In India, many women suffer from hypothyroidism due to iodine deficiency. It is a condition when the thyroid gland secretes less of the hormone which leads to a sluggish metabolism and slowing of all other functions in the body. This makes conception difficult. In fact, with an underlying problem like hypothyroidism, it is advisable to consult your doctor pre-conception. Here is all you need to know about thyroid and pregnancy.
How hypothyroidism affects conception?

Low levels of thyroid hormone interfere with the functioning of the ovaries and make them produce less progesterone.
It can interfere with ovulation, which impairs fertility. Also, some of the underlying causes of hypothyroidism — such as certain autoimmune or pituitary disorders — are known to make a woman infertile.

What should you do?
If you are planning a pregnancy seek help from your doctor. Depending on the severity of your condition your doctor might suggest medications or a hormone replacement therapy to restore fertility. It may take about 1 or 2 months to normalise your thyroid hormone levels with medication; and once you start medication, you must check your TSH levels to confirm they are in the normal range. Once the TSH levels are restored, a couple can try for a baby when they are ready.
How can hypothyroidism affect pregnancy?
Untreated hypothyroidism can affect the pregnancy; it can put the mother at risk of miscarriage, pre-eclampsia or premature delivery. Low thyroid hormone might also affect the fetal brain and heart development. Here are seven things that could lead to preterm labour.
How can hypothyroidism be treated during pregnancy?
Medications are prescribed to help one get the TSH levels to normal during pregnancy. However, it is important to keep a tab on the medications and your TSH levels simultaneously. An overdose of thyroid medications during pregnancy has consequences too. Don’t skip your doctor’s appointments so they can titrate the dosage of your medicines in keeping with your latest reports.
(With inputs from Dr Beena Jaysingh, Motherhood Hospitals, Bengaluru)
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Thyroid imbalances can lead to problems during conception. In fact, if you are lucky enough to conceive despite the problem the pregnancy can be challenging or affect the health of the fetus.  An underactive thyroid causes more problems during conception and pregnancy than an overactive one. So the good news is that while hypothyroidism makes it difficult to conceive, your chances improve with hyperthyroidism. But it is important to get the levels checked during pregnancy. A routine blood test which is done during pregnancy can reveal your thyroid condition. In case you are suffering from hyperthyroidism your doctor would prescribe medications to bring down the levels. ‘Ideally, you should do a blood test pre-conception to get an idea about your health status and how prepared your body is to carry on the challenges of pregnancy. If thyroid problems flare up during that time it is advisable to bring it under control and then plan a pregnancy,’ says Dr Beena Jeysingh, Consultant, Obstetrics and Gynaecology, Motherhood Hospitals, Bengaluru. Read to know how thyroid affects your pregnancy.
At times hyperthyroidism gets better during pregnancy and the hormones might settle without much help. However, if you have severe hyperthyroidism, your doctor might have to plan treatment for you to control the levels during pregnancy. Leaving the overactive thyroid condition untreated can lead to the following problems during pregnancy:

Miscarriage
Heart failure of the mother
Preeclampsia
Premature delivery
Stillbirth

