INFERTILITY IN WOMEN

For so many people around the world, having and raising children are extremely important events in their lives. Infact, some people believe fulfilling the need for reproduction make them whole and complete.

According to recent studies by the World Health Organization (WHO), approximately 8- 10% of couples are facing some kind of infertility problem. Globally, this means that 50-80 million people are facing this problem.

Infertility is defined as the inability to get pregnant after having unprotected sexual intercourse for at least one year, for women over 35 years old – six months. It also means the biological inability to contribute to conception and it affects one in six couples. Female infertility accounts for one third of all infertility cases.

CAUSES OF INFERTILITY IN WOMEN

According to a study carried out by the health science journal1, the most common cause of female infertility is problems in the fallopian tubes followed by unknown causes, disorders of menstruation and infertility due to problems in the uterus.

 

  1. Damage to the fallopian tubes and ovaries. This can be caused by one or more of the following
  • Abnormal cervical mucus: This can prevent the sperm from reaching the egg or make it more difficult for the sperm to penetrate the egg.
  • Pelvic Inflammatory Disease
  • A previous infection
  • Polyps in the uterus
  • Endometriosis
  • Fibroids
  • A birth Defect
  • Scar tissue or adhesions
  • Chronic medical illness
  • A previous ectopic pregnancy

 

  1. Ovulation Problems
  • Hormonal imbalance
  • A tumor or cyst
  • Extremely brief or nonexistent menstrual cycle

Age, alcohol or illicit use of drugs, obesity are factors that also contribute to infertility in women.

DIAGNOSIS OF FEMALE INFERTILITY

It is advised that you see your doctor if you’ve unsuccessfully been trying to conceive for six months, when you do this, a medical examination is carried out to determine what the cause(s) might be.

PREVENTION OF INFERTILITY IN WOMEN

When infertility is caused by genetic abnormalities, there is usually nothing that can be done to prevent it. Women can however advised to avoid illicit drugs & alcohol consumption and take steps to prevent sexually transmitted infections & diseases. They should also ensure to have annual medical checkups especially when sexually active.

TREATMENT OF INFERTILITY IN WOMEN

Fertility treatment significantly improve the chances of conception but varies from woman to woman.

Fertility drugs, hormone treatment and various assisted reproductive techniques like In vitro Fertilization (IVF) AND Intra Uterine Insemination (IUI) have been employed in the treatment of infertility.

The course of treatment is usually however determined by the cause. – Some of the drugs prescribed are used to stimulate ovulation.

Reference

http://www.hsj.gr/medicine/causes-of-infertility-in-women-at-reproductive-age.pdf

SIX REASONS WHY YOU SHOULD SEE A FERTILITY SPECIALIST

So whether you’ve been having trouble getting pregnant or are just starting to try, here are some good reasons to see a fertility specialist for an evaluation.

The process of trying to conceive is not often the easiest of processes especially when you are actively trying and also not been diagnosed of an anomaly. What this means is that for many couples trying to conceive, seeing a fertility specialist is an essential part of the process, sometimes it is not just patience you need, you might need help too as the information you get from the clinic helps you get proactive by addressing potential problems and also deciding on treatment options if the need be.

So when is the ideal time to book an appointment with a fertility specialist?

  1. If you have been trying for over a year (or 6 months if you’re 35 or older).

Infertility is actually defined as the inability to biologically contribute to conception after having unprotected sex for 12 months or six months if you are above the age of 35, so of you fall into this category, it is better to go see a fertility expert so you and yourpartner can be assessed and a targeted course of treatment can be made or decided upon.

  • If you have been diagnosed with cancer.

Cancer treatments usually have long term effects on fertility, so it is important to discuss with a fertility specialist what options are available for you to preserve your fertility while undergoing treatment. These options usually involve cryopreservation but each individual is different and at this point, the specialist knows best.

