Tag Archives: Pregnancy

ESHRE Endorses Egg Freezing : ASRM Lifts Experimental Label From Egg Freezing

The American Society of Reproductive Medicine (ASRM) and the European Society of Human Reproduction and Embryology (ESHRE) have endorsed oocyte freezing as a standard and safe procedure in  2012. ASRM  issued a new report on 22 October, 2012 stating that in young patients egg freezing techniques have been shown to produce pregnancy rates, leading to the birth of healthy babies, comparable to IVF cycles using fresh eggs. After much work and deliberation by fertility experts, who reviewed the world literature on the effectiveness and safety of egg freezing and, most importantly, on the desired outcome: healthy babies, egg freezing is can now be used in routine practice. More studies are being published regarding this age range, and all is reassuring.

 

APPLICATION:

Egg freezing could provide a viable alternative source for couples needing donor eggs to build their families. In addition, among the medical indications for its use are fertility preservation for patients who may be left infertile following medical treatments for other diseases  (viz., cancer),  some genetic conditions, or IVF treatment interrupted by the unexpected inability to obtain sperm.Cryotec

 

REASON FOR CAUTION:

The Committee points out that the age of the woman at the time of egg freezing is a very important factor. “Success rates with oocyte cryopreservation appear to decline with maternal age consistent with the clinical experience with fresh oocytes.”  ASRM did not encourage egg freezing for “social reasons,” such as a delay in childbearing as, although the technical procedure of egg freezing is safe, we do not have enough long-term data about babies born to women using eggs frozen when they are older than 35. Cryotec VitrificationCiting a lack of data on safety, efficacy, cost-effectiveness, and potential emotional risks, the report states, “Marketing this technology for the purpose of deferring childbearing may give women false hope and encourage women to delay childbearing. Patients who wish to pursue this technology should be carefully counseled.”

 

ROTUNDA EGG FREEZING PROGRAM:

Rotunda is now offering oocyte cryopreservation as part of its ART services  using the latest cutting edge Cryotec vitrification technique. We also have initiated donor egg bank. We have achieved comparable success rates with frozen donor oocytes  to fresh donor oocytes.

Rotunda Egg Freezing ProgramThe excellent survival rates, embryo development and pregnancy rates have given a tremendous new hope to young cancer women. These young cancer patients can now dream of becoming a mother one day in future when they are cured of their disease.

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Preparing for your IVF treatment

Your Emotional Preparedness:

There are many complex emotions that you will be encountering as you are anticipating your IVF cycle. If you are using donor eggs, donor sperm, or a surrogate, the emotions that you have will be even more splintered, as you also must consider the weight of genetics in this equation.

Before you proceed with IVF, you will want to speak with a psychotherapist that is trained in infertility. There are some very natural concerns that you will have and feelings that you will be confronted with. Your therapist can give you gentle guidance as you navigate through these new features, in your pursuit of pregnancy.

Some emotions that you can expect to have are:

• Loss or mourning over lost pregnancies, cycles that failed before and possibly even the loss of your ovaries. If you are having IVF, there is a strong likelihood that you have encountered a great loss to get there. It is natural that you will feel grief, as you are anticipating your cycle.

• Fear of not being a “real” parent is another very normal emotion that you may experience as you are preparing for your IVF cycle. Your child will not be any less than your child, and you will be no less their mother. You’ll still be the one they turn to, when they fall off their first bike. You’re just like any other pregnant woman, only you will have fought harder to get there.

. Being afraid that it won’t work after all of the time, money and emotions that you’ve invested in the procedure is natural. The truth is, it may not work and you need to understand that prior to moving forward. Your counselor will help guide you in this matter.

. You may feel scared that you will let down your donor, if they are a friend or family member. You may feel as though you are personally disappointing someone, who went through an enormous quest to help you, if the cycle fails. It’s important to know that you have no control over the outcome and they have been counseled in the possibilities of a failed cycle, prior to the retrieval.

Don’t be concerned if you start to question the decision to utilize IVF, donor eggs or sperm. When you are faced with a huge decision it’s not unusual to falter now and then. This is a big step and it takes some getting used to.

Finally, after all of these concerns and emotions, you may also feel something you haven’t felt in a long time; you may feel hope. Donor eggs may not be a certainty and IVF may not be 100% successful; but you can permit yourself to enjoy a dash of hope, in your anticipation.

Your Physical Preparedness:

As your cycle approaches, there are a few things that you can do to prepare yourself. It goes without say that you should limit your caffeine intake, eliminate smoking, and drinking alcohol. Light to moderate exercise is beneficial to both your emotional and physical well-being, which ultimately is good for your reproductive health. Consult your doctor before you start a new fitness plan and it’s important to remember that a rigorous routine should be omitted.

