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BICORNUATE UTERUS AND PREGNANCY – SYMPTOMS AND DIAGNOSIS

BICORNUATE UTERUS – WHAT DOES IT MEAN?

One of the causes of infertility in women is congenital anomalies of the reproductive system. One of them is the bicornuate uterus.

It is caused by incomplete fusion of 2 embryonic structures called Müllerian ducts. This means that 2 „horns“ are formed in the upper part of the uterus, which give it a heart-like shape.

SYMPTOMS

The condition is usually asymptomatic. It is possible for women to suffer from painful or heavier periods. If there are other congenital anomalies (usually of the kidneys) complaints from the urinary-excretory system could be expected. In women trying to conceive, spontaneous abortions are more frequent.

PREGNANCY AND BICORNUATE UTERUS

Pregnancy in women with a bicornuate uterus is considered risky but not contraindicated. Expect more frequent OBGYN visits, as well as the possibility of the baby being born prematurely. Due to the unusual shape of the uterus, in about 50% of cases the fetus is  breech, which means a higher frequency of c-sections.

Other possible pregnancy complications in women with a bicornuate uterus include:

Low birth weight of the baby (due to the smaller uterine cavity)

Arterial hypertension during pregnancy

Vaginal bleeding during pregnancy

Postpartum hemorrhage

DIAGNOSIS

The diagnosis can be made with an ultrasound. 3D ultrasound is considered to provide 99% specificity in the diagnosis of a bicornuate uterus. Other tests that may be recommended to you are MRI, laparoscopy and hysteroscopy. It is recommended to have your  urinary system (kidneys, ureters, bladder) checked out as well, because in rare cases concomitant abnormalities are possible.

TREATMENT

Treatment is not required except in cases of recurrent miscarriages. Surgical correction of the uterus aims to remove the tissue forming the two horns, and the operation is laparoscopic.

Despite its challenges, a bicornuate uterus doesn’t necessarily mean the end of motherhood dreams. With advances in medical technology and personalized care, many women with this condition can carry out successful pregnancies. Regular monitoring and close collaboration with obstetricians greatly helps to mitigate potential risks and ensure the best possible outcome for both mother and baby.

WHAT CAUSES INFERTILITY IN WOMEN?

HYPERTENSION DURING PREGNANCY

Кърменето

BREASTFEEDING – BASIC QUESTIONS AND ANSWERS

Breastfeeding has been considered the best source of nutrients for the newborn.

Do I have enough breast milk?

This is the main question that every mother asks herself from the moment the baby is first put to the breast.

Does he or she have enough milk – is everything okay…?

In the first days after birth, the amount of colostrum that your breasts produce is completely sufficient for the nutritional needs of the baby. In the next few weeks after birth, the babies need to nurse very often because their stomach is small, they get tired quickly and cannot take large amounts of breast milk to satisfy their needs for long periods of time.

In the beginning, it can be difficult to know if the food is enough for the baby. The simplest rule to help you is to keep track of diapers. During the first month of a child’s life, stools are an extremely sensitive indicator and can guide you when everything is fine and when you need to seek for help. It is known that sometimes bottle feeding can cause the baby to wean, and nursing mothers are often warned against using bottles.

But there are situations when complementary feeding is expected to be a long-term and essential part of the feeding plan, or the baby is in a more serious condition that requires feeding to take a minimum of effort, then parents choose the bottles. However, since bottle feeding does carry a risk to breastfeeding success, it is important to do it in a way that closely resembles and preserves breast feeding skills.

We will focus on several important points when choosing a bottle and teat:

The bottle – The only important thing when choosing a bottle is the material from which it is made. Because of serious doubts about the health risks of BPA, it is preferable to choose plastic bottles that have been proven to be free of BPA – or glass bottles.

The teat – The success of combining breast and bottle depends to a large extent on two things: The strength of the stream and the speed with which the milk is poured into the mouth. How similar the position of the baby’s lips and tongue on the teat is to the breastfeeding position.

Carefully monitor your baby’s pacifier for the following: How big an angle is achieved in the corner between the baby’s lips – sharp or obtuse?

When breastfeeding, we aim for the lips to be wide open with an angle of more than 120 degrees, and it is important that the same happens on the bottle. How do the lips lie on the teat – are any of them pressed and sucked in? Are there holes in the corners of the mouth where milk leaks out? The answers to these questions will guide you to what extent the pacifier you use allows you to mimic breastfeeding as well as possible.

