Is modern lifestyle the ground for the rising cases of infertility among women ??

Have you ever thought why few decades back, a childless couple was hard to find? I would like to shed some light on factors other than the natural or medical reasons due to which women fail to reproduce. The new sedentary lifestyle changes have not only increased diseases like diabetes, Blood Pressure and cholesterol, but it has also created a new menace - infertility. Stress, age, poor diet, sexually transmitted infections, medications, abortions, alcoholism, smoking and drug use adversely affects fertility in women.

1. Medications may impact fertility. Some medications and steroids prescribed to treat asthma , BP and thyroids have found to upset the normal ovulation pattern in women.
2. 
   
3. Alcoholism, smoking and drug use in women can also cause ovulation disturbances and endometriosis often resulting in infertility. Smoking can not only block the cervix and fallopian tubes but also cause premature aging of uterus, resulting in early menopause and sometimes miscarriages.http://bangaloreivf.blogspot.ae/2014/08/early-diagnosis-of-endometriosis-for.htmlhttp://bangaloreivf.blogspot.ae/2014/08/blocked-or-damaged-fallopian-tubes-can.html
4. Intake of a healthy and nutritious diet will go a long way in enhancing fertility. Zero figure is the fad of the day and lot of women are exercising and dieting vigorously for achieving this goal. But being both underweight and obese can impair fertility.http://bangaloreivf.blogspot.ae/2014/10/too-much-gym-reduces-chances-of-having.html
5. Age is also a deciding factor in pregnancy. Women are born with a fixed number of eggs. As the years pass, the number and quality of the eggs diminish and eventually gets depleted. So chances of conceiving will keep going down after the age of 30 and will considerably reduce after the age of 40. The trend of late marriages and postponing pregnancy for a long period, even after marriage is one of the major causes of infertility.http://bangaloreivf.blogspot.ae/2014/08/why-do-women-end-up-having-poor-quality.html
6. Too much stress while trying very hard for the pregnancy itself can cause  
   infertility problems. Though the exact connection between stress and   
   infertility is not proved, studies show there is definitely a link. So avoid
   stressing yourself, relax and be happy.         http://bangaloreivf.blogspot.ae/2015/01/scientific-benefits-of-regular-sexual.html
7. MTP or medically terminated pregnancy is usually safe, but can          sometimes cause complications like infections leading to blockage of        fallopian tubes resulting in infertility.         http://bangaloreivf.blogspot.ae/2014/08/blocked-or-damaged-fallopian-tubes-can.html
8. Sexually transmitted diseases like Chlamydia and gonorrhea can cause       infection in fallopina tubes and uterus permanently damaging them. Safe sex practice and sex with single partner is strictly advised to avoid infertility  issues.

So if few life style changes are made, the trauma undergone by many of the childless couples can be avoided. Exercise regularly in moderation, take a healthy diet and practice some relaxing hobbies like painting, music or yoga. 

http://bangaloreivf.blogspot.ae/2013/11/yoga-and-fertility-most-powerful-effect_25.html

Dr. Anita Mani
Infertility Specialist at Gift IVF Centre

anitadane@gmail.com

www.giftivf.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.

Case of positive screening for downs syndrome

Case of positive screening for downs syndrome

Dr.Anita mani

anitadane@gmail.com

The patient who conceived with IUI, after history of teratozoospermia ( abnormal sperms) , had screening test at 10 weeks with double marker test. The result came positive for downs syndrome . This is an indication that the the baby maybe suffering from downs syndrome, but we cannot confirm if the  baby actually has downs. It is often very stressful for parents to receive such a report . They need to undergo further tests like NACE or Amniocentesis to confirm or rule out downs. NACE will further screen  and is done to avoid amniocentesis , but it is not diagnostic. Amniocentesis will be done to confirm whether it is true downs or just a false alarm. If NACE test is also positive, Amniocentesis should be performed directly , it is done by taking fluid around baby and doing genetic test on that .

Downs syndrome is an abnormality of chromosome number 21, and those babies are mentally challenged and may have other abnormalities like cardiac problems as well.

