Dr.Sharda Kulkarni

Wednesday 18 March 2020

Does "Good Newwz" happen in real life..?

Does "Good Newwz" happen in real life..?

A big hi to all my readers!! We are already into March 2020 and this year should truly be marked as the Coronavirus year.

Hope you are all staying safe from the novel Corona virus while going about your daily lives!

To reminisce a bit about 2019, well, towards the end of that year , we a saw a big Bollywood hit in the movie "Good Newwz". It had brilliant performances by all the actors and portrayed the trials of two couples trying to conceive. While the idea was good, and it was executed brilliantly on screen, I am sure it sowed seeds of doubt into many couples' minds about the process of IVF.

I am not saying that mix ups dont happen in IVF but they are very, very rare. It's like plane crashes happening in the airline industry. There are hundreds and thousands of safe journeys happening all over the world everyday, which go unreported, behind every plane crash which makes it to the news. So, overall the industry is very safe with a lot of in- built checks and balances.

If we draw a parallel with the IVF industry, whenever a case of IUI ( artificial injection of husbands sperm into the wife's uterus) or IVF (test tube baby) is being handled in any good clinic, there is very strict labeling and separation of all samples and plastic ware used to handle it. Only one patient's material is handled per work station at a time, so there is no chance of mixing one patients gametes ( either egg or sperm ) with someone else's.

The processes are witnessed and signed by 2 people.

In addition, recently there is RFID tagging ( electronic tagging) being employed, but this is not possible as a routine at all clinics because it is very expensive.

The witnessing system mentioned earlier also is time tested and proven effective for so many decades, so there is a case in point that it needn't be discarded in favour of a new fancy technology, which may not be fool proof.

At the time of egg collection, as well as embryo transfer, great care is taken to identify the patient correctly and match her identity with her eggs and embryos.

In 25 years of practice so far, we have not seen a single case of mixed up gametes at Siddhilfe, and I am sure this applies to most reputed clinics in India.

So, if you are overly stressed about a 'Good Newwz' like scenario getting enacted in your lives, please don't be!.....we are conscientiously watching your eggs, sperm and embryos at every step to see to it that we only deliver good news in the truest sense!!

Cheers and stay safe!

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Give us a call, send an email or a letter - or drop by to have a chat. We are always here to help out in whatever way we can. More details at: www.siddhilifeartcentre.com

Disclaimer:- This blog is a personal blog written and edited by Dr.Sharda Kulkarni.The material on this blog is not to be used by any commercial or personal entity without expressed written consent of the blog author. The statements on this blog are not intended to diagnose, treat, cure or prevent any disease. The author does not in any way guarantee or warrant the accuracy, completeness, or usefulness of any message and will not be held responsible for the content of any message.

Sunday 5 January 2020

Egg freezing....the new frontier for working women..?

All workplaces all over the world are seeing more and more women as part of the workforce...there is no area of work, right from small cottage industries to space missions, where women are not seen in leadership roles. It's a sea change compared to the mid or even late 20th century.This, however, puts working women in a dilemma about prioritising their life goals. Completing a long academic journey, finding the right career and acquiring all the other skills to gel in a corporate set-up itself takes a young female job aspirant into her late twenties. So, typically, a girl who steps into any workforce finds stability in her career only by the mid- thirties, and, unfortunately, in the meantime,her biological clock, has already gone past its prime. This means, in short, that while she was chasing her career, a girl's best time to have a baby is over!!

So, in our cities now, we not only see very late marriages, but also a later start to parenting. It's not uncommon to see women wanting to start a family only after 35, or so.The western world has seen this trend much earlier, from the early part of this century itself. If a lady tries to delay her motherhood too much, there is a possibility of difficulty in conceiving due to failing ovaries. The maximum impact of AGE in a woman's case is on her ability to produce healthy eggs.

The IVF industry ( assisted reproduction industry) has been successfully freezing sperm as well as human embryos right from 1983 when the first test tube baby from a frozen embryo was born. But freezing of eggs was a very challenging task. Human eggs have a very large size compared to the human sperm, are in fewer numbers and they hold all the genetic material in the form of a very sensitive spindle which got easily damaged while freezing. Hence freezing of human eggs was done only experimentally until 2013. After a lot of fine tuning, the technique was finally perfected and the American Society of Reproductive Medicine, from 2013 onwards, allowed egg freezing to be done for humans.It was allowed after it was made sure that babies born from frozen eggs were as normal as those born naturally, and they had no developmental problems later. Since then, organizations like Facebook have offered funding to women employees who want to freeze their eggs and focus on their careers till such a time when they want to start a family. The Indian IVF industry, of course, offers all the options for reproduction as in the western world. So egg freezing is definitely available here too. Eggs, once frozen can stay in the frozen state for a period of 5 to 10 years and utilised later to start a family,....which is good news for a career focused indian girl!! But, there are a few things you need to be aware of, before opting for egg preservation:

1) You need to take hormonal injections to make your ovaries produce 8 to 10 eggs, which is a minimum number for having one attempt of IVF. This is an expensive procedure.

