PERILS OF SLEEP DEPRIVATION

What our forefathers believed centuries back makes sense today- “ Early to bed and early to rise makes a man- healthy, wealthy and wise." In today’s hustling and bustling calendar, it is almost unworkable to follow this wise thinking, but if you want to have a physically and emotionally stable life and want to be in the pink of health when you reach old age, unquestionably you need at least seven to eight hours of uninterrupted quality sleep in a day. It’s interesting to learn that the sleep needs of respective individuals are dissimilar, so if one person’s sleep quota is completed in 6 hours, another individual may require ten hours, yes, you read it correctly ten hours. Some theories even suggest that women require more sleep than men.

WHAT IS KEEPING YOU AWAKE

Have you ever been puzzled why the new generation is tormented by so many chronic illnesses compared to our grandfather's and great grandfather’s generation? The answer may be traced to the deprivation of sleep, combined with increased stress along with other environmental factors. The main cause of sleeplessness can be attributed to smartphones and other modern gadgets. Before popping sleeping pills, try to find out the cause for your misery through self-evaluation and find solutions like yoga, meditation or other forms of relaxation like music or dance. Some people have medical conditions of insomnia and depression which needs to be treated with medicines.

WHY SLEEPING WELL IS IMPORTANT FOR KIDS

I have heard several parents complaining that their kids are not concentrating on their studies, they cannot remember anything even after hours of toil, they always appear tired and exhausted. I always advise these parents to see that the kids are getting proper sleep. It’s not only video games or smart phones which are stripping the valuable hours of sleep, often long hours of tuitions and training are the culprits of burdening the budding minds. If you do not want them to grow up into emotionally and physically drained individuals, please see that they get appropriate sleep.

WHAT HAPPENS WHEN YOU ARE SLEEP DEPRIVED

You will be shocked to know that apart from depression, tiredness, mood swings and lack of concentration, sleep deprivation also leads to diabetes, heart and kidney problems, hair loss, early aging etc. There is a general perception that over- sleeping will lead to weight gain, but did you know that inadequacy of sleep can also lead to obesity. Hormone levels in the body are upset by sleep deficiency, which leads the mind to think that you are hungry, even when you are not and you keep eating and the result is obvious. Sleep deprivation can bring diabetes closer to you and it also shoots up the level of blood sugar in the diabetic patients. Sleeplessness can also indirectly cause sub fertility due to stress and depression.

SLEEP PATTERNS

Do not consider sleep as just a waste of time, your body is repairing and rejuvenating itself when you are under a deep slumber. The brain is not switched off during sleep, intriguingly brain activity is often accelerated in sleep. Sleep patterns can be broadly classified into two – REM (rapid eye movement) and NREM (non rapid eye movement)  and in the span of a night’s sleep, the body keeps changing between these stages in a cyclical pattern. There are stages of light sleep and deep sleep. In REM sleep, you might be dreaming and the eyeballs will be moving, but the body will be motionless and muscles are relaxed. This may be a body mechanism to avoid you acting out in the dream. This is the stage when a person is most difficult to be awakened.

After a good night’s sleep, you wake up feeling refreshed and full of energy, on the contrary, if you miss couple of hours sleep you wake up like a zombie, drained and tired.

"Sleep that knits up the ravelled sleave of care
The death of each day's life, sore labour's bath
Balm of hurt minds, great nature's second course,
Chief nourisher in life's feast."

-William Shakespeare, Macbeth

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 the 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.

Posted 1 week ago by Anitha Mani

Steps to be followed if you cannot conceive after trying for a year

The first and foremost thing to remember is ‘NOT TO PANIC’, keep in mind that anxiety and tension will stand in the way of your pregnancy. So relax and calm down, in many cases pregnancy is achieved over a period of time without any treatment.  Medical science has advanced so much that there is a solution for most of the problems. One small word to the friends and relatives as well, “please don’t taunt the couples with questions of the impending pregnancy. Do not trouble the already distraught souls”. Stress causes sub fertility, so try to reduce stress and spend quality time with your partner. http://bangaloreivf.blogspot.ae/2014/09/reduce-stress-to-improve-fertility.html

There are some simple tests and procedures which can detect the cause of infertility and more often than not, some simple procedures or medication can give you the result.  I frequently get patients who have undergone multifarious expensive tests and treatment in infertility centers, but some basic inexpensive tests which would have given the definite reason of the complication were omitted. Sadly as the years pass by, the chance for a successful pregnancy starts dwindling and the desperation and dismay along with the financial drain leads to depression and isolation.