Tips to improve IVF lab - Automatic carbon dioxide cylinder change

Tips to improve IVF lab - Automatic carbon dioxide cylinder change

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

In IVF lab , it is very important to have constant Co2 to all incubators ,as the embryos will not grow , if there is interuption . 

There are cylindres which supply the Co2,  just like the  LPG cylinders at home , these also become empty, with time. The constant supply is important as any delay can effect outcome . Usually when manual checking is done , there is always risk that it may become empty at night and may not be noticed  Therefore co2 sensors are connected , which gices alarm,  but again somebody doesn't promptly respond to alarm , especially at night , there can be interruption in supply temporarily . 

The automatic co2 changing equipment allows 2 cylinders to be connected , and as soon as 1 cylinder is empty, it will automatically connect to the other cylinder . It is a good mechanism , and chances of co2 failure  is minimal. This is not  installed in most of the IVF labs ,.even in art units in Uk ,  still the old method of alarm system is followed, wherein  somebody needs to personally attend to the problem, sometimes they have to be summoned from home in the night to fix the problem.

Women often undergo miscarriages, surgeries and ART for male sub fertility

Throughout my experience as an infertility specialist since 18 years, I have observed that there is a general misconception among Indians that failure to attain pregnancy is mostly due to medical problems in women. But this is just a myth, as men are also facing as much infertility issues as women. Many times the female partner undergoes all the painful procedures, even if the complication is related to male infertility or sub fertility.

The fact is that abnormal sperms can result in abnormal embryo and often this will result in miscarriage at first trimester and the woman may experience pain and bleeding and require undergoing D&C. There are again chances of tubal pregnancies, which may need surgery and which unfortunately may lead to maternal death in around 1 % of ectopic pregnancies.

The women may have to undergo IUI, ICSI or IVF for getting pregnant after vaginal scans and during these procedures, it is not just the pain or the side effects of medicines, but the emotional trauma which is difficult for the women The women suffers silently, during miscarriages and painful procedures, while the society and relatives often points finger at her even though the entire problem lies with the male partner. It’s really heartbreaking to witness my women patients forced to divorce for not having babies, wherein the problem is azoospermia (condition of absence of sperms) in husband. It is indeed a pathetic situation, I wish the men will understand this and be more considerate and caring towards women. Opting for donor sperm may be better in many cases, as they won't end up bringing up children with abnormalities. Men should undergo chromosomal test (karyotyping) when they have abnormal semen analysis for early pickup of problems.

Dr. Anita Mani
Infertility Specialist at Gift IVF Centre
anitadane@gmail.com
www.giftivf.com
bangaloreivf.blogspot.in

Failure of LH surge could indicate poor egg quality

                    Failure of LH surge could indicate poor egg quality

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

Failure of LH surge could indicate poor egg quality, as in this patient . She is 34 years, and follicle has been  hovering around 18 mm for last 4 days, with no sign or rupture and ULH is also negative . Her endometrial lining is 6 mm , which indicates low oestrogen.

We started oestrogen ,and lining improved ,but still not good . Advised to do AMH , as we may have to think of IVF\ ICSI , early.

Cancel IUI for Premature rupture of follicle in PCOS

                     Cancel IUI for Premature rupture of follicle in PCOS

Dr.Anita mani

anitadane@gmail.com

It was confusing that the ULH was positive, but follicles are small in today's scan for this patient. So went through records to see the reason , she was having PCOS , and was on low dose injections to stimulate ovary , what happened is that , she developed 6 follicles each side and premature surge of LH happened because of high level of oestrogen.

The chances of fertilisation are poor , so we cancelled IUI .

Many times , this gets missed if , ULH test is not combined with follicular study and if scans are not repeated during IUI .

To avoid  this, antagonistic injections can be given , which was not given in this particular patient , as i underestimated her PCOS .

Scan report 

Left - 15,14,14,14, 12, 12 

Right - 14, 12, 12,12 ,10,10 

EL - TL+  9mm

Success rates in infertility treatment

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

                    Success rates in infertility treatment

IUI

World wide , IUI success  rate is around 7 to 20 % .

