Thursday, 31 July 2014

Is Extensive Usage Of Cell Phones Reducing The Chances Of You Becoming A Father?

Mobile phones reduce fertility

It is a common misconception that women are more prone to infertility than men. The fact is that an equal number of men also faces infertility problem along with women. It won’t be wrong to blame the lifestyle changes for this humongous problem.

We are now living in a generation where cell phones have become a part and parcel of our life, but most of us are unaware of the impact of electromagnetic radio waves emitted from the phone on  male fertility. When you are keeping your phone in the pant pocket close to the testicles you are considerably reducing your chance of becoming a father. Radio - frequency electromagnetic radiation can adversely impact the semen quality resulting in a  significant decrease in sperm count, motility and viability.

I cannot advice you not to use the mobile phone as it is not practical, but see that you don’t keep it in the pant pocket specially when you are talking hands free as radiation level from the instrument is considerably elevated when you are talking.
Dr. Anita Mani

Saturday, 19 July 2014

Infertility linked to mercury in seafood

Who had ever thought that consuming the supposedly healthy and nutritious fish can have an adverse effect on fertility. But the latest studies have found a clear link between excess consumption of seafood and infertility. Pollution in sea has caused an increase in the mercury levels of fish and certain species like Shell fish, shark, tuna and mackerel have been placed in the high risk group.

Mercury is one of the most toxic substances. It is known to cause birth defects like autism, ADHD and epilepsy in children and impotency, reduction of sperm count and motility in men and inhibit fertility in women. It may cause disturbance in menstrual cycles and can even lead to abortions.

A research conducted on 150 infertile couples in Hong Kong proved this point. Tests carried out on these couples proved that they had high level of mercury than the normal fertile couples.

According to FDA guidelines no more than 12 oz of low mercury fish should be consumed weekly by pregnant women and those women who are planning to conceive.

Amalgam dental filling has been also attributed as a cause for mercury poisoning. Mercury is passed on to the fetus through placenta and even breast milk can have traces.

Fish is rich in omega 3 and zinc , and thus helps , but it should be taken in moderation, maximum 12 oz per week only. So it is wiser to stick with low mercury fish like Anchovies, Butterfish, Catfish, Clam, Crab (Domestic), Herring, Mackerel (N Atlantic, Chub), Oysters, Salmon, Sardines etc.

Consuming fish in moderation and opting for small river fishes which does not mercury content can decrease the risk of infertility.

Dr. Anita Mani
Infertility& Surrogacy Specialist at Gift IVF Centre

Friday, 18 July 2014

Healthy diet for male fertility


Regular intake of healthy food will go a long way in improving male fertility. A diet including lot of salads, raw vegetables and fruits which are loaded with antioxidants and vitamins helps to keep the sperm healthy. Many of the vitamins are lost in the process of cooking especially when they are cooked for a prolonged time or deep fried.

Fresh water small fishes and oysters are not only low in mercury but also  rich in omega 3 fatty acids and trace elements like zinc which are essential for sperm production and function.

Another magic food is nuts which will provide plant protein and essential fatty acids and is a good alternative for red meat, which is high in saturated fat.

Avoid snacking on bakery items like cakes, biscuits, pastries as they contain nothing but empty calories. They do not have nutritious ingredients and is packed with harmful stuff like tranfat from processed fat. Some of the chemical preservatives used can cause abnormalities in babies. Substitute refined flour (maida) with whole grains as they have more fibre and vitamin content

Eating  lot of fruits, especially the home grown fruits like banana, guava, mango, jackfruit, chickoo etc is very healthy, as they have plenty of vitamins and are chemical and pesticide free .The sheer act of gardening to grow these fruits is a good form of exercise which will keep men fit and healthy. Research has proven that gardening is one of the best ways of relaxation.

Drinking boiled well water is much better than drinking chemically treated bottled and canned water. Use mud pots or glass jars instead of plastic containers, as these contain chemicals called parabens and phthalates, which has clear links to infertility
Raw salads are best diet , added nuts make it tasty too 

Lightly cooked veggies preserve vitamins.

whole grains wheat bread is better than processed products as they have more fiber and vitamin content .