The tests which are to be undergone varies from person to person,  I would like to suggest some basic tests which might reveal where the problems lie. In many cases, a simple laparoscopic drilling can give instant results. Detecting the problem at an early stage and following up with prompt and appropriate treatment will increase the chance of pregnancy.

Tests for Men

Basic test is Semen Analysis

Tests for Women

AMH, On Day2 - LH, FSH, prolactin

Baseline Scan to check reproductive organs

Follicular monitoring for ovulation

Tubal patency tests

Lab Tests required For  Husband  & wife

General tests

C B C

R B S

Group+Rh

Urine R/E

For Infection screening

H I V 1 + 11

H B S Ag

H C V

VDRL

For Systemic Disorder

T S H

L F T

R F T

Genetic screening - Karyotyping might be required in later stages if multiple miscarriages or unexplained infertility

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 the 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.

Biogas - Transforming waste into energy

One of the greatest challenges faced by present world is the accumulation of waste. Organic waste can be used to produce biogas, which will lessen pollution, the burden of landfill and reduce the cost of waste disposal and revolutionize waste management. Many of the European countries and developed countries use organic waste optimally to produce biogas. In the present scenario, where the cooking gas has become expensive and world is facing shortage of fossil fuels, biogas can be the solution for many socio economic problems. Biogas can be used for cooking, heating and power generation. The byproduct of this process, the digestate slurry can be used as manure and is an excellent substitute for chemical fertilizers.

Anaerobic digestion is the method used in the production of biogas, in which organic waste is decomposed in the absence of oxygen by microorganisms. Biogas comprises of methane and little carbon dioxide and is a combustible gas. There are various stages in the production of this gas like hydrolysis, acidogenesis, acetogenesis, and the final stage is methanogenesis.  Through this process, harmful pathogens are destroyed and the waste is sanitized. The quality of the animal waste as a fertilizer is improved through this process and the digestate is a superb manure for plants.

Food waste, kitchen waste and animal waste can be used. Cow dung is most favorable in the production of biogas as the grass which the animal eats is converted into methane in the process of digestion. There will be no flies or bad odor as the drum used is tightly sealed and water proofed.

We have installed a small biogas plant in our premises and all the daily organic waste from our kitchen and hospital is put in this through a funnel and we get the gas through a pipe connection. I use the byproduct of this process, the liquid manure for all the vegetable and fruit plants and trees in my farm, thus avoiding the usage of harmful chemical fertilizers.

“PREVENT WASTING WASTE AND TURN IT INTO ENERGY”.  You can easily and economically install a mini biogas plant at home, this will benefit your family, the environment and the planet as a whole. 

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.

Link between alcohol and fertility

Numerous studies and researches conducted worldwide clearly point towards a direct link between alcoholism and male and female infertility. Fertility is inhibited not only by heavy drinking, even binge drinking has adverse effects.

Adverse affect on Male Infertility

If you are are an alcoholic having difficulty in having a baby, you have to realize  that alcohol may be hindering  your  dream of becoming a father. Alcohol can cause reduction in sperm count  and motility, result in abnormal sperms, impotency and  loss of mechanism of action.

Drinking reduces the LH levels and FSH levels, which are the main hormones responsible for spermatogenesis. It also has direct effect on testis by reducing the spermatogenesis.

Alcohol  reduces the testosterone levels and reduces the libido by acting at various levels. In heavy drinkers, there can be even complete failure, leading to testicular atrophy - meaning zero sperms.

When liver is affected, it stops producing Vitamin A and symptoms like gynaecomastia ( breast development ) can be seen in addition to other feminisation symptoms.

Effect on Female Fertility

It is not only the male fertility, even the women’s fertility also has to bear the brunt of  alcoholism.  The  ovulation process, menstruation cycle  and reproductive system of women is disturbed due the hormonal imbalances, often leading to irregular periods and problems in conceiving.

