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Revolutionizing Reproductive Options: Egg Freezing

Bhubaneswar, Sept 13: In recent years advancements in reproductive technology have given women the opportunity to exercise greater control over their bodies and reproductive choices. One such advancement that has gained significant attention is egg freezing, also known as oocyte cryopreservation.

Egg freezing allows women to freeze their eggs, preserving their fertility and providing them with the flexibility to start a family at a time that aligns with their personal and professional goals. Egg freezing offers numerous benefits and has become an empowering choice for women around the world.

In recent years India has witnessed a significant increase in the popularity of egg freezing, with more women opting for this procedure to secure their future fertility. Here’s how Obstetrician and Gynecologist Dr. Sujata Kar says:

What is Egg Freezing?

Egg freezing, otherwise known as cryopreservation is essentially the process of retrieval of eggs from the woman’s ovaries and freezing them at a temperature of -196° Celsius in liquid nitrogen for later use when the woman feels she is ready for conception and pregnancy. These eggs that are frozen are good for use and are not compromised in quality for up to many years after the freezing process is done.

Why Egg Freezing?

Social Egg Freezing-Social freezing means egg storing of a healthy, fertile woman, in order to have a pregnancy later in her life, i.e. at the age of 45 to 50, it should ideally be performed on women around 25 years of age in order to increase their chances of a future pregnancy As women age, the quantity and quality of their eggs decline, making it more challenging to conceive naturally. By freezing their eggs at a younger age, women can retain the higher quality eggs that they possess at that time, effectively preserving their fertility potential for the future. This empowers women to pursue their careers, education, or personal goals without the pressure of a ticking biological clock.

Egg Freezing for Cancer- Women in the early reproductive age group may suffer from various kinds of cancer like breast cancer, cervical cancer, ovarian cancer, leukaemia etc. Women with cancer often opt to have their eggs frozen since chemotherapy, radio therapy and treatment tend to affect their fertility.

Non-Cancerous Medical Reasons- Women who have been diagnosed with moderate to severe endometriosis, can opt to freeze their eggs to preserve their future fertility options.

Egg Freezing Process-

The process begins with an initial consultation with a fertility specialist or reproductive endocrinologist. During this consultation, the medical history and fertility goals of the individual are discussed. Once the decision to proceed with egg freezing is made, the individual will start a process called ovarian stimulation which involves the use of fertility medications, typically injectables, to stimulate the ovaries to produce multiple eggs. After stimulation of the ovary and continuous monitoring for some period of time the egg retrieval procedure done.

Once the eggs are retrieved, they are immediately taken to the laboratory for processing. The eggs are assessed for maturity and quality. They are then cryopreserved through a process called vitrification, which involves rapidly cooling the eggs to extremely low temperatures to prevent ice crystal formation and maintain their viability. When the individual is ready to use their frozen eggs, they can undergo a procedure called thawing. The eggs are carefully thawed in the laboratory and assessed for viability. The thawed eggs can then be fertilized with sperm through in vitro fertilization (IVF), and the resulting embryos can be transferred to the uterus for potential pregnancy.

Cost of Egg Freezing-

On average, the cost of egg freezing in India can range from ₹1,00,000 to ₹ 1,50,000, which is the cost of one-time egg retrieval and freezing. However, the recurrent annual fee for storing the frozen eggs has to be paid to the clinic. The Assisted Reproductive Technology (Regulation) Act, 2021 regulates all ART procedures, including egg freezing in India.

Indian society is becoming increasingly aware of the importance of reproductive choices and family planning. The cultural acceptance of egg freezing has grown and this acceptance fosters a supportive environment for women considering egg freezing, encouraging them to take control of their fertility and pursue their aspirations without compromising their desire to have children in the future.

As the demand for egg freezing continues to rise, ongoing advancements in medical technology and research are expected to further improve success rates and enhance the overall procedure. Continued research and innovation will make egg freezing even more accessible and reliable, offering women greater options and opportunities for family planning. This process has both pros and cons which should be taken into consideration by the women. Most importantly a consultation from the fertility expert is absolutely necessary before taking any decision.

