"I am a vegan", how can I get the required protein from vegan diet? What high protein vegan food should I eat? What are the vegan protein sources?

Vegans are bombarded with questions about where they get their protein. This concern about protein and protein nutrition is misplaced. Although protein is certainly an essential nutrient which plays many key roles in the way our bodies function, we do not need huge quantities of it. In reality, we need small amounts of protein.

How much protein do we need?

The RDA recommends that we take in 0.8 grams to 1 gm of protein for every kilogram that we weigh. Protein is made up of amino acids, often described as its building blocks. We actually have a biological requirement for amino acids, not for protein. Humans cannot make nine of the twenty common amino acids, so these amino acids are considered to be essential. In other words, we must get these amino acids from our diets. We need all nine of these amino acids for our body to make protein.

It is very easy for a vegan diet to meet the recommendations for protein. Nearly all vegetables, beans, grains, nuts, and seeds contain some, and often much, protein. Fruits, sugars, fats, and alcohol do not provide much protein, so a diet based only on these foods would have a good chance of being too low in protein. Vegans eating varied diets containing vegetables, beans, grains, nuts, and seeds rarely have any difficulty getting enough protein as long as their diet contains enough energy (calories) to maintain weight.

It is recommended to eat a variety of unrefined grains, legumes, seeds, nuts, and vegetables throughout the day, so that if one food is low in a particular essential amino acid, another food will make up this deficit. Even if you ate only one food and not the variety of foods typical of a vegan diet, you would probably get enough protein and essential amino acids. Remember, almost all protein sources of non-animal origin contain all of the essential amino acids (in varying quantities). You would have to eat a lot of the protein source (if there was only one source of protein in your diet) to meet essential amino acid needs and hence the emphasis to have a variety of foods.

If you are not sure, get a personalized, customized vegan diet plan online.

You have started to eat right, moving more and losing weight when you suddenly reach a plateau and see that your weight has stopped going down. The reason for this could be that as your weight goes down, your body requires lesser calories to maintain itself.

This could be achieved by recalculating your calorie requirements for the present weight. This is achieved by multiplying your present weight with 30 kcal and it will give you your new calorie needs.

When you are losing weight you are losing both muscle as well as fat which especially is true if your daily calorie deficit is more than 500 calories. This is because muscle burns 5 times more calories than fat, loss of muscle lowers your metabolism which in turn brings about the weight loss plateau. The best way to overcome this stage is to increase your activity levels either in the form of cardio activities or weight bearing or a combination of both to increase your muscle mass.

To counter the plateau stage, check whether you are eating the right quantity for the new weight or are you still eating the same calories that you started eating for weight loss. Recalculate your calorie needs for the present weight with upping your physical activity levels and you should be able to come out of the plateau stage soon. Check if you are eating too less, as eating too little causes your body to protect itself from starving by using hormones to create hunger and
prevent fat loss.

Secondary Infertility is inability to conceive in spite of having regular, unprotected sex for at least a year by a couple who already have one or more children. This category includes woman who have been pregnant before but not able to give birth to live child. In Secondary Infertility, the couples have become pregnant at least once, but in Primary Infertility the couples have never become pregnant.

What are causes of Secondary Infertility?

Causes of Secondary Infertility are almost similar to Primary Infertility. It includes:

1. Female Factors:

A) Advanced age

B) Polycystic Ovarian Syndrome

C) Endometriosis

D) Pelvic Inflammatory Disease

E) Fibroids

F) Uterine adhesions due to previous surgeries

G) Obesity

H) Exposure to certain medications

I) Chronic medical disorders like diabetes mellitus, hypertension.

2. Male Factors:

A) Low sperm count

B) Varicocele

C) Ejaculatory disorders

D) Radiation exposure

E) Advanced age

F) Smoking

G) Alcohol consumption

Secondary infertility may be caused due to male partner or female partner or due to both the partners.

When should we consider seeing a doctor?

It is advisable to consult a doctor, when the couples don’t conceive after having regular unprotected sex for about a year. In couple who are aged more than 35 years, it is advisable not to wait for too long, not more than 6months. As age advances, the fertility level drops. Advanced age happens to be a prime cause for Secondary Infertility.

What can we expect at Doctor’s clinic? Do we have to go through many tests?