In addition to the physical and medical factors, psychological factors also play a major role in pregnancy. Alcoholism  tends to cause stress in the other spouse and often is the cause of many marital problems. Stress and unhappiness in the married life is often the indirect cause of inability to conceive. So it is highly advisable to quit drinking and adopt a healthy life style, if you are planning to extend your family.

Similarly, drinking while you are pregnant is a big NO.  Alcohol  reaches the baby through placenta and needless to say it is highly toxic to the tender fetus. It will damage the child’s undeveloped liver and there are chances of undeveloped brain, other  physical deformities or even miscarriages.

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.

The distinctive and magnificent herb - "Mint" (Pudina)

When we list out the food items of healthy and medicinal value, time and again the name of herbs are left out. Nature has kindly bestowed on us a lot of herbs which have high nutritional and medicinal value and Mint or Pudina occupies a top place in this list. Mint is not only a flavor enhancer used in cuisines, but also has a plethora of medicinal benefits. The antioxidant properties of this herb are amazing. Mint comprises around 15 to 20 species including peppermint and spearmint. Mint oil, a product made out of mint is used in gums, pain balms, toothpaste, beauty products etc.

Indigestion and IBS (Irritable bowel syndrome) 
The calming and relaxing effect of mint has a soothing effect on the intestine, which helps to control indigestion, flatulence, acidity and stomach cramps and upsets. 

Home remedy for cold 

From ages, mint has been used as a home remedy for treating common cold and cough. Natural menthol present in mint acts as a decongestant and helps to loosen up and oust out the phlegm. Taking a steam with few drops of peppermint oil will clear the nasal passage and bring relief to sinusitis. Mint has strong anti- inflammatory and anti- bacterial features, which can cure a  sore throat and prevent infection. For an aromatic and refreshing tea, just add a few mint leaves to the water, when you are making tea. 

Allergies 
In recent times, there has been a rapid increase in skin allergies and allergic asthma due to lifestyle changes and pollution. Rosmarinic acid found in mint leaves act as an anti – inflammatory substance which is a natural cure for allergies. This hinders the production of leukotrienes in the body which causes allergic rhinitis. The soothing effect of mint, the anti – inflammatory and anti – bacterial properties also aids to maintain an acne and blemish free skin. It is one of the ingredients widely used in natural beauty products to enhance the glow of the skin.

Painkiller 
Mint extracts and oil is a major component in many of the pain balms and medicines. It has the power to reduce aches and pains when applied externally. Even consumption in the form of tea is said to calm the nerves and muscles. Women can find relief from menstrual pains, cramps, and other associated discomforts by taking the mint.

Oral and dental health 

Toothpaste companies use mint as an ingredient not only for mouth freshness and preventing bad breath, this herb has anti-bacterial and anti-inflammatory properties which will help in the overall dental and oral health. Chewing few leaves of fresh mint will ensure that you won’t get bad breath.

In addition to the above-mentioned uses, mint is also said to have anti - carcinogenic benefits and is useful in improving the overall immunity of the body.

  

The mint leaves which we buy from the market are often laced with pesticides, hence planting them in a pot is a great idea, just keep them near the kitchen window and pluck them fresh and use. Please don’t limit the use of mint leaves as a garnish or in biriyani or mint chutney.You can use them liberally in all curries, salads, cocktail and mocktail drinks to get the zing and flavor. When combined with fruits it imparts divine taste, so don’t be stingy while using them in fruit salads, fruit puddings, chocolate cookies etc. Tickle your imagination and sky is the limit.

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 18 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.  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. She has also set up an Ayurvedic centre named SATYA, a holistic wellness center located in Athani near Kochi Airport Junction, where the ancient healing of Ayurveda, Yoga, martial arts, dance forms and farming will heal your body and soul

SATYA - Svasthya Ayurveda Treatment, Yoga & Agriculture

Sesame seeds for Infertility, PCOS, Diabetes, BP, Heart Disease, Osteoporosis

Sesame seed known as “Til” in Hindi and “Ellu” in Malayalam is an ancient condiment and is used widely around the world in different cuisines. It won't be a bad idea to include this in your daily diet as It is an excellent source of copper, magnesium, potassium, calcium, phosphorus, iron, selenium, vitamin B1, B6, zinc and dietary fiber.