Remember that you’re not just preparing for IVF, you’re preparing for a pregnancy. It’s recommended that women who are attempting pregnancy begin taking folic acid, prior to conception and you may want to include prenatal vitamins, in your daily routine. This will create the best environment for your fetus.

A diet that is high in leafy greens, fruits, vegetables, calcium as well as protein, is optimal for your pregnancy. You may want to talk to your doctor or nutritionist about foods that would be most beneficial to you, during your pregnancy, or even to help you build a pre-pregnancy meal plan, to prepare you for conception. Do not begin any restrictive diets, such as low-calorie or low-carbohydrate. Though it’s not ideal to be overweight in pregnancy, this is not the time to start a weight loss plan. You can read more about fertility enhancing food on –  https://therotundaramblings.wordpress.com/2008/09/27/foods-that-make-you-fertile/

The month prior to your transfer your doctor may ask you to participate in a mock cycle, to show that you and your donor respond properly to your respective hormone therapies. The endometrium used to be accessed via biopsy, but this technology did not prove itself reliable. Today you will most likely have an ultrasound about 10-12 days into your estrogen-enhanced cycle to measure your endometrius.

You may need to start birth control pills to regulate your cycle so that you can synchronize with your donor’s. You may also be asked to use a gonadotropin releasing hormone (GnRH) antagonist, which inhibits the luteinizing hormone (LH) surge; so that your own cycle does not get canceled and the uterine lining is ready for the implanted embryo.

You may still feel unprepared when it is time to begin your cycle, but that is completely normal as well. You may never feel completely prepared. The important part is that you have made your decision and are headed toward the next step in your pursuit to have your child.

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Vitamin D Deficit in Pregnancy Tied to Caesarean Risk

Vitamin D deficiency greatly increases a pregnant woman’s likelihood of having a Caesarean delivery, U.S. researchers report.

During the two-year study, Boston University School of Medicine and Boston Medical Center researchers examined the relationship between vitamin D levels in pregnant women and Caesarean section. Of the 253 women in the study, 43 (17 percent) had a Caesarean section.

pregnant_vit-d2The study found that 28 percent of women with serum 25-hydroxyvitamin D [25 (OH) D] less than 37.5 nmol/L had a Caesarean section, compared to 14 percent of women with 25 (OH) D greater than 37.5 nmol/L.

“In our analysis, pregnant women who were vitamin D-deficient at the time of delivery had almost four time the odds of Caesarean birth than women who were not deficient,” study author Dr. Michael Holick, director of the General Clinical Research Center, a professor of medicine, physiology and biophysics, and an assistant professor of medicine, said in a medical center news release.

He noted that previous research has linked vitamin D deficiency with proximal muscle weakness and suboptimal muscle performance and strength, which may help explain the findings.

The study was published online in The Journal of Clinical Endocrinology & Metabolism.

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Second hand smoke affects fertility

If you need another reason to quit smoking, consider that it may diminish your chances of being a parent or grandparent. Scientists at the University of Rochester Medical Center have found that women exposed to second hand smoke, either as adults or children, were significantly more likely to face fertility problems and suffer miscarriages.

 second-hand-smoke1An epidemiologic analysis of more than 4,800 non-smoking women showed those who were exposed to second hand smoke six or more hours per day as children and adults faced a 68 percent greater chance of having difficulty getting pregnant and suffering one or more miscarriages. The study is published online in Tobacco Control and is one of the first publications to demonstrate the lasting effects of second hand smoke exposure on women during childbearing years.

“These statistics are breathtaking and certainly points to yet another danger of second hand smoke exposure,” said Luke J. Peppone, Ph.D., research assistant professor at Rochester’s James P. Wilmot Cancer Center.

 In the study, four out of five women reported exposure to second hand smoke during their lifetime. Half of the women grew up in a home with smoking parents and nearly two-thirds of them were exposed to some second hand smoking at the time of the survey.

More than 40 percent of these women had difficulty getting pregnant (infertility lasting more than a year) or suffered miscarriages, some repeatedly.

 “We all know that cigarettes and second hand smoke are dangerous. Breathing the smoke has lasting effects, especially for women when they’re ready for children,” said Peppone, who analyzed information in the Patient Epidemiology Data System, a well-studied cohort that has yielded information on a variety of cancers.

 Peppone analyzed surveys collected from 4,804 women who visited Roswell Park Cancer Institute for health screenings or cancer care from 1982-1998. The 16-page survey focused on lifestyle, habits, family and personal health history, and occupational and environmental exposures. Each participant in this study reported that they had never smoked, and had been pregnant at least once or tried to become pregnant.

