Now, the question is: Are vitamins included? What are the vitamins recommended for pregnant women? What will be the effects? Here’s the real truth about the vitamins pregnant women can and can’t get away right now.

Vitamins Essential for Moms-To-Be

1. Vitamin C

This vitamin is important in the manufacturing of your baby’s blood vessels, bones, and the whole skeletal system. Vitamin C helps produce collagen, a protein responsible for producing your baby’s skeletal foundation.  Vitamin C is also known as skin food because it feeds your skin as well as your baby’s skin with the right nutrients to help build healthy skin. As an antioxidant, it can also help you and your baby fight free radicals or delay the oxidation process.

Since your body can’t produce vitamin C, unlike most animals, and it can’t store it either, it is important that you get your daily supply of vitamins from supplements and foods rich in vitamin C, such as citrus foods, vegetables, and fruits.

2. Foliate

Foliate, a B vitamin, is another nutrient necessary for the production of healthy red blood cells. And not everybody gets enough.

Foliate is found primarily in fresh fruits and vegetables, and people who eat a lot of canned or pre-packaged foods can become deficient.  Pregnant women who live alone and don’t want to cook for one are especially at risk for anemia caused by foliate deficiency.

Health experts suggest that a few servings of fresh fruits and vegetables every day are the best bet for prevention. If you can’t bear Brussels sprouts, consider taking a daily nutritional supplement with 400 micrograms, the Daily Value of folic acid (the supplemental form of foliate).

3. Vitamin A

A daily intake of vitamin A between 10,000 and 15,000 IU (international units) may also provide healthy bones, skin, and eyes to your baby as well as healthy cells needed to build your baby’s internal organs.

However, pregnant women should speak with their doctors before supplementing their diet with vitamin A. Studies show that excessive intake of vitamin A can bring about birth defects, such as ear and eye abnormalities, microcephaly or small head, cleft lip and palate, hydrocephaly or enlargement of the fluid-filled paces in the brain, mental retardation, or heart defects.

Statistics show that pregnant women who consume more than 10,000 IU of vitamin A can lead to birth defects in 1 of every 57 infants. Also, excessive intake of vitamin A during pregnancy can cause higher risks of miscarriage.

4. Vitamin D

When researchers in a certain study measured levels of vitamin D in pregnant women, they saw that the more vitamin D in the blood, the better the insulin was at delivering glucose to the muscles.  So vitamin D is an important nutrient for many other reasons as well, such as helping produce healthy teeth, tissue, and bones for your baby and may help your body derail diabetes. Studies show that diabetes in pregnant women can be very risky and may even cause birth defects or morbidity.

Though vitamin D is produced when your skin is exposed to sunlight, a more reliable year-round source is milk. Four 8-ounce glasses of fat-free milk everyday can get you to the Daily Value of 400 IU. Alternatively, you can supplement your diet with 400 IU of vitamin D.

5. Vitamin B12

Vitamin B12 facilitates the formation of hemoglobin, the red blood cell component that carries oxygen through the bloodstream.  During pregnancy, more hemoglobin is required to supply your baby with oxygen. And the fetus also uses this vitamin to build its own blood supply.

Your body needs vitamin B12 to create red blood cells. This vitamin is found in chicken, red meat, dairy products, eggs, and fish, but not in plant foods. Most people get plenty, but super-strict vegetarians who don’t eat any non-vegetable foods are at risk for a deficiency of vitamin B12 and anemia.  The solution is to take a daily nutritional supplement that contains at least double the Daily Value of B12 (six micrograms).

Keep in mind that baby’s health depends on the mothers way of getting the proper amount of vitamins, so pregnant women can’t afford to skimp. Hence, pregnant women should make sure that they get enough of the nutrients every day.

Below is the full news:

PARIS (AFP) — Acupuncture can increase the chance of success for couples seeking to have a baby through in-vitro fertilisation (IVF), according to a review published online Friday by the British Medical Journal (BMJ).

The paper looked at seven studies in which 1,366 women undergoing IVF were given acupuncture or a sham form of it — in which dummy sensations were substituted for pinpricks — or no additional treatment at all.