The goal is for the baby’s lips to be wide open, without being tense and without the upper one being bitten inward.

The vacuum they create around the teat should be good and there should be no leakage of milk from the sides. Rubber or silicone? It’s a matter of personal preference. Rubber teats made of natural material are softer and may be more comfortable for a newborn baby. Their disadvantage is that they wear out quickly. Silicone is a harder and fully synthetic material, but it is significantly more resistant, which – combined with its attractive transparency – makes it a favorite of most mothers.

BREASTFEEDING: WHY IS IT GOOD FOR BOTH YOU AND YOUR CHILD?

ПРЕТОПЛЯНЕ НА БЕБЕТО

OVERWARMING THE BABY – HOW TO AVOID IT?

Summer is in full swing, and high temperatures are a fact.

How to protect the baby from the heat?

– is a question every mother asks herself.

What we should keep in mind and what to watch out for – you can read in the following lines.

During the first months of the newborn, his thermoregulation is still imperfect.

It is unable to respond adequately to sudden temperature changes occurring in its surroundings. Because of these physiological features, babies in the first months are more susceptible to both cooling and overheating. Overheating, especially in the summer months, often affects older children as well, but overheating in childhood can be the result of many factors – climate, inappropriate clothing, high temperature in the children’s room, thick blankets, etc. The sweat glands are not yet functional during the first months after birth, and this is also the reason why the body cannot cool itself by sweating.

In the following lines, we will pay attention to several signs that are associated with overheating and for which we should be careful:

  • Increased body temperature and manifestations of drowsiness
  • Rapid breathing
  • Redness of the face or other parts of the body
  • Sweating in the head or forehead area
  • State of nervousness
  • Nausea or vomiting
  • A rash characterized by small red pimples on the face, neck, the abdomen, back, chest, groin and other parts of the body.

How to avoid overheating the baby?

  1. The room temperature should be in the healthy range of up to 24 degrees
  1. Avoid exposing the baby to direct sunlight, especially in noon, when the sun is at its strongest.
  1. Do not dress the child in more layers of clothing than you wear yourself in the moment – if possible, the clothes should be made of natural material.
  1. Never leave your baby unattended in your vehicle.
  1. During the summer months, after a bath, avoid applying creams and lotions to the baby or oils.

The mild rash, which appears as a rash, does not have serious consequences for the child’s health, it is just a temporary discomfort.

However, overheating in a higher degree can lead to vomiting, pressure of the electrolyte balance, dehydration and other more serious problems. What to do if this still happens:

-as quickly as possible, provide a cool room to put the child in

– provide wet towels with lukewarm, but not cold water and apply to the skin – if possible give frequent small sips of water

– measure the temperature and if it does not fall below 39 degrees – contact your doctor

In conclusion, it is clear that with proper behavior in different seasons and avoiding the causes leading to overheating during the hot summer months, we could save ourselves unpleasant experiences, both for the baby and for the whole family.

SOURCE: APTEKI ZAPAD

GENTLE CARE – ADVICES FOR LITTLE ONES

КАКВО МОГА ДА НАПРАВЯ, ЗА ДА ПОВИША ШАНСОВЕТЕ СИ ЗА УСПЕХ ПРИ IVF?

WHAT CAN I DO TO INCREASE MY CHANCES OF A SUCCESSFUL IVF PROCEDURE?

The success rate of IVF (in vitro fertilization) can vary depending on a variety of factors, including the woman’s age, the cause of the infertility, the quality of the eggs and sperm, the number of embryos transferred, and the experience of the reproductive health center you choose.

In general, the success rate is higher in younger women and decreases with age. According to the American Society for Reproductive Medicine (ASRM), fresh embryo transfer IVF success rates for women under 35 are typically around 40-50% per cycle, while for women over 40 the success rate is lower, ranging from 10 -20% per cycle. However, these percentages may vary depending on individual circumstances.

HOW CAN I IMPROVE MY CHANCES OF SUCCESS?

    1. Choose a reputable reproductive health center: Look for clinics that specialize in ART (assisted reproductive techniques) and have experienced reproductive health professionals.

     

    2.Make positive lifestyle changes to optimize fertility. This includes maintaining a healthy weight, exercising regularly, quitting smoking, reducing alcohol consumption and managing stress. If you suffer from a chronic disease such as arterial hypertension or diabetes, it is important that it is well controlled.