Participants reported whether one or both of their parents smoked and if they lived with or worked with smokers as adults. They also estimated the amount of time they were exposed to second hand smoke.

 Peppone acknowledges that the data is based upon self-reporting and that is not perfect. However, he said “Women, especially mothers, have extremely accurate recall. Mothers can easily recall details like how long they breastfed, what vitamins they took during prenatal care, and childhood activities.”

 Many of the women in the study grew up in the 1940s and 1950s, long before the surgeon general issued the first warning about the dangers of cigarette smoking in 1964. Since then, millions of dollars were spent to study the dangers of cigarette smoking. Tobacco use contributes to more than nearly 90 percent of all deadly lung cancers and 30 percent of all cancer deaths in the U.S., and a host of other health problems.

 Since the mid-1960s, smoking bans and government-funded, anti-smoking campaigns have encouraged smokers to quit and discouraged others from starting using a number of passive and aggressive techniques. Smoking rates have declined, however people continue to use tobacco and suffer the health risks.

The study was funded by a National Cancer Institute grant and was previously presented at the Society for Behavioral Medicine and Society of Research of Nicotine and Tobacco conferences.

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Tanning and Pregnancy

tanningAh, that healthy glow — who doesn’t look better with one? But you’re wise to eschew tanning beds, booths, and sunbathing during pregnancy (and frankly, anytime). Exposure to UV rays can cause premature aging and skin cancer, so play it safe and protect your skin. As for self-tanners, or sunless tanners, the jury’s still out on whether they’re safe to use during pregnancy.

 Whether you’re with child or not, exposure to the sun puts you at risk for premature aging and malignant melanoma (skin cancer). The following information will help you think through tanning in a bed, on the beach, or with help from a bottle.

 In a Bed: There are no studies that provide conclusive evidence that tanning beds directly harm your baby. However, the following are some ways that tanning beds can be harmful to you. While there are no studies that state conclusively that tanning beds can harm the baby, most doctors will tell mothers-to-be that any activity that raises the body temperature or overheats (including saunas, hot tubs, and tanning beds – body temperature in pregnant women is not recommended to exceed 102 degrees) have been connected to spinal malformations in newborns.

Some studies also link UV rays and folic acid deficiency. Folic acid prevents neural tube defects, such as spina bifida, and is especially important in the first trimester. During pregnancy, your skin is more susceptible to burning and chlosma,  the dark splotches that appear on the face during pregnancy. Speak to your health care provider about the safety of tanning beds during pregnancy. There are additional studies that link UV rays to deficiencies in folic acid, which prevents neural tube defects and is especially important during the first three months of pregnancy.

 On the Beach: Many of the concerns about beach sun are the same as tanning beds. Pregnancy makes your skin more sensitive so the sun may cause hives, heat rash or worsened chloasma. Staying in the shade should prevent hives or heat rash. The same safety measures should be taken in the sun whether you are pregnant or not: drink plenty of water, use a sunscreen with SPF 30 or more, and wear a hat. If you feel dizzy, nauseated or tired go to an air conditioned area. Long hours in the sun that result in burning should be avoided.

 From a Bottle: This may be the best option if you are pregnant. Avoiding UV rays will ensure healthier skin and less chance of skin cancer, hives or worsened chloasma. There are so many different kinds of sunless tanning lotions, creams, and foams that have very good results. Many of the new varieties have minimal odor and provide immediate color.

The only concern is whether the active ingredient, dihydroxyacetone (DHA), is able to penetrate the skin. Studies do not confirm that it can, but some health care providers encourage women to wait until after the first trimester, just to play it safe. DHA has been used in cosmetics since 1960 and no problems have been reported. Even if you have used sunless tanners before, try a patch of skin first. Your skin may be more sensitive and irritable during pregnancy.

 Remember: To keep yourself safe when spending those hot summer days out of doors, take cover and retire to shady areas whenever possible.

Drink at least 8-10 glasses of water each day (more even, you are drinking for two now!).

Use a sunscreen of block with at least an SPF of 30 and reapply frequently – one application a day is not going to cut it.

Invest in a cute sun hat, and big fashionable sunglasses. If all else fails and you feel the heat starting to get to you causing dizziness or nausea, find somewhere air-conditioned and relax for a while.

Be kind to your body during this exciting time – it is in the middle of an amazing process!

 If you simply can’t stand the sight of those pale legs (if you can still see them, that is) consider a light dusting of bronzing powder instead. Here’s to a radiant pregnancy!