3. Do you have painful or irregular periods?

You should book that appointment then as this could be a sign of an ovulatory disorder. Polycystic Ovarian Syndrome (PCOS), a hormonal condition that interrupts ovulation and makes periods painful, irregular, and sometimes, completely nonexistent, is the most common. Although statistically, ovulatory disorders are the most common causes of infertility in women, most of them can be treated with medication

4. If you’ve had Pelvic Inflammatory Disease (PID).

Pelvic inflammatory diseases are infections of the female reproductive organs like the uterus, fallopian tubes and sometimes the ovaries. Most of the time, it is caused by bacteria from sexually transmitted infections like chlamydia and gonorrhea. Anytime you have these infections, there is an inflammation that can lead to scarring. Scarring can interrupt ovulation, or simply block the fallopian tubes and prevent the process of fertilization between the sperm and egg.

5. You have endometriosis.

This is quite similar to the pelvic inflammatory disease in the sense that it causes scarring as well and this can affect fertility. Treatments and outcomes vary greatly, but for many people, removing scar tissue can improve pregnancy outcomes, especially when paired with fertility treatments like IVF. So if you have a long history of endometriosis while trying to conceive, then you should consider seeing a fertility specialist.

6. If you are over 40.

It is not impossible to have a baby after the age of 40 although the older a woman gets, the greater chance her eggs will contain chromosomal abnormalities, which can result in miscarriage or the baby having a serious condition like Down syndrome. Seeing a fertility specialist will help you assess your risk and explore alternatives for starting a family.

WHAT IS HEPATITIS?

As part of creating awareness for hepatitis, here is a Q and A curated to clarify basic questions about the disease.

Q: What is hepatitis(HBV)?

A: Hepatitis is an inflammation of the liver. The condition can be self-limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer. Hepatitis viruses are the most common cause of hepatitis in the world but other infections, toxic substances (e.g. alcohol, certain drugs), and autoimmune diseases can also cause hepatitis.

There are 5 main hepatitis viruses, referred to as types A, B, C, D and E. These 5 types are of greatest concern because of the burden of illness and death they cause and the potential for outbreaks and epidemic spread. In particular, types B and C lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer.

Hepatitis A and E are typically caused by ingestion of contaminated food or water. Hepatitis B, C and D usually occur as a result of parenteral contact with infected body fluids. Common modes of transmission for these viruses include receipt of contaminated blood or blood products, invasive medical procedures using contaminated equipment and for hepatitis B transmission from mother to baby at birth, from family member to child, and also by sexual contact.

Acute infection may occur with limited or no symptoms, or may include symptoms such as jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.

Q: What are the different hepatitis viruses?

A: Scientists have identified 5 unique hepatitis viruses, identified by the letters A, B, C, D, and E. While all cause liver disease, they vary in important ways.

Hepatitis A virus (HAV) is present in the faeces of infected persons and is most often transmitted through consumption of contaminated water or food. Certain sex practices can also spread HAV. Infections are in many cases mild, with most people making a full recovery and remaining immune from further HAV infections. However, HAV infections can also be severe and life threatening. Most people in areas of the world with poor sanitation have been infected with this virus. Safe and effective vaccines are available to prevent HAV.

Hepatitis B virus (HBV) is transmitted through exposure to infective blood, semen, and other body fluids. HBV can be transmitted from infected mothers to infants at the time of birth or from family member to infant in early childhood. Transmission may also occur through transfusions of HBV-contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use. HBV also poses a risk to healthcare workers who sustain accidental needle stick injuries while caring for infected-HBV patients. Safe and effective vaccines are available to prevent HBV.

Hepatitis C virus (HCV) is mostly transmitted through exposure to infective blood. This may happen through transfusions of HCV-contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use. Sexual transmission is also possible, but is much less common. There is no vaccine for HCV.

Hepatitis D virus (HDV) infections occur only in those who are infected with HBV. The dual infection of HDV and HBV can result in a more serious disease and worse outcome. Hepatitis B vaccines provide protection from HDV infection.