Overall, the odds of pregnancy increased by 65 percent among the acupuncture group, although this figure may be overstated as data for the trials was uneven, say the authors.

They note that in trials where there was a generally high success rate, acupuncture conferred only a relatively slender advantage, of 24 percent.

In four of the trials where the outcome of IVF was known, acupuncture boosted the probability of a live birth by 91 percent.

Cautiously describing their findings as “preliminary evidence,” the authors say acupuncture “improves rates of pregnancy and live birth” among women undergoing IVF.

Previous research has generally found that acupuncture either has no effect on pregnancy rates or somewhat increases the chance of success.

An exception to this was a study last year that found women who had had acupuncture with IVF were less likely to get pregnant compared with counterparts who had not had the needles treatment.

Acupuncture has been used in China for centuries as a spur to reproduction, and its use is growing amongst couples turning to IVF to have a baby.

Among the theories circulating as to why acupuncture may be effective with IVF is the idea that it stimulates the flow of blood to the uterus, thus making the lining of the womb more receptive to the implantion of the embryo.

But assessing the practical benefits of acupuncture is a challenge, given the so-called placebo effect.

This term is used to describe an improvement that can happen among volunteers who are given a dummy treatment, or a placebo, used to draw a comparison with the real treatment.

Under IVF, a woman is giving hormones to stimulate production of eggs, which are gently harvested with a needle and fertilised in the lab using sperm from her partner.

One or several embryos are then transferred back into her uterus via the cervix.

here is the news:

A study in the American Journal of Obstetrics & Gynecology reports women who suffer a second-trimester miscarriage are at high risk in a subsequent pregnancy of spontaneous preterm birth and repeat second-trimester miscarriage.

Researchers studied 182 women in three groups — 30 who had a spontaneous second-trimester miscarriage, 76 who had a spontaneous preterm birth, and 76 who had full-term deliveries. All of the women had a subsequent pregnancy beyond 14 weeks’ gestation.

In the subsequent pregnancies, the frequency of second-trimester loss was highest — at 27% — in women who suffered a second-trimester loss in the first pregnancy.

Second-trimester loss in subsequent pregnancies for women who had spontaneous preterm birth was 3%, while the percentage was 1% in the full-term delivery group.

Source: nurse.com 

If you are trying to get pregnant, these positions might be worth a try, however, it is not one of the most significant factors in determining whether or not you get pregnant. It is the woman�s ovulation combined with successful sexual intercourse that result in pregnancy. Most likely, whatever you are already doing will do the job.

One position that has been shown to slightly improve the chance of conception is intercourse with the man on top, the so-called �missionary position.� This position naturally allows the man to ejaculate into the woman, with the semen flowing toward her uterus. This can be helpful for some couples who are trying to get pregnant.

Another position that can help you to get pregnant is any one of the positions that allow the couple to climax simultaneously. When a woman experiences an orgasm, the muscles of her vagina and uterus contract rapidly, helping the sperm to be drawn into the uterus. If the man ejaculates at the same time that she experiences orgasm, then this muscular action is utilized to increase the chances for conception. This fact is a strong argument to persuade you to continue with whatever positions that you as a couple both enjoy. If you can orgasm at the same time in a particular position, then this may increase your chances of getting pregnant.

One final consideration for positions that can help you to get pregnant is whether or not the semen leaks out immediately. If the semen is immediately flushed from the area after intercourse, this may reduce the chances of conceiving a baby at that time. Loss of the semen definitely does not make it impossible to get pregnant, but it may reduce the chances, and you are trying to maximize your chances.

They found that women who ate two or more servings of low-fat dairy foods a day had an 85 percent higher risk of a certain type of infertility than women who ate less than one serving of low-fat dairy food a week. 

Women who ate one serving of high-fat dairy food a day were 27 percent less likely to be infertile than women who avoided full-fat dairy foods. 

It was not the finding that nutritionist Dr. Jorge Chavarro of the Harvard School of Public Health in Boston had expected. 

