July 2014

“Babies for all” – Your fertility options

 If you are one of those who has not yet seen the joy of parenthood, this article is for you. With advances in medical science, even for extreme cases, there are multiple options available.

Initial treatment consists of history, examination, blood tests & specific workup of a couple. If simple
drugs, intrauterine insemination (IUI), etc. do not work, then a more advanced therapy is needed.

Let us begin with a man whose sperm count is zero; the world seems to be coming to an end. But wait, few hormone tests & a biopsy may reveal if the body is making sperms and if there is just an obstruction on the way. If this is the case, then with the help of surgery to remove the block or with in vitro fertilization (IVF) with needle aspiration of testicular tissue (TESA), you may have your own genetic child. For those whose body is not producing any sperms, one of the options is donor sperm IUI.
A large number of drugs & injections can help women, produce eggs. If not, there are always donor eggs. Donor eggs are also used when due to advanced age, a woman has stopped producing her own eggs.

If a woman is born without a normal uterus or has lost it to disease, then surrogacy is the answer. Surrogacy is often called “hiring a womb”, where another woman provides her uterus just as a room to grow the baby for nine months. Also various medical disorders, which do not allow a woman to carry a pregnancy surrogacy, may be used.

You just went for a routine ultrasound & there came the news of you carrying fibroids in your uterus. Don’t panic, fibroids are not an end to life. They are non cancerous growths arising from the muscle of uterus & most of them lie silently, without causing any ill effects.

Depending on their size & location, they may give rise to heavy menstrual flow, irregular menses, painful periods, difficulty in conceiving, repeated miscarriages, pregnancy complications, anaemia, heaviness in lower abdomen, etc. Fibroids are easily diagnosed on ultrasound.

This fibroid may not require urgent treatment

Various treatments options include simple reassurance to the patient, if symptoms are not many & patient is nearing menopause, as most fibroids tend to shrink after menopause.

Most large fibroids & those distorting the inner lining of the uterus will need treatment. Injections & several medicines can temporarily shrink the fibroids.

Hysteroscopy involves insertion of a narrow telescope through the vagina & removal of submucous variety of fibroids. Laparoscopy through very fine cuts, may be surgery of choice in a selected group of patients. Hysteroscopy & Laparoscopy are forms of minimally invasive procedures, which allow quick, pain free recovery, 1-2 days hospital stay & minimal blood loss. Other treatment options are embolization of uterine artery, Mrgfus.

Remember, you are not the only one living with fibroids. Leave the management to the doctor, there is more to life then worrying about fibroids.