by Dr Agilan Arjunan, Fertility Specialist & Gynaecologist, KL Fertility Centre (Malaysia)
Conceiving a child and procreating is a natural human tendency. Many of usare blessed with children . However, some couples do face obstacles in their journey towards parenthood.
Modern fertility treatment such as an in-vitro fertilisation ( IVF) has helped many couples to conceive. Current IVF technology had seen many advancements , thus achieving a higher pregnancy rate . IVF has also become safer for patients.
Common risks associated with an IVF procedure are ovarian hyperstimulation ( OHSS) and multiple pregnancy.
The risk of OHSS has reduced dramatically with the current IVF protocols. However, the risk of multiple pregnancy varies depending on several factors such as the age of the woman, quality of the embryo and number of embryo transferred into the womb.
A well established IVF centre have their own medical guidelines pertaining to number of embryos to be transferred into the womb. Some countries have their own national guidelines which advises fertility specialists on number of embryos to be transferred based on patient and embryo factors.
Statistical probability points towards a higher pregnancy rate with increasing number of embryos transferred . In conclusion, the more embryos transferred into the womb, the higher the pregnancy rate.
So, why are IVF doctors concerned about the number of embryos transferred ?
According to medical history, in the periods of Hippocrates in 460-375 BC , fibroid was known as ‘uterine stone’. The first surgery for fibroid was done for the American President Abraham Lincoln’s cousin in 1809. The term fibroid was introduced in 1860.
Many women had been diagnosed with uterine fibroid. For some the fibroid is not medically important but for some women, fibroid can cause infertility.
What is uterine fibroid?
A woman’s womb or uterus is made up of muscles known as ‘myometrium’ . This ‘myometrium’ is composed of many strands of muscle fibres.
Fibroids arise from genetic alteration in a single muscle fibre. This causes the muscles to overgrow and form a fibroid. Circulating female hormone called oestrogen can cause growth of the fibroid.
However, fibroids can also grow in low oestrogen environment , possibly due to conversion of male hormone called androgens into oestrogen. Yes, females have male hormones too!
The problem with fibroid is , it can be a silent killer. Woman may have fibroids without ever knowing about it! This is because not all the fibroids cause symptoms. Whether the fibroid causes a problem depends on the size and location of the fibroid.