“We wanted to know whether dairy foods in general affected fertility,” Chavarro said in a telephone interview. “There was pretty strong evidence in animal studies suggesting that a specific sugar in dairy, lactose, could be deleterious.” 
 But little work had been done in humans, so Chavarro and colleagues looked at data from the Nurses Health Study, an ongoing survey of tens of thousands of women who fill out regular questionnaires about their diet, activity and health. 

They chose the records of 18,555 women aged 24 to 42 who had tried to become pregnant or had became pregnant between 1991 and 1999.  Chavarro said most were of European origin — possibly an important factor because people of northern European descent are less likely to be lactose intolerant. 

The women who ate the most low-fat dairy foods were the most likely to report they suffered from anovulatory infertility, when the body fails to produce enough egg cells. 

Writing in the journal Human Reproduction, Chavarro said he found no difference between women who ate the most dairy and those who ate little or none. He found the differences only when he broke down the types of dairy products. 
 ”It was a bit of a surprise to us that high-fat dairy foods were positively related to fertility,” he said. “There is really not a very clear explanation. It is possible that dairy fat or something along with dairy fat such as the hormones in pregnant cows may be affecting ovulation in women.” 

He said more study was needed before conclusions could be drawn. 

Chavarro’s team had earlier found that women who ate more iron from supplements and from plant foods were less likely to be infertile, and found no link between fertility and various types of fats. 

But he does not recommend that women trying to conceive use this as an excuse to eat “buckets and buckets of ice cream.” 

“The benefit is at as low as one serving a day,” he said.

Some of the terms used to define the male reproductive system are: – Prostrate gland – this is a gland that supplies part of the fluid that is essential for the transportation of sperms. – Vas Deferens – is the tubule that carries sperms from the epididymis to the ejaculatory duct of the penis. – Follicle stimulating hormone – these hormones are pituitary hormones that stimulate the testicles.

Some of the physical conditions that may lead to infertility issues with males are: – Ctyptorchidism – this is a condition where the testicles do not descend into the scrotal sacs. – Hypospadias – is a structural abnormality of the penile shaft and can result in an opening of the underside. – Retrograde ejaculation – this is a clinical condition in which sperms are not ejaculated in a forward direction and actually refluxes into the bladder.

Other terms that males are likely to hear about during a visit to a fertility clinic are: – Asthenospermia – this is a condition where the movement of the sperms is hampered and this results in poor motility. – Azoospermia – is a complete absence of sperms. – Oligoasthenospermia – this refers to a condition where the sperm count is low coupled with poor mobility of the sperms. – Teratospermia – is mentioned when the shape of the sperms is abnormal. – Impotence in men – is a condition where an individual is unable to maintain an erection and has a total sperm count of less than 20 million.

Some of the treatment options that exist for males are: – Etoejaculation – this is a process of electrical stimulation of nerves that control ejaculation and this is used to obtain semen from men with spinal cord injuries. – Percoll – is a process in which sperms are centrifuged or washed to enable separation from debris and dead or immature sperm – Testicularlepididymal sperm aspiration- is a surgical procedure where the testicle or epididymis is biopsied for the purposes of obtaining sperm for Intracytoplasmic Sperm Injection. – Intracytoplasmic Sperm Injection is a process of injecting sperm into oocyte with micromanipulation technique.

Since the reproductive system of women is vastly different from that of males, the terms used are also different. – Fallopian tubes – a pair of hollow structures leading from the area of the ovaries to the uterus. Fertilization occurs in the fallopian tubes from where the eggs travels to the uterus and settles there. – Fimbria – are the end of the fallopian tubes and these help in picking up the egg from the ovary after ovulation. – Corpus Luteum – an organ responsible for progesterone production in the ovary after ovulation has occurred. This helps in preparing the lining of uterus for implantation. – Follicle – is a fluid filled structure on the surface of the ovary in which the maturing egg grows. It produces estrogen until release of the egg, after which it becomes the corpus luteum and secretes progesterone.

Some of the common problems that may occur in females are – Anovulation – lack of ovulation. – Amenorrhea – absence of menstruation. – Oligomenorrhea – infrequent menses. – Endometriosis – where the lining tissue of the uterus comes outside and lodges in the peritoneal cavity. – Ectopic pregnancy – a pregnancy that occurs outside the uterus, usually in the fallopian tube.