2) The procedure to remove eggs from the body involves surgery, which is done under general anaesthesia. There is a risk of infection, or bleeding or injury, which can

happen, as it does,during any other surgical procedure. However, this risk is very small for egg collection done using vaginal sonography.

3) The frozen eggs have to be injected with the husbands sperm ( using ICSI) to fertilise them. This , also, is an expensive procedure, with a success rate , of not more than 30 to 40 percent in one attempt of embryo transfer.

4) with increasing age , there are high risks to the pregnancy due to other conditions that a woman may develop, like diabetes, or hypertension.

Likelihood of growth retardation in the baby or a caesarean delivery, also are high.

5) compared to other techniques, like IVF or Embryo freezing, this is a much newer technique, so long term effects on any resulting children is not clearly known.

However, inspite of all this,the option of egg freezing becomes mandatory for some women. This is in case of women who have cancer. During cancer treatment, use of special medicines or radiation can do irreparable harm to the ovaries.So, before administering the cancer treatment, egg storage by freezing is offered to these women to give them a chance at motherhood later on.For a healthy woman, who wants to postpone pregnancy in order to advance in her career, however, all the above listed points need to be considered. And, remember that there is always a chance that, the frozen eggs, which cost so much to the patient! ....... inspite of the best efforts by the IVF centre, may not result in a pregnancy!

All working girls in a good place as far as work is concerned, need to make informed choices, so as not to be in a situation, where motherhood becomes a distant dream!

Tuesday 1 October 2019

What is ovarian ageing..?

In simple words, it means a womans OVARIES have aged, or grown old. Ageing is not always bad, is it?? .....we all know, its a must for wines, aged or older human beings are ( usually) wiser!! But the same does not apply to a womans capacity to have babies. You all know that its much easier to start a family in your 20s as compared to a later age. Until a decade or so ago...the mantra for girls in India was....get married early and have your babies also early! One rarely saw women giving birth into their mid and late 30s then.

However things have changed now. Its common to see girls getting married around 30 and think of becoming moms by the time they hit their mid 30s. This is a good trend if you look at the bright side of the issue. More financial stability as well as maturity means a more nurturing environment for the growing child. There is better scope for the mother to pursue a career and make inroads into any field, which she can pursue to the full extent after her maternity break or at least part time.

This should not be a problem if the woman has good overall health AND also has healthy ovaries. The ovaries ( egg sacks of the woman)normally start ageing ( slowing down) after 40 years of age. But...., sometimes the same process can start earlìer. Once the ovaries of the woman age, they quite rapidly lose their function, produce fewer and fewer eggs and finally shrink completely to result in the menopause.

The cause for premature ovarian failure ( P.O.F.)maybe due to a problem with the immune system ( auto-immune, overactive immune system) or diabetes or due to multiple other factors not yet known to science. It may also occur due to reasons like treatment for cancer, radiation treatment etc. If a girl or woman has had cancer and received treatment for it, fertility issues may occur later on.How does a woman know if her ovaries are doing well? A visit to a fertility centre would be required for this. There are tests like sonography, combined with hormonal tests like FSH, LH, AMH which can help in making a diagnosis.If the ovarian reserve( stock of healthy eggs in the ovaries) is poor or below average, options like egg freezing maybe required, especially for a woman who is still unmarried. However, treatment is very expensive and 2 or 3 treatment months or cycles maybe required to have a decent number of eggs frozen.

For married women, the option would be to try and have a baby as soon as possible. If the growth of eggs can be achieved easily, with tablets and a few hormonal injections, then the treatment is not very expensive. But if higher doses of injections are needed, and only a few eggs grow, usually IVF ( test tube baby) is required to give her the best chance of pregnancy.

Recently, new treatments like injecting certain growth factors (platelet rich plasma ) or stem cells into ageing ovaries has been tried and it has shown some promise, however, the benefit of these treatments is yet to be confirmed.

So, to summarise, every woman has a chronological age ( your age in calender years since birth) and a biological age ( the age of your internal organs, like the ovaries).

Usually, both of them are the same but sometimes the internal organs may age faster.

Hence all women in their late 20s and 30s need to find out about their reproductive potential ( health of internal organs) if they are planning to postpone child bearing.

It should not happen that your biological clock ran out before you woke up to the idea of becoming a parent.

More Details kindly visit at: wwww.siddhilifeartcentre.com

Sunday 8 September 2019

About a recent conclave we were invited to in Seoul, South Korea.

