Eight-month-old twins from Hayward Heath, West Sussex, recently met the surgeon who saved their lives even before they were born. The BBC reports how their mother, Katerina Ahouansou, at six months pregnant, during a routine scan, uncovered a serious issue with their development and blood supply.

Doctors diagnosed the twins with twin-to-twin transfusion syndrome or TTTS. It is a condition where one twin received more blood and nourishment than the other due to uneven blood vessel distribution in the placenta. In case there is no medical intervention, it could be fatal for both the twins.

A Specialist Steps In

This is when Ahouansou was referred to Professor Kypros Nicolaides at King’s College Hospital in London. Professor Nicolaides is a pioneer in fetal medicine and he specializes in a laser procedure that redistributes blood supply between twins in cases of TTTS.

When Ahouansou was scanned, Nicolaides observed that one of the twins were significantly smaller than the other. "There was a very high chance that if we did not intervene, both twins could die," he recalled.

An Operation No Less Than A Miracle

The life-saving laser surgery was performed and within a week the doctors saw an improvement with the twin who was smaller in size. When the twins were born, they weighed 1.5kg and 1.7kg. To recognize the efforts by the surgeon, Ahouansou named them Kai Kypros and Asher Nicolas after Professor Kypros Nicolaides.

Ahouansou also expressed deep gratitude for the professor's expertise and called him "proof that miracles can be performed by people who are devotees to their profession."

Professor Kypros Nicolaides has been at King’s College Hospital since 1980 and is widely regarded as a leader in fetal medicine. His groundbreaking research and development of screening and surgical techniques have saved countless lives.

Through his dedication, Professor Nicolaides has given many families hope, demonstrating how medical advancements continue to improve survival rates for complex fetal conditions like TTTS.

More about Twin-to-twin Transfusion Syndrome

As per the John Hopkins Medicine, TTTS is a rare pregnancy condition that affects identical twins or other multiples. It happens in pregnancies where twins share one placenta and a network of blood vessels that supply oxygen and nutrients essential for development in the womb. These pregnancies are known as monochorionic.

Sometimes, the blood vessels in the placenta are unevenly distributed, causing an imbalance in blood flow between the twins. The donor twin loses more blood than it receives, leading to malnutrition and potential organ failure. Meanwhile, the recipient twin gets an excess of blood, putting strain on the heart and increasing the risk of cardiac complications.

Impact on the Donor Twin

The donor twin loses blood volume (hypovolemia), reducing kidney function and urine production. This leads to low amniotic fluid levels (oligohydramnios) or, in severe cases, a complete absence (anhydramnios). Without proper blood circulation, the donor twin faces cardiovascular issues, increasing the risk of death.

Impact on the Recipient Twin

The recipient twin experiences excess blood volume (hypervolemia), causing increased urination and excessive amniotic fluid (polyhydramnios). The overworked heart struggles to handle the surplus blood, leading to cardiovascular dysfunction, heart failure, and, in extreme cases, death.

The journey of pregnancy is a biological marathon, demanding precise nutritional orchestration to support the developing fetus while maintaining maternal physiological homeostasis. Among the pantheon of essential micronutrients, vitamin E often occupies a quieter corner compared to the high-profile roles of folic acid or iron.

However, for the expectant mother and the newborn's burgeoning health, vitamin E is a critical antioxidant, a shield against oxidative stress, and a vital participant in preventing neonatal complications such as infantile jaundice.

Understanding Vitamin E: The Fat-Soluble Guardian

Vitamin E is not a single compound but a family of eight fat-soluble antioxidants—tocopherols and tocotrienols. Because it is fat-soluble, its absorption is intrinsically linked to the presence of dietary fats and proteins in the maternal diet. During pregnancy, the body undergoes significant metabolic shifts, and vitamin E serves as a potent defender against reactive oxygen species (ROS), which can threaten both placental integrity and fetal development.

Like every nutrient, vitamin E has values for recommended dietary allowances (RDA), adequate intake (AI), tolerable upper limits (UL), and toxicity dosage (TD), so one must be cautious while self-indulging in food sources, supplements, or food formula intake. The form of vitamin E, the source, and the adequacy of intake influence the biological outcomes.

As noted by a nutritional biochemist, "Vitamin E acts as the cellular gatekeeper. By stabilizing membranes against lipid peroxidation, it ensures that the physical architecture of both maternal tissues and the developing fetal brain remains resilient under the metabolic stress of gestation."

Vitamin E And Clinical Health

Vitamin E deficiency is infrequent, with overt symptoms typically absent in healthy individuals consuming low amounts. However, premature infants weighing less than 1,500 grams may experience deficiencies, which can lead to complications unless supplemented, albeit with an increased risk of infections. Individuals with fat malabsorption disorders, such as Crohn’s disease or cystic fibrosis, are more susceptible to deficiency because vitamin E requires fat for absorption.

