When you ejaculate, the sperm mix with fluid from the prostate and seminal vesicles. This forms semen. Semen then travels through the urethra and out of the penis. Male fertility depends on your body making normal sperm and delivering them. The sperm go into the female partner's vagina. The sperm travel through her cervix into her uterus to her fallopian tubes. There, if a sperm and egg meet, fertilization happens. The system only works when genes, hormone levels and environmental conditions are right. Causes Making mature, healthy sperm that can travel depends on many things. Problems can stop cells from growing into sperm. Problems can keep the sperm from reaching the egg. Even the temperature of the scrotum may affect fertility. These are the main causes of male infertility: Sperm Disorders The most common problems are with making and growing sperm. Sperm may: not grow fully be oddly shaped not move the right way be made in very low numbers (oligospermia) not be made at all (azoospermia) Sperm problems can be from traits you're born with. Lifestyle choices can lower sperm numbers. Smoking, drinking alcohol, and taking certain medications can lower sperm numbers. Other causes of low sperm numbers include long-term sickness (such as kidney failure), childhood infections (such as mumps), and chromosome or hormone problems (such as low testosterone). Damage to the reproductive system can cause low or no sperm. About 4 out of every 10 men with total lack of sperm (azoospermia) have an obstruction (blockage). A birth defect or a problem such as an infection can cause a blockage. Varicoceles Varicoceles are swollen veins in the scrotum. They're found in 16 out of 100 of all men. They are more common in infertile men (40 out of 100). They harm sperm growth by blocking proper blood drainage. It may be that varicoceles cause blood to flow back into your scrotum from your belly. The testicles are then too warm for making sperm. This can cause low sperm numbers. For more information please refer to the Varicoceles information page. Retrograde Ejaculation Retrograde ejaculation is when semen goes backwards in the body. They go into your bladder instead of out the penis. This happens when nerves and muscles in your bladder don't close during orgasm (climax). Semen may have normal sperm, but the semen cannot reach the vagina. Retrograde ejaculation can be caused by surgery, medications or health problems of the nervous system. Signs are cloudy urine after ejaculation and less fluid or "dry" ejaculation. Immunologic Infertility Sometimes a man's body makes antibodies that attack his own sperm. Antibodies are most often made because of injury, surgery or infection. They keep sperm from moving and working normally. We don't know yet exactly how antibodies lower fertility. We do know they can make it hard for sperm to swim to the fallopian tube and enter an egg. This is not a common cause of male infertility. Obstruction Sometimes sperm can be blocked. Repeated infections, surgery (such as vasectomy), swelling or developmental defects can cause blockage. Any part of the male reproductive tract can be blocked. With a blockage, sperm from the testicles can't leave the body during ejaculation. Hormones Hormones made by the pituitary gland tell the testicles to make sperm. Very low hormone levels cause poor sperm growth. Chromosomes Sperm carry half of the DNA to the egg. Changes in the number and structure of chromosomes can affect fertility. For example, the male Y chromosome may be missing parts. Medication Certain medications can change sperm production, function and delivery. These medications are most often given to treat health problems like: arthritis depression digestive problems infections high blood pressure cancer Diagnosis Causes of male fertility can be hard to diagnose. The problems are most often with sperm production or delivery. Diagnosis starts with a full history and physical exam. Your health care provider may also want to do blood work and semen tests. History and Physical Exam Your health care provider will take your health and surgical histories. Your provider will want to know about anything that might lower your fertility. These might include defects in your reproductive system, low hormone levels, sickness or accidents. Your provider will ask about childhood illnesses, current health problems, or medications that might harm sperm production. Such things as mumps, diabetes and steroids may affect fertility. Your provider will also ask about your use of alcohol, tobacco, marijuana and other recreational drugs. He or she will ask if you've been exposed to ionizing radiation, heavy metals or pesticides. Heavy metals are an exposure issue (e.g. mercury, lead arsenic). All of these can affect fertility. Your health care provider will learn how your body works during sex. He or she will want to know about you and your partner's efforts to get pregnant. For example, your healthcare provider may ask if you've had trouble with erections. The physical exam will look for problems in your penis, epididymis, vas deferens, and testicles. Your doctor will look for varicoceles. They can be found easily with a physical exam. Semen Analysis Semen analysis is a routine lab test. It helps show the cause of male infertility. The test is most often done twice. Semen is collected by having you masturbate into a sterile cup. The semen sample is studied. It can be checked for things that help or hurt conception (fertilization). Your health care provider will study your sperm volume, count, concentration, movement ("motility"), and structure. The quality of your sperm tells much about your ability to conceive (start a pregnancy). For instance, semen is normal if it turns from a pearly gel into a liquid within 20 minutes. If not, there may be a problem with the seminal vesicles, your male sex glands. Lack of fructose (sugar) in a sperm-free sample may mean there are no seminal vesicles. Or it may mean there is a blocked ejaculatory duct. Even if the semen test shows low sperm numbers or no sperm, it may not mean you are permanently infertile. It may just show there's a problem with the growth or delivery of