Wanted to share this about a recent conclave we were invited to in Seoul, South Korea. We were also invited to see their world famous gonadotropin manufacturing facility in IKKSAN, a 3 hour drive to the north of Seoul.

1. The country Korea gained independence almost the same time as us, was preceded by a tyrant regime which almost destroyed it financially and morally and they have equally crafty and evil neighbours like us and yet have come up much more compared to us.

2. Their next generation is almost completely westernised and the disconnect between them and our present generation is huge. The elders rue the loss of their heritage and seem to think of their kids as totally morally uprooted and unaware of their past. All their TV serials and daily “soaps” reflect this one way or the other.

3. The present generation is “looks” crazy and invests tons of money to improve/ maintain their looks. They are of course products of the “ hip hop” culture. They have huge emotional fault lines which show up frequently in the form of the alarming suicide rates.

4. For better or for worse,there is no religious CONNECT that may help or harm and their street icons reflect a young and vibrant but debauched morality.

5. They are like our present generation, very unsure deep within but very ‘COCKY’ on the outside.

6. They are far far better than the ‘rowdy’ Chinese or the ‘reticent’ Japanese, two countries which they will always be compared and contrasted with.

7. They have amazing sense of food and have a very evolved PALATE. Their use of the word ‘Taste’ extends to their aesthetics in the way they build their dwellings and office spaces.

A confounding mix of the sedate and quirky but definitely RICH Asian culture.

All in all, an eye opener for all of us here in India and a visit that was much more than the sum of the parts. A truly revealing experience for me, personally.

Disclaimer:- This blog is a personal blog written and edited by Dr.Sharda Kulkarni.The material on this blog is not to be used by any commercial or personal entity without expressed written consent of the blog author. The statements on this blog are not intended to diagnose, treat, cure or prevent any disease. The author does not in any way guarantee or warrant the accuracy, completeness, or usefulness of any message and will not be held responsible for the content of any message.

Thursday 25 July 2019

World embryologist's day

Today is a special day!

It is celebrated worldwide as 'World IVF day' as well as 'World embryologist's day'.

This is because the world's first IVF baby or Test-Tube baby, Louise Brown was born on this day 41 years ago in England, thanks to the sustained efforts of gynecologist Dr. Patrick Steptoe, Embryologist

Dr. Robert Edwards and their nurse co-ordinator Jean Purdy. The news of this path- breaking achievement took the whole world by storm! It awakened new hope for all the childless couples of the world, especially women with blocked tubes. It was, truly, a major step in women's empowerment. After this, the technology was embraced by the scientific communities all over the world and IVF slowly became a routine therapy for infertility, not only abroad but also in India. India also has the credit of the second IVF baby in the world, Durga, born due to unstinting efforts of Dr Subhash Mukherjee in Kolkata. She was born just a month after Louise Brown but her birth went uncelebrated and unsung, and her creator died a broken hearted man a couple of years later, since the then government and his colleagues refused to acknowledge his work. Subsequently, Dr. Indira Hinduja and her team in Mumbai achieved the first 'official' test tube baby success in 1985. And soon, the IVF industry took quick roots in our country.

All through the last century, and into this one, the world of assisted reproduction( scientific name for IVF) has grown by leaps and bounds. The technology is now used to treat many more causes of infertility, affecting both men and women. The advances have been on the clinical side as well as the laboratory side. These are the two main arms of the treatment. The clinical arm deals with investigating the couple and planning the hormonal treatment for the IVF cycle, whereas the IVF laboratory handles the male and female gametes ( sperm and egg) and culturing ( growth ) of the embryos. The process of fertilisation ( coming together of egg and sperm to form an embryo) underwent an advance in 1993,

when a new technique called ICSI ( Intra cytoplasmic sperm injection) was discovered in Belgium. This has been further refined, and is now available as IMSI, PICSI etc.

We can now, offer even men with no sperm seen in their semen sample ( azoospermia) the hope of fathering a healthy child with the help of techniques like TESE, TESA, ( both methods are for extracting live sperm from the testis) or PESA ( extracting sperm from the epidydimis, an area just above the testis).

The greatest advances in assisted reproduction have been in the area of freezing, of embryos, eggs as well as sperm. With the help of excellent freezing techniques, we can now offer women a success rate of almost 70 to 80 percent after 3 attempts of embryo transfer. It has also helped us overcome the risk of ovarian hyperstimulation which could be a potentially life threatening condition affecting women undergoing IVF treatment. Egg freezing offers women wanting to postpone child bearing the chance to store their healthy eggs at a younger age and take a shot at pregnancy when they are more settled in their careers. ( But beware, this is still not recommended strongly because human eggs do not necessarily have optimum survival after freezing). Sperm freezing has been around for quite some time and has improved further so that we can now even freeze 5 to 10 sperm removed surgically from the testis.