However, don’t go take medications during pregnancy without consulting your doctor. If you skip an appointment and continue taking the medication as prescribed earlier, it could have an adverse impact. To avoid any mishap, make it a point to visit your endocrinologist and gynaecologist during your scheduled appointments to check your health status and they will titrate your dosage as needed.
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Researchers at Massachusetts Institute of Technology (MIT) have found that a simple test of cervical mucus may reveal pregnant women’s risk of going into labour too early. Up to 18 per cent of babies born worldwide arrive before they are full-term, defined as 37 weeks of gestation. The study, published in the journal Scientific Reports, showed that cervical mucus from women who delivered their babies before 37 weeks was very different from that of women who delivered later. This type of analysis could offer an easy way to calculate the risk of early labor, potentially allowing doctors to try to intervene earlier to prevent preterm births.
“Our prediction is that we might be able to identify risk for preterm birth ahead of time, before labour sets in,” said senior author of the study Katharina Ribbeck, Associate Professor at MIT. Between 25 and 40 per cent of early births are believed to be caused by infections that occur when microbes reach the uterus through the cervical plug, which is made of mucus and normally blocks access to the uterus. For the new study, the researchers decided to investigate the mucus’s permeability to small particles. Mucus is formed from polymers known as mucins, and the composition and arrangement of these mucins determine how porous the gel is. Read here 7 things that could lead to preterm labour and you can prevent it!
The researchers collected samples from two groups of patients. The low-risk group included pregnant women who came in to their doctors’ offices for routine visits around 30 weeks and ended up giving birth after 37 weeks.  The high-risk group included women who went into labor early, between 24 and 34 weeks. Doctors were able to halt labour in these women, and the samples were taken after they were stabilised. They all ended up giving birth before 37 weeks. Read here 11 factors that increase your risk of delivering a premature baby
The researchers found a significant differences in mucus permeability and adhesiveness – the peptides were able to pass through samples from high-risk women much more easily. This suggests that cervical mucus from women at high risk for early labour, for reasons not yet known, may be more susceptible to invasion by potentially harmful bacteria and microbes, making it more likely that those women will experience an infection that leads to preterm birth, Ribbeck said.
In addition, the altered mucus may be less able to retain helpful immune system components such as antibodies or antimicrobial peptides, which would normally help to combat infection, the study said. Ribbeck anticipates that cervical mucus testing could be done early in pregnancy, as part of a routine screen that would reveal whether a woman was at high risk of preterm birth.
Source: IANS
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According to a new study, a team of scientists have identified a drug that may protect women from life-altering infertility that commonly follows cancer treatments. Women who are treated for cancer with radiation or certain chemotherapy drugs are commonly rendered sterile in most of the cases. According to a 2006 study from Weill Cornell Medicine, nearly 40 percent of all female breast cancer survivors experience premature ovarian failure, in which they lose normal function of their ovaries and often become infertile. The current study identified a so-called checkpoint protein (CHK2) that becomes activated when oocytes are damaged by radiation. CHK2 functions in a pathway that eliminates oocytes with DNA damage, a natural function to protect against giving birth to offspring bearing new mutations. When the researchers irradiated mice lacking the CHK2 gene, the oocytes survived, eventually repaired the DNA damage, and the mice gave birth to healthy pups.
John Schimenti, the paper’s senior author. Vera Rinaldi, a graduate student in Schimenti’s lab, said, “It turns out there were pre-existing CHK2 inhibitor drugs that were developed, ironically enough, for cancer treatment, but they turned out not to be very useful for treating cancer. By giving mice the inhibitor drug, a small molecule, it essentially mimicked the knockout of the checkpoint gene.” By inhibiting the checkpoint pathway, the oocytes were not killed by radiation and remained fertile, enabling birth of normal pups. Schimenti shared, “The one major concern is that even though these irradiated oocytes led to the birth of healthy mouse pups, it’s conceivable that they harbor mutations that will become manifested in a generation or two, because we are circumventing an evolutionarily important mechanism of genetic quality control. This needs to be investigated by genome sequencing.” Read here 5 common reasons of female infertlity
When doctors recognize the need for oocyte-damaging cancer treatments, women may have their oocytes or even ovarian tissue removed and frozen, but this practice delays treatment. Also, when women run out of oocytes, women’s bodies naturally undergo menopause, as their hormonal systems shift. “That is a serious dilemma and emotional issue. When you layer a cancer diagnosis on top of the prospect of having permanent life-altering effects as a result of chemotherapy, and must face the urgent decision of delaying treatment to freeze oocytes at the risk of one’s own life,” noted Schimenti. The study sets a precedent for co-administering this or related drugs and starting cancer therapy simultaneously, though such interventions would first require lengthy human trials. Schimenti concluded by saying, “While humans and mice have different physiologies, and there is much work to be done to determine safe and effective dosages for people, it is clear that we have the proof of principle for this approach.” The study was published in Jounral Genetics. (Read: Gene linked to unexplained female infertility identified)
Source: ANI
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Good news, would-be-mothers! Now using mobile phones during pregnancy is unlikely to have any adverse effects on your child neurodevelopment, finds a study. A study has found that children born to mobile phone users had a 27 per cent lower risk of having lower sentence complexity, 14 per cent lower risk of incomplete grammar and 31 per cent lower risk of having moderate language delay at age three, compared to children of mothers who reported no mobile phone use.