Hepatitis E virus (HEV) is mostly transmitted through consumption of contaminated water or food. HEV is a common cause of hepatitis outbreaks in developing parts of the world and is increasingly recognized as an important cause of disease in developed countries. Safe and effective vaccines to prevent HEV infection have been developed but are not widely available.

culled from world health organization

EIGHT THINGS YOU NEED TO KNOW ABOUT HYPEREMESIS GRAVIDARUM

1
Hyperemesis gravidarum is the medical term for ‘morning sickness’ although it is more severe and is marked by symptoms such as intractable and persistent nausea, vomiting that could lead to electrolyte and metabolic disturbance, dehydration and nutritional deficiency and sometimes could require the hospitalization of the patient. It occurs in pregnant women
2.
Statistically in happens in three out of a hundred pregnancies.

3.

It is the most common cause of hospitalization in pregnancy usually due to the severe dehydration it causes. The cause of hyperemesis is unknown but it has been linked to the presence of higher level of hormones like oestrogen or human chorionic gonadotropin (hCG) during pregnancy.

4.

Women who are at a higher risk of experiencing hyperemesis:

  • Those that had it in previous pregnancies,
  • Women with a family history of hyperemesis,
  • Women pregnant with multiple babies.

5.

It usually starts between the sixth and eighth week of pregnancy and peaks by the twelfth week. Nausea and vomiting normally ends at the first trimester for most women but women diagnosed with hyperemesis usually experience it throughout their pregnancy.

6.

It can be clinically diagnosed by your physician after all other causes of nausea and vomiting in pregnant women have been eliminated.

7.

No research has linked hyperemesis to problems relating to foetal organ development and health risks to the foetus in women with hyperemesis are minimal but there are risks of low birth weight or premature babies. Also, women with hyperemesis have lower rates of miscarriage.

8.

Women with hyperemesis are usually advised to combine rest, hydration, consumption of food in smaller portions and avoiding whatever triggers that provoke n

SECONDARY INFERTILITY – WHAT DOES THIS MEAN?

People who have had babies can be infertile too…

Many parents struggle with this, partly because they cannot grasp the fact that it is possible to be unable to sire a child after previously having one.

Secondary infertility is the inability to become pregnant after a previous birth irrespective of whether the said child is alive or dead. Globally, almost 3 million couples are affected; secondary infertility accounts for one-third of visits to a fertility specialist.

 

 

WHAT CAUSES IT?

Many of the causes of secondary infertility are the same as for primary infertility. Age-related issues are however a common reason as fertility rates drop sharply as a woman ages and it is more difficult to get pregnant after the age of 35.Various diseases such as increasing reproductive hormonal problems, endometriosis, thyroid disease, irregular ovulation and periods, infections that can scar fallopian tubes, fibroids or polyps of the uterus, adenomyosis of the uterus, and also a decline in egg quality are associated with getting older.

Secondary infertility could also be as a result of complications from the first pregnancy and birth e.g. scarring from a Caesarean section or a miscarriage. Ageing is related to increasing reproductive hormonal problems, thyroid sickness, irregular ovulation and intervals, infections which can scar the fallopian tubes, fibroids or polyps of the uterus, endometriosis in the pelvis, adenomyosis of the uterus and weight benefit. Even when those troubles do not occur, growing age is constantly associated with a reduced excellent or quantity of eggs. All of those are viable explanations for secondary infertility in ladies.

Although uncommon, getting pregnant a second time can be be related to the first one. There may be scarring of the uterus after a D&C following a miscarriage or placental-related complications. Other styles of surgeries on the uterus may additionally have an effect.

Secondary infertility can also be caused by problems in men, in fact, male infertility is the number one clinical issue in approximately 25% of infertility cases, and a contributing factor 25% of the time. A large percentage of male infertility instances is due to low sperm count.

There is more than one explanation for a decline in sperm quality, quantity or transport. Age, Azoospermia (absence of sperm cells in semen samples), Asthenospermia (progressive motility of sperm is less than 32%) etc. are some causes of infertility in men. Sexually transmitted infections, stress, obesity, abuse of alcohol or recreational drugs, exposure to certain chemical substances and/or excessive heat are also contributing factors.

