doctor4patient

Sawal , Samasya ne samadhan

Archive for the category “General”

New outlook


Advertisements

HAPPY DIWALI


HAPPY DIWALI

to all my friends, follows and reader of docter4ever blog

without your support I never touch such position.

THANKS and

wishing you a Happy diwali glowing with joy, peace and prosperity

 

Change lifestyle, prevent infertility


There are millions of couples around the world who battle infertility. Experts are reporting a steady increase in the number of people who are affected by this problem.

However, it is possible to prevent some potential kinds of infertility by bringing about certain changes to your day-to-day lifestyle. The environment we live in has a huge impact on your potential fertility,” says doctor. Gynaecologist and Infertility Specialist , says that while most types of infertility cannot be prevented, there are a few ways in which fertility can be improved. Overweight or underweight women experience a higher risk of ovulation disorders.

“Weight loss should be gradual and accompanied by a balanced diet and moderate exercise. Women following fad diets and doing strenuous activity, have decreased ovulation and increased menstrual disturbances. In men, strenuous exercise leads to a decrease in the sperm count due to an increase in the testicular temperature, impairing sperm production. Since consumption of too much tea or coffee in a day can affect bodily functions, it is also associated with an increased risk of miscarriages. Drugs like cocaine and marijuana have been linked to irreparable damage and infertility in both sexes. In India, tuberculosis is a major cause of infertility, as it destroys the reproductive tract in both sexes if not treated early,”

Repeated abortions or undergoing unsafe abortion leads to a higher risk of infertility, as it can cause scarring of the uterine cavity or tubal blockage. Pesticides, lead, heavy metals, toxic chemicals and ionising radiations reduce fertility in both sexes.

 

 

 

Infertility expert says that knowing what compromises one’s fertility and devising ways to avoid potential hazards is the best way to prevent it. “Smoking has been linked to low sperm counts and sluggish sperm movement in men, and an increase in miscarriage in women. Alcohol (especially binge drinking or chronic abuse), affects the fertility of both men and women trying to conceive either naturally or through infertility treatments. Alcohol reduces sperm counts, can interfere with sexual performance, disrupt hormone balances and increase the risk of miscarriage.”

Moderate amount of exercise helps make a large difference in one’s probability of becoming fertile. Avoiding excessive weight gain is one of the best ways to prevent infertility. Early diagnosis of conditions like pelvic inflammatory disease, endometriosis and cervical cancer may prevent infertility. Detection and treatment of sexually transmitted diseases helps safeguard one’s fertility.

Gynaecologist  says that a woman’s fertility goes down steadily with age, more so after 35. “It is better not to delay pregnancy. Safe sexual practices, having one sexual partner and promptly treating sexually transmitted infections are very important. Couples are increasingly reporting reduced sexual frequency and interest, which is impacting fertility negatively. Stress can throw hormones off-balance and upset ovulation. PCOS, diabetes and high blood pressure, all of which are related to obesity, and which impact pregnancy and its outcome, are unfortunately, on the rise,”

Boost your daily intake of natural antioxidants through simple dietary modifications.

– Vitamin E is a powerful antioxidant, which improves egg quality by preventing egg damage during the process of maturation. Dietary sources include nuts, seeds, green leafy vegetables, cereal brans such as wheat, oat or rice bran and vegetable oils.

Vitamin C has been shown to better fertility in women with poor ‘luteal phase’, and improve chances of implantation of the egg in the uterus. Citrus fruits, strawberries, guavas, kiwi and veggies such as tomatoes, broccoli, cauliflower, vegetable greens and bell peppers are rich sources.

– Folic acid is an important prenatal vitamin — it prevents the incidence of birth defects in the foetus and is essential to produce genetic material in every cell of our body. An ideal fertility diet should contain green leafy vegetables, coloured veggies, fruits, sprouts, nuts and seeds, beans, vegetable oils, dairy products, whole grains, fish and lean meat. Foods consumed in their natural raw state give maximum benefit — over-cooking destroys vital nutrients.

IVF process negatively impacts women’s sexual relationships


An Indiana University study has found that women undergoing in-vitro fertilization report that the process of infertility treatment has many negative impacts on their sexual relationship with their partner. Little attention has been given to the sexual dynamics of couples as they navigate infertility and treatments such as IVF, despite the important role that sex plays in a couple’s attempt to conceive a child.

“Sex is for pleasure and for reproduction, but attention to pleasure often goes by the wayside for people struggling to conceive,” said Nicole Smith, a doctoral student with the Center for Sexual Health Promotion at the IU School of Public Health-Bloomington. Smith is conducting the study in collaboration with Jody Lyne- Madeira, associate professor in the IU Maurer School of Law. “With assisted reproductive technologies (ART), couples often report that they feel like a science experiment, as hormones are administered and sex has to be planned and timed. It can become stressful and is often very unromantic and regimented; relationships are known to suffer during the process.”

