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Obesity and Pregnancy
When couples strive to increase their chances of fertility, a multitude of factors may be considered. They may be more conscious of the foods they eat, alcohol or caffeine consumed, or exercise regimen maintained. Although these day-to-day habits are certainly good to keep in mind, it is also important to remember that one’s weight plays a part in his or her overall health, and when it comes to fertility, weight is yet another factor that may influence success rates.

To become pregnant, a healthy weight matters. Being overweight or obese can impact your fertility. Obesity is a rising epidemic affecting millions worldwide. Obesity also significantly affects a woman’s capacity to carry on a pregnancy to term. Obesity is defined by an extraordinarily high Body Mass Index (BMI) in which the index is a reflection of body fat content. Around 1 in 4 women are at least overweight as per surveys and studies. The rates are higher among women facing problems of conception. Obese women are three times more likely to suffer infertility than women with a normal body mass index. Overweight or obese women experience longer times to pregnancy and reduced probabilities of conception relative to their normal-weight counterparts. Moreover, they are at an increased risk of early and recurrent miscarriage. These women generally have reduced oocyte quality, lower developmental potential, and poor clinical outcomes when they undergo assisted reproduction treatment.

“Healthy women have healthy eggs and are more likely to have healthy children,”

Obesity has a number of different effects on fertility of men and women as follows:

1. Obesity affects hormones
When body mass index goes past the overweight category (BMI of 25–29.9) into the obese category (BMI of 30 and above), hormonal changes may occur in the female body. When the levels of natural hormones change, the chances of conception decrease.

2. Obesity leads to insulin resistance
The hormonal imbalance that comes with obesity often leads to insulin resistance. That is a major risk factor on the road to diabetes — but it also affects fertility and can create abnormal menstrual cycles. Insulin resistance can lead to anovulation, in which body does not produce eggs properly.

3. Obesity affects natural and assisted pregnancies
Obesity makes it more challenging to become pregnant, no matter whether a couple is using natural means or reproductive technologies such as in-vitro fertilization (IVF). It also increases the risk for a miscarriage. This issue may be caused by the hormonal issues or because of poor quality eggs.

4. Obesity decreases Men's fertility, too
Although much of the focus on obesity and infertility is on women, it absolutely affects men, too. For men, obesity leads to a drop in testosterone, which can lead to infertility. On top of that, erectile dysfunction occurs at a higher rate among obese men.

5. Losing weight can improve all of the above
In recent years, the connection between lifestyle, weight, nutrition and fertility is gaining more public exposure. A multidisciplinary approach to weight management is more likely to be a successful treatment option. The emphasis should be on lifestyle change, education about proper diet, exercise, and behavior modification. A more holistic approach to obesity and reproductive health can help increase the chances of conception in obese women. In doing so, it would also have a positive impact on the general health.

As a result of weight loss, the hormonal imbalances and other effects of obesity begin to decrease.

Know in detail about fertility treatment in male and female at http://www.blossomivfindia.com/fertility-treatments

More specifically, the greater a woman’s body-mass index (BMI) is, the less likely she is to have a successful IVF experience. A Recent study has shown that to a large extent, today’s generation is what their moms and dads ate prior to and around their conception. "This is a huge issue that really does carry through to certainly the next -- and probably the next two -- generations."

Obesity has negative effects on reproductive health. It has been established that obesity is associated with decreased natural fecundity, a decreased ovulation rate, increased time until conception, and increased rates of miscarriage. Additionally, an increased rate of pregnancy complications, including gestational hypertension, preeclampsia, gestational diabetes, postpartum hemorrhage, and fetal macrosomia, are all associated with obesity. Since the incidence of obesity is continually rising, an increasing number of overweight and obese women are seeking fertility treatments through assisted reproduction technology (ART).

There is nothing in medical science that says that IVF can't be done on fat or obese women. IVF remains more complicated for Obese Women and they require different medication doses than normal weight women. Consequently, there is a need to understand the full impact of obesity on in vitro fertilization (IVF) treatments. In vitro fertilization is used to help women become pregnant by mixing the sperm and egg outside the body, then implanting the embryo into the woman’s uterus.

