Pregnancy Week by Week | Pregnancy Stages

Assisted Reproductive Technology refers to different types of artificial and partially artificial means to become pregnant.  It is the current management to worsening infertility problems nowadays.  It is also called ARTs for short.  ARTs are not easily recommended by physicians.  It is a rule of thumb to always try out the most conservative measures first.  This technology is very invasive and expensive.  ARTs should be the couple’s last resort.  In the late 1980s, the first test-tube baby was born via in vitro fertilization (IVF).  After this, there was increased popularity not only of IVF but also other forms of ARTs.

IVF & ICSI

The first and most popular is the in vitro fertilization (IVF).  In this process, the eggs and sperms are combined in a petri dish inside a laboratory and waits until fertilization occurs.  The embryos are left to develop for about 3 to 5 days then placed in the mother’s uterus.  Success rate is about 28% to 35%.  In intracytoplasmic sperm injection (ICSI), on the other hand, one sperm is injected directly inside an egg.  After fertilization occurs, the embryo is then placed inside the uterus.  It has a 35% success rate and more expensive than IVF.

GIFT & ZIFT

In gamete intrafallopian transfer (GIFT), eggs and sperms are combined in a dish and then injected surgically into the fallopian tubes where fertilization usually takes place.  It has a low success rate and is not a common practice anymore nowadays.  Zygote intrafallopian transfer (ZIFT) is very similar to GIFT.  It differs in the sense that fertilization should take place first and the zygote is injected in the fallopian tube.  Still, this has a low success rate compared to IVF, and that’s why it is not commonly practiced nowadays anymore.

Donors and Surrogacy

Donors are needed when one of the partners are not able to produce mature and functioning eggs or sperms.  Donated cell is mixed with the functioning cell, they wait for fertilization, and then the embryo is implanted on the mother’s uterus.  You may have to need bigger budget as you may have to pay big for the donor cells and the procedural cost itself is more expensive than others.  Surrogacy, on the other hand, is the last resort of all the last resorts.  It is done when the mother’s uterus is not competent enough to go through pregnancy.  Another woman carries the embryo from the husband and wife’s egg and sperm then gives you the baby after being born.  There are many legal and ethical concerns not only with surrogacy but for ARTs in general.  Always remember that careful review, consideration and consultation is required before making a decision.

Infertility is a reproductive problem encountered by some couples nowadays.  Many infertile couples eventually experience insecurities and incompetence especially those who are wishing to be parents.  In the advent of modern science, many treatments were established to enhance the probability of pregnancy in most infertile couples.  One of which is the use of fertility drugs.

 Types and Uses of Fertility Drugs

Fertility drugs are medication used to induce pregnancy.  These drugs are especially designed to improve the production of hormones responsible for ovulation in women and spermatogenesis (production of sperm) in men.

A common infertility problem encountered by women is decrease in production or failure to produce egg cells.  This is due to the decrease in production of gonadotropic hormones which is composed of the follicle-stimulating hormones (FSH) responsible for the maturation of the ovum and the luteinizing hormone (LH) which is responsible for ovulation.  Clomide Citrate is the drug, which is the counterpart of FSH and LH.  Besides inducing ovulation, it also enhances production of sperm in males with low sperm count.

Another drug which enhances ovulation is menotropin (pergonal).  This is also known as the Human menopausal gonadotropin.  They have been taken out from the menopausal woman’s urine sample which contains FSH and LH.  Human Chorionic Gonadotropin (HCG) is combined with menotropin to potentiate the effects of the latter drug to induce ovulation.

Some women have abnormalities in the production of FSH.  Most physicians prescribe them with Urofollitropin (Metrodin).  This drug usually contains only FSH.  This is indicated to women with polycystic ovary syndrome.  As a side effect, women often have multiple ovum production every month resulting in multiple pregnancies.

Progestin or Progesterone, which is also known as the” hormone of the mother”, is another drug used to treat infertility.  Progesterone stimulates the anterior pituitary gland to secrete hormones which thickens the uterine wall in preparation for implantation.  As the fertilized ovum is released from the fallopian tube, it needs to attach to the uterine lining and begin to form germ layers which eventually will become the essential organs of the fetus.  This drug is indicated to those women who have habitual miscarriages.

