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signs of high fertility in a woman
14Dec

Conception occurs when an egg is fertilized by sperm. Unlike sperm, which is consistently available, eggs are only viable for a few days each month. Successful conception relies not just on a healthy sexual relationship but also on timing intercourse correctly. Numerous couples, despite maintaining a regular frequency of intercourse, struggle to conceive due to insufficient knowledge about the most fertile days. Therefore it is important to know what are the symptoms of the highest fertile day.

How do you know if your fertile is high?

As tricky as it may seem, the answer is actually very simple. Nature has its own of encouraging procreation. During their high fertile days, women exhibit various signs. Bay following the pattern of these signs, pregnancy can be achieved successfully.

Menstrual Cycle Regularity

One of the primary indicators of high fertility in women is the regularity of the menstrual cycle. A consistent and predictable menstrual cycle is a positive sign, suggesting that the woman is likely ovulating regularly. Ovulation is a key component of fertility, as it is during this process that an egg is released from the ovary, ready for fertilization.

Tracking the length and consistency of the menstrual cycle can provide valuable insights into a woman’s reproductive health. While the average menstrual cycle is around 28 days, variations can occur, and cycles ranging from 21 to 35 days are considered normal. Irregularities in the menstrual cycle may signal hormonal imbalances or other underlying issues that could affect fertility.

Basal Body Temperature (BBT)

Monitoring basal body temperature (BBT) is a method used by many women to pinpoint the timing of ovulation. BBT refers to the body’s temperature at rest, typically measured in the morning before any physical activity. A slight rise in BBT indicates that ovulation has occurred. This temperature shift is usually subtle but can be a reliable sign of the fertile window.

Charting BBT over several months can help women identify patterns in their menstrual cycles and predict when they are most fertile. Specialized fertility tracking apps are available to simplify the process, making it easier for women to understand and interpret their BBT charts.

Cervical Mucus Changes

Cervical mucus undergoes distinct changes throughout the menstrual cycle, playing a crucial role in fertility. During the fertile window, cervical mucus becomes more abundant, slippery, and stretchy – resembling the texture of raw egg whites. This change is designed to facilitate the movement of sperm through the reproductive tract and increase the chances of fertilization.

By paying attention to these cervical mucus changes, women can gain insights into their fertility status. The method of observing and recording cervical mucus is known as the cervical mucus method and is often used in conjunction with other fertility awareness methods.

Ovulation Pain

Some women experience mild pelvic pain or discomfort during ovulation. This pain typically occurs on one side of the lower abdomen and may last for a few hours to a couple of days. While not all women experience ovulation pain, those who do can use it as an additional sign of fertility.

Ovulation pain is believed to result from the stretching of the ovarian wall as the follicle releases the egg. Paying attention to these sensations can help women pinpoint the time of ovulation, providing valuable information for those trying to conceive.

Sore Breast

Some women may experience breast soreness, specifically in post-ovulation period. The pain can range from mild to severe. The breast can feel lumpy, dense, and tender but symptoms usually improve immediately after menstruation has started.

Increased Libido

Hormonal fluctuations, particularly the rise in estrogen, can contribute to heightened sexual desire. Paying attention to changes in libido can help couples maximize their chances of conception by engaging in intercourse during the woman’s most fertile days.

It’s important to note that while increased libido can be a sign of high fertility, it is not a foolproof method for predicting ovulation. Combining this observation with other fertility signs can enhance the accuracy of predicting fertile days.

Changes in the Position and Feel of the Cervix

The cervix undergoes changes in position and feel during the menstrual cycle. As a woman approaches ovulation, the cervix becomes softer, higher, and more open. These changes are influenced by hormonal fluctuations and can be observed through self-examination.

While checking the cervix may not be as widely practiced as other fertility awareness methods due to practical impossibility, some women find it to be a valuable tool in understanding their reproductive cycles.

Positive Ovulation Predictor Kits (OPKs)

Ovulation Predictor Kits (OPKs) are tools that detect the surge in luteinizing hormone (LH), which precedes ovulation. A positive result on an OPK indicates that the woman is likely to ovulate within the next 24-48 hours. These kits are convenient and widely available, making them a popular choice for women actively trying to conceive.

