During IVF (in-vitro fertilization), the healthiest embryos are chosen and transferred to the woman’s uterus through a catheter. 

But how to determine which embryos to transfer? 

Embryos created in the lab during IVF are graded by the embryologist to distinguish between a good, an average, and a poor quality embryo, so that the one with the highest chance of becoming a baby is transferred.  

Embryo transfers normally occur either 3 days or 5 days after fertilization. 

In fact, there are different grading systems for day 3 embryos and day 5 embryos because embryos are developmentally different on these days.

Day 3 Embryos

Day 3 embryos are referred to as “cleavage stage” embryos because the cells in the embryos are dividing.

At this stage of development, embryos are graded based on:

• The number of cells in the embryo
• The symmetry of the cells in the embryo
• The degree of fragmentation

The number of cells in the embryo

Theoretically speaking, embryos would divide in a specific sequence: 1 cell becomes 2 cells, 2 cells become 4 cells, 4 cells become 8 cells, and so on… 

At this stage, the cells are known as blastomeres. 

However, not all good quality embryos follow this specific sequence.

Some embryos will have 3, 5, or 6 cells, and that’s because cells don’t divide synchronously. 

At day 3, a good embryo should ideally contain between 6 and 10 cells or blastomeres.

The symmetry of the cells in the embryo

The presence of blastomeres of unequal size (> 20% difference) in embryos signifies that there might be a high probability of chromosomal abnormality. 

Therefore, embryos with significantly uneven blastomeres are less likely to be selected for embryo transfer.

At day 3, a good embryo should ideally have blastomeres at equal size (or slightly uneven).

The degree of fragmentation

As embryos divide, sometimes a small portion of cytoplasm breaks off and forms fragmentation.

Think of fragmentation as crumbs when a piece of bread is broken apart.

Less than 20% fragmentation in human embryos is common and fine. 

However, embryos containing a lot of fragmentation lose too much cytoplasm and are less likely to be selected for transfer. 

At day 3, a good embryo should ideally have no fragmentation (or <20%).

Day 5 Embryos 

Day 5 embryos are referred to as “blastocyst stage embryos” because it is the stage of development that the embryo must reach before it can implant in the uterus.

A defining moment in embryonic development is when fluid starts to accumulate between cells at the morulae stage of development.

As the fluid’s volume increases, a cavity appears gradually forming the blastocoel.

This normally happens between Days 4 and 5 in human embryos in vitro and marks a new ‘era’ in the embryo’s life, the blastocyst stage.

The blastocyst differentiates into:

1. The inner cell mass (ICM)
2. The trophectoderm epithelium (TE)
3. A fluid‐filled cavity called the blastocoel

ICM are the cells that will develop into the actual fetus, the TE will eventually become the placenta, and the blastocoel will become the yolk sac.  

At this stage, embryos are graded based on:

• The degree of cavity expansion
• The appearance of ICM
• The appearance of TE

The degree of cavity expansion

Fluid starts to accumulate between the cells. 

As the fluid’s volume increases, the cavity appears gradually within the zona pellucida – the thick membrane surrounding the embryo before implantation.

The expansion of the fluid-filled cavity (blastocoel) relates to how large the blastocoel is. 

Grades range from 1 to 6, with 6 being the most developed.  

A good grade embryo will be one with a large cavity expansion.

Examples of the expansion grades are:

Early blastocyst (Grade 1) in which the cavity is less than half the volume of the embryo.

Expanded blastocyst (Grade 4) in which the cavity is greater than the original volume of the embryo and the ZP is thinned. 

Hatched blastocyst (Grade 6) in which the embryo has completely hatched from the zona pellucida. 

The appearance of ICM

The ICM can range from being very large with tightly packed cells to almost non-existent with loosely bound cells. 

Accordingly, the ICM has been categorized into three morphological categories:

Grade A: in which ICM contains many cells that are tightly packed together

Grade B: in which ICM is composed of several cells that are loosely grouped (may be grainy in appearance)

Grade C in which ICM contains very few cells that are loosely bound

A good grade embryo is one with a large ICM that has many cells tightly packed together. 

The appearance of TE

The TE cells play a key role in embryo implantation in the uterus.

They are scored in a similar way to ICM: 

Grade A in which TE contains many tightly packed cells of equal size

Grade B in which TE is composed of a loose layer of cells (irregular and grainy in appearance)

Grade C in which TE contains very few cells that struggle to form a cohesive layer

A good grade embryo is one with uniformly-sized cells in the TE. 

Conclusion:

Embryo grading is a tool that helps embryologists determine which embryos will most likely lead to a successful pregnancy after IVF. 

It is taken into account along with a host of other factors such as your age, fertility history, the day of transfer, and the number of embryos to transfer. 

If you are undergoing IVF, read our article Would You Tell People You Are Doing IVF? and always make sure you ask about the grades of your embryos to be transferred.

