March 2018 - Ин витро клиника, акушерство и гинекология България

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ANABOLIC STEROIDS AND MALE FERTILITY

Тestosterone and its synthetic derivatives have been used to increase muscle mass for a long time. Although forbidden for professional athletes, they are sometimes used by men practicing amateur sports. Along with their effects on physical appearance and libido, steroids also affects male fertility.

WHAT HAPPENS IN THE BODY WHEN YOU TAKE ANABOLIC STEROIDS ?

Testosterone stimulates spermatogenesis. When a man is taking extra testosterone, its internal production in the testes is inhibited and spermatogenesis is disturbed. The result is reduced amount to a complete absence of sperm in the semen, which can be detected by a regular semen analysis. This effect is very often observed when anabolic steroid administration is not prescribed or overseen by a physician.

Some couples have problems conceiving because of anabolic steroids intake by the male partner. Although their use may lead to complete suppression of spermatogenesis, this condition is in most cases reversible. The longer the drugs were taken, the longer the recovery of spermatogenesis takes. Improvement of semen analysis results can be observed after at least 3 months following discontinuation of the anabolic steroids. After that many couples get pregnant naturally. In rare cases, long-term use of steroids leads to permanent suppression and male infertility.

ANABOLIC STEROIDS AND ASSISTED REPRODUCTION

Even if the man hasn’t used anabolic steroids for a long time, sometimes there are indications for in vitro fertilization (IVF) or intrauterine insemination (IUI). This could be caused by a female infertility factor. If this is your case, you must inform the treating fertility specialist that you have taken steroids in the past.

Anabolic steroids are strictly prohibited prior to an assisted reproductive procedure (IUI or IVF). ANABOLIC STEROID INTAKE NOT PRESCRIBED BY A PHYSICIAN ESPECIALLY PRIOR TO AN ASSISTED REPRODUCTIVE PROCEDURE HAS STRONG NEGATIVE IMPACT ON THE OUTCOME OF THE PROCEDURE.

If you use or have used steroids and you have been trying to get your partner pregnant for more than a year, consult with a reproductive medicine specialist. They will refer you for the necessary hormonal tests (e.g. for testosterone, follicle stimulating and luteinizing hormone) and semen analysis. This will give you information about your hormonal profile and sperm count. If necessary you will be prescribed medication that will improve hormonal imbalance and stimulate spermatogenesis.

WHAT IS IMSI FERTILIZATION and HOW IS IT DIFFERENT FROM ICSI?

An in vitro fertilization (IVF) procedure normally starts with hormonal stimulation, proceeds with oocyte recovery trough an ovarian puncture, oocyte fertilization, culturing of the resulting embryos and concludes with an embryo transfer procedure. The step considered by many to be the most technically complicated is the oocyte fertilization step. This is especially true if fertilization is carried out by the IntraCytoplasmic Sperm Injection (ICSI) method. The other main method of fertilization is called Conventional In Vitro Fertilization.

What is ICSI fertilization?

ICSI fertilization is mainly used in male factor infertility cases. The nature of the procedure allows oocytes to be fertilized even in the presence of only single motile spermatozoa with good morphology. This is achieved as the embryologist catches these single spermatozoa by means of the so called micromanipulator (See Fig.). Each of the selected spermatozoa is separately immobilized, aspirated in the injection micropipette and injected into a single oocyte.

What is the difference between ICSI and IMSI?

IMSI is an improved version of ICSI (IntraCytoplasmic Sperm Injection) which allows the embryologist to look at spermatozoa at a much higher magnification (x 6000), compared to x600 or less for the standard ICSI procedure. The higher magnification allows much more detailed visualization of subcellular structures like the acrosome, the head, the midpiece, the cytoplasmic droplet or the tail of the spermatozoon. Therefore, with IMSI a much more precise selection of spermatozoa is achieved. Following the selection of particular spermatozoa, the IMSI procedure is identical to ICSI.

The IMSI method is useful for patients with a very low percentage of spermatozoa with normal morphology. Although it is more laborious and much more time-consuming, for those patients it is definitely beneficial. In some cases the IMSI procedure is also recommended for couples with a few unsuccessful ICSI cycles as well as couples with recurrent abortions. Talk to your reproductive specialist to find out which is the most suitable method in your case!

A BOY OR A GIRL

A BOY OR A GIRL – WHAT ARE THE PREFERENCES OF THE PARENTS OF TODAY?

Some parents know whether they want a boy or a girl even before they have seen the positive test. Others do not have particular gender preferences and only hope for the pregnancy to go smoothly.

However, it is far more interesting how the preferences of modern parents have changed from those of the previous generations.