     

    3.Strictly follow the prescribed medications and treatment protocols provided by your reproductive health professional. This may include taking various pills, or injecting yourself or examinations at your reproductive health center.

     

    1. Consider preimplantation genetic diagnosis (PGD): it can help identify chromosomally normal embryos, which would increase the chances of successful implantation, reducing the risk of miscarriage.

     

    1. Psychological support: IVF can be emotionally challenging. Seeking counseling or joining support groups can reduce stress and improve overall well-being during the process.

     

    1. Be informed and ask questions: Educate yourself about the IVF process, potential risks and success rates. Ask questions and communicate openly with your reproductive health professional to make sure you understand the treatment plan and have realistic expectations.

If you have had an unsuccessful IVF procedure, remember that this does not equal failure. It is important to consult with a qualified professional in the field who can provide personalized advice based on your particular situation.

I AM 40. IS IT TOO LATE TO HAVE A BABY?

БЕБЕ

THE FIRST MONTHS WITH OUR BABY – SHORT GUIDE

The appearance of the new member in the family is associated with many emotions, excitement and sometimes with fears, especially if we become parents for the first time.

The reason for this is the uncertainty we feel, the power of responsibility we assume as parents and at the same time the desire to give the best to our baby. In fact, our fears are completely unfounded.

Let’s not forget that our child carries our genetic „material“ and his sense of comfort approaches ours. It is very important to be calm in the first weeks after birth in order to learn to recognize the signals that the baby is giving us – so we will provide him with what he needs.

Often in the first months we receive a lot of different and sometimes contradictory advice.

How to decide which advice to take? – well, it’s simple. Imagine the advice you’ve been given, how it will affect you if you apply it to yourself – and instantly you’ll feel whether it’s good and suitable or not – for

your baby.

For example, if we expect our baby to eat at a precise interval – a precise amount, we should think about whether we would be as happy if we had to consume a precise amount at a precise time.

We certainly won’t like it.

Sometimes we sleep longer, sometimes we just ate more and won’t be hungry at the appointed time, so modes are a subjective concept and the only important thing for our baby is to get what he wants according to his needs and desires. The same rule applies to the conditions under which we raise our baby and the maintenance of his personal hygiene.

For example, how would we feel if we had to sleep with a hat or with limited movements, or how would we feel if we didn’t know we were in the bathroom and someone poured water on our back, we would immediately react by tensing our body. Therefore, we must approach in every action to our baby as we want and approach ourselves. It is very important to mention the attention we must pay to inform ourselves in detail about the reception, storage, method of use, period of use of every single thing that we had to give to the baby.

Most often, in the first months, these are drops for colic, probiotics, vitamins and medications that facilitate bowel movements.

Accurate and specific information would certainly help us feel at ease and at the same time save us from some rather unpleasant situations arising from underestimating the importance of this action. Thus we come to the conclusion that calm, secure and informed parents certainly create conditions for their children to grow up healthy, calm and happy.

GENTLE CARE – ADVICES FOR LITTLE ONES

APTEKI ZAPAD

МОГА ЛИ ДА ПЪТУВАМ СЛЕД ЕМБРИОТРАНСФЕР?

CAN I TRAVEL AFTER AN EMBRYO TRANSFER?

WHAT CAN I DO AFTER EMBRYO TRANSFER?

Summer is approaching and many of us are starting to make vacation plans. However, what about the women who are about to undergo an embryo transfer? In this article, we will look at this question and provide some ideas to help you make an informed decision.

Embryo transfer is the final step in an IVF treatment where, with the help of a thin catheter, the gynecologist deposits the embryos into the uterine cavity.

After embryo transfer, you can return to your normal lifestyle. You don’t have to lie down all day (if you don’t want to), but it’s extremely important to take enough time to rest. Avoid intensive workouts, stressful situations, as well as overheating (going to the beach or sauna, taking a bath, etc.).

CAN I STILL TRAVEL?

In general, most medical professionals recommend avoiding long trips immediately after an embryo transfer. The first 24 hours after the procedure are crucial for the implantation of the embryo, which is why it is important to minimize stress.

However, short trips or moderately strenuous activities that do not involve excessive physical exertion are generally considered safe.

It is recommended that you listen to your body and take the necessary precautions by avoiding heavy lifting, intense exercise or anything that may put unnecessary strain on your body.