Symptoms of deficiency include peripheral neuropathy, ataxia, skeletal myopathy, retinopathy, and immune response impairment. Rare cases, such as abetalipoproteinemia, necessitate high doses of supplemental vitamin E for proper absorption due to severe deficiencies linked to nerve damage and retinal degeneration.

Another similar condition, Ataxia with Vitamin E Deficiency (AVED), results from a defective alpha-tocopherol transfer protein, leading to significant deficiency and associated nerve damage, requiring substantial supplemental vitamin E to avoid loss of mobility.

Excess Intake And Harmful Effects

Research indicates that consuming vitamin E through food poses no adverse effects; however, high doses of alpha-tocopherol supplements can lead to hemorrhage and disrupt blood coagulation. In vitro studies suggest that elevated doses inhibit platelet aggregation. Notably, many in the latter trial were also using aspirin, raising concerns about vitamin E's propensity to cause bleeding.

The Food and Nutrition Board (FNB) has set Upper Limits (ULs) for vitamin E due to these potential hemorrhagic effects, applicable to all supplementary forms of alpha-tocopherol, including its eight stereoisomers in synthetic vitamin E. Doses up to 1,000 mg/day (1,500 IU for natural form or 1,100 IU for synthetic) appear safe, yet the evidence primarily stems from small participant groups taking up to 3,200 mg/day only for short durations. Long-term consumption exceeding the UL increases the risk of adverse health outcomes, with ULs for infants yet to be determined.

Maternal Diet And The Synthesis Of Health

A well-rounded maternal diet is the foundation for a successful pregnancy. Because vitamin E is fat-soluble, its bioavailability is optimized when consumed alongside healthy fats and high-quality proteins. Proteins serve as the transport vehicles for these nutrients, while fats facilitate the bile-assisted absorption process in the small intestine.

Almonds As A Source Of Fat-Soluble Vitamin E

One of the most efficient and nutrient-dense ways to ensure adequate vitamin E intake during pregnancy is through the inclusion of nuts, specifically almonds. Almonds represent a "superfood" synergy: they provide a robust concentration of alpha-tocopherol (the most biologically active form of Vitamin E) nestled within a matrix of heart-healthy monounsaturated fats and plant-based proteins.

For the expectant mother, snacking on almonds provides a dual benefit. The fat content aids in the absorption of vitamin E, while the protein profile contributes to the amino acid pool necessary for fetal organogenesis. By integrating almonds into a mid-morning snack or a yogurt topping, women can achieve a steady serum level of this vital antioxidant throughout the day.

Roasted almonds are the best bet when compared to soaked almonds, as soaked almonds absorb more moisture and reduce the bioavailability of vitamin E.

Vitamin E And The Prevention Of Infantile Jaundice

Infantile jaundice, a condition characterized by the yellowish discoloration of the skin and eyes, is one of the most common clinical scenarios in neonatology. It arises from hyperbilirubinemia, where the breakdown of red blood cells results in an accumulation of bilirubin that the infant’s immature liver cannot yet efficiently process.

The link between vitamin E and jaundice is rooted in its ability to protect red blood cell membranes. During the late stages of pregnancy, vitamin E stores are transferred from the mother to the fetus. If maternal levels are insufficient, the foetal red blood cells may be more susceptible to oxidative damage. When these fragile cells break down prematurely after birth, they flood the infant’s system with excessive bilirubin.

By maintaining optimal vitamin E levels, the mother supports the structural integrity of fetal erythrocytes. While vitamin E is not a cure for all forms of neonatal jaundice, its role as a membrane protector is a fundamental preventative measure in promoting neonatal metabolic stability.

Key Nutrients For Maternal And Neonatal Support

Effective dietary planning during pregnancy requires a balance of micronutrients. An average of 15mg-20mg of vitamin E is required per day during pregnancy.

The Clinical Perspective: Why Supplements Aren't Always Enough

While the temptation to reach for a prenatal supplement is common, clinicians emphasize that whole-food sources provide superior bioavailability. The matrix of an almond contains fiber, polyphenols, and minerals, which creates a "nutritional choir" that is far more effective than isolated tocopherol supplements.

As one of the renowned obstetricians asserts, "Nutrition during pregnancy is not about isolated bullets; it is about the landscape of intake. When a mother consumes Vitamin E through nuts, seeds, and healthy oils, she is providing her baby with a complex biological support system that a synthetic pill simply cannot replicate."