Other fertility drugs are especially produced for men with low sperm count or low sperm motility.  Proxeed is a drug used to treat oligospermia but there are few reports to provide evidences of cure.

Additional Information

Fertility drugs can really induce pregnancy, but make sure that you use a drug that is prescribed by your physician.  Dedication and conscientiously drinking these medications will give a better chance of having pregnancy and living your life as a parent.

Search the net and ask your friends.  There are a lot of ways in which people claim to predict baby genders correctly while it’s still in the womb.  There are some that obviously are myths of old times, but some, surprising at it may seem, produce correct results.

Are They Superstitions?

Gender prediction of unborn babies is one of the favorite parts of a mother conceiving.  It’s just so exciting to guess whether you will have a little baby boy or girl.  There is actually a Chinese calendar where you predict your baby’s gender by determining the Chinese age of the mother during a certain month.  Some guess according to whether you have a big belly, your hair and nails grows faster or slower than usual or if you like sweet or sour foods.  Some say you will have a boy if the baby’s heart rate is above 140 while a girl’s heart rate would fall below 140.  These all seem like superstitions.  The only definitive and objective way to determine the sex of your baby is to get an ultrasound at around 20 weeks age of gestation when the baby’s genitals are fully differentiated and recognized.  The debate is - should we know the baby’s gender before birth or not?

The Bad

Parents who decided not to know the gender of the baby say that knowing it is one of the most wonderful moments of being a parent.  They love to be in suspense, and the element of surprise is there.  It gets you to think about different possibilities with both genders.  You get to choose two different set of names and spend your pregnancy wondering which baby clothes and stuff you should buy.  They also like the guessing game that people and friends play all throughout the pregnancy.

The Good

Parents who decided to know the gender of their baby via ultrasound argue on practicality.  They say that it helps them plan ahead and ready themselves.  They can pick the color of the child’s room and things accordingly while saving themselves from the hassle of repainting and returning baby stuff for different colors.  It helps them decide on important issues like whether to circumcise the baby or not.  Most importantly, some parents say that knowing the baby’s gender right away makes them feel more bonded with their child.  They are able to pick out a name and call their baby its name even before he or she is born.  They also say that it gives them motivation during difficult labor that they are already going to meet little John.

It’s Up to You

Whether or not to know your baby’s gender is up to you.  There is no right or wrong answer.  It is based on the beliefs and opinions of the two most important people in the baby’s life.  Whether you keep it a surprise or not, the most important is, the baby is healthy and you take care of him/her the best you can.

Because of the increasing number of infertile couples due to inevitable conditions, researchers found a way to revive procreation and give a chance for couples to start a family.

What are the Indications of Egg Donation?

Egg donation is defined as providing egg cells to research institution for the purpose of helping those misfortunate (infertile) couples.  Most of these eggs are used in artificial insemination (in vitro fertilization).  Egg donation is needed by women with abnormalities in the reproductive system.  Women, as young as 20 years, can experience menopause.  Some women were born with mal-developed ovaries or without ovaries.  Another reason for egg donation is for the benefit of those women who underwent hysterectomy or have reproductive problems.  Other women with genetic disorder or gay couples can benefit from egg donation.

Egg Donor’s Criteria and Motivation

Egg donors are screened both physically and mentally to assure of the soundness of the eggs.  Every egg donor is required to sign an informed consent before the start of insemination.  Egg donors agree to give up any claim of ownership to the egg.  Most egg donors come from donor registries and others are provided by couples who want to submit to artificial insemination.  After signing the informed consent, the donor undergoes IVF simulation and egg retrieval procedure.  After retrieving the egg, the sperm is then combined with the ova and is placed in the laboratory for several days.  When the embryo is formed, it is then placed in the recipient’s uterus to be carried for 9 months and treat the baby as her own.

Egg donors have only two reasons for motivation.  Some women served as volunteers to help couples who want to have a family.  They like the feeling of helping others without asking in anything return.  On the other hand, some women are attracted to the handsome monetary compensation offered by many health institutions.

Advantages and Disadvantages of Egg Donation

Definitely, egg donors are of great benefit to their recipients.  But donors and recipients still encounter problems after insemination.  Donors can suffer from hemorrhage or abnormal production of egg cells becomes of hormonal replacement therapies.  They can result to hyper-ovulation or liver failure.  Apparently, most donors increase their risk to ovarian cancer and early menopause.