Treatments for infertility in women range from surgical procedures to almost natural ones. – Artificial insemination – this is a procedure where the prepared sperm is placed in the uterus with the help of a specialized catheter. – Intrauterine insemination – a process that involves placing the sperm directly into the uterus. – Blastocyst – is also known as preimplantation embryo and refers to a more developed embryo that implants into the uterine lining about a week after fertilization. – Laparoscopy – a technique which uses a narrow lighted instrument to visualize the ovaries, uterus and fallopian tubes. – Salpingostomy – refers to surgical procedure to create an opening at the end of blocked fallopian tube. – Fimbrioplasty – is a surgical process where the constricted end of a fallopian tube is opened. – Laparotomy – is a process that involves making an incision through the abdomen to allow direct visualization of the reproductive system. – In Vitro Fertilization – is the latest technique in which the fertilization is achieved outside the body and then embryo transfer is done into the uterus. – Gamete Intra fallopian transfer – is a variation of IVF and needs laproscopy wherein the eggs are mixed with sperms outside the body and then placed into the fallopian tube. The fertilization occurs inside the body.

Equipped with this knowledge of fertility related terms, understand and decoding what the experts tell you should not be a tough job, as it normally is.

Fertility Facts http://www.fertilityfacts.org offers extensive articles and resources on fertility, infertility, treatments and pregnancy etc

Unfortunately, the the test reveal that she is still not pregnant. However, based on the doctor, this is possible due to some hormon imbalance. We actually try for 3 type of test, i.e. urine test, ultrasound scan and also blood test. however, all of them come out negative. Too bad.

Having said that, there were something that I would like to share. With using ultrasound test, we can see that my wife having nearly mature egg! The size is about 10mm in diameter, it is very round and seem very pretty.

Based on the doctor, it is a healthy egg. From my uneducated guess, I think this egg is big and healthy because it was three month since my wife take folic acid and take care of her health. The doctor also said that the egg should be matured within one week, and ask us to visit her again if she is overdue in the month of January.

My wife actually always complain that she feel pain in the lower abdomen (the same place she can saw the eggs. I guest if the egg is big, she will feel a bit painful especially if the egg is matured and ready to ‘go out’ from the ovaries. Today is monday and she mention that she didn’t feel the pain anymore. I think the egg is out and ready!

I think for a women who didn’t have normal period, she should see a doctor and ask for this test instead of buying ovulation test kits and test by themself. this is because, by seeing a doctor, the doctor can advice about this and she also can see the egg physically if the egg is ready, nearly ready or if it is not so perfect, which the doctor can actually do something about it.

One important way of taking care of the body we have is to feed it a balanced diet of nourishing foods—and stay away from those that are detrimental to it.

There’s no one right way to eat that will apply to every human body because each one is unique. And, because of illness, stress, pregnancy, exposure to toxins, the quality of the food supply, and many other factors—no single diet is the ideal diet for everyone at every stage in life. But, there are some basic guidelines that can help you find the regimen that’s right for you.

Pile love foods on your plate by getting what you need in the way of sex vitamins and minerals—vitamins A, C and E, plus selenium. Foods low in fat and high in nutrients will help you keep healthier and enhance your sex drive.

Loving tomatoes are a good source of vitamin C—which aids in the formation of hormones that are involved in sexual vitality such as estrogen, and progesterone. Passionate peaches are rich in vitamin A, which is important for sexual health—providing various benefits such as a strong thyroid and the making of the hormone progesterone.

Erotic black beans are high in another sex vitamin that helps you stay energized and feeling sexually vibrant. Steamy hot onions can help stave off heart disease so that you don’t need heart disease drugs, which zap a man’s libido and sexual performance. Sensual clams can have amatory effects due to their high levels of zinc, which has been shown to help control prostatitis and impotence.