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Navigating pregnancy with care: A guide to essential precautions

Pregnancy is a remarkable journey filled with joy anticipation and care. Amid the excitement, it’s essential to navigate these nine months with a keen understanding of the precautions that can contribute to a healthy pregnancy. In this article, we’ll delve into the important “don’ts” that can contribute to a healthy and harmonious pregnancy.

According to Dr Sujata Kar, Obstetrician and Gynecologist Doctor in Bhubaneswar, these are some key things to avoid during pregnancy:

Smoking and Alcohol Consumption: Both smoking and alcohol consumption can have harmful effects on the developing foetus. They are associated with a higher risk of birth defects, premature birth, and developmental issues. It’s best to completely abstain from these substances during pregnancy.

Too much tea or coffee: While moderate caffeine consumption is generally considered safe, excessive intake can potentially lead to complications. Limit your caffeine(coffee or tea) intake to around 200 milligrams per day to reduce the risk of miscarriage and preterm birth.

Certain Foods: Raw or undercooked seafood, unpasteurized dairy products, and processed meats can carry harmful bacteria and increase the risk of foodborne illnesses. These can be particularly risky during pregnancy. Make sure to cook foods thoroughly and opt for pasteurized products.

Strenuous Exercises: While staying active during pregnancy is important, extremely strenuous exercises or activities with a risk of falling should be avoided. Always consult your healthcare provider before starting or continuing any exercise routine.

Self-Medications: Some medications and herbal supplements can be harmful to the developing foetus. Always consult your doctor before taking any medication, even if it’s over-the-counter or herbal.

Exposure to Harmful Chemicals: Limit exposure to household cleaning products, pesticides, and other chemicals that may be harmful during pregnancy. Opt for natural or less toxic alternatives whenever possible.

Hair dyes: Hair dyes are composed of chemicals that can get absorbed through the scalp in to the blood stream. This can lead to complications in foetal development and other cause reactions in the body of the pregnant women. It is best advised to wait until after pregnancy to dye your hair.

Stress and Overexertion: High levels of stress and overexertion can impact your well-being and potentially affect the baby. Practice relaxation techniques, engage in light exercise, and ensure you’re getting adequate rest.

Ignoring Warning Signs: If you experience any unusual symptoms, such as severe abdominal pain, bleeding, or sudden swelling, don’t ignore them. Contact your healthcare provider promptly to rule out any potential complications.

Every pregnancy is unique, and it’s essential to have open communication with your healthcare provider and your OB GYN. They can provide personalized guidance based on your medical history and specific circumstances. By being mindful of these common “don’ts,” you can contribute to a safer and healthier pregnancy journey.

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Rising cases of cervical cancer: Symptoms, diagnosis, treatment

Cervical cancer is a significant public health concern in India, accounting for a substantial number of cancer-related deaths among women. The prevalence of this preventable disease is often attributed to limited awareness, inadequate screening, and lack of access to healthcare.

According to HPV Information Centre cancer of the cervix is the second most common cancer among women in India, with an estimated 123907 new cases and 77348 deaths reported annually. However, with the introduction of cervical cancer vaccines, there is hope for a significant reduction in its incidence.

According to Dr Sujata Kar, Obstetrician and Gynecologist Doctor in Bhubaneswar, the primary cause of cervical cancer is persistent infection with high-risk strains of the Human Papillomavirus (HPV). HPV is a common sexually transmitted infection (STD) that can lead to the development of cervical lesions and, eventually, cancer.

Factors such as poor sanitation, multiple pregnancies, sexual activity at an early age and limited access to healthcare services also contribute to the prevalence of cervical cancer.

