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The myths about In vitro fertilization (IVF) Having a child is the greatest happiness that a couple can experience. At times, when they are not able to conceive naturally, science and technology can come to their rescue. In-vitro Fertilization   is a process of conception, in which eggs are collected from the woman and combined with the male partner’s sperm, outside the woman’s body - in the laboratory.  This fertilized egg  is then put back into the woman’s womb for the embryo  to grow there, until the delivery. There are, however, some myths around IVF, that we need to put at rest.

MYTH 1. One needs to take complete bed rest during IVF: It is one of the most prevalent myth that plagues every IVF patient . Many people think that they need “strict” bed rest during the IVF and also after the embryo transfer . Many patients are scared that the embryos will fall out if they walk around. Patients need to know that nature designed the body with enough ‘ability’ that walking, running, coughing, and sneezing does not cause an embryo to fall out. The fetus remains safe in the womb, and just because they have been in an incubator in the IVF does not make any difference. IVF allows us to copy nature, and once the embryo reaches the uterus, it is just like a natural embryo.

 MYTH 2. IVF is a painful procedure: Many couples  believe that IVF is a painful procedure, which is not true. The needed injections are given with the help of a specialized pen, which is a painless process. In the egg retrieval process, the woman is administered anesthesia, so there is absolutely no pain in that process. After this, there are certain injections that we inject in luteal support, they are also minimally painful. In some cases, we can avoid the injections and replace the same with gel or tablets. So it is a painless procedure.

MYTH 3. IVF means we will have twins: This is also a common myth that if we opt for IVF, we will have twins only. It depends on how many embryos are transferred as part of the IVF cycle and also on how many embryos continue to grow in the womb. The chances of a twin pregnancy is higher if more than 1 embryo is transferred. But it is not guaranteed that IVF will ALWAYS result in twins.

Obesity and Infertility  Obesity or overweight is the body mass index (BMI) of 30 or above. It is a condition where excess fat accumulates to such an extent that affects the health of an individual. The link between obesity and infertility is more significant when excess fats get accumulated in the abdominal region. Obesity  causes changes in the secretion of sex hormones  and thereby increases infertility. The hormonal imbalance leads to an increased production of androgens called hyperandrogenism. Insulin is significant for the production of sex hormones. Increased insulin production due to obesity leads to hyperandrogenism and abnormal follicles in the ovary. Women with PCOS  face issues of disruption in the ovarian and menstrual cycle leading to infertility.

An obese woman faces the following problem which contributes to infertility:

•        Problems about ovulation

•        Irregular menstrual cycle

•        Hyperandrogenism

•        Increased risk of miscarriages

•        PCOS (polycystic ovarian syndrome) Infertility is not an absolute condition.

An obese woman faces the following problem which contributes to infertility:

•        Problems about ovulation

•        Irregular menstrual cycle

•        Hyperandrogenism

•        Increased risk of miscarriages

•        PCOS (polycystic ovarian syndrome) Infertility is not an absolute condition.

Did one know that deficiency of vitamin B12 can cause infertility in both men and women ? If one has been trying to urge pregnancy for an extended time, but with no success, then one among the explanations might be lack of vitamin B12 in your body.

Vitamin B12 is a water-soluble vitamin and plays a vital role in producing the genetic components, DNA and RNA of the egg and the sperm. Deficiency of Vitamin B12 results in infertility in both men and women.

In men:

Vitamin B12 is helpful in the generation and maturation of the sperms. A deficiency of this vitamin may negatively affect the sperm count or cause subsequent issues:

• Low sperm count

• DNA damage in sperm cells

• Low motility of sperms

• Loss of libido

• Premature Ejaculation.

In women:

Conception is not easy for a woman with Vitamin B12 deficiency. The chances of foetal loss are higher even if one gets pregnant . The lack of B12 possibly interferes with the reproduction process that leads to the following problems:

• Abnormal ovulation

• Disruption in normal cell division

• Impaired development of the egg

Global Family Day is an international day of love, peace and sharing celebrated every January 1 globally. The motto of this day is to unite and spread peace throughout the planet earth. This day remarks to make the world a better place to live for everyone as one large family. It is a day where individuals and families share food and joy with friends (especially the needy), make personal pledges of non-violence, and spread a message of peace and sharing by ringing a bell or beating a drum in hopes of making the society and the world united as a family.

