Dr. S.K Sreekumar talks about infertility and other gynecological problems
Infertility appears to be on the rise and is affecting a large number of young couples today. Dr. S.K. Sreekumar talks about this condition and its prevalence in the Indian population.
Infertility and sexual dysfunction has slowly been the rise among couples working in IT sector. It is mainly due to long working hours, stress, obesity and irregular body cycles. Infertility is a common medical problem today and it is defined by the World Health Organization as the inability to conceive after more than one year of unprotected intercourse. Worldwide, 10 to 14% of couples in the reproductive age group face difficulty in conceiving. More than 90% of infertility is treatable with advances in medical technology.
Dr. S.K. Sreekumar is a Senior Consultant Gynecologist specialized in Infertility treatment. With over 12 years of experience, he started his own Infertility Centre –CHERISH Centre for Reproductive Medicine at Koramangala, Bangalore. The centre is solely dedicated to the management of infertility. The aim of all forms of Infertility treatment is to help couples have children and CHERISH provides the entire range of infertility treatment procedures, all under one roof. Till date he has treated over 2500 couples by the IVF/ICSI(TEST TUBE BABY TREATMENT) method alone and the success rate has always been on par with and almost always better than the international standards. We talk to Dr. Sreekumar about infertility and the advancement in the IVF procedures.
1) Infertility rate is high among women, so is there something called as a right age to conceive?
From a strictly biological perspective, the 20s is the best decade for conceiving and carrying a baby: Experts say the average woman's fertility peaks when she's 24.The best time for a women to conceive is by 30 years. This is important to have a healthy child. 32 years is still okay but after 35 years, the chances of conception start going down and the child is likely to develop some anomalies. Fertility rate in women drops drastically after 30 and another drop is at 35. There are no methods to turn back the clock. In your 20s, you're less likely to have other gynecological problems like fibroids and endometriosis, which often progress and become more of a problem over time.
Pregnancy itself is usually physically easier for women in their 20s, since they're at lower risk of health complications like high blood pressure and diabetes. Finally, younger women are less likely to have premature or low-birth-weight babies than women over 35. The greatest advantage of being a young mother is increased fertility. Since women are most fertile between the ages of 17 and 25, it is less likely that you'll have trouble conceiving at this age. . In addition to their increased fertility, young mothers are typically in better physical health than older mothers. This means that women between the ages of 17 and 25 have the lowest risk of experiencing complications during pregnancy. Also, young mothers generally have more energy for the physical demands of childbearing.
2) What are the kinds of symptoms that women may generally overlook? What are the keys to overcoming the natural obstacles to fertility?
It is important for a woman to know her body and monitor it closely. Physical changes such as irregular periods or the absence of menstruation, pelvic pain, chronic acne and weight gain can act as clues. Telling your doctor about any symptoms right away can help him/her make a diagnosis and bring you and your partner one step closer to your goal.
Since PCOS (Polycystic ovary syndrome) can have many variable and subtle symptoms, some doctors may overlook the diagnosis in young women not trying for pregnancy, especially if they are simply interested in regulating periods with birth control pills. In addition, there is no single test to definitively diagnose PCOS.
3) What are some of the most popular fertility treatments?
Intrauterine Insemination – Is a process in which the processed semen is directly placed into the uterus of a female with the help of a catheter. The process is effective in cases of male factor infertility, unexplained infertility, endometriosis, anovulatory infertility etc.
In Vitro Fertilization and Embryo Transfer - IVF or in vitro fertilization, commonly known as the Test Tube Baby procedure. It is the most common procedure in fertility treatment. In IVF, mature eggs are taken out from the ovaries of the female and fertilized with the sperms of the male in the laboratory. The fertilized eggs (zygotes) are then cultured to grow into embryos, one of which is then transferred to the uterus of the female.
Intracytoplasmic Sperm Injection - ICSI is an advanced form of IVF. A delicate process, it effectively boosts fertilization rate for patients with severe male factor infertility. ICSI involves injecting a single sperm into each egg with the help of a special instrument called ‘Micromanipulator’.
OOSIGHT - Spindle View Imaging System. It is an advanced microscope and is called POLOSCOPE. It helps to observe and assess the egg’s chromosome spindle (GRADING) and also avoid damage to spindle and chromosomes during the ICSI procedure. Thus it can help us to pick out and transfer only the healthier Embryos, thereby increasing the fertilization rates and pregnancy outcomes mainly for women with less number of Eggs, in older women and those with previous failed IVF / ICSI.