Using OPKs, women can strategically time intercourse to coincide with their most fertile days, increasing the likelihood of successful conception. It’s essential to follow the instructions provided with the kits to ensure accurate results.

While these signs can offer valuable insights, individual variations exist, and other factors such as age, overall health, and lifestyle choices also play roles in fertility. For those actively trying to conceive, consulting with a healthcare professional can provide personalized guidance and support on optimizing fertility and increasing the chances of a successful pregnancy.

How do I know if I am fertile enough to get pregnant?

Despite all efforts, sometimes pregnancy cannot always be achieved due to common treatable causes such as fibroids. Dr. Imtiaz Ahmed, an expert endovascular surgeon and interventional radiologist, has assisted numerous couples in starting their families. Specializing in curing treatable causes of infertility, he extends his services not only to women but also to men facing fertility issues.

For more information email us at at info@drimtiazahmad.com. Follow us on Instagram @Profdr_imtiaz_ahmad for daily updates.

obesity and infertility
7Jun

What is Obesity?

Obesity is caused by excess fat accumulation in the body. This is a gender-neutral disease, and more or less affects everyone the same way. While a multitude of health-related risks are associated directly with obesity, many pathologies enable gain in weight and also make it an arduous task to shed some pounds. A standard way of concluding if you’re overweight or borderline obese is to calculate your body mass index (BMI). All you need for this calculation is an accurate weight (in Kilograms) and height (in meters), however, these units can be easily converted to and from pounds, centimeters, or ft. The simple formula is to divide the weight in kilograms by the square of height in meters. The resultant BMI can then be matched with the following paradigm:

BMI (kg/m2) What It Means
<18.5 Underweight
18.5-24.9 Normal
25-29.9 Overweight
>30 Obese

When you calculate the BMI a few times, you will realize that a few extra kilograms make a lot of difference since after reaching a certain age, the only variation between height and weight is in weight. A key point to remember here: BMI does not differentiate between body types. Your BMI may classify you as obese when you are only muscular or pregnant. Therefore, it is not the ultimate test of your body health under every circumstance but an accurate comparison index besides that.

Nevertheless, obesity has now become a pressing problem worldwide but especially in the developed regions. This imposes a burden on the healthcare system as obesity never sustains on its own. It is not how the human body is designed, and it certainly impacts the person in more than one way: all of which are severely detrimental if not considered as such in due time. Obesity without any underlying condition such as metabolic disorders is mainly caused by a long-term ignorance of a balanced diet and lack of physical activity.

However, when obesity impacts not just an individual’s mental health but also bleeds into other consequences such as reproductive health, the disease becomes ten times as serious and of concern.

Infertility in Women

Several studies have successfully drawn a link between obesity and infertility in women. Data suggest Polycystic Ovary Syndrome(PCOS) is associated with obesity, thus leading to infertility. Although the underlying mechanism of PCOS is not precisely understood, insulin resistance is often seen to be at the foothold of the syndrome. Influence of Obesity is further confirmed in nonobese women with PCOS who are not as frequently diagnosed with Insulin Resistance. Moreover, even in an otherwise normal weight female, the abdominal pattern of fat can decrease fertility. In fact, this may be more detrimental than being obese overall.

The way in which obesity affects reproductive health is predicated on metabolism. Altered follicle production and complications in embryo development are found to be associated with steroid metabolism and other adipokines(signaling molecules of metabolism). Consequently, an overall poor ovarian response in obese women causes reduced oocyte (egg) retrieval.

Moreover, even miscarriages are more common in obese women. Nevertheless, there is also some discrepancy in the data for obesity and infertility due to a variation in what is considered as the endpoint for obesity to start associating it with infertility. As a general rule of thumb, BMI and infertility are linked when the former is above 30.

Infertility in Men

Contrary to the responsibilities of a female body that produces eggs and becomes the site for fertilization and implantation, the reproductive health of men is majorly equitable to the health of their sperms. While obesity might directly impact androgen production, it may also play a role in Erectile Dysfunction, which influences the delivery of sperm. Studies have reported a prominent decrease in the levels of free testosterone in the blood in obese men. The levels of testosterone are found to be associated with impaired stimulatory and inhibitory processes.

