It is better to have questions than to assume or sulk in solitude. Please remember that even though it seems like conception and having children are the most basic and natural thing that can happen to human beings (how else do you explain the population explosion..) but just because it happens naturally does not mean that the entire process is very simple and plain. Human body is a masterpiece where all our organs operate in symphony. There are many pieces that have to fall in place for our body to operate, so is conception and fertility, believe us, it is no less than a rocket science.
Q. Does Frequency Matter ?
Not really. Typically couples have intercourse once or twice a week. Normal sperms can survive in the female reproductive tract and retain the ability to fertilize an egg for at least 3 and up to 5 days, therefore having intercourse twice a week should suffice the need for procreation. Trying to time sex or make it more frequent has not shown to improve pregnancy rates as compared to having sex as when desired. The reason for this is when someone makes an effort to have intercourse; it induces a lot of stress which itself reduces the chances of pregnancy. In short, if you’re forcing yourself to have intercourse more frequently or trying to time your ovulation, you might as well visit a fertility clinic.
Q. How important is 'position' ?
Position has absolutely no effect on the chances of conception. Otherwise probably hanging upside down after intercourse would make everyone pregnant! Neither is resting after intercourse necessary
Q. When we talk about Lifestyle change for improving fertility, what kind of changes do we mean? And does it help ?
Lifestyle and environmental factors influence chances of conception and deserve serious consideration while discussing fertility. Some of the important variables are:
- Obesity: About 30 % subfertile couples are overweight (BMI>30) and it is proven that these couples have a higher incidence of subfertility when compared to couples with normal BMI. So weight loss is probably one of the most important things that a couple can do while planning pregnancy.
- Substance Abuse: Especially Tobacco/Smoking has an adverse effect on fertility and therefore smoking cessation is strongly recommended. It is also advisable to limit alcohol consumption to four or fewer drinks per week. Excessive caffeine also is harmful therefore one should limit consumption to not more than two standard beverages per day (25 mg/day).
- Other Harmful Occupational Exposures may be identified like dry cleaning industry (perchlorethylene), printing industry (Toluene), radiant heat, heavy metals, pesticide exposure, laptop heat, etc. which are known to affect chances of conception and therefore should be avoided. If you have any concerns regarding your working environment it would be best to contact your Health and Safety Officer or visit your fertility specialist sooner rather than later because at times, these effects can be irreversible.
Q. Is it true that stress reduces fertility ?
Yes. At the same time I think to tell someone who’s undergoing Trans Vaginal Scans, Daily Injections, IUI or IVF with Embryo Transfer, not to worry, not to think about results and not to stress out is plain stupid. Inability to conceive is a stressful situation so there’s no running away from that. What is advisable is to understand the problem, the treatment options, success rates and then discuss it in depth with your partner and fertility specialist. This makes things a lot easier to handle therefore resulting in less stress. Most clinics also have qualified counselors and couples can just come in and discuss their issues with these counselors and take necessary steps to optimize chances of conception. At times, plain counseling is all that is required for a couple without any medical intervention whatsoever.
Q. We have been trying to conceive since some time, does it make sense to visit an Infertility specialist right away ? Or should we consult a regular gynecologist first ?
If it has been more than a year or if there are other issues like inability to have intercourse, irregular cycles, delayed age of marriage, knowledge of previous medical/surgical problems that might affect your chances of conception, it is advisable to go to visit your fertility specialist directly. All qualified Infertility Practitioners are Gynecologists as well so they should be able to take care of all the issues. The other reason is that evaluation of the male partner is an important part and Andrologists are a part of the fertility clinic, something which a regular Gynecologist will not be able to do. At times couples are wary of going to fertility specialists because of the risk of “over treatment”. I think that is quite understandable and something that a couple should discuss openly when they visit the fertility clinic
Q. How to choose the right Infertility Clinic ?
If I had the right answer, I would have all the infertile couples of the world coming to my center! The things to look out for would be:
- Facilities available: Comprehensive, One Stop Solutions- All investigations and treatment options under one roof , Availability of latest technology like 3D 4D Scans, ICSI, Laser Assisted Hatching, Blastocyst culture etc.