sperm. More test may be needed. Transrectal Ultrasound Your health care provider may order a transrectal ultrasound. Ultrasound uses sound waves bouncing off an organ to get a picture of the organ. A probe is placed in the rectum. It beams sound waves to the nearby ejaculatory ducts. The health care provider can see if structures such as the ejaculatory duct or seminal vesicles are poorly formed or blocked. Testicular Biopsy If a semen test shows a very low number of sperm or no sperm you may need a testicular biopsy. This test can be done in an operating room with general or local anesthesia. A small cut is made in the scrotum. It can also be done in a clinic using, a needle through the numbed scrotal skin. In either case, a small piece of tissue from each testicle is removed and studied under a microscope. The biopsy serves 2 purposes. It helps find the cause of infertility. And it can collect sperm for use in assisted reproduction. Hormonal Profile The health care provider may check your hormones. This is to learn how well your testicles make sperm. It can also rule out major health problems. For example, follicle-stimulating hormone (FSH) is the pituitary hormone that tells the testicles to make sperm. High levels may mean your pituitary gland is trying to get the testicles to make sperm, but they won't. Treatment Treatment depends on what's causing infertility. Many problems can be fixed with drugs or surgery. This would allow conception through normal sex. The treatments below are broken into 3 categories: Non-surgical therapy for Male Infertility Surgical Therapy for Male Infertility Treatment for Unknown Causes of Male Infertility Non-Surgical Treatment for Specific Male Infertility Conditions Many male infertility problems can be treated without surgery. Anejaculation Anejaculation is when there's no semen. It's not common, but can be caused by: spinal cord injury prior surgery diabetes multiple sclerosis abnormalities present at birth other mental, emotional or unknown problems Drugs are often tried first to treat this condition. If they fail, there are 2 next steps. Rectal probe electroejaculation (RPE, better known as electroejaculation or EEJ) is one. Penile vibratory stimulation (PVS) is the other. Rectal probe electroejaculation is most often done under anesthesia. This is true except in men with a damaged spinal cord. RPE retrieves sperm in 90 out of 100 men who have it done. Many sperm are collected with this method. But sperm movement and shape may still lower fertility. Penile vibratory stimulation vibrates the tip and shaft of the penis to help get a natural climax. While non-invasive, it doesn't work as well as RPE. This is especially true in severe cases. Assisted reproductive techniques like in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) are of great value to men with anejaculation. Congenital Adrenal Hyperplasia (CAH) CAH is a rare cause of male infertility. It involves flaws from birth in certain enzymes. This causes abnormal hormone production. CAH is most often diagnosed by looking for too much steroid in the blood and urine. CAH can be treated with hormone replacement. Genital Tract Infection Genital tract infection is rarely linked to infertility. It's only found in about 2 out of 100 men with fertility problems. In those cases, the problem is often diagnosed from a semen test. In the test, white blood cells are found. White blood cells make too much "reactive oxygen species" (ROS). This lowers the chances of sperm being able to fertilize an egg. For example, a severe infection of the epididymis and testes may cause testicular shrinking and epididymal duct blockage. The infection doesn't have to be sudden to cause problems. Antibiotics are often given for full-blown infections. But they're not used for lesser inflammations. They can sometimes harm sperm production. Non-steroidal anti-inflammatories (such as ibuprofen) are often used instead. Inflammation from causes other than infection can also affect fertility. For example, chronic prostatitis, in rare cases, can also block the ejaculatory ducts. Hyperprolactinemia Hyperprolactinemia is when the pituitary gland makes too much of the hormone prolactin. It's a factor in infertility and erectile dysfunction. Treatment depends on what's causing the increase. If medications are the cause, your health care provider may stop them. Drugs may be given to bring prolactin levels to normal. If a growth in the pituitary gland is found, you may be referred to a neurosurgeon. Hypogonadotropic Hypogonadism Hypogonadotropic hypogonadism is when the testicles don't make sperm due to poor stimulation by the pituitary hormones. This is due to a problem in the pituitary or hypothalamus. It's the cause of a small percentage of infertility in men. It can exist at birth ("congenital"). Or it can show up later ("acquired"). The congenital form, known also as Kallmann's syndrome, is caused by lower amounts of gonadotropin-releasing hormone (GnRH). GnRH is a hormone made by the hypothalamus. The acquired form can be triggered by other health issues such as: pituitary tumors head trauma anabolic steroid use. If hypogonadotropic hypogonadism is suspected, your health care provider may want you to have an MRI. This will show a picture of your pituitary gland. You will also have a blood test to check prolactin levels. Together, an MRI and blood test can rule out pituitary tumors. If there are high levels of prolactin but no tumor on the pituitary gland, your provider may try to lower your prolactin first. Gonadotropin replacement therapy would be the next step. During treatment, blood testosterone levels and semen will be checked. Chances for pregnancy are very good. The sperm resulting from this treatment are normal. Immunologic Infertility Scientists first showed that some infertility cases were linked to immune system problems in the early 1950s. There has been much research since then. Though steroids (by mouth) are sometimes used to lower antisperm antibodies, this rarely works. In vitro fertilization with Intracytoplasmic Sperm Injection (ICSI) is now preferred for fertility problems caused by the immune system. This