Diet experts say that the exotic banana is rich in potassium, which is essential for the proper functioning of nerves and muscles—the key to successful lovemaking. The magical asparagus is a rich source of potassium, phosphorous and calcium—all of which are essential for energy, and it stimulates the urinary tract and kidneys. (Sex drive is derived from the kidneys)

Whatever diet you follow, select fresh foods whenever possible. A varied diet also helps avoid getting too much of something that’s not good for you. One thing for sure—a prudent and carefully planned diet can be one of the best tactics for a healthier sex life and longevity.

* When the man’s sperm count is on the low side or abnormal, yet potentially capable of fertilizing an egg. Here IVF may be useful because fertilization can possible be manipulated and observed by the scientific team. This does not necessarily require sperm injection, or zona drilling, but simply very careful preparation of the sperm in suitable laboratory solutions.

* For certain women who have problems with the cervix perhaps ‘hostile’ mucus, IVF bypasses the cervix and its mucus.

* For women who are not ovulating spontaneously, but who produce eggs on fertility drugs without conceiving. In this situation, the ability to force the ovary to produce many eggs and then select the best ones for fertilization and transfer means that IVF may be suitable option.

* For some women with endometriosis or with very carefully investigated infertility which remains unexplained. We think that endometriosis is an excellent indication for IVF and have had particular success.

* For couples who have several factors together which are causing infertility; commonly a combination of poor male fertility and tubal disease are the most usual indications.

* Most recently, for certain couples who are at high risk of having genetically abnormal babies.

STAGES OF IVF TREATMENT:

1. TESTING A COUPLE’S SUITABILITY BEFORE TREATMENT

Preliminary preparation for an ART procedure may be as important as the procedure itself.

* Testing for ovarian reserve may be recommended in order to predict how the ovaries will respond to fertility medication.

* Blood Tests to assess the general health of the couple (ask the clinic for a complete list)

* Hysteroscopy to assess the inside of the uterus to look for problems like fibroids, polyps, or a septum may need to be corrected before IVF.

* Laparoscopy may be required to assess problems like endometriosis and to treat problems like hydrosalpinx; a fluid-filled, blocked fallopian tube which reduces IVF success should be removed prior to IVF.

* Semen analysis and culture

* Lifestyle issues should be addressed before ART. Smoking, for example, may lower a woman’s chance of success by as much as 50%. All medications, including over-the-counter supplements, should be reviewed since some may have detrimental effects. Alcohol and drugs may be harmful, and excessive caffeine consumption should be avoided. Some vitamins especially folic acid is started.

2. DOWN REGULATION

The process of stimulating the ovaries to produce eggs is a controlled one and requires that the body’s own internal capacity to regulate that growth be stopped. Otherwise the eggs may mature early and their collection may not be possible. For this purpose an injection is started usually in the previous cycle (D21) or sometimes even in the same cycle. At a particular time, (usually D2) blood levels of Estradiol (E2) and LH are tested to confirm the down regulation before starting stimulation.

3. OVARIAN STIMULATION

The best chance of successful pregnancy is obtained when more than one embryo is placed in the uterus at the same time. This is because so many early human embryos, normally fertilised, are lost or do not develop into babies. Consequently, one way of overcoming this natural loss is to put back several embryos simultaneously during IVF. During ovarian stimulation, also known as ovulation induction, ovulation drugs, or “fertility drugs,” are used to stimulate the ovaries to produce multiple eggs rather than the single egg that normally develops each month. Multiple eggs are needed because some eggs will not fertilize or develop normally after egg retrieval. Drug type and dosage vary depending on the program and the patient. Most often, ovulation drugs are given over a period of eight to 14 days. Ovulation drugs include clomiphene citrate, human menopausal gonadotrophins (hMG), follicle stimulating hormone (FSH), recombinant FSH and LH, and human chorionic gonadotrophin (hCG). Gonadotropin releasing hormone (GnRH) agonists or GnRH antagonists are used in conjunction with these medications to prevent premature ovulation.

4. ASSESSING THE DEVELOPMENT OF THE EGGS

Egg collection is generally timed to within a few hours of when the woman is expected to ovulate. If eggs are not collected very close to this time, they may not fertilise properly. This is the main reason why so many tests are often done to confirm the status of the woman’s hormones and, thus, development of her eggs.