This study, which is one of the first in the United States to examine women’s sexual experiences while undergoing assisted reproductive technologies, used the Sexual Functioning Questionnaire to assess the impact of IVF treatment on couples’ sexual experiences. Compared to a sample of healthy women, women undergoing IVF reported significantly less sexual desire, interest in sexual activity and satisfaction with their sexual relationship. They had more difficulty with orgasm and were more likely to report sexual problems such as vaginal pain and dryness. Similar to emotional and relationship challenges associated with assisted reproductive technologies, the sexual problems intensified as a couple’s use of ART proceeded.

When couples meet with their physicians, their sex life might not top the list of issues they want to discuss, either because of unease talking about the subject or simply because they have so many other important issues to discuss. Still, Smith and Madeira say, the doctor-patient relationship is key, and couples can be told up front about the potential sexual side effects and resources that can help. If they have issues with dryness, for example, they could be counseled on remedies such as purchasing lubricant or other sexual enhancement products. In addition to referring couples to mental health counselors, reproductive endocrinologists could also refer them to sex therapists.

“There’s just a dearth of knowledge on how infertility affects sexual behavior,” Madeira said. “The focus is more likely to be on the social and support dimensions of the relationship, but sex is a big part of that. Just letting patients know they aren’t alone in this would be helpful.”

If more information about sexual challenges becomes available, couples might find it on their own.

“Women interested in ART are generally well-educated and tend to spend time researching these issues,” Madeira said. “They would be very responsive to this information, and proactive.”

The study involved 270 women who completed an online questionnaire; interviews with 127 men and women using IVF to try to conceive; and interviews with 70 professionals, including physicians, nurses, mental health experts and other providers who work directly with patients.

IVF is a procedure in which mature eggs are retrieved from a woman’s ovaries and fertilized by sperm in a lab, forming embryos. The embryo(s) are then implanted in the woman’s uterus. It is considered an effective procedure but one that is used after couples try several other less invasive procedures. By the time couples begin IVF, they might have been trying to conceive for many years. Nine percent of the women in their study had been through five IVF cycles, which could take at least a year.

Here are some of their other findings:

  • Women who reported being sexually active with a partner in the past month also were more likely to engage in masturbation and report fewer sexual problems.
  • The women reported similar problems with sexual function regardless of the type or source of infertility involved: male factor, female factor, or both male and female factor.
  • Hormonal treatments used in assisted reproductive technologies likely affect women’s sexual experiences and pain, but these effects are not as well understood and receive less priority than other conditions, such as heart disease and cancer.

Smith will discuss “Utilizing Assisted Reproductive Technologies and the Impact on Sexual Function: Validating the SFQ Among a Sample of Infertile Women,” at 7:30 p.m. EDT Tuesday, Oct. 30. The research was supported in part by the Kinsey Institute for Research in Sex, Gender and Reproduction, the IU School of Public Health-Bloomington, and the Faculty Research Support Program in IU’s Office of the Vice Provost for Research.

Source: Indiana University

Eat Foods that Make You More Fertile


Avoid foods and drinks that may reduce your ability to conceive or harm a newly conceived baby. Some substances are harmful to your chances of conception, while others can harm your newly developing baby.

  • Women planning to conceive should avoid alcoholic beverages for up to 2 months prior to attempting conception. This is especially true for couples who are having a difficult time conceiving.
  • Avoid excessive caffeine intake – this includes both food and drink. Women who drink more than 3 cups of a caffeinated beverage daily are significantly less likely to get pregnant compared to women who consume 2 cups or less.
  • Do not smoke or use drugs. Nicotine and illegal street drugs, such as cocaine or marijuana, can impair your body’s ability to get pregnant and develop a healthy baby. Tobacco affects cervical mucous in ways that may obstruct fertilization.Smoking also reduces sperm count and sperm health.Exposure to second-hand smoke can be just as counterproductive.
  • Consumption of pesticides may also be linked to pregnancy difficulties, so now may be a good time for couples to choose organic foods.
  • Avoid trans fat, often found in processed baked goods and sweetened foods. There is some evidence that a diet high in trans fat (especially relative to monounsaturated fat intake) can increase chances of infertility.
  • Avoid questionably prepared raw fish, unpasteurized cheeses, sprouts, prepackaged foods that don’t look fresh, and lunch meats containing nitrates. These foods and other foods that are undercooked or improperly cleaned can lead to food poisoning or illness, reducing your chances of supporting a healthy pregnancy.

Eat foods thought to increase fertility. Traditional medicine and folklore have long held that certain foods promote or decrease fertility and sexual appetite. In recent years, scientific research has confirmed some of the potential biological mechanisms for certain foods’ perceived effects on fertility.