It is also a rich powerhouse of high-quality protein, good for vegetarians and vegans. It prevents diabetes and reduces blood pressure and is also good for the heart as it protects against  atherosclerotic lesions. PCOS and diabetes patients can make this healthy food a part of their diet, as the glycemic index is very low.

The presence of Copper in Sesame seeds aids in bringing down the swelling, inflammation and pain in rheumatoid arthritis and strengthens bones and joints. Magnesium content is helpful in preventing airway spasm in asthma, reduce blood pressure and the symptoms and side effects of menopause like irritability and hot flashes. Black sesame seeds are said to decrease testosterone levels, increase absorption of insulin and regulate the menstruation.  Rich iron content in sesame seeds is good for keeping anemia at bay.

These nutritious seeds occupy one of the top places in the list of food for fertility, as it acts as hormone regulators and enhancers. Zinc will help in ovulation in women and semen production in men. Zinc is essential for maintaining healthy bone density. So old men and women should increase their intake of sesame seeds. It also aids in the production of collagen, which keeps the skin young, healthy and elastic.

Sesame seeds are especially good for women, as the calcium helps to prevent osteoporosis, which often follows menopause due to hormonal changes and resultant bone loss. Calcium content reduces considerably in hulled seeds, so preferably go for the black seeds which are not hulled.

Phytosterol present in high quantity in black unshelled  sesame seed is known to reduce cholesterol and  also has anti-carcinogenic properties, which helps in prevention of cancer.

The rich fiber content helps in digestion and smooth bowel moments, thus preventing constipation and colon disorders.

Some studies indicate that regular consumption of sesame oil can bring down the readings of blood sugar, cholesterol, and triglyceride. Sesame oil is an integral part of hair care products in Ayurveda and is used by south Indian women for healthy and glowing hair. Another specialty of this oil is that it doesn’t turn rancid for a long time, hence ideal for making pickles.

Sesame seeds are an integral part of the Middle Eastern cuisine, it is used to make Tahini paste, (roasted sesame seeds ground in olive oil)  used in dips and sweets and is a healthy and delectable alternative to mayonnaise.

Grind and add sesame seeds to the  curries for a rich and creamy texture, sprinkle toasted seeds on salads, soups, vegetables,dosa, oats, upma etc. for taste and visual appeal and who can forget the delicious Indian sweet "Chikki" Kerala speciality " Elleunda" – a  combination of sesame and jaggery.

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.

Food for healthy pregnancy

Nutrition intake during pregnancy significantly contributes to the development of an individual, it’s a crucial period which often decides the overall health of the person for years to come. Little care and caution during pregnancy can ensure that you will have a hale and healthy baby who will develop into a healthy adult. We are what we eat, so this is the time, when maximum care is required. In addition to the usual diet, we can add some amazing stuff to the diet to increase the nutritional value of the food during pregnancy.

An ideal diet includes plenty of fruits and vegetables and the goodness will be amplified if it is organic. Fiber intake is essential to keep bowel movement smooth and a good portion of veggies like banana flower(kodappan) and banana inner trunk (pindi) will really help. Green leafy vegetables and an assortment of different bright coloured fruits and vegetable should be made a part of the daily diet, so that all the vitamins reach your baby. Fresh fruits have more vitamins than their shelved and preserved counterparts, so pluck fresh fruits from the backyard  and have a bite, instead of consuming old/preserved fruits from supermarkets, which are packed with insecticides.

Whole grains like wheat, ragi and  boiled rice will provide the much needed carbohydrates and fibers. But make it a point to avoid maida (refined flour) and white rice. Innovative ideas like making  chappathi or roti with a combination of flours like wheat, ragi,  bajra (pearl millet), Makkai (maize) and jowar (white millet) is great, especially if you are intolerant to gluten (wheat contains gluten). The soluble fibres and low glycemic index  of  these flours are good during pregnancy. Do not try to substitute rotis with whole grain breads, as it  contains preservatives, yeast and vegetable fat

The nutritional value increases when the seeds are sprouted, hence include them in salads after  washing thoroughly so as to reduce the risk of infections. Sprouting is a simple process of germination, which can be easily carried out at home and all the pulses like green gram, chick peas, peas, lentils, fenugreek and cereals like wheat, buckwheat, rice, amaranth, oil seeds like sesame and peanuts etc can be  sprouted effortlessly.