Following are the effects of obesity on in vitro fertilization (IVF) success rates.

1. Obese women need higher doses of drugs: Obesity is associated with higher doses of medications to stimulate the ovaries. Obese women also take longer to respond, have increased cycle cancellation rates, and fewer eggs retrieved.

2. Obese Women are less likely to get Pregnant: IVF pregnancy rates are lower in obese women. The age-adjusted odds of live birth are reduced due to high BMI. In other words, the chances of having a baby decrease as the woman’s weight increases.

3. Obesity Affects Eggs and Embryos: Egg quality, fertilization rate and embryo quality all decrease in obese women. This means that eggs retrieved may result in a failed IVF cycle. Obese women are less likely to have successful IVF from their own eggs (and not donor eggs), due to poorer egg quality. When it comes to IVF with donor eggs, obese women apparently have normal success rates. It is apparent that women with a BMI of >25 and especially those with a BMI of >30 exhibit a poorer ovarian response to fertility drugs (impaired follicle and embryo development with fewer blastocysts becoming available for transfer). These women also tend to have a reduced ability to implant transferred embryos into their uterine linings because of its thickness, perhaps due to reduced endometrial receptivity.

4. Obesity Affects the Uterine Lining: An obese woman is at a greater risk of developing abnormal thickening of the uterus lining. This is because estrogen is secreted in excess in an obese woman. The uterine lining becomes thick and is less receptive in obese women. It is apparent that women with a BMI of >25 and especially those with a BMI of >30 exhibit a poorer ovarian response to fertility drugs (impaired follicle and embryo development with fewer blastocysts becoming available for transfer). These women also tend to have a reduced ability to implant transferred embryos into their uterine linings because of its thickness, perhaps due to reduced endometrial receptivity.

All fertility options and treatments available for infertile couples can be learned at http://www.blossombestivfindia.com/Program/OurFertilityPrograms

Women who are planning to get pregnant or to enter IVF programs should be advised to lose weight before starting so, as very strict diets are not allowed during pregnancy or while on IVF. The clinical significance of a growing population of overweight women is enormous because not only can this compromise their overall reproductive performance, but it also compounds the risk of chronic medical conditions such as diabetes, and coronary/cerebral/peripheral vascular disease, and thus compromises life expectancy as well as the quality of life. As such, being overweight represents an overall life hazard that should be addressed by the medical profession as well as by society as a whole. The answer is surely not a simple one, but the solution does not lie in dieting alone. Instead, it requires an overall modification in lifestyle.

It is important to note that reducing BMI through weight loss has been demonstrated to significantly improve fertility treatment outcomes and to lower both treatment and pregnancy complications. In other words, not only does obesity make it much more difficult to conceive, but it also exposes both the mother and the infant to all manner of risks before and after birth.

Blossom Fertility & IVF Center in India is for IVF, IUI, ICSI, Surrogacy, Egg & Sperm Donation. The clinic offers IVF (In Vitro Fertilization) treatment to infertile couples from all over the world. Clinics expertise in fertility treatment and cutting edge technology has helped majority of the patients achieve pregnancy. Obese women coming for fertility and infertility treatment are advised to reduce weight and to get BMI corrected. All options related to pregnancy for obese women are explained in detail. Finally, it is important to emphasize that overweight women are at far greater risk during pregnancy than are women of normal body weight. Women who are planning to get pregnant or to enter IVF programs are advised to lose weight before starting, as weight loss "improves ovulatory function" as well as pregnancy outcomes. It is important to note that reducing BMI through weight loss has been demonstrated to significantly improve fertility treatment outcomes and to lower both treatment and pregnancy complications. In other words, not only does obesity make it much more difficult to conceive, but it also exposes both the mother and the infant to all manner of risks before and after birth. "Because of the complex nature of obesity and of reproduction, when an obese woman with sub fertility presents for fertility treatment, an individualized yet systematic approach is needed.