* Hormone tests: As the follicle swells, the hormone oestrogen (Estradiol or E2) is produced in increasing amount. Regular blood test can detect this increase.

* Ultrasound: The swelling follicle can be directly measures using Trans vaginal ultrasound. This is usually done daily. We know from experience that, when the follicle is about 20 mm across, ovulation is imminent.

Using ultrasound examinations and blood testing, the physician can determine when the follicles are appropriate for egg retrieval. Generally, eight to 14 days of FSH and/or HMG injections are required.

5. Egg Retrieval

When the ovaries are ready, hCG or other medications are given. The hCG replaces the woman’s natural LH surge and helps the eggs to mature so they may be capable of being fertilized. The eggs are retrieved before ovulation occurs, usually 34 to 36 hours after the hCG injection is given. However, 10% to 20% of cycles are cancelled prior to the hCG injection.

Egg retrieval is usually accomplished by transvaginal ultrasound aspiration, a minor surgical procedure. Some form of anaesthesia is generally administered. An ultrasound probe is inserted into the vagina to identify the mature follicles, and a needle is guided through the vagina and into the follicles. The eggs are aspirated (removed) from the follicles through the needle connected to a suction device. The egg retrieval is usually completed within 30 minutes. Some women experience cramping on the day of the retrieval, but this sensation usually subsides by the next day. Feelings of fullness and/or pressure may last for several weeks following the procedure because the ovaries remain enlarged.

6. Insemination, Fertilization, and Embryo Culture

After the eggs are retrieved, they are examined in the laboratory The best quality, mature eggs are placed in IVF culture medium and transferred to an incubator to await fertilization by the sperm. Sperm, obtained by ejaculation or a special condom used during intercourse, are separated from the semen in a process known as sperm preparation. Motile sperm are then placed together with the eggs, in a process called insemination, and stored in an incubator. Fertilization occurs in the laboratory when the sperm cell penetrates the egg, usually within hours after insemination.

Visualization of two pronuclei the following day confirms fertilisation of the egg. One pronuclei is derived from the egg and one from the sperm. Approximately 40% to 70% of the mature eggs will fertilize after insemination or ICSI. Lower rates may occur if the sperm and/or egg quality are poor. Occasionally, fertilization does not occur at all. Two days after the egg retrieval, the fertilized egg has divided to become a 2-to 4-cell embryo. By the third day, the embryo will contain approximately six to 10 cells. By the fifth day, a fluid cavity forms in the embryo, and the placenta and foetal tissues begin to develop. An embryo at this stage is called a Blastocyst. If successful development continues in the uterus, the embryo hatches from the surrounding zona pellucida and implants into the lining of the uterus approximately six to 10 days after the egg retrieval. Embryo Transfer The next step in the IVF process is the embryo transfer. Embryos are usually transferred to the uterus on the 2nd or 3rd day after the egg retrieval. A short anaesthesia is given although not absolutely necessary. The physician identifies the cervix using a vaginal speculum. Two or three embryos suspended in a drop of culture medium are drawn into a transfer catheter, a long, thin sterile tube with a syringe on one end. The physician gently guides the tip of the transfer catheter through the cervix and places the fluid containing the embryos into the uterine cavity. The procedure is usually painless, although some women experience mild cramping.

Cryopreservation

Extra embryos remaining after the embryo transfer may be cryopreserved (frozen) for future transfer. Cryopreservation makes future ART cycles simpler, less expensive, and less invasive than the initial IVF cycle, since the woman does not require ovarian stimulation or egg retrieval. Once frozen, embryos may be stored for several years. However, not all embryos survive the freezing and thawing process, and the live birth rate is lower with cryopreserved embryo transfer. Couples should decide if they are going to cryopreserve extra embryos before undergoing IVF.

SUCCESS RATES

Currently the success rate per oocyte retrieval cycle is about 30%. Failures bring with it a lot of frustrations and depression but one must have faith as the cumulative success rates over 3-4 attempts is about 70%. The success rates depend on a lot of factors and especially the woman’s age. The live birth rate for each IVF cycle started is approximately 30% to 35% for women under age 35; 25% for women ages 35 to 37; 15% to 20% for women ages 38 to 40; and 6% to 10% for women over 40.