This 1/1/2021 let us pledge to make the world a happier place to live in and believe in living and let live. GarbhaGudi family wishes one and all peaceful family day and helps accomplish the dreams of those couples who wish to have a complete family.

A baby  is a blessing from heaven, to cherish. GarbhaGudi fertility center has been delivering miracles to couples since 2011, it has been amongst the best fertility centers in Bangalore, playing a key role in bringing more than 6000 babies into the world. Choosing a fertility center for treatment is a commitment emotionally, financially, and psychologically. Finding the right fertility center is one of the key decisions which needs to be made to ensure a successful result. Garbhagudi is a leading fertility chain, with treatment options to help couples have their bundle of joy. What sets apart GarbhaGudi from other fertility clinics? Our Team: We are a team of committed entrepreneurs, healthcare specialists, doctors, and embryologists led by Dr. Asha S Vijay , who is a renowned gynecologist and fertility specialist. Our Success Rates The success rate at GarbhaGudi is over 65% in IVF and we have helped more than 6000 couples in their journey towards parenthood. We are known for our holistic approach and transparency in treatment. Types of Service Offered: We offer IUI, IVF / ICSI, Donor cycles (semen, egg, and embryo), Surrogacy, surgical treatment like hysteroscopy/laparoscopy, surgical sperm retrieval (TESA, PESA, Micro TESE, etc.), and many other treatments. Embryology Laboratory: We are equipped with the best in house Embryology laboratory, which has a huge influence on the outcome of the IVF process. We give the highest level of importance to the following, which directly has a bearing on the success of the IVF cycle. The quality of the equipment

- The media and the consumables used in embryo  culture

- The experience of the embryologist and the team influences the success rate At GarbhaGudi, we have the best infrastructure, manned by highly qualified and experienced embryology staff. We never compromise on the quality, The culture media and consumables used are of the highest quality available with proven results. Location and Accessibility: GarbhaGudi fertility center has 4 centers (and a fifth one coming at Marathahalli, very soon) spread around Bangalore city  for the convenience of patients, thus choosing a center near where you live goes a long way in reducing your traveling anxiety and stress. IVF cycles require daily visits to the clinic, so travel time can be a major consideration. Our Costs: The cost of fertility treatment is often one of the deciding factors for many couples. Many centers quote low costs to start the cycles and then hidden costs are added which comes as a shock to the patients. We at GarbhaGudi, give you clear information on costs including ‘extras’ such as drugs or surgery with no hidden charges. We even offer zero  percent interest in EMI payments to patients  to lessen the burden of costs. Credentials and experience of staff: The most important factor which decides the outcome of the treatment is the clinician who plans and executes your treatment. All clinicians at GarbhaGudi are doctors who have completed their super specialization in infertility with extensive experience in treating infertility.

ICSI stands for Intracytoplasmic Sperm Injection and is a specialization in In Vitro Fertilization. In couples where there is severe male infertility and is unable to conceive even after repeated fertilization attempts by conventional IVF treatment or after egg freezing (oocyte preservation), ICSI is the next step in fertility treatment. If a man does not have any sperm in his ejaculate, but he is producing sperm in his testis, these produced sperms are retrieved through a surgical step called as testicular sperm extraction (TESE). Sperm retrieved through TESE require the utilization of ICSI as they are not capable of fertilizing on their own. ICSI is also the method of choice in cases of retrograde ejaculation, where the sperm retrieval is from the urine. However, severe male infertility is not the only cause, where ICSI-IVF has opted. Other reasons where ICSI is the choice are:

• Previous IVF cycle had no or few fertilized eggs: In some cases, with a good number of eggs retrieval and healthy sperm count, but still, no eggs get fertilized. In such cases during the next IVF cycle, ICSI is tried. • Frozen sperm is being used: If the thawed sperm appear to be inactive, ICSI-IVF is on a recommendation.

