Ask Dr. Rita Bakshi

Question 1: I am 32 year-old women and trying to conceive from past eight months. My TSH level (thyroid) is low. Should I be worried? Is it going to affect my fertility? How long would it take to bring it back to the normal range ?

Answer: You have not described the exact TSH level, however, the inappropriate TSH levels, may be caused by problems in the thyroid gland itself. When the gland can produce too much hormone, it is called as hyperthyroidism. Common symptoms of hypothyroidism include fatigue, weight gain, constipation, loss of sex drive, hair loss, dry skin, loss of periods, and miscarriages. The most common cause of hypothyroidism is Hashimoto’s thyroiditis, an autoimmune condition where the body makes antibodies that destroy parts of the thyroid gland. Thyroid dysfunction has been shown to adversely affect fertility. Treating hypothyroidism is an important part of any effort to correct infertility. Not all women who are hypothyroid are infertile, and many hypothyroid women do conceive.

In your case, I would suggest to seek an additional help from an infertility specialist with all your medical reports. Sometimes your TSH just rebalances itself, so no deeper testing is necessary. And if you have hypothyroidism and become pregnant, tell your doctor immediately. During pregnancy close monitoring of your thyroid hormone level is necessary as it can promote normal fetal development and reduce the risk of miscarriage. Screening for hypothyroidism is recommended for all pregnant women and is usually done during your first prenatal visit. Hypothyroidism is readily treated with a daily oral dose of thyroid hormone.

Question 2: My age is 22 and I am having irregular periods from last 2-3 years. What should I do to get back my regular periods?

Answer: You have irregular periods from last 2-3 years. Have you ever visited your nearest GP? You should discuss the details with the doctor as in some cases, it may be a symptom of sever issues such as endometriosis. Besides taking help from doctor, I would advise you to do some relaxation exercises in the morning by doing slow and deep breathing. Take 8 glasses of water daily. Keep your weight normal as compared to your height. Hope this will help you in your periods.

Question 3: I have been trying to conceive from one year but unsuccessful so far. I am 35 and my wife is 34-years-old, and my semen analysis report shows, sperm concentration is low. What If I will pursue for natural pregnancy instead of IVF directly, please help?

Answer: Nobody wants to do IVF in the first place. Whenever an individual or a couple arrives at fertility clinic or IVF centre, they wish to maximize the chances for pregnancy as naturally as possible. There can be two reasons, financial and emotional. It is quite difficult for some couples to step into the world of IVF where one or two embryos are created in the petri dish and the entire process is done in the laboratory instead of taking place inside the body.

But in your case, one year has passed with unsuccessful results and you have also found the root of the problem, low sperm concentration. Thus it certainly means, you are suffering from general infertility. In this scenario, I would like to elaborate the situation in which IVF treatment can help you to achieve pregnancy rather than waiting for natural conception to occur.

You might be thinking to improve your sperm quality. This could be done with the changing lifestyle, by taking vitamins and minerals or through medication such as Clomid to maximize the stimulation of the testes, and through intrauterine insemination to deliver more sperm to the ends of the fallopian tubes.

But none of the above options is as effective as doing IVF. The basic reason is that by doing IVF, we can bypass all concerns associated with sperm be it count, motility, morphology. All the things are being treated with advanced a single procedure, by doing intracytoplasmic sperm injection, or ICSI. ICSI places the sperm into the eggs.

IVF is considered an extraordinarily effective treatment, as long as the sperm’s DNA can support a healthy embryo. So, you should be going for IVF thus to achieve the successful pregnancy, otherwise waiting will not provide you any benefit.

Question 4: I am 37 year old women with having high quantity of eggs but with low quality. How can IVF help me to have a successful pregnancy?

Answer: Your situation is indeed a complex one but not worrisome. Many couples, particularly when women whose age is above 35-years-old, increasingly worry about egg quality. IVF is not beneficial for all the cases particularly with old age woman with poor quality of eggs.

As far as your case is concerned, I would say IVF is a numbers game. During the treatment, you are given high-dose fertility drugs, and instead of the two to four eggs we would be aiming for ten, fifteen or twenty eggs with IVF. Thus, if egg quality is a concern, and egg quantity is high, then IVF has a superb chance of being more beneficial than any other therapy. The process will happen when ten to twenty eggs are fertilized at a time. It is like one to two years of trying naturally all focused into a single cycle. By taking such steps, you can easily attain a successful pregnancy.

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