Every story and every journey is different!

Saw A. and M. today, this gorgeous couple who's been seeing me for about almost three years. They're young. They're only 31, 32. When they first came, they had a desire to have a big family. Neither of them knew that they had issues. They started trying. Things didn't happen for six months. They decided to see their GP. Baseline investigations from the GP was all fine. The GP gave them a referral, saying, and I remember reading this note from GP, saying, "They're not really keen on doing anything exciting or IVF. They just want some general advice about fertility."

I remember seeing them after reading the GP's note and reading between the lines, and knew that this is a young couple who was not keen on IVF treatment, which is absolutely fine, because IVF is usually used as a last resort, but sometimes IVF is essential. You can't move forward without it.

With that in mind, I remember doing some investigations for both of them. A. just was perfect. Everything was fine, fit, healthy, beautiful, just had a very low AMH, or anti-Müllerian hormone, in other words. It's a test for ovarian reserve, or how many eggs that there are in a ovary for any given age, which was the first indication of something being not quite right. M. just had some issues with the semen analysis, other than that, was a perfect bill of health.

They walked out of the office today very happy because they are pregnant and they are ever so grateful. It's taken them three long years to get here, and during the three long years' journey, they have tried everything that was not IVF. It didn't work. They eventually resorted to IVF treatment and it worked.

For a lot of people, when it's absolutely unexplained or some minimal issues with their fertility, it's just really hard to know what's going on. The the eggs are released in the body. The sperm finds the egg in the body. There's no way of putting a real time camera in the uterus. I sometimes wish I could invent that, put a camera inside the uterus and see what's going on with those two. What's the egg doing? Is it accepting the sperm? Are they fertilizing? Are they lodging back into the uterus for implantation?

There is so much that we do not know. We're all learning as we go. If you are having difficulty falling pregnant, and you spend a lot of time wondering about what to do next, it's best to make an appointment.

Please feel free to call my office on 03 9473 4730 and make an appointment.

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(c) Chandrika Parmar

Polycystic ovarian syndrome may not be as complex as you think!

Polycystic ovarian syndrome is a condition where you have a hormonal imbalance where you don't have the right balance of estrogen and progesterone. Sometimes you're not ovulating, and other times you have excess male hormones in your system, which gives rise to some of the side effects of symptoms of polycystic ovarian syndrome like facial hair, hair on your breast, hair around your belly button. Your visits to the beauty salon increases probably waxing and laser treatment increase. Sometimes it gives rise to insulin resistance and altered carbohydrate metabolism, and you're just not able to lose weight. In fact, the body is so sensitive to rises of insulin that you could very easily put on weight if you're not careful. You could sweat it out in the gym, but not lose weight as quickly as you girlfriend does who doesn't have polycystic ovarian syndrome.

There are times when polycystic ovarian syndrome does not have any symptoms. The only symptom you have is lack of ovulation. It can present in any form from a spectrum of absolutely normal cyclical rhythm menstruation and no male hormone symptoms, normal looking pelvic ultrasound scans and having no issues with falling pregnant, to the other end of the spectrum where you can have everything possible.

Whilst polycystic ovarian syndrome is in some ways a misnomer and the ovaries are not always polycystic .Its not a disease but rather a condition where things are out of balance and sometimes you would need assistance to get it back to normal. A lot of the management and treatment on polycystic ovarian syndrome is based on lifestyle, healthy diet exercise, trying to normalize your BMI, possibly cutting out processed carbohydrate from diet and just being sensible. There is a genetic basis for polycystic ovarian syndrome, so you can't totally clear it off the system, however you can control it. When it comes to fertility sometimes you may need some simple treatments like ovulation inducing medication. Very commonly prescribed by fertility specialists and best taken under supervision and cycle monitoring to get a better outcome .

If you're having issues with polycystic ovarian syndrome, just want some advice and lifestyle management or wanting to fall pregnant, make an appointment.

Please feel free to call my office on 03 9473 4730 and make an appointment.

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(c) Chandrika Parmar

Sometimes it just takes time


Sometimes it just takes time. Human reproduction is not simple. It can be complicated. If you're trying to fall pregnant, sometimes takes up to three to six months, can be as long as eight to nine months. When you're young, it's okay. You can wait for that long. When you're older, say over 35 and you're really wanting to have two or three children, every month that passes by is difficult.

What initially is just something between two people's desire to make a baby becomes a whole lot complicated. You start Googling things. You start looking at information that's available on the web. And you started looking at the chemist aisles where it shows how to test for ovulation. You start downloading apps that tell you when is the right time to try. You start talking to girl friends, friends, family, and then you get absolute information overload.

While some of this information is good and it's good to research a little bit and try and improvise and improve your chances, there's a lot of information out there that has to be taken in context. What is somebody else's story is not necessarily your story. What was the problem with somebody else is not necessarily the problem that you have. It's very hard to differentiate what's right from wrong.

Your friends and family who are there to help and support you equally are desiring to become their auntie or uncle at the same time. So they are biased, and they're pushing you into doing stuff that might not necessarily be effective. One in six couples will need some form of assisted reproduction. It's common. There'll be one child, even up to two children in a classroom in Australia that have been born with the help of assisted reproduction. It's probably something that we're aware of. But we're also able to acknowledge that sometimes it just takes time.

I had a patient the other day who saw me a few years ago. I saw her once. She'd been trying for nine months. I tracked her cycle and told her what to do, some general advice. She rang me up and said she's pregnant. We did the pregnancy scan. There was a positive heartbeat at six weeks. Off she went to the obstetrician. Fortunately, everything went well.

Two years on, she called me again and said that she was having difficulty. She'd been trying for a few months. I did pretty much what I did the first time around, saw her, I tracked her cycle. She rang me again after two weeks and said, "Guess what? I'm pregnant." It is amazing. It's an amazing feeling.

She came back for her six-week scan for the second baby, which seemed to be going as per track, on track. Sorry. As she left, we both smiled. I said to her, "It's not hard getting you pregnant." And she said to me, "Next time, I'll just FaceTime you." We both laughed at this. I do wish her all the best. I hope everything goes well with her, and I can see her again for a third time.

If you're having difficulty falling pregnant, you're not sure what's going on, and you've had enough advice from Dr. Google, and your friends, and family, and it's just getting to be a bit too much, come and have a consultation. It doesn't hurt. It doesn't mean that you'd need IVF treatment. You'd want to just clarify some of the myths, might give you some direction, and hopefully, the desired outcome.

Please feel free to call my office on 03 9473 4730 and make an appointment.

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(c) Chandrika Parmar