Even though obesity is not as widely studied in men as it is in women, the association of abnormal weight with men’s infertility can not be ignored. Hence, to circumvent health issues arising from being overweight or obese, the minimally invasive bariatric embolization procedure is now available in Pakistan, conducted by the pioneer of embolization procedures Dr. Imtiaz Ahmed, who is a consultant Endovascular surgeon and an Interventional Radiologist.

Treatment For Obesity: Bariatric Embolization

Infertility in women and men who are obese can be restored once the underlying reason is addressed i.e. excess weight. Bariatric embolization is a minimally invasive alternative to the infamous bariatric surgery, which comes with a glut of side effects. On the contrary, Bariatric Embolization works on the same principle but comes under the umbrella of Interventional Radiology. This not only increases the precision of this minimally invasive endovascular procedure and makes it many fold effective but also reduces the recurrence rate and post-procedure patient noncompliance.

To delineate, Gamma block bariatric arterial embolization is performed under 3-dimensional live imaging to precisely identify the vessels leading to the fundus of the stomach. This innovative procedure was first introduced by Dr Imtiaz Ahmad in 2017 and since then has been performed successfully on hundreds of patients with excellent results to date. Microcatheters are guided under imaging to either the radial or the femoral artery, which then reaches the left gastric artery, right gastroepiploic artery and short gastric arteries supplying arterial blood to a specific area in the gastric fundus. Embolization, too, is performed under image guidance, which blocks the blood supply to the fundus; the part of the stomach ”Hunger center” that releases hunger hormone(ghrelin). Consequently, ghrelin is inhibited, reducing the feeling of hunger in the patient. As a result, the patient can focus on reducing weight through physical activity and not get distracted by his/her hunger pangs.

Weight loss through Gamma block bariatric arterial embolization has the potential to tackle the serious epidemic of obesity and infertility. If you are tired of seeing the weighing scale reading and depressed over getting repeatedly negative pregnancy tests, it is time to consider Bariatric Embolization. In Pakistan, you can consult Dr. Imtiaz Ahmad through an appointment in Karachi or Lahore.

bariatric embolization procedure
10May

In the 21st century,  obesity is a leading public health issue and a burgeoning pandemic. It has staggering effects on human health and is a severe burden on health care. Obesity is a major cause of morbidity and mortality associated with a range of comorbid diseases such as cardiovascular disorders, liver diseases, diabetes mellitus, and cancer. Over a period of time, it can exacerbate numerous medical ailments. Besides just being a physical and cosmetic concern, it has psychological manifestations. Traditional treatments for obesity like bariatric surgery can be ineffective for some patients, carry side effects, and are very expensive. A relatively new treatment approach is the bariatric embolization procedure is patient-oriented and overcomes these limitations.

Obesity – What Does It Cost?

There was a time when obesity was seen as a health concern in high-income countries, but now the highest numbers of obesity cases are observed in middle and low-income countries. When it comes to obesity it gets more complex than what meets the eye. It is a multifactorial disease that is defined as the accumulation of excessive body fat. People who have a body mass index (BMI) equal to 25 kg/m2 are deemed overweight while those having a BMI equal to or greater than 30 kg/m2 are considered obese. The prevalence of obesity in adults rises up to 27.5%, with an overall mortality increase of 29%, for every five-unit increase in the BMI above 25 kg/m2. Moreover, it is estimated that by 2025, global obesity prevalence is expected to reach 18% in men and surpass 21% in women, with many countries experiencing much higher levels. Numerous polymorphic gene products, gut microbiome, and especially hormonal effects play a major role in the balance of food intake and weight gain by sending signals to multiple areas in the central nervous system that are responsible for appetite regulation. One of such hormones is ghrelin, which is an anabolic gastrointestinal hormone that increases body weight by stimulating appetite.