But stay hopeful because you may see many cycles fail after transferring 3 perfect looking embryos, and you may also see beautiful babies born after transferring only one “low grade” embryo. 

No matter the grading system, the embryo grades do not tell us what happens inside the embryo genetically. 

So in case you have had several miscarriages or you’re afraid to pass on a genetic disorder to your baby, your embryos can undergo a preimplantation genetic screening (PGS), so that only healthy embryos are transferred to the uterus for implantation.

If you are pregnant or breastfeeding, you may be wondering whether you should take the covid-19 vaccine or not. 

A recent study has shown that breastfeeding women who have received the Pfizer vaccine have antibodies in their breast milk, which could help protect their babies.

Let’s tackle a few questions regarding the vaccine together before you can decide for yourself. 

Are Vaccines Normally Used in Pregnancy?

Pregnant women and women who are breastfeeding are already routinely and safely offered vaccines in pregnancy. 

Non-live vaccines such as those against flu have previously been shown to be safe in pregnancy.

Many of these vaccines also protect the babies from infection. 

Are Covid-19 Vaccines Considered Safe in Pregnancy?

There is limited information about the effects of COVID-19 vaccination in pregnancy. 

However, around 90,000 pregnant women have been vaccinated mainly with mRNA vaccines, such as Pfizer and Moderna, with no sign of problems.

The mRNA vaccines are not live virus vaccines, which means that these vaccines do not enter the nucleus and do not alter human DNA.

As a result, they cannot cause any genetic changes. 

Pfizer and Moderna are generally considered safe in pregnancy.

They have been given to around 90,000 pregnant women in the United States and the data have not raised any safety concerns.

There are no reported concerns with the AstraZeneca vaccine in pregnancy.

However, there is less experience in pregnancy with this vaccine compared to the Pfizer and Moderna vaccines.

Are Covid-19 Vaccines Considered Safe on Babies?

New research finds that vaccinated women who breastfeed can pass covid-19 protection to their babies.

The study involved 84 women who received 2 doses of the Pfizer vaccine 21 days apart. 

Samples of breast milk were collected before the first dose and then after 2 weeks (once a week for a total of 6 consecutive weeks).  

2 weeks after the first shot, the level of antibodies have significantly increased.

This spike further increases after the second vaccine dose. 

Only 4 newborns experienced fever and congestion, among which 3 cases were resolved without treatment. 

The results from this study seem promising.

However, there are no available data on the long-term effects of vaccination on the mother, the breastfed baby, and on milk production or excretion. 

Participants in this study are still having blood drawn at regular intervals to determine what protection the antibodies against COVID-19  may provide to the baby, and how long they might last. 

Hopefully we will receive better insights soon!

Meanwhile you can read our article Is the Covid-19 Vaccine Safe while Trying to Conceive for more information about safety concerns and fertility. 

Couples who are having trouble conceiving naturally may be wondering what type of fertility treatment they should undergo. 

When it comes to fertility treatment, there are different procedures to consider including IUI and IVF. Some people are more familiar with the term “IVF” and aren’t aware of the differences between both procedures. 

This article explains in detail how IUI works so that you know what to expect. 

What is IUI

IUI refers to the term intrauterine insemination (also known as Artificial insemination). 

The procedure involves the insertion of washed sperm directly into the female’s uterus around the time of ovulation. 

Male Partner

A fresh semen sample has to be obtained through masturbation after an abstinence of 3-4 days, so that the amount of sperm will be enough for a successful IUI. 

If you are using frozen sperm, then the sample is defrosted on the day of IUI. 

In both cases, sperm is washed with a media to clear out impurities in order to obtain the most viable and more motile sperm, which are more likely to reach an egg and fertilize it. 

The washed sperm is then loaded into a syringe to which a catheter is attached. 

Female Partner

Women should have clear and open fallopian tubes (where sperm meets the egg and fertilization takes place) for the treatment to be effective. 

IUI can be done during the woman’s natural ovulation. 

Ovulation predictor kits (OPK) can be used to determine when the woman is ovulating.

However, women having ovulation problems are given medications to induce ovulation and also to increase the number of their eggs in order to increase chances of fertilization.

The Process 

A speculum is introduced into the woman’s vagina allowing the entrance of the neck of the uterus to be made visible. 

The catheter that has been charged with sperm is introduced high enough to the uterus and sperm is manually injected to swim faster towards the fallopian tubes. 

Placing sperm directly into the uterus shortens the distance that the sperm needs to naturally travel in order to reach their target. 

The procedure is safe and is much less invasive than IVF and cheaper because the woman’s eggs are not extracted from the body, and there is no use of great laboratory equipment or monitoring.

Keep in mind that IUI might also increase a couple’s chance of conceiving twins or multiples, because the woman is given medications to increase her number of eggs.

Reasons To Pursue IUI

IUI may not be the most suitable fertility treatment for a couple but it can be a good starting point for couples facing issues to conceive. 