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Allergy shots, Immunotherapy and Pregnancy

 

Immunotherapy is like a vaccination against your allergies. Vaccine shots are to prevent infections; immunotherapy shots are to prevent allergies. However, the two work in opposite ways. Vaccinations prime the immune system to help the body react swiftly if the disease is encountered again, whereas immunotherapy dulls the reaction to allergens.

picture-36In the long term, allergy shots can minimize the need for antihistamines or other allergy

medications. Immunotherapy builds up your tolerance to specific allergens, so your body won’t overreact to them.

Immunotherapy shots are used for most airborne allergens, including tree, grass, and weed pollens, dust mites, and animal allergens. Immunotherapy shots can also be used to prevent severe sting reactions from honeybees, yellow jackets, hornets, wasps, or fire ants.

How does it work?

Your allergist will first confirm what you’re allergic to with allergy testing. Next, he or she will inject small amounts of allergens over the course of many months, periodically increasing the amount of allergens injected. After receiving each shot, you will need to stay in the doctor’s office for 20-30 minutes to see if you react adversely. Also, your allergist will ask you how you felt after getting the previous shot.

picture-46The injection schedule depends on the individual. Generally, 1-2 shots are given weekly in the beginning during the “dose building” stage. They eventually taper off to monthly “maintenance” shots. For some people, it may take up to 12 months to reach the maintenance dose.

Immunotherapy during Pregnancy:

 

Allergy shots (or allergen immunotherapy) can be safely continued during pregnancy if a woman has not had any serious reactions to the shots previously, but it is not advised that women begin shots or increase the dose of their shots while pregnant. This is because allergic reactions to the shots, which are uncommon but can be dangerous, occur more often during the initial, buildup stage, when the dose is being increased. A severe allergic reaction could cause low blood pressure in the mother, and the baby might not get enough oxygen for a few minutes. In addition, the treatment for a severe allergic reaction — which is epinephrine — could temporarily reduce the blood supply to the baby. So rather than taking these risks, allergists avoid beginning or increasing allergy shots during pregnancy, an approach accepted by professional allergy and obstetrical societies. There is some preliminary evidence that mothers who get allergy shots while they are pregnant may lower their baby’s risk of being allergic, but more study is needed before this can be considered fact.

 

The American College of Obstetricians and Gynecologists has issued new guidelines in the management of asthma symptoms in pregnant women, saying that “ it is safer for both fetus and mother for pregnant asthmatic women to continue to use their asthma medication in the lowest dose possible to manage symptoms during their pregnancy.”

Regarding allergy immunotherapy shots, the recommendation is as follows:

Women who already use immunotherapy (allergy shots) at or near maintenance level to improve asthma symptoms may continue getting shots during pregnancy. However, women should not begin immunotherapy during pregnancy. Allergy shots are typically given with lower doses of serum to start and then are gradually increased to higher levels. These escalating doses may cause anaphylaxis during pregnancy, which has been associated with maternal and fetal death.

A discussion of the risks and benefits of continuing allergy shots during pregnancy should be had between the patient and allergist, with input from the patient’s obstetrician, before deciding on a treatment regimen.

 

 

 

 

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Couple Celebrate Their Miracle Baby

A mother has become the first in Britain to have a successful pregnancy after receiving a double organ transplant.

Emma Smith, 37, from Little Wymondley gave birth to healthy 6lb baby Oliver at the end of last month despite having a donor pancreas and kidney. 

It is extremely rare because anti-rejection drugs, which must be taken for life, can cause infertility or complications during pregnancy. 

Ms Smith, who lives with her boyfriend Steve, said: “After my transplants I did wonder if I would ever be able to have kids. When I found out it was a complete surprise. The suppressants lower fertility and it is very rare to get pregnant and to go on to have a birth without complications. 

“They didn’t have any data about being pregnant on the drugs I was on, but they didn’t want to take the risk of changing them and damaging my organs so they kept me on the same drugs and monitored me very carefully. 

“I’m thinking of having another baby now. This one has gone so well, I’m quite reassured about it. 

“I hope it shows other people who have had a transplant that they can have children – if it gives them hope then that’s great.” 

Emma was diagnosed with type 1 diabetes when she was 11 and had to have daily injections of insulin. Because of the disease her organs deteriorated until it was necessary to have the transplants five years ago. 

She gave birth at St Mary’s Hospital, London, under the care of leading surgeon Professor Nadey Hakim. 

Prof Hakim said: “It’s special because the fact of having had a transplant you need to be on anti-rejection therapy. Any medication could be detrimental to the foetus and these are very potent drugs. 

“With this little small baby we had to be very careful to have just enough medication on board so the baby doesn’t get damaged. 

“It should encourage patients who’ve had transplants to have a normal life – people will not say ‘I’ve had a transplant I can’t get pregnant’.

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