After having had the previous pregnancy without any infertility problems, it can be quite stressful to learn that medical help is required for the next pregnancy to happen. The doctor usually thoroughly evaluates the couple through detailed history, examination and special medical tests before arriving at any diagnosis.

History:

1. Medical history of both the couple

2. Time elapsed since the previous pregnancy

3. Duration since the couple have been trying to conceive

4. Menstrual history of woman

5. History of previous pregnancies

Physical Examination:

1. Routine examination of pulse, temperature, blood pressure

2. Pelvic examination of woman to rule out any abnormal masses

3. Genital examination of the men

Tests:

1. Semen analysis in men

2. Blood tests to detect hormone levels in women

3. Ultrasound

4. Hysterosalpingography

5. Hysteroscopy

How is Secondary Infertility treated?

1. Medicines- Fertility drugs are advised in woman if the sperm count in male partner is normal and female partner reproductive tract intact without any blockage or adhesions. These drugs help in inducing and regulating ovulation.

2. Assisted Reproductive Techniques (ART): When the quality of sperm is poor or when there is some blockage in female reproductive tract, ART like IVF, ZIFT, GIFT, ICSI is recommended.

3. Laparoscopic surgery to treat blocked fallopian tubes, fibroids, endometrial deposits.

Is there any way to prevent Secondary Infertility?

As mentioned earlier, age and other lifestyle changes account for secondary infertility to a greater extent. Stress is also a causative factor. Exercise, meditation, healthy diet can help the couple to some extent. In case of advanced age, its better to seek medical help, the sooner the better chances of having another kid.

Other medical conditions like fibroids, endometriosis, ovulation disorders and other infections cannot be prevented. So it is always advisable to get evaluated at the earliest without wasting much time in just waiting. The couple can also take some counseling and help from support groups, if they are finding it difficult to handle the situation and unable to digest the fact that they are getting evaluated for infertility after having proven the fertility once or more than once before.

Though it is difficult to prevent secondary infertility, it can always be treated with all the advanced techniques and medicines available now.

Take a Medical Second Opinion

There are several infertility treatments and avenues available. If you don’t know what to do next, or where to go, you can confidentially and directly ask top specialists in the Infertility, Obstetrics, Gynaecology panel who can give a medical opinion online. Being knowledgeable will ensure that you make an informed decision. Contact us if you need more information on how to get medical second opinion from a top Ob/Gyn and Fertility specialist.

Image Source: Wikimedia Commons

Fertility drugs are the medicines which are prescribed to restore the fertility. They induce ovulation. They are used in women who are infertile due to ovulation disorders. They act like natural hormones FSH and LH to bring about ovulation.

They are also used in IVF treatments. Here though the woman has normal ovulation, these drugs are given with intention of producing more eggs.

How are these fertility drugs administered?

They can be administered orally or through injections

What are the hormones involved in ovulation?

To understand the action of fertility drugs, it is important to know the basics of ovulation. It is the functioning of several hormones that brings about ovulation. Any imbalance in these hormonal system leads to various problems, infertility being prime among those. GnRH (Gonadotropin Releasing Hormone), FSH (Follicle Stimulating Hormone) and LH (Luteinizing Hormone) are the hormones that regulate ovulation. They send message to the ovaries to release eggs.

Which are the commonly used oral drugs for infertility? For how long can they be used?

1. Clomiphene Citrate (for example, Clomid) is the first drug of choice in treatment of infertility due to ovulation disorders. It acts by releasing the hormones GnRH, FSH and LH which stimulate the ovaries to release eggs and bring about ovulation.

Clomid Pregnancy: Normally the doctor starts with a mild dosage of the drug which is administered on 3^rd, 4^th and 5^th day of menstrual cycle and increases the dosage until ovulation occurs. Once ovulation starts, the drug is given for until 6months. If pregnancy doesn’t occur, doctor will advise for other medicines.

2. Metformin- This drug is used where infertility is caused secondary to insulin resistance. It is commonly used in patients with PCOS. This drug reduces the insulin resistance and brings about ovulation

Which are the injectable fertility drugs? When are they used?

If oral drugs don’t bring about pregnancy, injectable forms are used.