• Frozen oocytes are being used: Verification of eggs can cause hardening of eggshell, which causes complication in fertilization. IVF  with ICSI can help in overcoming this hurdle.

• PGD is being done: PGD (Preimplantation Genetic Diagnosis) is an IVF technique which allows genetic screening of embryos. Here ICSI is essential for the embryo biopsy

• IVM (In Vitro Maturation) has opted: IVM is an IVF technology where eggs are retrieved from the ovaries before they are completely mature. They go through the ultimate stages of maturation within the lab. Some research has found that the rate of fertilization of IVM eggs by sperm cells is lower when compared to fertilization through traditional IVF. But IVF with ICSI can be the only option in some select cases. Who can opt for ICSI?

• Couples who want to include PGT in their cycles to ensure fertilization is better. • Couples who are facing severe male infertility

• When the only course of action is by sperm retrieval through TESE/MESA

• Poor oocyte quality/ low oocyte yield

• Suitable for women aged over 40 years of age ( to overcome sperm-Oocyte Penetration Issues)

 • Couples who are facing repeated fertilization failure

• Ejaculatory Dysfunction The procedure involved in IVF-ICSI:

   As with regular IVF procedure, ovarian stimulation drugs are given.    Fertility Doctor monitors the progress with blood tests and ultrasounds.    Once enough good-sized follicles are produced, egg retrieval will be done, from the ovaries with a specialized ultrasound-guided needle.    The partner provides sperm samples the same day(unless you are using a sperm donor or previously frozen sperm)    Once the eggs are retrieved, an embryologist places the eggs in a specific culture medium.  

 Using a microscope and tiny needle, the embryologist injects a single sperm into the egg cytoplasm. The process will be for each egg retrieved.    These injected eggs are then cultured in the lab, under ideal conditions, to allow the fertilized eggs to grow and divide.    If fertilization takes place and if the embryos are healthy, they will be transferred into the female uterus via a catheter placed through the cervix, two to five days after the retrieval. Risks involved with ICSI:    

Even though the fertilization rates of IVF with ICSI can be as high as 50 to 80 per cent, not all fertilized eggs will develop into healthy embryos. A few or many of the eggs may be abnormal, depending on the age of the women. Fertilization may result in abnormal embryos in some cases. Occasionally, eggs may get damaged in the procedure. There is also a theoretical study that says  ICSI allows less healthy sperm to fertilize an egg , which may result in defective embryos which may not develop and grow. These sperm would never have been able to fertilize an egg naturally.  

The risk of defective birth in children conceived naturally is same as of with children conceived with IVF and ICSI. The risk of an ICSI-conceived child having defects is low, less than one per cent.  While, earlier studies found some specific risks of defective birth, which may be due to lower quality sperm (sex chromosome abnormalities, defects in the urinary system or genitals, and other rare syndromes), more recent studies have found that the chance of this happening appears to be  almost non-existent.  

A calm and relaxed state lies at the heart of anyone’s success. A true leader is peaceful in the middle of a crisis because she believes in her ability to find solutions.

Can executive presence be improved through coaching? How?

One can certainly improve one’s executive presence through executive coaching.

To put it simply, our executive presence is what people are talking about us when we are not in the room. It’s the positive impact that we create on our ecosystem with our presence.

Through focused executive coaching a powerful presence can be developed over a period of 4 to 6 months.

This happens when we discover our innate greatness. Coaching process acts a catalyst to help us rediscover our innate greatness.

For the executive presence to grow, the three dimensions of our being, our body, mind, and spirit, need focused nurturing.

At the level of the body, we need to have confident body language and charisma that have a direct impact on executive presence.

At the level of mind, a leader with a calm mind has a 360-degree grasp over the situations, and they can focus on solutions.

At the level of spirit, one needs to be clear about one’s purpose and vision. It helps one develop heart leadership that is at the core of having a high executive presence.

