Infertility affects couples in early 20s, shows new study

‘Genetic Defects, Toxins Lead to Cases; Most of Unknown Origin'

Virility may no longer be a marker for youth as infertility is hitting those as early as 21 years, a new study has shown.

A recent study by Indian Society of Third Party Association and Reproduction (INSTAR), which covered 300 couples at assisted reproductive technology (ART) clinics in five states, including Tamil Nadu, found that 27% of them were in the 21to 25 years age group.

“Infertility rate is still highest among those above 35 years, but the incline isn't as high as what we see among those in the 20's, “said Dr Himanshu Bavishi, president of INSTAR, a society comprising IVF specialist doctors, lawyers and ART banks. The paper was presented at a two-day seminar on infertility management, which concluded here on Sunday.

While stress, issues linked to lifestyle, poor nutrition, pollution and obesity have been linked to this unsettling trend, Dr Bavishi said most of them were observations by doctors and not based on research. “We are seeing an increase in younger women come to us with premature ovarian failure. The reasons for this could be varied, from genetic defects to toxins, but most of them are of unknown origin,“ he said. Premature ovarian failure is the loss of normal function of ovaries before 40. This obstructs the release of eggs regularly, resulting in infertility.

Dr Nithya Ramamurthy, senior consultant gynecologist and obstetrician at Fortis Malar Hospital, said low ovarian reserve could be the result of women going through repeated in vitro fertilisation cycles. “Only less than 20% of couples in their 20s actually need assisted reproductive technology, “she said. Among those who undergo the procedure -which involves “pumping up“the ovaries to make enough eggs -there needs to be at least a three month break after the sixth cycle. “But couples, in their desperation, switch hospitals and undergo the procedure again. This can adversely impact the ovaries,“ said Dr Ramamurthy .

Infertility is defined as not being able to conceive after one year (or longer) of unprotected sex. Among men, doctors at the conference attributed infertility to low sperm count and sexual dysfunction.

Sexologist Dr Narayana Reddy, who was present at the conference, said it isn't just infertility that gives youngsters sleepless nights. “Infertility isn't just a medical problem. It is a psycho-social issue. Fewer people are engaging in healthy sex, “said Dr Reddy.

Dr Shivani Sachdev Gour - A Prominent Gynecologist in Delhi, India

Book an instant appointment with Dr. Shivani Sachdev Gour, a renowned Obstetric and Gynecologist in Delhi (NCR) and get solution and treatment for your infertility problem.

Dr. Shivani Sachdev Gour is a prominent Gynecologist in Kailash Colony, Delhi. She has been a successful Gynecologist for the last 19 years and has helped thousands of couples in treating the infertility problem and fulfilling their dreams by giving parenthood. She is an MBBS, MD - Obstetrics & Gynecology, DNB - Medical Genetics. Dr. Shivani Gour has completed her graduation and has done her special training in Gynecology and Obstetrics from Mumbai. After that she has worked and trained in IVF for at least four years in the UK at Hammersmith Hospital, London and the Royal Infirmary of Edinburgh, Scotland as well.

Read full story here - https://www.prlog.org/12661055-dr-shivani-sachdev-gour-prominent-gynecologist-in-delhi-india.html

Dr Shivani Sachdev Gour @ News 24 Panel Discussion on Healthy Pregnancy

Dr Shivani Sachdev Gour (IVF Expert) Explaining How To Measure Vitamin D & Important for Women?

Dr Shivani Sachdev Gour, Gynaecologist and IVF Expert, SCI Healthacare shares her views on how despite being sun abundant in India, Vitamin D deficiency is found in the country especially in women. She discusses the sources by which one can get Vitamin D, consequences and signs of deficiency and how one can measurement it. She further discusses the importance of Vitamin D for women. Vitamin D increases fertility, prevents breast cancer, make bones healthy and strong, prevents PCOD and support immune system. She suggests that one could obtain Vitamin D from three sources namely sun exposure, fortification of staple foods with Vitamin D and Vitamin D supplementation.

Inspite of India being a country of abandoned sunshine, it is estimated that more than 80% of healthy Indians especially women are Vitamin D deficient. Indian women both in urban and rural settings and of all socio economic strata are Vitamin D deficient and are not even aware of this deficiency and its consequences.

Vitamin D deficiency is associated with high prevalence of

•           Type2 Diabetes – Vitamin D is required to balance sugar levels in the blood by regulating the secretion of insulin. Hence, Vitamin D deficiency increases the risk of developing Type2 Diabetes later in life.