Commonly used injectable drugs include:

1. Human Chorionic Gonadotripin (HCG)

2. Follicle Stimulating Hormone (FSH)

3. Human Menopausal Gonadotropin (HMG)

4. Gonadotropin Releasing Hormone (GnRH)

5. Gonadotropin Releasing Agonist

6. Gonadotropin Releasing Antagonist

What are the complications (side effects) of fertility drugs?

1. Multiple pregnancies (twins from use of fertility drugs)

2. Enlarged ovaries (Ovarian hyperstimualtion syndrome)

3. Mild symptoms like blurring of vision, nausea, headache, bloating.

Are fertility drugs used in men also? If so, which ones are they?

Yes, fertility drugs are used in men also.

Commonly used drugs include:

1. Clomiphene Citrate- This releases FSH and LH which sends message to testicles to produce testosterone and bring about healthy sperm production.

2. Human Chorionic Gonadotropin- This helps in promoting healthy sperm production

What are the indications of these fertility drugs in men?

1. Primary hypogonadotropic hypogonadism

2. Sometimes prescribed in men with low sperm count

For how long can fertility drugs be used?

They can be used for 3-6 months.

Brand Names of Fertility Drugs

Note: This list is provided for information only, and this article is not a recommendation for the use of any of these drugs. Please consult your fertility doctor.

1. Clomiphene Citrate such as Clomid, Serophene etc.

2. Human Chorionic Gonadotropin such as Pregnyl, Novarel, Ovidrel, Profasi etc.

3. Follicle Stimulating Hormone such as Follistim, Fertinex, Bravelle, Gonal-F etc.

4. Human Menopausal such as Gonadotropin-Pergonal, Repronex, Metrodin etc.

5. Gonadotropin Releasing Hormone such as Factrel, Lutrepulse etc.

6. Gonadotropin Releasing Hormone Agonist such as Lupron, Zoladex, Synarel etc.

7. Gonadotropin Releasing Hormone Antagonist such as Antagon, Cetrotide etc.

Take a Medical Second Opinion

There are several infertility treatments and avenues available. If you don’t know what to do next, or where to go, you can confidentially and directly ask top specialists in the Infertility, Obstetrics, Gynaecology panel who can give a medical opinion online. Being knowledgeable will ensure that you make an informed decision. Contact us if you need more information on how to get medical second opinion from a top Ob/Gyn and Fertility specialist.

Intrauterine Insemination (IUI) is the commonly used AI technique.

What are the indications for Artificial Insemination?

1. Men with ejaculatory disorders

2. Men with low sperm count

3. Men with poor sperm motility

4. Women with thick cervical mucus which comes in the way of penetration of sperm.

5. Women with semen allergy.

What is semen allergy?

Some women are allergic to the proteins in the semen. They develop allergic reactions like redness,

burning, swelling following intercourse. The only way they can prevent such reactions, is by using condoms. But pregnancy is not possible if condoms are used. Therefore AI, where sperms are separated from proteins in the semen and then introduced into the genital tract is a good option.

Apart from the routine Infertility tests, are there any special tests for AI?

There are no special tests for AI.

Which is the most commonly used AI technique and Why?

Intrauterine Insemination is the most commonly used AI technique. It is because the success rate is more in this technique compared to other AI techniques. As the motile sperms are placed close to the fallopian tube, the chances of fertilization are more compared to that in other techniques.

What are the different factors that determine the success rate of this procedure?

1. Age- Younger the age, greater is the chances of conception.

2. Duration of Infertility- longer the duration, lesser the chances of conception.

3. Sperm quality- Very poor quality of sperm definitely affects the outcome of procedure

4. Fallopian tubes condition- The fallopian tubes have to be in a healthy condition.

5. Ovaries should be functional.

What are the important aspects of this procedure?

1. Firstly, timing of ovulation is very important. The doctor regularly monitors for the signs and symptoms of ovulation. Ultrasonography and blood tests (to check for hormone levels) are more reliable to determine the ovulation timing.

2. Secondly, insemination is done at around or just after the ovulation. Timing of insemination determines the outcome of procedure.

How is Artificial Insemination done?

1. Semen is collected from the male partner and subjected to washing. Washing of sperm is a procedure where the active sperms are separated from the less active sperms, other proteins, bacteria present in the seminal plasma.

2. Artifical Insemination can be done with ovarian stimulation (fertility drugs are given to women to produce more follicles). This increases the success rate.