Through executive coaching which usually lasts from 4 to 6 months, I help my clients at all these levels. Through my time tested 7 step master framework , I have been able to support a lot of senior leaders in reaching CXO positions

Here is a short description of these steps:

1. Know your presence: The first step is about knowing where you are in terms of your executive presence. What impact you are creating on your environment and where you want to be.

2. Nurture your charisma: Executive coaching helps leaders develop charisma by enhancing three components of charisma, focus, power, and warmth.

3. Master your public speaking: Public speaking is a skill that comes in very handy to senior leaders to enhance visibility and create the desired impact. Executive coaching helps in that.

4. Articulate your life purpose: Senior leaders need to be clear about their life purpose as it helps with their motivation and executive presence.

5. Be a master influencer: Through focused executive presence coaching, you improve your influencing skills and become a master influencer.

6. Enhance your emotional intelligence/positive intelligence: A leader with a well-developed emotional intelligence can influence others.

Through executive coaching, one can become aware of the things that can derail one from a calm and peaceful state and work towards improving it.

How is one to one leadership coaching useful for a high potential leader?

 “A Leader’s job is not just to get the best out of their people..... Leader’s job is to create more leaders”- Simon Sinek Every leader has an innate talent and hidden potential.

Leadership Coaching helps leaders discover their innate talent and help them unleash their potential. 

 The result is just magical. Leadership  coachings especially useful for high potential leaders in an organization. It helps to bring out the best in them. 

 Here is how one to one leadership coaching is useful for a high potential leader: 

• Working with potential future leaders helps in creating a strong leadership pipeline

• Facilitates focused behavioural change to make them more impactful and eminent leaders 

• Enhanced executive presence 

• Ability to navigate through organizational politics 

• Uncovers their blind spots while working with teams to enhance team effectiveness 

• Improved understanding of individuals and team dynamics to institutionalize new learning 

• Help the, learn how to drive change initiatives in an organization 

• Executive coaching fast tracks leadership development  across the organization 

 • Helps the, discover their innate ability to inspire and motivate teams, across various geographical locations 

• More creativity, empowerment, commitment and ownership unleashed in the business 

• Open communication and transparency with the management, thus slowly helping the culture build-up of the organization and its employees  Investment in one to one coaching for high potential leaders has now become a norm and has started benefiting the individual and the organization 

“What got you here won’t get you there”  

Marshal Goldsmith (Author and Coach)

 An Executive Coach  is a qualified professional who works with senior executives, often high-potential senior leaders of a business or organization and support them in gaining self-awareness, clarify goals, achieve their development objectives, unlock their potential, and act as a confidant. In short an Executive Coach acts a catalyst to senior leaders and speed their journey towards their cherishes goals

 There are certain skills and qualities which propels the growth in our career to an extent and up to a certain level. However, it’s not necessary that the same skills and qualities will take us to the next level. 

 That’s where an executive coach plays a critical role. 

 You can consider engaging with an executive coach if – 

 - You are a senior leader with 15 plus years of experience with a desire to fast track your career growth to be a CXO 

 - You are open to put in a lot of efforts to reach your desired goals & you are ready take a plunge and challenge  your comfort zone 

 - You have a desire to do something extra ordinary and leave a legacy Common Goals set by Executives during Coaching: 

 - Enhancing Executive Presence 

 - Developing second line of leaders 

 - Enhanced personal effectiveness 

 - Improved collaborative mind-set 

 - Excellent Stakeholder Relationships 

 - Overcoming limiting self-beliefs 

 - Improved presentation and public speaking 

 - Achieving time bound business results. 

 - Enhanced work life balance 

 - Improved Team relationships 

 - Reduced Conflicts 

 - Clarity about purpose 

 - Enhanced Communication and Influencing Skills 

 - Improved Emotional Intelligence

- Improved Assertiveness 

 - Improved Strategic mind-set 

A powerful executive presence very much needed in modern time specially in such times when all of us are working from home and the interaction is primarily happening through virtual channels

 Lest step back and understand that what is Executive Presence.

