Dr Rashi Kalra

🗓 September is here, and with it comes an important opportunity to raise awareness about Polycystic O***y Syndrome (PCOS) 🥚 ​​​​​​​​​​​​​​​​​​🤔 Did you know that PCOS affects 1 in 10 women globally? Despite its prevalence, it remains one of the most misunderstood and under-diagnosed conditions 🩺 This month, let’s come together to change that 🌟

🧬 What is PCOS?
📍PCOS is a condition that is often characterised by:
🩸 irregular periods
📈 hormonal imbalances
🥚 ovarian cysts
🧬 extra body hair
⚖️ weight gain
👶 infertility

💡 Awareness and increased education for PCOS is needed, so that we can have:
📍earlier diagnosis
📍community support
📍advancing research

🤔 So, how can you make a difference? Try educating yourself and learning more about the condition, share your knowledge with others around you, and engage in discussions to learn from others’ experiences 💬

📚 By sharing your story or simply learning more, you help to break the silence surrounding PCOS and support those who are affected 💪 Let’s work together to ensure that every woman with PCOS feels seen, heard, and empowered 💜 For more resources and support, get in touch with me ☎️

😰 In today’s fast-paced world, stress has become a common part of our lives, but can it really impact your fertility? 🤔 Let’s explore the connection between stress and reproductive health 👇​​​​​​​​​​​​​​​​​​😣 Stress can impact your fertility in a number of different ways:
⚖️ chronic stress can cause an imbalance in hormones like cortisol and adrenaline, which can disrupt the normal regulation of reproductive hormones such as estrogen and progesterone
🩸high stress levels can lead to irregular or missed periods, affecting ovulation and making it more challenging to conceive
🧬 stress may also impact male fertility by affecting s***m production and quality, potentially leading to lower s***m counts and reduced motility
💕 stress can diminish libido and affect the frequency and quality of s*xual activity, further influencing fertility

👶 While stress alone is unlikely to be the sole cause of infertility, it can certainly contribute to existing fertility issues or exacerbate challenges 🩺 Addressing stress is an essential part of a comprehensive approach to reproductive health 😌 That’s why it’s important to stay as calm as possible, and engage in stress reduction practices like:
🧘‍♀️ yoga
😌 mindful meditation
🏃‍♀️ exercise
🥦 healthy eating

🤔 Wondering how your reproductive health is faring? Get in touch with me and we can find out ☎️

🩺 The disappointment following unsuccessful IVF can make you feel hopeless, and it can be difficult to find the energy to try again 😔 However, the next cycle could be the one that makes your family dreams come true, so keep going 💪​​​​​​​​​ ​​​​​​​​​☎️ Give me a call if you need some help on your fertility journey 👶

🧬 Human papillomavirus (HPV) has been thought to be of most danger to people with female reproductive organs because HPV is the leading cause of cervical cancer 🦠 HPV is a s*xually transmitted disease that is passed from person to person via skin-to-skin contact 💕 It has been previously assumed that HPV does not pose a risk to male health, but new research may change the way we think about this disease 👇​​​​​​​​​​​​​​​​​​🔬 Olivera et al. (2024) found that high-risk strains of HPV are linked to lower levels of immune cells in the male ge***al tract, which may lead to a higher risk for other infections that could cause infertility 👶

🦠 While HPV doesn’t pose as significant a risk in males as it does in females, there still may be consequences to health 🩺 If you’re worried that there may be underlying infections causing your difficulty to conceive, then get in touch with me so we can get to the bottom of it ☎️

🧬 For decades, scientists have been interested in ways to extend the time in which women can become pregnant 👶 Given that age-related fertility decline is one of the major causes of infertility, the quest for ways to extend female fertility has been important 🩺 Could the answer lie in a drug commonly used for assisting organ transplants? Let’s take a look 👇​​​​​​​​​​​​​​​​​​💊 Rapamycin is a drug commonly used to prevent organ transplants from failing 🧬 However, recent research has shown that it may have a preservation effect on female fertility 🥚 Rapamycin works by inhibiting the action of mTOR - a key regulator in cell metabolism and growth 🔬 Dou et al. (2017) demonstrated that rapamycin can improve egg quality, the ovarian environment, and preservation of egg follicles in female mice 📈 Furthermore, Garcia et al. (2019) found that rapamycin offset menopause and ovarian ageing in mice ⏰

📍These results suggest that rapamycin may be effective at boosting fertility and delaying age-related fertility decline 🎂 However, human studies have not been conducted yet, so we’ll have to wait and see if this treatment will become available 🤔