 Salad with baked chicken and whole wheat bread

These sweet delights looks very delicious and yummy , but are very harmful for our health 



Thursday, 17 July 2014

Shampoo, creams,lotions - A Cause For Male Infertility !!

It is a shocking news that the shampoos and creams we use everyday, which we consider harmless can be a cause for  infertility and even testicular cancer in boys even before they are born. The culprit is Phthalates commonly found in  skin lotions, shampoos, conditioners, make-up, perfumes, nail polish, hair spray etc. Phthalates is rarely listed as an ingredient on the bottle, so most of the time we are unwittingly using them

Phthalates are hormone-disrupting chemicals. Numerous studies conducted worldwide have confirmed that they are toxic to reproductive system and have other side effects. Phthalates reduce female fertility and can cause premature breast development in young women. Phthalates in a mother’s body can affect the fetal development of her child. Pregnant ladies who are exposed to high levels of phthalates are more likely to have sons with altered genital development and altered levels of testosterone.

 This chemical disrupts the male hormone testosterone at a crucial stage of foetal development and doubles the rate of defects. In men, phthalates lower sperm counts, reduce sperm motility and damage sperm. The alarming increase of reported cases of testicular cancer may also be attributed to this chemical. Women of reproductive age were found to have higher level of Phthalates in their body; the reason could be the growing use of cosmetics and plastic products. Phthalates have also been linked to obesity, as they can also act as endocrine disruptors. Statistics show that in the last 50 years, infant boys diagnosed with genital abnormality have doubled. By  using some brands of shampoo and  make-up, the pregnant women are unknowingly increasing the risk of their sons suffering defective sex organs, low sperm counts and even cancer.


Phthalates are used to make plastics soft and flexible. A 2002 study tested 72 cosmetic products from major U.S. brands found phthalates in nearly 75% of them. None of them had the word phthalates on the label. The only remedy for this Gordian knot is to reduce our exposure to phthalates by avoiding Vinyl and PVC plastic and choosing  phthalate - free cosmetics. Alternatives like Shikkakkai and herbal powders can be used for shampoos, dye can be substituted with natural henna  and homemade fruit face packs and honey can be used to replace chemical rich cosmetic creams. The  health and wellbeing of the future generation is in our hands, so taking a little extra effort will ensure our children will be hale and healthy.

Dr. Anita Mani
Infertility& Surrogacy Specialist at Gift IVF Centre

Monday, 14 July 2014

Follicular study for egg donation in surrogacy

The follicles are measured after the injections are given for stimulation in an egg donor.Today they are around 17 mm and when they are 20 mm, inj Hcg is given for egg pickup after 34 hours. After pickup, IVF / ICSI is done and resulting embryos are transferred to surrogate mother, who will be synchronised for embryo transfer. Only excellent embryo is transferred, and if there are excess embryos, they are frozen by vitrification .
Dr Anita mani

Scan for endometrial lining for surrogate mother

Scan  for endometrial lining for surrogate mother 

This is transvaginal scan for checking inner  lining ( endometrial thickness ) of uterus  of a patient .
She wants to become surrogate mother and  is ready with priming with estradiol tablets, to make her uterus ready for implantation .
Here, she has clear trilaminar pattern, that is  3 lines seen clearly. The thickness should be ideally 9 to 12 mm.
We will start luteal support medicines for her and then do the embryo transfer.
Dr Anita mani 

Scan is the best mode of antenatal check up , for surrogates

Scan is the best mode of antenatal check up  for surrogates

This is a 16 week scan to check on the growth of baby in a surrogate mothers womb. It gives us a clear picture of how the baby is growing inside the mother. This also helps in identifying any abnormalities, position of placenta and the amount of fluid around baby ( amniotic fluid ). Regular scans help in picking up growth retardation, any bleeding problems, chance of preterm delivery. This helps in higher success of surrogacy, in attaining full term baby with good growth and to avoid complications like intrauterine growth retardation, intra uterine death, foetal distress and NICU admissions .
Dr. Anita mani

Friday, 11 July 2014

Foetal karyotyping proves triploidy in recurrent miscarriage with donorsperm IUI

29 year old patient came with a history of 9 donor sperm IUI and 2 miscarriages. Her husband had azoospermia.

