Name: Ranirasmi
Hai friends,
I am posting this details taken from some websites which I don't remeber. However it will help you a lot.
Trying to make a baby? Here are some tips on what you can do to increase your chances of conceiving.
Keep track of your period
Have intercourse on days you are most likely to conceive. Timing is everything. Women are most likely to conceive on days they are ovulating. If you aren’t already keeping a menstrual calendar, start doing so now. Note down the dates your period starts, how long it lasts, and any other information you feel may be of help to your gynecologist. If you have irregular periods, it may not be easy to calculate the days you are ovulating
A menstrual calendar will also help you keep track of your date of conception, and you will consequently be able to calculate your due date with more accuracy.
Lie down after sex
Don’t get up and run around immediately after having sex. Lie down for a while. This increases the chances of the sperm meeting the egg. It is even recommended that you place a high pillow, cushion or bolster under your hips after making love, to direct the sperm upwards towards the egg. Believe it or not, this really does help!
Discuss medication with your doctor
This pose is difficult to achieve initially. You may find it difficult to grab your foot, and you may also find it difficult to turn. If you cannot reach the foot initially, try and reach whatever part of your leg you can – maybe the calf. Do this pose sitting close to a wall, so you can try and reach for the support of the wall as you turn around, instead of placing your hand on your back. Make sure you are not sitting too close to the wall though, you want to have place to turn around.
Avoid coffee
Give up drinking coffee at least for the time you are trying to conceive. Caffeine is believed to reduce the flow of blood to the uterus, restricting the growth of the baby. Studies also suggest that excessive caffeine contributes to a reduction in fertility levels. What constitutes excessive coffee? More than three cups a day is definitely excessive. One or two cups a day is fine but if you are having problems conceiving, give it up for now. If you can’t do without your daily cuppa, switch to decaf.
Reduce alcohol consumption
Reduce your consumption of alcohol. Alcohol reduces male fertility levels and so does smoking. Excessive smoking and drinking also affects the quality of sperm, so if you want to get pregnant, give up your vices for the time being. The chances of a healthy pregnancy are higher.
Breathe clean air
If your workplace exposes you to hazardous materials or chemicals, this may affect the quality of your sperm, and it may cause a reduction of fertility levels. It is also unsafe for a pregnant woman to be exposed to hazardous material, as it may adversely affect the foetus, leading to birth problems.
Keep your vagina clean
Saliva can kill sperm, and so can some forms of vaginal lubricants, glycerine and oils. While this shouldn’t matter if the male sperm count is very high, if you are having problems conceiving it is best to keep your vagina ‘sperm friendly’, which means no oral sex or lubricants. Similarly, don’t wear scented tampons and avoid vaginal sprays. Keep your vagina clean and natural. Avoid douching, as douching alters the natural acidity of the vagina. It may even lead to vaginal infections, which in a way defeats the very purpose of douching.
Yoga and exercise
Exercise regularly so your body stays fit and in optimum shape, and try these yoga asanas.
How long can it take to get pregnant
Some couples are surprised to learn that conception does not take place as a matter of course once they stop using contraceptive precautions. Stopping the pill or noy using a condom does not work as simply as just unlocking the door to let the sperm in to fertilize a waiting egg. The fact is that if you and your partner do not have any infertility problems, there will be approximately a 1 in 3 chance of becoming pregnant as a result of unprotected intercourse during the fertile phase of each cycle. Those women who do become pregnant without any medical assistance generally do so within 2 years of trying, 80% conceiving during the first year.
When do I need to consult a doctor for help
If you have been timing your intercourse and trying for more than 6 months without any success, it is time to see a gynecologist. The gynecologist will prescribe certain diagnostic tests and either treat you herself or send you (and/or your partner) to a fertility specialist.
Women all around me are getting pregnant, why can’t I
For the majority of women there is no problem in getting pregnant. If, however. you are one of the 10% of couples in whom there are factors which may delay or prevent the arrival of the much longed for baby, then despair and despondency can rapidly follow. This is not helped by the apparent ease that others about you seem to have in conceiving. The girl in your office having a termination of pregnancy, your sister having her third baby, babies in supermarkets and TV advertisements – everyone is having a baby except you – even people who don’t realty want one! You may even feel “IT ISNT FAIR!”.
Why you may have trouble ?