In the past, parents preferred having a boy. In the social context of the past that was fully understandable. The norm was for the son to remain at his father’s house, while the daughter went to her husband’s house. In this way she became part of his family, continued his family line and takes care of his parents when they grow old. Some societies nowadays have still not managed to break free of this stereotype and most parents over there still prefer having boys.

Nowadays, young couples do not have to live with either one’s parents. Furthermore, the boundary between gender roles is now almost obsolete. Both men and women have close to equal opportunities for career development and financial well-being. In some families in the west children even inherit BOTH their mother and their father’s last name. The most famous example of that is Shiloh Jolie-Pitt, the first born daughter of Angelina Jolie and Brad Pitt. All these things contributed to the shift in gender preferences for babies. More and more parents-to-be say that they want to have a girl.

CAN PARENTS CHOOSE THE SEX OF THE BABY?

For pregnancies conceived naturally, the answer is no. However, the sex of the baby usually becomes known at around the 20^th week of gestation as part of a routine ultrasound examination. It can be known even earlier (~ 9^th week of gestation) if an optional non-invasive DNA screening test is done.

А Вие имате ли предпочитания за пола на бъдещото Ви дете? А ако вече сте родители, сбъдна ли се Вашето желание?

For pregnancies conceived through IVF there is a method that makes possible the transfer of only female or male embryos. It is called Preimplantation Genetic Diagnosis (PGD) and is usually employed in cases where there is a genetic disease segregating in the family. The method can be used for selecting embryos based on gender, not only based on the absence of a disease gene. However, according to Bulgarian Law gender selection of embryos is only allowed for medical reasons. In other words, it is allowed in cases of sex-linked genetic diseases which affect predominantly one gender (usually males – hemophilia, color blindness, etc.).

Do you have any preference for the sex of your future child? And if you are already a parent, was your wish fulfilled?

International Women’s Day

In honor of the International Women’s Day, New Life clinic would like to invite all ladies who still do not know us personally to come for a free gynecology exam and pap test with one of our specialists.

The goal of the campaign is Prevention in Women’s Health.
Coming out for the exam and pap test does not make you financially obligated in any way. It is completely free!
New Life clinic kindly asks those wishing to take advantage of the offer to call 032/ 693 693 in advance to make an appointment.
The number of free examinations is limited due to the busy timetable of our specialists so we do ask you to call in advance.

Physicians participating in the Women’s Health Prevention campaign: Dr. Dimitar Tanev and Dr. Andrey Minchev. You can receive your test results via e-mail or at the clinic.

We at the New Life clinic have always tried to be useful and we hope that this time we have surprised you pleasantly! Happy Holiday to You All, Ladies!

Campaign starts 08/03/2018 – ends 30/03/2018.

Conditions: Make an appointment at: 032 693 693

CAN I CONCEIVE NATURALLY IF I HAVE ENDOMETRIOSIS?

We have published articles, dedicated to endometriosis in the past. Undoubtedly, the one question which interests many of you the most is “Can I conceive naturally if I have endometriosis?” In this article we address this question specifically.

What is endometriosis?

Endometriosis is a condition in which cells from the uterine lining / endometrium / is found in atypical sites – Fallopian tubes, ovaries and even intestines. These outgrowths are influenced by sex hormone levels. They react in very much the same way that the lining of the uterus does (bleeds cyclically every month). This is a prerequisite for the development of inflammation that results in the formation of adhesions that may lead to issues in the future, including such related to conception.

Conception and endometriosis

In general women with mild forms of endometriosis have the same chance of getting pregnant naturally as women without this condition. In middle and severe forms of endometriosis, issues associated with natural conception may occur. These issues are most often caused by adhesions in the fallopian tubes or endometrial outgrowths in the ovaries. Fallopian tube adhesions partially or completely obstruct the transportation of the egg along the tube while endometrial growths in the ovaries can affect ovarian reserve. Depending on the exact cause, the treating obstetrician-gynecologist directs the patient to the most suitable method of treatment which would allow the patient to conceive. Methods of treatment include conservative treatment with medication, intrauterine insemination (IUI), in vitro fertilization (IVF) or surgical removal of endometrial growths.

It is very important to know that endometriosis is diagnosed only histologically. In other words a diagnosis is put forward only after a laparoscopic surgery and histological tests. Endometriosis is by no means a verdict especially when it comes to conception. Some minor changes in lifestyle can help natural conception. For example, a diet rich in fruit and vegetables along with regular physical activity suppresses inflammatory processes, which cause adhesions and tissue damage.

We must not forget that the most important thing when it comes to any medical condition is early diagnosis, which allows timely and successful treatment.

Monthly Archives: March, 2018