During your vacation, don’t forget to eat well and drink enough fluids in the summer heat. Avoid swimming in pools due to the risk of infection.

Of course, before you book your trip, it’s a good idea to discuss your plans with your reproductive health specialist. They can give you the best advice on whether traveling would be safe for your specific case.

Ембриотрансфер при ин витро

БРЕМЕННОСТ И ТРОМБОФИЛИЯ

PREGNANCY AND THROMBOPHILIA – WHAT WE SHOULD KNOW?

Thrombophilia is a condition in which the blood has an increased tendency to form blood clots. Pregnancy is a state in which the woman’s blood becomes more prone to clotting, and this tendency is further enhanced in women with thrombophilia. This can lead to serious complications during pregnancy and childbirth.

TYPES OF THROMBOPHILIA

Inherited thrombophilias include factor V Leiden mutation, prothrombin G20210A mutation (also referred to as factor II mutation), protein C deficiency, protein S deficiency, antithrombin deficiency and methylenetetrahydrofolate reductase mutations. Acquired thrombophilia is associated with antiphospholipid syndrome and unfortunately is one of the most severe forms of thrombophilia.

TESTING FOR THROMBOPHILIA

Congenital thrombophilias are detected by genetic testing for mutations. Antiphospholipid syndrome is diagnosed when there are positive tests for lupus anticoagulant, anticardiolipin antibodies and anti-β2-glycoprotein antibodies.

WHAT ARE THE RISKS ASSOCIATED WITH THROMBOPHILIA?

Thrombophilia can increase the risk of conditions such as pre-eclampsia, miscarriage, stillbirth, and placental abruption. Women with thrombophilia are also at higher risk of developing deep vein thrombosis (DVT) during pregnancy.

Apart from pregnancy complications, thrombophilia is connected to an increased risk of heart attack, stroke and pulmonary embolism.

RISK PREVENTION

To manage the risks associated with thrombophilia during pregnancy, women may need to take anticoagulant medications, which help to prevent blood clots from forming. They may also require regular ultrasounds to monitor the health of the fetus and placenta. Even if you suspect you may suffer from thrombophilia, don’t take any medications unless they have been prescribed by a physician!

It is important for women with thrombophilia to discuss their pregnancy plans with their healthcare provider and receive appropriate counseling and treatment to reduce the risk of complications.

ПОВТАРЯЩА СЕ НЕУСПЕШНА ИМПЛАНТАЦИЯ И ИН ВИТРО: КАКВО ТРЯБВА ДА ЗНАЕМ?

СЪХРАНЯВАНЕ НА СТВОЛОВИ КЛЕТКИ ПРИ РАЖДАНЕ

STEM CELLS HARVESTING AT BIRTH

Stem cell have the unique ability to transform into any cell in the human body.

It is believed that the beginning of the study of stem cell was in the 1960s after the research of Canadian scientists Ernest McCulloch and James Till. The umbilical cord contains two types of stem cells: hematopoietic, found in the blood of the umbilical cord, and mesenchymal, found in the tissue of the umbilical cord.

WHAT CAN STEM CELLS BE USED FOR?

As medicine advances, new uses for stem cells are constantly being discovered. They are approved for the treatment of nearly 100 severe conditions, including blood disorders, different types of cancer, metabolic disorders, autoimmune diseases, etc. Studies are underway on the use of stem cells to repair the heart after a heart attack. Stem cells are also used to repair severely damaged soft tissues.

IS STEM CELL HARVESTING DANGEROUS FOR THE DONOR?

Stem cells are harvested from the baby’s umbilical cord after birth. The process is painless and safe for both mother and baby. Usually both cord blood and tissue are harvested. The procedure can be performed either by the delivery team or by a person from the tissue bank of your choice.

FOR HOW LONG ARE STEM CELLS STORED?

Stem cells are stored for a period of 20 years. After that, the contract can be renewed by your child who will already be an adult.

HOW MUCH DOES STEM CELL HARVESTING COST?

The entire procedure of performing the necessary laboratory tests, the harvesting itself, processing and storage of the stem cells for 20 years costs about BGN 5,000. Most tissue banks offer various installment payment options.

There is an option to donate stem cells to the National Public Umbilical Cord Stem Cell Donor Bank, which is free of charge. The difference with private tissue banks is that in a public tissue bank the preserved biological material is made available to the people who need it, whether they are donors or just people needing a transplant.