IUI can be effective for couples meeting one of the following requirements:

• The female patient has at least one clear and open fallopian tube and functional ovaries; otherwise, sperm can’t meet the eggs in the fallopian tube, and fertilization does not occur. 
• The male patient has at least 1 million motile sperm to ascend through the fallopian tubes.
• The female patient has mild endometriosis
•  The male patient has erectile dysfunction (ED) – inability to get or keep an erection firm enough to have sexual intercourse.
• The female is using cryopreserved sperm (frozen sperm) or a sperm donor.
• The couple is not being able to have sexual intercourse during the fertile window due to work or travel. 
• The couple has unexplained infertility; It is generally recommended that couples try three rounds of IUI before moving to IVF.

If you or your partner don’t meet the requirements for IUI, then you might consider IVF.

What About IVF

IVF refers to the term in-vitro fertilization. 

The process involves extracting the eggs from a woman’s body using a needle that goes through her vagina. 

Those eggs are then fertilized with washed fresh sperm or frozen sperm in the lab. 

After the fertilization, the fertilized eggs start dividing into cells to become embryos. 

The embryos are monitored carefully and then the healthiest 1-3 embryos are transferred into the woman’s uterus for implantation to occur.   

IVF is usually recommended for couples facing the following issues:

• Severe male infertility (low sperm count and/or motility)

• Damaged or blocked fallopian tubes

• Impaired ovulation

• Unsuccessful IUI treatment

• Concern about passing on certain genetic disorders to the embryo; in that case, you should do IVF with PGD testing (preimplantation genetic diagnosis) to identify genetic disorders or chromosomal abnormalities in embryos before transfer. 

• Female patient is over 40 years old

Free Consultation

If you want to know more about fertility treatment and your options, feel free to consult with me through email. Send me a message with your name, age, location, number of pregnancy attempts, and your diagnosis (if any). I can review your history and discuss a recommended course of action. 

With summer around the corner, it is time to get beach ready and get a little sun-kissed glow. 

But is it safe to tan during pregnancy?

Aside from skin cancer risks, pregnant women have a number of other risks to consider if they spend too much time in the sun. 

The rest of this article explains how to tan safely when pregnant and lists the safest ways to get a glow without harming your skin and your baby’s development. 

Tanning Risks 

Below is a list of 4 potential drawbacks of tanning while pregnant:

1: Sensitive Skin

When you are pregnant, the rapidly increased level of hormones in your body causes your skin to become more susceptible to burning and skin conditions [1].

The female sex hormones – mainly estrogen and progesterone – stimulate the melanocytes to produce more melanin pigments when the skin is exposed to sun or any other type of tanning. 

Consequently, a lot of women develop chloasma during pregnancy.

Chloasma (also known as melasma or “the mask of pregnancy”) is a common skin condition that is characterized by dark brownish patches often found on the cheeks [2].

So instead of a tan, you may end up with freckles, hives, a heat rash, or worsened chloasma.    

2: Preterm Contractions

Prolonged sun exposure can drain your body from fluids and cause dehydration.

With dehydration, your blood volume decreases, which in turn increases the concentration of oxytocin – a hormone that causes uterine contractions. 

So in other words, the lack of fluids in the body could lead to excessive stress and fever, which in turn may cause early labor (prior to 37 weeks of pregnancy) and/or birth defects. 

3: Folic Acid Deficiency

The UV rays of the sun can break down folic acid in your body – an essential vitamin that your baby needs to develop a healthy nervous system [3]. 

Women who are exposed to high levels of UV radiation during their first trimesters are more likely to deliver babies with neural tube defects (known as spina bifida) and multiple sclerosis.

The most dangerous period for the baby is during organogenesis (2 to 15 weeks after conception).

4: Cancer

Pregnancy affects every system in your body. 

Changes in hormone levels and immune system function can make you more vulnerable to infections and serious complications.

You can see now why the risk of developing skin cancer (known as melanoma) is on the rise when you are pregnant if you do not take precautions.

3 Ways To Bronze Safely During Pregnancy

So how can you bronze your skin during pregnancy? 

Here are some suggestions on how to protect yourself and your unborn baby from too much sun exposure.

1: Cover Your Baby Bump

Wearing a one-piece maternity bathing suit is ideal to protect your bump from sun rays. 

Too much exposure to the sun’s UV rays can cause your pregnancy line (known as linea nigra) to darken, and your belly to sunburn. 

Overheating is associated with spinal malformations in the baby. 

So covering the belly prevents overheating of the body and heat strokes. 

Remember to protect your breasts too, as the heat could dilate the capillaries and the ducts through which the milk will pass, increasing the risk of congestion in this very delicate area.  

2: Stay Hydrated

Staying hydrated is very important while pregnant. 

Drink plenty of water to keep your body cool and prevent overheating. 

Another way to keep your body cool is to take a dip into the water. 

The water will provide immediate relief from the heat. 

During the last trimester of pregnancy, your legs swell and become heavier. 