Omega 3 fatty acids found in fishes like sardine helps in the development of infant’s brain. But too much intake of fish is not good as some fishes like tuna, shark, sword fish and king mackerel  contains higher concentration of  mercury which is not good for the baby. Nuts and dry fruits will make a healthy snack,  as most of the nuts like walnut and almonds are rich in Omega 3 fatty acids, fibers and vitamins. Lean meats and eggs can be taken in limited quantities.


Coconut oil is excellent for skin nourishment, it helps in keeping the skin supple and soft  and will help in avoiding stretch marks which occur in pregnancy.

Lactobacilli are extremely useful in keeping the vagina healthy, so taking curd or fermented foods will not only help in getting protein and calcium, but also aid in avoiding infections.

Equally important is avoiding some food items, minimize eating out at hotels, especially Chinese food should be a strict no because of their ajinomoto content. Fast foods and  fried foods, bakery items and sweets can be very bad for the carrying mother and the  unborn baby and should be replaced with healthy home cooked food. To know in detail about foods to avoid during pregnancy read http://bangaloreivf.blogspot.ae/2014/11/food-items-which-should-be-avoided.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.

Facts and information on PCOS discussed in World PCOS conference 2015 - Seattle, USA

PCOS (Polycystic Ovarian Syndrome ) is a common condition affecting numerous teenage girls in the present scenario, causing obesity, irregular periods and excessive hair growth. Recent studies and researches reveal that a shocking 20% of teenagers are affected and the numbers even go up to 60% in some urban cities.  PCOS results in abnormal hormones in the body which often leads to infertility and other metabolic disorders like diabetes and heart diseases. The psychological issues like anxiety and depression and social problems like feeling of isolation are often inadequately recognised by both healthcare providers and the parents.

It was indeed a great learning experience for me to attend the first annual world Polycystic Ovarian Syndrome Conference  held on November 16-18, 2015 in Seattle, Washington, USA. The conference highlighted scientific studies and discussions on PCOS.The selection of top 42 research fellows from all over the world, was impeccable. The expert doctors from around the globe shared creative ideas about the various aspects of research and also various measures to help create public awareness on the subject.

Professor Richard L Stouffer presented a paper on PCOS, after studying the effect of western style diet on monkeys and concluded that the diet developed PCOS in the animals. He is the Senior Scientist in the Division of Reproductive & Developmental Sciences, ONPRC and has published over 200 papers. Presently, the dangerous trend in India is that lot of fast food chains are coming up and we, especially the young generation are embracing this diet with open arms and mind, which could be catastrophic. This could be one explanation for the recent rice in cases of PCOS among Indian teenage population.

Professor Dimitrios Nikolaou from the Imperial College School of Medicine, London, tried to establish that PCOS  is a misnomer ! He is considered as one of the most original thinkers in the field of Reproductive Medicine. He argued that women are protected against early ovarian ageing and have a number of social characteristics due to male hormones  that are advantageous.

Dr. Angeline Beltsos from Fertility Centers of Illinois, USA advocated single frozen embryo transfer in IVF cases for PCOS . Higher IVF implantation rates and improved pregnancy outcomes can be achieved by pre-implantation genetic screening, followed by single frozen embryo transfer which may improve placentation and infant health as well. 

Dr. Yen Hao Chen, a researcher from Georgia Regents University, USA, established a new study to prove that  Adipose tissue ( fat cells ) dysfunction is present in PCOS. This may help in finding new treatment in future.

Dr.Sheng Wu, from Johns Hopkins University did Study of PCOS through the interaction of androgens and insulin.  High levels of male hormones and insulin  are believed to play prominent roles in the genesis and progression of the disease and study revealed intricate cellular mechanism.