Medicines 10 % , medicine plus injections 20% .

it will be higher if 4 to 6 cycles are done . Also the success is higher with donor sperm IUI (20 to 40%after 4 cycles ) .

At GIFT, IUI success is 8% in Bangalore and 13 % in cochin , the quality of sperms are quite bad in Bangalore generally .

IVF

International Success in IVF is 30 to 60 % depending on quality of embryos , which in turn is dependant on the quality of gametes . Younger the women, better the result. BMI and ovarian reserve are other important determining factors. There are genetic problems in 50 % of the cases, which mostly doesn’t  get detected leading to low success.

At GIFT, success is high in couple with normal children and in young women less than 30 years , 60% .(  foIVF for secondary infertility can be done for couple with child ) Donor egg IVF success is 60 to 80% in women with healthy uterus.

ICSI

Success in ICSI is similar to IVF, but will be less if the sperms are very poor in quality .

Even if egg fertilises , it may not implant if its not good embryo. GIFT success in creating embryo is high , ie 80% , but live birth rate after ICSI for abnormal semen is around 30% .

Laparoscopy

Laparoscopy is very effective in infertility treatment , especially in case of PCOS, and 60 % conceive after the procedure .

Laparoscopy for infertility treatment

                                    

  

Laparoscopy,which is also known as keyhole surgery or minimally invasive Surgery  is the surgical method, in which a small camera is passed through the umbilicus to visualize  the internal organs on a monitor. The surgeon can  perform even complicated surgeries like removal of uterus  easily through this procedure.

Advantages

1.     No hospital admission is required.

2.     Wound is small and less than 1cm.

3.     No need for rest.

4.     Precise surgery.

5.     Minimal blood loss.

6.     Short surgery.

7.     Surgery can be recorded and viewed later.

8.     Enlarged and clear view compared to open surgery.

9.   Cost is comparatively less, when the loss of job and loss of work at home is taken into account.

10.Excellent treatment for infertility,  especially for checking tubes and ovarian drilling in PCOS.

11.Infections are much lesser compared to open surgery and are easily treatable.

12.Easier for surgeons, especially for obese patients as laparotomy is difficult in such cases.

13.Risk in diabetics patients is minimal.

14.Less chance for thrombosis (blood clotting)

15.Hysteroscopy gives good vision of uterine cavity and it is possible to remove polyp, fibroid or correct septum.

16.No weight gain risk,  as patient do not need rest post operation.  

17.Risk of post op adhesions less.

18.Laparoscopy can be repeated any number of times as the cut is very small.

19.Risk of injury to viscera is also minimal.

If pregnancy cannot be achieved even after 3-6 months of treatment, ideally laparoscopy should be done. Taking medicines blindly is bad for the body, as it may increase risk of cancer in future. The skill of surgeon is very important in laparoscopy  for getting a good result.

Common surgeries:

Diagnostic Hysterolaparoscopy

Done to evaluate the inside and outside of uterus, B/L tubes, ovaries and pelvis. Tubes can be checked for block and infection in vagina, cervix, and pelvis can also be detected.

Laparoscopy  & ovarian drilling

This is very effective in PCOS for getting rid of old follicles and stimulating the ovulation process.   

Laparoscopy tubal/ Fimbrial cystectomy

Small cysts in tubes make them ineffective in picking up the egg after ovulation, even if the tubes are open. The surgery is very effective to rectify this problem.

Laparoscopy &  ovarian cystectomy

Different types of cysts which are formed in the ovaries can be managed by laparoscopy.

Laparoscopy  & cauterization of endometriosis

Endometriosis causes block in tubes, adhesions, stops ovulation and can cause pain. This surgery needs good skill and high precision and is very effective in infertility cases.

Laparoscopy for ectopic pregnancy

Pregnancy occurring outside uterus can be removed by this method.

Laparoscopic myomectomy

Fibroids are benign tumors of uterus and can be removed if they affect fertility or if they are symptomatic.

Diagnostic hysteroscopy

Is conducted to check if the cavity is normal in size, shape and if tubal opening is clear.