Symptoms:

Cervical cancer does not usually don’t exhibit symptoms well until advanced stages. Also, it is pretty easy to confuse symptoms of this cancer with other gynaecological diseases such as urinary tract infection, yeast infection, irregular menstrual cycle, etc. Here are a few symptoms you should watch out for:

  • Unexplained vaginal bleeding. If it occurs in between your menstrual cycle, or after menopause, be alarmed.
  • Bleeding after sexual intercourse.
  • Excessive and abnormal vaginal discharge.
  • Foul smelling vaginal discharge.
  • Abnormal vaginal discharge after menopause.

Diagnosis:

  • Pap Smear Tests: Doctors can detect abnormal cell growth through a pap smear test. This involves swabbing the cervix with a cotton swab and then sending it for a close examination.
  • HPV Test: The patient may be required to go through a human papillomavirus test. This is very similar to the pap smear test.
  • Other Tests: Pelvic sonography, CT scan, and MRI are some other tests that may be conducted to detect cancer.

Treatment options:

Treatment of cervical cancer depends on the stage of the cancer. The available treatment options include surgery, radiotherapy, chemotherapy, laser ablation, cryotherapy and targeted therapy.

Preventive Measures:

  • HPV Vaccination: In India, HPV vaccines like Gardasil and Cervarix are available and recommended for young girls and women between the ages of 9 and 43. Administering the vaccine before sexual debut provides the best protection.
  • Regular Screening: Regular screening through Pap smears or HPV testing helps detect cervical abnormalities early, allowing for timely intervention. Regular screening can detect pre-cancerous changes in the cervix that can be treated before they progress to cancer
  • Quit Smoking: Women who smoke are more vulnerable to cervical cancer.
  • Safe Sexual Practices: Practicing safe sexual behaviours, such as using condoms, reduce the risk of HPV transmission.

Cervical cancer remains a significant health issue in India, but the introduction of HPV vaccines offers a ray of hope for its prevention. By increasing awareness, promoting vaccination, and improving healthcare access, India can make substantial progress in reducing the burden of cervical cancer and improving women’s reproductive health. It is crucial for healthcare authorities, policymakers, and stakeholders to collaborate to ensure that cervical cancer vaccines reach those who need them the most, thereby contributing to a healthier future for Indian women.

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Breastfeeding – A Blessing for Mother and Child

Sujata Kar, Gynaecologist & Obstetrician

Bhubaneswar, Aug 12: Breastfeeding plays a vital role in nurturing infants’ health and development and fosters an intimate and irreplaceable bond between mother and baby. But breastfeeding is more than just a bonding experience; it plays a pivotal role in promoting a mother’s health and provides a plethora of benefits to her. Despite the long list of benefits, a lot of myths are associated with breastfeeding. Hence, along with spreading awareness regarding breastfeeding, it’s also essential to dispel some myths surrounding it while highlighting the undeniable facts.

Benefits of breastfeeding for the child:

  1. Optimal Nutrition: Breast milk is uniquely tailored to meet the nutritional needs of a baby, providing the perfect blend of proteins, fats, vitamins, and minerals.
  2. Immune System Boost: Breast milk contains antibodies that help protect the baby from infections, reducing the risk of illnesses like respiratory infections, ear infections, and gastrointestinal issues.
  3. Cognitive Development: Studies suggest that breastfeeding may support better cognitive development in infants, potentially leading to improved IQ and cognitive abilities later in life.
  4. Lowered Risk of Allergies: Breastfeeding has been associated with a reduced risk of developing allergies, asthma, and eczema in infants.
  5. Reduced Risk of Chronic Diseases: Breastfed babies may have a lower risk of developing certain chronic conditions, such as obesity, type 1 and type 2 diabetes, and childhood leukemia.
  6. Proper Jaw and Teeth Development: The act of breastfeeding helps babies develop proper jaw and teeth alignment.