  • Eat a diet rich in organic plant-based foods that includes grains, nuts, fruits, and vegetables. The antioxidants, vitamins, and minerals provided by these foods are thought to improve cellular health and even promote a healthy uterine lining.
  • The right kinds of protein can help boost fertility; tofu, chicken, eggs, and some seafood are high in omega-3 fatty acids, iron, selenium, and other fertility-enhancing components.
  • Consuming full-fat dairy products, such as whole milk or full-fat frozen yogurt, can potentially improve fertility over a diet of only low-fat or fat-free dairy

Eat as if you were already pregnant. One of the best ways to prepare your body for conceiving and hosting a baby is to eat as if you were already nurturing a developing baby. Not only that, but following a healthy diet before pregnancy can be essential to conception and will make it easier to maintain a healthy diet during pregnancy.

  • This does not mean increasing your calorie intake, but it does mean avoiding fatty and sugary foods, high-mercury fish, caffeine, and alcohol while upping your intake of fresh fruits and vegetables, dairy or dairy substitutes like coconut and soy-based alternatives, whole grains, and lean protein sources

 Take prenatal vitamins. There is some evidence that iron, folic acid, and a good balance of essential vitamins and nutrients can assist in conception. For example, taking folic acid supplements before trying to conceive may reduce the risk of spina bifida and other neural tube defects.

  • The nutrients in prenatal vitamins are excellent to already have in your diet once you get pregnant. As a bonus, you will already be in the habit of taking a prenatal vitamin once you are pregnant

Encourage your partner to eat foods that promote sperm health. Men should take a multi-vitamin that contains vitamin E and vitamin C, eat a diet rich in fruits and vegetables, and avoid excessive alcohol, caffeine, and fat and sugar intake.

  • Men should also make sure they get plenty of selenium (55mcg per day), as selenium is suspected to increase fertility particularly in men.

Pregnancy Tips


1. Have Sex Often: Your odds of getting pregnant are best when you have sex 1 to 2 days before you ovulate. But cycles vary in length, and some women are irregular or have miscalculated their cycle. Sperm can survive in a woman’s body for up to 5 days. To hedge your bet, have sex frequently starting 3 days before ovulation and continuing for 2 to 3 days after you think you’ve ovulated.
2. Lie Low After Sex: Give sperm a chance to swim upstream before going to the bathroom. Stay in bed for at least a few minutes after intercourse.
3. Create a Sperm-Friendly Environment: Avoid vaginal sprays, scented tampons, artificial lubricants, and douching. They can alter the normal acidity of the vagina.
4. Know When You Ovulate: Chart your basal body temperature and your cervical mucus. You might also use an over-the-counter ovulation predictor kit (OPK) to check for hormonal changes in your urine before ovulation.
5. De-Stress: Try yoga, meditation, or long walks to reduce stress. Research indicates that stress can interfere with getting pregnant. No need to quit your job or change your life. Simple acts such as exercising, writing in a journal, or holding hands with your spouse can lower stress.
6. Maintain a Healthy Weight: Studies show that weighing too little — or weighing too much — can disrupt ovulation and may also affect production of key reproductive hormones. A healthy BMI is between 18.5 and 24.9.
7. Trying for a Boy or a Girl? There’s no sure, natural way to choose the sex of your baby. But male sperm swim and expire faster than female sperm. To aim for a boy, have intercourse about 12 hours before you ovulate — or as close to ovulation as possible — so the male sperm will be there when the egg drops. To aim for a girl, have intercourse several days before ovulation, so more female sperm will be around when the egg drops. Still, experts say your odds are 50-50 unless you use a sperm-sorting technique, followed by artificial insemination.

How do I use ovulation prediction kits (OPK) ?


Ovulation prediction test kits (OPK) are available abroad (or in India at a few chemists) over the counter . If you live in India, you can also buy them from online store. These kits detect LH which is produced in large quantities shortly before ovulation and can be found in the urine . Once the LH surge has occurred, ovulation usually takes place within 12 to 44 hours. Urine testing is started about two days prior to the expected day of ovulation and continues until the test becomes positive. The urine should be collected at the same time every day – and testing the first morning urine sample is a good idea.

If your menstrual cycles are irregular, testing should be timed according to the earliest and latest possible dates of ovulation. For example, if your cycle ranges between 27 and 34 days, you could possibly ovulate between days 13 and 20. Therefore, testing should begin on day 11 and continue until ovulation is indicated or through day 20. There is an 80 percent chance of detecting ovulation with five days of testing and a 95 percent chance with ten days of testing. Occasionally, ovulation may not occur in a particular cycle. If the ovulation prediction test has been timed and performed accurately and has not turned positive, you should discontinue testing and begin again with your next menstrual cycle. Persistent failure of the test to turn positive may indicate a problem with regard to ovulation.

Once a test has registered positive, indicating that ovulation is about to take place, it is no longer necessary to continue testing. Remaining tests in a kit may be saved and used in the following menstrual cycle if pregnancy does not occur.