Dr. Lora Shahine, had done fellowship in Reproductive Endocrinology and Infertility at Stanford University. Her work was a proof that women with PCOS suffer not only from difficulty in conceiving, but a higher rate of early miscarriage compared to women of the same age without PCOS because of obesity, endometrial defects and hormonal imbalances.

Professor in Clinical Biochemistry at the University of Manchester, Dr.Brian keevil 
focused on the simultaneous measurement of testosterone, androstenedione DHEA, DHT, DHEAS and 17 OHP and their potential use in the investigation of PCOS. The possible use of salivary androgen assays were interesting, which offered a possibility of no blood tests in future.

Dr. Janelle Luk , who graduated from Yale University , and did residency at Harvard, presented paper on IVM ( in vitro maturation ). This is a technique in which immature eggs are collected from women with PCOS and is matured and used in IVF/ ICSI. This technique is probably going to be employed in the future treatments, as it helps in reducing injections and also risks of hyper stimulation.  

The matter of  increasing public health concern, as the incidence is highly associated with the metabolic syndrome  was highlighted by Dr.Donna Vine. She is the recipient of McCalla Professorship in Teaching, Service and Research. 

Russian Professor,  L. A. Ivanova did a study on the effect of thioctic acid on PCOS, and it is now available.

We had expert doctors from various fields who emphasized the side effects of PCOS on different parts of the body. The Dermatologist from Sweden, Dr. Maria Palmetun indicated that quality of life is very badly affected by PCOS and the dentist Dr. Ozgun Ozcaka, from Turkey  Spoke about the connection between PCOS and gingival inflammation.

Dr. Awatif Al Bahar, from Dubai Health Authority, UAE,  threw light at the epidemiology of PCOS and the economic cost which it is causing to the healthcare sector. It is shocking  that every year the health insurance companies incur huge costs to cover the direct and indirect  medical expenses related to PCOS ! 

A new era of medicine has started with study of bacteria in our body. Dr. Felice L Gersh from USA gave a wonderful insight into this new topic titled -  The care and feeding of the microbiome: A new approach to lowering the inflammation of PCOS. More DNA exists within us which derives from the trillions of bacteria comprising our microbiome than from our personal genetic DNA. Bad news is that, the standard Western diet, comprising of huge amounts of processed foods, which are nutrient deficient, chemical laden, antibiotic containing and which are devoid of sufficient quantities of both soluble and insoluble fiber, kills rather than supports a healthy microbiome. Women with PCOS frequently experience gastrointestinal problems, have irritable bowel syndrome and tend to develop chronic low grade systemic inflammation as a consequence of the unhealthy state of their gut bacteria.

Exercise is an extraordinarily effective way to reduce systemic inflammation and lower oxidative stress and should be an integral part of every PCOS treatment program, explained Bob tygenhof, the exercise specialist.

Julie Booker, rightly pinpointed that Stress and anxiety have been found to suppress the ovarian and menstrual cycle. She provided a treatment plan including acupuncture, diet, lifestyle, Chinese herbal medicine and supplements.

My presentation on long term managment of PCOS highlighted that Life style changes including diet, exercise and weight loss should precede any medicines. Protocols should be provided to doctors  to assess  cardiovascular disease (CVD) risks. (currently this protocol is not widely followed, although recommended by Royal colleges of London and Australia) Medicines are rarely needed ,as in  gestogens to induce periods atleast 3-4 times a year to reduce risk of endometrial hyperplasia/cancer.

 
Recent studies suggests that Insulin-sensitising agents like metformin, which is commonly prescribed for PCOS does not seem to have any long-term benefits and should be restricted to only diabetic / glucose intolerant PCOS.

Ovulation inducing agents like clomiphene should be used only for  6 to 12 months, as prolonged use of this medicine increases risk of cancer, the option of IVF should be considered after this period.

Laparoscopic ovarian drilling will induce ovulation in 60% of the subjects for 20 years, especially in PCOS patients who are not overweight. Psychological issues are often easily overlooked, problems like depression and anxiety must be screened, assessed and referred to professionals. 

Creating public health awareness on healthy eating and the necessity of regular exercise is very essential and should be included in the school curriculum. Specialised PCOS clinics with a trained team of doctors, dieticians, exercise specialists and counselors is absolutely needed in proper long-term management of PCOS.

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.