Vitamin E And Drug Interactions

Mothers who are on anticoagulant and antiplatelet medications must be cautious, as they may interact with vitamin E, which can inhibit platelet aggregation and antagonize clotting factors, potentially increasing bleeding risk, particularly when intake of vitamin K is low. Additionally, vitamin E combined with antioxidants like vitamin C and niacin can blunt increases in cardioprotective HDL cholesterol when taken with simvastatin.

Dietary Strategies for the Expectant Mother

To maximize the benefits of Vitamin E, expectant mothers should consider the following dietary adjustments:

1. Prioritize Healthy Fats: Incorporate avocados, groundnut oil, ghee, and nuts into everyday meals to ensure the fat-soluble Vitamin E is absorbed by the digestive tract.

2. Combine with Protein: Pairing Vitamin E-rich foods like sunflower seeds or almonds containing protein helps maintain tissue growth, blood volume, and ensures efficient nutrient utilization.

3. Consistency Over Intensity: Because Vitamin E is stored in body fat, a consistent, moderate intake is more effective than intermittent high-dose supplementation, which may lead to toxicity.

Conclusion

The complexity of pregnancy requires a proactive approach to nutrition that extends beyond caloric intake. Vitamin E, as a guardian of cellular integrity, plays an understated yet essential role in protecting the mother from oxidative stress and safeguarding the newborn from the hematological instability that often leads to infantile jaundice.

By focusing on whole-food sources like almonds, that provided vitamin E, healthy fats and proteins are present at the table, mothers can provide their infants with the foundation of a healthy start to life. The health of the newborn is inextricably linked to the maternal diet; by choosing nutrient-dense, antioxidant-rich foods, the expectant mother is not just eating for two, but she is building the biological infrastructure for a lifetime of wellness.

(Dr. Shobha Registered Clinical Dietitian, Manager, Dept of Nutrition & Dietetics, Cloudnine Group of Hospitals)

While mothers rightly deserve recognition for their strength during childbirth, fathers' efforts and support are often overlooked.

A recent social media debate involving Belgian footballer Jeremy Doku has reignited conversations about the role of fathers during childbirth.

The Manchester City winger's decision to consider leaving the World Cup to witness the birth of his child drew widespread admiration. What followed from a French TV presenter, however, drew something very different.

France Pierron, a presenter on French sports channel L'Equipe, called childbirth "a disgusting moment, excuse me, where the dad is useless" during an appearance on the television show.

The remarks sparked widespread backlash, prompting Pierron to apologise on X, saying the comments reflected only her personal opinion.

"These remarks are solely my own and in no way reflect a collective position," she posted on X. "I understand that they may have shocked, offended, or hurt some of you, and I am sorry for that."

Doku, meanwhile, returned to his team after the birth of his son to resume playing in the FIFA World Cup 2026.

Amid the debate, HealthandMe spoke to obstetricians and gynecologists to understand the role of fathers in the delivery room.

According to the experts, fathers are far from passive observers in the delivery room. They stated that a father's support before, during and after childbirth can positively influence both the mother's experience and the family's transition into parenthood.

Preparing for Labor

Read More: Father's Day: AI Now Reading Sperm, Giving Hope of Fatherhood to Infertile Men

Dr Richa Gangwar, Senior Consultant and Director of Obstetrics and Gynaecology at Clodunine Group of Hospitals, Lucknow, said a father's role begins well before labour.

Fathers must "attend antenatal appointments and childbirth classes, understand the stages of labor, discuss the birth plan with their partner and ensure hospital essentials are ready".

Supporting Mothers During Labor

According to Dr Richa, emotional support during labor can significantly reduce a mother's anxiety.

"A calm presence, words of encouragement, holding hands, maintaining eye contact and simply being there can make a positive difference," she said.

She also recommended fathers to help with breathing exercises, gentle back massages, position changes and reminders to stay hydrated, as guided by the healthcare team.

Dr Sonamm Tiwari, Robotic and Laparoscopic Gynaecologist at Gleneagles Hospital, Parel, Mumbai, added that fathers can further ease stress by encouraging deep breathing, communicating with doctors and helping mothers remain calm and relaxed throughout labour.

Also read: Sepsis: India Joins Global Trial To Screen Newborns For Deadly Drug-Resistant Infections

Advocating For The Mother

Dr Richa said fathers can also act as advocates by communicating the mother's birth preferences, asking questions when necessary and helping her understand information shared by the medical team, while remaining flexible if the birth plan changes.

The Role Continues After Birth

The experts emphasized that a father's responsibilities do not end after delivery.

Dr Richa recommended participating in early bonding, assisting with skin-to-skin contact, supporting breastfeeding and sharing newborn care.