3. Insemination is done around the time of ovulation. Depending upon the type of insemination, the sperms are introduced into the female genital tract using a catheter.

Are there any post-procedure advice?

It is a very simple procedure, carried out in the doctor’s office. Normally the patient is advised to resume back to their routine work without any restrictions.

When should I go for the pregnancy test?

It is advised to go for pregnancy test 2 weeks after the procedure is done.

If the first attempt of AI turns out to be a failure, where do I go from here?

Normally, couple can go for 6 attempts of AI (6 cycles). If the couple has to conceive, they will by 6 cycles. Otherwise they are advised to go in for IVF (Invitro fertilization).

Take a Medical Second Opinion

There are several infertility treatments and avenues available. If you don’t know what to do next, or where to go, you can confidentially and directly ask top specialists in the Infertility, Obstetrics, Gynaecology panel who can give a medical opinion online. Being knowledgeable will ensure that you make an informed decision. Contact us if you need more information on how to get medical second opinion from a top Ob/Gyn and Fertility specialist.

How do ovarian cysts develop?

Every month ovary produces one egg. This egg develops inside a sac called as follicle. At the time of ovulation, the follicles rupture and release the egg. Suppose the follicle keeps growing without releasing the egg, it results in formation of cyst. It is known as functional cyst.

What are different types of ovarian cysts?

Commonly seen ovarian cysts include:

1. Follicular cyst- It is a functional cyst that develops when ovulation does not occur.

2. Corpus Luteum cyst- It is a functional cyst that develops after the egg is released from the follicle. It may contain blood.

3. Hemorrhagic cyst- It is a functional cyst that develops due to bleeding inside the follicle.

4. Dermoid cyst- It is an abnormal cyst that contains other tissues like fat, hair, bone etc.

5. Endometrioid cyst – It develops when endometrial tissue is present in the ovary

6. Polycystic ovaries- It results due to hormonal imbalance leading to formation of multiple cysts

7. Cystadenomas – They develop from ovarian tissue and may be filled with fluid or mucus.

What are the symptoms of ovarian cyst?

Most of the times, they do not produce any symptom and may be accidently detected during a routine pelvic examination or ultrasound imaging.

If symptoms are seen, the common ones include:

1. Irregular menstrual periods

2. Lower abdominal pain or pelvic pain (ovarian cyst pain)

3. Pelvic pain after sexual intercourse

4. Nausea and vomiting

5. Pain while passing urine and bowel movements

6. Bleeding or spotting from vagina

7. Infertility

Do all the types of ovarian cyst result in infertility?

Not all types of ovarian cyst cause infertility.

The ovarian cysts that may be associated with decreased fertility include:

1. Ovarian cysts resulting from polycystic ovaries

2. Endometriomas

What are all the different tests done to diagnose ovarian cyst?

1. Pregnancy test

2. Pelvic ultrasound (Endovaginal ultrasound)

3. CT scan

4. MRI

5. Hormonal levels- Blood tests to detect FSH, LH, estrogen and testosterone

6. Serum CA-125 assay

Can ovarian cyst lead to ovarian cancer?

Majority of ovarian cysts are benign. Very rarely it leads to cancer. Chances are more if the risk factors are present. It includes advanced age (more than 55years), family history of cancer and never being pregnant.CA 125 is used as cancer marker. But elevated CA 125 levels don’t confirm malignancy as it may be seen in some benign conditions as well (endometriosis, uterine fibroids). Ovarian tissue biopsy is the confirmatory test.

How are ovarian cysts treated?

Treatment of ovarian cyst mainly depends on the age of the patient and size of the cyst. If it develops during reproductive years of a woman and causing no symptoms, it can be left alone and monitored with repeated ultrasounds to check for any change in size. As malignancy is rare in this age, surgery can be ruled out.

Other modes of treatment include:

1. Oral contraceptives

2. Pain relieving medicines

3. Laparoscopic surgery- with the help of laparoscopy the cyst is removed.

4. Laparotomy- incision is made through the abdominal wall to remove the cyst

Ovarian cysts and pregnancy: If patient wishes to have pregnancy, oral contraceptives are best avoided and wait and watch treatment is advised. Usually functional cysts resolve on their own. Only in extreme cases surgery is advised.

When is surgery indicated as the treatment for ovarian cysts?