Therefore, go for walks in the water to reduce swelling in your legs and feet and to refresh you and make you feel lighter.    

3: Choose The Right Sunscreen

Sunscreens are the best options to protect your skin from the sun. 

However, some sunscreens contain oxybenzone, a dangerous chemical that absorbs into the skin and ends up in the bloodstream.  

Oxybenzone can disrupt your body’s hormones, which can lead to developmental problems and low birth weights in newborn babies. 

Consequently, you should avoid any product that contains oxybenzone, and apply sunscreen lotions at least every two hours instead of sprays to make sure that you don’t miss a spot. 

Relax and Enjoy Summer Days

You don’t have to stay indoors when you are pregnant. On the contrary, sun exposure is beneficial because it makes your body produce Vitamin D, which is essential for strengthening your bones.

However, remember to avoid sunburn, dehydration, and fatigue. 

The most important thing is to relax and have extra care to protect your skin and your unborn baby. 

References:

[1]. Danielsson, Krissi. “Low Folic Acid Levels and Miscarriage Risk.” Very Well Family, 2020, https://www.verywellfamily.com/do-low-folic-acid-levels-cause-miscarriage-2371735.

[2]. Herndon, Jaime. “Melasma.” Healthline, 2019, https://www.healthline.com/health/melasma#_noHeaderPrefixedContent.

[3]. Weiss, Robin. “How Does Skin Change During Pregnancy?” Very Well Family, 2020, https://www.verywellfamily.com/skin-changes-in-pregnancy-p2-2759974.

 This is a wholly personal decision. There is no right and wrong answer to whether you should tell anyone about your journey.

However, it’s high time we break the taboo of infertility and divulge more information about the journey of IVF and the way it makes you feel. 

When going through IVF, many women don’t reveal to even close friends they are undergoing fertility treatments. 

First, the silence results from feeling stressed and overwhelmed to find out if you are going to be pregnant after all the injections and uncertainty.  

Second, you may feel inferior and ashamed of your situation – as if your body has failed you – so it becomes very natural for you to put up walls of protection. 

It is like you become a member of an underground club, and it’s only when you open up that others may also reveal their membership!

Staying isolated during the process of IVF isn’t always the best decision.

Therefore, considering the pros and cons of telling people can help you make the best choice. 

Why Tell People You’re Doing IVF

• Telling people you are doing IVF may stop them from pressuring you. You can just be open and honest when people ask, “when are you going to have kids”. Say that you are trying but having problems. They will probably be more understanding and sensitive around you – especially when you are having a bad day. 

• IVF is a tough experience for both you and your partner. It is not always easy relying solely on your husband to talk about grieves and emotions. Sharing your infertility journey with your friends may take a lot of pressure off your husband, especially when he’s too busy or away. 

• Another benefit of sharing is you’ll give the closest people to you an opportunity to show that they understand, care, and support you. It might be nice having someone to confide in, attend appointments with, and help with injections, or a shoulder to cry on when feeling down after a negative pregnancy test. Read our article for more information on How To Deal With Disappointment After a Negative Pregnancy Test.  

• It is also essential to find support from someone outside of the IVF process who is ready to listen to you, and distract you with a film, ice cream, and different topics of conversation to light up your mood and ease your struggles. 

• Telling your friends you are doing IVF can help when potentially uncomfortable situations arise such as baby showers, drinking parties, taking days off from work. You can turn invitations down or leave work half way through the day without worrying about inappropriate comments.

Why Keep Your Treatment A Secret

• You may not want to share your story with others because you don’t want to be pitied.

• You just don’t want to be the huge elephant in a room, where everybody is afraid to talk about. Some friends may even feel afraid to tell you anything about their pregnancy or new babies and you don’t want to make them feel uncomfortable. 

• You don’t want anyone asking you how things have gone as soon as you’ve embarked on your fertility journey, especially if it’s not good news. You might prefer to avoid the hassle of being judged. 

• You feel resentful that other people get pregnant with no effort while you are having infertility problems. So opening the subject alone is emotionally difficult. 

• You don’t want to deal with people’s lack of understanding and inappropriate comments. Some people don’t even agree with the whole concept of IVF and don’t know how to handle these subjects in a sensitive way.

Help Break the taboo Around IVF

Having trouble trying to conceive and turning to alternative ways to get pregnant, like IVF is nothing to be ashamed of.

You should have no reason to be concerned what other people think.

Instead, remember that the moment you get to hold your beautiful baby in your arms, it won’t matter how he or she got here.

Your baby will not be any different because you needed help to conceive.

But YOU will be different; a bit braver, stronger, and more grateful! 

By being open about your fertility issues, you are helping open the door for someone else to talk about their fertility issues.

Remember that you are not alone walking this path, so be open and honest about the work you are doing to become a parent.

Your journey can spread hope and positivity to a lot of couples struggling in silence. 