abnormality is very rare. Reactive Oxygen Species (ROS) ROS are small molecules found in many bodily fluids. They are in white blood cells. They are also in the sperm cells in semen. ROS can help prepare the sperm for fertilization. But too much ROS can hurt other cells. Sperm are easily harmed by ROS. Recent studies have shown more ROS molecules in the semen of infertile men. Many compounds have been used to detoxify or "scavenge" (fix) ROS levels. The most studied of these, Vitamin E (400 IU twice daily), can work well as an antioxidant. Pentoxifylline, coenzymeQ, and Vitamin C have also been shown to lower sperm ROS. They're used much less often than Vitamin E. Retrograde Ejaculation Retrograde ejaculation, semen flowing back instead of going out the penis, has many causes. It can be caused by: prostate or bladder surgeries diabetes spinal cord injury anti-depressants certain anti-hypertensives medications used to treat prostate enlargement (BPH) Retrograde ejaculation is found by checking your urine for sperm. This is done under a microscope right after ejaculation. Drugs can be used to correct retrograde ejaculation. It is often treated first with over-the-counter medications like Sudafed®. If medications don't work and you need assisted reproductive techniques (ARTs), your health care provider may try to collect sperm from your bladder after ejaculation. Surgical Therapy for Male Infertility Varicocele Treatments Varicoceles can be fixed with minor outpatient surgery called varicocelectomy. Fixing these swollen veins helps sperm movement, numbers, and structure. For more information on varicocele treatments please refer to our Varicoceles page. Azoospermia Treatments If your semen lacks sperm (azoospermia) because of a blockage, there are many surgical choices. Microsurgical Vasovasostomy Vasovasostomy is used to undo a vasectomy. It uses microsurgery to join the 2 cut parts of the vas deferens in each testicle. For more information on this treatment please refer to our Vasectomy Reversal page. Vasoepididymostomy Vasoepididymostomy joins the upper end of the vas deferens to the epididymis. It's the most common microsurgical method to treat epididymal blocks. For more information on this treatment please refer to our Vasectomy Reversal Page. Transurethral Resection of the Ejaculatory Duct (TURED) Ejaculatory duct blockage can be treated surgically. A cystoscope is passed into the urethra (the tube inside the penis) and a small incision is made in the ejaculatory duct. This gets sperm into the semen in about 65 out of 100 men. But there can be problems. Blockages could come back. Incontinence and retrograde ejaculation from bladder damage are other possible but rare problems. Also, only 1 in 4 couples get pregnant naturally after this treatment. Treatment for Unknown Causes of Male Infertility Sometimes it's hard to tell the cause of male infertility. This is called "non-specific" or "idiopathic" male infertility. Your health care provider may uses experience to help figure out what works. This is called "empiric therapy." Because infertility problems are often due to hormones, empiric therapy might balance hormone levels. It's not easy to tell how well empiric treatments will work. Each case is different. Assisted Reproductive Techniques If infertility treatment fails or isn't available, there are ways to get pregnant without sex. These methods are called assisted reproductive techniques (ARTs). Based on the specific type of infertility and the cause, your health care provider may suggest: Intrauterine Insemination (IUI) For IUI, your health care provider places the sperm into the female partner's uterus through a tube. IUI is often good for low sperm count and movement problems, retrograde ejaculation, and other causes of infertility. In Vitro Fertilization (IVF) IVF is when the egg of a female partner or donor is joined with sperm in a lab Petri dish. For IVF, the ovaries must be overly stimulated. This is often done with drugs. It allows many mature eggs to be retrieved. After 3 to 5 days of growth, the fertilized egg (embryo) is put back into the uterus. IVF is used mostly for women with blocked fallopian tubes. But it's being used more and more in cases where the man has very severe and untreatable oligospermia (low sperm count). Intracytoplasmic Sperm Injection (ICSI) ICSI is a variation of IVF. It has revolutionized treatment of severe male infertility. It lets couples thought infertile get pregnant. A single sperm is injected into the egg with a tiny needle. Once the egg is fertilized, it's put in the female partner's uterus. Your health care provider may use ICSI if you have very poor semen quality. It is also used if you have no sperm in the semen caused by a block or testicular failure that can't be fixed. Sperm may also be taken from the testicles or epididymis by surgery for this method. Sperm Retrieval for ART Many microsurgical methods can remove sperm blocked by obstructive azoospermia (no sperm). The goal is to get the best quality and number of cells. This is done while trying not to harm the reproductive tract. These methods include: Testicular Sperm Extraction (TESE) This is a common technique used to diagnose the cause of azoospermia. It also gets enough tissue for sperm extraction. The sperm taken from the testicle can be used fresh or frozen ("cryopreserved"). One or many small biopsies are done, often in the office. Testicular Fine Needle Aspiration (TFNA) TFNA was first used to diagnose azoospermia. It is now sometimes used to collect sperm from the testicles. A needle and syringe puncture the scrotal skin to pull sperm from the testicle. Percutaneous Epididymal Sperm Aspiration (PESA) PESA, like TFNA, can be done many times at low cost. There is no surgical cut. More urologists can do it because it doesn't call for a high-powered microscope. PESA is done under local or general anesthesia. The urologist sticks a needle attached to a syringe into the epididymis. Then he or she gently withdraws fluid. Sperm may not always be gotten this way. You may still need open surgery. Microsurgical Epididymal Sperm Aspiration (MESA) With MESA, sperm are also retrieved