1. Cysts that are not functional type and persist for long causing pain and other symptoms.

2. Cystic masses that develop after menopause (because chances of malignancy greater after menopause)

What is the prognosis of this condition of ovarian cysts?

Prognosis depends on the age when it occurs and also the size of the cyst.

Take a Medical Second Opinion

There are several infertility treatments and avenues available. If you don’t know what to do next, or where to go, you can confidentially and directly ask top specialists in the Infertility, Obstetrics, Gynaecology panel who can give a medical opinion online. Being knowledgeable will ensure that you make an informed decision. Contact us if you need more information on how to get medical second opinion from a top Ob/Gyn and Fertility specialist.

Image Source: Wikimedia Commons

How does PCOS cause infertility?

Normally, one or more mature eggs are released from the follicles in the ovary during ovulation. But in PCOS, eggs don’t mature and are not released from the ovary. That is there is no ovulation. Instead they develop into small cysts inside the ovary. Mature eggs are not available to the sperm for fertilization, thereby no pregnancy.

How does a patient with PCOS usually present to the doctor?

Signs of PCOS: A patient with PCOS presents to the doctor with following symptoms.

1. Absent menstrual periods

2. Irregular menstrual periods

3. Obesity

4. Development of male features like:

a) Male pattern distribution of hair on chest, abdomen, face

b) Male pattern baldness

c) Deepening voice

d) Increased muscle mass

5. Thickening and darkening of skin around the neck, axilla, breasts, groin.

Even though the other symptoms may be absent, menstrual disturbances are definitely present in a patient with PCOS

Which are the hormones that get affected in PCOS?

1. There is excess production of male sex hormones called androgens which results in development of above mentioned male characteristic features.

2. Elevated blood insulin levels.

3. Excess production of LH hormone

Apart from the routine infertility tests, what are the special tests done to diagnose PCOS in infertility patients?

1. Blood tests:

a) Estrogen levels

b) Testosterone levels

c) LH level

d) FSH level

e) Tests for insulin resistance

f) Lipid levels

g) Thyroid function tests

h) Prolactin levels

2. Imaging

a) Ultrasound

b) Pelvic laparoscopy

What are the diseases associated with PCOS?

1. Diabetes Mellitus

2. Hypertension

3. Heart disease

4. Endometrial cancer

5. Skin disorders

6. Infertility

What are the treatments available for infertility secondary to PCOS?

1. Ovulation inducing drugs

2. Gonadotropin hormone injections

3. Anti-diabetic drug

4. ART methods

5. Weight loss management

What are the chances of pregnancy in a patient diagnosed with PCOS?

Pregnancy with PCOS: If any of the above mentioned symptoms are present and the couple is unable to get pregnant, it is advisable to see the doctor immediately and get evaluated for infertility. Chances of pregnancy are good, when diagnosed early and preferably at a younger age. Pregnancy rates are pretty good if properly evaluated at right time and right kind of treatment is made available to the patient

Take a Medical Second Opinion

There are several infertility treatments and avenues available. If you don’t know what to do next, or where to go, you can confidentially and directly ask top specialists in the Infertility, Obstetrics, Gynaecology panel who can give a medical opinion online. Being knowledgeable will ensure that you make an informed decision. Contact us if you need more information on how to get medical second opinion from a top Ob/Gyn and Fertility specialist.

Image Source: Wikimedia Commons

What are different types of Uterus Fibroids?

Based on their location, they are classified as follows:

1. Submucosal Fibroid- They occur beneath the inner lining of uterine wall.

2. Subserosal- They develop on the outer surface of uterine wall.

3. Intramural- They are found within the muscular wall of uterus.

What are the Uterine Fibroids symptoms?

Many women with fibroids in uterus are asymptomatic. It may be detected during pelvic exam or ultrasound imaging.

If symptoms are present, the commonly found includes:

1. Heavy menstrual bleeding

2. Prolonged menstrual bleeding

3. Pain in pelvic area

4. Frequent urination

5. Constipation

6. Back pain

These symptoms are based on the location of fibroid. Submucosal fibroids cause abnormal menstrual bleeding. Subserosal Fibroids, when outgrow in size result in pressure symptoms like frequent urination, constipation.

What are the Fibroids complications?

1. Anemia

2. Infertility

3. Recurrent miscarriages

Fibroids Pregnancy: How does a Fibroid cause Infertility?