According to researchers, exposure to radio frequency electromagnetic fields associated with the maternal use of mobile phones during pregnancy is not linked to neurodevelopment in children. Lead study author Dr. Eleni Papadopoulou from the Norwegian Institute of Public Health said, “The concern for harm to the foetus caused by radio frequency electromagnetic fields, such as those emitted by mobile phones, is mainly driven by reports from experimental animal studies with inconsistent results.” “Our findings do not support the hypothesis of adverse effects on child’s language, communication and motor skills due to the use of mobile phone during pregnancy,” Papadopoulou added. Read more about Are your mobile phones and electronics making you infertile?
The study analysed 45,389 mother-child pairs and the data was collected from mothers and children during and after pregnancy. The follow-ups were later assessed at ages three and five. Senior author Professor Jan Alexander from the Norwegian Institute of Public Health said, “Our investigation revealed for the first time that maternal mobile phone use may actually have a positive impact. More specifically, mobile phone use in pregnancy was associated with lower risk of the child having low language and motor skills at 3 years of age.” Read here 8 common mistakes every pregnant woman makes!
They also found that children born to mobile phone users had an 18 per cent lower risk of low motor skills at age three, compared to children born to non-users of mobile phones. The beneficial effects remained even after adjusting for relevant confounders and were also relative to the level of reported mobile phone use by the mother. The study appears in the open access journal, BMC Public Health.
Source: ANI
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According to media reports recently a woman delivered a baby girl in the toilet of a hospital and the reason behind this being a complete negligence of the hospital authorities. It is allegedly said that the doctors refused to attend her. According to HT, the name of the patient is Muskan, a 24-year-old woman who was seven-mont pregnant was admitted to Sultania WOmen Government Hospital As her condition suddenly deteriorated on Wednesday. As reported by HT her mother-in law Heera BAi said that on Thursday morning Muskaan complained of severe pain in her stomach, but the doctor who was on-duty refused to attend to her. Her mother-in-law, Heera Bai, said to HT, “In an acute pain, Muskan went to the toilet where she delivered the baby. The baby got stuck in the commode. When Muskan didn’t come out for 45 minutes, I knocked the door and found the baby was stuck in the toilet and I called the hospital staff.” She continued to say, ” I scolded them for their negligence but instead of accepting their mistake, they pushed me out,”
After which, the baby was rushed to the Hamidia hospital, and unfortunately, her condition is said to be critical. The hospital has refuted all allegations. This isn’t the first time some hospital has shown negligence towards its patients. It was just recently that because of an awful spat between doctors during in an emergency c-section in Rajasthan an infant lost his life, the video of this incident went viral too. (Read: Medical negligence case: Do we know our rights and responsibilities as a patient? )
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In India, malnutrition claims one out of three lives among children under five. A large majority of these deaths are attributed to inappropriate feeding practices during the initial years of life. According to recent studies, 46 per cent of deaths in children under-five occur in the neo-natal period and breastfeeding in the first hour can reduce the risk of neo-natal deaths by 33 per cent. This is because breast milk is the child’s first source of nutrition and immunity, protecting them from various diseases such as diarrhoea, respiratory infection, sepsis, omphalitis, hypothermia, weight loss, and malnutrition. Despite the known benefits of breastfeeding to both mother and baby, a survey conducted by Medela India revealed that only 39 per cent of mothers in India initiated breastfeeding in the first hour. The survey further showed that over 30% of mothers fed their babies with formula milk immediately after birth highlighting the fact that a large majority of Indian mothers do not engage in the act of breastfeeding to provide the first and best nutrition for their babies. Nutrition is integral to of survival, health and development for current and succeeding generations. Breastfeeding is a healthy start for laying a strong foundation in the initial years as breast milk provides the energy and nutrients that an infant requires during this stage. The first feed post birth is especially critical as it contains, colostrum which acts as a shield against a host of fatal diseases and impacts the intelligence of the child positively. Recognising this, the World Health Organisation advocates exclusive breastfeeding for the first six months of a child’s life and prolonged breastfeeding up to two years for best results.
Commenting on the need for mothers to breastfeed for providing the best nutrition to their babies during the initial years, Ms. Emilie Moulard, Managing Director, Medela India said, “The health benefits of mother’s milk are abounded and leave an imprint on the child for a lifetime. Therefore, we at Medela engage in comprehensive and consistent research on human milk as we strongly believe that it is the best suited for infants. Our aim is to enable and empower mothers to breastfeed at home and in workplaces by providing lactation support so that they can continue being a nutrition provider for their babies”. The lack of breastfeeding practices among mothers can be due to reasons such as low awareness, increasingly stressful lifestyles, home and work-life imbalance, lack of adequate family support and health conditions. Therefore mothers should be encouraged and motivated through counselling, education and family support to initiate and continue breastfeeding for a healthier tomorrow. The National Nutrition Week is commemorated from 1st -7th September every year to raise awareness on the importance of nutrition for good health which has far-reaching implications on the development, productivity and economic growth of the nation. (Read: Shatavari – a wonder herb for breastfeeding mothers )
 