from the epididymal tubes. This method uses a surgical microscope. MESA yields high amounts of motile sperm. They can be frozen and thawed later for IVF treatments. This method limits harm to the epididymis. It keeps blood out of the fluid. Even though MESA calls for general anesthesia and microsurgical skill, it has a lower problem rate. It's also able to collect larger numbers of sperm with better motility for banking. After Treatment Male infertility can often be fixed with an outpatient procedure. These are done under general anesthesia or IV sedation. While pain after surgery is usually mild, recovery and follow-up vary. After varicocele repair, your health care provider should do a physical exam. This is to see if the vein is completely gone. Often the veins stay enlarged, since they are not removed during surgery but only closed off to prevent abnormal blood flow. Semen should be tested about every 3 months for at least a year, or until pregnancy. If your varicocele returns, or you stay infertile, ask your health care provider about ARTs. Vasectomy reversals cause only mild pain after surgery. But expect an out-of-work recovery of 4 to 7 days. The chance for pregnancy depends on many things. It mostly depends on the age and fertility of your female partner. The number of years between your vasectomy and reversal also affects success. The longer you wait, the less likely the reversal will be a success. content source
What Should one Look For In A Surrogate?
Surrogates are generally caring, generous, family-oriented women who feel very strongly about giving others the gift of family. Most are responsible, conscientious woman who are very devoted to the process of surrogacy. The majority of surrogates come from medium to low-income households. The relationship status of surrogates varies from single moms to married women, and education levels vary from GED’s to advanced degrees. What should intended parents look for in a surrogate? Clearly, the primary concern of any intended parent should be the surrogate’s general health and lifestyle and pregnancy history. That being in order, here are some things every intended parent should take into consideration: • The support system the surrogate will have during the surrogacy (will she have the support of a partner, a parent, a roommate, her place of employment or a close friend)? • Her responsiveness to requests from the agency, e.g. whether she has followed through with appointments, etc. (You can ask your agency about that.) • How her partner, husband and/or family feels about the surrogacy? • Whether or not she plans on dating during the surrogacy (assuming she is single). • Whether you and she agree on issues such as reductions or pregnancy terminations. • How your surrogate feels about invasive procedures such as amniocentesis, etc. • How much involvement you want in the surrogate’s life during (and after) the pregnancy/birth (e.g. phone calls, Skype, emails, appointments, through agency only, on-going relationship, etc.) • How important a surrogate’s diet is during the pregnancy and how willing she is to follow requested guidelines. Also, don’t discount your own “Spidey Sense”. Sometimes you just get a vibe about someone, good or bad, and you should go with your instinct. What does an agency look for in a potential surrogate? As you can imagine, many factors go into deciding whether or not we should accept a potential surrogate into our program. Among the factors we consider are: • Health history • Criminal background check • Willingness to work with all types of families • Whether she responds to emails, calls, etc. in a timely manner • Her motivations for wanting to become a surrogate • Her level of openness about the surrogacy • Her ability to make it to her appointments (reliable car and/or form of transportation) • Her overall health, including: o BMI o non-smoker, drugs or alcohol o mental health o pregnancy history • Current living situation: o how many people she lives with and whom o whether her environment is safe and clean o whether her home is close to medical facilities o how her partner and children feel about the surrogacy You mentioned the potential surrogate’s motivations—can you elaborate? There’s no question that compensation is a big motivator for potential surrogates. The funds often help with down-payments on a house, college education, children’s college funds and other major expenses. Additionally, surrogates tend to be women who enjoy helping others and love being pregnant. How do you screen your surrogates? It depends how the surrogate finds or is referred to an agency, but generally the process is this: • The agency has an initial phone conversation with the surrogate to discuss general requirements like height, weight, why she wants to become a surrogate, etc. • Assuming she meets the basic standards of surrogacy, she is then asked to fill out an application which delves deeper into her medical/personal history, etc. At this time, most agencies ask her for permission to conduct a background check for any criminal history she may have. • If everything, including the background check, looks good, a home visit to check her living situation, meet her children and partner (if applicable) and get a general overall view of her lifestyle is conducted. • It’s at that point that an agency will formally admit her into their program and start sending her profile out to intended parents for consideration. content source
Fertility test for women