Benefits of breastfeeding for the mother:

  1. Reduced Postpartum Bleeding: Breastfeeding stimulates the release of oxytocin, which helps the uterus contract and reduce postpartum bleeding.
  2. Weight Loss: Breastfeeding burns calories, aiding in post-pregnancy weight loss and helping mothers return to their pre-pregnancy weight.
  3. Hormonal Balance: Breastfeeding can help regulate hormones, potentially reducing the risk of postpartum depression and anxiety.
  4. Reduced Risk of Certain Cancers: Long-term breastfeeding has been associated with a decreased risk of breast and ovarian cancers in mothers.
  5. Delayed Return of Fertility: Exclusive breastfeeding can act as a natural form of birth control for the first six months, known as the Lactational Amenorrhea Method (LAM).
  6. Convenience and Cost Savings: Breast milk is readily available and requires no preparation, saving time and money on formula and feeding supplies.
  7. Health Benefits for Mothers: Breastfeeding has been linked to a lower risk of type 2 diabetes, cardiovascular disease, and osteoporosis later in life.

For breastfeeding to be successful, a well-balanced diet is essential. Mothers should consume nutrient-rich foods, including fruits, vegetables, lean proteins, and whole grains. Staying hydrated is also crucial for maintaining an adequate milk supply. Additionally, finding the most comfortable breastfeeding position is key to ensuring a satisfying and enjoyable experience for both mother and child. Common positions include the cradle hold, the football hold, and the side-lying position. Each mother-baby pair is unique, so experimenting with different positions to find what works best is encouraged.

In spite of its numerous advantages, breastfeeding is a topic often surrounded by a plethora of myths and misconceptions. Let’s debunk some of the common myths:

Myth Fact
The formula is as good as breast milk. Breast milk is uniquely tailored to a baby’s nutritional needs & formula can’t replicate the benefits of breastmilk.
Small-breasted women produce less milk. Milk supply is primarily determined by hormone levels and the mother’s overall health and nutrition.
Babies need water in addition to breast milk. Giving water to a breastfed baby may fill them up, reducing their intake of essential nutrients from breast milk.
You should stick to a strict breastfeeding schedule. Feeding on demand is recommended for newborns and infants
Breastfeeding can distort a mother’s figure Breastfeeding can help new mothers she pregnancy weight by burning extra calories & fats.

These misconceptions, including many others, can lead to misunderstandings and may deter mothers from considering or continuing breastfeeding.

Breastfeeding is a fundamental aspect of early parenthood, providing immeasurable benefits for both mother and child. All mothers should be encouraged to embrace this nurturing bond, dispel common myths, and seek the support they need to make breastfeeding a fulfilling and rewarding journey. By empowering women with knowledge and fostering a supportive environment, we can celebrate the transformative power of breastfeeding in promoting lifelong health and wellbeing for families.

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Is it just a period cramp or Endometriosis?

Menstrual cycle or periods defines a woman’s womanhood. But there are also several complications associated with it and cramps or pain in abdomen is one of the major discomforts. While in most cases the endurance of the cramp is no more than a week, some might find the discomfort lasting longer than period days. This abnormality could be endometriosis, a sign of danger and should not be ignored. This prevalent, painful condition affects 1 out of every 10 women during their menstruation years and is affecting 190 million women globally (as per WHO).

Endometriosis is a medical condition that affects women of reproductive age. It occurs when endometrium, the tissue lining inside of the uterus, grows outside the uterus, attaching to other organs such as the ovaries, fallopian tubes, and pelvic area. Endometrial tissue in the uterus normally thickens every month and is shed during the menstrual period, leaving the body through menstrual blood. But with endometriosis, the tissue that grows outside of the uterus can’t exit the body like tissue in the uterus does. It also may cause scar tissue to develop in the pelvis or a cyst (a fluid-filled sac) to form in an ovary, which can lead to severe pelvic pain.

Unlike a typical period, women with endometriosis have periods accompanied by excruciating cramps. People with endometriosis are seen describing their pain as stabbing, sharp, throbbing, gnawing or even intense cramping. The symptoms of endometriosis can vary in severity, and many women may not even realize they have the condition. It starts off with the complaint of having really bad cramping to the point of not being able to accomplish basic daily tasks, going to work or school.