HOW IS SECONDARY INFERTILITY DIAGNOSED?

Multiple factors could be responsible for secondary infertility; it could be due to one or each of the above named factors so an intensive assessment is carried out by your doctor  in order to be sure of the causes and take necessary action.

WHY YOU SHOULD SEE A FERTILITY EXPERT

It is advised to be proactive with your health so the earlier you see one, the earlier you get a diagnosis and thus proper treatment. If you are 35 or older, you should seek treatment after six months of unprotected sex and 12 months if younger.

If you however experience abnormal menstrual cycles, heavy bleeding, hormonal troubles, weight problems, fibroids, endometriosis, pelvic adhesions, etc., see your gynaecologist or a fertility expert right away.

TREATMENT

Treatments for secondary infertility are the same as for primary infertility. Treatments may include:

  • Fertility drugs
  • Injectable fertility drugs, known as gonadotropins
  • IUI – The procedure itself involves transferring specially washed semen directly into the uterus via a thin catheter.
  • In-vitro fertilization, sometimes in combination with other assisted reproductive options
  • Surgery, usually laparoscopic surgery, to repair blocked fallopian tubes, or to remove fibroids or endometriosis deposits

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KNOWING AND CONTROLLING YOUR BLOOD PRESSURE

Many people have high blood pressure without knowing it. Once you know about your condition, though, you can reduce your risk and live a healthier life. It takes proper treatment and some changes in your lifestyle but it is totally worth it!

What is blood pressure?

Blood pressure is the force of blood pushing against the walls of blood vessels in the body. When blood pressure is measured it is recorded as two numbers, for example, 124/80.

The top number is called systolic pressure. This is the pressure of blood pushing against blood vessels when the heart beats. This number should be around 120.

The bottom number is called diastolic pressure. This is the pressure of blood pushing against blood vessels when the heart is relaxed between beats. This number should be around 80.

The instrument used to measure blood pressure is called a sphygmomanometer

What do the numbers mean?

 

 

You have high blood pressure (hypertension) if your top number is constantly bove 140 or your bottom number is always above 90.

What causes Hypertension?

Usually there is no definite cause. However in a small percent of people, kidney disease or abnormal production of hormones from the adrenal glands above the kidney may cause high blood pressure. Occasionally some medicines used to treat ulcers, arthritis or depression may cause a rise in blood pressure. High blood pressure is more common as we get older and it tends to run in families. It is also common in people who are overweight, who drink too much alcohol and in people who take a lot of salt in their diet.

Should you be bothered about your blood pressure?

High blood pressure adds to the workload of the heart and can damage the lining of blood vessels. Then the blood supply to your heart, brain, kidneys, eyes etc. will be put at risk. The risk of heart attack, stroke, kidney disease and eye damage will be higher in somebody with high blood pressure compared to somebody with normal blood pressure.

Risks of high blood pressure

• Heart disease
• Heart failure
• Stroke
• Kidney disease or failure
• Eye problems

How Can I Reduce High Blood Pressure?

By treating high blood pressure, you can help reduce your risk for a stroke, heart attack, heart failure or kidney failure. Here are steps you can take now:

  • Eat a heart-healthy diet that is rich in vegetables, fruits, and whole grains and includes low-fat dairy products, poultry, fish, legumes (beans and peas), nontropical vegetable oils and nuts; and limits intake of sodium, sweets, sugar sweetened beverages and red meats. Choose foods rich in potassium.
  • Reach and maintain a healthy weight.
  • Be more physically active.
  • Don’t smoke and also avoid second-hand smoke.
  • Limit alcohol intake
  • Know what your blood pressure should be and work to keep it at that level.

Remember by controlling high blood pressure
the risk of heart disease and stroke is greatly reduced.

WHAT DISEASES TO GET SCREENED FOR – WHEN AND WHY

Do you know a visit to your doctor when you are not Ill is one of the ways of staying healthy

The essence of regular medical checkup is to evaluate the current health status, screen for diseases or risk factors and provide preventive counseling depending on the age of the individual.  This helps to prevent onset of disease or worsening of an existing one. When diseases are in their early stages and detected early, if adequate diagnosis and treatment are available, there is a good chance it can be cured.

