Tuesday 8 December 2015

Hazards of smoking on male and female fertility


                             “Love yourself enough to lead a healthy life "

We know that smoking can be a ground for cancer, heart problems, stroke and pulmonary diseases. Sadly, the list doesn’t end here, studies and analysis conducted worldwide indicates that smoking can cause infertility in both men and women. Smoking is not good for the health of  sperms and in turn has adverse affect on fertility. The fact is that smoking can actually cause infertility, miscarriages, preterm labours, growth retarded babies and the worst - childhood cancer.

Shocking fact is that more than one-third of the world’s population over the age of 15 years are smokers. 
Cigarette smoke contains more than 4000 harmful chemicals. It has around 60 carcinogens and mutogens including nicotine, carbon monoxide, heavy metals, benzopyrene, dimethylbenzanthracene, dimethylnitrosamine, naphthalene, and metanaphtalene. 

Negative consequences of smoking on  male fertility

The smokers semen samples showed reduced sperm count, motility  and viability. This low quality sperm is  less likely to fertilize eggs, which in turn inhibits the chance of conceiving.

Mechanism of action
Creatine kinase (CK) is an enzyme, expressed by various tissues and cell types that require high energy. This enzyme reversibly catalyzes conversion of creatine and adenosine triphosphate (ATP) to phosphocreatine and adenosine diphosphate (ADP). CK activity in seminal plasma, sperm cells and total semen considerably diminished with smoking. 

There is  permanent and severe DNA damage leading to prevention of oocyte fertilisation or the development of the embryo resulting in miscarriages. This damaged sperm loses its power to ward off destructive free radicals in semen. Toxic materials have also been detected in smokers semen. Nicotine  is also known to alter the hormonal balance through stimulation of cortisol, the growth hormone, which in turn will  curb the release of LH,FSH and PRL. Smoking can also lead to erectile dysfunction due to circulatory problems caused by the blocking of arteries.

The reactive oxygen species ( ROS) are atoms with unstable electron and are byproducts of metabolism of glucose in living cells. They grab electrons from surrounding atoms, making them unstable, which ultimately becomes like a chain reaction, making the cells damage, degenerate or mutate. The ROS is found to be high in smokers. In normal conditions anti oxidants  repair the negative effects by donating the extra electron that the ROS requires. The levels of antioxidants are found low in smokers, even their capacity to neutralise ROS is found to be less.

Leukocytes (WBC) are the major source of reactive oxygen species (ROS) in the ejaculate and elevated leukocytes impairs fertility by the formation of reactive oxygen species, which are in turn harmful to sperm DNA and membrane phospholipids because of oxidation, thus damaging sperms and causing mutation of genes leading to abnormalities. For more details on antioxidants read http://bangaloreivf.blogspot.ae/2015/10/what-are-antioxidants-and-their-benefits.html

Negative consequences of smoking on  female fertility


It is highly advisable for women to quit smoking before they plan their pregnancy. A pregnant smoker is risking her unborn baby’s life, as smoking aggravates the risk of spontaneous abortion, premature birth, very low birth weight, sudden infant death and ectopic pregnancies. I advice my patients to quit smoking at least 3 months prior doing the IVF procedure, as smoking unfavorably affects the procedure through premature aging of ovaries. Physiology of the men is such that they keep producing semen throughout their life. But women are born with a fixed number of eggs, if these eggs are damaged or depleted no amount of treatment can bring them back. Heavy Cigarette smoking has proven to cause tubal and  cervical problems  and DNA damages to the ovarian follicles. Even early menopause caused by premature aging of ovaries has been linked to smoking.


Dr. Anita Mani
Infertility Specialist at Gift IVF Centre
anitadane@gmail.com

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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. 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. Her proficiency is in genetic abnormalities and high risk pregnancies.



Sunday 6 December 2015

Myths and Facts About Infertility




Infertility is a women's problem
This is untrue. It is shocking that even some of the educated people are quite surprised to know that infertility is a female problem in 35% of the cases, a male problem in 35% of the cases, a combined problem of the couple in 20% of cases It is commonplace that most of the cases of failure to conceive are blamed on women

I don't have to worry about my eggs until I'm 40.
As a woman ages, the ovarian reserve declines. A woman's egg supply starts to decline in the late 20s, again in the 30s and then most notably after age 35.
Under the best of circumstances, even in the case of a healthy young fertile couple whose timing is perfect, on the average, there are just about 25% chances of conceiving per month.So as the age factor goes up, chances of conceiving comes down drastically.

Maybe you two are doing something wrong!
Infertility is a medical condition, not a sexual disorder in most of the cases.

Men with Azoospermia ( zero sperm ) Cannot have kids 
Obstructive azoospermia is a medical condition when the person produces sperm, but it does not come out in semen due to blockage in the male reproductive tract, Testicular aspiration can be done to aspirate sperms and  ICSI can be done to achieve pregnancy.

Women without womb ( uterus ) cannot have babies

Infertility does not affect marriage 
Researchers found that, over a span of 12 years, 27 percent ( one-third ) of women who did not have children after their fertility treatments were no longer living with their partner. The study  comprised of 47,515 Danish women.


IVF is only the last option 
IVF can be the first treatment option for women with bilateral blockage of tubes, severe male infertility, and advanced age. Unnecessary delay and risks of prolonged treatment can be avoided by timely IVF.

IVF is only for affluent people
The cost of IVF has not increased over the years. it is less than buying a vehicle / furniture these days and results in a lifetime of happiness.


Women cannot conceive after menopause 
Through egg donor IVF, women can easily have children at any age.


Adoption is difficult
Earlier, many couples found that adoption was costly and time-consuming. 
New guidelines for adoption of children has become operational and under the new system, parents in India need not approach adoption agencies for registration. Parents can register online and upload relevant documents to determine their eligibility.

Infertility is nature's way of controlling population.
Zero population growth is a goal pursued now in this time of world overpopulation, but logically speaking couple can still have two children.


It is not an easy situation when you are struggling with infertility. You know what loving parents you would be, and it is painful to have to explain to others that you have a medical problem.

Dr. Anita Mani
Infertility Specialist at Gift IVF Centre
anitadane@gmail.com

-----------------------------------------------------------------------------------------------------------------------

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. 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. Her proficiency is in genetic abnormalities and high risk pregnancies.