Pregnancy was achieved after another donor sperm IUI, but unfortunately another miscarriage followed , there was no fetal heart at 10 weeks .

Foetal karyotyping by FISH, was done by sending fresh - products of conception after evacuation of uterus to find out if the baby was abnormal. FISH (fluorescence in situ hybridization) is a technique that is used to detect and localize the presence or absence of specific DNA sequences on chromosomes. The result came as triploidy, fetuses with Triploidy or Triploid Syndrome have an extra set of chromosomes in their cells. This proved that, the eggs may be abnormal in her, so that even after donor sperm IUI, either she fails to conceive ( due to early embryo loss)or miscarriage happens .

Though not proven, an Interesting fact is that often infertile men those who don't have enough sperm count choose infertile women. Whether it is by natural selection or if the healthy sperms increase fertility in women is debatable and research might be interesting

Dr.Anita mani


Thursday, 10 July 2014

Pregnancy after priming with estradiol

Pregnancy after priming with estradiol 
30 year old Patient with history of small uterus and PCOS , not conceived after several IUI and  1 IVF and 2 FET cycles.
She had priming with estrogen tablets for 6 months and while waiting for second IVF , she conceived naturally .
Today's scan showed normal viable foetus at 9 weeks , mother was laughing as she saw the baby , and the foetus appears to be responding ! Wonder whether it's laughing too.

Dr.Anita mani

Saturday, 5 July 2014

Foetal ovarian cyst

Fetal ovarian cyst 

Fetal ovarian cyst is a common finding and it is due to hormonal changes in the mother. There is no need to panic, a scan can be done after delivery to check  and the cyst usually disappears in couple of weeks. 
This video shows fetal ovarian cyst along with filled bladder in the baby .

Dr.Anita mani

Friday, 4 July 2014

Antenatal care for surrogate mother

Antenatal care of surrogate mothers 

Dr.Anita mani

Counselling and antenatal class 
Serial S.Bhcg
Weekly scan + NT(TVS) scan at 9 to 12 weeks 
Urine routine
Double Marker    test/Triple marker test
BP, wt weekly
NACE/ Materne T21 test- for fetal DNA Test if needed 
 Luteal support medicines, folic acid 



Regular Antenatal check up
Urine routine
20 weeks 3D/4D anomaly scan
24, 28 weeks-growth + Doppler scan
Iron and calcium supplements 
Protein supplements 
Regular Antenatal check up
Iron and calcium supplements 
Protein supplements 
Repeat FBS, RBS , Urine Routine
Growth + Doppler scan once in two week
CTG weekly once
Other tests as needed By clinical Judgment

YOGA - remedy for male infertility

Yoga has many ways of improving fertility. There are Physiological, Psychological and Neurological Changes happening in the body, when Asanas are practised regularly.

At GIFT IVF center we promote yoga for male and female infertility and advise yoga to improve sperm parameters, to improve sexual performance by increasing circulation and flexibility, to compact stress and to reduce weight.

The main function of the yoga is an improvement in blood circulation. It helps in the release of hormones from the various glands as they get squeezed during the asanas. The stretching of the nerves helps in improving the neurological functions and also helps in relaxation of the body and the mind. Some of the asanas aid in pooling of blood in reproductive organs and certain other asanas avoid pooling of blood in the veins   (peripherals). Internal organs get massaged, thus improving their functions. Praanayama (breathing exercise) improves oxygenation and reduces carbon dioxide content in the body and also augments the lung capacity.

Ø  Padahasthasana
The Pelvis and the Spine get fully stretched, thus stretching the nerves and improving the neurological function. This helps in attaining and maintaining a good erection in men. Erectile dysfunctioning is often quite embarrassing for male partners and many a times results in marital issues.Yoga can completely cure certain forms of erectile dysfunction.

Ø  Virabadrasana
There is extreme stretching of pelvic nerves, which helps in the neurological function; this posture also helps in reducing the temperature of Scrotum which in turn improves the motility of sperms. The temperature of scrotum increases due to prolonged sitting as in office jobs, especially when laptops are used causing male infertility. Asthenospermia (reduced motility)  is commonly found in white collar job officials.