1. Submucosal Fibroids may come in the way of implantation and growth of embryo.

2. Some fibroids may block the fallopian tube thereby preventing the entry of fertilized egg into uterine cavity.

3. Some fibroids may block the cervix thereby preventing the entry of sperm into uterine cavity.

But not all the Fibroids lead to infertility. Before going for fibroid treatment for fertility reasons, other causes of infertility should be excluded.

What are the tests done to detect Uterine Fibroids?

1. Pelvic examination

2. Abdominal or transvaginal ultrasound

3. Hysteroscopy

4. Hysterosalpingography

Fibroids Treatment: How are Fibroids treated?

1. Observation- When the patient is asymptomatic, no treatment is required. Normally periodic check ups like pelvic exam and ultrasound are done to check for any change in size and number of fibroids.

2. Medical treatment – It is hormonal treatment. It is aimed at reducing the size of fibroid and associated abnormal menstrual bleeding. Medicines are given to relieve the pain.

3. Surgical treatment includes:

A) Myomectomy- Only the fibroid is surgically removed leaving the uterus intact.

B) Hysterectomy – Here the uterus is surgically removed along with the fibroid.

C) Uterine artery embolization – Here blood supply to the fibroid is obstructed which results in shrinkage of the fibroid.

What is the treatment of choice in Fibroids associated with Infertility?

1. Firstly, other causes of infertility should be excluded.

2. Secondly, a thorough infertility assessment should be done.

3. Lastly the uterine cavity should be assessed using Hysterosalpingogram (HSG) or Hysterosonogram

Medical methods of treatment, uterine artery embolization are not recommended here as they come in the way of fertility. Hysterectomy is ruled out as uterus is removed.

So treatment of choice is Myomectomy, wherein only the abnormal growth is removed leaving behind the uterus intact.

What are the chances of recurrence of fibroids after it is surgically removed?

Fibroids can come back again. So it is advised to have a regular follow up with the doctor.

Take a Medical Second Opinion in Infertility

There are several infertility treatments and procedures available. If you don’t know what to do next, or where to go, you can confidentially ask top specialists in Infertility, Obstetrics, Gynaecology, who can give a medical opinion online. Being knowledgeable will ensure that you make an informed decision. Contact us if you need more information on how to get medical second opinion from a top Ob/Gyn, Fertility, Infertility specialists.

Surrogacy is of 2 types:

1. Gestational/IVF Surrogacy

2. Traditional /Natural Surrogacy

What is Gestational Surrogacy? How is it different from Traditional Surrogacy?

Gestational Surrogacy is a process where the egg and sperm belong to the biological parents or the donors . The egg is fertilized invitro by the sperm and the embryo is implanted into the surrogate’s uterus. Surrogate carries the pregnancy to term, delivers the baby and hands over the baby to biological parents. It is important to note here that Surrogate is nowhere genetically linked to the baby here. IVF or ICSI methods are adopted for fertilization here.

In Traditional Surrogacy, the egg belongs to the surrogate and sperm to the biological father (male partner) or donor. So here the surrogate mother is genetically linked to the baby. Surrogate is either inseminated or the embryos resulting from in vitro fertilization implanted to her uterus. The baby is not genetically linked to female partner.

Where is Traditional Surrogacy indicated?

It is indicated in following conditions:

1. Premature ovarian failure- Here ovaries are non-functional and female is unable to produce eggs.

2. Genetic diseases- when the female partner is suffering from some genetic disease and there is chances of it passing on to the baby.

In Gestational Surrogacy, IVF is used with biological parent’s gametes. Why can’t the embryo be implanted to female partner’s uterus instead of Surrogate’s uterus?

Even though the female partner is donating her eggs for IVF or ICSI, her uterus may not be in a good condition to receive and implant the fertilized egg. Those conditions include:

1. Hysterectomy – Uterus is removed following rupture or heavy bleeding following Caesarean section

2. Congenital absence of uterus- Uterus not present since birth

3. Malformed uterus – Unicornuate uterus, bicornuate uterus, T-shaped uterus

4. Tuberculosis of endometrium

5. Chronic medical diseases – Diabetes Mellitus, Cardiovascular diseases, Kidney diseases.

6. Repeated miscarriages

7. Repeatedly failed ART methods.

How to find a Surrogate?