🩺 Interested in learning more about fertility preservation? Get in touch with me today ☎️

🩺 When my patients are thinking about fertility preservation, I often get asked “what’s best, embryo or egg freezing?” 🤔 Let’s take a look 👇​​​​​​​​​​​​​​​​​​❄️ Freezing embryos involves taking the eggs and s***m of a couple, creating one or multiple fertilised embryos, and storing them for up to 5 years 🗓 The chances of a successful live birth occurring from a frozen embryo are quite high, sitting at around 44% for women aged 30-34, and 52% for women aged 35-39 📈 However, be mindful of any legal consequences of freezing an embryo with your partner, in case you break up in the future 💔

🥚 Egg freezing is more common, as it allows women to preserve their fertility before they meet a potential co-parent or partner 🧬 It involves extracting mature eggs and storing them for more than 10 years in some cases 🗓 The chances of achieving a live birth are pretty good 👶 An egg has a 70% chance of developing into live birth if the eggs were frozen before 35 years of age ❄️ However, after 35, the success rates drop 📉

🤔 Curious about which option is right for you? Get in touch with me and we can chat ☎️

🗓 Happy Women’s Health Week! This is a great chance to check in with your health and assess what you could do to improve your internal well-being 🧬 Here are some small actions that can lead to significant improvements in overall health, including fertility 👇​​​​​​​​​​​​​​​​​​🍷 Limit alcohol consumption, and have no more than 10 drinks a week
🥦 Create a ‘rainbow’ on your plate, and try to incorporate foods of various different colours in your meals
💤 Aim for 7-8 hours of sleep a night
🏃‍♀️ Try to move your body for 30 minutes each day
🧘‍♀️ Engage in stress-reduction practices, which might look like yoga, mindfulness, or self-care

👶 Curious about what else you can do to boost your reproductive health? I’m always happy to share some tips ☎️

🗓 With World Sexual Health Day falling in the middle of Women’s Health Week, let’s take a look at what you can do to protect yourself from s*xually transmitted infections 🦠​​​​​​​​​​​​​​​​​​💕 When practising safe s*x:
📍always use a form of protection, such as condoms or dental dams 🍆
📍yes, even during a**l or oral s*x!
📍wash your s*x toys before and after use 🧼
📍get tested for infections after every new s*xual partner 🩺
📍if you have a regular, monogamous s*xual partner, it’s still important to get checked regularly 🗓
📍treat any infection you have immediately 💊
📍inform your s*xual partners of any infection you have 💬

💡 Remember that leaving s*xually transmitted infections untreated can have serious impacts on your health, including your fertility 👶 Make an appointment to see your GP or a gynaecologist like me if you’re worried about your s*xual health ☎️

🗓 September is Gynecological Cancer Awareness Month 💡 In 2022, an estimated 2,111 Australian females died from gynaecological cancers 🧬 So, here are some tips on how to reduce your risk👇​​​​​​​​​​​​​​​​​​🗓 Get regular cervical screenings if you’re older than 25
💉 Protect yourself from HPV by getting vaccinated if you aren’t already, and always use condoms during s*x
🚬 Quit smoking
🥦 Eat a healthy, well-balanced diet consisting of fruit, vegetables, whole grains, and lean proteins
🩺 See your doctor when you experience abnormal symptoms, such as irregular vaginal bleeding, pelvic pain, or bloating
💬 Ensure to share your family medical history with your doctor

💡 Remember that early detection is key, so it’s important to monitor your health and have regular appointments with your doctor 🩺 If you have any abnormal symptoms or just want to discuss your gynaecological health with an expert, then get in touch with me ☎️

A day spent at HealthEd informing GPs about the RWH and the public fertility service, making fertility services accessible and affordable.

🗓 Father’s Day can mean different things to different people 💔 For some, the 1st of September 2024 is:​​​​​​​​​❣️another Father’s Day spent wanting to be a dad​​​​​​​​​❣️the first Father’s Day after losing a child
❣️the first Father’s Day after losing a parent
❣️a day of grief for children lost via miscarriage
❣️the first Father’s Day after learning they might not be able to become a dad

🤍 This Father’s Day, reach out to those in your life who may not feel like celebrating, and remind them that you’re always there for support 🌻

Catching up with my new neighbours at ,
Thrilled to be part of a group of doctors that have all gone through rigorous formal postgraduate training in the area of fertility and ivf at the esteemed Reproductive Services Unit

I am a CREI, certified reproductive endocrinologist and infertility specialist. Less than 2% of specialists have this qualification. It allows me to expertly manage a full range of infertility, recurrent miscarriage, genetic and fertility preservation issues.