Contact the Fertility experts of Blossom Fertility Centre regarding any fertility problems including male infertility, female infertility, IVF, ICSI, Blastocyst Transfer, Donor Eggs and various other complex processes at http://www.blossombestivfindia.com

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Infertility due to Diminished Ovarian Reserve
Ovarian reserve is a term that is used to determine the capacity of the ovary to provide egg cells that are capable of fertilization resulting in a healthy and successful pregnancy.The ability of a woman's ovaries to produce high-quality eggs is known as ovarian reserve (OR). As women get older, their OR naturally declines, the number and quality of eggs go down, and it becomes harder to get pregnant. Women attempting pregnancy after age 40 often have difficulty getting pregnant for this reason.

Premature Ovarian Aging and Infertility & Diminished Ovarian Reserve

DOR or POA negatively affects female fertility primarily through sub-optimal number of eggs and poor quality of eggs. Smaller number of lower-quality eggs reduce women’s fertility in two ways: they make it more difficult to get pregnant, and once pregnant, miscarriage are more likely to happen.

The standard goal of all fertility treatments is the improvement in pregnancy rates in patients with infertility problems. Within the past years, ovulation induction has contributed to the success of assisted reproduction techniques, in vitro fertilization (IVF) and embryo-transfer (ET). The efficacy of these techniques depends on a personalized protocol of controlled ovarian hyperstimulation (COH) and an adequate oocyte recruitment.

A woman is born with her entire life supply of eggs, approximately 1-2 million. At the time of her first menstrual period, the number of eggs has diminished to 300,000-400,000. Each cycle, hundreds of eggs undergo stimulation and usually only one is released during ovulation; the others are reabsorbed and are not functional. Peak fertility in women occurs before age 30, with a monthly pregnancy rate of 20-25 percent. This monthly rate starts to decrease around age 32, but rapidly declines beginning in the late 30’s and into the 40’s. Approximately one in three women experience infertility by age 40, mainly due to poor egg quality. Egg quality decreases as a woman ages, resulting in impaired fertilization, reduced implantation, and increased miscarriage along with the increased potential for chromosomal abnormalities of the fetus.

As more women are delaying childbirth and more baby boomers are reaching midlife, the problem of diminished ovarian reserve (DOR) is increasing. This has several major medical consequences including infertility, decreased bone mass with risk of fracture, abnormal uterine bleeding from lack of regular ovulation, and hot flashes. This article will address ovarian reserve testing and its impact on treating infertility.

As a woman, your fertility potential is largely determined by your ovarian reserve. Ovarian reserve refers to the number of eggs you carry in your ovaries, as well as the health and quality of those eggs. Assuming no other reproductive problems exist, ovarian reserve plays a large role in determining whether you will get pregnant or not. Your ovarian reserve depends not only on the quantity and quality of the eggs in your ovaries, but also on the quality of the response of ovarian follicles to hormone signals from the brain.

Ovarian reserve is a biological variable, and egg quantity and quality in an individual woman can be average for her age, better than average, or worse than average. Women with poor egg quality are said to have poor ovarian reserve , poor ovarian function, or occult ovarian failure.

Know in detail about Infertility in male and female and their treatment at http://www.blossombestivfindia.com/InfertilityServices

Diminished Ovarian Reserve

Diminished ovarian reserve (DOR) is a condition where the ovary loses normal reproductive potential, which will compromise fertility. DOR can occur from injury or disease, but it is most often the result of normal aging. Around 20% of women diagnosed with infertility have DOR. Diminished Ovarian Reserve (DOR) is a condition meaning a woman's natural reserve of eggs has significantly reduced. This is a process that does normally occur for a woman as she is nearing menopause, but it can occur in a woman of any age. When this occurs, conceiving becomes difficult for a woman as her ability to produce eggs begins to diminish. Diminished ovarian reserve does not eliminate the possibility of pregnancy. However, this problem should encourage a woman to be more aggressive in her quest to become pregnant as time is clearly of the essence.