This would not have been possible a few years ago! Even couples with genetic problems can now make use of a technique called PGD and choose normal healthy embryos to replace into the womb. This way, we can avoid the birth of an affected or abnormal child.

Today, we in India, can proudly say that all the above techniques are available in India, at a much lower cost than in the western world. Our success rates also closely match with european standards. The ICMR ( Indian Council of Medical Research) is in the process of giving recognition and licensing to centres which are following good standards of care. Our centre, Siddhilife Assisted Reproducion Centre, Borivli, is one such centre.

I would like to end this blog by stressing on the fact, that all said and done, the success rates of all the above modern techniques depends on the AGE OF THE WOMAN who is undergoing treatment. Fertility potential of women, especially Indian women, goes down dramatically after 35 years. The best results of any treatment are achieved when the woman is 32 years or less. So any aspiring couple wanting to embark on the path to parenthood should not delay their decision to seek help from qualified people. On this world IVF day, here's wishing every aspiring mom or dad going through IVF treatment currently, all the very best!! Wish you success in your endeavour and may you become a happy family soon!

Details at: www.siddhilifeivf.com

Friday 28 June 2019

JUNK FOOD LINKED TO INFERTILITY IN YOUNG MEN

Males who eat unhealthy food produce fewer sperm than those who eat a balanced diet

( Article in Times of India Wednesday June 26, 2019)

Interesting! Well, until now, we blamed unhealthy food for our waistlines only, but now, we have actual documentation of the "internal" damage that it can cause.

Not only the western world, but also several Asian as well as Indian studies have clearly found that sperm counts are steadily dropping, compared to what they were, in the 70s.

While there may be several contributing factors like smoking, sedentary lifestyle, exposure to heat from gadgets, obesity, increased incidence of lifestyle diseases like diabetes and hypertension, this article is about a study which looks at DIET alone as a significant contributor to a poor sperm count. The study has been conducted in Europe. In a group of 3000 men, those following a balanced non vegetarian diet ( fish, lean meats, fruits and vegetables) and those who consumed predominantly vegetarian ( with soy and eggs ) or scandinavian diets ( processed meats, whole grains, cold fish and dairy) had the best sperm counts. There is no similar Indian research study but we are seeing a substantial increase in the occurrence of obesity and diabetes in India. Consuming processed or junk food as well as a sedentary lifestyle are the biggest contributors to this epidemic. When it comes to treating infertility, conventional wisdom has focused more on women. The onus of infertility was never on the men. Here is a study which should be a wake up call to all aspiring fathers- to-be to "Eat healthy and Stay fit"with regular physical activity.

As far as actual dietary planning is concerned, there is no " One size fits all" diet plan. With the huge variations in cuisines that India has, it would be a shame to give a sample dietary plan suggesting only a particular type of cuisine. The treating physician or a qualified dietitian would be your best guide for dietary changes, after they perform some preliminary tests.

We, at Siddhilife Asisted Reproduction Centre, therefore, have a dietician on our team who guides, not just the women but the men as well, from the pre-conception itself.

Whatever changes are made to diet or lifestyle, with or without medications ( like anti-oxidants) typically positive results in the form of an increased sperm count, will show only after about 3 months. Sperm formed in the testis have a development and maturation process which takes approximately 90 days or 3 months.

Last, but not least, some men have primary testicular failure, which will not respond to lifestyle changes or medications. Or there may be permanent damage to the function of the testis ( infection, prolonged smoking, diabetes) due to which therapies may not work. When that happens, typically advanced treatments like IVF or ICSI ( test tube baby) offer the only hope.

Until the next blog, hope this article helps men with dietary problems contributing to weight and fertility issues.

Best Wishes from,

Your Fertility Guide.

Give us a call, send an email or a letter - or drop by to have a chat. We are always here to help out in whatever way we can. More details at: www.siddhilifeartcentre.com

Dr.Sharda Kulkarni

Wednesday 18 March 2020

Does "Good Newwz" happen in real life..?

022-66914442 / 022-28611916

Office Hours

Borivali West Branch

Borivali East Branch

Sunday 5 January 2020

Egg freezing....the new frontier for working women..?

022-66914442 / 022-28611916

Office Hours

Borivali West Branch

Borivali East Branch

Tuesday 1 October 2019

What is ovarian ageing..?

022-66914442 / 022-28611916

Office Hours

Borivali West Branch

Borivali East Branch

Sunday 8 September 2019

About a recent conclave we were invited to in Seoul, South Korea.

Thursday 25 July 2019

World embryologist's day

Friday 28 June 2019

JUNK FOOD LINKED TO INFERTILITY IN YOUNG MEN

022-66914442 / 022-28611916

Office Hours

Borivali West Branch

Borivali East Branch