Ovulation prediction kits offer the advantage that they allow you to predict when ovulation will occur – thus maximising the chances that intercourse will be timed at your most fertile period. They can also be done in the privacy of your own home. However, they are expensive; and some of the kits have very tedious and involved testing procedures, so that errors are not uncommon.

A newer device, The Clear Plan  Easy TM Fertility Monitor, is a palm-sized, electronic system, that provides information about fertility status by interpreting the levels of two hormones, estrogen and luteinizing hormone, in the urine. You need to test your urine for the presence of these, using dip sticks, and the information is then input into the system, which uses it to calculate your fertile days.

How can you adapt to the decision to live childfree ?


Remember, there can be real advantages to life without children: more personal freedom, more time to spend on your own interests, and more emotional energy to invest in your emotional relationships. Start enjoying your time with your spouse more – remember the early heady days of your marriage before you were striving for a child? Try to recapture those magic moments again.

A new lifestyle may be difficult to think about and many people advise that you try to do many things that interest you to give yourself a chance to spend some of your pent-up needs – the need to be needed and the need to do something. It’s a matter of balance. The answer to wanting one thing exclusively is to be involved in many things – to spread yourself around. Taking a holiday to mark the end of treatment and the beginning of a new lifestyle can be very helpful and allows time to relax and assess the situation.

Acceptance or resolution of infertility doesn’t mean putting all desire to have children into the past and forgetting about it. Infertility, your experiences and thoughts will always be a part of you and will be remembered with mixed emotions, including sadness, regret and frustration, over the years. Acceptance is more an acknowledgement that your hopes weren’t to be and that you have to make some readjustments. It is not something you can do suddenly. You gradually come to this point, maybe over the course of your infertility tests and treatments or maybe only when treatment has finished.

The way in which people cope with childlessness will depend on many factors, but remember that:

  • There is no “right” way of coping with childlessness. Each person’s way of coping will depend on their own experiences and emotions and has to suit that individual.
  • You have to give yourself time.
  • There will be times when it is easier to manage than at others, and your level of coping will fluctuate. There are bound to be moments of doubt and questioning – what if…?
  • Denying that it is hurting doesn’t help. The more you express your feelings in words, tears, writing down your thoughts or whatever, the easier it will seem.
  • You may feel angry because the thought of childlessness might be so hard to contemplate. This might be directed toward your partner, yourself, your doctor. Recognise that this is a start to acknowledging your feelings.
  • Try not to apportion blame – there is no one to blame
  • Others have survived this crises and gone on to lead happy and contented lives.

Even as you get older, you may still find that other people treat you as “odd ” or different” because you have no children. You have to accept this – and learn that you need not conform to others’ norms to lead a happy life.

Creating a new identity without children is an important part of asserting control over your infertility. This involves trying to think beyond children and deciding what you want for yourself. The only effective way to cope with childlessness is to build up your self-esteem which may have been battered by the experience of infertility. Creating a new identity does not mean abandoning your reasons for wanting a child. Just as those reasons shaped your infertility experience, so they affect the form that your resolution takes. For example, you may choose to spend time with a children’s organisation as a volunteer.

Taking an interest in other people’s children on a regular basis may also be helpful. When you were a child, remember how you longed to see that special auntie or uncle? Enjoy the children around you – use your energies for a child that exists.Another useful outlet for the longing to nurture is to keep pets. A lovable and furry pet such as a dog or cat are most popular, because they can give love back, but infertile couples report pleasure in almost anything alive – from fish to flowers to gardens.

The passage of time heals – but it can’t be hurried. Time brings a sense of perspective or the “larger view of life” for those who have had tunnel vision focused on infertility for a number of years.

Soul searching can be helpful – and try answering these questions together – honestly.

  • Why do you want a child?
  • Why would you not want to have a child?
  • Think of the time before you tried for a baby. What made you happy? What did you do with your time? What did you look forward to?
  • What are your other dreams and ambitions besides having a child?

Remember, that the value of, and reward from, a firm resolution are what you make of it. If you select a child-free life, and then treat it as a second-rate existence, that’s exactly what it will become. But if you invest it with all your interests, pleasures, energies and talents, this lifestyle can be creative fun, delightful and filled with accomplishment. Such a lifestyle may not be for everybody, but it may be just right for you!

Can Stress Cause Infertility?


Historically, infertility, particularly “functional” infertility, was attributed to abnormal psychological functioning on the part of one or both members of the couple. Preliminary works in the 1940s and 1950s considered “psychogenic infertility” as the major cause of failure to conceive in as many as 50% of cases. As recently as the late 1960s, it was commonly believed that reproductive failure was the result of psychological and emotional factors. Psychogenic infertility was supposed to occur because of unconscious anxiety about sexual feelings, ambivalence toward motherhood, unresolved Oedipal conflict, or conflicts of gender identity. Fortunately, advances in reproductive endocrinology and medical technology as well as in psychological research have de-emphasized the significance of psychopathology as the basis of infertility, and modern research shows that there is little evidence to support a role for personality factors or conflicts as a cause of infertility. This perspective unburdens the couple by relieving them of the additional guilt of thinking that it is their mental stress that may be responsible for their infertility.

