Diminished Ovarian Reserve:
Ovarian reserve refers to the number of eggs in a woman’s ovaries. As a woman ages, particularly after the age of 35, her ovarian reserve begins to decrease. Diminished ovarian reserve means that there is a lower number of eggs (follicles) available for fertility. It’s important to note that the quantity of eggs does not necessarily indicate their quality or the ability to conceive a healthy baby.
The quality of eggs is independent of ovarian reserve. Even if a woman has a low ovarian reserve, she may still have high-quality eggs, which can increase her chances of getting pregnant. Conversely, a woman with a high ovarian reserve may have poor egg quality. Therefore, diminished ovarian reserve does not directly correlate with egg quality.
Egg Freezing:
Formally known as oocyte cryopreservation, egg freezing is a method of preserving a woman’s fertility for future family planning. The process involves collecting a woman’s eggs, freezing them, and storing them for later use in fertility treatments. and then thawing them later on so they can be used in fertility treatment.
The primary purpose of egg freezing is to capture and preserve a woman’s eggs when they are young and of high quality.
As women age, the quantity and quality of their eggs decline, making it more challenging to conceive naturally. By freezing eggs at a younger age, women can potentially increase their chances of achieving pregnancy later in life. When the woman is ready to use her frozen eggs, they are thawed and used in assisted reproductive techniques such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).
Embryo Freezing:
Embryo freezing is a procedure commonly performed during IVF or ICSI treatments. In cases where there are surplus good-quality embryos after embryo transfer, instead of discarding them, they can be frozen for future use. Embryo freezing offers the opportunity for patients to store the embryos for various reasons, such as ensuring future chances of conception or attempting to have a sibling.
Not all embryos are suitable for freezing, as only good-quality embryos are selected for cryopreservation. Embryos can be frozen at different stages of development, including the single-cell stage, the two to eight-cell stage, or the blastocyst stage. Cryoprotectants, a special solution, are used to protect the embryos during freezing by drawing out water and minimizing damage caused by ice crystal formation. The embryos are then rapidly frozen using a technique called vitrification and stored in tanks of liquid nitrogen until needed.
Embryo freezing is not only valuable for patients undergoing fertility treatment but also for fertility preservation purposes, allowing individuals to preserve their fertility potential without undergoing additional egg retrieval procedures in the future.
Family Balancing / Gender Selection:
Family balancing, also known as gender selection, is a technique used when a couple desires to choose the sex of the embryo to be transferred into the uterus. Preimplantation genetic testing (PGT) is often performed during IVF, and it provides information about the genetic makeup of the embryos, including their gender. This information allows couples to select embryos of a specific gender for transfer.
The ability to choose the gender of embryos can help balance families and fulfill personal preferences. It’s worth noting that family balancing through gender selection is currently legal in the United States and the United Arab Emirates.
Fertility Assessment:
A fertility assessment involves a comprehensive evaluation of both partners to determine their reproductive health. The extent of testing can vary, but it typically includes physical examinations, medical history reviews, and diagnostic tests.
Some common components of a fertility assessment include:
- Semen analysis: This test assesses the quality and quantity of sperm in a man’s semen.
- Female blood tests: These tests measure hormone levels and ovarian reserves in women.
- Female ultrasounds and pelvic examinations: These examinations help assess the condition of the reproductive organs, including the ovaries and uterus.
- Hysterosalpingogram: This X-ray procedure examines the fallopian tubes and uterus’s structure and can detect any blockages or abnormalities.
- Hysterosonography: It involves placing a saltwater solution in the womb before examination to evaluate the uterine cavity.
Fertility assessments play a crucial role in diagnosing any underlying fertility issues and formulating appropriate treatment plans.
Fertility Preservation:
Fertility preservation involves the process of safeguarding sperm, eggs, or reproductive tissue to be used in the future for conception. It is especially relevant for individuals who anticipate challenges to their fertility due to medical treatments, age-related fertility decline, or personal circumstances. The most common method of fertility preservation is the freezing and storage of eggs or embryos.
