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Silent Pain : Endometriosis
by Dr Agilan Arjunan, Fertility Specialist & Gynaecologist, KL Fertility Centre ( Malaysia)
Pain relates to a neurological sensation causing emotional or physical discomfort. The endurance of pain not only limits the individuals capabilities but may alter their quality of life. Therefore, the pursue of relief is of outmost importance and need.
Pelvic pain is commonly associated with women and is one of the common reasons for a visit to the gynaecologist. The diligent gynaecologist conducts a through examination, orders several test as required, identifies the root cause and administers appropriate treatment. This task is carried out so that the pelvic pain is relieved and the women is back to her pain free lifestyle.
What if the medical examination and routine test by the gynaecologist yield normal results? In that case, what is the cause of the pelvic pain? Can the pain be relieved?
I am sure some women have gone through this similar predicament. They are quite familiar with the medical term “Endometriosis”. A condition related to pelvic pain that have silently been endured by these women.
What is Endometriosis ?
Endometriosis is a condition where the cells of the uterus ( womb) lining ( endometrium) is found outside of the womb. Endometriosis is often associated with cyclical period pain and sometimes it leads to long term pelvic pain.
Deposits of endometriosis can be found anyway outside of the womb, namely on the innermost layer of the abdomen ( peritoneum) , ovaries , Fallopian tubes , bladder and large bowels.
In severe cases, it can also be found on the vaginal wall.
Oral pills for Azoospermia
by Dr Agilan Arjunan, Fertility Specialist & gynaecologist, KL Fertility Centre ( Malaysia)
For men with Azoospermia ( no sperm in his ejaculate) , oral tablets can be used to ‘push’ sperm production in his testicles.
Study-finds-combination-therapy-to-be-safe-effective-for-treatment-of-male-infertility
However, before starting the tablets, men need to undergo initial fertility assessment to check for suitability of stating these medications.
If sperms seen in the ejaculate, they can be frozen and used for an IVF / ICSI later.
Source: News Medical Life sciences
I Have Irregular Period
by Dr Agilan Arjunan, Fertility Specialist & Gynaecologist, KL Fertility Centre ( Malaysia)
This is a simple basic guide for women with irregular period.
What are absent or irregular periods?
Absent or irregular periods are periods that do not happen at all or that happen less than 6 to 8 times a year. If a woman does not get her period for a while, it might be because she is pregnant. Or in some cases, it might be that she has a medical condition that affects her reproductive system.
What causes absent or irregular periods?
Absent or irregular periods can be caused by:
●Pregnancy
●PCOS (which stands for “polycystic ovary syndrome”). In women with this condition, the ovaries make too much male hormone. This can disrupt a woman’s periods and cause excess facial hair, acne, and problems with weight. PCOS is the most common cause of absent or irregular periods.
●Being too thin or not having enough body fat
●Exercising too much
●Too much prolactin – Prolactin is a hormone made in the “pituitary gland”, which is a small organ at the base of the brain.
●Early menopause – Menopause is the time in a woman’s life when she naturally stops having periods. Menopause usually occurs between the ages of 45 and 55. But in some women, menopause comes early – before the age of 40. Early menopause happens when the ovaries run out of eggs earlier than normal.
●Certain types of hormonal birth control – Some forms of birth control can cause absent or irregular periods. This is more common with those that contain only the hormone progestin. Examples include the progestin-only pill (sometimes called the “minipill”), the implant, and hormone-containing intrauterine devices (IUDs).
Should I see a doctor or nurse?
See your doctor or nurse if:
●You are older than 15 and still have not had your period
●You used to get periods, but you have not had a period for more than 3 months
●Your periods happen more than 45 days apart
Fertility Genetics Simplified
by Dr Agilan Arjunan, Fertility Specialist & Gynaecologist , KL Fertility Centre ( Malaysia)
The science involved in the treatment of infertility has rapidly advanced in the past few years . This advancement is clearly seen in the field of In-Vitro Fertilisation or IVF.
Current technology enables us to look into the genetics of human reproduction. Genetic testing also provides answers to infertility; and in some cases solutions.
Preimplantation Genetic Screening ( PGS)
IVF involves creating embryos in an IVF laboratory and replacing the embryo/embryos back into the womb.
Traditionally an embryo is graded based on its morphology ( external appearance under a microscope). The embryo/embryos with the best gradings is/are transferred back into the womb.
A morphologically-normal embryo with the best grading does not necessarily indicate that the embryo is genetically normal ( euploid embryo).
A genetically-normal embryo will lead to a successful pregnancy , assuming there are no other factors contributing to a failed embryo implantation or pregnancy.
Preimplantation genetic diagnosis (PGS) looks at the genetic normality of the embryo prior to an embryo transfer procedure.
Embryos are typically grown up to 3 to 6 days before the biopsy is performed.
Biopsy of the embryos are done when the embryo is either 3 days old or when they have reached Day 5 or 6 , known as a blastocyst.
Biopsy of the blastocyst is usually preferred because more cells are obtained from the embryo thus increasing the chances of the PGS to be performed successfully.
To be able to perform the biopsy, a small opening is made on the outer layer of the embryo , using either mechanical, chemical or laser technology.