 In a very simple terms we can say that Executive Presence is what your colleague talk about you when you are not in the room. It’s the positive impact that you create around your ecosystem which would include your superiors,, your peers, your subordinates, your customers and other stakeholders.

 A leader with strong executive presence utilizes his or her appearance, demeanour and communication skills to inspire confidence among the team, build strong smooth relationships which in turn will lead to increased productivity at the workplace. The leader with a powerful executive presence can engage, inspire, align and cause a positive movement in people to act in an organization.

 A leader with a powerful executive presence can bring the following to an organization or a project:

 • Gaining Efficient and High-Quality Results

 • Improved and Smoother Relations within the organization 

 • Clear and Effective Communication with the team and in public To summarize , we can say that leadership  with a powerful executive presence can be very helpful in bringing about a positive change .

The journey  to motherhood is unique and beautiful in every woman. But due to various medical reasons in some women, the journey to motherhood may not be as comfortable and happening. One such reason can be Early Ovarian Ageing (EOA) which can cause a hurdle in one’s pathway to motherhood.

 What is EOA? 

All women are born  with a definite number of eggs. There is no production of new follicles at any stage of life. A healthy female has 10—20 lakhs primordial follicles at birth. It reduces to 4 lakhs by puberty each of which contains an immature ovum. During the reproductive  life span of an adult female, 300-400 follicles reach maturity. The remaining follicles get depleted or exhausted. Ovarian Reserve refers to the number of potential follicles left in the ovaries at a given point of time. In an individual, the significant decline in ovarian reserve is at 35 years of age. However, in some women, the reduction happens at an early stage of life termed as Early Ovarian Ageing (EOA). EOA occurs in 10% of women. Women with EOA are usually asymptomatic while some may have normal fertility. However, with advancing age, continuous follicular depletion will result in loss of fertility potential, menstrual irregularities and eventually lead to early menopause.

 Infertility is a stressful condition. While it is not a disease, it causes a lot of mental and psychological upheavals. It leads to social isolation and withdrawal, commonly in traditional societies. 

 It is advisable for women to: 

• Take fertility  treatment at the right time of the right age. 

• Advisable for couples planning to postpone their pregnancy, get their ovarian reserve test to take necessary precautions and plan accordingly. 

How does pelvic endometriosis affect pregnancy?

 Endometriosis is often the main cause of infertility which affects 10% of women . Endometriosis is a painful condition, where the endometrial lining grows outside the uterus into other areas of the abdominal cavity. Endometrial tissues normally line the inner wall of the uterus but in this condition may grow outside of the uterine wall, such as ovaries, fallopian tubes, pelvis, and in worse cases in the intestine, rectum, bladder, vagina, etc. 

 The main symptom of endometriosis is pelvic pain, often associated with menstrual periods.

 Other symptoms include: Pain with intercourse, pain with bowel movements or urination, excessive bleeding and you may experience fatigue, diarrhea, constipation, bloating, or nausea, especially during menstrual periods. This disorder commonly occurs in women of reproductive  age.

 The endometrial tissue present elsewhere, outside the uterus, also grows and bleeds every month, like normal menstruation. This results in collection of menstrual blood in the ovary, pelvis, bladder, etc. This collection causes pain. The blood collected causes irritation of surrounding tissue, eventually developing scar tissue and adhesions which causes organs to bind with each other.

 Endometriosis can result in infertility when there are lesions in the fallopian tubes that cause blockages, preventing sperm from reaching the egg. In some cases, the reproductive organs become fused together because of the scarred tissues, which prevents the release of eggs  and the normal cycle is disrupted.

 Endometriotic lesions also cause cysts in the ovaries that halt proper ovulation or egg production. Endometriosis can influence fertility in several ways: it can distort the anatomy of the pelvis due to the adhesions, which bind to organs, scarred fallopian tubes, inflammation of the pelvic structures, altered immune system functioning, disrupts the hormonal levels which in turn affects ovulation, impaired implantation of a pregnancy , egg quality is altered,etc. 