Conceiving
Although getting pregnant may seem like the easiest thing in the world, it is actually not so for many people. There are several reasons for this, and any one or more of the following may be applicable.
Late planning (advanced age)
The trend today is for women to complete their education and establish their careers before they think of settling down and starting a family. However, for a woman over the age of 35, conceiving becomes a problem. Infertility increases with age. Fertility peaks for both sexes in their mid-twenties and then appears to decline steadily in women over thirty and men over forty. Tubal infections, fibroid tumors and endometriosis are more common in older women and are a common cause for infertility.
Excessive drinking, smoking, drug use
Research has shown that the excessive consumption of alcohol or the use of illicit drugs like marijuana, cocaine, heroin and crack, by a potential father prior to pregnancy can be the cause of infertility. Illicit drugs can also reduce the sperm count, damage the sperm, reduce testosterone levels, and change testicular functioning. (These are generally ejaculated with the sperm.) Heavy drinking can affect a woman’s menstrual cycle as well. Note however, that as long as drinking, smoking and drug use have been curtailed before getting pregnant, prior use seems to pose almost no risk to the baby.
Ovulation / Menstruation problems
Ovulation is a pre-requisite for getting pregnant. In women with regular menstrual cycles of 28-35 days, ovulation takes place once every cycle. However, many women have erratic menstrual cycles (often getting periods 3-4 times a year or even less). This means that they have fewer chances of getting pregnant not only because they have fewer possible fertile periods, but also because they may not be ovulating in every cycle. (Note that ovulation does not necessarily take place in every menstrual cycle).
Low sperm count (for males)
The normal sperm count ranges from 20 million to 100 million sperm per cubic centimeter. Counts below 20 million may be a cause for difficulty in conception. Factors such as fatigue, excessive alcohol, smoking or other drug abuse, prostate gland infection, poor diet, or occupational exposure to chemicals can cause a small, temporary decrease in the sperm count. Varicocele is a condition when there are varicose veins on the scrotum. This is another cause for infertility and can only be corrected through surgery.
Retroverted uterus
Many women are born with their uteruses facing backward (retroverted) instead of forward. This condition can be diagnosed either by your gynecologist, or through an ultrasound. One simple way to compensate for this problem of a retroverted uterus is for the woman to lie on her stomach after intercourse. (Women with regular uteruses who are planning to get pregnant are asked to lie on their backs and lift their legs from their hips after sex in order to improve the chances of fertilization). If retroverted uterus is the only problem, then in most cases the woman will conceive. However, if she still does not get pregnant, then the doctor may advise surgery.
Polycystic ovaries
Cysts are formed when the follicle fails to rupture at the time of ovulation and begins to grow instead. This condition occurs due to hormonal imbalance and is marked by absent or infrequent menstruation. Women having this condition have a chronic tendency to have their periods at intervals ranging from every six weeks to six months. Conception becomes difficult due to irregular ovulation.
Intercourse pattern
Very often, you may simply be mistiming your intercourse. In order for you to get pregnant, it is essential for you to have sex during your fertile days. It could also be possible that you may be trying too often in a particular cycle, and thereby causing a reduction in sperm count.
When should I think of consulting an infertility specialist
If you are 19 years old, only married for 6 months and already worrying about why you are not yet pregnant, your worries are probably unnecessary and rather premature. If, on the other hand, at the age of l9 you are only having 2 or 3 periods a year, then it is a good idea to consult the doctor. It is better to attempt to regularize your menstrual cycle earlier than later because irregular periods means fewer opportunities to get pregnant.
If you and your partner are in your mid-thirties and finding it difficult to conceive an early referral to a fertility specialist is recommended. Female fertility begins to decline after the age of 30 and more rapidly from the age of 35 years.
I am scared of going to a fertility specialist
This is a common sentiment amongst women who have been trying to become pregnant for some time without success. Some women feel that by going to a fertility specialist they are admitting to themselves that they have a problem. Women all around them seem to become pregnant so easily, so surely it is just a matter of time. In this way, women swallow their disappointment month after month burying their heads in the sand like ostriches. They live in fear that the doctor will pass the verdict that they are infertile. The attitude is one of ‘ignorance is bliss.”