 Laparoscopic varicocelectomy  

 is done for men with complaints of varicocele.

Other laparoscopic surgeries include laparoscopic hysterectomy, laparoscopic appendectomy, laparoscopic cholecystectomy, Hysteroscopic polypectomy,       hysteroscopic septal division, hysteroscopic tubal cannulation etc. 

Dr.Anita Mani

anitadane@gmail.com

Infertility Specialist at Gift IVF Centre

Steps in IVF

                                                                    Steps in IVF

The procedure in which the eggs are fertilized outside the body with husband’s sperm to obtain an embryo is known as IVF

Indications:-

When the tubes are blocked due to diseases like endometriosis, pelvic infections, ovarian cyst etc, the eggs and sperm will not meet and fertilisation does not take place. Surgical correction may not be possible or successful in some patients and IVF is done for them.Sometimes, even with normal tubes, fertilisation does not happen,specially in women with PCOS. IVF procedure is done, when other treatments do not work. Even in unexplained cases of infertility, IVF can be done. 

ICSI is done for male infertility.

 

 Steps:-

Initial consultation for detailed evaluation, fitness tests with blood and urine tests, Mock Embryo Transfer (MET), Counseling, Consent form completion etc are done in O.P setting

Consultation & Counselling:-

About procedure, method, duration, cost, side effects, success, frequency of visits etc. are given

Fitness Tests :-

Detailed history of husband & wife, medical examination of both partners ,Lab tests for blood routine, sugar levels, hormone levels like LH, FSH, TSH, prolactin, infection screening HIV, HCV ,hepatitis B, syphilis, USS(Scan) is a must to check pelvis , and is done by Gynecologist herself.

MET (Mock Embryo Transfer):-  

  

Trial of embryo transfer, without actual embryo is conducted to check the position, length and ease of E.T. This helps doctor to decide how to perform E.T. Some time , sedation is given if patient is anxious.Dilation (D&C) is done with GA if Cervix is tightly closed.Different type of harder cannula is used if cervix is curved.  Infections detected in Cervix/Vagina are treated accordingly.

Ovarian Stimulation:- Ovaries are stimulated by daily injections (FSH) starting D2 or D3. They are small injections given just under skin or IM and needs to be taken daily for 9-12 days.

Doctors will check the growth of follicles by scan on and off. When the eggs are matured , that is when it is around 20 mm, a final injection with  hcg is given.Egg collection (OR) is done under sedation/GA after 36 hours of hcg injection.

Egg Collection (OR)

The doctor uses a small long needle guided through the vaginal scan probe, to collect the fluid from the follicles. This is done with extreme precision, with the doctor watching the needle on scan, all the time, to avoid  injury to other internal organs.

 Embryology:-

All the follicles are tapped using suction force, and the eggs are identified by the embryologist under specialized microscope in the IVF lab. The eggs are then mixed with washed sperms from husband, to fertilise on its own.

The embryologist will keep monitoring the embryos for growth  and will provide media for its growth and keep it in an incubator,  which provides set temperature & PH for the growth.

  Embryo Transfer (ET):-

They are transferred on day 3 or day 5 into the uterus by Embryo transfer(ET). The technique of ET is highly skilled procedure. As they are very delicate, the  embryos need to be handled in a very gentle manner and they are loaded in very soft,  non toxic cannula. Difficulty, or presence of blood suggest high chances of failure. So the ET is  performed with great concentration and high precision. 

Luteal Support:-

Medicines are given to support the growth of the baby as Vaginal preparations , called Luteal support.

Pregnancy Test:-

UPT is done by 14th day to check result. Blood test (bhcg) can also be done.Depending on the result, doctors will give further advises.

FET (Frozen Embryo Transfer):-

Embryos can be frozen if there are excess embryos. They are transferred (FET) in the later months according to cycle.

Counseling:- 

In cases if pregnancy does not occur due to failure of implantation or poor embryo quality, doctors will counsel to provide further options and to clarify your doubts.