Eggs are typically harvested from the ovaries, fertilized (if desired), and then frozen through a process called cryopreservation. Research indicates that embryos have a high survival rate of up to 90% after the freezing and thawing process. This preservation technique allows individuals to preserve their reproductive potentialin the face of potential fertility challenges.
Fertility preservation can benefit several groups of individuals, including:
- Cancer patients: Chemotherapy, radiation therapy, and certain cancer treatments can negatively impact fertility. Fertility preservation options like egg or sperm freezing before cancer treatment can provide the opportunity to have biological children later.
- Individuals with medical conditions: Certain medical conditions or treatments, such as autoimmune diseases, genetic disorders, or surgeries, can affect fertility. Fertility preservation allows individuals to preserve their reproductive options before undergoing treatments that may impact fertility.
- Women delaying childbearing: Many women choose to delay childbearing for personal or professional reasons. Egg freezing offers the option to preserve their eggs at a younger age, when they are of higher quality, to increase the chances of future successful pregnancies.
- It’s important to note that while fertility preservation techniques have advanced significantly, they do not guarantee future pregnancy or the birth of a healthy child. The success of fertility preservation depends on various factors, including the individual’s age at preservation, the quality of the preserved gametes or embryos, and the fertility clinic’s expertise.
- Fertility preservation techniques have opened up new possibilities for individuals and couples facing fertility challenges. By preserving reproductive potential, individuals can make informed decisions about their family planning options and have increased control over their reproductive health.
Gynecology:
Gynaecology or gynecology (see American and British English spelling differences) is the area of medicine that involves the treatment of women’s diseases, especially those of the reproductive organs. It is often paired with the field of obstetrics, forming the combined area of obstetrics and gynaecology (OB-GYN).
Integrative Medicine:
Integrated medicine (or integrative medicine as it is referred to in the United States) is practising medicine in a way that selectively incorporates elements of complementary and alternative medicine into comprehensive treatment plans alongside solidly orthodox methods of diagnosis and treatment.
Obstetrics:
Obstetrics is the study that looks at pregnancy, childbirth and the postpartum period. As a medical specialty, obstetrics is combined with gynecology under the discipline known as obstetrics and gynecology (OB/GYN), which is a surgical field.
Ovarian Rejuvenation:
Ovarian rejuvenation is a medical process that can help women who are experiencing fertility challenges due to age or specific medical conditions. The procedure stimulates the ovaries to produce healthier and more abundant eggs. This can increase the chances of conception and pregnancy. It often involves PRP and Stem Cell Rejuvenation.
PCOS:
Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects women of reproductive age. It is characterized by hormonal imbalances that can disrupt the normal menstrual cycle and cause a variety of symptoms. PCOS is a common condition, affecting approximately 5-10% of women.
Symptoms of PCOS:
The symptoms of PCOS can vary from person to person, but common signs and symptoms include:
- Menstrual irregularities: PCOS can cause infrequent or prolonged menstrual periods, or even the absence of periods altogether.
- Ovarian cysts: Multiple small fluid-filled sacs, called cysts, can develop on the outer edge of the ovaries. These cysts contain immature eggs, known as follicles. However, these follicles often fail to mature and release eggs regularly.
- Hormonal imbalances: PCOS is characterized by elevated levels of androgens (male hormones) in the body. This hormonal imbalance can lead to symptoms such as acne, excessive hair growth (hirsutism), and male-pattern baldness.
- Insulin resistance: Many women with PCOS exhibit insulin resistance, which means their bodies have difficulty using insulin effectively. Insulin resistance can lead to high insulin levels in the blood, potentially increasing the risk of developing type 2 diabetes.
- Weight gain: PCOS is often associated with weight gain or difficulty losing weight. Insulin resistance and hormonal imbalances can contribute to weight-related issues.