Ø  Navasana
As the lower part of the body is lifted, except for the pelvic region, there is a pooling of blood in the pelvis. The rich blood circulation nourishes the pelvic organs and helps in improved sperm production and in removing the toxic cellular waste. Oligospermia is a condition where sperm count is low and this yogasana can improve the condition. This asana  can also improve concentration, calm the mind and reduce the stress from the modern day life. 

Ø  Naukasana
Now it is time for some grinding. In this yogic pose, lower abdomen, thighs and pelvic organs are squeezed. Reproductive functions are improved. Stretching of lower abdomen muscles provides an internal massage to the pelvic organs, additional benefits are gained from the pooling of blood in the same area. The spinal nerves get stretched, which helps in calming and improves the neurological function. The blood pooling in varicose veins are reduced, this is helpful in testicular varicocele, a common condition in male subfertility.

Ø   Gomukasana
The pelvis gets tilted and rotated, thus Squeezing the pelvic organs and this internal massage helps the reproductive organs.The circulation is improved, it helps in reducing cholesterol and fat around visceral organs.

Ø  Bujangasana
This cobra pose asana opens up the lungs, increasing the oxygen consumption; the body gets purified, with extra oxygenation. It also helps in relaxation of the mind. There is stretching of the spine, which improves the sympathetic and parasympathetic activities, any tiredness due to long working hours, travelling, pollution or bad postures are rectified with bujangasana.  It is a common complaint that we hear from patients,  that they were too tired to have sexual intercourse.

Ø  Ardhapavanamukthasana
When the thighs are squeezed on to the abdomen and chest, the pancreatic juices are released. This helps in prevention and curing of diabeteand the nerves supply to the pelvic gets maximum stretches. Erectile function is supported by complex neurological function from sensory, sympathetic parasympathetic nerves.

Ø  Vajrasanam
The heel of both the feet should be pressing the buttocks region. This compresses the prostatic gland, which produces the enzymes and the fluid to carry the sperms. Prostatic massage is effective in increasing the volume of the semen and the enzymes- alkaline phosphatase.

Dr. Anita Mani
Infertility& Surrogacy Specialist at Gift IVF Centre


Dr. Anita Mani is a renowned infertility specialist in south India with 15 years experience in ART (Assisted Reproductive Technology). Dr. Anita has successfully set up ART hospitals in Cochin and Bangalore,  along with her spouse  Dr. S Mani, who specialises in surrogacy. She completed MRCOG, from Royal College of Obstetrician and Gynaecologist  London, DFFP from  ART Warwick university and  worked in UK for 5 years. Dr. Anitha believes in scientific and ethical practice and is currently the director of Gift Gyno IVF centre Cochin and  Bangalore.  Apart from advanced laparoscopic surgeries, she is also an expert in various ART techniques including IVF, IUI, ICSI , donor egg / sperm  and surrogacy. Her proficiency is in genetic abnormalities and high risk pregnancies.

Thursday, 3 July 2014

Endometrial receptivity assay ERA - success after repeated IVF failuresat GIFT ivf center

Endometrial receptivity assay ERA - success after repeated IVF failures at GIFT ivf center 

   At the age of 37 years , and after failing 4 IVF cycles, she came for donor egg plus surrogacy. She had history of PCOS and he had teratozoospermia.
After a scientific analysis, we felt she needed to have hysterolaparoscopy, which was surprisingly never suggested . Flimsy tubal adhesions were released and ovarian drilling was done. We also performed endometrial receptivity test ( ERA ). This is an analysis of expression of 238 genes, to check if the endometrial lining, allows implantation. The test was positive and she was very much reassured by the fact that she can conceive.
While they were waiting for a ivf with donor egg next cycle , I suggested IUI. To our great surprise , she conceived and had a smooth pregnancy and Caesarian at term. The healthy girl baby is very cute. I am sure that she will be as bubbly as her mother. I am so happy to see them hold their own baby and save lot of expenses.
Psychology plays an important role in fertility, which we ignore most of the time .
Dr Anita mani.