If you and your partner are trying to have a baby but haven't been able to, you may start to wonder if you should get fertility tests. Experts say it's time to check with a doctor if you've had regular sex without birth control for 12 months if you are under the age of 35 and for 6 months if you are over 35. It's important for the two of you to go for testing together. When you see your doctor, he'll probably start by asking questions about your health and lifestyle. He'll want to know things about you and your partner like: Medical history, including any long-term conditions or surgeries Medicines you take Whether you smoke cigarettes, drink alcohol, eat or drink things with caffeine, or use illicit drugs If you had contact with chemicals, toxins, or radiation at home or work He'll also want to know about your sex life, such as: How often you have sex Your history of birth control use If you've had sexually transmitted diseases Any problems having sex Whether either of you had sex outside the relationship Your doctor will also have questions about things connected with your periods, such as: Have you been pregnant before? How often have you had periods over the last year? Have you had irregular and missed periods or had spotting between periods? Did you have any changes in blood flow or the appearance of large blood clots? What methods of birth control have you used? Have you ever seen a doctor for infertility, and did you get any treatment? Infertility Tests for Women There is no single best test for infertility. Doctors use a variety of ways to identify any problems that might help cause fertility trouble. You may get a Pap smear. It can detect cervical cancer, other problems with the cervix, or sexually transmitted diseases. Any of these can interfere with getting pregnant. To get pregnant, you need to release an egg each month -- called "ovulation." You may need tests that check for that. Your doctor may ask you to take a urine test at home for luteinizing hormone, or LH. This hormone shows up in high levels just before you ovulate. Your doctor also may check levels of the hormone progesterone in your blood. Increases in progesterone show that you are ovulating. On your own, you can check your body temperature each morning. Basal body temperature rises a bit just after ovulation. By checking it each morning, you'll learn your pattern of ovulation over several months. Your doctor may also run tests on your thyroid, or check for other hormonal problems, to rule out conditions that might cause missed or irregular ovulation. Tests of Reproductive Organs Before you can get pregnant, your uterus, fallopian tubes, and ovaries all need to work right. Your doctor may suggest different procedures that can check the health of these organs: Hysterosalpingogram (HSG). Also called a "tubogram," this is a series of X-rays of your fallopian tubes and uterus. The X-rays are taken after your doctor injects liquid dye through the vagina. Another method uses saline and air instead of dye and an ultrasound. The HSG can help you learn if your fallopian tubes are blocked or if you have any defects of your uterus. The test is usually done just after your menstrual period. Transvaginal ultrasound. A doctor places an ultrasound "wand" into the vagina and brings it close to the pelvic organs. Using sound waves, he'll be able to see images of the ovaries and uterus to check for problems there. Hysteroscopy. Your doctor puts a thin, flexible tube -- with a camera on the end -- through the cervix and into the uterus. He can see problems there and take tissue samples if needed. Laparoscopy. Your doctor makes small cuts in your belly and inserts tools, including a camera. This surgery can check your entire pelvis and potentially correct problems, such as endometriosis, a disease that affects the uterus. Other Infertility Tests A doctor may order other tests to check for fertility problems. You may get a blood test to check your levels of follicle-stimulating hormone, or FSH, which triggers your ovaries to prepare an egg for release each month. High FSH can mean lower fertility in women. The FSH blood levels get checked early in your menstrual cycle (often on day 3). Clomiphene citrate challenge testing can be done with the FSH test. You take a pill of clomiphene citrate on the fifth through ninth days of your menstrual cycle. FSH gets checked on day 3 (before you take the medicine) and on day 10 (after). High FSH levels suggest you have lower chances of getting pregnant. Your doctor may also suggest a blood test to check for a hormone called inhibin B. Levels may be lower in women with fertility problems, but experts are divided about whether the test can predict infertility. Take this assessment to find out if there are other health care providers who can help with your symptoms. Another exam is called postcoital testing. Your doctor examines your cervical mucus after you've had sex. Some studies suggest it may not be so useful. Your doctor may also recommend an endometrial biopsy. In this procedure, he takes a sample of tissue from the lining of your uterus. But evidence is mounting that endometrial biopsy is not helpful in predicting or treating infertility. You may not need to have all these tests. Your doctor can discuss with you which ones are best in your situation. After the testing is done, about 85% of couples will have some idea about why they're having trouble getting pregnant. content source
In Vitro Fertilization (IVF) - an overview
The first step in IVF involves injecting hormones so you produce multiple eggs each month instead of only one.You will then be tested to determine whether you're ready for egg retrieval. Prior to the retrieval procedure, you will be given injections of a medication that ripens the developing eggs and starts the process of ovulation. Timing is important; the eggs must be retrieved just before they emerge from the follicles in the ovaries. If the eggs are taken out too early or too late, they won't develop normally. Your doctor may do blood tests or an ultrasound to be sure the eggs are at the right stage of development before retrieving them. The IVF facility will provide you with special instructions to follow the night before and the day of the procedure. Most women are given pain medication and the choice of being mildly sedated or going under full anesthesia. During the procedure, your doctor will locate follicles in the ovary with ultrasound and remove the eggs with a hollow needle. The procedure usually takes less than 30 minutes, but may take up to an hour. Immediately following the retrieval, your eggs will be mixed in the laboratory with your partner's sperm, which he will have donated on the same day. While you and your partner go home, the fertilized eggs are kept in the clinic under observation to ensure optimal growth. Depending on