Vitrification - is one of the latest advancements in fertility treatment. The process refers to the freezing of eggs (also embryos) to store them for an indefinite period. Unlike sperms, unfertilized ova cannot be stored using the slow freezing technique. Rather, vitrification works by using higher concentrations of cryoprotectants that ensure much faster cooling rates, and without the formation of ice crystals. It is useful for women who face the possibility of sterilization in future.
4) Also women are opting for surrogacy these days, as they do not have enough time for family life. What do you have to say about this trend?
Not a healthy trend, but it’s their life, they have to decide. More and more career-minded couples, especially the ones where both partners are holding top management positions in their respective careers, are opting to rent a womb rather than go through the hassles of a pregnancy. With the pressure of work and the need to retain their places at the top of the corporate ladder engulfing them, they are opting for the easy way out, despite these women being healthy enough to conceive and carry a child to term.
Surrogacy can have emotional and psychological implications at a later stage. These couples opt for surrogacy despite being healthy enough to have their own child. But the emotional bonding with the child is equally important. If they don’t have time for pregnancy, it’s questionable whether they will have time to spend in the child’s growing up years. It is not the right thing to say that you do not have time to have a baby. Ethically, doctors should not encourage women to go for surrogacy if they are healthy enough to carry the child.
Medical surrogacy, however, is performed if a woman doesn't have a uterus, has had cervical cancer, has undergone multiple miscarriages or is facing other medical problems that prevent her from carrying a pregnancy safely. In this case, it's not anyone's fault. Social surrogacy should not blind us to the dilemma of those who were genuinely in need of medical surrogacy.
5) A lot of NRI couples are coming to India for IVF treatments, what do you think is the reason behind this?
First and foremost is the cost factor. A test tube baby in India can cost anywhere from 1 to 2 Lakhs. The same procedure in the US can range from 5 to 10 lakhs. IVF with Surrogacy also comes at a reasonable price here. Other reason for India’s pull as a surrogacy destination is its laws. It is far simpler to become legal parents in India. Second is the waiting period. In most developed countries seeking physician’s appointments is a challenging task. It takes a minimum of six to eight months for couples to start the procedure from the day they decide to have a test tube baby. However, in India, within a month of arriving, couples are already into the process of conception of an embryo.
Third is the communication between doctor and patient. Indian hospitals provide complete transparency throughout the procedure. Another reason for foreign couples to opt for India to treat infertility is the stringent rules for the procedure in their mother country. For instance, in Italy only three eggs can be used for fertilization at one go and the remaining has to be frozen, while in Australia intra-uterine insemination (IUI) is not allowed.
6) Are there any ways for women to optimize lifestyle and nutrition that might improve gynecological and overall health?
It has been known for a long time that smoking has a negative effect on conception but many fail to realize just how drastically smoking affects both male and female fertility. Women who smoke not only increase the time it takes them to conceive as well as raise the risk of spontaneous miscarriage, they also jeopardize the health of their baby yet to be born. Female smokers are also at a greater risk for delivering premature or low birth weight babies and developing pelvic inflammatory disease.
Regularly drinking alcohol can reduce fertility levels by up to 50%. Another chemical to avoid in order to improve your chances of conception is caffeine, which can be found in tea, coffee, chocolate and soft drinks. Caffeine reduces the fertility level of both men and women and even a single cup of coffee may reduce the chances of conception to half.
Eating a healthy, balanced diet has many advantages. It helps maintain an ideal body weight, keeps the hormone levels of the body normal and improves the health of the reproductive system. When making diet choices, though, reach for foods that are rich in antioxidants, vitamin C and E and certain minerals. Regular diet, moderate exercise and a healthy mind and body are key to improve your fertility as well as overall health. It is always better to observe your lifestyle more closely and make some small changes for better chances of bringing a child into this world.
Maintain a balanced diet
• Both vitamins C and E play key roles in female and male fertility. These vitamins can reduce stress on eggs and the reproductive organs.
• Some research shows that if you are trying to conceive, it is wise to avoid sea food as the high level of mercury may be responsible for abnormal semen and decreased fertility.
• Many infertility issues crop up due to hormonal imbalances. This can be avoided by removing all processed flours and sugars such as white bread, pasta, pop, candy, and sugary juices from the diet.
• Eating foods with a low glycemic index such as fruits, vegetables, and beans; lean protein like yoghurt, chicken, tofu, and turkey; and essential fat including walnuts, sesame seeds, and extra virgin oil at every meal helps maintain the hormonal balance in the body and improves the functioning of the reproductive organs.
• Certain herbicides and pesticides sprayed on crops have been found to have drastic effects on fertility. Choosing organic foods whenever possible will help you to avoid this chemical as well as others.