Whatever You Decide: Find The Support You Need

Friends or family may not completely understand your experience, but most of them have struggled in life, which is enough to show care and support on some levels. 

If you don’t feel you can talk to friends or family, there are plenty of mobile applications, online forums, and communities that can offer some of the best support.

People on those platforms understand fully what you are going through.  

You can even reach out to a counselor or a fertility specialist (even “Me” if you feel comfortable to).

Whatever you decide, you do not need to deal with things alone, and always remember that IVF is nothing to be ashamed of! 

References:

Planned Parenthood. “What is IVF?” PlannedParenthood, 

https://www.plannedparenthood.org/learn/pregnancy/fertility-treatments/what-ivf.

If you are trying to conceive, undergoing fertility treatments, or are already pregnant, you may be wondering whether you should take the covid-19 vaccine or not. 

Unfortunately, there was a widely spread myth that the covid-19 vaccine would cause infertility. 

This article debunks the falseness of this belief among many women to help you make an informed decision. 

The Truth Behind The Myth

While many people are aware that the coronavirus is real, there are others who believe the virus is nothing more than another strain of the flu.

Perhaps because they don’t personally know anyone who has died as a result of the virus, so “it can’t be that bad”!

The myth about the coronavirus causing infertility started when conspiracy theories attracted a worldwide following on social media, and because of a fictional series called Utopia.

A large number of healthcare workers have hesitated to take the covid-19 vaccine.

Many of those people used social media to create conspiracy theories against the vaccine. 

One of their concerns was the impact of the vaccine on a protein called syncytin-1, which has some small genetic similarities to the coronavirus spike protein. 

Syncytin-1 is involved in the formation of the placenta – the organ that develops in the uterus during pregnancy to provide oxygen and nutrients to the growing baby. 

Misconception 1: the vaccine might trigger an immune response against syncytin-1, rendering women infertile.

Response 1:  The coronavirus’s spike protein and syncytin-1 are only similar on such a tiny level. 

They actually share small stretches of the same genetic code, but not enough to make them a match. 

Think of it as two people whose phone numbers are different but share one similar digit. 

It’s not like you will dial one number to reach the other person. 

Besides, if the vaccine could trigger an immune response against the placental protein, so could an actual COVID-19 infection. 

With that being said, millions of women around the world who suffered COVID-19 over the past year are suddenly unable to have children – which is untrue!

Anti-vaccine activists also claim that our real life pandemic shares resemblance with much of the plot of a miniseries called Utopia.  

Utopia, broadcasted on Amazon Prime, tells the story of a scientist who aims to depopulate the earth with a pandemic. 

The drugmaker created the illusion of a flu pandemic to convince people to get vaccinated. 

He finally reveals that the vaccine doesn’t prevent infection, but is rather designed to make people infertile in order to radically reduce the world’s population.

Misconception 2: The show’s resemblance to our real life pandemic is a reflection of what could happen if you get vaccinated. 

Response 2: According to a spokesperson for Amazon, the series is pure fiction and was written and filmed prior to the covid-19 pandemic. 

The series is based off of the 2013 British series by the same name. 

I am not certain it’s entirely responsible to release this series into the world as it is right now.

However, prior to vaccine trials, women were given pregnancy tests and were immediately excluded from the study if they were already pregnant. 

This certainly raises the question about the effect of the vaccine on pregnancy.

No wonder why many women are still reluctant about taking the covid-19 vaccine. 

Misconception 3: The vaccine alters fertility patterns and pregnancy since pregnant women were not included in the vaccine trials. 

Response 3: Although pregnant women were not included in the vaccine trials, a few dozen women who participated in the trials became pregnant, likely by accident. 

Those pregnant women continued as part of the study with no safety problems.

Although the number is small, it points to a similar rate of pregnancy among vaccinated and unvaccinated women.

Several pregnancy and fertility healthcare provider organizations recommend COVID-19 vaccination for:

• people who are trying to or planning to conceive
• patients undergoing fertility treatment
• women who are pregnant already

These include ACOG, ASRM, and the Society for Maternal-Fetal Medicine (SMFM).

Trials and common medical knowledge indicate that there are no strong safety concerns for vaccination in pregnant people.

However, you better weigh the risks and benefits of vaccination with your doctor. 

Reference:

Soygur, Bikem. “The role of syncytins in human reproduction and reproductive organ cancers.” Society For Reproduction and Fertility, vol. 152, no. 5, 2016. Reproduction, https://rep.bioscientifica.com/view/journals/rep/152/5/R167.xml.

Vineyard, Jennifer. “Gillian Flynn Knows ‘Utopia’ Has ‘Unsettling’ Covid Parallels.” NY Times, 2020, https://www.nytimes.com/2020/10/20/arts/television/utopia-gillian-flynn.html.

When you are trying to get pregnant, it is only natural to ask whether exercise will interfere with conception. 

Many women stop working out completely to minimize any stress on the body for fear of upsetting the fertilized egg whilst on its way to implant in the uterus. 