 Women with mild endometriosis, as visualized by laparoscopy, may conceive naturally. Laparoscopic ablation of endometriotic spots, restoration of pelvic anatomy may help women conceive spontaneously or with intrauterine inseminations (IUI). Women with moderate to severe endometriosis, especially ovarian endometrioma of > 3cm, may require surgical excision before proceeding to assisted reproductive technologies.

 At GarbhaGudi, We have helped thousands of couples in conceiving and have onboard a team of the best infertility specialists like gynaecologists, surgeons, embryologists, technicians, and staff who will develop a personalized fertility treatment plan for each couple. 

What are the symptoms of pelvic adhesions?

 Adhesions can form when the abdomen is injured because of disease or surgery. Adhesions are bands of connective tissue that may form between abdominal organs (uterus, fallopian tubes, ovaries, or bowel) and/or between these organs and also the wall of the abdomen. 

 Depending on their location, adhesions may make it difficult for one to get pregnant or can cause bowel obstruction or pain. Your doctor might suspect you have adhesions if you experience any of these conditions. To diagnose and treat adhesions Laparoscopic surgery is required.

 Appendicitis, colon inflammation, and gallbladder inflammation are quite uncommon causes of infertility because of adhesions. The further your disease  has progressed, the more severe the adhesions will be. 

 Surgery on the ovaries uterus or tubes can cause adhesions. Any surgery can cause adhesions but is more likely after traditional or open surgery than after minimally invasive surgery or laparoscopy. Minimally invasive surgery may cause less tissue damage because the surgeon only makes a couple of small openings and uses a camera to look at your internal organs and abdomen.

 Adhesions that form on a woman’s  ovaries or fallopian tubes are more likely to cause infertility. Women with adhesions in or around their Fallopian tubes have a greater risk of ectopic (tubal) pregnancy, which is a pregnancy that develops outside the uterus (womb). 

 Adhesions that form within the womb can lead to infertility and repeated miscarriages. Adhesions involving the small intestine (bowel) can partially or completely block your bowels (bowel obstruction), adhesions are the most common cause of bowel obstruction.

 Symptoms and Conditions Caused by Pelvic Adhesions Adhesions

 may cause pain within the abdomen or pelvis, particularly if they cause organs to move from their normal location or if they become fixed (stuck) in an abnormal location. 

 Blocked fallopian tubes– Blocked fallopian tubes are the most common form of infertility caused by adhesions. Adhesions wrap around delicate structures inside the reproductive tract prevents the reproductive system from working normally.

 Hydrosalphynx– Another common tubal blockage is a hydrosalpinx. This occurs when fluid collects within the Fallopian tube – generally because of an infection. As adhesions form at the end of the tube close to the ovary the tube swells, hydrosalpinx usually indicates a totally blocked tube. 

Unexplained infertility –Most diagnostic tests do not reveal adhesions, exploratory surgery is required in order to verify that a patient has adhesions. Unfortunately, most patients are unaware of adhesion this could the reason in women  affected by unexplained infertility. 

 Previous surgery – Surgeries are sometimes necessary to save a woman’s life, as in the case of an appendectomy.  In the case of undiagnosed pain, a doctor may suggest doing exploratory surgery to directly visualize the pelvic contents. Because adhesions form after most pelvic surgeries, the very surgery to correct a problem may be the reason for adhesion formation as the body heals.

 • Chronic pain - Common  descriptions we hear from patients affected by adhesions are they feel the abdomen tight, immobile, constantly uncomfortable. Because adhesions bind to structures and build constant tension, it's no wonder why so many patients with adhesions also suffer from chronic pain. 

Being diagnosed with infertility can be hard to accept, whether it is you who is infertile or your partner or both of you. But most important is to understand that infertility is not your fault, it is just a medical  condition and can be treated with the right guidance at the right fertility centre by the experts. 

 Your fertility journey may be difficult but never blame yourself or your partner for it. Instead be there for each other, support, motivate and comfort each other, as fertility is not impossible. Remember your support and care during this journey  is what matters. The stronger and supportive you are for each other, the brighter and the magical your little miracle will be.