S01 | EP17: All about hypnobirthing with Niati V Mariiyya

Unknown Speaker  0:00  
Welcome to mommy track daddy whispers podcast season two.

Unknown Speaker  0:04  
So by the time the girl the woman reaches menopause, she has exhausted her reserves of eggs in her body. Of course he It is one of the factors we cannot pinpoint it to be the only factor you know because of exposure to illness toxins all free radicals and all the inevitable forces of everyday life.

Unknown Speaker  0:28  
My name is the vet and we are joined by Dr. Manoj Sina alkire who is a gynaecologist from Mumbai. And today we are going to discuss planning to start or extend our families in late 30s or 40s. Let's gather the facts together and make an informed choice. Mansi Welcome to mommy track daddy whispers podcast.

Unknown Speaker  0:49  
Thank you, Divya. Thank you for having me here.

Unknown Speaker  0:53  
And thank you for finding time and odd as to be on board with us and be a part of Azure.

Unknown Speaker  0:59  
You know,

Unknown Speaker  1:00  
a little online virtual nest as I like to call it. Oh, yeah. Okay, so sub sub le Mansi maps a question for tonight on wiki HMI as a Lakota Hey, and we assume that age does affect our fertility, right? Yeah. So in medical terms, how, how much does it affect our fertility?

Unknown Speaker  1:24  
Okay, so the thing is that every woman is born with a fixed number of eggs. Unlike men who are able to produce firms throughout their life, in the sense that at birth, every girl is born with around a million eggs in her ovaries. By the time she reaches puberty, this number drops to half a million. And then after that, each month after puberty, she loses up to 1000 eggs, of which only one matures and is released. So by the time the girl, the woman reaches menopause, she has exhausted her reserves of eggs in her body. And it's not just about the number, but even the egg quality declines with age, you know, because of exposure to illness, toxins, all free radicals and all the inevitable forces of everyday life, which causes a lot of damage to the DNA as well. Hence, there is a chance of having genetically abnormal eggs as the age advances.

Unknown Speaker  2:25  
So

Unknown Speaker  2:27  
if we look at the statistics are the chances of natural pregnancy each month starts dropping as you advance in age, the chance of natural pregnancy at 25 is around 25%. Whereas it drops to just 5% after 40 years.

Unknown Speaker  2:43  
Okay, so when we say natural pregnancy that is being able to conceive right,

Unknown Speaker  2:49  
and then being able to conceive without any assistance from your doctor.

Unknown Speaker  2:54  
Okay, okay, and could all be factors. Oh, thank you, Dr. Key, I mean, because we are living in a fast paced world. And we all want to achieve our professional goals before we raise a family. So are there some other factors that can help us reverse this age effect maybe.

Unknown Speaker  3:15  
Unfortunately, the number of eggs and the quality of eggs cannot be reversed. But there are other factors that you know, for example, a woman who goes into pregnancy for the first time after the age of 35 is by definition called an elderly primary traveller, you know, as per our textbooks, because this kind of pregnancy is also associated with a lot of other problems, like for example, the chances of having miscarriages the chances of having high blood pressure, diabetes going into premature labour, having low birth weight babies, or for example, even having the higher chance of needing civilian delivery. So all these factors increase. With age, you had asked me about regular exercise so moderate regular exercise can improve fertility and the chance of having a baby because it reduces the chances of miscarriage it if you know the woman has something like polycystic ovarian syndrome, it will increase the frequency of ovulation. Even in men, the sperm quality improves with regular exercise. You know, it also releases the happy hormones which are called endorphins, which improve your emotional well being which also reduce the symptoms of anxiety, depression, and in general, they let you go into pregnancy with a better state physically and mentally. And any physical activity would be better than none. So that is one thing. Another thing is you know, cutting down on your cigarettes, you're smoking your alcohol, because these other things that irreversibly affect your fertility. So these are a few things that you can do to reverse the effect of age. But then the egg quality, the egg number, this is something that is, you know, like age. So you cannot really reverse your ageing, you don't unfortunately, you don't have the elixir of life to, you know, keep on living as a 16 year old forever. But this is something that you can do. Of course, even, you know, I see a lot of women in my practice these days who are having a really poor ovarian reserve women in their 20s who have the ovarian reserve of a woman who is around for tea. That is because of the toxins and the chemical pills, the preservatives. So probably going more and more organic, getting less exposed to chemicals, you know, using more natural products in our day to day life that also could be a contributory factor. Genetics is a thing which you don't really have a control on. Because it is generally said that, you know, a girl achieves menopause, she attains menopause around the age at which her mother did. So if your mother had regular periods still say around her 40s, late 40s you can expect to get your menopause around the same time. Genetics is something that is not in our control. Sometimes there are a few women who have premature ovarian failure, or early menopause which runs in the family. So, you know, that also signifies a decline in the ovarian reserve or decline in the number of the eggs earlier than is expected.

Unknown Speaker  6:43  
Okay, and I think these are some good points that one can look at if they're planning their pregnancies, for example, less use of cigarettes and alcohol, jerky matcha latte, right. We don't really give importance to we think exercise is enough, but these are the toxin substances that we consume and they affect our fertility as well. Like you said right. And another thing Andromeda is a samurai heavy Hickey the effect of age cannot be reversed. But we can delay it a bit by exercising by being healthy and and if somebody is planning their pregnancy, they can also look at menopause as an important term, the menopause history in their family as an important pointers to how their ovarian health is at this point in time. Thank you so much doctor, that was a wonderful set of points for our listeners. He is an absolute Krishna Chong Ito, again, have a healthy pregnancy coming no matter what our age is. Exercising prior to that and making sure that you've been exercising a few years before you plan your pregnancy. He is a chatty guy here to have a healthy pregnancy.

Unknown Speaker  8:13  
Of course, he It is one of the factors we cannot pinpoint it to be the only factor having a healthy lifestyle in general, a good diet, which is rich in you know, say fresh fruits and vegetables, which cause anti inflammatory effects, which have a lot of good antioxidants. So all of these things help to improve your general health. So basically, what we tell our patients is that you need to optimise your health before you go into pregnancy. That is because once you get pregnant, you're going to have your body's going to have the added burden of looking after another human being which is growing. So we need to ensure that the baby is properly nourished and that will only happen if you are in the best of your health. And if you need to do that you need to you know first cut down on all the junk all the the smoking the alcohol basically ensure that you get into pregnancy in the best of health so that you can take care of your baby while it is inside your womb in the best possible way.

Unknown Speaker  9:22  
Yes, makes sense. And esrd points are very much valid for men as well. Of course, okay, because I'm gay bar Yeah.

Unknown Speaker  9:33  
Okay, there is another thing called as epi genetics which is coming up now. Which basically means that the the genetics of the baby or the kind of genes that you pass on to the baby are dependent on the quality of the sperm and the egg, which is also affected by the environmental effects and your lifestyle. So if you want your baby to be healthy in the Long Run, you need to be healthy, even pre pregnancy, both the mother and the father.

Unknown Speaker  10:06  
Okay, make sense, and definitely a good plan of preparation for your pregnancies. And anyway, for your health

Unknown Speaker  10:14  
in general.

Unknown Speaker  10:15  
Yes.

Unknown Speaker  10:16  
Another question that I'd like to ask you is, now we know what are the points, we need to look at the pregnancy plan, and when should we plan it, and how worried we should be if we, you know, think of planning it in the late 30s, and 40s. Are there some signs of dropping fertility to, that somebody can actually look out for as an emergency or rather, as something that signals them that now is the time that they really want to, you know, plan a pregnancy, they can plan it now, then late. So there's some signs of an alarm of a dropping fertility.

Unknown Speaker  10:59  
In general, there aren't a lot of signs or basically not a lot of symptoms that you can look for in yourself, except the only thing is that if your parents start getting very irregular, so a woman who was having periods like clockwork, and she suddenly starts getting them delayed, without any of this weight gain, or, you know, any other issue that she's facing, that might indicate the irregular periods or have a variety of reasons, some of them could be like, say, a hormonal imbalance, which is something like a polycystic ovarian syndrome, or it could also signify impending menopause. That is, you know, now your ovarian reserve has started to decline. And that is why your payments are coming more and more infrequently, matters is a very important sign that you need to look out for. And also, as we mentioned, the history of menopause in your family. So if your mother reached menopause at a younger age than the usual than the average, for example, in her late 30s, then you also need to be careful. Of course, there are a lot of tests that your doctor can run, you know, it is very the elder people or the previous generations used to say that the earlier you plan your pregnancy, the better. Of course, you shouldn't plan your pregnancy in your teens, because that is when your body is also not completely developed to look after the added stress of you know, carrying a pregnancy. But maybe in the late 20s and early 30s, that is considered to be the optimum time, because the health of the eggs is good. Your general health is good. Also, if you get into pregnancy at a little older age, you know, if you calculate the type two way, if, if you first get pregnant when you're 40 as lifestyle based illnesses affect you more and more, for example, high blood pressure or diabetes, the chances of having these issues while you're pregnant will also increase

Unknown Speaker  13:07  
okay.

Unknown Speaker  13:08  
So, that puts your pregnancy to be at a higher risk than younger women. But then, you also need to take into consideration that it is not fair for the women to because women are moving shoulder to shoulder with men in all different areas. And it is not fair to the woman to ask her to conceive or to plan a pregnancy because again, that leads to a setback in her career for a few years at least and she will have babies able to fend for themselves. So, considering this factor, it is if you are if a woman is planning to delay her pregnancy for a few years, it is it would be prudent to consult a gynaecologist before that because there are a few tests that we can run. So there are there is a test with on your blood which is called a serum a MH or anti mullerian hormone. It indicates the ovarian reserve so it will tell you about the number of eggs that are left in your ovary. It would tell you whether you have ample time to delay pregnancy by a few years. And if not, there is always the option of egg freezing or empty of reason. So a lot of women are you know maybe they don't find the right partner or they are very busy in their career paths. We have the option of freezing their eggs outside you know outside the body in the in the lab so that the eggs for example, if a woman raises her eggs at the age of 26 or 27 and she gets married or she finds her partner at the age of 3839, we would have more eggs of the age of 2627. And so even these eggs would pay off Quality genetically as well as in general, to form more healthier babies. And then she can always go for the pregnancy she can get them transferred inside her womb later on once she is ready to carry the pregnancy.

Unknown Speaker  15:18  
Yes. And member curious who is question came a key egg freezing, India may how successful that is?

Unknown Speaker  15:29  
Or it is very successful. Okay freezing or there is another option of embryo freezing as well. So, you know if you're a captain, so exercising is for women who are single, or you know that they haven't really thought about whether whether they want a pregnancy or not. No, that is something that is at the moment it is on the back burner, but then after a few years, they might consider but egg freezing is for them. for couples who know that they are going to have a baby but not now maybe after 510 years. For them, we have the option of embryo freezing that is we can form the embryos. So with the egg we fertilise the egg with the sperm of the male partner and we freeze these embryos in the lab and then later on the transfer them back inside her womb whenever they are ready for the pregnancy. So both of these options are very well accepted these days. Both in India and abroad. abroad, I think you would have heard of the instances where Apple offered egg freezing no actor very considerable rate to its women employees, Apple and Facebook they had offered it to all the women who are working with them.

Unknown Speaker  16:42  
Okay, miracle us neighbour that Yeah, and I think but that's a delight. That something Yeah, yeah, that puts off pressure from women who are working and gives them an opportunity to have children maybe later. Yes. So yay, all these points were related to how women can plan their early pregnancies, what are the options that are available to them?

Unknown Speaker  17:06  
Okay,

Unknown Speaker  17:07  
another question that I had for you was that a lot of couples these days? Because I think of the amount of effort that having a child requires or opting for no children at all. I probably okay, and delayed and then they realise that probably it's not a good time to have a child later. Does that affect our health in general men and women, those who do not opt for having a baby? biologically, does that affect our health? anyway?

Unknown Speaker  17:44  
Oh, yes, there are a few things that a few conditions for which pregnancy does have a protective role, for example, of breast cancers. So if you are pregnant, and if you breastfeed your child, that is a that has a very positive protective effect on the development of breast cancers, cancers of the ovary, fibroids of the uterus condition called as endometriosis, so all these things are suppressed, because what happens when you get pregnant, your hormones are put to rest for the period of nine months, your ovaries are put to rest, and this suppresses the effect of these hormones on all these organs in your body. So that plays a protective role. But then of course, it is it is entirely the couple's decision of what they want to do, whether they want to have children and when and this alone should not be the reason for them to, you know, force themselves to get into pregnancy if they are not keen about it. And, of course, there are a lot of screening tests that are available for all these conditions also, which you can readily get in touch with your gynaecologist about and they can help you look after yourself and your health or at regular intervals.

Unknown Speaker  19:04  
Yeah. So to protective side here of bringing a child into the world order naturally upper body develops a self protective mechanism, you know, that might not get activated maybe, right? That right, but that does not mean that you may have a bad life. Just mechanism. Okay. Lovely. So doctor, first pregnancy is key lava algorithm. second pregnancy is a bad career. I think that that question is very important to me. If you've had our first in the 30s, our first child and we want to, you know, plan our second but maybe we want to do it later. So in terms of having a second child, it does that age factor come in just as it is for a normal first year. So how late would be a lead for a second child say 35 to 14 is maybe.

Unknown Speaker  20:08  
Right? See, there was another thing that we missed mentioning in the previous questions. One was that no along with the chances of conceiving, there is another thing because the egg quality declines genetic disorders, that is the older the woman is when she conceived the risk of having a genetically abnormal baby. Like, for example, something like Down syndrome, that will increase. So if I were to skirt some statistics, I at the age of 25, the risk of a woman having a genetically abnormal pregnancy is just one in 475. But once she crosses 40, it becomes one in 62, while at the age of 45, it is one in 18. So for every 18 babies that are conceived at the age of 45, one of them would be genetically abnormal. So the risk of having a baby with for example, a Down syndrome will increase with the increasing age. And this is irrespective of whether it's your first or your second that is one thing. Second thing is that your chances of conceiving of course would fall once you get older. But all this should not deter you from going ahead and planning a pregnancy if you are open with it. The thing is that what you need to know is that there are a lot of tests there are a lot of screening modalities available these days sciences advanced enough. foetal medicine has developed into a great branch of Obstetrics, which helps to find out whether your baby's healthy or not, while it is in your womb. And it is possible to take certain corrective measures, of course, genetic disorders cannot be corrected. But if at all, we find out that there is some problem, we can act on it even before you deliver the baby.

Unknown Speaker  22:17  
Right in time, probably not to have some

Unknown Speaker  22:21  
Right, right. Okay. Oh, yeah. So this is not hard and fast that you would definitely have an abnormal baby, only thing your risk would be higher. But that should not be for you from you know, you should not stop yourself from conceiving if you feel that that is what you really want. But of course, you should consult your doctor before you go ahead with it. Because there are all these factors that you need to take into consideration.

Unknown Speaker  22:50  
Right, and I think come the hotbar we don't consult a doctor while we are preparing to have a child why we are trying to cry. And that is a very good point that have brought up key. There are a lot of tests available. So if you're planning to have a child, maybe three years from now, we can actually plan it better with those tests to figure out what is the ovarian health? Correct. And just just a normal checkup with a gynaecologist? Yes. That's a great point that you've brought up and thank you for emphasising on it for all our listeners. Dr. Mansi. Another thing that I wanted to ask you was late pregnancies, I would not call it late, but pregnancies in 30s or 40s rather, does this also increase the chance of frequencies that is having twins and you know, triplets? That ways?

Unknown Speaker  23:49  
Yes, it does. And one of the most important reason for that is women who are older tend to go in for fertility treatments more commonly than younger women. So, one of the very common side effects as we would call it, of going ahead with a fertility treatment is having multiple pregnancies like twins or triplets or even higher order than that. So that is because when we give you medicines when when you undergo fertility treatment, you receive certain medicines, which cause more number of eggs to ovulate from your ovaries every cycle. So in a natural cycle, if you were to release just a single egg or occasionally two eggs from your ovaries, when you undergo fertility treatment, there is a chance that it could be two or three or even four sometimes. And that is why the chances of conceiving higher order pregnancies does increase with increasing age.

Unknown Speaker  24:49  
Right. So if I were to summarise all of this, I would say the first is we need to be healthy in general. If they think about planning our pregnancies at any point in time, health is summary for the child and for you. And for men and women both. The second would be not shying away from your doctor's many when you're planning your pregnancy. Even if you think that you're good to conceive, you should still go and discuss it out, it would help, you know, maybe prevent certain things that may come up later.

Unknown Speaker  25:29  
Absolutely. And then, if I may interrupt, there is also one bitterman, called folic acid, which is very essential to be started pre conceptionally. So a lot of women come to the doctor only after they missed their periods, and they have a positive during pregnancy test. And after that, you know, usually starting folic acid free conceptionally would have great benefits because that would reduce a deficiency of folic acid in your body would increase the risk of your baby developing certain deformities in the development of the neural tube, which could lead to you know, maybe the skull being abnormally fused or the spinal cord the bones around the spinal cord being a little abnormal. So for a good health of the skull and spinal cord, the brain and the spinal cord, it is important to have this vitamin folic acid free conceptionally

Unknown Speaker  26:27  
I did not know that when I plan my first may be folic acid bag mysuru kurata. And my friend whose sister is a gynaecologist. She started it earlier. So that's important. Yes, yes. So the third point that I would like to use as a summary would be that a very important point, I think, delight for women out there who have careers were ambitious, and well, and, you know, do not want to impact their families because of that, that embryo freezing, and that egg, I mean, egg freezing, rather, these are very successful in India, I did not know that I only read about this in the foreign countries. So that's a wonderful thing to know that these are very much successful in India, and you can opt for it, if you want, you can go and talk to me, in fact, go and talk to your doctor, if you have any questions. Rather than just dealing because you're so caught up in Korea, and in your work. And you you do want to plan a pregnancy, but it just gets delayed under just just because of the amount of work that we have, it just gets delayed. And then at the end of it, we're like, we don't have pretty much the options that we might have had like five years earlier, because we could have gotten our egg freeze or the embryo freeze. So right, thank you so much doctor, would you like to, you know, say something as a last note of advice or something to our listeners based on your observation of how, you know, you receive complaints or the way you get to patients, probably there's something that you've observed and you want to talk it out to our listeners, the mothers expecting mothers and are those who want to prepare their pregnancy,

Unknown Speaker  28:23  
right. One of the very important things that I would like to stress upon is stress because you know, a lot of women, a lot of couples, they are too caught up in their careers and the by the time they realise that Okay, now we need to start planning a pregnancy, they come to me in a state of rush, you know, we have to do this in the next three months. So it's not like a time bomb, you know, and it's not pregnancy cannot be planned, even if you undergo fertility treatment, there are there is only a certain percentage of success to it. So, you cannot really time it on basis of memorabilia weaker man. So, you really need to give your body time you need to give yourself time and you need to think about these things from the time you probably get into a relationship or even before that, because your body is going to get older you cannot really stop that and you cannot expect yourself to something like you know I need to perform I need to take this or there is no medicine which is a wonder drug there is nothing nor treatment that works like magic. You really need to give it time it is again there are certain factors that are also not under the control of you or your doctor. Stress is another very important thing which negatively impacts fertility in a lot of ways. It's not just fertility, but also your quality of life in general. So you need to give yourself some time you need to find some lead time you need to undergo activities or do more of the things that make you happy that helps you reduce your stress, because these are the things that are ultimately going to help you in the long run.

Unknown Speaker  30:16  
Yes, and a very important point that have brought up stress. He thought it's like free advice these days. Hey, can we be as we don't realise we have it because we are again rushing from one task to another and similarly sheis hamari planning of pregnancies or baby baby jata. Here we are rushing it from one task to another. So because, yeah, and also because this also brings me to this point that we in India, probably as a family tradition, don't talk about. You know, what can go wrong? Maybe.

Unknown Speaker  30:59  
So, we don't talk about planning your child we talk about just, you know, conceiving it, conceiving a better a,

Unknown Speaker  31:08  
we don't talk about

Unknown Speaker  31:09  
planning it. So a very important point for all our listeners out there keep up Kareena Blanca de Cali Karina Blanca de you start saving from yours, to have that, you know, Dream House, you can also start, you know, preparing and planning to have your dream baby, maybe,

Unknown Speaker  31:27  
if that Exactly. That's a very, very good point that you've put up. Also, another thing which I noticed in India is the one of the major factors in contributing to the stress of couples is societal and family pressure. So I think we need to realise that the decision of whether or not to have a baby and when to have it is completely resting upon the couple, they are the parents it is their body, it is their life. And it is them that who should be the, you know, the forerunners of taking this decision. And then, because of societal and family pressures, they get even more stressed. And that negatively impacts their fertility in a lot of ways. loke Yaga, Ganga is the another biggest, negative, it's the biggest villain these days, yes, or

Unknown Speaker  32:24  
Saudi Arabia will die, like I'm seeing around me with friends and key, when you pressurise somebody too much, they might actually even if they want to have a baby, maybe they might actually delay because they feel that pressure, and they want to come out of that pressure. Sorry, man, I actually, you know, stop having that thought of having a baby because it feels like a burden on them rather than a free will.

Unknown Speaker  32:53  
Absolutely. And basically, all women need to be able to enjoy the feeling of motherhood, they should be able to enjoy their pregnancy, it should be able to enjoy the process of even conceiving a pregnancy, because later on, what happens is that you view it as a task. What I often tell the couples who come to me is that the your pregnancy or baby is going to be a part of your life. It's not going to be your whole life. So you need it. So you shouldn't really make your entire life revolve around that there are so many women who quit their careers who stop working just because they want to plan a pregnancy. You know that they do that at a at the planning stage, not only not later on, not after they conceive or not after they deliver the booty. They want to focus on conceiving, that is why they quit their jobs, they sit at home and then they think a lot about this and get even more stressed.

Unknown Speaker  33:58  
It leads to a lot of your post islands ideas well, because all of us are exactly the way they imagined the things were not pretty much that way and yeah. seems lost. Yeah. That that's a really important point. Yeah.

Unknown Speaker  34:13  
And the thing is that it is very essential to keep yourself busy throughout your pregnancy. I never stopped my patients from working I tell them that they can continue their work their jobs, till they can their body tells them to so you know it is not necessary. All pregnancies. Even those which are conceived by IVF do not mean that you need to have bedrest throughout your pregnancy because there are certain conditions that we need to consider like for example, some risk high risk pregnancies where we need to take extra care. But then in a normal pregnancy, you can continue staying active even exercise is not contraindicated in pregnancy, the more active you stay throughout pregnancy. It is the better For you and your baby. So my suggestion to all the women is that you need to be on your toes even when you're pregnant.

Unknown Speaker  35:10  
Yes, that that's a really important point. Yeah. Thank you so much for bringing that very, very important point. Dr. Mansi. And it was wonderful to have you to have all those questions answered. Because we are constantly focusing on what lies ahead. So I really hope this helps. And in fact, I know this will help a lot of our listeners out there. Thank you so much for your time, Dr. Massey,

Unknown Speaker  35:40  
thank you that that thank you for having me over. It was a pleasure talking to you. And it was a great, it's a great initiative by you to educate women and men all over over different topics, through your experience and through recruiting other experts in the field. I wish you all the best.

Unknown Speaker  36:02  
Thank you so much. I'm learning all along. Thank you so much.

Unknown Speaker  36:07  
Thank you.

Unknown Speaker  36:10  
Mark Twain said it is an issue of mind over matter. If you do not mind. It doesn't matter. But there is something called a biological age, the effect of which can be delayed, but cannot be reversed. We do not believe in showing support from the place of lack of knowledge or understanding of the issue. It was very important for us to talk about this talk about age and fertility because it is very much a part of our society. While we aim to provide support, we aim to provide support from the place of knowledge from the place of fact, the aim here is to help you make those tough decisions in life from a strong foundation, and not on a whim. If this makes sense to you. Please share it with someone who needs it right now. Subscribe and follow our podcast on whichever platform you listen to us. You can write to us at mommy drive daddy whispers at the rate gmail.com you can just chat with us drop a review or just talk to us. Ask us questions because we are here to bring answers. At the end of it. Stay focused, stay informed and stay happy. Lots of love, because you got the bar. Thank you. Stay tuned.

Transcribed by https://otter.ai