So is exercise safe when trying to conceive? 

Every patient is unique and everyone should keep their bodies moving in ways that are right for their conditions. 

The rest of this article expands on different types of women and explains how working out could impact fertility. 

Inactive Women

Research has claimed that women with a sedentary lifestyle have lower fertility rates. 

Therefore, sedentary women are recommended to start an exercise program at least 6 weeks before getting pregnant. 

If you don’t exercise regularly, try to introduce low to moderate activities into your daily routine.

This will help improve your fitness level and prepare your body for pregnancy. 

Walking or swimming three times a week, gardening or even running house chores are good for your body and future baby.

Active Women  

If you already work out regularly, then you don’t have to change your workouts when trying to conceive. 

However, if you are a seasoned athlete and your workout routines are very strenuous, then you need adequate nutrition in parallel.

This will help you maintain a healthy weight. 

Vigorous workouts without adequate nutrition drain your body from baby-making nutrients.

This could lead to an underweight Body Mass Index (BMI), which interferes with ovulation and irregular menstrual cycles. 

Therefore, if you are planning to get pregnant soon, stick to moderate exercise with a healthy diet. 

You will be able to get back to your high-intensity workouts after you deliver when you find the time!

It is important to listen to your body, rest whenever needed, and drink plenty of water. 

Women with PCOS

Exercise with or without weight loss is beneficial for all PCOS patients. 

Women with PCOS suffer from irregular menstrual cycles – missed periods, very light periods, or irregular periods. 

They may find themselves taking so much time to conceive because of irregular ovulation or failure to ovulate. 

Options for these patients include certain medication to induce ovulation.

Some studies have shown that regular physical activity improves hormonal balance, and regulates the menstrual cycle. 

Read our article Can You Get Pregnant with PCOS to get better insights on the subject matter.

Women with Obesity

Obesity is associated with fertility problems due to irregular menstrual cycles and miscarriages. 

Some studies show improved cycle regularity and conception with physical activities in obese women with or without weigh loss.

Regular exercise will eventually help improve your hormonal balance, insulin resistance, ovulation and conception, and will help you achieve a healthy weight. 

Maintaining a normal BMI is important before you get pregnant because pregnancy is not the best time to try and lose pounds.

Furthermore, obesity can increase the risk of complications like preeclampsia.

Women Undergoing IVF

The process of IVF can take a toll on women’s lives due to the medications, the injections, the clinic’s appointments, the egg retrieval procedure, and the recovery after. 

If you have gone down this road before, then you may have experienced most (if not all) of the hardships of IVF. 

Many women experience bloating and fatigue and are in no mood to work out. 

However, even when motivation is hard to come by, any low movement that gets your heart pumping is worth the effort.  

Aiming for a moderate exercise routine of 20-30 minutes three times a week before getting pregnant will relieve some of the pregnancy symptoms like back aches and bloating.

It will also prepare your body to bear more weight, and make the delivery of the baby go much smoother.  

Why is excessive workout contraindicated during the IVF treatment? 

Patients often wonder whether the transferred embryos can fall off the uterus if they work out or even walk after the procedure. The answer to this is NO!

In fact, exercising during IVF has no impact on implantation. 

However, the major reason that patients are asked to avoid strenuous exercises during the IVF treatment is because it can lead to ovarian torsion.

Ovarian torsion is a condition when the ovary and/or the fallopian tube twists around the ligaments that hold it in place, blocking adequate blood flow to the ovary. 

When undergoing IVF, the ovaries become enlarged with developing follicles and are at a higher risk of becoming twisted due to strenuous exercise. 

Therefore, avoid exercising the large muscles in the arms and legs that may take the blood away from the ovaries and uterus like crunches and heavy-weight lifting. 

Additionally, any fall or injury to your abdomen could compromise your reproductive health.

Keep in mind that hormones produced during pregnancy cause the ligaments that support your joints to stretch, increasing the risk of injury.  

So in order to be safe, focus on meditative exercises that encourage stress relief such as walking, yoga, pilates, light stretching, low-intensity swimming, and aerobics. 

Listen To Your Body

Keep up your normal daily physical activity for as long as you feel comfortable. 

Some exercises will become harder to do as your pregnancy progresses anyway. 

Even if you are used to exercise, it is still best to be careful not to put added pressure on the fetus. 

If you suffer from some forms of heart or lung diseases, you should cut down your workout to a moderate level to minimize the risks of complications during pregnancy. 

References:

Foucaut, Aude-Marie. “Sedentary behavior, physical inactivity and body composition in relation to idiopathic infertility among men and women.” Plos One, 2019 https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0210770.

Kallen, Amanda. “The Best Types of Exercise for Polycystic Ovarian Syndrome (PCOS).” Healthline, 2020, https://www.healthline.com/health/womens-health/exercise-for-pcos.