🩺 Estrogen is a hormone that plays a crucial role in many aspects of health, including fertility, heart and blood vessel functioning, and bone health 🦴 Decreased estrogen is often seen in menopause, but it can also occur at other times in life or as a side effect of other conditions 🧬​​​​​​​​​​​​​​​​​​📉 Symptoms of low estrogen levels include:
📍dry and itchy skin
📍hot flashes
📍decreased bone density
📍fatigue
📍vaginal dryness
📍mood swings
📍anxiety and depression
📍headaches and migraines
📍infertility

🥬 Luckily, low estrogen levels can sometimes be managed through diet, weight loss, moderate exercise, stress reduction, or getting enough sleep 😴 In more severe cases, hormone replacement therapy may be the best treatment option 💊

🩺 Worried that low estrogen is the underlying cause of health-related symptoms? Get in touch with me - I’m always here to help ☎️

🔬 Recently, scientists conducted a study to see if a woman’s fertility really impacted the pheromones in her body odour 🤔 It’s been previously believed that finding someone’s smell s*xually attractive might reflect how fertile they are 👶 However, the researchers at the University of Leipzig found no evidence to suggest that a woman’s fertility can be detected via her body odour 👃 They determined this by asking men to rate women’s body odour on different days, and also tested the chemical composition of the body odour samples 🧬​​​​​​​​​​​​​​​​​​💡 Are you surprised by these findings? While it may not be fertility, it’s possible that there are other reasons for finding someone’s scent s*xually appealing 💕

💭 It’s a common misconception that, to increase chances of pregnancy, you must have s*x multiple times a day during your fertile window 💕 However, it’s unlikely to increase your chances of pregnancy, as each subsequent ej*******on will contain fewer and fewer s***m cells 🧬 Having s*x once a day or every other day in your fertile window is optimal, and can help preserve your sanity too 🥴 ​​​​​​​​​​​​​​​​​​❣️ Avoiding s*x during the weeks between trying for a baby and taking a pregnancy test is also not necessary, and won’t harm your chances of success 👶

🤔 Have other questions about trying to get pregnant? I’m always happy to chat ☎️

In celebration of National Fertility Awareness Week, let’s look at how the definition of infertility is changing​​​​​​​​​​​​​​​​​​🗓 This 19th-25th August is National Fertility Awareness Week 👶 This week comes at the perfect time, as fertility specialists in Australia and New Zealand have recently been looking to improve the definition of infertility 🧬 Let’s take a look 👇

🩺 Currently, medical infertility is diagnosed when a couple is unable to conceive a natural pregnancy after 12 months of unprotected s*x 👶 However, this definition is limiting, particularly for same-s*x couples and those wanting to solo-parent 🏳️‍🌈

🩺 At the 2024 ANZSREI conference, specialists and board members campaigned to expand “infertility” to include “the inability to achieve a successful pregnancy based on a patient’s:
📍medical, s*xual, and reproductive history
📍age
📍physical findings
📍diagnostic testing
📍or any combination of these factors”

👏 This is a huge win for the field of fertility treatment, and for those that are unable to access services based on the current definition of infertility 👶

🩺 Curious about getting some advice about your fertility? Get in touch with me today ☎️

👶 If you’ve started to think about having a baby, you might be wondering where to get started 🤔 Here are my top tips to help begin your journey 👇​​​​​​​​​​​​​​​​​​⏰ Timing is one of the most important factors when wanting to get pregnant 🗓 Start to track your cycles and ovulation, to get an idea of when your fertile window occurs 🧬

🎂 Age can impact fertility, particularly the number of eggs you have left (known as your ovarian reserve) 🥚 When wanting to get pregnant, it’s a good idea to check on your levels of AMH, which can tell you information about your ovarian reserve 🩺

🥬 Good nutrition is essential when pregnant, but eating well and exercising before trying to conceive can give you the best chance of success 🥕Starting prenatal vitamins early is also a good idea, to ensure your body is prepared to support a pregnancy 💊

🚬 Smoking and drinking alcohol can increase the time it takes to get pregnant, and may negatively impact your overall fertility and health 🍷 Quitting these habits now will ensure you have the best chances of conceiving 📈

🩺 Now’s the time to complete all the health checks you’ve been putting off: cervical screenings, STI tests, gynaecological check-ups, and general health assessments 🔬 Doing these tests now will put your mind at ease, or alert you to any issues that might be present so you can seek treatment before conceiving 🧬