the clinic, you may even wait up to five days until the embryo reaches a more advanced blastocyst stage. Once the embryos are ready, you will return to the IVF facility so doctors can transfer one or more into your uterus. This procedure is quicker and easier than the retrieval of the egg. The doctor will insert a flexible tube called a catheter through your vagina and cervix and into your uterus, where the embryos will be deposited. To increase the chances of pregnancy, most IVF experts recommend transferring up to three embryos at a time. However, this means you could have a multiple pregnancy, which can increase the health risks for both you and the babies. Following the procedure, you would typically stay in bed for several hours and be discharged four to six hours later. Your doctor will probably perform a pregnancy test on you about two weeks after the embryo transfer. In cases where the man's sperm count is extremely low, doctors may combine IVF with a procedure called intracytoplasmic sperm injection. In this procedure, a sperm is taken from semen -- or in some cases right from the testicles -- and inserted directly into the egg. Once a viable embryo is produced, it is transferred to the uterus using the usual IVF procedure. content source
Infertility and In Vitro Fertilization
Today, in vitro fertilization (IVF) is practically a household word. But not so long ago, it was a mysterious procedure for infertility that produced what were then known as "test-tube babies." Louise Brown, born in England in 1978, was the first such baby to be conceived outside her mother's womb. Unlike the simpler process of artificial insemination -- in which sperm is placed in the uterus and conception happens otherwise normally -- IVF involves combining eggs and sperm outside the body in a laboratory. Once an embryo or embryos form, they are then placed in the uterus. IVF is a complex and expensive procedure; only about 5% of couples with infertility seek it out. However, since its introduction in the U.S. in 1981, IVF and other similar techniques have resulted in more than 200,000 babies. What Causes of Infertility Can IVF Treat? When it comes to infertility, IVF may be an option if you or your partner have been diagnosed with: Endometriosis Low sprem counts Problems with the uterus or fallopian tubes Problems with ovulation Antibody problems that harm sperm or eggs The inability of sperm to penetrate or survive in the cervical mucus An unexplained fertility problem IVF is never the first step in the treatment of infertility except in cases of complete tubal blockage. Instead, it's reserved for cases in which other methods such as fertility drugs, surgery, and artificial insemination haven't worked. If you think that IVF might make sense for you, carefully assess any treatment center before undergoing the procedure. Here are some questions to ask the staff at the fertility clinic: What is your pregnancy ratio per embryo transfer? What is your pregnancy rate for couples in our age group and with our fertility problem? What is the live birth rate for all couples who undergo this procedure each year at your facility? How many of those deliveries are twins or other multiple births? How much will the procedure cost, including the cost of the hormone treatments? How much does it cost to store embryos and how long can we store them? Do you participate in an egg donation program? content source
Pregnant? Don't ignore these warning signs, it may be preeclampsia
Preeclampsia can be defined a condition that occurs only during pregnancy. Some symptoms of preeclampsia may include high blood pressure and protein in the urine, occurring after week 20 of pregnancy. Preeclampsia is often precluded by gestational hypertension. While high blood pressure during pregnancy does not necessarily indicate preeclampsia, it may be a sign of another problem. Preeclampsia affects at least 5-8 percent of pregnant women. What are the symptoms of preeclampsia? Mild preeclampsia: high blood pressure, water retention, and protein in the urine. Severe preeclampsia: Headaches, blurred vision, inability to tolerate bright light, fatigue, nausea/vomiting, urinating small amounts, pain in the upper right abdomen, shortness of breath, and tendency to bruise easily. Contact your doctor immediately if you experience blurred vision, severe headaches, abdominal pain, and/or urinating very infrequently. How is preeclampsia treated? Treatment depends on how close you are to your due date. If you are close to your due date, and the baby has developed enough, your doctor will probably want to deliver your baby as soon as possible. If you have mild preeclampsia and your baby has not reached full development, your doctor will probably recommend you to do the following: You should rest on your left side to take the weight of the baby off your major blood vessels. Increase prenatal check-ups. Consume less salt Drink at least 8 glasses of water a day Change your diet to include more protein If you have severe preeclampsia, your doctor may try to cure you with blood pressure medication along with bed rest, dietary changes, and supplements. How can preeclampsia affect the mother? If preeclampsia is not treated quickly and properly, it can lead to serious complications for the mother such as liver or renal failure and future cardiovascular issues. It may also lead to the following life-threatening conditions: Eclampsia: This is a severe form of preeclampsia that leads to seizures in the mother. HELLP Syndrome (hemolysis, elevated liver enzymes, and low platelet count): This is a condition usually occurring late in pregnancy that affects the breakdown of red blood cells, how the blood clots, and liver function of the pregnant woman. How does preeclampsia affect my baby? Preeclampsia can prevent the placenta from getting enough blood. If the placenta doesn’t get enough blood, your baby gets less oxygen and food. This can result in low birth weight. Most women still can deliver a healthy baby if preeclampsia is detected early and treated with regular prenatal care. Content source Featured image source
What to do when you find breast lumps during pregnancy?