Ernst, Holly. “Preeclampsia.” Healthline, 2018, https://www.healthline.com/health/preeclampsia.

Although 10% of all known pregnancies end in miscarriage, talking about it still feels so taboo. 

Statistics won’t make a woman dealing with a miscarriage feel comfortable, but what may help her is realizing that she is not alone. 

So how can you heal physically and emotionally from a miscarriage? 

In fact, you should know that not every woman deals with miscarriage in the same way.

There is indeed no right or wrong way to grieve and heal from a miscarriage.

However, the best ways to recover are: taking time off, expressing your feelings out loud or on paper, seeking help without feeling ashamed, and finding distractions.

The rest of this article explains what is a miscarriage and expands on the above strategies to help you deal with the grief of a miscarriage. 

What Is a Miscarriage? 

A miscarriage is the loss of a baby before the 20th week of pregnancy. 

A miscarriage can often occur before a woman is even aware that she’s become pregnant (also known as chemical pregnancies). 

The main sign of a miscarriage is vaginal bleeding, which may be accompanied by severe cramps in the lower abdomen and back pain. 

However, keep in mind that light vaginal bleeding is relatively common during the first trimester (from week 1 to the end of week 12) and does not necessarily mean that you are having a miscarriage.

The bleeding of a miscarriage is similar to a menstrual period but may have clots that look like tiny tissues in the vaginal discharge.

Severe symptoms like fever, dizziness, and contractions should be treated as a medical emergency. 

What Are The Causes of a Miscarriage? 

First Trimester

The first trimester is the most critical time in your pregnancy. 

The majority of miscarriages that occur during the first trimester are caused by abnormal chromosomes in the baby.

These genetic abnormalities (having too many or not enough chromosomes) prevent the fetus from properly developing.

Usually, these issues are not related to the parents – they’re just the result of a pregnancy that couldn’t be brought to term. 

Another cause leading to a miscarriage is a deficiency in progesterone – the hormone involved in regulating the woman’s cycle and maintaining the early stages of pregnancy.

Without sufficient production of progesterone, the uterus won’t be able to sustain the embryo. 

Second Trimester

At this stage, a miscarriage is likely to occur because of malformations in the uterus, the placenta or the cervix.

Problems range from placental abruption, placental previa, or cervical insufficiency – meaning the mother has a weakness of the cervix, which can’t hold the pregnancy.   

Other factors that can increase the risk of miscarriage include maternal health conditions such as diabetes, thyroid disease, high blood pressure, kidney disease, and some blood clotting disorders.

Certain bacterial infections like bacterial vaginosis, or cytomegalovirus can also inflame the lining of the uterus and cause a miscarriage.

Smoking and drinking alcohol also contribute to the development of a miscarriage.   

After the 20th week of pregnancy, the loss of a baby is referred to as a stillbirth rather than a miscarriage. 

4 Ways To Help You Process The Pain of Miscarriage

Below are 6 tips to help you deal with the grief of miscarriage:

1: Take a Step Back If You Need To

A miscarriage can come with a roller coaster of emotions ranging from feelings of guilt, shock and anger. 

You may feel angry at the world over other pregnancies that make it to term. 

Therefore, give yourself some time alone to grieve. 

If certain gatherings or celebrations, such as baby showers, are too painful for you, allow yourself not to attend.

It is very natural to feel tired, lose your appetite, or to have trouble sleeping after a miscarriage. 

Give yourself permission to take some compassionate leave to recover emotionally as well as physically.  

2: Express Your Feelings

Some people find it comforting talking about their feelings, while others find the topic difficult to discuss. 

Be honest with your friends and loved one. 

Communicating your feelings in a constructive and honest way can help you and the people who want to support you. 

Some of your friends may not know what to say to you, so talking to them honestly without trying to run away from your real emotions – which can be exhausting – can make the situation more understanding. 

If you find it difficult to talk about your feelings, it might help to write them down. 

You may not be able to put what you feel into words, but this can give you a chance to process your own emotions until you become ready to start planning for your next pregnancy. 

Remember that the father of the baby may also be affected by the loss. 

However, some men may find it harder to express their feelings. 

Therefore, make sure you openly discuss how both of you are feeling to get through miscarriage together.

Be kind to each other, listen, and respect each other’s way of coping. 

3: Seek Help

Miscarriage can be a draining experience. 

Don’t feel ashamed to ask your friends and loved ones for emotional and practical support. 

Pregnancy loss can create a sense of loneliness, but remember that you don’t have to go through this alone – surround yourself with people you feel most comfortable with. 

While your friends and family will always be there for you, connecting with others who have gone through the exact same loss can even be more helpful.

There are many in-person and online support groups available where you can chat anonymously to other women who really understand what you are going through. 

Joining a support group can have a lasting positive impact on your life in the long run. 

The same way you have reached out to someone for support, another parent who can relate to your struggle may also reach out to you someday.  

If you are religiously inclined, it may also help to speak to a spiritual leader or attend group worship events. 