Biologically, since the hypothalamus regulates both stress responses as well as the sex hormones, it’s easy to see how stress could cause infertility in some women. Excessive stress may even lead to complete suppression of the menstrual cycle, and this is often seen in female marathon runners, who develop ” runner’s amenorrhea”. In less severe cases, it could cause anovulation or irregular menstrual cycles. When activated by stress, the pituitary gland also produces increased amounts of prolactin, and elevated levels of prolactin could cause irregular ovulation. Since the female reproductive tract contains catecholamine receptors catecholamines produced in response to stress may potentially affect fertility, for example, by interfering with the transport of gametes through the Fallopian tube or by altering uterine blood flow.

However, more complex mechanisms may be at play, and researchers still don’t completely understand how stress interacts with the reproductive system. This is a story which is still unfolding, and during the last 20 years, the new field of pychoneuroimmunology has emerged, which focuses on how your mind can affect your body. Research has shown that the brain produces special molecules called neuropeptides, in response to emotions, and these peptides can interact with every cell of the body, including those of the immune system. In this view, the mind and the body are not only connected, but inseparable, so that it is hardly surprising that stress can have a negative influence on fertility.

Stress can reduce sperm counts as well. Thus, testicular biopsies obtained from prisoners awaiting execution, who were obviously under extreme stress, revealed complete spermatogenetic arrest in all cases. Researchers have also showed significantly lower semen volume and sperm concentration in a group of chronically stressed marmoset monkey, and these changes were attributed to lower concentrations of LH and testosterone (which were reduced in the stressed group). However, how relevant these research findings are in clinical practise is still to be determined.

In addition to these direct effects, stress can also suppress libido, cause erectile dysfunction, and result in a reduction in the frequency of intercourse, which in turn could also reduce fertility. Also, many women start overeating in response to the stress of infertility. The increased fat cells then disrupt the hormonal balance, making a bad situation even worse.

While studies have shown that infertile couples do show psychologic dysfunction and even psychiatric abnormalities ( such as depression or anxiety), this is actually a chicken and egg problem, and in reality the response of the infertile couple is a perfectly “normal” response to their abnormal situation, which is designed to help them to cope with the difficult circumstances they find themselves in. However, many people start blaming the couple, and many couples themselves start believing that it is the stress which they are under which is causing them to be infertile.

Victim blaming is popular – especially where fertility and women are concerned, and instead of providing them with support, couples receive completely gratuitous and unwanted advise. Ironically, victim blaming has become more prevalent today because of the fashionable “holistic health” belief about the influence of the mind on the body, which holds that even patients with cancer can cure themselves by the power of positive thinking. Many IVF – In Vitro Fertilization couples too may subscribe to the belief that success is practically guaranteed if the patient remain optimistic and relaxed. Thus, if the attempt fails, it was because the patient was “too tense” or ” too stressed out”.

This myth has been perpetuated by anecdotes of friends or relatives who have conceived while on holiday, and stories of couples conceiving after many years of infertility after they have adopted a baby are a part of today’s “urban myths”.

Stress and infertility often have a circular relationship, and they can aggravate each other, setting up a vicious cycle. Infertile couples, who are under stress because of their infertility, start blaming themselves for their infertility. This increases their stress levels and further aggravates the problem! As one mind-body expert has said, “Stress causes illness causes more stress which causes more illness.”

When to change your doctor during Infrtility tratment??


Because infertility is often a long drawn-out process, anger is a natural result – and often this is transferred to your doctor. However, constantly changing doctors or doctor-shopping can be counterproductive! If the quality of care you are receiving is good, be cautious about changing doctors – a doctor who knows you and your infertility well can be of significant help to you.

Changing doctors is never easy, because, over a period of time you do build up a personal relationship with your doctor. However, you should consider changing doctors if you feel that:

  • the doctor is incompetent (i.e., he has ignored obvious symptoms, missed a diagnosis, prescribed the wrong drug, or can’t get to the bottom of your problem)
  • the doctor does not communicate with you effectively ( i.e., his explanations are not in lay person’s language or no time is given to you to ask questions and bring up related problems)
  • the doctor does not pay attention to your needs and concern
  • you have lost confidence in the doctor’s skill and ability
  • you find the doctor is too inconsiderate ( i.e., he makes you wait a long time for an appointment, he fails to return your phone calls, he does not provide clinic time during evening or weekend hours )
  • your doctor is too expensive.

A common problem patients face is that when they go to a new doctor, he insists on repeating all the tests all over again. While this can be frustrating and expensive, it can be helpful as well, because it allows the doctor to reassess your problem with a fresh perspective. Please ask your doctor to explain why he needs to repeat the tests, and how this will help in your treatment. If tests have already been done, but are more than a year old, or if they have been done from an unreliable lab, you may need to repeat some of these again.