🆘 It’s also important to seek help if you’ve been trying to conceive for more than 12 months 🗓 Getting in touch with a fertility specialist like me can help you uncover any issues that might be standing in your way ☎️

💻 While the possibilities of AI can be scary to think about, its utility in medical diagnosis is looking very promising 💡 A recent study has shown that an AI model was about 74% accurate in detecting male infertility risk from blood samples (Kobayashi et al., 2024) 🩸 While not 100% accurate, this model could aid doctors in detecting fertility problems without a semen a**lysis 🩺​​​​​​​​​​​​​​​​​​🔬 We’ll likely see further development in this field, with AI models soon becoming available to aid in healthcare 🧬 Until then, don’t delay diagnosis or treatment if you’re worried about your fertility - get in touch with me today ☎️

💊 Deciding to stop taking the pill and start trying for a baby can be so exciting, but it’s important to keep a few things in mind 🤔 When you cease taking hormonal birth control, your cycle can be a bit inconsistent for a few months before returning to its natural rhythm 🗓 Therefore, it can be hard to predict when you might be most fertile during this time, and you might want to wait until your menstrual cycle returns to normal before trying for a baby 👶 In reality though, if you have ceased taking hormonal contraception like the pill, the hormones leave your system after about 24-48 hours 🧬​​​​​​​​​​​​​​​​​​🥚 Normal ovulation will likely return within 6 months of going off the pill, but the exact time varies person-to-person ⏰ It is possible for someone to get pregnant soon after ceasing hormonal birth control, without having had a period in the meantime 🩸 Luckily, there is no danger in getting pregnant immediately after ceasing birth control, so you may like to start trying straight away 🩺

👶 If you don’t fall pregnant within 6 months of going off the pill, this likely isn’t cause for concern 🤔 It’s possible that ovulation hasn’t returned to normal yet, so infertility may not be a factor 🔬 However, if you have been trying for more than 12-18 months after going off the pill, you may like to think about getting some help from a fertility specialist like me ☎️

🎉 Finding time to celebrate your pregnancy is important, especially if you’ve faced fertility issues 👶 However, you may find yourself beginning to think ahead and worry about what comes next 😬 Here are some tips to help you start planning for the next 9 months and beyond:​​​​​​​​​🩺 start thinking about obstetricians and midwives to include in your pregnancy dream team ​​​​​​​​​🗓 schedule your first prenatal appointment as soon as possible
🥬 focus on diet and look into pregnancy supplements that include folate
📱 do some research to find healthy ways to exercise during pregnancy (horse riding and high-altitude sports should be avoided, amongst others)
🍷 limit alcohol and other harmful substances

😁 And of course, take some time to enjoy the exhilaration and excitement 🥳

🔬 Australian researchers have discovered that the DNA in saliva samples could be used to predict your likelihood of having twins or fertility issues (Mbarek et al., 2023) 👶 The research has shown that mothers of non-identical twins share similar genetic patterns 🧬 The DNA available in saliva samples can also be linked to female reproductive factors, like ovarian insufficiency and the follicle-stimulating hormone (FSH) pathway 🩺 This means that saliva samples could provide valuable insight into infertility, and could improve the testing process 🧪​​​​​​​​​​​​​​​​​​🩺 While fertility testing via saliva samples is not yet available, hopefully, we’ll see these methods become accessible soon 🗓 In the meantime, get in touch with me if you need some help understanding your reproductive health ☎️

🦷 This week is National Dental Health Week 🗓 While oral hygiene is important if you want healthy teeth and a bright smile, it also seems to be linked to fertility 👶 Research from Khanna et al. (2017) suggests that poor dental hygiene is associated with more difficulty conceiving 😔 Furthermore, there seems to be an association between poor dental health and s***m quality 🧬 ​​​​​​​​​​​​​​​​​​🦠 This link may be due to the bacteria that is caused by poor oral hygiene - evidence suggests that this bacteria can travel to other parts of the body and cause inflammation 🩺

🦷 If you’re hoping to conceive but are having some trouble, a trip to the dentist or a fertility specialist like me might be a good starting point ☎️

🩺 The average age for women beginning fertility treatment has been slowly increasing over the last 20 years 📈 In 2000, the average age was 33 🎂 Compared to 2022, the average age has increased by more than 2 years, coming in at just over 35 🗓​​​​​​​​​​​​​​​​​​🤔 There are a few reasons as to why this increase might have occurred, including delays in treatment due to COVID-19 or changes in attitudes towards having children 👶 However, if you know you want kids, it’s best not to delay treatment 🔬 Get in touch with me if you’re worried about how age might impact your fertility ☎️