Other symptoms of endometriosis include heavy or irregular period, low energy, pain with intercourse, pain with bowel movements or urination, excessive bleeding, infertility and diarrheal or constipation during a menstrual period. The condition can decrease quality of life due to severe pain, fatigue, depression, anxiety, infertility and also rarely causing cancer. Most women with endometriosis are diagnosed late, more than 7 years on an average. Endometriosis-associated infertility is affecting a large number of women and is only realised during family planning. The condition occurs in 6% to 22% women of reproductive age, making it one of the most common gynaecological disorders.

Although the exact cause of endometriosis is yet not certain, possible reasons include problem with menstrual period flow, immune system disorder, hormones disorder, surgical scar implantation and genetic factor. There are also several risk factors associated with endometriosis such as early puberty, prolonged or frequent periods, not being able to bear child and obstruction in menstruation flow

Also there is no known way to prevent endometriosis completely but the symptoms can be treated with medicines or, in some cases, surgery. Better lifestyle choices can also help fight the symptoms like lowering your estrogen levels with birth control pills, avoid alcohol consumption and smoking, cut down on caffeine, ensuring 30 minutes workout daily, eat a healthy diet, avoid refined sugar, flour and processed foods, drink plenty of water, dress lightly, take supplements like vitamin E, evening primrose oil, Vit B complex, calcium & magnesium and also back therapy can do wonders to alleviate symptoms.

The disease can be diagnosed through a physical exam, ultrasound, or laparoscopy. The treatment options include pain medication, hormonal therapy, and surgery. Providing education on the early symptoms of endometriosis is crucial for detecting the condition early, promoting menstrual health, and reducing stigma of the condition.

Most importantly, counselling to the endometriosis sufferer plays a vital role. The life of a woman with endometriosis affects not only her – but everyone around including her partner, parents, siblings, family, friends, colleagues and even her children. Therefore, one should take utmost care of the sufferer. Try to communicate more with her, understand her pain and difficulties, give her utmost comfort and care.

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Lifestyle choices and chemicals in environment are major reasons for decline in Men Sperm Count Globally

As a reproductive health expert, it is very disheartening to say to a couple that they are infertile or cannot have a baby. Infertility in today’s context has become a global health issue as millions of couples are found to be infertile or not able to conceive. Not only women, but also men in millions have been found to be the reason of infertility of a couple.

A recent study, published in the journal Human Reproduction Update shows 50% decline in men sperm count globally, including India leading to infertility in med largely. Fall in sperm count is not new. We have been witnessing the declination for decades and the recent alarming report indicates the focus to be equal on male reproductive issues.

There have been two major factors contributing largely to the declension of the total sperm count in male such as lifestyle choices and environmental chemicals. While lifestyle choices include improper diet, sleeping habits, smoking and alcohol consumption or drug abuse, environmental chemicals include exposure to pollutants, toxins in the air, radiation hazards from mobiles, laptops, plasticizers in plastics or pesticides in our food.

Plasticizers, found in most plastics like water bottles and food containers has negative impacts on testosterone and semen health. Herbicides and pesticides abound in the food supply specifically those with synthetic organic compounds that include phosphorus negatively affect fertility of men. Air pollution is subject to particulate matter, sulfur dioxide, nitrogen oxide and other compounds that likely contribute to abnormal sperm quality. Radiation exposure from laptops, cellphones and modems has also been associated with declining sperm counts, impaired sperm motility and abnormal sperm shape. Heavy metals such as cadmium, lead and arsenic are also present in food, water and cosmetics also harm sperm health.

While environmental factors may not be in one’s control, lifestyle choices that will help in sperm health can be adopted. A little modification in lifestyle such as avoiding junk food, smoking and alcohol, proper sleep, minimizing stress and exercising regularly could improve one’s sperm count as well as quality. Also checking with one’s environment like limiting use of plastics, eating organic, limiting usage of phones and laptops, wearing mask while outside can also help in male fertility.