Read To Know: More Indian Women Turning To Egg Freezing For Future Family Planning: Know The Risks And Benefits

Dr Sonamm told HealthandMe that "fathers should also help with burping, diaper changes, bathing the baby, doctor's appointments, household responsibilities and providing emotional support to the mother during recovery".

She emphasized that "fathers should not underestimate their contribution, as their involvement helps build a strong foundation for parenthood".

As India's birth rate slips below replacement level, fertility specialists say nearly half of all conception struggles trace back to the male partner. Yet most men still wait years before getting tested.

Walk into almost any Indian fertility clinic fifteen years ago, and the pattern was the same. The couple sat down, and within minutes, the questions, the tests, and the unspoken blame had settled on the woman. The man was usually an afterthought. What has changed is the arithmetic, not attitudes. Somewhere between 40 and 50 per cent of infertility cases in India trace to a male factor, and once you add the couples where both partners contribute, a man is involved in roughly seven of every ten.

The timing has a lot to do with where the birth rate is heading. India has fallen to about 2.1 children per woman, the level at which a population just replaces itself, and several states sit below it. Between 15 and 20 per cent of couples face infertility, more of them in the cities. Against that backdrop, the thing nobody wanted to discuss, men's fertility, has finally pushed into the 2026 conversation.

The Global Decline in Sperm Counts

The figures that forced the issue are not really Indian. They are global. A large 2022 review in Human Reproduction Update pooled decades of data and found average sperm concentration had roughly halved between 1973 and 2018, a 52 per cent drop, with the curve steeper after 2000.

For years, this was filed away as a rich-world problem. It is not. The same pattern shows up across Asia, South America, and Africa, and Indian clinicians report counts falling steeply over the last thirty years.

Why Men Delay Fertility Testing

Ask why, and the list is depressingly ordinary. We sit too much, carry more weight than we used to, and live with stress, cigarettes, alcohol, and a daily soup of pollutants and hormone-disrupting chemicals. The trouble is that none of it shows on the surface. A man can feel perfectly fit and still have a problem, and one belief does real damage: that if sex works, fertility must be fine too. Sperm quality can decline long before any symptoms become apparent, and a semen analysis remains one of the simplest and most informative tests in the fertility workup. Yet couples treat it as a last resort instead of a first move.

And the waiting costs them. Clinical reviews suggest Indian men get checked three to five years after their partners do, held back by embarrassment and everything masculinity is supposed to mean. Those years are not harmless. Problems that could have been fixed quietly get worse, age creeps in, and the emotional weight keeps building.

Some of what turns up is genuinely tricky. Take azoospermia, where no sperm show up in the semen at all. It affects around one in a hundred men generally, and up to ten to fifteen per cent of infertile men. One Indian study put the share with an obstructive form, caused by a blockage, at about 21 per cent, and a blockage is often something a surgeon can fix. Even so, a difficult diagnosis is not necessarily a dead end when identified early. Microsurgical sperm retrieval and advanced sperm selection techniques have enabled fatherhood for many men who were once told they had little chance of conceiving biologically. In many cases, the greatest obstacle is not the science but the silence and stigma surrounding male fertility.

How IVF and ICSI Are Changing Outcomes

When the male factor is severe, IVF has redrawn what counts as possible. The world ran around 200,000 cycles in 2000 and now runs well over three million a year, with India one of the fastest-growing markets anywhere, heading toward 400,000 cycles by 2030, and much of that demand coming from smaller towns.

The real game-changer is ICSI, where a single good sperm is placed straight into the egg. For a man with azoospermia, even a few sperm retrieved surgically can be enough. However, the benefits of these advances are significantly reduced when diagnosis is delayed for years.

New Tools Are Improving Male Fertility Diagnosis

The tools for finding the problem have sharpened, too. Beyond the basic count, clinics now run tests like the DNA Fragmentation Index, which checks the genetic integrity of the sperm and can explain failures that otherwise make no sense. Genetic screening picks up causes that used to slip by, and AI is making semen analysis more consistent and helping grade embryos in the lab.

Underneath the technology sits a slower shift doctors say matters most. Instead of testing the woman first and getting to the man later, both partners are increasingly looked at together from day one. That spares women invasive tests they never needed and catches male problems before years are wasted. Fertility is a shared responsibility, and so is the process of identifying the underlying cause when conception does not occur. Assess both people at once, kindly and without blame, and the answers come faster.

Why Early Testing Matters

So, the message reaching Indian men now is simple, and it is losing its edge of shame. Your reproductive health is just your health. A test taken early, with no embarrassment attached, may be the most important thing a couple ever does on the way to having a child.

PS: This article is intended for general awareness and educational purposes and does not constitute medical advice. Individuals experiencing fertility concerns should consult a qualified specialist for personalized evaluation and guidance.