On the other hand, recipients are at risk for communicable diseases.

In order to avail of the monetary compensation for egg donations, some donors conceal their true reputation.

Sometimes, physicians accidentally place two or more eggs in the recipient’s uterus.  That’s why multiple births are common effects of egg donation.

During the period of adolescence and early adulthood, many teenagers and young adults become curious of their sexuality and sexual preferences.  They tend to experiment and engage in sexual activities, but oftentimes, curiosity can lead to accidents.  By accidents, I mean unwanted pregnancies or catching STDs.  Perhaps as early as the school age years, children are exposed to issues on sex and protection against STDs or unwanted pregnancies.

As the girl reaches puberty, her body undergoes tremendous changes, both physical and emotional changes.  Hormones, such as estrogen and progesterone, increase in production, and they are the ones responsible for the changes in the woman’s body.

Basal Body Temperature

There are changes in a woman’s body which can help determine the fertility and infertility periods.  A method which can determine if a woman is fertile is by measuring her basal body temperature.  The basal body temperature is baseline temperature of your body.  During the ovulation period, the temperature rises slightly by 1/3 to 1/2 degrees.  This is considered as the woman’s infertile days, thus, it is safe to engage in sexual intercourse.  On the other hand, if the woman’s basal body temperature falls and rises up to a full degree, it is considered as her fertile days.  It is not safe to engage in sexual intercourse.  But in order to achieve the accurate results, a woman must take her temperature before getting up in the morning, apart from performing any activities.

Cervical Mucus Test

The use of cervical mucus can also determine your fertility period.  A woman can observe her underwear for traces of mucus, or she can get a sample of mucus from the opening of the cervix.  If a woman is infertile, the cervical mucus is thick in consistency and does not stretch when it is pulled between the fingers.  Alternatively, if a woman is fertile, the consistency is thin, watery and clear.  It stretches one inch when pulled between the fingers.  Usually after every menstrual period, woman experiences dryness for several days, then it becomes low and cloudy.  But during the ovulation phase, it becomes slippery and transparent.

Cervical Position Test

Another method to determine your fertility period is by checking your cervical position.  You can choose any position as long as it’s comfortable for you.  Some women prefer the sitting position while others choose to squat or pull one leg up after the other.  You may use your non-dominant hand to spread the vaginal lips and insert your other hand to the position of the cervix.  It is somewhat round, cylindrical in shape.  If it’s far back, then you’re infertile, but if it’s in a low position, then you are fertile.

A fetus is at term between 36 – 39 weeks age of gestation.  An uncomplicated vaginal delivery within this period is referred to as normal deliveries.  According to recent statistics, only 66% of babies are born term.  The other 44% are born either preterm or posterm.

Is it False or True Labor?

Labor precedes delivery.  Usually, false labor is experienced first.  Normally, as labor progresses, you cervix opens up and become thinner.  This allows the baby to gradually go down the birth canal.  False labor has no effect in your cervix.  Contractions are irregular, and walking relieves these contractions.  When a woman is in false labor, there is no reason to go to the hospital yet.  True labor increases in duration and intensity.  In true labor, the cervix thins and opens.  It is best to go to the hospital when you have already started with true labor and a few centimeters dilated or open already.

Stages of Labor and What to Do

The duration of labor for those who are to deliver for the first time is normally longer.  There are three stages.  The first stage covers the time from the start of cervical opening or dilatation to the time when full dilatation is reached.  In this stage, the mother should not yet push.  It will only use up her energy, and she will end up exhausted by the time pushing is really required.  In this stage, the mother and the fetus is closely monitored for their progress and condition.  The second stage covers the time of full dilatation until the expulsion of the fetus.  Here, the mother feels intense urge to bear down.  The mother should not hold her breath or clench her fist during bearing down for it to be proper and effective.  This is a crucial stage because inappropriately strong or weak pushing may cause injury to the baby and the vaginal canal.  In the next stage, the placenta is born.  This is also an important stage because the mother is at great risk to bleed.  The uterus should be hard and board-like after expulsion of the placenta to prevent hemorrhage.  To do this, the mother or the nurse must massage her abdomen or stimulate her nipples to contract the uterus.