Breast lumps during pregnancy Breast lumps detected during pregnancy are generally benign and reflect fibroadenoma, lactating adenoma, cysts, infarction of the breast or galactocele. Although rare, the possibility of breast cancer must also be considered to avoid any delays in diagnosis. After patient questioning and clinical examination, the first imaging modality to use is ultrasound. No further assessment is called for If the clinical signs are unclear then mammography and often biopsy should be performed. The changes to the secretion pathway do not occur evenly within the breast during pregnancy. Hyperplasic lactating adenoma, can cause one or more palpable lumps. Clinical changes Clinical examination reveals a darkening of the nipple and areola, a more prominent nipple and dilated superficial skin veins as from the end of the first trimester. During the final stages of pregnancy, breast adipose tissue nearly completely disappears and is replaced by hard, tight lobes; the skin becomes thinner. A little colostrum may be released by breast massage. Clinical examination can be challenging due to the increased size of the breasts, their sensitivity and especially their harder, more nodular consistency. A previously palpable lump can be concealed during pregnancy by hypertrophic breast tissue, or may increase in size, hence the importance of examining the patient's breasts at the beginning of pregnancy and then at regular intervals during its course. Duct ectasia is frequently observed using ultrasound. The breast is more hypoechoic due to lobular hyperplasia and duct dilation; its echogenicityis more or less homogeneous. Mammograms of pregnant women generally show a higher tissue density because of the young age of the women but also due to glandular development and adipose tissue atrophy, which decreases the sensitivity of mammography. Even so, mammography remains a very helpful modality for diagnosing breast cancer and should therefore be performed if there is the slightest doubt.Pre-pregnancy assessment is important to monitor changes such as increased size or heterogeneity of existing lesions (particularly fibroadenoma, hamartoma and cysts) during pregnancy. Clinical examination When a patient consults for a palpable lump that she has detected, she should be questioned and thoroughly examined in order to confirm the presence of a mass, describe it and prescribe the appropriate complementary investigations.Questioning should be aimed at determining the date of appearance of the lump, as well as individual patient history (possible known fibroadenoma) and familial history. Clinical examination is based on careful breast inspection and palpationand comparison with the contralateral side to: • confirm the presence of the mass; • identify its location and size; • describe its consistency and mobility; • detect related signs: skin retraction, nipple changes, discharge, lymph nodes, signs of inflammation, pyrexia. Finding a breast lump in a young pregnant woman in majority cases (80%) the lump is benign and the patient can be reassured and continue her pregnancy relieved. And when it is cancer, the delay in diagnosis (still very frequent) due to postponing investigations until after delivery, may have serious consequences. Ultrasound is used as the first-line imaging technique. It enables accurate diagnosis of simple cystic lesions and sometimes helps to confirm that there is actually no lump but just normal fibroglandular tissue. It allows accurate investigation of solid lesions. Mammography When 4-view mammography is performed, the mother receives a dose of radiation of about 3 mGy and the dose received by the uterus is lower than 0.03 μGy . The fetus is therefore exposed to a negligible amount of radiation . Doses of up to 1 mGy are considered to be acceptable for the fetus. The threshold value above which there exists a risk for the fetus. Mammography may be performed with a lead screen or apron that approximately halves the dose to the fetus and reassures the patient. Mammography should be prescribed on even the slightest doubt after clinical and/or ultrasound examination, because it can be particularly useful for diagnosis in cases of breast cancer. Moreover, if a lesion contains fatty density, its benignity can be affirmed and biopsy avoided. MRI On the basis of current knowledge, the injection of gadolinum, as is required for breast MRI, is contraindicated during pregnancy. Breast samples It is essential that pathologists be aware that the patient is pregnant before assessing breast samples. Cytological assessment can lead to false negative, as well as false positive results. If atypical findings are observed, taking a biopsy is mandatory in these cases. Biopsy Taking biopsies is the most reliable method for diagnosing solid masses. Biopsies are generally performed using ultrasound guidance but are sometimes also carried out using stereotactic guidance (microcalcifications). In the latter case, there is a slightly higher rate of complications (milk fistula, infection or bleeding), and post-biopsy compression should be applied for a longer time. Pregnancy-associated breast cancer (PABC) PABC is defined as breast cancer that occurs during pregnancy or within the year following childbirth. It is a rare disease that accounts for only 6–10% of all breast cancers in women aged under 40 years.. The average age of onset is 34 years. Patient questioning on familial history is essential and women with a significant risk should be examined carefully. In majority of cases, breast cancer occurs in young women with no noteworthy history, so the possibility of cancer should not be excluded in a 25-year-old woman just because she has no family history of the disease. Patients may be treated surgically at any time during pregnancy and chemotherapy may be initiated from the 2nd trimester on. The main risk for the fetus is prematurity. Radiotherapy is generally contraindicated during pregnancy, as is hormone therapy. Numerous different oncological, obstetrical, psychological and personal parameters (choice, mother's age, other children, risk factors) need to be taken into account. . Conclusion Breast masses discovered during pregnancy should be investigated immediately either to reassure the patient (most lesions are benign), or if necessary, rapidly implement treatment when breast cancer is diagnosed since any delay in diagnosis and therapy can jeopardize successful management. content source
Why and how CVS test is done?