My neighbors and friends are always giving me advice
When it comes to pregnancy, everybody and his cousin thinks that they are experts on the subject. While the advice offered by your friends, relatives and neighbours is well-intentioned, it may not be accurate and could be harmful. The fact remains that your doctor is the best person to approach for professional advice. Your family doctor is a trained professional. If he has an interest in infertility problems, there is a considerable amount that he can do in the way of giving advice and initiating basic investigations. If he has no particular interest in infertility, he should at least be able to refer you to someone who can help you.
Coming to Terms with your Infertility
Introduction
People take parenthood as much for granted as birth and death. You are born, you get an education, then a job, followed by marriage, parenthood and finally death. This is some kind of unwritten cosmic schedule that humans follow and no one really thinks about the progression of events as they live their lives. You just flow from one phase of life to another in a seamless fashion. For couples who discover that they cannot have children for whatever reason, the loss of parenthood, a basic ingredient of life, comes as a rude shock.
Most couples who are told that they are infertile find it difficult to accept this verdict. After all, people all over the world are having babies every minute. It’s the most natural thing in the world. The next thought that occurs to them is considering the rate at which medical technology is advancing, surely the problem can be fixed. This is true to a certain extent. Various infertility treatments have worked for many couples who were having difficulty conceiving a child. But there are still some couples that slip through the cracks. After spending huge amounts of money and following all the doctors’ instructions, some couples still fail to conceive a child.
These couples often slip into a deep depression. They think – “Why us?” They should realize that there is no point beating themselves up pointlessly about something that is beyond their control. They should try to resign themselves to the fact some things are just not meant to be. However, couples pass through many agonizing hours of self-doubt and despair before they reach this ideal state of acceptance.
Guilt
The husband or the wife often feels guilty thinking that it is his or her fault that conception was not possible. Sometimes the man or woman’s own feelings of guilt drive them to ascribe these feelings to their partners. This is usually unwarranted as the thought may have never crossed their partners’ minds, nor have they acted in a manner indicating that they blamed the other person.
Social stigma
Women who are infertile often feel that the fact that they cannot bear children makes them less of a woman or inadequate in some way. Unfortunately, this is a sentiment that is often supported in society. Being barren is not a stigma that a woman should have to bear like a cross for the rest of her life. There is much more to a woman than her ability to bear a child.
Similarly, if conception was not possible as a result of male infertility, the male partner may feel that it is a slur on his manhood. Men should remember that sterility does not automatically mean a loss of virility. Sterile men can still be extremely virile.
Be positive
Childless couples should make every attempt to pull themselves out of the depths of despair. Speaking to other couples in a similar situation can be a source of great solace. These couples should try to find out about infertility support groups. They should learn to accept their childlessness as a fact of life and learn to deal with it positively. Adoption is an option that they may want to consider. If adoption is not a choice they would like to make, then they will have to find other ways to channel their love for children. Remember that parenthood is an experience that should not be missed out on if possible. But if you can’t be a parent, life does go on. There is a whole wide world out there with a new experience around every bend.
Causes of Male Infertility
What are the indications for male infertility
Statistics show that in at least 40% of infertile couples, there is a male factor contributing to the problem. Male fertility screening is done through semen analysis. The general rule is that the lower the sperm count and the poorer the sperm quality, the longer it will take and the more difficult it may be for a pregnancy to occur. However, even men with very low sperm counts may eventually be successful in causing a pregnancy. The sperm count only needs to be high enough for that one time that ovulation occurs, in order for a pregnancy to be possible.
What are the major factors affecting sperm production
Oligospermia is the term used to describe the condition when the sperm count is low. If there are no sperm at all in the semen sample, the condition is termed azoospermia. In such cases, the clinic will wish to see your husband to take a more detailed history and to examine him. In his history, specific questions will be asked about any past condition that may have affected the testicles. For instance, he will have to answer queries regarding whether he has had any operations in the groin area or for undescended testicles in childhood. The specialist will also ask questions to determine whether there has been any major injury or infection in the genital area.
Infected semen can be a cause of infertility. Earlier, it was believed that mumps could cause sterility in men. However, it is now known that even when the testicles are involved in mumps orchitis (very painful swelling of the testicles), it is extremely rare for this to lead to sterility.