Miscarriage can also cause feelings of anxiety, depression, and relationship problems. 

Talking with a therapist with expertise in reproductive medicine in this case may help you recover more quickly and effectively. 

4: Find Your Own Distractions

Try to come up with your own list of distraction activities to drive your attention away from unwanted emotions. 

Sometimes, focusing a lot on one aspect of life can make your feelings more out of control. 

Therefore, by temporarily distracting yourself, you may give your feelings some time to decrease in intensity, making them easier to manage. 

Meditating and reading are things you can try to slowly come to term with your grief.

Try to refocus your energy on other life aspects such as family, work, and hobbies. 

Do Not Lose Hope

Initially, miscarriage may come as a huge shock to some couples and it is completely normal to need some time to make sense of what has happened and why. 

Remember that you are not alone and that you will recover in time. 

Fortunately, most women can have normal pregnancies and births after a miscarriage. 

Don’t feel ashamed to talk about miscarriage and to seek help.

It is very important to normalize this subject in order to spread awareness and help other couples who have been through pregnancy loss. 

References:

Goldman, Rena. “A Breakdown of Miscarriage Rates by Week.” Healthline, 2018, https://www.healthline.com/health/pregnancy/miscarriage-rates-by-week.

De Bellefonds, Colleen. “What Is a Chemical Pregnancy?” What to expect, 2020, https://www.whattoexpect.com/pregnancy/chemical-pregnancy/.

Brazier, Yvette. “Everything you need to know about cytomegalovirus.” Medical news today, 2018, https://www.medicalnewstoday.com/articles/173811.

Even if there are no concerns, a girl should see a gynecologist at some point in her life in order to make sure that her reproductive organs remain healthy.

Young girls feel more open talking about their intimate and personal health issues to their physician rather than with their parents. 

Therefore it is important to find someone with experience and trust.

So what to look for in a gynecologist? 

To choose the right gynecologist, get referrals, research the gynecologist’s credentials, determine what hospitals they’re affiliated with, and evaluate their values and communication style.   

The rest of this article reveals 4 important factors to help you choose the right gynecologist.

4 Ways To Find the Right Gynecologist 

Here are 4 recommendations to ensure you find the right gynecologist:

1: Get Referrals

The first step towards finding a good gynecologist is to ask people you trust – friends or family members – for recommendations.

You can also ask your general physician for a referral list. 

Some specialists will only see you if you are referred to them by your GP. 

In fact, word of mouth and referrals are often good resources for finding a good gynecologist. 

To narrow your referral list, you should look into the background of each doctor before making an appointment.   

2: Research The Gynecologist’s Credentials

If you are getting treated for a certain health condition, look for a gynecologist with a specialty in treating that particular condition of yours.  

It is best to look for someone who is up to date on the latest medical treatments and procedures, and who has a high level of experience in the field.  

The more experience the gynecologist has, the better treatment and care you will most likely receive. 

Therefore, research the gynecologist’s credentials.

Find out where they have studied and completed their residency, and how many years they have practiced.  

 3: Determine Hospital Quality

Whether you visit the hospital for a regular checkup, or to undergo some treatments or a procedure, hospital quality should be your top priority in terms of care, cleanliness, and survival rate.  

Patients at top-rated hospitals have better survival rates because the doctors working there are more competent. 

So to choose a good gynecologist, make sure that the hospital they’re affiliated with has high quality standards and is located conveniently for you. 

4: Evaluate The Gynecologist’s Values

When meeting a gynecologist for the first time, ask them a question and check how they answer it. 

You need someone who makes you feel comfortable talking openly about your reproductive health and concerns.  

Therefore, choose a well-informed and friendly gynecologist who’s capable of answering all your questions, knows how to manage your anxieties, and provides you with the highest level of care and attention.   

Besides, your gynecologist should recommend the appropriate treatment for your condition and respect your decision-making process.  

Try to find out their opinions and views regarding particular topics such as birth control, abortion, and pregnancy in order to check whether you both share similar values or have opposite standpoints.  

Establish a Good Relationship With Your Gynecologist

A gynecologist is someone who can accompany you throughout different stages in your life from puberty until menopause. 

Therefore, you should find someone experienced with whom you are comfortable discussing your most intimate and personal reproductive health issues. 

Getting recommendations, doing a little background research, and communicating with your gynecologist will help you choose the right one to manage a big portion of your healthcare. 

Sources and References:

1. WebMD. “What Is a General Practitioner?” WebMD, 2020, https://www.webmd.com/a-to-z-guides/what-is-a-general-practitioner 
2. HealthStandards. “Why Standards Matter.” Health Standards, 2020, https://healthstandards.org/standards/why-standards-matter/
3. Harvard Medical School. “Abortion (Termination Of Pregnancy).” Harvard Health Publishing, 2019, https://www.health.harvard.edu/medical-tests-and-procedures/abortion-termination-of-pregnancy-a-to-z