The Chorionic Villus Sampling or CVS Test is prescribed between the 10th to 12th weeks of gestation. It is a prenatal test, which helps detect genetic diseases, birth defects, and any other issues related to the pregnancy. What happens in the CVS Test? In the CVS test a tiny bit of Chorionic villi is drawn out from the placenta as sample. This sample is taken from the place where the placenta is attached to the uteral wall. The Chorionic Villi are taken because they possess the same genes, which will be present in the baby eventually. Therefore, they make the best sample to ascertain whether the baby is at risk of developing any genetic diseases or birth defects. This test helps detect any such conditions early in the pregnancy. Diseases and Disorders Easily Identifiable Via The CVS Test Here are some diseases that the CVS test helps detect timely and with 98% accuracy – Chromosomal disorders such as - Down syndrome Genetic diseases like - cystic fibrosis, sickle cell anemia, Tay-Sachs disease, and sickle cell anemia. Gender specific disorders such as - muscular dystrophy commonly seen in male babies. This test is also used to identify the gender of the foetus as well. Who is suggested the CVS Test? Experts advise that the CVS test may only be suggested to women who are at a greater risk of having babies with genetic defects and disorders. These include - Couples where one partner already has a genetic disorder or carries a genetic disease/chromosomal abnormality. Couples with a family history of birth defects either in a previous pregnancy or a family member who has birth defects. A pregnant woman 35 years or older on her due date. Higher the age of the woman, greater is the risk of the offspring having chromosomal defects such as Down syndrome. A pregnant woman who displays abnormal results in genetic tests. It is, however, a couple’s choice whether to get the test done or not. Advantages of the CVS Test CVS takes place very early in the pregnancy. It is done even before amniocentesis. Therefore, it informs about defects and diseases quite early allowing timely action and appropriate choices. The results of the CVS test come within 10 days. Termination of pregnancy upon receipt of abnormal test results is much safer for the woman since the same is done early in the pregnancy. Disadvantages of the CVS Test The CVS poses a little higher threat of miscarriage as compared to amniocentesis, as it is done very early in pregnancy. Risk of infection too is higher at this stage. The CVS Test Procedure Counseling - When someone is recommended a CVS test, she is given elaborate genetic counseling that involves detailed information of the advantages and disadvantage of taking the test. The risks involved are clearly communicated to the patient so that an informed decision can be made. Ultrasound - After the counseling an ultrasound examination is done to ascertain the gestational age of the foetus and to identify placental location. This is because it is best to perform the CVS test 10 to 12 weeks from the last menstrual period of the woman. Collection of the chorionic villi - The chorionic villi are collected from the placenta either via the abdomen or the vagina. A quick test, it takes hardly 30 minutes in all. The procedure might be slightly painful to some women. There are two ways of collecting the sample. These are - The abdominal collection - This is done using a needle. This needle is inserted into the placenta through the mother’s abdomen. The vaginal collection - This is done using a speculum, which is inserted in the vagina. Then, a small portion of the placenta is removed by inserting a thin tube of plastic into the cervix via the vagina. Ultrasound imaging is used to guide the whole process. Laboratory sample testing - The collected sample is sent to the lab. Here it is cultured for in a fluid for further testing after a few more days. Results - The results are made available to the patient in two weeks. Precaution to take after the CVS Test Take it slow and easy once the test is over. Get off the bed slowly and take assistance while you steady yourself. Avoid driving yourself back home. Make sure someone assists you to the hospital and back. Rest well the rest of the day and preferably put pillows under your feet for added comfort. It is normal for doctors to advise abstinence from exercise, strenuous work, and sex for the next three days to avoid any stress. Experiencing minimal bleeding and some cramps are normal. However, the same must still be reported to the doctor. Any discharge or fluid leaks from the vagina must immediately be reported to the doctor without any delays. The test when suggested is in your best interest. It is therefore advised that if your doctor feels the need for a CVS test, you must consider it to ensure you have a healthy baby.