Weight-Loss Options

The first approach to weight loss that makes the most sense is to be mindful of eating habits and physical activity. However, for some individuals, obesity might have reached a point of no return. They might be at a high risk of developing comorbidities or life-threatening diseases. In order to expedite their weight loss process, several interventions can be done. Let’s go through the major treatment options. Obesity can be addressed through lifestyle modifications, medical interventions, and surgical procedures. However, surgical options are highly invasive and accompany several side effects. While lifestyle modification is almost always the initial approach towards weight loss by eating a controlled diet and exercising regularly, studies have shown that it helps only up to 5% to 10% in the case of either overweight or obese patients. The next option to avail is weight-loss through pharmacotherapy. For this, there is a very limited repertoire of anti-obesity agents that can be used which engender their own set of side effects.

Patients that are morbidly obese, and experience obesity-related comorbidities require more aggressive and rigorous management. For such patients, the last resort is bariatric surgery or more simply put, weight-loss surgery. There are several types of bariatric surgeries that result in weight loss which essentially works on the same principle, that is reduced food consumption or malabsorption. Gastric Banding and Sleeve Gastrectomy are some of them. Bariatric surgery, when combined with lifestyle modification, has proven to result in significant and sustained weight loss. Estimated weight loss among different surgical procedures accounts for up to 19% for gastric banding, 30% in sleeve gastrectomy, and approximately 36% in Roux-en-Y surgeries. However, don’t forget that because you’re going under the knife, these surgeries are associated with a relatively high morbidity rate that ranges from 2% to 17% generally.

In this regard, there is a real need to develop new treatments that are clinically effective, less invasive, and cost-effective for prospective patients. This is especially true for patients who don’t want to go down a surgical route. Considering that the principle that bariatric embolization employs works well to enhance weight loss. An intervention to supplant the surgical route with that of a non-invasive one makes the most sense. One such technique is the bariatric embolization procedure which bridges the gap between bariatric surgery and a non-invasive procedure for weight loss.

What Is Bariatric Arterial Embolization?

Bariatric arterial embolization (BAE) or simply bariatric embolization is a relatively new endovascular image-guided technique that provides a low-cost and minimally invasive alternative for obese patients. It is a trans-catheter procedure that aims to regulate endocrine functions of the gastric fundus by inducing metabolic changes similar to those induced by bariatric surgery.

This technique uses embolic microspheres for the trans-arterial embolization of the gastric fundus (the region which is mainly involved in the production of appetite-stimulating endocrine functions within the stomach) mainly through the left gastric artery (LGA) and, to a lesser extent, the gastroepiploic artery (GEA) with the final goal of inducing localized ischemia of the gastric fundus which is aimed to reduce ghrelin production, leading to appetite suppression and weight-loss.

The safety and efficacy of BAE have been demonstrated in many preliminary pre-clinical and clinical trials. Although the data is limited, there is a growing body of literature that verifies this procedure as feasible and well-tolerated by obese patients resulting in 7% to 17% weight loss. Clinical data has shown no serious adverse effects after the embolization procedure apart from nausea, vomiting, and superficial stomach ulceration or epigastric discomfort in the most severe of the cases.

Now it is your time to rejoice in your weight-loss journey since this procedure has been introduced and employed by Dr. Imtiaz Ahmed – an endovascular specialist, interventional radiologist, and non-surgical weight loss specialist in Pakistan who has been using an FDA-approved drug for the procedure since 2017. This facility can be availed in Karachi and Lahore with state-of-the-art technology and skilled team members. Although it is an outpatient procedure, the patient can expect a follow-up up to 6-12 months as a part of post-treatment practice.

obesity treatment
2Mar

Obesity Uncovered

Obesity is a complex disease which is characterized by abnormal and excessive accumulation of body fat. It is a condition that is defined as having a Body Mass Index (BMI) greater than or equals to 30 kg/m2. Over the past few decades, obesity has managed to become one of the major global public health epidemics that affects both children and adults. Therefore, it isn’t any more just a cosmetic concern, as it is accompanied by excessive health risks and medical problems that makes it a major cause of morbidity and a high rate of mortality worldwide. Along with its negative psychological manifestations it either causes, exacerbates, or adversely impacts numerous medical comorbidities and has now been recognized as a risk factor for several health ailments including diabetes mellitus, liver and cardiovascular diseases, musculoskeletal disorders such as degenerative joint disease and even malignancy. It is linked with several inherited and environmental factors, combined with lifestyle choices such as diet and exercise preferences. This explains why some people amongst us face difficulty in shedding the extra fat by varying degrees.