It is all too common to find that infertility clinics do not provide complete medical treatment details to their patients. They often do this in order to make sure that the patient remains with them, and does not go to another doctor. This is very unfair remember that your medical records are your property, and you are entitled to a copy of them.

You may find that your new doctor criticises the treatment your previous doctor provided. Remember that doctors do have big egos, and they are often intensely competitive and critical of each other. This can upset you, because you may start feeling that you were given substandard medical care. As long as you have a clear understanding of what was done to you and why, you should ignore this criticism – don t let it disturb you. Anyone can be wise with hindsight and do remember that all doctors will try to do their best to help you to get pregnant!

Many doctors will repeat exactly the same treatment the previous doctor has administered often because they have nothing better to offer! However, remember that even though you have changed your doctor, you have remained the same and the purpose of changing doctors should be to allow you to progress further with your treatment.

What should you do when you need to phone your doctor ?


However, you need to learn to make intelligent use of the phone to get appropriate help from the doctor. The following routine may help you to help the doctor give you the care you need over the telephone:

  • Keep a pen and paper ready so that you can write down the relevant instructions.
  • Make sure all your medical records are at hand, so that you can answer questions about your medical problem intelligently and accurately.
  • Identify yourself properly, giving your full name as well as your diagnosis ( try not to tax your doctor’s memory!).
  • Ask if you can take a few minutes of the doctor’s time now, or whether you should call back again this is common courtesy!
  • Report specific symptoms. For example, rather than just saying, I don’t feel well, or I’ve got the flu, which can be interpreted in different ways, be prepared to describe your symptoms precisely; for instance, fever, sore throat, cough, and/or bodyache.
  • When you don’t know what you need (for example, you may not be sure how serious the illness is, i.e., if you require a visit to the clinic), tell the staff you’re uncertain and request that you speak to a nurse or the doctor’s assistant over the phone. Don’t be hesitant; if you’re feeling concerned or anxious, let the clinic staff know.
  • Don’t insist on talking only to the doctor every time you call. For example, if you just need to make an appointment, or merely clarify a doubt, the nursing staff or receptionist may be able to help you. To put it differently: respect your doctor’s time!
  • Don’t misuse the phone by trying to wangle a free consultation. Not only is this act unfair to the doctor, but also such a consultation is likely to be very unreliable!

Today, many physicians make themselves, an assistant or other staff member available to their patients over the phone. Pre-visit questions and routine follow-up on the phone can save you and your doctor both time and money. Before making a call, you need to certain relevant information in advance:

  • When is the best time to call?
  • What is the doctor’s rule for returning calls?
  • Whom should you speak with (e.g., assistant, nurse) if the doctor can’t come to the phone?
  • What is the phone number for making emergency calls or for calls when the office is closed?
  • Whom can you call if your doctor is out of town?

Making effective use of the telephone can help to save both you and your doctor considerable time, effort and money! learn to use this instrument wisely and well.

Many doctors today are happy to answer your queries by email and this can be very helpful if your doctor is in a different city. Please find out from your doctor what his policy about email queries is !

Find problem with hormonal report in male infetility


Interpretation of hormonal

Sperm

numbers

FSH

LH

Testosterone

 
Low orzero VeryLow VeryLow Very Low Pituitary gland problems can cause poor FSH and LH production, which lead to low testosterone and infertility

 

 

 

Low orzero VeryHigh VeryHigh Low toNormal High levels of FSH and LH, together with low to normal levels of testosterone, show a problem in the testes
 

 

 

 

 

 

Low orzero VeryHigh Normal Normal In many infertile men, the testosterone producing cells (Leydig cells) in the testes are working normally and only the sperm-producing tubules (seminiferous tubules) are a problem. The body makes more FSH to try and overcome the problem
 

 

 

 

 

 

 

Zero Normal Normal Normal Possible blockage to sperm flow

How important is counseling to the patient undergoing infertility treatment?


The physician helps the infertile couple find the most appropriate therapeutic path to overcome barriers to conception, but before a treatment is started, patients need to be aware of all its aspects, including its constraints. Beyond the medical expertise, infertile couples are also looking for counseling and support. From a psychological point of view, infertility is often a hard condition to cope with. During treatment and before a pregnancy is achieved, feelings of frustration or loss of control usually experienced by the infertile couple are likely to be exacerbated. Management of infertility includes both the physical and emotional care of the couple. Therefore, support from physicians, nurses and all people involved in treating the infertile couple is essential to help them cope with the various aspects of their condition. Offering counseling and contact with other infertile couples and patient associations can provide help outside the medical environment.

Myths and Misconceptions


Myth: Painful periods cause infertility.
Fact: Painful periods do not affect fertility. In fact, for most patients, regular painful periods usually signal ovulatory cycles. However, progressively worsening pain during periods ( especially when this is accompanied by pain during sex) may mean you have endometriosis.