Success Rate:-

Depends on quality of egg and sperm and physicians skill also plays a part. Generally we have 60% success in young healthy couple, 30% success in aged (more than 35 years) 

Dr. Anita Mani

Infertility Specialist at Gift IVF Centre

anitadane@gmail.com

www.giftivf.com

bangaloreivf.blogspot.in

 

Cost of donor egg IVF

Cost of donor egg IVF

By Dr.Anita Mani

anitadane@gmail.com

Cost 

Cost includes preparation of donor , donor IVF/ ICSI and donors expenses and renumeration.

Preparation charges of the donor involves following cost 

Psychological analysis                                        

Counselling.                                                        

Background check - of donor                     

Blood tests , urine tests

HIV, HBASG,HCV,VDRL,RBS, FBC,LFT,RFT and others as needed                    

Medical checkup                                                   

Past Medical history, surgical history , family history, gynaecological & obstetric history , details of previous pregnancy ,delivery or Caesarian , any complications , birth weight of previous babies, any history of smoking, alchohol ism,drug abuse

Examination  includes BP, wt , ht , Cardiovascular system,Respiratory system,Per abdominal examination, Per vaginal examination and speculum examination  (ECG, CXR if needed)

Trans vaginal scan                                               

Transport                                                                

Food                                                                      

Accommodation                                                    

Consent by lawyer.                                                

Screening of partner of donor for infections by blood test  

Medicines - contraceptive pills to adjust date , folic acid, multivitamins -                                     

Payment for coming for screening and checkup 

Record keeping ,file                                               

Admin charges                                                       

Doctors fee , nursing charges              

                 

Total cost 

Total cost Depends on donor profile , but it is roughly around 3 lakh INR , for full donor cycle which include 3 cycle ( 1 fresh and 2 Frozen cycle) . FET if required will cost 20,000 for thaw and transfer fee.

Upto dec 2014 

Donor egg IVF/ ICSI

By Dr.Anita Mani 

anitadane@gmail.com

GIFT IVF Center

When the women is unable to produce healthy eggs to have a baby, donated egg can be used to achieve pregnancy through donor egg IVF. The below steps are followed during and before the procedure

1.     Counselling:  Is done to make the parents aware of the future  implications of undergoing donor egg IVF.

2.     Medical screening :    Both recipient , donor and their partner needs detailed screening with Medical history, family history , examination, Blood tests, urine tests and Scanning

3.     Legal procedures : Consent forms and legal procedures are meticulously completed. Advocates are involved for proper legal documents.

4.     Synchronization:  Both the recipient and the donor are given medicines ,  to synchronize their periods to similar dates.

5.     Priming  :   Recipient is given medicines , for her uterus to prepare the lining to accept the embryo. She needs to reach clinic only by 12^th  day for scan , so travel dates can be arranged accordingly and arrangements made  to stay for around 1 week until Embryo Transfer  is completed .

IVF (In Vitro Fertilisation):       

 Injections are given to the egg donor to stimulate the ovaries .Scan guided egg pick up is done under general anaesthesia .Steps of IVF are followed and donors eggs are fertilised with either the husbands’ sperm or donor sperm depending on request. subsequently, the same steps for IVF protocol are followed and the resulting embryo is transferred  to the recepient .

 Criteria   

 At GIFT we have strict donor criteria.

1.     Medically, physically, mentally healthy women less than 28 years.

2.     Minimum qualification of graduation is a must.

3.     Colour matchingof skin and hair is done.

4.     All lab tests, scanning, screening must be completely normal.

5.     All the legal papers must be signed.

6.     Doctors screen them to make sure, that they are good individuals.

7.     We are also very particular that babies should be looked after well, so detailed counseling  is done before selection.

Confidentiality 

Strict confidentiality is maintained at the hospital. All the staff of GIFT have taken the ‘oath of secrecy’ and is aware that , any breach will result in imprisonment.Only the doctors will know the exact identity of both, and this  will never, ever be revealed to anybody else.

The details of using donor egg or donor sperm  must be known only to partners and not to any family or friends. We will not do the treatment, if other family members are involved

Success 

Success is usually 60 to 80% if 3 cycles are  done , if the patient has a healthy uterus .