- Clinical Competence with Sensitivity : Qualified and Certified Doctors and Nursing Staff who understand that they are dealing with couples having difficulty in conception and not patients with some form of disease.
- Value for time: Choose a place which values your time by following a strict consultation/procedure appointment system. Not only quality of care but the efficiency at which it is delivered is equally important.
- Transparency: Transparency in cost, treatment options, and success rates is a must. Confidentiality is of extreme importance and must be strictly followed.
- Men’s Health: A lot of clinics focus purely on female factors and therefore a clinic which offers a robust Andrology section is desirable. After all, 30 % of infertility is because of male factors.
Q. Will I have to run through Labs and Sonography Centers frequently when I decide to undergo treatment for infertility ?
If you visit a center which has all the facilities of infertility evaluation and treatment in house like Hormone assessment, sonography, procedure rooms etc. it will save you from running around from one place to another.
Q. We are a working couple, will we have to take leave of absence frequently while on Infertility treatment ?
Some amount of leaves will have to be taken depending on the treatment proposed. This can be minimized by taking appointments in advance, online appointments and utilizing special slots for working couples-something that we as professionals understand. For more details please feel free to drop in a line or give us a call stating your personal requirements and we will try to adjust the dates and time according to that.
Q. What to expect during the first visit to an Infertility Specialist ?
A thorough clinical evaluation of both partners including review of previous investigations. Discussion regarding probable cause of infertility and then discussing various options available.
Q. Will the medication given to me for ovulation cause serious side effects like Cancer ?
Excessive use of Ovulation causing drugs has been associated with a slight increase in the incidence of ovarian cancer. As fertility specialists are aware of this, overuse should not occur.
Q. Will I be involved in the decision making process of the treatment plan suggested by my Doctor ?
It’s your right to be involved in decision making. It makes you as an individual or as a couple more comfortable with what is going on and at the same time reduces anxiety and stress associated with treatment.
Q. Will I have to undergo IVF right away ?
Infertility treatment ranges from counseling to IVF-ICSI. You may need any of these depending on what the diagnosis is.
Q. Will I have twins or Triplets if I take ovulation inducing drugs ?
If conventional treatment protocols are used, the chance of having multiple pregnancy is increased to about 1 in 10 as compared to 1 in 100 in the natural conception group. If you strongly want a single baby, you can let your specialist know so as to minimize the chances (like cancelling an IUI cycle if more than 2 follicles grow, transferring only one blastocyst in an IVF Cycle)
Q. Will I put on weight when placed on ovulation inducing drugs ?
No. Some medicines can cause an increase in fluid content due to water retention but if you exercise regularly and maintain adequate hydration, it can be avoided. Weight gain associated with Infertility treatment is more because of self-imposed restriction in physical activity during and after treatment more than anything else.
Q. Can I travel after an IUI or IVF cycle ? Will that reduce my chances of Pregnancy ?
No problem in travelling after IUI. After IVF we recommend avoiding long duration flights for at least 48 hours after Embryo Transfer.
Q. If I plan on medical tourism to India for IVF how many months should I plan to spend in the country for best result ?
If you send all your documents/reports etc in advance, your preparation for the cycle can be done remotely. For the cycle you will need to come to India for about 2 weeks which if planned properly should be more than enough for ovarian stimulation, egg retrieval, embryo transfer and atleast 2-3 days of rest after Embryo Transfer.
Q. If we are advised to opt for Sperm donor, is there any way to choose profile of Donor ?
Non identifying variables like color of hair, color of skin, color of eyes, height, weight, Education, Blood Group are provided with the sample.
Q. If I opt for surrogacy, will the child inherit any genes from the Surrogate Mother ?
No. The baby is genetically similar to the biological parents and does not inherit anything from the surrogate.
Q. If we are advised to opt for surrogacy, can we choose profile of Surrogate Mother ?
The profile of surrogates is sent to you by mail from which you can shortlist 2-3. We then organize an appointment with all these surrogates after which you can finalize whom to go ahead with. All the surrogates are screened for medical and familial disorders before being included as a potential surrogate.
Q. Do we get legal assistance when opting for surrogacy from the Clinic ?
Yes. We have an experienced team of lawyers who can help you draw up the contract with the surrogate and get it registered with the local notary.