When a woman is diagnosed with DOR (high baseline FSH, low antral follicle counts and/or low AMH), most often she is told her chances of conceiving a biological child are very slim and that common infertility treatment, such as IVF, may also not be successful. Most of these women are told their only option is to seek out an egg donor to help her successfully achieve a pregnancy.

What are common causes of diminished ovarian reserve?

By the age of 45, few women remain fertile. However, success rates for fertility improve using in vitro fertilization (IVF) and egg donation. Certain things contribute to the diminished ovarian reserve. The common causes include:

Age of 35 years and older
Smoking
Cancer treatments using chemotherapy and radiation
Genetic abnormalities, such as X chromosome abnormalities
Surgical removal of a portion or all of an ovary

What signs and symptoms are associated with DOR?

There are no outright symptoms and signs associated with diminished ovarian reserve, other than shortening of the menstrual cycle (going from 30 days to 24 days). Once menopause occurs, women show symptoms and signs of low estrogen, which include vaginal dryness, hot flashes, missed or absent menstrual periods, and trouble sleeping.

How is the ovarian reserve assessed?

To diagnose diminished ovarian reserve, the fertility specialist will perform a thorough physical examination and take blood samples. Testing is done on the second or third day of the menstrual cycle to measure estradiol and follicle-stimulating hormone(FSH) levels. Fluctuations in normal baseline values of these two hormones indicates a decline in the ovarian reserve. Another blood test that checks fertility is the anti-Mullerian hormone (AMH), which reflects the actual number of eggs in the woman’s body. In addition, the doctor will conduct ultrasounds to visualize the number of follicles on the ovaries.

Learn in detail about egg donation, egg quality, sperm donation, sperm management and cryopreservation of egg and sperm at http://www.blossomivfindia.com/archives/1071


How is DOR treated?

At present, there are no treatments for slowing down or preventing ovary aging. After DOR is diagnosed, a woman can cryopreserve (freeze) eggs or embryos for later use. With ovarian failure, or when ovaries do not respond to ovarian stimulating drugs, donor eggs are recommended by the fertility specialist. Women with DOR can use eggs donated from younger women to conceive long after menopause occurs. Part of the treatment for infertility is injectable gonadotropin (FSH). The response of the ovaries following FSH for stimulation is predictive of egg quantity. In vitro fertilization is a treatment option for women who have poor egg quality, as well as few viable eggs. A natural IVF cycle is used for women who produce 2-3 follicles, and it does not require ovarian stimulation. With natural IVF, the success rate is only 5%. However, with regular IVF, the success rate is 10%.

The option which offers the highest pregnancy rate for women with a poor ovarian response is to use donor eggs. While this is medically straight forward, it can be very hard for a young woman with regular cycles to accept this option. Often, it's worth doing one cycle with your own eggs even if the chances are poor, so that you have peace of mind that you did your best. This also may make it easier to explore the option of donor eggs for the future. When making the choice to move on to donor eggs or adoption be sure that you have explored all available treatment options to your satisfaction.

Many treatment strategies have been developed in order to treat women with poor ovarian reserve. Because time is at a premium for these women, treatment needs to be aggressive, in order to help them conceive before their eggs run out completely. IVF is usually their best option, as it offers the highest success rates. Superovulating these women can be quite tricky, and this is where the experience and the expertise of the doctor makes a critical difference ! Blossom Fertility and IVF Centre and its team of experts take individual interest in each and every patient because the problem of ovarian reserve differs from patient to patient. It is true that a skilled doctor will be able to design an optimal superovulation for women with poor ovarian reserve, it is also true that the results are still likely to be poor. We the doctors at Blossom, provide all the help to patients from blood test, counselling, ultra sonography and all other support till the success of the treatment and the ultimate goal of having a baby.

Contact Blossom Fertility and IVF Centre if you are facing the infertility issue due to diminishing ovarian reserve and our team of experts will be happy to assist you in all the ways. Visit our website at http://www.blossombestivfindia.com/

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