Obesity Treatments: What are your options?

There are several obesity treatment options in the market today which include lifestyle modifications, medical interventions, and surgical procedures. Where lifestyle modifications such as controlled diet and regular exercise can help in your journey to weight loss but only by 5% to 10% in case of either overweight or obese patients with low long-term efficacy, as reported by previously undertaken obesity research around the globe. To put more emphasis on this point, there are numerous studies that have shown that patients are likely to return to their original weight in about three years’ time frame.

Bariatric pharmacotherapy options are also available, but it requires you to fit a particular criterion to be eligible for using these medications. Currently, there are 6 FDA-approved anti-obesity drugs which mostly tinker with your nervous system, resulting in either reduced appetite or enhanced satiety. Unfortunately, the weight-loss efficacy of these medications is found to lie between only 3 to7%, and that too as adjuvants to other traditional therapies.

However, for patients that are either severely obese or those experiencing obesity-related comorbidities may require more aggressive and rigorous invasive medical management such as bariatric treatment or more simply put it, weight-loss surgery. However, it has been found to be associated with a relatively high morbidity rate in addition to the hefty costs that are required to undergo these surgical procedures. Yet, even after these cons, this approach towards weight loss has limited treatment outcome. There are several types of bariatric surgery options for you to undergo, but in essence, weight loss is achieved via reduction in the consumption of food or through either poor absorption of nutrients into the blood dream. Bariatric procedures when combined with lifestyle changes can however result in significant and sustained weight loss. Different types of bariatric procedures that are most commonly used include:

stomach - obesity treatmentGastric Banding – In this type of surgical intervention, a ring with an inner inflatable band around the top of your stomach is placed to create a small pouch. The gastric band makes you feel full much sooner after eating a small amount of food.

Sleeve Gastrectomy – In this procedure, the surgeon removes a major chunk of your stomach, leaving only a banana-shaped section behind therefore, this type of surgery cannot be reversed. The surgery limits the amount of food that can be consumed to a large extent that makes you feel full sooner.

Roux-en-Y surgery (Gastric Bypass) – This procedure allows your surgeon to staple the top part of the stomach which creates a small pouch, and then attach it to the middle part of the small intestine so as to reduce the intake as well as absorption of food from the gut.

Gammablock Bariatric Arterial Embolization

Luckily, there is an alternative treatment with lower morbidity rate and cost also available, termed as Gammablock Bariatric Arterial Embolization or simply Bariatric Embolization it is a novel technique first discovered and used by Dr Imtiaz Ahmad in 2017.It is a minimally invasive trans-catheter procedure that employs the endovascular approach. It aims to induce localized ischemia in the stomach to modulate the endocrine functions related to appetite that result in weight loss. Multiple clinical trials and studies have yielded exciting results that demonstrate appetite suppression and weight loss in patients after undergoing BAE. Clinical data obtained through research have shown no major or serious adverse events after the embolization procedure apart from nausea, vomiting and superficial stomach ulceration.

Gammablock bariatric arterial embolization is performed by Sr Imtiaz Ahmad under real-time imaging guidance. In this procedure, trans-arterial embolization of the gastric fundus via the gastric arteries i.e., the left gastric artery (LGA), gastroepiploic artery (GEA) and Short Gastric Arteries supplying the gastric fundus is performed using embolic microspheres to induce localized ischemia in the gastric fundus, which is aimed to decrease ghrelin (hunger hormone) production in the stomach, leading to appetite suppression and weight-loss.

If your weight loss journey has only seen the troughs, it is now time to culminate it with a non-invasive, high yielding treatment option near you. This facility of availing this embolization procedure is now available in Pakistan in its two major cities; Karachi and Lahore, using FDA-approved drug by Dr. Imtiaz Ahmad, who is a renowned interventional radiologist and endovascular surgical specialist. As a part of post-treatment practice, the patient can expect a follow-up up to 6 months to a year.