ESSENTIAL TESTS AND TIPS FOR A PEACEFUL PREGNANCY

КАКВО ВСЪЩНОСТ Е ТИРЕОИДИТ НА ХАШИМОТО?

WHAT IS HASHIMOTO’S THYROIDITIS?

In women with Hashimoto the immune system attacks the thyroid gland, which secretes the hormones Triiodothyronine (T3) and Thyroxine (T4). Due to structural and functional damage, over time the thyroid gland starts to secrete smaller amounts of T3 and T4. The medical term for this condition is “hypothyroidism” (“hypo” – sub, low). The main function of both hormones is to regulate basal metabolic rate, heart rate and body temperature. When T3 and T4 levels are low, the metabolic and heart rates drop and body temperature decreases. This leads to a number of other symptoms, most notably constipation, fatigue and weight gain.

GETTING PREGNANT WITH HASHIMOTO

As we have discussed in previous articles, being overweight by itself makes conceiving more challenging because of the hormonal imbalance it causes. The increased amount of fatty tissue converts male sex hormones (androgens) into female sex hormones (estrogens). Often this is accompanied by insulin resistance (cells do not react to insulin), which in turn leads to elevated levels of insulin and androgens (male sex hormones). All of these factors have a negative effect on ovulation. It can become irregular or stop completely, which makes getting pregnant more difficult.

Even if they are not overweight, women with Hashimoto have a hormonal imbalance associated with decreased levels of T3 and T4. This can in itself lead to ovulation disorders and difficulty getting pregnant.

Even after getting pregnant, hormone levels in women with Hashimoto have to be monitored much more closely, because pregnancy has higher demands on the thyroid gland. If those are not met complications and even miscarriage can ensue. However, close monitoring of the pregnancy and good management of the autoimmune condition greatly improve chances of an uncomplicated pregnancy carried to term.

All this may sound alarming but remember that modern medicine offers very good management of Hashimoto’s thyroiditis. The most important thing is early diagnosis! In February 2018, the famous American supermodel Gigi Hadid announced on social media that she was diagnosed with the autoimmune disease. However, that did not stop her from becoming the 5th highest paid model in 2017, with $ 9.5 million annual income.

 

ПРОБЛЕМНО ЗАБРЕМЕНЯВАНЕ, ДОНОРСТВО И ЗАМРАЗЯВАНЕ НА ЯЙЦЕКЛЕТКИ (1)

INFERTILITY, DONOR EGGS AND EGG FREEZING

Some couples, in order to conceive, need donor eggs. To confirm that, your fertility specialist will first order a panel of tests. An alternative to donor eggs would cryopreservation a.k.a. egg freezing earlier in your life.

WHO MIGHT NEED DONOR EGGS?

The main category of patients who might benefit from donor eggs are the so-called “low responders”. Those are women, who do not respond well to ovarian hyperstimulation due to their age or premature ovarian failure, or women who have not frozen their own eggs.

WHO CAN BE AN EGG DONOR?

In Bulgaria, according to Ordinance 28 on Assisted Reproduction, egg donation „can be from anonymous donors or from related donors (sister, cousin)“ In both cases, the donor must meet strictly defined criteria: age, to have at least 1 live-born child, and to have negative test results for HIV, hepatitis B and C, and syphilis.

WHEN IS IT APPROPRIATE TO FREEZE MY OWN EGGS?

There are a few situations where your doctor might recommend egg freezing. For example, if you’ve been diagnosed with premature ovarian failure or you have family history for premature menopause. Also, cancer patients can greatly benefit from egg freezing, as life-saving chemo- or radiotherapy can impact ovarian reserve and fertility.

CAN I FREEZE MY EGGS WITHOUT MEDICAL INDICATIONS?

There is also the so-called egg freezing for social reasons, which is becoming increasingly popular. It is suitable for women who would like to postpone motherhood for later in life due to career development, studying, lack of a suitable partner, etc. We know that as you get older, not only does the quantity but also the quality of eggs decreases, which affects fertility, as well as the success rate of assisted reproduction. When you choose cryopreservation, the eggs remain at the age at which they were frozen, which gives women great freedom to choose the best moment to become mothers.

EGG QUALITY- HOW CAN I HAVE THAT ASSESSED? (newlifeclinic.bg)

Egg freezing – Ин витро клиника, акушерство и гинекология България (newlifeclinic.bg)

Asked questions about New Life’s donor egg program (newlifeclinic.bg)

 

 

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