What other factors affect sperm production
Heat can have a detrimental effect on normal sperm production. It is for this reason that nature has placed the testicles outside the body in the scrotum rather than in the abdomen like the ovaries. Some infertile men soak themselves in a bathtub full of scalding water and emerge looking like lobsters. This can almost stop sperm production completely. Obese men can also become sterile because the sagging layers of fat can overheat the testicles. Men whose jobs involve long hours of sitting, e.g. long distance lorry-drivers may have infertility due to the increased heat to the genital area.
Very frequent intercourse can lead to the demand exceeding the supply. There are quite a number of infertile men whose sex drive is such that they must ejaculate 2-3 times a day. This explodes the myth that links infertility to lack of virility. It can be extremely difficult for these men to reduce their ejaculation rate to every 48 hours.
Smoking over 20 cigarettes a day has been shown to reduce both the sperm count and the sperm motility to quite a major degree.
Excessive alcohol intake will lead to infertility mainly because a man loses both the inclination and the ability to rise to the occasion! Alcohol can also lower the production of sperm and of the male hormone testosterone.
The workaholic husband can find that fatigue can have similar effects on his interest in intercourse as excessive alcohol intake.
What problems can be identified during examination
Every infertile man must be carefully examined. The examination of the external genitalia in the male rarely shows anything out of the ordinary. However, sometimes one or both testicles are very small or rarely may even be absent. Additionally there may be congenital absence of each vas deferens, the ducts through which sperm pass from the testicles to the female at intercourse.
Other factors which may contribute to lowered fertility, and which can be identified on examination include:
Varicocele is a term used to describe a condition where there are varicose veins around the testicle and vas deferens. In the case of varicoceles, there is an increase in the blood flow and temperature around the testicle. Even a small varicocele may be significant and affect sperm production.
The presence of excessive fluid around the testicle is known as a hydrocele.
There can occasionally be anatomical defects in the development of the penis. Consequently, during intercourse and ejaculation the sperm cannot be deposited within the vagina very easily. Retrograde ejaculation is a rare condition when some men ejaculate backwards into the bladder. This could be the result of earlier surgery to the urethra (the outflow tube from the bladder).
A rectal examination can help determine whether the prostate gland may be a source of chronic infection.
Various Male Fertility Disorders
Azoospermia
Azoospermia characterized by the absence of sperm is either due to an obstruction in the outflow system from the testicle, in the epididymis or vas deferens, or due to a failure in sperm production (spermatogenesis). If a biopsy of the testicle showed that spermatogenesis was normal, this would then indicate that an obstruction was the cause of his azoospermia. Vasograms, which are X-rays of the vas deferens can then be performed to identify the location of the obstruction.
Presence of Antibodies
Sometimes, a semen sample when seen under a microscope, will show sperm clumping. This may indicate the presence of sperm antibodies that are causing the sperm to stick together. A blood sample can be tested for the presence of agglutinating and other sperm inhibiting antibodies.
Klinefelter’s Syndrome
Very small testicles may be the manifestation of Klinefelter’s Syndrome. This is caused by a chromosomal aberration. Thus, a chromosome investigation will show the presence of an extra X (female) chromosome.
Hormone Disorders
Hormone disorders are rare causes of male infertility, but it may sometimes be helpful to check his F.S.H., L.H., testosterone (male hormone), prolactin and thyroid hormone levels.
Bacterial Infection
The existence of an excessive amount of white blood cells in the semen sample may indicate that an infection may be reducing the ability of the sperm to fertilise an egg. The semen sample should then be cultured to determine the type of infecting bacterial organism.
How should I select the infertility clinic
It is important that you select a reputed infertility clinic. Your family doctor would probably be a good person to turn to for advice on the subject. Treating infertility can be a long and frustrating process in some cases. It is important that you share a rapport with your infertility specialist. There is no harm if you make appointments with two or three specialists till you find one that your comfortable with and in whose abilities you feel confident.
How soon can I find out if I am infertile
Infertility assessment and management takes time, whether in the surgery, gynaecological out patient clinic or specialist infertility clinic. You should be prepared to undergo a whole battery of tests and procedures and long hours of waiting in the doctor’s clinic before the verdict about your fertility comes in.
Should my husband also accompany me to the specialist
A lot of men are reluctant to be seen at a fertility specialist's clinic because they feel that in some way it is a slur on their manhood. Men tend to confuse virility with sterility and live in horror that the blame for the couple’s inability to conceive will be laid at their doorstep. If your husband has a low sperm count, it does not make him less of a man in any way.