In preventive healthcare, measures are taken for disease prevention, as opposed to disease treatment.

Here are a few screenings for women at different ages:
Blood pressure: Have your blood pressured at least every once every two years if it is in the healthy range (under 120/80) or once a year if it is above normal (between 120/80 and 139/89).

  • Cervical cancer: A Pap smear is recommended every three years for women 21-65 who have a cervix. At age 30 a pap test and HPV test every 5 years is an option. If you are 65 or older, ask your doctor or nurse if you need to keep having Pap tests.
  • Diabetes screening: Diabetes may run in families or be linked to certain lifestyle factors. You should be tested if you have any of these risk factors:

1.Obesity

  1. Previous abnormal glucose screening results
    3. High blood pressure
    4. High cholesterol
    5. History of gestational diabetes or a baby weighing more than 9 pounds at birth
  • Bone density: Get this test at least once at age 65 or after. Talk to your doctor or nurse about getting tested if you’re younger than 65 and about repeat testing.
  • Breast cancer: Mammography every two years for women ages 50-74. If you are 75 or older, ask your doctor or nurse if you need to continue having mammograms.
  • Colorectal cancer:This screening is recommended for women ages 50-75. Talk to your doctor about which screening test, (fecal occult blood testing, sigmoidoscopy, or colonoscopy) or combination of tests, is best for you and how often you need it and if you should continue having these tests after 75.
  • HIV/AIDS: Get tested for HIV/AIDS at least once after age 20, or earlier if you are at high risk for being infected by the human immunodeficiency virus. Discuss further testing with your doctor.
  • Lipid profile: Starting at age 20, women at increased risk for developing heart disease should have regular cholesterol tests.

*Sexually Transmitted Infections: Get tested for chlamydia yearly through age 24 if you are sexually active or pregnant. After age 25, get tested for chlamydia and other sexually transmitted diseases if you are at increased risk for getting a sexually transmitted infection.

You need to stay ahead of diseases by warding them off before they even start.

IVF Process: 4 Steps to Getting Pregnant

Are you having problems getting pregnant? Then you may wonder if in vitro fertilization (IVF) is right for you in one of the best hospital in Nigeria. Many women find pregnancy success after trying IVF. If you are ready to learn more, check out the four primary steps you can expect during the in vitro fertilization process.

Step 1: Ovulation Induction
Before and during the in vitro fertilization process, your fertility specialist will monitor your ovaries and the timing of the egg release. The doctor will make sure that your ovaries are producing eggs, and that your hormone levels are normal, among other procedures.

Most women take fertility medicines or hormones at this time to stimulate the ovaries to produce one or more eggs. Having several eggs available for IVF will increase the chances that you will get pregnant.

If you cannot produce any eggs, talk to your doctor about donor eggs for the IVF process.

Step 2: Egg Retrieval
During this step in the IVF process, pain medication is given to reduce any discomfort. Then a very thin needle is passed through the upper vaginal wall. With the use of vaginal ultrasound, fluid is removed from the follicles under gentle suction.

Immediately after aspiration of the follicle, the oocyte (egg) is isolated from the follicular fluid. The egg is placed in a culture dish containing nutrient media and then transferred to the incubator.

Step 3: Fertilization
The next step of the IVF process is the fertilization of the egg. A sperm sample is secured, either from your partner or a donor, and the most active sperm is mixed with the egg in a special chamber. Sometimes the sperm is directly injected into the egg. Then, the sperm and egg are placed in an incubator and monitored to make sure that a healthy embryo develops.

Step 4: Embryo Transfer and Implantation
The final step of the IVF process is the embryo transfer. First, the embryos are examined to select the healthiest ones for transfer. To transfer the embryo(s), a speculum is placed into your vagina and the embryo(s) are transferred via a small plastic tube placed through the cervix into the uterine cavity.  After the IVF process is complete, bed rest is often advised for around 24 hours.

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