Sometimes a family member or friend may opt to become a surrogate. If not, there are several firms and agencies which work for this line. They help in finding appropriate surrogate who would match the parents. But it is very important to check for the validity of these agencies, how reliable they are and the criteria and screening methods they use to select a surrogate.

What are the different screening methods used before taking surrogate for the procedure?

Before considering for the procedure, surrogate is thoroughly screened.

1. Detailed medical, surgical, family and personal history taken.

2. Age group 21-35years.

3. Should have carried and delivered at least one child normally.

4. Good obstetric history from previous pregnancies- That is, no miscarriages, no antenatal or postnatal complications.

5. Screened for infectious diseases – Hepatitis B, Hepatitis C, HIV, VDRL

6. No history of smoking, alcohol, drug addiction.

How to Take a Medical Second Opinion in Infertility?

There are several infertility treatments and procedures available. If you don’t know what to do next, or where to go, you can confidentially ask top specialists in the Infertility, Obstetrics, Gynaecology who can give a medical opinion online. Being knowledgeable will ensure that you make an informed decision. Contact us if you need more information on how to get medical second opinion from a top Ob/Gyn, Fertility, Infertility specialists.

Image Source: Wikimedia Commons

What is a Varicocele?

A Varicocele is abnormal dilatation of network of veins within the spermatic cord. It more commonly affects the left scrotum, and are more common in men aged 15-25. It is one of the commonest causes of male infertility (40%).

How does varicocele cause infertility?

Increased temperature of the testicles – testicular varicocele – affects the semen quality thereby causing infertility.

What are the testicle varicocele symptoms?

1. Enlarged veins in scrotum which is referred as bag of worms when felt with hands

2. Infertility

3. Painless lump in the scrotum (in some men, varicocele pain can be felt in the scrotum).

How is a patient with varicocele evaluated?

1. Proper medical history

2. Thorough reproductive history

3. Physical examination

4. At least 2 semen analyses

Scrotal ultrasound is done only when physical exam is inconclusive (when varicocele is not palpable on examination)

If I am an infertile man with varicocele, whom should I see first, urologist or infertility specialist?

It is advisable to consult an Infertility specialist before seeing an urologist. Urologist would definitely advise for surgical repair.

But if the patient is planning to conceive and wants to get treated for the varicocele for fertility benefits, there are many factors which account for the efficacy of treatment. It can be decided only by an infertility specialist.

What are the deciding factors of varicocele treatment in infertile men?

1. Varicocele palpable on physical examination of scrotum.

2. Couple has known infertility.

3. Female couple has normal fertility or treatable cause of infertility

4. Male partner has abnormal semen parameters.

If I have palpable varicocele and abnormal semen analyses but not planning for pregnancy, should I still go for treatment?

Yes, for varicocele repair.

What are the varicocele treatment options for infertile men?

1. Varicocele Repair

2. Intrauterine Insemination

3. IVF (Invitro Fertilization) with ICSI (Intracytoplasmic Sperm Injection)

Which of the above said treatments most recommended and effective?

It depends on several factors.

1. Varicocele repair is the treatment of choice when the semen analyses of male partner shows abnormal results. Female partner should be fertile.

2. IUI and ART considered when along with male infertile factor, female also has known infertile factors.

How is varicocele repair done?

1. Varicocele Surgery

2. Percutaneous embolization

Are there any risks involved in the procedure?

1. Infection

2. Hydrocele

3. Recurrence of varicocele

Will the procedure benefit infertile couple?

It improves the semen parameters in most men thereby improving the fertility

After the procedure, is semen analysis repeated?

After procedure, semen analysis is done at three months interval till pregnancy occurs.

What are the alternatives, if pregnancy doesn’t occur?

1. IUI

2. ART

How to Take a Medical Second Opinion in Infertility?

There are several infertility treatments and procedures available. If you don’t know what to do next, or where to go, you can confidentially ask top specialists in the Infertility, Obstetrics, Gynaecology who can give a medical opinion online. Being knowledgeable will ensure that you make an informed decision. Contact us if you need more information on how to get medical second opinion from a top Ob/Gyn, Fertility, Infertility specialists.

Image Source: Wikimedia Commons

Other Terms: sintomi varicocele, sintomas varicocele