Symptoms of lower sperm count should not be avoided. One should immediately see a doctor if any of these symptoms is witnesses. Symptoms include problems with sexual function like low sex drive erectile dysfunction, pain/ swelling or a lump in the testicle area, decreased facial or body hair or other signs of a chromosome or hormone abnormality.

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Negligence of PCOS May Cost High

Infertility is becoming a common complication among couple globally now-a-days. Whether it’s men or women, Infertility is not a curse, rather the result of ignorance. In case of women, negligence of symptoms like irregular menstrual cycle, moderate weight, blood sugar levels and healthy diet etc. leads to Polycystic Ovary Syndrome (PCOS) which is one of the most common causes of female infertility. 1-in-10 women of childbearing age get affected with PCOS.

Polycystic ovary syndrome (PCOS) is a complex hormonal disorder common among women, caused due to factors like Insulin resistance, Obesity, Genetic and Environmental. Insulin resistance means cells in muscles, fat, and liver don’t respond well to insulin which results the body can’t use insulin well. As a result Insulin levels build up in the body and cause higher androgen (male hormones) levels, which stops eggs from being released (ovulation) and cause irregular periods, acne, thinning scalp hair and excess hair growth on face and body. In case of Women with obesity (overweight) PCOS complications become worse. On the other hand, under genetic factor women whose mother or sister has PCOS or type2 diabetes are more likely to develop PCOS. Likewise, the toxic chemicals presented in the environment are also the reason of PCOS.

The World Health Organization (WHO) data suggests that approximately 116 million women (3.4%) are affected by PCOS globally. The PCOS statistics in India 2021 shows that one in five Indian women suffers from PCOS. So the ignorance of PCOS may cause some serious health issues in many cases like Infertility, Type 2 diabetes, Miscarriage or premature birth and Cancer of the uterine lining (endometrial cancer).

Adopting lifestyle modification can help in PCOS reduction. Changes in diet, exercise and other aspects of life can also help to reduce the burden of symptoms. Switching to a nutritious and balanced diet is advisable. Among overweight women, the symptoms and overall risk of developing long-term health problems from PCOS can be greatly improved by losing excess weight. Weight loss of just 5% can lead to a significant improvement in PCOS. Low-fat, high-carbohydrate diets might increase insulin levels.

So if you’re getting irregular periods, having trouble getting pregnant or have signs of excess androgen, which might include new hair growth on face and body, acne and male-pattern baldness. Then you should consult with your doctor.

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First-line ovulation induction for polycystic ovary syndrome: an individual participant data meta-analysis.

Hum Reprod Update. 2019 Nov 5;25(6) : 717-732. Doi: 10.1093/humupd/dmz029.

Wang R1,2,Li W2, Bordewijk EM3, LegroRS4, Zhang H5, Wu x6, Gao J6, Morin-Papunen L7, Homburg R8, Konig TE9, Moll E 10, Kar S11, Huang W12, Johnson NP1,13, Amer SA 14, Vegetti W15, Palomba S16, Falbo A17, Ozmen U18,Nazik H19, Williams CD20, Federica G21, Lord J22, Sahin Y23, Bhattacharya S24, Norman RJ1,25, Van Wely

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Racial and ethnic differences in the prevalence of metabolic syndrome and its components of metabolic syndrome in women with polycystic ovary syndrome: a regional cross-sectional study.

Am J Obstet Gynecol. 2017 Aug; 217(2):189.e1-189.e8.doi:10.1016/j.ajog.2017.04.007.Epub 2017 Apr 8.Am J Obstet Gynecol.

Chan JL 1, Kar S2, VenkyE3, Morin-Papunen L4, Piltonen T4, Puurunen J5, Tapanainen JS6, Maciel GAR7, Hayashida SAY7, Soares JM Jr7,Baracat EC7, Mellembakken JR8, Dokras A9.

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