•           Tuberculosis

•           Cardiovascular diseases

•           Osteoporosis, osteopenia (thinning of bones) – as Vitamin D helps in absorption of Calcium from the food we eat in the intestine. Therefore, Vitamin D deficiency will lead to calcium deficiency as well which will lead to weak and achy bones causing osteoporosis and increased risk of fractures.

•           Cancer

•           Asthma

•           Flu – as Vitamin D plays an important role in activating the cells of the immune system which helps to fight infections. Therefore, if deficiency leads to risk of recurrent infections.

•           Anaemia

•           Infertility – a daily morning walk of 20 minutes under the sun can help in boosting the reproductive system as Vitamin D stimulates the production of female hormone progesterone.

Know more here Why Vitamin D is important for women?

Know More about Post Delivery Bleeding & Important Clinical Situation by Dr Shivani Sachdev Gour

Talking about the post delivery bleeding which is an important clinical situation which can have some serious consequences on the health of woman if not managed properly at the same time, Dr Shivani Sachdev Gour, Gynaecologist and IVF Expert, SCI Healthcare shares her views on how one can manage the situation. She says that its management involves an aggressive approach which includes resuscitation of the compromised mother and also to find out the cause of bleeding. This involves oxygen administration, bimanual massage of uterus, immediate intravenous fluid administration and certain injections to contract the uterus which can stop the bleeding. If the blood loss is excessive, the woman might need blood transfusion. If the bleeding persists even after massage and injections then there may be some retained placental tissue or there might be a traumatic cause for which the patient needs to be shifted to the operating room and complete exploration of the genital tract is required by an expert and experienced assistants for evidence of any injury.  She lists out absence of blood transfusion facilities and ignorance of illiterate women is the factors contributing to excessive bleeding after delivery. It can cause infection, blood transfusion reactions, thrombosis and failed lactation. In order to prevent post delivery bleeding one should pay proper attention to nutrition and a balanced diet should be taken daily.

After the delivery of baby, there is bleeding from the uterine bed from where the placenta is detached. This bleeding is stopped by effective contraction of the uterus. Bleeding after delivery may continue for about a month but becomes lesser in amount and pinkish in the later days. It consists of blood and shedding of the uterine lining. Excessive post delivery bleeding is an important clinical situation which can have some serious consequences on the  health of the woman  if not managed properly  at the right time. It can occur either  after a vaginal birth or following cesarean section.

In medical terms Post delivery bleeding has been defined as excessive if the blood loss following vaginal delivery is more than 500ml or in case of C Section  more than 1 Litre. But sometimes  blood loss even less  than this cut off may be poorly tolerated by the mother if she is anemic. It  is a clinical emergency which has to be dealt with immediately in the form of fixed protocol. This is defined as PPH(Post Partum Haemorrhage) drill which has to be followed by the attending obstetrician along with the team members. Read More

Know How to Sunshine Vitamin Can Help to Boost Fertility by Dr Shivani Sachdev Gour

Sunlight boosts fertility in both men and women by increasing their level of Vitamin D. Vit D helps in preventing pregnancy complications such as gestational diabetes, small babies and pregnancy related hypertension. Daily exposure to sunshine for 15-20 minutes can help to improve the success rate of IVF in infertile couple, says Dr Shivani Sachdev Gour, Gynaecologist and IVF Expert, SCI Healthcare.

Sunlight plays a vital role in maintaining the health of our body.  A short duration of sunlight exposure is necessary for everyone since it helps in producing vitamin D in our body which helps in absorption of calcium and phosphorus which is essential for healthy bones. Recently, newer roles of vitamin D have been found as its deficiency has been found to be associated with obesity, cardiovascular disease, and in development of certain cancers. Many studies have proven its important role in reproduction. The active form of vitamin D helps in maintaining estrogens level, also produced from uterine lining and plays role in embryo implantation. Vitamin D is necessary for maintaining the balance of sex hormones in the female and for sperm motility in males. It also helps in improving the sperm count and quality. Also, it increases the level of testosterone in males leading to an increase in libido. It has been shown that women ovulate less in winters as compared to summers which supports the fact that sunlight plays a vital role in conception. There are many causes of infertility. IVF (In Vitro Fertilisation) is the treatment option for those who are not able to conceive naturally. Vit D deficiency has been found to be a co existing factor with other causes of infertility as researchers have revealed most of the infertile couples to be vit D deficient.

Vit D is also known as the “sunshine vitamin” and is a fat soluble vitamin. It can be produced in the body by sitting in the sunlight during peak sunlight hours and exposing the arms and legs. In the presence of sunlight the skin makes the natural form of  Vit D by a form of cholesterol present in skin, which is then converted to active form of Vit D first in the liver and then in the kidneys. Sunlight exposure improves the success rate of IVF in infertile couples. Also, Vit D helps in preventing pregnancy complications such as gestational diabetes, small babies and pregnancy related hypertension.