Myth: Infrequent periods cause infertility.
Fact: As long as the periods are regular, this means ovulation in occurring. Some normal women have menstrual cycle lengths of as long as 40 days. Of course, since they have fewer cycles every year, the number of times they are “fertile” in a year is decreased. Also, they need to monitor their fertile period more closely, since this is delayed ( as compared to women with a 30 day cycle).

Myth: Blood group “incompatibility” between husband and wife can cause infertility.
Fact: There is no relation between blood groups and fertility.

Myth: The reason I’m not getting pregnant is because most of the sperm leaks out of the vagina after intercourse.
Fact: Loss of seminal fluid after intercourse is perfectly normal, and most women notice some discharge immediately after sex. Many infertile couples imagine that this is the cause of their problem. If your husband had his climax inside you, then you can be sure that no matter how much fluid you lose afterwards, enough sperm will reach the cervical mucus. This discharge is not a cause of infertility.

Myth: If you work at it and want it enough, you’ll get pregnant.
Fact: Unlike many other parts of your lives, infertility may be beyond your control. While newer methods of treatment have improved most couples’ chances of having a baby, some problems are still unsolvable.

Myth: Just pray and have faith.
Fact: Believing in God can help you to maintain a positive outlook – but sheer will and blind faith won’t overcome a physical problem like blocked tubes or absent sperms.

Myth: A man can judge his fertility by the thickness and volume of his semen.
Fact: Semen consists mainly of seminal fluid, secreted by these minal vesicles and the prostate. The volume and consistency of the semen is not related to its fertility potential, which depends upon the sperm count. This can only be assessed by microscopic examination.

Myth: Infertility is hereditary.
Fact: If your mother , grandmother or sister have had difficulty becoming pregnant, this does not necessarily mean you will have the same problem ! Most infertility problems are not hereditary, and you need a complete evaluation.

Myth: A retroverted ( “tipped”) uterus causes infertility because the semen cannot swim into the cervix.
Fact: About one in five women will have a retroverted uterus. If the uterus is freely mobile, this is normal, and is not a cause of infertility. This is not an indication for surgery !

Myth: We should be having intercourse every day to achieve pregnancy.
Fact: Sperm remain alive and active in woman’s cervical mucus for 48-72 hours following sexual intercourse; therefore, it isn’t necessary to plan your lovemaking on a rigid schedule. Although having sexual intercourse near the time of ovulation is important, no single day is critical. So, don’t be concerned if intercourse is not possible or practical on the day of ovulation.

Myth: A woman ovulates from the left ovary one month and the right ovary the next month.
Fact: Only one ovary actually ovulates each month. However, the pattern may not be regular from side to side.

Myth: Pillows under the hips during and after intercourse enhance fertility.
Fact: Sperm are already swimming in cervical mucus as sexual intercourse is completed and will continue to travel up the cervix to the fallopian tube for the next 48 to 72 hours. The position of the hips really doesn’t matter.

Myth: If you just relax, you’ll get pregnant.
Fact: If pregnancy has not occurred after a year, chances are there is a medical condition causing infertility. There is no evidence that stress causes infertility. Remember, all infertile patients are under stress – it’s not the stress which causes infertiliity, it’s the infertility which causes the stress !

Myth: Periods that occur less than or greater than 28-day intervals are irregular.
Fact: A woman’s period will often vary from month to month. As long as a woman can count on a period at a regular interval every month, this is normal.

Myth: I’ve never had symptoms of a pelvic infection, so I can’t have blocked tubes.
Fact: Many pelvic infections have no symptoms at all, but can cause damage, sometimes irreversible, to tubes.

Myth: My gynecologist has done an internal examination and said I am normal; therefore I should have no problem getting pregnant.
Fact: A routine gynecological examination does not provide information about possible problems which can cause infertility.

Myth: If a woman takes fertility drugs, she’ll have a multiple birth.
Fact: Although fertility drugs do increase the chance of having a multiple pregnancy ( because they stimulate the ovaries to produce several eggs) the majority of women taking them have singleton births.

Myth: A man’s sperm count will be the same each time it is examined.
Fact: A man’s sperm count will vary. Sperm number and motility can be affected by time between ejaculations, illness, and medications.

Myth: I have no problems having sex. Since I am virile, my sperm count must be normal.
Fact: There is no correlation between male fertility and virility. Men with totally normal sex drives may have no sperms at all.

Myth: All physicians are equally interested in the treatment of infertility.
Fact: Not all physicians or even all infertility centers have similar interests. It is important for you to ask your physician about the available treatment he/she can offer you and what are the pregnancy results following such treatment in his/her practice.

Myth: Infertility treatment should not be offered in India, because there are too many babies in this country already . Why exacerbate the population problem by producing more ?
Fact: The right to have children is a fundamental right of every human being and a very basic biologic urge. Just because a neighbour has too many children should not deprive the infertile couple of their right to have their own.