DONOR SPERM, EGGS, AND EMBRYOS

IVF may be done with a couple’s own eggs and sperm or with donor eggs, sperm, or embryos. A couple may choose to use a donor if there is a problem with their own sperm or eggs, or if they have a genetic disease that could be passed on to a child. Donors may be known or anonymous. In most cases, donor sperm is obtained from a sperm bank, and sperm donors undergo extensive medical and genetic screening. The sperm are frozen and quarantined for six months, the donor is tested for sexually transmitted diseases including the AIDS virus, and sperm are only released for use if all tests are negative. Overall, the use of frozen sperm rather than fresh sperm does not lower success rates.

Donor eggs are an option for women with a uterus who are unlikely or unable to conceive with their own eggs. Egg donors undergo the same medical and genetic screening as sperm donors, although it is not currently possible to freeze and quarantine eggs like sperm. The egg donor may be chosen by the infertile couple or the ART program. Egg donors selected by ART programs generally receive monetary compensation for their participation. Egg donation is more complex that sperm donation and is done as part of an IVF procedure. The egg donor must undergo ovarian stimulation and egg retrieval. During this time, the recipient (the woman who will receive the eggs after they are fertilised) receives hormone medications to prepare her uterus for pregnancy. After the retrieval, the donor’s eggs are fertilised by sperm from the recipient’s partner and transferred to the recipient’s uterus. The recipient will not be genetically related to the child, but she will carry the pregnancy and give birth. Egg donation is expensive because donor selection, screening, and treatment add additional costs to the IVF procedure. However, the relatively high live birth rate for egg donation, between 40% to 45%, provides many couples with their best chance for success. Overall, donor eggs are used in nearly 10% of all ART cycles.

In some cases, when both the man and woman are infertile, both donor sperm and eggs have been used. Donor embryos may also be used in these cases.

SURROGACY/GESTATIONAL CARRIER

A pregnancy may be carried by the egg donor (surrogate) or by another woman (gestational carrier). If the embryo is to be carried by a surrogate, pregnancy may be achieved through insemination alone or through ART. The surrogate will be biologically related to the child. If the embryo is to be carried by a gestational carrier, the eggs are removed from the infertile woman, fertilised with her partner’s sperm, and transferred into the gestational carrier’s uterus. The gestational carrier will not be genetically related to the child. All parties benefit from psychological and legal counselling before pursuing surrogacy or a gestational carrier.

RISKS OF ART

* Small risk of hyperstimulation. The stimulated cycle is very carefully monitored. However in any cycle there is a small risk of hyperstimulation which may result in enlargement of the ovaries. Most cases resolve with very simple treatment.

* Pregnancies involving Assisted Reproduction have higher miscarriage rates than normal.

* Removing eggs through an aspirating needle entails a slight risk of bleeding, infection, and damage to the bowel, bladder, or a blood vessel.

* The chance of multiple pregnancies is increased in all assisted reproductive technologies (about 30%) when more than one embryo is transferred. Some couples may consider multifetal pregnancy reduction to decrease the risks due to multiple pregnancies.

* First trimester bleeding may signal a possible miscarriage or ectopic pregnancy. Some evidence suggests that early bleeding is more common in women who undergo IVF and GIFT and is not associated with the same poor prognosis as it is in women who conceive spontaneously. Miscarriage occurs after ultrasound in nearly 15% of women younger than age 35, in 25% at age 40, and in 35% at age 42 after ART procedures. In addition, there is approximately a 5% chance of ectopic pregnancy with ART.

(Dr. Rajeev Agarwal is a Gynaecologist with a Special Interest and Training in Infertility. He obtained his MD from Kasturba Medical College and trained further at the Manipal Assisted Reproduction Centre. He has received various awards during his training and further received the prestigious Kumud Tamaskar Award for his research work on Polycystic Ovarian Syndrome. He has various papers and lectures to his credit. He received further training und)