Remember that it takes two people to make a baby. Since both you and your husband are involved in the process of making a baby, it is only fair that he be part of the solution if there is a problem. The infertility specialist will be in a position to be able to discuss with both of you the different options that you have and to also debate the chances of success and the possibility of failure.
When should one start treating infertility
Treatment in its truest sense commences as soon as you seek professional help. Many infertile couples have to go through a long and arduous process to conceive with no guarantees of success. On the other hand, there are women who become pregnant just after their first appointment with the fertility specialist, without any treatment at all. Tension can be a big obstacle in the path of conception. For some women just meeting with an infertility specialist releases tension. They feel that they are in the hands of a professional who will just fix the problem if there is one.
What is the success rate of infertile women getting pregnant with treatment
Over half of the couples with more than two years of infertility eventually become successful in achieving a pregnancy. With advances in infertility research and wider availability of newer techniques, it is to be hoped that the success rate of infertility treatment would be much higher.
First Visit to the Specialist
What can I expect during the first visit
Couples are usually quite nervous about their first visit to an infertility specialist. After all their inability to conceive is a highly personal subject and something that most couples are very sensitive about. The couple has nightmares thinking about all those embarrassing questions that they will probably have to answer. They cannot imagine discussing their sex lives with a complete stranger.
Actually, the first visit is rarely the nightmare that couples expect it to be. It generally takes about half an hour during which the doctor takes a full history, conducts an examination, discusses the findings with you and outlines a plan of action. The doctor will put you at ease by first questioning you about general medical facts rather than immediately inquiring about the frequency of intercourse! You will be questioned about your ages, the length of your relationship, and for how long you have been trying to conceive.
Will previous pregnancies be discussed
Yes. Previous pregnancies can provide information that may help in determining the causes of infertility. You will be questioned about the duration of the previous pregnancy, whether it was normal, a spontaneous miscarriage or whether you have had an abortion. You will be asked about the method of delivery, the outcome of the pregnancy and any significant complications. For instance, the fact that antibiotics were required for pain and a high temperature following a termination of pregnancy, may suggest a problem with the tubes as being the cause for your subsequent infertility.
Will contraceptives that we have used also be discussed
Yes. The infertility specialist will be especially interested if you have used an Intra-Uterine Contraceptive Device (I.U.C.D.) or the combined contraceptive Pill. The I.U.C.D. can sometimes be associated with inflammation in the uterus and tubes and the Pill with prolonged intervals between periods after the need for contraception has passed.
What will the doctor want to know about my menstruation cycles
Menstruation plays a key role in conception so you can expect the doctor to make detailed queries about your menstrual cycle. The doctor will ask you how often you get your period and whether you have a regular cycle. This will help the doctor whether you are ovulating in every cycle. The heaviness of the bleeding and the amount of pain are also to be considered, as these could be symptoms of infertility. If your periods have become very scanty or have stopped altogether, you will be asked whether you have recently gone on a crash diet as drastic weight loss can cause periods to stop completely.
You will be asked if you are aware of the fertile period during each cycle, i.e. when conception is more likely to occur. Do not be ashamed to admit your ignorance. You are not the only ones. The number of times a week that you have intercourse becomes important in determining whether or not there is a reasonable chance to have expected a pregnancy to have already occurred.
What will be asked of our medical histories
Both of you will be asked to give details of your past medical histories. In the woman all abdominal operations and especially pelvic surgery are of interest. Conditions such as appendicitis are very significant if associated with peritonitis. Among the Asian community direct inquiry will be made into a history of Tuberculosis (T.B.) as this can occasionally affect the uterus and tubes.
All medicines taken on a regular basis should be mentioned. Heavy cigarette smoking (20 a day or more) either by you or your husband may be very relevant. There is now evidence to show that the fertility of women who are smokers is half that of non-smoking women. Men who are heavy smokers may be reducing both the quantity and quality of the sperm that they are producing. The operations in the male of special interest are those in the region of the groin and scrotum. Operations for undescended testicles and the ages at which they were performed are of obvious importance.
Will they undertake a physical examination of me
Once the doctor has taken down your medical history, he will conduct a physical examination. He will first take your weight. He will then move on to examine your breasts and abdomen.
