Understanding Female Infertility

Dr. Rita Bakshi explains female infertility, causes, tests and treatment options

Let’s talk off female infertility and, you know, really speaking, today I want to tell when should a couple really think of worrying and not worrying.

So if you have been married for a year and you have been together for a year, you do not use any kind of contraception and you are young. That means you are less than 35. If you’re more than 35, the same period reduces to six months.

So if you have not used any contraception, you tried for a year, tried means really, you know, your relation period, and you have tried to be together at least three times a week. And you have not conceived, then you should think of visiting a doctor. Some people. If you are very young, say you’re just 25, 26, then, maybe even we can extend from one year to two years. So two years is the maximum time I would say and you have been together again, not become pregnant, then time to visit a fertility consultant and just get your basic checkups done. The doctor can decide that if everything is coming out normal, can still give you more time or can decide to go if you little bit of help in the form of. The assisted reproductive techniques, which are available.

If anybody decides to become pregnant, that is no way that really he will not, or she will not have a baby provided you with the patience, the perseverance and the finance that goes with it because we have a gamut of programs available. If there is a dearth of egg or a sperm, you have sperm or an egg donor. If there’s anything wrong with the uterus, you have a surrogate. So you have everything available provided your mind is open. You are ready to persevere. You know you don’t give up after the cycle and say, no, I don’t want a baby anymore. If you know, because this whole thing does, it’s very emotional. And it, it there’s a lot of emotional, uh, strength required to go through the whole program.

It requires you and your partner to be together to be at peace and to you have a very positive attitude only then. You can ensure that success will be yours. So coming to the problem of fertility, again, as I said, you’ve tried to for a year or two years as whatever it is, but after 35 years, again, no more than six months, because that’s the time when a woman’s egg goes down steeply.

And I really mean the steeply down. So don’t give up your fertility for your career. There are a lot of women I know who would wait for their careers to be up and about, and then try pregnancy and the costs of what this benchmark of 35 years. And then it is a total downhill.

I’m not saying that you don’t get pregnant after 35, but the chances are so much lower. And then you would be opting for donors when you could have had your own biological child.

So let me just say that careers can wait, but the biological clock just doesn’t wait.

At this incident, I would also tell you that the best eggs are between 21 to 24. When most of us would not even think of getting married at, but from even if you get married to 28 or 29, do you don’t have the kind of six years, 10 years gap. And then you can plan. I know of a woman who came at the age of 42 from the US. and she said that still not found the right partner. And she came for, can you preserve my eggs? Because you see she’s already lot the best eggs. So for women, well, the into modelling and celebrity industry and who don’t want to have a pregnancy early in their life, then it is right time to cryopreserve. Freeze your eggs and then have a baby whenever you want.

At least you have this option, but for most others, I would say, please have your babies fast. And then maybe your careers can, can wait. So as we talk of female, the latest, just say that a female has to have a good egg for pregnancy. A good egg means every month you have so many eggs starting developing, but there’s one good egg which comes up. The rest of them, all a trophy and that one good egg, if it meets the sperm on the right date. And that date, as I said, is very fixed, 14 days before your coming upcoming period. And the egg is alive only for 24 to 48 hours. It’s said, you have that one, one or two day window for, uh, you know, for you to ovulate and for you to fertilize the egg. So it’s so important to be together. And that, so it’s very important to check your relation, to check your fertility, to know that right date and be together. So there are couples who say they have been together all, all month long, but not on the right date, especially for people who work, you know, in far off places would come for a little while. And they would have past years, and not met at the right date. So it’s so important to feel me. It’s important to know. The other thing very important as I said is the egg reserve. Some people are born with less reserve. So at 28, I still would go for the simple testing in like an AMH It’s your egg reserve, your anti Mullerian hormone That value will just tell you if your value is said in between 0.8 to 1 is so low.

I would say don’t wait even for one month. Go ahead, try a pregnancy. But if her value comes at 3.5, 4, 4.5, give one year, two years, whatever she’s wanting . So it important to know your egg reserve and that is the first and foremost test that I would say that you go through, if that is low, as I said, if it is good, Then of course you can wait for your time. The second important part in the female fertility is the tube. Yes. There are people who have no idea on the tubal status. They have no idea whether the tubes are blocked or open. It requires an open tube from two ends, from the uterine end, and from the ovarian end to be open because fertilization takes place in the tube. If the tubes are blocked on any end the sperm even if it travels from the uterus is not going to reach the tube and the egg also has to reach the tube. So both the ends up to be open and fertilization will only and only happen in the tube. And if the tube are not healthy, Then sometime the pregnancy will remain that it has to travel. It has the functionality of the tube has to be good. It has to travel after getting fertilizing the tube into the uterus and get implanted there. But if the tube is defective, it’ll stay there and become an ectopic pregnancy or a tubal pregnancy, which is life-threatening. So it is important again, to know the status of the two.

How do you know that by doing a simple hysterosalpingogram, that’s a dye test. You’re pushing a dye from below and you see the dye coming out from above and, you know, you have a nice Peyton tube. So, you know, the tubes are open and if you have a good egg reserve the other thing that’s left is looking at the uterus. If the uterus chose a good line as good spongy line, say a day 12 day 14, it has to be spongy enough for the embryo to come and get implanted. It’s very thin because especially in India, tuberculosis, repeated DNCs, repeated MTP girls get through abortion, not realizing that we are destroying the lining of the uterus. Or the endometrium and it didn’t ever become thick enough for the pregnancy to implant.

So the three things, if we can test, the ovarian reserve, the tubal status and the uterine lining, and if all three are good and your age is good, no harm, you can keep waiting for a little while. But if the, if any of the factors are not good, then you should take treatment whatever’s required. If the tubes are blocked, you have the option of going through a microsurgery, get your tubes opened. If your egg reserve is less, there are some medications available, which you can take to increase the egg reserve. Not that you can do too much about it. And if the lining is not good enough, you have medicines that can go, you know, if a Rashomon, you know, you have formed the dashes because of NTP the DNC, then get a history, laparoscopy done. Get your addition removed form a good lining, and then try again.

So the idea is that a female should know how she is, how her reproductive organs are behaving and the right time to go through it.

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