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No more fertility woes

Dr Nandita Palshetkar, Feb 12 2018, 15:48 IST
Fertility issues worry many women

Fertility issues worry many women

Infertility is on the rise among couples in India. Statistics indicate that this condition affects about 10% to 14% of the Indian population. Among many factors responsible for infertility, particularly among women are stress, unhealthy lifestyle, and a condition called polycystic ovary syndrome (PCOS).

About 20% to 25% of the women in India in the childbearing age suffer from PCOS, shows a study. Those with PCOS have been found to have higher than normal insulin levels. This increase in the level of insulin can make the ovaries produce more male hormones like testosterone. Such women therefore struggle with weight issues and excessive hair growth, complicating the disorder further.

PCOS & infertility

PCOS causes the development of cysts, as the ovaries are unable to release eggs on time. Because of this, the follicles keep growing and form multiple cysts, which appear like a string of pearls. Women, whose mother or sister suffers from PCOS, are likely to develop the condition.

Let's look at the symptoms of PCOS:

Weight gain

Fatigue

Excessive hair growth & thinning hair

Infertility

Acne

Pelvic pain

Headaches

Sleep problems

Mood swings

Young women with PCOS tend to experience irregular periods or amenorrhoea, and heavy or scanty bleeding during their menstrual cycles. PCOS can also put women at risk of other health complications such as hypertension, high cholesterol, anxiety, depression, sleep apnoea, heart attack, diabetes and endometrial, ovarian and breast cancers.

Treatment & management

Although this condition cannot be cured, it can be managed through other treatment options. The treatment is tailored according to symptoms, other health problems, and whether the woman wishes to conceive. A new procedure is making it easier for women with PCOS to conceive without having to use the hormone injections and endure the associated side effects.

The procedure, called IVM or in-vitro maturation, involves maturing eggs in the lab before implanting them into the womb lining, rather than in the ovaries. In an IVM cycle, the ovaries are not stimulated with drugs. On the contrary, a scan is carried out to study the resting follicles in the ovaries and the same needle used for an IVF egg collection is used to go through the top of the vagina. This needle then helps in draining these tiny follicles. Further, the immature eggs are taken out of the ovaries, and matured in the lab for about two days. Once this is done, the procedure is the same as an IVF cycle, where the matured eggs are transferred back. Although not used extensively in India currently, IVM can help avoid complications and pain for women wanting to bear a child. It also costs significantly lesser than IVF.

In a traditional IVF procedure, women inject themselves with hormone medications for eight to 10 days. This helps in stimulating the ovaries into producing multiple eggs for fertilisation and increases the chances of creating healthy embryos to transfer into the uterus. However, this can be risky for women with PCOS, as they stand the chance of developing ovarian hyper-stimulation syndrome (OHSS), wherein the ovaries become swollen and painful. Therefore, IVM is slowly becoming the preferred mode of treatment for women with PCOS.

In conclusion

PCOS can be managed through exercise and a healthy diet, which in turn will regulate the menstrual cycle and lower blood glucose levels. Additionally, the following tips can help:

Consume foods that are high in fibre such as broccoli, cauliflower and spinach. Include nuts like almonds and walnuts in your meal and eat foods rich in omega-3 fatty acids like soy, salmon, chia seeds and flaxseed.

Have five small meals instead of three big meals, as this will help smooth metabolism and weight management.

Indulge in physical activity for about 30 minutes a day, five days a week to reduce or maintain a reasonable weight.

(The author is medical director of Bloom IVF & President-elect of the Federation of Obstetrics and Gynaecological Societies of India)

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