These days we hear a lot about miracle babies and childless couples being blessed with kids in their 60s and 70s. Most newspapers that carry such news also claim that the couple conceived naturally and gave birth to a healthy baby. Well, natural conception is possible until a particular age or before a woman hits menopause. Beyond that, couples might need to take help of assisted reproductive techniques or IVF procedures if they are planning a baby. There are a lot of misconceptions that people have regarding IVF procedures.  To break these myths and misconception we had a detailed discussion with Dr Sandeep Mane, The Origin International Fertility Centre, Mumbai, here is what he had to say.

Is there a cut-off age for doing IVF with one’s eggs?

A woman’s natural egg reserve, especially for Asian women, tends to drop after 40 or 45 years of age. There are no procedures or techniques to revive eggs or provide a woman with more number of eggs. However, for some women, this reserve might get exhausted early, like in their 20s or thirties. There could be various reasons for this. When a woman opts for an IVF procedure, tests are done to see if her egg reserve is exhausted.
In general, every month a woman releases one or more eggs from ovaries which increase her chances of pregnancy. However, if conception has not taken place normally, hormonal injections are used to release more eggs from her ovaries. But beyond 45 or 50 years of age when a woman’s natural egg reserve is exhausted, even IVF procedures cannot help her to conceive with her own egg, unless she has frozen her eggs before. In such cases, looking for an egg donor is advisable. For a menopausal woman who wishes to get pregnant, this is an ideal option. Here is everything you need to know about freezing of eggs.

Even if a couple in their 50s, 60s or 70s wants a baby with the help of IVF,  what are the chances that the pregnancy would be healthy?

With age, pregnancy becomes challenging. There are laws in the making which are yet to decide on a cut-off age for couples to get pregnant. But a pregnancy in 50s and 60s is not unheard of; of course, a pregnancy in 70s is out of the question even with assisted reproductive technologies (but not impossible). The simple reason to avoid late pregnancies is that bringing up a child beyond a certain age becomes challenging. Apart from that, the pregnancy itself could be risky and there can be postpartum issues that the mother and child have to face.
When a couple opts for a pregnancy at a later stage in life, there are three things that need to be taken into consideration: sperm health, quality of eggs and the viability of the womb. In men, even at the age of 50 or 55 sperms might be healthy for conception. In women, most of them might have hit menopause by then. The ovaries will have exhausted its eggs, there would be a dip in the female hormones and the womb would have shrunk. Taking all these things into consideration, conception becomes difficult. She will need donor eggs to continue with her pregnancy or retrieve her frozen eggs, if any. However, the womb can be reactivated with hormonal injections to get back to its pre-menopausal state and carry the pregnancy to term. But if the woman is having other health problems like blood pressure, diabetes or thyroid this can make the pregnancy risky. An incompetent womb, too many failed IVF cycles might be indications that she needs to look for a surrogate to carry her pregnancy to term.

Why do some younger women need donor eggs to conceive?

Sometimes a woman’s egg reserve might get exhausted early in her 20s or 30s. There could be various reasons for it, like, receiving less number of eggs during the formative period in the womb, the hereditary tendency of early menopause, infections like tuberculosis that can scar the ovaries, surgeries during childhood for conditions such as ovarian cysts or torsion of ovaries, etc. There cannot be a single cause that can be pinpointed; these are some of the possible causes. In such cases, a donor egg is needed to help the woman conceive.

What are the other situations when a couple might need donor eggs?

There are two prime scenarios when a couple might need to seek donor egg: a. if the woman’s egg reserve is exhausted or are weak and b. when IVF have failed beyond three cycles. However, a doctor decides this after undergoing a number of tests and procedures. If a couple is unable to conceive, blood tests and sonography are done to ascertain the problem. If the first line of tests and sonography shows that the woman has weak eggs or her eggs aren’t suitable for fertilisation, she might need to seek donor eggs.
If there is a possibility that she can conceive with her eggs, medications are prescribed to help attain hormonal balances and ovulation to help the couple conceive. If that fails to give results, the second step is to do an IUI or intrauterine insemination, where sperms are placed inside a woman’s uterus to facilitate fertilisation. The goal of IUI is to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilisation. Beyond that, a laparoscopy is done to understand where the problem lies and then the couple is counselled for an IVF. If more than three IVF cycles fail,  the need for donor eggs might arise.

What tests are done to assess the quality of the woman’s egg to check if they are fertile enough for conception?

Two tests namely the AMH blood test and advance sonography are done to check for the quantity and quality of the eggs and the ovarian reserve.