Cost 

Cost includes preparation of donor , donor IVF/ ICSI and donors expenses and remuneration.

Breast cancer in IVF/ ICSI patient

Breast cancer in IVF/ ICSI patient 

The 37 year old patient being prepared ivf , casually complained about a breast lump .she was coming for second attempt after failed ICSI  from a different country 

 After examination , we strongly suggested a surgical biopsy , which later confirmed a breast cancer. She had mastectomy last week and is recovering.

Timely intervention saved her life .what if i carried out ivf and it ended up in pregnancy , then we would have a situation of baby and mother at risk .i had to force them to go to a surgeon , as they were reluctant , because of the limited time they had for IVF.

It is very important for any breast lump to be investigated. There is higher  risk in infertile women as they have not done breast feeding . There is also risk related to intake of oestrogen , which should be used judiciously in practise .

Dr anita mani 

anitadane@gmail.com

Marriage among relatives increases foetal abnormalities

The practice of marrying first cousins (consanguineous marriages) is rampant in countries like India, Pakistan and Bangladesh. There are several grounds for this ongoing tradition, sometimes it  is for protecting the family property, sometimes it is just for cultural and social reasons.  Statistics  reveal that, one in ten children out of these marriages develop genetic abnormalities and die in infancy or keep suffering from serious disorders through their entire life.

The explanation for this disorder lies in the recessive gene disorders. Every human being is a carrier of some abnormal recessive genes, but in most cases no visible defects are observed because the normal gene overrules the abnormal one. But in consanguineous marriages, both the partners often carry the same abnormal recessive genes, hence the chance for their child to develop genetic abnormalities like blindness, deafness, heart, kidney, lung, liver ailments are very high. Even if the children does not show any visible symptoms, they can still act as carriers and still chances are there that the next generation will be affected.

Below is the case of  a consanguineous couple, who had to suffer repeated neonatal deaths. The couple  were first cousins and had 3 incidences of their babies death. The chromosome analysis showed a minor abnormality in both the parents, who appears perfectly normal otherwise. The same abnormality seen in both of them was again seen in the result of the baby ( expired).

Now they have come to us for donor sperm or donor egg treatment. We have counseled and informed them that although less, there  are still chances for abnormalities, as they will still be using one gamete with the genetic problem. But we cannot conclude anything for sure. They may still have chance for a normal living child, but cannot guarantee.

We have an option of testing baby in the womb at  10 weeks after pregnancy happens. But I would rather advise the parents not to do the test, in order to avoid unnecessary termination of pregnancy, as the baby may be having it  and still be viable.

Genetic testing and counseling is a very important aspect of infertility treatment, as most of the time the women fail to conceive or have abortions because of genetic problems.

Dr. Anita Mani
Infertility Specialist at Gift IVF Centre

anitadane@gmail.com

www.giftivf.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.

Fathers result 

Mothers result 

Childs report( expired ) 

Is smoking the reason for your Infertility?

It’s a well known fact that smoking is a silent killer causing cancer, heart problems, stroke and pulmonary diseases. But numerous studies have also clearly identified a clear link between smoking and male / female infertility. "Vitality and beauty are gifts of Nature for those who live according to its laws."

Several researches and studies conducted worldwide reveals that considerable degradation  of semen quality in smoking males  were noticed  compared to their nonsmoking counterparts. 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.

Human sperm comprises  proteins called protamine 1 and protamine 2. In smokers, the perfect balance between these two proteins is lost and 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 looses 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.

Smoking---------> alter protiens in semen -------> DNA damage--

-----> failure of fertilisation, infertility,  miscarriages, abnormal babies

Smoking------> nicotine -----> steroid release-----> alter FSH, LH,PRL----->male infertility

Smoking------> clogged arteries --------> Erectile problems-----> male infertility

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.

Bottom line is " if you want to cuddle a hale and healthy baby, then don’t delay and quit smoking today".

Dr. Anita Mani
Infertility Specialist at Gift IVF Centre

anitadane@gmail.com

www.giftivf.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.