Recovery Period

Recovery is faster with normal delivery compared to cesarean section.  It is important to start breast feeding as soon as possible.  Breast feeding not only gives time for you and your baby to bond, but it also assists the body in its healing process.  Infection during this period is one of the major concerns and that it why proper hygiene should always be prioritized.

Laparoscopic Surgery and Endometriosis

Endometriosis is one of the causes of infertility in most women.  They have caused pain and inability to function.   That’s why most women undergo surgery as a form of treatment.

Endometriosis Signs and Symptoms

Endometriosis is a problem concerning the woman’s uterus.  The endometrium is the place in the uterus that holds the baby during pregnancy.  In the case of endometriosis, the growth of the endometrial wall does not occur inside the uterus, but they proliferate in other parts of the reproductive system.  They can grow in the bowels, fallopian tube or even in the ovaries.  They can cause grave pain to a woman.  The most common sign of endometriosis is severe dysmenorrhea.   Others experience heavy menstrual flow.  Some women are asymptomatic, and the only way to determine the problem is when they cannot get pregnant.  That’s why women with endometriosis undergo surgery as a form of treatment.

Treating Endometriosis with Laparoscopy

Laparoscopy is a procedure used to diagnose and treat endometriosis.  This procedure is performed by making small holes in the abdomen and inserting a tube with a small implanted camera called the laparoscope.  Before undergoing the procedure, the patient must not eat or drink for 8 hours.  During the procedure, the patient is in general anesthesia, then the surgeon will inflate the abdomen with gas, preferably carbon dioxide which is injected through a needle.  This facilitates a better viewing of the internal organs.  If surgery will commence, the surgeon will also create additional incisions to insert additional instruments to excise any endometrial cysts in the bowel, bladder or ovaries.  Usually, the procedure will only take 30 to 45 minutes, and the patient can go home in just one day.  After the surgery, the patient can go back to her normal activities in 1 week.   Laparoscopy can immediately bring pain relief as compared to hormonal therapy.  There is 75 to 85 percent chance that pain is relieved.

This procedure is safe and effective, but complications can happen.  Women after laparoscopic surgery should be aware of the following signs of complications.  There can be an occurrence of pelvic infection which is manifested by fever, swelling and foul-smelling discharge, internal hemorrhage which may require laparotomy, formation of scar tissues and damage to the bladder, ureters or the bowels.

Follow-up checkup is essential after surgery.  A post-operative patient should visit her physician after a month.  The physician will assess if there is any chance of getting pregnant or if other treatment are needed to improve the woman’s condition.

 The Basal Body Temperature Method is also called BBT or the Symptho-Thermal Method.  It requires careful and accurate measurement of daily morning temperature and precise recording of these temperatures.  There are hormonal physiologic basis for this method.  Before ovulation, a woman’s temperature is low because the Estrogen level in the body is higher than Progesterone.  During ovulation, Progesterone levels exceed Estrogen levels which cause a spike in temperature.  This happens usually for 3 days.  After the temperature spike, you return to your normal low temperature, and Ovulation already took place.  This is not a very popular natural family planning method mainly because it is difficult for some to give the commitment and responsibility it requires.  But this method, for those who are able to do it correctly, has a very high success rate.

Measure and Record

To use this method, you are required to take your temperature as soon as you wake up, and as soon as you wake up means before doing anything at all.  You should not go out of bed, eat, drink, have sex or smoke before taking your temperature.  For your record to be accurate, temperature should be taken at the same time everyday.  Using an alarm clock is a smart idea.  Also, using the same thermometer is a must.  There are special types of thermometer especially made for BBT purposes available at your local pharmacy.  These thermometers are more accurate in detecting even 0.1 F fluctuations in your core temperature.  Lack of sleep affects your core temperature.  It is ideal that you have at least 4-6 hours of sleep the night before you take your temperature.  Where you document your temperature readings is up to you, but there are lots of BBT monitoring sheets downloadable from the internet.

Note That Fluctuation

During ovulation, your temperature increases about 1-2 F and is sustained for around 3 days.  These are the days when you are likely to have your ovulation.  If you are trying to get pregnant, it is best to have sex at least 2 days before and during this 3 day spike.  If you are avoiding pregnancy, it is best to abstain completely from sex during these days.  The reason why some couples use this method is because they have shorter abstinence period.  With the correct implementation, BBT is a very effective and safe family planning method.