What happens during an IVF cycle?

For a woman to get pregnant, it is necessary that her hormones are in tandem with her cycles and leads to ovulation, that is, for an egg to release from the ovary once a month. Sometimes this natural process might not yield results and a couple might seek IVF treatment. In an IVF treatment, high doses of hormonal injections are given to release eight or 10 eggs which are then retrieved and united with the partner’s sperm to form an embryo in a laboratory set-up. Of the resulting embryos, two or three can be inserted into the womb to increase chances of pregnancy. The rest can be frozen to be used later in case an IVF cycle fails. The duration of an IVF cycle is of four weeks or a month.

What if IVF cycles fail?

There are chances of IVF failures. However, a couple can try for three IVF cycles before exploring other options. If a woman’s womb is incompetent to continue the pregnancy, then an option like surrogacy is suggested.

When is the option of IVF surrogacy laid out?

You need a sperm, an egg and a healthy womb to help you carry the pregnancy to term. However, if a woman’s egg reserve is exhausted, she might have to borrow eggs from a donor. The eggs will be fertilised with the partner’s sperms to form an embryo which needs to be inserted into the womb for a fetus to grow and develop. If the woman’s womb isn’t capable of carrying the pregnancy to term or she is physically unfit to carry a pregnancy, she might need a surrogate mother to help her with the pregnancy and carry it to term.
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Soha Ali Khan has been all over the internet for posting her pregnancy workout pics on Instagram. And why not, she has been giving fitness goals to all the pregnant ladies out there. Now if you have been a non-exerciser throughout, you should get started during your pregnancy. Yes, exercise can help ease your labour. Exercise helps you deal with the demands of pregnancy and labour better, and this has been stated for long with enough evidence. Here’s how exercise helps.
1. Improves your endurance: Labour can be both mentally and physically draining. It can go on for hours and can seem incredibly daunting. Cardiovascular activities can improve your endurance and increase your ability to tolerate labour process [1].
2. Strengthens your pelvic floor muscles: Exercise can help support the pelvic floor muscles which in turn support your vagina, bladder, rectum and urethra. When you are in labour, it is necessary that you relax your pelvic floor muscles for the smooth passage of the foetus through the birth canal [2]. So working your pelvic floor muscles can help ease labour.Follow thiss exercise guide for first, second and third trimester of pregnancy. 

3. Strengthens thigh muscles to combat labour stress: For the same reasons perform your Kegal exercises with vigour. Apart from your pelvic floor muscles Kegels also make your thigh muscles strong to fight the stress of labour. Often it’s the thigh muscles that get fatigued during labour [3]. And that’s when a doctor decides to go for a C-section seeing that a woman has given up due to sheer exhaustion.
4. Prevents excessive weight gain during pregnancy: Many factors such as your age and the weight can influence the first stage of labour. Regular exercise can reduce the possibility of excessive weight gain during pregnancy which in turn can potentially ease the first stage your labour [4].
5. Helps you recover faster after labour: Indulging in physical activity during pregnancy can help you recover faster after delivery [5]. You will also be able to bounce back faster to your pre pregnancy weight. Every pregnant woman must perform these four breathing exercises. 
References:
[1] Hammer, R. L., Perkins, J., & Parr, R. (2000). Exercise During the Childbearing Year. The Journal of Perinatal Education, 9(1), 1–14. http://doi.org/10.1624/105812400X87455
[2] Marques, A., Stothers, L., & Macnab, A. (2010). The status of pelvic floor muscle training for women. Canadian Urological Association Journal, 4(6), 419–424.
[3] Bahadoran, P., Asefi, F., Oreyzi, H., & Valiani, M. (2010). The effect of participating in the labor preparation classes on the maternal vitality and positive affect during the pregnancy and after the labor. Iranian Journal of Nursing and Midwifery Research, 15(Suppl1), 331–336.
[4] MOTTOLA, M. F., GIROUX, I., GRATTON, R., HAMMOND, J.-A., HANLEY, A., HARRIS, S., … SOPPER, M. M. (2010). Nutrition and Exercise Prevent Excess Weight Gain in Overweight Pregnant Women. Medicine and Science in Sports and Exercise, 42(2), 265–272. http://doi.org/10.1249/MSS.0b013e3181b5419a
[5] Bogdanis, G. C. (2012). Effects of Physical Activity and Inactivity on Muscle Fatigue. Frontiers in Physiology, 3, 142. http://doi.org/10.3389/fphys.2012.00142
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