Myth: Azoospermia ( no sperms) is a result of excessive masturbation in childhood.
Fact: Masturbation is a normal activity which most boys and men indulge in. It does not affect the sperm count. You cannot “run” out of sperms, because these are constantly being produced in the testes.

Myth: It must be the couple’s fault if they are infertile.
Fact: Infertility carries a major social stigma – and this “victim-blaming” is very common, partly because most people know so little about their own fertility.

Myth: Infertility is not a medical illness and treatment should not be covered by insurance.
Fact: Infertility is a medical problem, which is often amenable to medical treatment. Insurance should cover the treatment costs.

Myth: IVF is too expensive for India to be able to afford.
Fact: IVF and related technologies are undoubtedly expensive – but then, so is heart surgery. Yet, no one objects when over Rs 1 lakh are spent to try to salvage the heart of a 70 year old man (whose life expectancy in any case is only about 5 years and is not extended by the surgery). Why then should medical technology not be used to help couples in their thirties (with their whole lives ahead of them) have their own baby ? In fact, IVF is a much more cost-effective use of medical resources than a number of other accepted surgical procedures (such as joint replacement surgery or kidney transplants).

Donor conception


What is donor conception?

Donor conception means having a baby using donated sperm, or donated eggs or embryos.Deciding to pursue donor conception is a big step. That’s because it has far-reaching implications for your whole family and, of course, your child. Any form of assisted conception treatment can be stressful. But donor conception presents you with many more decisions and issues to consider.

Before you begin your donor conception journey, you’ll need to consider how you will cope both now and when your baby is older.

Is donor conception for me?

If you’ve reached this point, it’s likely that other routes to parenthood haven’t worked for you. You may feel a sense of lossbecause you can’t have a child with the person you love.If you have had years of fertility tests and treatments, you may also feel let down by your own body. And you may wonder if your body or your relationship can stand any more interventions.

Or it may be that these treatments have brought you and your partner closer together and made you stronger as a couple.

If you’re in a same-sex partnership, deciding whether donor conception is the right option may take many years of talking and planning.

It may be hard to come to terms with the idea of using someone else’s genetic material to conceive. Or perhaps your partner is less comfortable with raising a child with whom they have only a part, or no, genetic connection. Even when it is the only option for conceiving, these feelings may seem insurmountable. Talking through how you feel with your partner or someone close to you may help.

It’s likely that many of your fears and worries have been felt by other people who have been in your situation. You may feel less alone if you can gain some insight and support from them.

The Donor Conception Network is a network of couples and single parents with children conceived by donor conception. You’ll be able to find information and support there that may aid your decision.

Or you can find a counsellor specialising in fertility issues and treatments through the British Infertility Counselling Association.

How will I tell my child?

If you do opt for donor conception, dealing with the questions your child may ask as they grow up may seem a daunting prospect.These are some of the issues you will need to think about:

    • Who will you tell about your decision to use a donor? Will you share it with your family, friends, and strangers, or would you rather keep it more private?
    • You will need to prepare for when, years later, your child will ask the inevitable question about where they came from.
  • Will you be open from the start? This is usually the best approach. It will then feel like a normal part of family life as your child grows up.

The Donor Conception Network provides information and personal accounts from parents with older children, which may help.

You should be offered counselling from someone who isn’t directly involved in the treatment process. This will help you to think through the physical and psychological impact of donor conception for your whole family.

When can my child find out about the donor?

Once they reach 16, your child will have access to a register of donors for children who were donor conceived. They’ll also be able to find out if they have any donor siblings.The Human Fertilisation and Embryology Authority (HFEA) holds this information, which details donors who registered or re-registered from April 2005 onwards.

The information is split into two categories:

Non-identifying informationincludes information such as the donor’s:

  • physical appearance
  • ethnic group
  • number of children at that stage, and their gender
  • goodwill message to their potential children

Your child can apply for this information when he or she reaches 16 years, or you can apply on your child’s behalf before then.

Identifying informationdetails the donor’s:

  • name
  • date of birth
  • last known address

Your child may apply for this information when they are 18 years old, or from age 16, with their partner. If they’re getting married, entering a civil partnership, or considering a sexual relationship, HFEA can check that they are not genetically related to their partner.

For more information about the register visit the donor area of the HFEA website.

Since 2010, donor-conceived adults have the opportunity to put their contact details on a sibling contact register called the Donor Sibling Link. The HFEA administers this register which enables donor-siblings to contact each other by mutual consent. However, parents are not allowed to trace the donor-siblings of their children.

Some donor-conceived adults are not interested in finding out about the donor and any potential half-siblings, while others will want to know as much as they can. You will need to be prepared for either scenario and to support your child through their choice.

Find out how other parents have coped with teenage donor-conceived children in the personal accounts at the Donor Conception Network website.

Post Navigation

%d bloggers like this: