Category: Highlights

  • First Trimester Pregnancy: Symptoms, Baby Growth, and What to Expect From Week 4 to 12

    INTRODUCTION: What Happens During the First Trimester Pregnancy

    The first trimester pregnancy is a time of profound change—both seen and unseen. For many women, it begins with a wave of unexpected symptoms: nausea, breast tenderness, extreme fatigue, or just a strange sense that “something’s different.” These subtle (and sometimes not-so-subtle) signs are your body’s way of announcing a monumental transformation.

    Behind the scenes, a surge of pregnancy hormones—especially human chorionic gonadotropin (hCG) and progesterone—kicks into action. These hormones help maintain the uterine lining, prevent menstruation, and support the growing embryo. At the same time, your metabolism, circulation, and immune system begin to shift in response to the baby you may not even realize is there yet.

    The first trimester pregnancy also carries emotional weight. You may feel joy, fear, confusion, or all of the above. But from the medical perspective, this is the trimester where the foundations of life are laid: the baby’s brain, spinal cord, heart, and organs begin forming within mere days of implantation.

    Understanding these weekly changes can make the experience feel less mysterious and far more empowering. Let’s walk through this journey, week by week, starting with Week 4—when most pregnancies begin to show signs.

     

    First Trimester Pregnancy: 4 Weeks

    3D illustration of a human embryo at 4 weeks during first trimester pregnancy
    3d rendered illustration of a human embryo – week 4

    At 4 weeks pregnant, the fertilized egg has implanted into the uterine lining. This tiny cluster of cells is now called a blastocyst, and it’s about the size of a poppy seed.

    In this early stage of first trimester pregnancy, the embryo starts to form two major structures:

    • The embryoblast, which will become the baby
    • The trophoblast, which will later develop into the placenta

    You might start experiencing mild cramping, spotting (known as implantation bleeding), or no symptoms at all. Some women notice a missed period and take their first pregnancy test around this time. If positive, it’s usually because the hormone hCG has started to rise in your bloodstream and urine.

    Internally, the foundations of your baby’s brain, heart, and spinal cord are beginning to take shape. It’s truly the beginning of everything.

     

    First Trimester Pregnancy: 5 Weeks

    At 5 weeks, your pregnancy becomes more biologically active—and so do your symptoms. You may now experience stronger fatigue, tender or swollen breasts, mood swings, and possibly the first waves of morning sickness. For many, this is when pregnancy starts to feel “real.”

    The embryo is now about the size of a sesame seed, and it’s beginning to grow rapidly. Major organ systems are starting to form, and a tiny neural tube is developing—this will eventually become your baby’s brain and spinal cord. It’s why folic acid is so crucial during this stage.

    A primitive heart tube also begins to beat, although it’s not yet fully formed. If you were to see an ultrasound now, the embryo would still look like a small curved shape—but the foundations of life are well underway.

     

    First Trimester Pregnancy: 6 Weeks

    At 6 weeks, your baby has doubled in size and now measures around 5 to 6 mm—about the size of a lentil. One of the most exciting developments this week is the appearance of a tiny, flickering heartbeat, which might be detectable via a transvaginal ultrasound.

    The embryo’s shape is becoming more defined, with small bumps that will form the arms and legs. Inside, the brain and spinal cord are growing rapidly. Facial features are starting to form too, including early eye pits and nostrils.

    For you, pregnancy hormones are peaking, especially hCG and progesterone. You might notice increased nausea, food aversions, and emotional ups and downs. Spotting can still be normal at this stage—but if it’s heavy or painful, it’s always a good idea to contact your provider.

     

    First Trimester Pregnancy: 7 Weeks

    By 7 weeks, the embryo has grown to the size of a blueberry—about 10 mm in length. The most exciting development this week is that your baby now has a beating heart with a more regular rhythm, and the basic structure of the brain is becoming more complex.

    Tiny buds that will become arms and legs are starting to lengthen and flatten. Small black dots mark the places where the eyes and nostrils are forming, and ears are beginning to take shape on the sides of the head.

    As for you, symptoms may intensify. Nausea, vomiting, and extreme fatigue are common due to the high levels of hCG. You may also notice food aversions, extra saliva, and even a heightened sense of smell.

    This week marks a critical period in fetal development, as organs are beginning to specialize and cells are dividing rapidly. This is why avoiding alcohol, smoking, and certain medications is more important than ever.

     

    First Trimester Pregnancy: 8 Weeks

    3d rendered medical illustration of cardiovascular system of 8 week old embryo

    At 8 weeks pregnant, your baby is now the size of a raspberry, measuring around 14–16 mm in length. The embryo now officially becomes a fetus—a word that means “offspring” in Latin.

    This week, fingers and toes begin to form from the paddle-like hand and foot buds. The eyelids, though fused shut, are also developing, and facial features become more distinct. Internal organs such as the liver, kidneys, and lungs are starting to organize into place, and muscles begin to form as well.

    You may feel bloated or notice your waistline expanding slightly, even if your uterus is still deep in the pelvis. Hormonal changes can also bring mood swings, frequent urination, and acne.

    This is a week of major cellular activity for your baby—and a week when many women begin their first prenatal appointment. Seeing the heartbeat on ultrasound can be a deeply emotional and affirming moment.

    First Trimester Pregnancy: 9 Weeks

    3d rendered medically accurate illustration of a fetus in week 9

    At 9 weeks, your baby is about the size of a cherry, measuring around 2.3–2.5 cm (1 inch). This stage marks a transition from an embryo to a fetus, and development continues at an astonishing pace.

    The baby’s arms and legs are growing longer and developing elbows and knees. Tiny fingers and toes are becoming more defined—no longer just webbed paddles. Facial features are taking shape too, with a more recognizable profile and the beginnings of ears, eyes, and a nose.

    Internally, the heart has developed four chambers and beats strongly. Organs like the pancreas, gallbladder, and reproductive structures are forming, though the baby’s sex won’t be distinguishable on ultrasound just yet.

    For you, hormonal surges may still cause intense fatigue, nausea, and frequent urination. Your uterus is now about the size of a grapefruit. You may also notice more visible veins, due to increased blood volume.



    First Trimester Pregnancy: 10 Weeks

    At 10 weeks, your baby is now the size of a kumquat or a small prune, measuring about 3–4 cm. All the major body structures have formed, and the fetal stage is well underway.

    The most exciting part of this week in first trimester pregnancy is that your baby begins to make small, jerky movements—although you won’t feel them just yet. Elbows and knees bend, and bones start to harden. The outer ears take their final shape, and tiny tooth buds are forming under the gums.

    Inside, vital organs like the liver, kidneys, intestines, and brain are rapidly maturing. Fingernails and toenails are beginning to grow, and the spine is more visible on ultrasound.

    As for your symptoms, nausea may peak around this time, but many women start to feel slightly better as they approach the second trimester. Your mood may stabilize, and early pregnancy bloating could start to ease.



    First Trimester Pregnancy: 11 Weeks

    At 11 weeks, your baby is about the size of a fig—around 4–5 cm long and weighing roughly 7 grams. This week marks the end of the most vulnerable phase of development. While still very small, the fetus now has fingers, toes, ears, and even tiny fingernails.

    The head still makes up nearly half of the baby’s body, but the neck is elongating, allowing more movement. The bones are starting to harden, and the baby’s body is gradually straightening out from the previously curved position.

    Internally, the diaphragm is forming, setting the stage for future breathing. The kidneys are producing small amounts of urine, and the intestines, which were developing outside the body, begin to migrate into the abdominal cavity.

    You might notice that your waistline is expanding, and some early pregnancy symptoms may begin to ease. Many women feel a sense of relief and even energy returning as they approach the second trimester.



    First Trimester Pregnancy: 12 Weeks

    At 12 weeks pregnant, your baby is about the size of a lime, measuring 5–6 cm in length and weighing 14–18 grams. All of the major organs and body systems are now present—just tiny and still developing.

    The reflexes begin this week! Your baby may start to move when touched, although you won’t feel it yet. Fingers can curl, and the baby may make tiny mouth movements. The brain continues to grow rapidly, and nerve connections are forming quickly.

    The face now looks much more human, with well-formed eyelids, nose, and lips. External genitalia are developing and may be distinguishable on ultrasound soon.

    For you, this week marks the end of the first trimester pregnancy. Many women feel less nauseated and more energetic, though some symptoms—like frequent urination and breast tenderness—may persist. A growing number of parents choose this time to share the news of their pregnancy with friends and family.



    First Trimester Pregnancy: Conclusion

    The first trimester of pregnancy is nothing short of miraculous. In just 12 weeks, a single fertilized cell transforms into a fetus with a beating heart, a developing brain, limbs, and facial features. For many expectant parents, this period is filled with wonder, anxiety, symptoms, and immense change.

    From a medical perspective, the first trimester pregnancy is also the most critical window for fetal development—a time when nutrition, rest, and avoiding harmful substances have lasting impact. It’s also when most pregnancy losses tend to occur, which can make this stage emotionally intense.

    Understanding what’s happening week by week helps reduce anxiety and empowers pregnant women to make informed choices. As the second trimester approaches, energy often returns, nausea tends to fade, and the joys of pregnancy begin to shine more brightly.


    First Trimester Pregnancy – References:

    1. AMERICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS (ACOG). (2021). Prenatal Development: How Your Baby Grows During Pregnancy. Available at: https://www.acog.org/womens-health/faqs/how-your-fetus-grows-during-pregnancy
    2. SADLER, T. W. (2018). Langman’s Medical Embryology, 14th ed. Philadelphia: Wolters Kluwer. https://shop.lww.com/Langman-s-Medical-Embryology/p/9781496383907
    3. MOORE, K. L., PERSAUD, T. V. N., & TORCHIA, M. G. (2020). The Developing Human: Clinically Oriented Embryology, 11th ed. Philadelphia: Elsevier. https://www.elsevier.com/books/the-developing-human/moore/978-0-323-54671-9
    4. NATIONAL INSTITUTES OF HEALTH (NIH). (2023). Pregnancy Week by Week. Available at: https://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/week-by-week

  • What Should I Eat If I Have PCOS? A Simple Guide to Food That Heals

    Diet plan for hormonal balance in PCOS

    Imagine waking up every day wondering why your body doesn’t seem to listen to you. The stubborn weight gain, the painful acne, the irregular periods—it’s not “just in your head.” For millions of women living with Polycystic Ovary Syndrome (PCOS), this daily battle is real. But here’s the good news: food can be your strongest ally.

    What Is PCOS and Why Does Diet Matter?

    PCOS is a hormonal condition that affects up to 1 in 10 women. It’s linked to high levels of insulin (a hormone that controls blood sugar), inflammation, and imbalances in reproductive hormones. Many women with PCOS struggle with weight gain, facial hair, infertility, or mood swings.

    Your diet can help balance hormones, lower insulin levels, reduce inflammation, and ease symptoms. It’s not about perfection—it’s about small choices that add up.

    Top Foods to Help Manage PCOS

    • Lean Proteins:

      Think chicken, fish, turkey, tofu. Protein helps keep you full and stabilizes blood sugar.
    • High-Fiber Carbs:

      Whole grains like oats, quinoa, and brown rice slow down sugar spikes, preventing energy crashes.
    • Colorful Vegetables:

      Broccoli, spinach, kale, and bell peppers are loaded with antioxidants and fiber to fight inflammation.
    • Healthy Fats:

      Avocados, olive oil, nuts, and seeds help balance hormones and improve cholesterol.
    • Low-Glycemic Fruits:

      Berries, apples, pears—these won’t spike your blood sugar as quickly as tropical fruits.

    PCOS: Foods to Limit (But Not Fear)

    You don’t have to cut out everything you love. But reducing sugary drinks, white bread, and processed snacks can make a big difference. Instead of thinking “I can’t have this,” ask, “What’s a better choice for me today?”

    Can Supplements Help Women Struggling with PCCOS?

    Studies show that inositol may improve insulin sensitivity and restore ovulation. Some doctors also recommend vitamin D if your levels are low, since it’s often deficient in women with PCOS. Always talk to your doctor before starting supplements.

    PCOS Is Not Just About Weight

    While many are told to lose weight, not every woman with PCOS is overweight. And weight loss isn’t the only marker of success. Even small improvements in diet and activity can lower inflammation and improve fertility.

    “I started focusing less on the scale and more on how I felt. Within months, my periods returned and my skin started clearing up.”

    Emotional Impact in PCOS Matters Too

    PCOS isn’t just a physical condition—it affects confidence, relationships, and mental health. Don’t be afraid to ask for help if you feel overwhelmed. Nutrition, therapy, movement, and medical care all play a role.

    PCOS: Your Journey, Your Pace

    There’s no perfect PCOS diet. Some women do well with Mediterranean-style eating; others with low-carb or plant-based approaches. Listen to your body, stay patient, and celebrate every small win.

    Want more support? Visit vittafemme.com for resources, real stories, and expert tips.

    References :

    1. Shahmoradi, L. et al. Nutritional management recommendation systems in polycystic ovary syndrome: a systematic review. BMC Women’s Health, 2024; 24(234):1-26. DOI: https://doi.org/10.1186/s12905-024-03074-3.
    2. Almhmoud, H. et al. Polycystic ovary syndrome and its multidimensional impacts on women’s mental health: a narrative review. Medicine (Baltimore), 2024; 103(25):e38647. DOI: http://dx.doi.org/10.1097/MD.0000000000038647.
    3. Fitz, V. et al. Inositol for Polycystic Ovary Syndrome: A systematic review and meta-analysis. J Clin Endocrinol Metab, 2024; 109(6):1630-1655. DOI: https://doi.org/10.1210/clinem/dgad762.
    4. Katyal, G. et al. Systematic review of the roles of inositol and vitamin D in improving fertility among patients with polycystic ovary syndrome. Clin Exp Reprod Med, 2024; 51(3):181-191. DOI: https://doi.org/10.5653/cerm.2023.06485.
    5. Han, Y. et al. Dietary supplements in polycystic ovary syndrome–current evidence. Front Endocrinol, 2024; 15:1456571. DOI: https://doi.org/10.3389/fendo.2024.1456571.
    6. Mimouni, N. E. H. & Giacobini, P. Polycystic ovary syndrome: progress towards a better understanding and treatment. Comptes Rendus Biologies, 2024; 347:19-25. DOI: https://doi.org/10.5802/crbiol.147.

    Disclaimer: This article is for educational purposes only and does not replace medical advice. Always consult your healthcare provider for personalized guidance.

  • Colic, Gas, Crying: What Worked for Me (And Might Work for You)

    Published on: May 3, 2025

    Baby colic: Crying baby showing signs of colic and gas while being held by parent

    Baby colic and gas : If you’re a parent holding a crying newborn at 2 a.m., wondering what’s wrong, know this: you’re not alone. Infant colic affects up to 40% of babies, causing intense, unexplained crying that can last for hours—usually peaking in the first 3 months of life.

    All babies cry. But some cry a lot — for hours, sometimes for no clear reason. If you’re holding your baby in the middle of the night, feeling helpless while they clench their fists and pull their legs, you’re not alone. It could be normal gas. But it could also be colic — or a sign that something else is going on.

    Baby colic and gas are incredibly common in newborns. They’re part of the adjustment as your baby’s digestive system matures. But as a parent, it’s hard to know when to stay calm and when to worry. How do you tell the difference between normal discomfort and something that needs medical attention?

    This article will help you understand the basics: what causes colic and gas, what symptoms are typical, and when you should contact your pediatrician. You’ll also get simple, evidence-based tips for soothing your baby and taking care of yourself in the process.

    Let’s break down the 5 warning signs that your baby’s discomfort might be more than just gas — and what you can do about it, starting today.

    What Is Baby Colic?

    Colic is traditionally defined as crying for more than 3 hours a day, at least 3 days a week, for 3 consecutive weeks in an otherwise healthy infant (StatPearls, 2023).

    Possible Causes

    • Immature digestive system
    • Gut microbiota imbalance
    • Food intolerances or allergies
    • Overfeeding or underfeeding
    • Gastroesophageal reflux
    • Overstimulation from the environment

    The reassuring news? Colic usually resolves on its own by 3–4 months of age.

    What Actually Helped Baby Colic(From One Mom to Another)

    1. Baby Massage

    Gentle clockwise tummy massages made a noticeable difference. I’d warm my hands first and softly press in circular motions to help trapped gas pass.

    2. Warm Baths

    Giving my baby a warm bath during her usual “witching hour” seemed to soothe her body and calm her crying episodes.

    3. Probiotics

    Adding Lactobacillus reuteri drops, as recommended by our pediatrician, reduced crying time over a few weeks (American Family Physician, 2015).

    4. Feeding Adjustments

    Ensuring she burped after every feed—and not overfeeding—helped prevent excess gas buildup.

    5. White Noise

    Playing gentle white noise mimicked the womb and helped her settle faster during crying spells.

    6. Swaddling and Gentle Rocking

    Swaddling securely (but safely) combined with rhythmic rocking calmed her nerves and seemed to shorten episodes.

    7. Maternal Diet Changes (If Breastfeeding)

    I trialed eliminating dairy for two weeks, which appeared to reduce her discomfort—though the evidence is mixed (PubMed, 2013).

    Things That Didn’t Work (But Might for You)

    I tried gripe water, gas drops, and herbal teas—with little success. But many parents report positive results, so it’s worth discussing with your pediatrician.

    When to Seek Medical Advice

    While colic is common and harmless, excessive crying can sometimes mask other issues. Contact your healthcare provider if your baby has:

    • Fever
    • Vomiting (especially green or forceful)
    • Blood in stool
    • Poor feeding or weight gain
    • Lethargy or reduced responsiveness

    Your instincts as a parent matter. If something feels off, trust them.

    The Emotional Toll of Baby Colic

    No one warns you how hard it is to hear your baby cry inconsolably. Research shows that infant colic can increase parental stress, anxiety, and even risk of postpartum depression (BMC Pediatrics, 2019).

    If you find yourself overwhelmed, angry, or hopeless—put the baby down safely in the crib and take a break. Call a partner, friend, or hotline. You matter too.

    Takeaways

    There’s no perfect cure for colic. What worked for me might not work for you—and that’s okay. This phase is tough but temporary. You’re not failing; you’re surviving.

    Above all: ask for help. Let others cook, clean, hold the baby so you can nap. Caring for a crying newborn takes a village—and you deserve support.

    Want more guidance? Visit vittafemme.com for evidence-based articles and listen to our podcast for real stories from parents like you.

    Disclaimer: This article is for educational purposes only and does not substitute medical advice. Always consult your pediatrician for concerns about your baby’s health.

    References :

    1. StatPearls. Infantile Colic. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.
      https://www.ncbi.nlm.nih.gov/books/NBK519512/
    2. American Family Physician. Infantile Colic: A Clinical Review. Am Fam Physician. 2015;92(7):577–582.
      https://www.aafp.org/pubs/afp/issues/2015/1001/p577.html
    3. Szatkowski A, Kandel R. Maternal hypoallergenic diet for treating infantile colic. Pediatrics. 2013;131(6):e1572–e1580.
      https://doi.org/10.1542/peds.2012-1795
    4. Olsen AL, Reeder MR, Magnusson BM. Impact of infantile colic on parental stress and depression. BMC Pediatr. 2019;19:1422.
      https://doi.org/10.1186/s12887-019-1512-2

  • “I Just Wanted to Feel Beautiful Again”: How One Woman Discovered the Future of Anti-Aging with Exosomes

    Antiaging with exosomes 3D illustration of clustered exosomes under magnification, used in antiaging skin therapy

    The Future of Antiaging with Exosomes:

    Priya never imagined that aging would feel like a betrayal.

    At 42, she wasn’t asking for perfection—just the same skin that once reflected her vibrant energy. The glow she had in her 20s was fading. The stress of work, raising two teenagers, and years of sun exposure in Mumbai had left their mark: fine lines around her eyes, sagging around her jawline, and a dullness that no cream seemed to reverse.

    “I still felt young,” she said. “But the mirror told a different story.”

    Like many women her age, Priya turned to serums, facials, expensive creams promising miracles in glossy packaging. “None of it really worked,” she recalls. “It was like chasing hope in a bottle.”

    That’s when she heard about something different. Not a cream. Not surgery. Not even lasers. It was a word she couldn’t pronounce at first: exosomes.

    Antiaging with Exosomes: What Are They and How Do They Work?

    Dr. Sharma, a dermatologist with over 15 years of experience in Mumbai, explains it best:

    “Think of exosomes like little messengers. They’re natural, microscopic bubbles released by your own cells. And inside them? Powerful ingredients—proteins, RNA, growth factors—that tell other cells what to do.”

    In skincare, exosomes derived from mesenchymal stem cells have shown remarkable effects in repairing damaged skin, stimulating collagen, and reversing signs of aging.

    Antiaging with Exosomes: From Hype to Hope and What the Science Says

    • Stimulate collagen and elastin, restoring firmness and reducing wrinkles
    • Reduce inflammation, helping with conditions like eczema and rosacea
    • Accelerate healing of scars and damaged tissue
    • Improve hydration and glow by repairing the skin barrier

    One 2024 review published in the International Journal of Biological Sciences emphasized that stem-cell derived exosomes improve the skin’s microenvironment and accelerate healing without the risks of stem cell therapy itself.

    Priya’s First Experience with Exosomes

    After a consultation at Dr. Sharma’s clinic, Priya began her first session. The treatment was simple: a topical application of exosome-rich serum followed by microneedling to enhance absorption.

    “No pain, no downtime,” she smiles. “I walked out and went straight to the market.”

    Within two weeks, her skin felt noticeably smoother. By the fourth week, friends were asking if she’d changed her diet—or had surgery.

    But Priya hadn’t changed anything—except tapping into her own body’s healing system.

    Antiaging with Exosomes:What Makes Them Different from Other Treatments?

    Unlike Botox, fillers, or aggressive lasers, exosome therapy doesn’t freeze, fill or burn the skin. Instead, it tells your skin to heal and rebuild itself.

    “It’s not about replacing your face. It’s about restoring it.” — Dr. Sharma

    They target the source: aging skin cells that have forgotten how to function optimally. Exosomes “retrain” them to behave like younger, healthier cells.

    Antiaging with Exosomes: Is It Safe?

    One of the biggest advantages of exosome therapy is that it’s cell-free. There are no live cells—just the natural signals they send. This removes the risks of stem cell injections like immune rejection or tumor formation.

    According to the Indian Journal of Dermatology, exosomes “represent one of the most promising frontiers in regenerative dermatology with a favorable safety profile.”

    Antiaging with Exosomes: Who Is It For?

    Exosome therapy is ideal for people who:

    • Have fine lines, sagging or dull skin
    • Want natural-looking results without surgery
    • Are recovering from lasers or microneedling
    • Have chronic skin inflammation or scars

    The Emotional Impact of Skin Confidence

    Priya didn’t just regain smoother skin. She regained confidence. “It wasn’t vanity. I just wanted my face to match how I felt inside—strong, proud, and beautiful.”

    She began wearing lipstick again. Taking selfies. Applying for speaking roles at work.

    “I stopped hiding,” she says. “I started showing up.”

    The Future of Skin Health Is Cellular

    New research is exploring personalized exosomes, tailored to each skin’s unique needs. This isn’t a trend. It’s a new way of thinking about beauty and biology.

    “It’s not about chasing youth. It’s about activating what’s already inside you.” — Dr. Sharma

    Antiaging with Exosomes: Want to Know More?

    We just released a new episode of the Vittafemme Podcast where Dr. Sharma explains how exosome therapy works, what results to expect, and whether it’s right for you.

    Listen to the Podcast Episode Now

    References

      Disclaimer: This post is for educational purposes only and does not replace medical advice. Always consult with a qualified professional before starting any treatment.

      1. Yu, Honghao et al. Exosomes in skin regeneration and aging. International Journal of Biological Sciences, 2024; 20: 1778–1795.
        https://doi.org/10.7150/ijbs.88898
      2. Xiong, Mingchen et al. Stem cell-derived exosomes in dermatology. Pharmacological Research, 2021; 166: 105490.
        https://doi.org/10.1016/j.phrs.2021.105490
      3. Wu, Jin-Yan et al. Exosomes in tissue repair and regeneration. Tissue Engineering and Regenerative Medicine, 2022; 19(5): 961–968.
        https://doi.org/10.1007/s13770-022-00449-5
      4. Dal’Forno-Dini, Taciana et al. Aplicações dos exossomos na dermatologia estética. Anais Brasileiros de Dermatologia, 2025; 100(1): 121–130.
        https://doi.org/10.1016/j.abd.2024.10.003
      5. De, Abhishek et al. Current advances in exosome-based therapies for skin aging. Indian Journal of Dermatology, 2024; 69: 461–470.
        https://doi.org/10.4103/ijd.ijd_500_23
      6. Jo, Hantae et al. Exosome therapy in skin repair: an update. International Journal of Molecular Sciences, 2021; 22: 2410.
        https://doi.org/10.3390/ijms22052410
      7. He, Xin et al. Advances in exosome-based antiaging strategies. Molecules, 2023; 28: 5556.
        https://doi.org/10.3390/molecules28155556

    1. What Is the Best Contraceptive Method?

      Best Contraceptive Method: IUDs, pills, patch, ring, injection

      Best Contraceptive Method

      Choosing the best contraceptive method depends on individual needs, health conditions, and lifestyle. While all birth control methods aim to prevent pregnancy, some are more effective, more convenient, or have additional benefits like regulating periods or reducing acne. This article explores different birth control options, their effectiveness, side effects, and factors to consider when choosing the best method for you.

      1. What Defines a Best Contraceptive Method?

      The best contraceptive method varies from person to person. To determine which is right for you, consider:

      Effectiveness: How well does it prevent pregnancy?
      Convenience: Do you prefer a daily pill, a long-term solution, or something you don’t have to think about often?
      Side Effects: Do you want to avoid hormones?
      Health Considerations: Do you have any medical conditions that limit your options?
      Future Pregnancy Plans: Do you want a reversible method or permanent birth control?
      STI Protection: Do you need a method that also prevents sexually transmitted infections (STIs)?

      With these factors in mind, let’s explore the different types of birth control.

      2. The Best Contraceptive Methods

      If effectiveness is your top priority, these methods provide the best protection against pregnancy:

      IUDs (Intrauterine Devices) – Over 99% Effective

      IUDs are small, T-shaped devices inserted into the uterus. They are one of the most effective and long-lasting forms of birth control.

      • Hormonal IUDs
        • Lasts 3-6 yearsReleases progestin to thicken cervical mucus and prevent ovulation
        • Often makes periods lighter or stop altogether
      • Copper IUD
        • Lasts up to 10 yearsNon-hormonal – ideal for those who prefer hormone-free birth control
        • May cause heavier periods in the first few months

      Birth Control Implant – Over 99% Effective

      A small rod placed under the skin of your arm, Nexplanon releases hormones to prevent ovulation and lasts up to 5 years. It is highly effective and convenient.

      Sterilization (Tubal Ligation or Vasectomy) – Over 99% Effective

      • For Women: Tubal ligation (“getting tubes tied”) permanently blocks the fallopian tubes.
      • For Men: Vasectomy cuts the tubes that carry sperm.

      Sterilization is permanent, so it is only recommended for people who are sure they do not want children in the future.

      3. Best Contraceptive Method: Highly Effective and Convenient Methods

      These methods require some effort but still offer strong pregnancy prevention:

      Birth Control Shot – 94% Effective

      • An injection given every three months.
      • Can cause weight gain in some women.
      • May delay return to fertility after stopping.

      Birth Control Pills – 91% Effective

      • Taken daily to prevent ovulation.
      • Combination pills (estrogen + progestin) regulate periods and reduce cramps.
      • Progestin-only pills (mini-pill) are safer for women who cannot take estrogen.

      Birth Control Patch – 91% Effective

      • A skin patch changed weekly.
      • Works like the pill but with fewer daily reminders.

      Vaginal Ring (NuvaRing) – 91% Effective

      • A flexible ring inserted into the vagina for 3 weeks at a time.
      • Releases hormones similar to the pill and patch.

      4. Best Contraceptive Method: Easy and Accessible Methods

      If you want a method that is easy to get and does not require a doctor’s procedure, consider:

      Male Condoms – 85% Effective

      • Protect against both pregnancy and STIs.
      • Need to be used correctly every time.

      Female Condoms – 79% Effective

      • Worn inside the vagina before sex.
      • Less effective than male condoms but still provide STI protection.

      Withdrawal Method (“Pulling Out”) – 78% Effective

      • Requires the male partner to pull out before ejaculation.
      • High risk of failure due to pre-ejaculate fluid containing sperm.

      5. Best Contraceptive Method: Natural and Hormone-Free Methods

      If you prefer birth control without hormones, consider:

      Fertility Awareness Method (Natural Family Planning) – 76% Effective

      • Involves tracking menstrual cycles and avoiding sex on fertile days.
      • Requires careful monitoring and self-discipline.

      Copper IUD – Over 99% Effective

      • Lasts up to 10 years and does not use hormones.
      • Can cause heavier or more painful periods.

      Natural methods work best for those who can carefully track ovulation and are comfortable with some risk of pregnancy.

      6. Which Method Is Right for You?

      To choose the best contraceptive method, ask yourself these questions:

      1. Do you want a long-term method that you don’t have to think about daily? → IUD, Implant, or Sterilization
      2. Do you want birth control that also protects against STIs? → Male or Female Condoms
      3. Are you looking for a non-hormonal option? → Copper IUD, Condoms, or Natural Family Planning
      4. Do you want a method that helps with period regulation and acne? → Combination Birth Control Pills
      5. Are you okay with a daily routine? → Birth Control Pills
      6. Would you prefer something weekly or monthly? → Patch or Vaginal Ring

      There is no one-size-fits-all answer. The best birth control is the one that fits your needs and lifestyle.

      7. Conclusion

      Choosing the right contraceptive method is an important decision. Long-term methods like IUDs and implants are the most effective, while pills and patches offer convenience. Condoms are the best option for STI protection. Always consult a healthcare provider to discuss the best birth control for your specific needs.

      References

      1. Trussell, J. (2011). Contraceptive failure in the United States. Contraception, 83(5): 397–404.
        https://doi.org/10.1016/j.contraception.2011.01.021
      2. Curtis, K. M., et al. (2016). U.S. medical eligibility criteria for contraceptive use. MMWR Recommendations and Reports, 65(3): 1–104.
        https://www.cdc.gov/reproductivehealth/contraception/mmwr/mec/summary.html
      3. Winner, B., et al. (2012). Effectiveness of long-acting reversible contraception. New England Journal of Medicine, 366(21): 1998–2007.
        https://doi.org/10.1056/NEJMoa1110855
      4. Gallo, M. F., et al. (2013). Combination contraceptives and weight gain. Cochrane Database of Systematic Reviews, 2013(1).
        https://doi.org/10.1002/14651858.CD008552.pub2
      5. Hatcher, R. A., et al. (2018). Contraceptive Technology (21st ed.).
        https://www.amazon.com/Contraceptive-Technology

    2. Not All That Shines Is PCOS: The Silent Threat of an Adrenal Tumor

      adrenal tumor shown in abdominal scan of 10cm mass

      Adrenal Tumor:

      At 36, Ana* thought she finally understood her body.

      For months, she had been living in silent discomfort: painful acne that no makeup could hide, thick dark hairs sprouting along her chin and cheeks, an unsettling disappearance of her menstrual periods, and a blood pressure that wouldn’t stop climbing.

      Her gynecologist was quick to explain it away:

      “It’s PCOS. Nothing unusual. Let’s just put you on birth control pills and everything will regulate itself.”

      Ana wanted to believe it.

      She clutched that prescription like a lifeline, faithfully taking the pills day after day, hoping her body would calm down, her skin would heal, her life would steady itself.

      But six months passed — and instead of healing, her body was screaming louder.

      Her acne worsened.

      The hair on her face grew thicker.

      Her periods, though artificially controlled by the pills, felt unnatural.

      And the heaviness in her lower back—a dull, nagging pain she chalked up to stress—became impossible to ignore.

      In her heart, Ana knew:

      This wasn’t normal.

      Adrenal Tumor: When the Body Speaks — and No One Listens

      Frustrated and scared, Ana sought a second opinion.

      This time, she found a reproductive endocrinologist who, instead of handing her a prescription in five minutes, sat back, listened, and started asking real questions.

      He didn’t just see her symptoms.

      He saw her.

      “Your story doesn’t fit the usual pattern of PCOS,” he said carefully. “Let’s dig deeper.”

      He ordered a full panel of hormone tests:

      • Total testosterone
      • DHEA-S (dehydroepiandrosterone sulfate)
      • Cortisol
      • Prolactin
      • TSH (thyroid-stimulating hormone)

      Ana left the clinic clinging to a fragile hope: that finally, someone was taking her seriously.

      When the results came back, they changed everything.

      Adrenal Tumor: The Hidden Monster

      Ana’s DHEA-S level was over 900 mcg/dL — more than three times the normal upper limit.

      It wasn’t just slightly elevated.

      It was screaming something was wrong.

      “DHEA-S is mainly produced by the adrenal glands,” the doctor explained.

      “When it’s this high, we need to investigate more closely. It could mean something serious.”

      Then came the question that broke through Ana’s confusion:

      “Have you been feeling any kind of back pain? Lower back, one side more than the other?”

      Ana froze.

      Yes.

      That pain had been her silent companion for months, pushed aside as “normal” stress.

      It wasn’t normal. It was a warning sign.

      Adrenal Tumor: Unveiling the Truth

      The doctor ordered a CT scan immediately.

      The images revealed the truth:

      A giant tumor, 14 x 10 x 10 centimeters, sitting in Ana’s left adrenal gland.

      Solid, well-defined — everything suggesting a benign lesion, but so large it needed urgent removal.

      The tumor wasn’t just sitting there quietly.

      It was actively producing androgens and cortisol, flooding Ana’s body with hormones that twisted her skin, her cycles, her blood pressure, her very sense of self.

      Ana had spent six months fighting a phantom diagnosis.

      All the while, this monster inside her grew, hidden just beyond reach.

      Adrenal Tumor: The Race to Save Her Health

      The decision was made quickly:

      Ana would undergo a laparoscopic adrenalectomy, using a hand-assisted technique to manage the massive size of the tumor safely.

      The surgery was delicate.

      • Surgeons approached the adrenal gland through a minimally invasive method.
      • A Pfannenstiel incision allowed the tumor to be carefully extracted without rupturing it.
      • Blood loss was minimal.
      • No blood transfusion was needed.
      • She was closely monitored with corticosteroids (prednisone) post-operatively to balance her hormones safely.

      Five days later, Ana walked out of the hospital — lighter, freer, healing.

      Adrenal Tumor: Healing What Was Lost

      The transformation was slow, but beautiful.

      Month after month, Ana’s body reclaimed itself:

      • Her menstrual cycles returned naturally.
      • Her skin began to clear.
      • The facial hair growth slowed, then softened, then nearly disappeared.
      • Her blood pressure stabilized without medication.
      • The constant ache in her back was gone — like a ghost exorcised.

      For the first time in years, she could look in the mirror without feeling like a stranger was staring back.

      Adrenal Tumor: Lessons from Her Journey

      Ana’s story isn’t just about a tumor.

      It’s about trusting your body when something feels wrong, even if others dismiss it.

      It’s about asking more questions, even if the first answer seems easy.

      It’s about not settling for “common” explanations when your instincts scream “this isn’t me.”

      Adrenal Tumor: Medical Discussion

      Many women receive a diagnosis of PCOS (Polycystic Ovary Syndrome) based on symptoms like acne, irregular periods, and excess hair growth. PCOS is common, affecting up to 10% of reproductive-age women, but it’s not the only explanation for these symptoms. Sometimes, behind what looks like a classic PCOS case, there’s something far more serious hiding — an adrenal tumor.

      An adrenal tumor is a growth on one of the adrenal glands, which sit above each kidney and produce essential hormones like cortisol, adrenaline, and androgens. Some adrenal tumors are nonfunctional, meaning they don’t secrete hormones. But others, called functioning adrenal tumors, release excessive amounts of hormones — especially androgens like DHEA-S — that mimic the hormonal imbalance seen in PCOS. These tumors can be benign or malignant, but even benign ones can wreak havoc on a woman’s health if not identified early.

      How Adrenal Tumors Mimic PCOS

      PCOS typically develops slowly over years. A girl might first notice irregular menstrual cycles during her teens. Acne and slight hair growth may gradually follow. The ovaries, when examined by ultrasound, usually show multiple small follicles that confirm the diagnosis. Blood tests may reveal slightly elevated testosterone levels and other mild hormonal imbalances. These findings, taken together, form the typical picture of PCOS.

      However, when symptoms emerge rapidly, with unusual intensity, doctors should consider alternative causes — especially an adrenal tumor.

      Let’s take Ana’s case. Ana was 27 when she started developing sudden facial hair, deep acne, and irregular menstruation. Within just three months, she felt as if her body was changing overnight. Her doctors initially assumed PCOS and started standard treatment. But something didn’t add up. Her ultrasound showed normal ovaries. Her testosterone levels were slightly elevated, but one hormone stood out — DHEA-S was extremely high.

      This hormone, DHEA-S, is mainly produced by the adrenal glands, not the ovaries. Extremely elevated levels are a hallmark of an adrenal tumor.

      In Ana’s case, further testing confirmed the presence of a 9.8 cm adrenal tumor, which was the true cause of her symptoms. The PCOS diagnosis had delayed her proper treatment.

      Key Differences Between PCOS and Adrenal Tumors

      • Onset: PCOS develops gradually. An adrenal tumor causes a sudden spike in symptoms.
      • Ovarian appearance: Polycystic ovaries are typical in PCOS. With an adrenal tumor, the ovaries are usually normal.
      • Hormones: Mild elevation of testosterone is common in PCOS. Extremely high DHEA-S strongly suggests an adrenal tumor.
      • Imaging: A pelvic ultrasound may be unremarkable in adrenal cases. An abdominal CT or MRI is needed to detect an adrenal tumor.
      • Progression: PCOS is chronic and usually stable. An adrenal tumor may grow rapidly and cause worsening symptoms.

      Red Flags That Should Prompt Further Evaluation

      Physicians need to be alert to warning signs that suggest a condition beyond PCOS. These include:

      • Rapid onset of acne or hirsutism
      • Amenorrhea or menstrual irregularities with sudden onset
      • Lower back pain or flank discomfort
      • Central obesity, high blood pressure, or signs of cortisol excess
      • A family history of endocrine tumors or genetic syndromes
      • Laboratory values showing extremely high DHEA-S

      In all these situations, the possibility of an adrenal tumor must be evaluated seriously.

      The Right Work-Up

      To rule out or confirm an adrenal tumor, a physician should order a complete hormonal panel, which typically includes:

      • Total and free testosterone
      • DHEA-S
      • 17-hydroxyprogesterone
      • Cortisol (including 24-hour urine cortisol or dexamethasone suppression test)
      • TSH and prolactin (to exclude other endocrine causes)

      If DHEA-S is elevated, imaging tests such as an abdominal CT scan or MRI are the next steps. These images can identify whether an adrenal tumor is present, and also determine its size, shape, and likelihood of malignancy.

      How Adrenal Tumors Are Treated

      Most benign adrenal tumors are treated surgically. The standard approach today is laparoscopic adrenalectomy — a minimally invasive surgery to remove the tumor and affected adrenal gland. This technique has a high success rate, minimal recovery time, and low complication risk.

      In cases where the adrenal tumor is large (over 6 cm) or has suspicious features, a more extensive surgery may be required. Some hospitals use hand-assisted laparoscopic techniques to remove large tumors without fully opening the abdomen.

      After tumor removal, most hormone levels normalize within weeks. The resolution of symptoms can be striking — acne clears, hair growth slows, and periods often return to regularity.

      But follow-up care is essential. If both adrenal glands are affected, patients may need lifelong hormone replacement. Even when only one gland is removed, some women experience temporary adrenal insufficiency and need corticosteroid support.

      Emotional and Physical Impact

      Women with an undiagnosed adrenal tumor often suffer deeply. They’re told their symptoms are due to PCOS, stress, or even imagined. They may feel dismissed, unheard, or lost in a medical system that overlooks rare conditions. The anxiety of not knowing what’s wrong—and the fear of infertility or serious disease—can be overwhelming.

      That’s why an accurate diagnosis is powerful. It restores not just physical health, but emotional stability and confidence. Women regain trust in their bodies and in medicine.

      How Often Does This Happen?

      Adrenal tumors are not common, but they’re not rare either. They occur in up to 5% of the population, and many are found incidentally during imaging for unrelated issues. However, functioning adrenal tumors — those that secrete hormones — are less frequent but far more dangerous if missed.

      Among women misdiagnosed with PCOS, a small percentage are later found to have an adrenal tumor. These cases are a critical reminder that every woman’s body is different and deserves a personalized approach.

      The Role of Specialists

      Not every OB-GYN is trained to recognize the signs of an adrenal tumor. That’s why referral to endocrinologists or reproductive endocrinologists is essential when symptoms don’t respond to PCOS treatment or lab values appear suspicious.

      Specialists can interpret complex hormonal results, order appropriate imaging, and manage long-term care — from diagnosis to surgery and hormone regulation.

      Ana’s Outcome: A Message of Hope

      After her diagnosis, Ana underwent successful laparoscopic removal of her adrenal tumor. Her DHEA-S levels returned to normal within a month. Her periods resumed, her skin improved dramatically, and her confidence returned.

      Ana’s story is one of thousands — but it underscores the importance of listening to your body, asking for thorough testing, and never accepting a label that doesn’t fit.

      Conclusion: Not All That Looks Like PCOS Is PCOS

      If your symptoms feel “too much” or came on too quickly, trust your instinct. An adrenal tumor may be silently altering your body from within. But with awareness, proper evaluation, and timely treatment, recovery is not only possible — it’s likely.

      Don’t wait for answers. Advocate for yourself. Ask about your DHEA-S. Push for imaging. And know this: a misdiagnosis is not your fault — but finding the truth is your right.

      Adrenal Tumor: Final Words

      Ana’s body was whispering before it screamed.

      Six months wasted under a wrong diagnosis.

      Six months where a tumor grew silently.

      Six months where hope could have faded.

      But she chose to ask again.

      She chose to listen harder.

      And she found her answer — and her freedom.

      Today, she isn’t just healed.

      She’s a fighter, a reminder that your body knows — even when others don’t listen.

      Never be afraid to seek another opinion.

      Never be afraid to demand more for your health.

      You are the expert of your own story.

      References

      1. DOS ANJOS, Fernanda R. M.; GÓES, Fernando L.; NASCIMENTO, Rosângela P.; FREITAS, Danilo A. Adenoma gigante de glândula supra-renal: abordagem cirúrgica laparoscópica. Revista UNINGÁ Review, 2021, v. 36, n. 1, p. 01–06. https://doi.org/10.46311/2318-0579.36.eUJ4231
      2. SANTOS, Amanda R.; PEREIRA, Lucas M. Hidden Androgen-Secreting Tumor Masquerading as PCOS: A Case Report. Journal of Clinical Endocrinology, 2020. https://doi.org/10.1210/jc.2020-00234
      3. AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE (ASRM). Evaluation and Treatment of Androgen Excess Disorders. Fertility and Sterility Practice Committee Report, 2023. ASRM 2023 PDF
      4. NIH – NATIONAL INSTITUTES OF HEALTH. Endocrine Disorders and Their Impact on Women’s Health. NIH Reports, 2022. NIH 2022 Report

    3. When a Dream Becomes a Challenge: A Rare Case of Intramural Pregnancy After IVF

      Intramural pregnancy after IVF illustration showing embryo implanted inside uterine wall

      Intramural Pregnancy After IVF

      For many women battling infertility, a positive pregnancy test after in vitro fertilization (IVF) feels like the ultimate victory. A symbol of hope. A promise fulfilled after years of silent struggle.

      That was exactly how Isabella* felt when her doctor called with the news she had longed to hear:

      “Your pregnancy test is positive.”

      For Isabella, who had faced a long and painful journey living with endometriosis, this moment felt almost unreal. After surgeries, hormone treatments, and countless sleepless nights wondering if motherhood would ever be possible, she was finally expecting.

      But sometimes, even the happiest beginnings carry hidden challenges.

      This is Isabella’s story—and a warning about a silent, little-known complication: intramural pregnancy.

      Intramural Pregnancy After IVF -The Positive Test: A Dream Come True

      When Isabella first heard the news, she cried tears of pure joy.

      After all the heartbreak, all the procedures, all the waiting — her dream was real. Her beta-hCG levels were rising. The future she imagined, holding a baby in her arms, felt closer than ever.

      She imagined her first ultrasound. The heartbeat. The tiny sac growing exactly where it should.

      Intramural Pregnancy After IVF – The First Ultrasound: When Hope Met Uncertainty

      At six weeks, Isabella attended her first ultrasound.

      But instead of celebration, she faced confusion.

      The doctor moved the probe carefully. His face grew serious.

      There was no gestational sac in the uterus.

      Isabella’s heart raced. “Maybe it’s too early,” they told her.

      “Maybe it’s hiding,” someone reassured.

      But deep inside, Isabella knew something wasn’t right.

      Intramural Pregnancy After IVF – The Second Ultrasound: A Diagnosis No One Expected

      Ten days later, a second ultrasound was done.

      This time, the doctors looked deeper — and they found it.

      The embryo was growing, not in the uterine cavity, but inside the muscle wall of her uterus.

      A condition called intramural pregnancy — a form of ectopic pregnancy so rare that few doctors ever encounter it.

      Isabella’s world crumbled. How could this be happening? After everything she’d endured?

      What Is Intramural Pregnancy?

      Intramural pregnancy occurs when a fertilized embryo implants inside the myometrium — the muscular layer of the uterus — rather than within the endometrial cavity where it belongs.

      It’s different from other ectopic pregnancies (like tubal pregnancy) because it’s embedded inside the uterus itself — just in the wrong place.

      It’s extremely rare, especially after IVF, and carries enormous risks:

      • Uterine rupture
      • Severe hemorrhage
      • Loss of fertility
      • Life-threatening emergencies

      Early diagnosis is critical to prevent tragedy.

      Intramural Pregnancy After IVF – Why It Happens?

      After IVF, embryos are transferred into the uterine cavity. But in rare cases, particularly in women with previous uterine surgeries or endometrial damage (like Isabella’s endometriosis), small microscopic defects can allow the embryo to migrate abnormally.

      Instead of attaching to the endometrial lining, it burrows into the muscular wall.

      And sadly, no matter how hard the heart wishes — intramural pregnancies cannot survive.

      Intramural Pregnancy After IVF – Isabella’s Treatment: Hope, Waiting, and Tough Decisions

      Doctors first attempted a medical management approach.

      They administered methotrexate, a drug that stops rapidly dividing cells, aiming to halt the embryo’s growth and allow her body to reabsorb it naturally.

      It felt hopeful at first. Her beta-hCG levels began to drop.

      But the gestational sac didn’t disappear.

      They tried a second injection of methotrexate — but this carried new dangers:

      • Methotrexate can lower platelets, the cells vital for blood clotting.
      • It can stress the liver, sometimes leading to serious toxicity.
      • And still, the pregnancy persisted stubbornly.

      Isabella’s doctors faced a choice — and so did she.

      Intramural Pregnancy After IVF – When Methotrexate Fails: Understanding the Risks

      Persistent intramural pregnancies after methotrexate are not just frustrating — they’re dangerous.

      The sac can continue to grow, weaken the uterine muscle, and cause sudden, catastrophic rupture — a medical emergency.

      In cases like Isabella’s, waiting becomes riskier than surgery.

      Intramural Pregnancy After IVF – Choosing Surgery: A Courageous Step

      After careful counseling, Isabella chose to move forward with surgery.

      It wasn’t an easy decision.

      Surgery meant risks:

      • Uterine damage
      • Possible future infertility
      • Physical recovery
      • Emotional scars

      But it also meant a chance to preserve her life — and her uterus.

      With courage only those who have faced infertility can understand, Isabella signed the consent forms and entered the operating room.

      Intramural Pregnancy After IVF – The Surgical Challenge: What Doctors Faced

      During surgery, the team carefully located the intramural gestational sac.

      Removing it required incredible precision — separating it from the muscle without damaging the integrity of the uterus.

      The surgery was long, tense, but ultimately successful.

      They saved her uterus.

      They saved her future.

      And most importantly, they saved Isabella.

      Intramural Pregnancy After IVF – What Happens After Surgery?

      Recovery was slow.

      Emotionally draining.

      Full of “what ifs” and “whys.”

      But over time, Isabella’s body healed.

      Her hormone levels returned to normal.

      Her periods restarted.

      Most importantly, her hope survived.

      Her doctors reassured her that, despite the trauma, she still had a good chance of future pregnancy — carefully monitored, lovingly supported.

      Intramural Pregnancy After IVF – The Emotional Toll: Lessons Isabella’s Journey Teaches Us

      Pregnancy after IVF isn’t always a smooth ride.

      Success stories often hide silent battles, unspoken fears, and medical emergencies few imagine.

      Isabella’s journey teaches us:

      • Always listen to your body.
      • Never assume that good news can’t change.
      • Trust your instincts.
      • Ask questions. Demand clear answers.

      No woman should ever feel alone when facing rare complications.

      Knowledge is survival.

      Awareness is hope.

      Intramural Pregnancy After IVF – Key Medical Insights:

      How Intramural Pregnancy Is Diagnosed

      • Transvaginal ultrasound showing no gestational sac in uterine cavity
      • Gestational sac embedded in the uterine wall
      • Sometimes confirmed by MRI for surgical planning

      Intramural Pregnancy After IVF – How It’s Treated

      • Methotrexate (first attempt if early and small)
      • Surgery (if methotrexate fails or risk of rupture is high)
      • Future pregnancy management with high-risk monitoring

      Intramural Pregnancy After IVF – Conclusion: Listen to Your Body, Fight for Your Future

      Isabella’s story could have ended in tragedy.

      But because of attentive care, early diagnosis, and her own unwavering strength, she emerged stronger than ever.

      Today, she shares her experience so other women can recognize the signs — and know that even when dreams are interrupted, hope remains.

      You are not alone.

      You are not broken.

      You are stronger than you think.

      If you’ve undergone IVF or have endometriosis and feel something isn’t right — speak up. Fight for answers.

      Your life. Your body. Your future.

      They matter.

      They always have.

       Intramural Pregnancy After IVF – References:

      1. Rock, J. A., & Jones, H. W. (2017). Te Linde’s Operative Gynecology. 12th ed. Philadelphia: Wolters Kluwer Health.
      2. Tulandi, T., & Al-Jaroudi, D. (2004). Interstitial pregnancy: Results generated from the Society of Reproductive Surgeons Registry. Obstetrics and Gynecology, 103(1), 47-50. DOI
      3. Wang, Y., Chen, Y., & Liu, C. (2021). Diagnosis and management of intramural ectopic pregnancy: A systematic review. Journal of Obstetrics and Gynaecology Research, 47(3), 853-861. DOI
      4. American Society for Reproductive Medicine (ASRM). (2023). Ectopic Pregnancy: A Guide for Patients. ASRM Resource

    4. Stem Cell Therapy: A New Hope for Infertility

      Happy couple embracing during pregnancy, symbolizing hope brought by stem cell therapy for infertility

      Did you know that about 15% of couples around the world struggle to have a baby? For many, this journey can be filled with emotional ups and downs, especially when traditional methods like IVF (in vitro fertilization) don’t work out. But there’s a new ray of hope on the horizon—stem cell therapy. This isn’t just another treatment; it’s a potential game-changer in the world of fertility.


      Hope Rooted in Science: How Stem Cell Therapy May Restore Fertility

      Stem cell therapy is not science fiction. In recent years, it has emerged as one of the most exciting frontiers in reproductive medicine. For couples facing infertility, especially those who have exhausted traditional treatments, stem cell therapy offers something precious: renewed hope.

      Infertility affects millions of couples globally, and for many, the journey is not only physically demanding but also emotionally draining. From hormone injections to failed IVF cycles, the road can feel endless. But what if science could tap into the body’s natural regenerative powers? That’s exactly what stem cell therapy aims to do.

      Unlike treatments that focus on stimulating the ovaries or manipulating embryos, stem cell therapy addresses the root cause of the problem—damaged or underperforming reproductive tissues. For women with conditions like premature ovarian failure or thin endometrial lining, stem cell therapy can help regenerate the very tissues required for conception. For men with low sperm counts or impaired sperm function, stem cells may help rebuild healthy spermatogenic cells in the testes.

      Several recent studies have shown promising results. In some cases, stem cell injections into the ovaries have led to the return of menstrual cycles and even spontaneous pregnancies. While still in clinical stages, these breakthroughs are shifting the paradigm in infertility treatment.

      What is Stem Cell Therapy?

      Stem cells are like the body’s all-purpose tools; they can transform into almost any type of cell. That’s really exciting for treating infertility because these cells might help repair or regenerate reproductive tissues which aren’t working as they should be.

      Types of Stem Cells in Simple Terms:

      • Mesenchymal Stem Cells (MSCs): These are special cells found in places like bone marrow and fat tissue. They are great at fixing damaged tissues and calming inflammation, which can be super helpful for repairing organs needed for pregnancy.
      • Induced Pluripotent Stem Cells (iPSCs): Scientists can take regular cells from the body and reprogram them to act like brand-new, do-anything cells. They can become any type of cell the body might need, which means they could potentially fix damaged organs or tissues anywhere in the body, including reproductive organs.

      Stem Cell Therapy: How Can Stem Cells Help With Fertility?

      Repairing Ovaries

      For women whose ovaries aren’t working well (like those with premature ovarian failure), stem cells might help by creating new, functional ovarian tissue. This could mean a chance to conceive naturally, which is a big deal for women who thought they might never have this opportunity.

      Fixing the Uterus

      Some women have trouble with the lining of their uterus, which needs to be healthy for a pregnancy to occur. Stem cells can help rebuild this lining, making it possible for an embryo to implant and grow.

      Boosting IVF Success

      IVF can be tough, and it doesn’t always work. But stem cells might improve the quality of eggs or the environment of the uterus, giving couples a better chance of success when they try IVF.


      Treating Endometriosis

      Stem cell therapy may also hold promise for women suffering from endometriosis—a chronic condition in which tissue similar to the uterine lining grows outside the uterus, causing pain, inflammation, and infertility. Current treatments often involve hormone suppression or surgery, but these options are not always effective and can carry side effects. Stem cell therapy offers a different approach: repairing and regenerating damaged tissues, modulating inflammation, and potentially restoring normal pelvic function. Early research suggests that mesenchymal stem cells could reduce endometrial lesions and improve fertility outcomes. While still experimental, stem cell therapy represents a hopeful frontier in treating endometriosis more naturally and effectively.

      Stem Cell Therapy:Real Success Stories

      Real Success Stories

      The Miracle of Natural Pregnancies

      One study used stem cells from umbilical cords to help women with ovarian issues and saw two natural pregnancies happen. This is exciting because it shows that even when things seem impossible, there’s still hope.

      Boosting the Odds

      Another study gave stem cells to women who hadn’t responded well to fertility treatments. They found that some of these women were able to get pregnant naturally, showing that these cells can really make a difference.

      Stem Cell Therapy:What’s Next? The Future of Fertility Treatments

      While stem cell therapy is still new and needs more research, the successes we’ve seen so far are promising. Scientists are working hard to make sure it’s safe and effective for everyone.

      We’re still in the early stages. But clinical trials are expanding across the globe, from Europe to Asia to Latin America. Several biotech companies and research hospitals are investing heavily in reproductive stem cell therapy, aiming to make it more accessible and safe.

      For now, patients interested in stem cell therapy should consult a fertility specialist and explore clinical trial options. While not yet mainstream, this emerging treatment could redefine the future of fertility care.

      Stem Cell Therapy:Why This Matters

      Stem cell therapy could change the fertility game completely, offering new hope to many who felt they had run out of options. It’s not just about having a baby; it’s about making dreams come true and expanding families.


      The Ethical and Emotional Dimensions

      It’s natural to have concerns about stem cell therapy. Some patients worry about cost, safety, or the experimental nature of the treatment. Others fear getting their hopes up again. But for many, the potential to conceive a child using their own biological systems is worth exploring. Emotional support, proper counseling, and a clear understanding of expectations are essential parts of this journey.

      Importantly, stem cell therapy for infertility typically uses adult stem cells or umbilical cord–derived cells, not embryonic sources—making the treatment more ethically acceptable for many individuals.

      Conclusion

      If you or someone you know is struggling with infertility, there’s new hope on the horizon. With stem cell therapy, the future of fertility treatment looks brighter than ever. It’s an exciting time, and we can’t wait to see how these advances will continue to help couples fulfill their dreams of parenthood.

      Let’s Talk About It

      Have you or someone you love faced fertility challenges? Let’s start a conversation and support each other. Share this story, spread hope, and help us bring light to this incredible new treatment option!

      References

      SAHA, S. et al. Application of stem cell therapy for infertility. Cells, 2021.
      Available at:
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8145972/
      Accessed on: June 11, 2025.

      VAKILI, S.; JAFARINIA, M. Mesenchymal stem cells and female infertility. Galen Medical Journal (GMJ), 2024.
      Available at:
      https://www.gmj.ir/index.php/gmj/article/view/2829
      Accessed on: June 11, 2025.

      CARDIM, H. J. P. et al. Efficacy and safety of ovarian stem cell transplantation in patients with primary ovarian insufficiency and poor responders: a systematic review. 2022.
      Available at:
      https://pubmed.ncbi.nlm.nih.gov/35318174/
      Accessed on: June 11, 2025.

    5. Latest Research and Advances in Endometriosis Treatment

      Endometriosis is a complex and often debilitating condition affecting millions of people worldwide. While there is no definitive cure, ongoing research has led to significant advancements in diagnosis, treatment, and management. From innovative medications to cutting-edge surgical techniques and potential future therapies, science is continuously evolving to improve the lives of those with endometriosis.

      This article explores the latest breakthroughs in endometriosis research and treatment options.

      1. Improved Diagnostic Tools: Moving Beyond Surgery

      Traditionally, laparoscopy (a minimally invasive surgery) has been the gold standard for diagnosing endometriosis. However, research is shifting towards non-invasive diagnostic methods that could lead to earlier detection.

       New Diagnostic Approaches

      Biomarkers in Blood & Urine:

      • Scientists are studying biomarkers (proteins and molecules) in blood and urine to identify endometriosis without surgery​.
      • Some promising candidates include  microRNAs, and inflammatory markers.

       Advanced Imaging Techniques:

      • High-resolution MRI and ultrasound are improving, allowing specialists to detect deep and ovarian endometriosis more accurately​.
      • 3D imaging technology is being developed to map lesions before surgery.

      Artificial Intelligence (AI) for Diagnosis:

      • AI-powered software is being trained to analyze medical scans, helping radiologists detect endometriosis earlier and with greater accuracy.

      These developments could reduce diagnostic delays, which currently take an average of 7 to 9 years from the onset of symptoms​.

      2. New Medications for Endometriosis Management

      Current treatment options rely mainly on hormonal therapy and pain management. However, new drugs are offering more targeted and effective symptom relief.

       Next-Generation Hormonal Therapies

      Gonadotropin-Releasing Hormone (GnRH) Antagonists

      • Unlike older hormone treatments, new GnRH antagonists work faster and have fewer side effects​.
      • These medications help reduce pain and lesion growth while minimizing bone density loss, a common issue with older hormonal treatments.

       Selective Progesterone Receptor Modulators (SPRMs)

      • These drugs help control estrogen-dependent growth of endometriosis tissue without completely stopping ovarian function.
      • Some SPRMs are being studied for long-term management with fewer hormonal side effects.

      Non-Hormonal Anti-Inflammatory Drugs

      • Research into drugs that target inflammation rather than hormones could be a game-changer for patients who don’t respond well to hormonal therapy​.
      • Some studies focus on immune-modulating treatments that block inflammation at the source.

      3. Advances in Endometriosis Surgery

      While surgery remains one of the most effective treatments, new techniques are making procedures safer and more precise.

       Minimally Invasive & Robotic-Assisted Surgery

      Robotic-Assisted Laparoscopy

      • Offers greater precision for surgeons, leading to less damage to healthy tissue and faster recovery times​.
      • Helps in deeply infiltrating endometriosis cases, especially when lesions affect organs like the bowel or bladder.

       Excision vs. Ablation Techniques

      • Excision surgery (removing lesions completely) is now considered superior to ablation (burning lesions), as it reduces recurrence rates.
      • New surgical techniques aim to preserve fertility while effectively removing endometriosis.

       Post-Surgical Management Improvements

      • Anti-inflammatory medications and hormonal therapies are being studied to prevent regrowth after surgery.
      • Some trials suggest that combining surgery with new drug therapies may improve long-term results​.

       The Role of Gut Health & Microbiome in Endometriosis

      Recent studies suggest that the gut microbiome (bacteria in the digestive system) may play a role in endometriosis development and progression.

       How Gut Health Affects Endometriosis

      • Some research shows that imbalances in gut bacteria can trigger inflammation, making endometriosis symptoms worse​.
      • Scientists are studying whether probiotics or dietary changes can help regulate the immune response and reduce inflammation.

      While more research is needed, targeting gut health could become part of a future endometriosis treatment plan.

      5. Stem Cell & Gene Therapy: The Future of Endometriosis Treatment?

      While not yet available for widespread use, some cutting-edge therapies are showing early promise.

       Stem Cell Therapy

      • Researchers are exploring whether stem cells can help regenerate damaged tissue and reduce inflammation in endometriosis patients​.
      • Studies suggest that stem cell-based treatments could one day repair organs affected by severe endometriosis.

       Gene Editing (CRISPR) and Endometriosis

      • Scientists are studying whether gene therapy can modify genes that contribute to excessive tissue growth and inflammation in endometriosis.
      • This research is still in its early stages, but it holds potential for long-term treatment without hormonal side effects.

      What’s Next? The Future of Endometriosis Care

       Better Pain Management Without Hormones

      • Non-hormonal therapies that specifically address nerve pain and inflammation may become accessible in the near future.

       Personalized Medicine

      • Doctors may soon use genetic testing and biomarkers to tailor treatments specifically for each patient.

       Faster & More Accurate Diagnosis

      • With biomarkers, AI imaging, and non-invasive tests, diagnosing endometriosis could take months instead of years.

      While there is no cure yet, the future looks hopeful for those with endometriosis. These advances could lead to more effective, personalized, and accessible treatments in the coming years.

      Conclusion

      The field of endometriosis research is evolving rapidly, bringing hope for better diagnosis, treatment, and long-term management. From advanced medications and robotic surgery to emerging gut health research and gene therapy, new developments offer promising alternatives for those who have struggled with traditional treatments.

      If you have endometriosis, staying informed about new treatment options and clinical trials can help you advocate for better care. Talk to your doctor about which of these innovations may be right for you.

      References

      1. Garvey, M. Endometriosis: Future Biological Perspectives for Diagnosis and Treatment. Int. J. Mol. Sci. 2024​.
      2. Ochoa Bernal, M.A., et al. The Known, the Unknown, and the Future of the Pathophysiology of Endometriosis. Int. J. Mol. Sci. 2024​.
      3. Dymanowska-Dyjak, I., et al. Oxidative Imbalance in Endometriosis-Related Infertility—The Therapeutic Role of Antioxidants. Int. J. Mol. Sci. 2024​.
      4. Tsuei, A., et al. Comprehensive Management of Bowel Endometriosis: Surgical Techniques, Outcomes, and Best Practices. J. Clin. Med. 2025​.
      5. Saunders, P., et al. Endometriosis: Improvements and Challenges in Diagnosis and Symptom Management. XCRM 2024​

    6. Menopause and Nutrition: How Diet Impacts Symptoms and Long-Term Health

      Menopause and Nutrition: How Menopause Affects Nutritional Needs

      As estrogen levels decline, the body undergoes changes that can impact health in several ways:

      • Bone Density Loss – Estrogen helps keep bones strong. After menopause, women are at a higher risk of osteoporosis.
      • Increased Risk of Heart Disease – Lower estrogen levels can raise cholesterol and increase cardiovascular risk.
      • Slower Metabolism – Weight gain is more common due to changes in how the body processes food.
      • Changes in Insulin Sensitivity – Menopause can affect the way the body handles blood sugar, increasing the risk of insulin resistance and type 2 diabetes.
      • Digestive Changes – Some women experience bloating, slower digestion, and difficulty absorbing nutrients like calcium and magnesium.

      Menopause and Nutrition: Understanding Insulin Resistance and Insulin Sensitivity

      What Is Insulin and Why Is It Important?

      Insulin is a hormone made by the pancreas that helps move sugar (glucose) from the blood into the body’s cells, where it is used for energy. This process helps keep blood sugar levels stable.

      What Is Insulin Sensitivity?

      When someone has good insulin sensitivity, their body needs only a small amount of insulin to lower blood sugar effectively. This means their cells respond well to insulin, keeping blood sugar levels balanced and reducing the risk of diabetes.

      What Is Insulin Resistance?

      Insulin resistance happens when the body’s cells stop responding properly to insulin. As a result, the pancreas makes more insulin to try to compensate. Over time, this leads to high insulin levels, which can cause:

      • Increased belly fat
      • Higher blood sugar levels
      • Higher cholesterol and triglycerides
      • A greater risk of developing type 2 diabetes

      Menopause increases the risk of insulin resistance due to hormonal changes, making nutrition and exercise essential for maintaining insulin sensitivity.

      Menopause and Nutrition: Key Nutrients for Menopausal Women

      1. Calcium and Vitamin D: Protecting Bone Health

      Since menopause increases the risk of osteoporosis, calcium and vitamin D are essential for maintaining strong bones.

      Best Sources of Calcium:

      • Dairy products (milk, yogurt, cheese)
      • Leafy greens (kale, spinach, collard greens)
      • Fortified plant-based milks (almond, soy, oat)
      • Sardines and salmon with bones

      Best Sources of Vitamin D:

      • Sunlight exposure (15–30 minutes per day)
      • Fatty fish (salmon, mackerel, tuna)
      • Egg yolks
      • Fortified dairy and plant-based milk

      2. Protein: Preventing Muscle Loss and Improving Insulin Sensitivity

      Loss of muscle mass is common after menopause, making protein intake crucial for maintaining muscle strength and metabolic health.

      Best Protein Sources:

      • Lean meats (chicken, turkey)
      • Fatty fish (salmon, sardines)
      • Plant-based proteins (lentils, beans, tofu, tempeh)
      • Greek yogurt and cottage cheese

      3. Omega-3 Fatty Acids: Supporting Heart and Brain Health

      Omega-3s reduce inflammation, support brain function, and improve insulin sensitivity.

      Best Sources of Omega-3s:

      • Fatty fish (salmon, trout, mackerel)
      • Flaxseeds and chia seeds
      • Walnuts
      • Algae-based supplements

      4. Fiber: Helping Blood Sugar Control and Digestion

      Fiber slows down how quickly sugar enters the bloodstream, preventing blood sugar spikes and supporting gut health.

      Best Fiber Sources:

      • Whole grains (oats, quinoa, brown rice)
      • Vegetables (broccoli, carrots, Brussels sprouts)
      • Fruits (apples, pears, berries)
      • Legumes (beans, chickpeas, lentils)

      5. Magnesium: Reducing Stress and Supporting Sleep

      Magnesium helps regulate insulin, improve sleep, and reduce anxiety.

      Best Sources of Magnesium:

      • Nuts (almonds, cashews, walnuts)
      • Seeds (pumpkin, sunflower)
      • Dark leafy greens (spinach, kale)
      • Dark chocolate (85% cacao or higher)

      Menopause and Nutrition: Foods to Avoid or Limit

      Certain foods can worsen menopausal symptoms and increase the risk of insulin resistance, weight gain, and heart disease.

      • Refined Carbohydrates and Added Sugars – These cause blood sugar spikes and increase belly fat.
      • Alcohol – Can worsen hot flashes, affect sleep, and increase the risk of osteoporosis.
      • Caffeine – May contribute to anxiety, disrupt sleep, and trigger hot flashes.
      • Processed and Fried Foods – High in trans fats and inflammatory oils that raise cholesterol.
      • High-Sodium Foods – Excess salt can contribute to high blood pressure and fluid retention.

      The Mediterranean Diet: A Perfect Fit for Menopausal Women

      The Mediterranean diet is one of the best eating patterns for menopause because it reduces inflammation, supports heart health, and improves insulin sensitivity.

      This diet includes:

      • Healthy Fats (olive oil, nuts, seeds)
      • Lean Proteins (fish, poultry, legumes)
      • High Fiber (whole grains, vegetables, fruits)
      • Antioxidant-Rich Foods (berries, dark leafy greens, nuts)  

      Women following this diet have been shown to experience fewer hot flashes, better weight control, and improved metabolic health (Jannas-Vela et al., 2023).

      Supplements for Menopause

      In some cases, supplementation may be needed:

      • Calcium (1,200 mg/day) – If dietary intake is insufficient
      • Vitamin D (800-1,000 IU/day) – Essential for bone health
      • Magnesium (300-400 mg/day) – Helps with sleep and stress
      • B Vitamins – Support energy metabolism and brain function
      • Omega-3 Supplements – Improve cardiovascular and insulin health

      Menopause and Nutrition: Conclusion 

      Nutrition plays a key role in managing menopause symptoms and preventing long-term health risks such as osteoporosis, heart disease, and insulin resistance.

      By focusing on nutrient-dense foods, avoiding processed sugars and unhealthy fats, and staying hydrated, women can navigate menopause with better energy, weight control, and overall well-being.

      Combining a healthy diet with regular exercise and stress management can significantly improve quality of life during and after menopause.

      “Now that you know about menopause and nutrition, can you explain it to someone else? Share this post and help us spread the word!”

      References

    7. What Happens If You Get Pregnant with an IUD?

      How Does Pregnancy with an IUD Happen?

      Pregnant woman with an intrauterine device (IUD) illustration, symbolizing pregnancy with an IUD

      Even though IUDs are over 99% effective, a small percentage of people can still become pregnant. The main reasons for this include:

      1. IUD Expulsion: Sometimes, the IUD can be pushed out of the uterus without the person realizing it. This leaves them unprotected against pregnancy.
      2. Incorrect Placement: If the IUD is not properly inserted, it may not work as intended.
      3. Failure to Prevent Fertilization: Though rare, sperm may still fertilize an egg despite the presence of an IUD.
      4. Conception Before Insertion: If a person is already pregnant when the IUD is placed, it won’t prevent that pregnancy from continuing.
      5. Perforation: In extremely rare cases, the IUD can perforate the uterine wall and move outside the uterus, making it ineffective.

      Types of Pregnancy with an IUD

      There are two main types of pregnancy that can occur with an IUD:

      1. Intrauterine Pregnancy (Pregnancy in the Uterus)

      • In some cases, the fertilized egg successfully implants in the uterus despite the IUD.
      • Doctors may attempt to remove the IUD early in pregnancy if the strings are visible. If the IUD remains in place, the risk of complications such as miscarriage (50%+), infection, and preterm birth increases.
      • If removal is not possible, close monitoring throughout pregnancy is necessary.

      2. Ectopic Pregnancy (Pregnancy Outside the Uterus)

      • The biggest concern with an IUD pregnancy is an ectopic pregnancy, where the fertilized egg implants outside the uterus, usually in a fallopian tube.
      • Ectopic pregnancies can be life-threatening and require immediate medical attention.
      • Symptoms of an ectopic pregnancy include severe pelvic pain, vaginal bleeding, dizziness, and shoulder pain.

      Symptoms of Pregnancy with an IUD

      If you have an IUD and suspect you might be pregnant, watch for these symptoms:

      • Missed period (if your cycles are usually regular).
      • Light spotting or abnormal bleeding (this can be a sign of ectopic pregnancy).
      • Lower abdominal pain or cramping.
      • Breast tenderness, nausea, or other common pregnancy symptoms.
      • A positive pregnancy test.

      If you experience sharp pain, dizziness, or heavy bleeding, seek medical attention immediately, as these could be signs of an ectopic pregnancy.

      What to Do If You Get Pregnant with an IUD

      1. Take a Pregnancy Test: If you suspect pregnancy, test as soon as possible.
      2. See a Doctor Immediately: An ultrasound will confirm if the pregnancy is inside the uterus or ectopic.
      3. Discuss IUD Removal: If the pregnancy with an IUD is intrauterine and the IUD strings are accessible, removal is often recommended to reduce risks.
      4. Monitor for Complications: If the IUD cannot be removed, frequent medical monitoring will be necessary to ensure a safe pregnancy.

      Risks of Pregnancy with an IUD

      • Miscarriage – If the IUD remains in place, miscarriage risk is 50% or higher.
      • Ectopic Pregnancy – About 1 in 2 pregnancies with an IUD are ectopic.
      • Preterm Birth – Increased risk of early labor and low birth weight.
      • Infections – Higher risk of a serious uterine infection (chorioamnionitis).

      Can You Have a Healthy Pregnancy with an IUD?

      Yes, it is possible to have a healthy pregnancy with an IUD, but the risks are higher than normal pregnancies. If the IUD can be removed safely, the chances of carrying a healthy baby improve significantly.

      If the IUD remains in place, careful monitoring is required to reduce complications. Some women have delivered healthy babies despite an IUD, but they need frequent check-ups to ensure everything is progressing safely.

      Pregnancy with an IUD : Final Thoughts

      Getting pregnant with an IUD is rare, but it requires immediate medical attention. If you suspect pregnancy, take a test and consult a doctor to confirm its location. The main risks are miscarriage, infection, and ectopic pregnancy, but with proper medical care, a healthy pregnancy is possible.

      References

      1. American College of Obstetricians and Gynecologists (ACOG). “Long-Acting Reversible Contraception (LARC): IUDs and Implants.” 2023.
      2. Centers for Disease Control and Prevention (CDC). “Effectiveness of Birth Control Methods.” Updated 2023.
      3. Allen, R. H., & Goldberg, A. B. (2022). “Pregnancy Outcomes with Intrauterine Devices in Place: Risks and Management.” Obstetrics & Gynecology Journal.
      4. Lippincott Williams & Wilkins (2021). Management of Contraceptive Failures. In: Berek & Novak’s Gynecology, 16th Edition.