While in the sunlight one should know that to obtain maximum benefit, sunblock cream should not be applied. Also, the exposure must not be too prolonged so as to obtain tanning as it may affect the skin. The amount of time period of sun exposure  necessary for any individual depends on a number of factors like skin type or complexion, season (summer or winter) and  which time of the day. Those with a darker skin require more time to produce vit D as compared to those with lighter skin. There is a greater exposure to sunlight in summers. Also the amount of absorption of sunlight and hence vitamin D production is more if larger area of skin is exposed.

There are many food sources of vit D, such as liver, mushroom, cheese, oily fish, milk and eggs. But only 20% of the recommended daily dose of vit D is obtained from food, the remaining 80% should be obtained from sunlight. The best advantage of this source is that it is free of cost and can be obtained in abundance anywhere.

Vit D helps building up the immune system of the body which helps in fighting infection. Uterine infection is one among the many causes of failure of implantation of the embryo.  Sunlight also has a direct effect on bacteria and helps in killing them. In older times, sunlight was used as healing therapy for many diseases.

Vitamin D helps in the absorption of calcium from diet, which we all know is important for healthy bones. In the absence of Vitamin D, calcium is absorbed from the bones which lead to weak bones. Apart from this, Calcium also plays a role in conception as it is required for the maturation process sperm undergoes for fertilisation. Calcium is also important for motility of the sperm which is vital for fertilisation. Calcium is not only important for sperm functioning; it is also important for development of oocyte and also plays a role in embryo growth.

Vit D helps utilise magnesium in the body. Low magnesium levels contribute to infertility by causing contractions in the fallopian tubes and hence interfere in implantation of the egg. Prolonged magnesium deficiency also leads to anxiety and obesity. Magnesium also increases the blood supply to the uterus and helps in egg production. It also helps to decrease the risk of abortions.
Vit D also helps in the absorption of zinc from the gut. Though zinc deficiency alone is not a cause of infertility, it is required for the proper functioning of the reproductive system. It helps in maintaining the balance of the hormones estrogen and progesterone and also helps in egg production. It also contributes to male fertility by improving the quality of sperm and helping in its maturation process.
There is some evidence that vit D deficiency might be related to the pathogenesis of polycystic ovarian syndrome (PCOS) which is a metabolic syndrome characterised by insulin resistance, ovulation problems, menstrual irregularities and hormonal imbalance. It is an important cause of infertility.

Sunlight helps in controlling the melanin production which is the “sleep hormone” that is produced by a small gland in the body at night and helps you sleep and is also responsible for the dark colour of skin. Excessive melatonin contributes to infertility by affecting the sperm count and motility and thus affects the process of fertilization. It also causes a change in the levels of female sex hormones which affects menstruation and ovulation. Melatonin also has an effect on thyroid hormone.

EFFECT OF SUNLIGHT ON MENTAL HEALTH Infertile couples are under a lot of stress. While undergoing IVF treatment the stress is even more. Sunlight is very important as it helps in the production of serotonin which has anti-depressant effect. It is important for regulating sleep, appetite, memory and mood. Few minutes in the sun helps elevate the mood by releasing endorphins in the body that are “happy hormones”.

Daily exposure to sunshine for 15 to 20 minutes helps maintain the sleep wake cycle and to keep the mind rejenuvated. It helps to fight fatigue and energies the body. Being in the sunlight encourages one to socialize and engage in outdoor activities, this helps in improving the quality of life. Another advantage is that one gets a chance to observe the nature which helps the mind and body to relax.
While in the sun one should bear in mind that over exposure to sunlight has its own drawbacks as it may lead to excessive tanning of the skin, sunburns and some other skin diseases, premature ageing of the skin and eye problems. But these occur only if the exposure is too prolonged and mostly in those with a fair complexion.

Nowadays, with the advent of technology, use of computers and other lifestyle choices that involve indoor work, we all tend to miss direct sunlight exposure. Also due to busy schedule and fear of skin problems many of us miss the beneficial effects of sunlight. One should make an active effort to take out 15-20 minutes a day for at least 4 times a week if not daily and sit outside and let nature help you in the best possible way.

About author:
I am dedicated writer specially about healthcare information, have good knowledge about IVF services and here also I have tried my best to share best and informative content that matches to your searches and hospital services. Delhi leading IVF hospital SCI Healthcare, that founder & director DR SHIVANI SACHDEV GOUR, is much experienced IVF doctor.