💔 Experiencing infertility can be extremely hard, and it’s common for people going through infertility to feel isolated and lonely 😔 It can be especially difficult to talk to friends and family about what you’re feeling, as they may not have experienced infertility themselves 👶 Here are some common things that infertile couples wish their friends and family knew:​​​​​​​​​🩺 IVF isn’t a guarantee for a baby​​​​​​​​​👍 Advice to ‘stay positive’ is not helpful
🧠 How hard infertility is mentally
💵 Affording to socialise is not always possible due to the cost of treatment
😌 ‘Relaxing’ won’t make it happen
💕 Pregnancy announcements can be difficult, but that infertile couples can also feel happy for their friends

🤔 What do you want your friends and family to know about infertility? Let me know in the comments 👇

👋 I’m thrilled to introduce you to two wonderful members of my new Melbourne IVF team 🩺 Ella and Aimee are experienced and registered nurses who are here to support you through your treatment 💕 Having an amazing fertility team on your side is crucial, so make an appointment with me to experience the excellent care and skill my team offers ☎️

👶 When we think of fertility, we often attribute our chances of getting pregnant to biology, genetics, and lifestyle 🥬 However, a recent study has suggested that social factors, such as education level and income, may play a role in assisted reproduction outcomes 🤔 Let’s take a look 👇​​​​​​​​​​​​​​​​​​📝 Novel findings presented at the ESHRE 40th Annual Meeting in Amsterdam demonstrated that social disparity may impact live birth rates 👶 The findings showed that:
🎓 Women with a PhD were over 3 times more likely to achieve a live birth after assisted reproduction, compared to women with a primary school education
💵 Women in the highest income group were twice as likely to achieve live birth as compared to those in the lowest income group
💼 Unemployed women had the lowest likelihood of success

⚖️ These socioeconomic disparities indicate that not everyone is on an equal playing field when it comes to fertility treatment and outcomes 🩺 In the future, we’ll hopefully see more health, education, and fertility services offered at a subsidy 💵 In the meantime, ensure to check what government initiatives might be in place to help boost your access to fertility services or education 📚 You can always make an appointment with me to discuss your reproductive health ☎️

📉 Recent data has shown that the Australian birth rate is at a historic low 👶 This will have implications for the economy and the future of Australian life, but what will this look like? Let’s take a look 👇​​​​​​​​​​​​​​​​​​💡 According to experts, the declining fertility rate will lead to an ageing population and an under-resourced workforce 💼 To address this, we’ll likely need:
📍integration of artificial intelligence across the workforce
📍increased migration
📍government incentives to increase birth rate
📍flexibility in workplaces for parents
📍cost of living relief
📍government climate action

👶 If you’re wanting to have a baby but don’t know where to start, then make an appointment with me ☎️

🗓 The 22nd - 28th of July is National Pain Week 😣 The goal of this campaign is to raise awareness of chronic pain, and to break down barriers faced by those who suffer from chronic pain conditions 🧬 ​​​​​​​​​​​​​​​​​​🩺 Historically, the chronic pain of women and gender-diverse people have been ignored or downplayed by medical practitioners, particularly when it comes to gynaecological conditions 🩸 Conditions like endometriosis and adenomyosis can cause debilitating pain, and they have only recently seen more attention, understanding, and funding 💵

🔬 I am proud to be a and will always endeavour to listen to and believe chronic pain sufferers 💪 If you’re concerned about your pelvic or gynaecological pain, then I’m always here to help you get to the bottom of it ☎️

👶 About 1 in 25 children born in Australia are conceived using IVF 🔬 So, how do health outcomes differ between children born by IVF and those conceived naturally?👇​​​​​​​​​​​​​​​​​​📝 A 2022 Australian study by Hart and Wijs explored the long-term outcomes for children born by IVF, and found that:
📍in adolescence, IVF-conceived children were better behaved and demonstrated less externalising behaviour traits
📍IVF-conceived children may perform better academically
📍incidences of depression were higher in IVF-conceived children, but this discrepancy dissipated by 17 years of age
📍BMI was lower in IVF-conceived females compared to those naturally-conceived

🩺 These findings seem to suggest some positive health and behavioural outcomes for children conceived via IVF 🧬 If you’re considering pursuing IVF, then these findings may help to put your mind at ease when thinking about the long-term outcomes for your children 🗓 Get in touch with me today if you want to start your IVF journey ☎️