Pregnancy During Days of Covid19 / Corona

The whole world is, quite literally, locked down due to the current Covid-19 pandemic. It is, therefore, understandable, if a woman is pregnant and deeply worried. Being pregnant is stressful and it becomes even more so now.

Covid-19 is an infectious disease that spreads mainly through discharge from the nose or saliva droplets when an infected person coughs or sneezes. Currently there is no specific vaccine or treatment protocol for the disease and prevention is considered the best defence.

So, what can a pregnant woman do? 

Here is what we know.

1. While there is no data to show that pregnant women are more susceptible than anyone else, they are in what is called the “immunocompromised” group and are likely to have respiratory infections. Hence, good hygiene and social distancing everywhere is advised.
2. Ideally, all pregnant women should get tested for Covid-19.
3. Clean, disinfect frequently and have the laundry done daily.
4. DO NOT put cloth covering/masks on children younger than 2 years.
5. Clinical studies have, till now, shown no evidence of the virus in breast milk, amniotic fluid and cord blood. 
6. There have been a few cases of preterm births, but it is unclear whether the virus is to blame. The sample size was very small.
7. If you are a nursing mother and are infected, it is advisable to use a breast pump and have someone else feed the milk to the baby. Wear a mask and wash your hands before holding the baby.
8. Stay at home and stock up on essentials and medications if any prescribed. Better safe than sorry.
9. If you are due and are at the hospital, then there will be restrictions on visitors; you will not be able to walk around as is normal; you may be discharged early after birth and all doctors and nurses will be wearing protective gear.
10. If you are confirmed infected and give birth, then the baby will have to be kept in a separate area or, at the very least, kept six feet or two meters away. The baby should be tested as of 24 hours of age and again when 48 hours old. If the test cannot be conducted, then the baby should be treated as positive for  a 14-day quarantine period.

This disease is new to everyone and the situation is constantly changing. So stay informed, stay healthy and stay safe.

Blog Reviewed By: Dr. Radhika Meka

Mail Us:paramparafertility@gmail.com 
Book an appointment:paramparafertility.com/book-an-appointment.php

Laparoscopic Treatment of Ectopic Pregnancy

The fertilization of sperm and egg occurs in the fallopian tube and the embryo is implanted in the spongy endometrial lining in the uterus in a conventional pregnancy. This lining is where all the nutrients necessary for the egg are provided and helps in the development of the embryo. When this implantation happens just outside like in the fallopian tubes, abdominal space, ovary, or even the cervix, the egg does not mature and the embryo will not survive. This is called ectopic pregnancy.  This is also called tubal pregnancy because most of the implantation occur in the fallopian tubes. An ectopic pregnancy is dangerous as it could prove fatal for the mother and the only option is to terminate the pregnancy.

If the termination cannot be managed effectively with medications, laparoscopic surgery is performed. It is a key-hole surgery performed under general anaesthetic where a small telescope like instrument is passed through the belly button to inspect your pelvis and ectopic pregnancy once identified is removed. This surgery is of 2 types:

• Salpingostomy: Here a small cut is made in the fallopian tube and is used to remove the ectopic growth. The cut is then left to heal on its own or is stitched back.
• Salpingectomy: If ectopic pregnancy has ruptured and damaged the fallopian tube, the part of the fallopian tube where the ectopic growth is seen is removed, and the remaining length of the tube is reattached. 

The incisions made are minute and the scars will barely be visible after a few months. Post surgery, care should be taken to avoid standing for long periods, lifting heavy objects, doing heavy housework and walking long distances.

Blog Reviewed By: Dr. Radhika Meka

Mail Us:paramparafertility@gmail.com 
Book an appointment:paramparafertility.com/book-an-appointment.php

All about Azoospermia And treatment options

Parenthood is a major transition in a person's life. The nonfulfillment of this wish due to infertility can put them in tremendous emotional turmoil. Both males and females have an equal role in infertility. 

There are multiple reasons for infertility in men. One of the reasons is Azoospermia or an absence of sperm in the ejaculate. It is estimated that azoospermia is the reason for infertility among 1 in 15% of infertile men. 

What is Azoospermia? 

Azoospermia is a condition of a man whose semen contains no sperm due to a block in the reproductive tract, known as Obstructive azoospermia or inadequate sperm production, known as Non-obstructive azoospermia. This is considered as one of the primary reasons for infertility. Azoospermia is classified into two categories - obstructive and nonobstructive azoospermia. 

• Obstructive azoospermia is a condition when the sperm is produced but is blocked from reaching the ejaculate due to an obstruction in the reproductive tract. 

            Causes: vasectomy, infections, congenital conditions and surgical complications

• Non-obstructive azoospermia is a condition caused by low sperm production. 

Causes: Genetic Causes, Varicocele, Hypospermatogenesis, Maturation Arrest, Sertoli-Cell Only Syndrome (SCO) or Germ Cell Aplasia (GCA), Medical Treatments, Prescription Drugs Past infections, Hormonal causes, Undescended testicles, and Injury or twisting of the testicles

Treatments for azoospermia

Obstructive azoospermia: Treatment for OA mainly focuses on eliminating the obstructions that block the sperm reaching ejaculate. Microsurgical or endoscopic reconstruction is used to repair most of these obstructions and restores the normal flow of sperm into the ejaculate.

Non-obstructive Azoospermia

The following are the most common treatment options for NOA.

Hormone treatment

Hormone therapies can help coaxing sperm back to their semen or to find sperm during extraction. 

These hormones include: 

• Follicle-stimulating hormone (FSH)
• Human chorionic gonadotropin (HCG)
• Clomiphene
• Anastrozole
• Letrozole

Varicocelectomy

Having varicocele in the scrotum can also impede sperm production. Varicocelectomy is a procedure used to identify and tie off the enlarged and offending veins causing varicocele. 

Sperm retrieving procedures:

• Percutaneous Epididymal Sperm Aspiration (PESA).
• Testicular Sperm Aspiration (TESA).
• Microsurgical Epididymal Sperm Aspiration (MESA).
• FNA mapping
• Microdissection testicular sperm retrieval

Men with azoospermia should realize that countless couples achieved their wish of having a family through the right treatment methods and infertility medications. 

Blog Reviewed By: Dr. Radhika Meka

Mail Us:paramparafertility@gmail.com 
Book an appointment:paramparafertility.com/book-an-appointment.php