Diagnosis and Treatment:
PCOS is a common hormonal disorder that can affect the menstrual cycle and cause various symptoms. While the exact cause is unknown, hormonal imbalances and insulin resistance likely play a role. Diagnosis involves a combination of medical history, physical examination, and laboratory tests. Treatment aims to manage symptoms, reduce the risk of complications, and improve fertility if desired. Early diagnosis and lifestyle modifications can help mitigate the long-term risks associated with PCOS.
PGS / PGT-A Testing: (Preimplantation Genetic Screening/Preimplantation Genetic Testing for Aneuploidy):
PGT-A (previously known as PGS) is a diagnostic procedure used in conjunction with IVF or ICSI to assess the chromosomal status of embryos. By identifying embryos with normal chromosome numbers, PGT-A aims to improve the chances of successful pregnancy and reduce the risk of certain genetic conditions. It is commonly recommended for older women, those with repeated IVF failures, or individuals with a history of chromosomal abnormalities. However, it’s important to discuss the benefits, limitations, and ethical considerations of PGT-A with a healthcare professional before making a decision.
Platelet Rich Plasma: (PRP) in fertility treatment:
Platelet-rich plasma (PRP) is a treatment that has been used alongside conventional fertility treatments like IVF to potentially enhance egg quality, uterine lining thickness, and endometrial receptivity, particularly in cases of recurrent implantation failure. PRP involves the extraction and concentration of platelets from the patient’s own blood, which are then re-administered in a targeted manner, such as into the ovaries.
While the preliminary evidence suggests potential benefits, further research is needed to establish the optimal protocols and confirm its efficacy. As with any fertility treatment, it is important to consult with a qualified healthcare professional to assess individual circumstances and determine the most appropriate course of action.
Recurrent Pregnancy Loss:
The definition of recurrent pregnancy loss (RPL) in the United States is two or more consecutive failed clinical pregnancies. A pregnancy loss is defined as a clinically-recognized pregnancy involuntarily ending before 20 weeks. Most pregnancy losses result from chromosomal, or genetic, abnormalities, and are random events.
In the United Kingdom, the definition is as having three or more consecutive early pregnancy losses. Naturally, this can be an incredibly difficult physical and emotional experience.
Recurrent Pregnancy Loss (RPL):
Recurrent pregnancy loss is defined as the occurrence of two or more consecutive pregnancy losses in the United States and three or more consecutive early pregnancy losses in the United Kingdom. While most pregnancy losses are caused by chromosomal abnormalities and are random events, other factors such as uterine abnormalities, hormonal imbalances, blood clotting disorders, immune disorders, and lifestyle factors may contribute to recurrent pregnancy loss. It is important for individuals experiencing recurrent pregnancy loss to seek emotional support and undergo a comprehensive evaluation to identify potential causes. Treatment options depend on the underlying cause, if identified, and may include surgical interventions, hormonal therapies, or supportive care during subsequent pregnancies.
Semen Analysis (sperm count test):
Semen analysis, or sperm count test, is a diagnostic procedure that evaluates the health and characteristics of a man’s sperm. It assesses sperm count, morphology, and motility, which are important factors for male fertility. The results of a semen analysis provide valuable information about sperm health and can guide further evaluation and treatment options if necessary. It is typically performed in specialized laboratories or fertility clinics under the guidance of healthcare professionals.
Stem Cell Rejuvenation:
Stem cell rejuvenation for ovarian treatment is an emerging field within regenerative medicine. The use of stem cells, such as mesenchymal stem cells derived from adipose tissue or fetal stem cells, is being explored for their potential to regenerate and treat the ovaries. Treatment is carried out using mesenchymal stem cells (derived from the patient’s own adipose tissue), or fetal stem cells, with the number of cells used decided according to the condition of the patient. Stem cells are removed in a hospital environment and after adequate reproduction, are injected directly into the ovary region. However, the clinical evidence supporting these therapies is still limited, and further research is needed to establish their efficacy, safety, and optimal protocols. It is important for individuals considering such treatments to consult with qualified healthcare professionals and understand the current state of scientific knowledge in this area.