A vaginal examination provides the doctor with information about the size, shape and position of the uterus. He will be able to determine if there is any reduction in the mobility of the uterus, or if there are fibroids of the uterus or cysts on the ovaries, any of which may indicate a cause of your infertility. He may also take a cervical smear if this has not recently been carried out.
It is unlikely that your husband will be examined at the first visit. This only becomes necessary if it is obvious that there is a significant male infertility factor.
What will the doctor learn from the first visit
After the history, general examination and pelvic examination have been completed, the majority of patients usually fall into one of the three broad categories:
No apparent abnormality has been found on taking your history or on examination.
Periods are so irregular (or even totally absent), that ovulation, if it occurs at all, is completely unpredictable, e.g. periods occurring every 1-4 months.
There are factors in your history or examination indicating possible tubal damage, such as a history of peritonitis. The vaginal examination may have revealed that the uterus is immobile because of possible adhesions in the pelvis.
Your specialist will now decide which investigations and/or treatments are indicated in your individual case. This will, of course, be discussed with you and fully explained. If there is any aspect of these investigations that you or your husband do not understand, do not hesitate to clarify your doubts.
Why you may have trouble
Conceiving
Although getting pregnant may seem like the easiest thing in the world, it is actually not so for many people. There are several reasons for this, and any one or more of the following may be applicable.
Late planning (advanced age)
The trend today is for women to complete their education and establish their careers before they think of settling down and starting a family. However, for a woman over the age of 35, conceiving becomes a problem. Infertility increases with age. Fertility peaks for both sexes in their mid-twenties and then appears to decline steadily in women over thirty and men over forty. Tubal infections, fibroid tumors and endometriosis are more common in older women and are a common cause for infertility.
Excessive drinking, smoking, drug use
Research has shown that the excessive consumption of alcohol or the use of illicit drugs like marijuana, cocaine, heroin and crack, by a potential father prior to pregnancy can be the cause of infertility. Illicit drugs can also reduce the sperm count, damage the sperm, reduce testosterone levels, and change testicular functioning. (These are generally ejaculated with the sperm.) Heavy drinking can affect a woman’s menstrual cycle as well. Note however, that as long as drinking, smoking and drug use have been curtailed before getting pregnant, prior use seems to pose almost no risk to the baby.
Ovulation/menstruation problems
Ovulation is a pre-requisite for getting pregnant. In women with regular menstrual cycles of 28-35 days, ovulation takes place once every cycle. However, many women have erratic menstrual cycles (often getting periods 3-4 times a year or even less). This means that they have fewer chances of getting pregnant not only because they have fewer possible fertile periods, but also because they may not be ovulating in every cycle. (Note that ovulation does not necessarily take place in every menstrual cycle).
Low sperm count (for males)
The normal sperm count ranges from 20 million to 100 million sperm per cubic centimeter. Counts below 20 million may be a cause for difficulty in conception. Factors such as fatigue, excessive alcohol, smoking or other drug abuse, prostate gland infection, poor diet, or occupational exposure to chemicals can cause a small, temporary decrease in the sperm count. Varicocele is a condition when there are varicose veins on the scrotum. This is another cause for infertility and can only be corrected through surgery.
Retroverted uterus
Many women are born with their uteruses facing backward (retroverted) instead of forward. This condition can be diagnosed either by your gynecologist, or through an ultrasound. One simple way to compensate for this problem of a retroverted uterus is for the woman to lie on her stomach after intercourse. (Women with regular uteruses who are planning to get pregnant are asked to lie on their backs and lift their legs from their hips after sex in order to improve the chances of fertilization). If retroverted uterus is the only problem, then in most cases the woman will conceive. However, if she still does not get pregnant, then the doctor may advise surgery.
Polycystic ovaries
Cysts are formed when the follicle fails to rupture at the time of ovulation and begins to grow instead. This condition occurs due to hormonal imbalance and is marked by absent or infrequent menstruation. Women having this condition have a chronic tendency to have their periods at intervals ranging from every six weeks to six months. Conception becomes difficult due to irregular ovulation.
Intercourse pattern
Very often, you may simply be mistiming your intercourse. In order for you to get pregnant, it is essential for you to have sex during your fertile days. It could also be possible that you may be trying too often in a particular cycle, and thereby causing a reduction in sperm count.
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