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.

Egg freezing, once perceived as a concept limited to celebrities or affluent urban populations, is gradually becoming an important part of reproductive planning among Indian women, according to fertility experts.

Dr. Tarang Yadav, Senior Consultant - IVF, Obstetrics and Gynecology, ShardaCare–Healthcity, told HealthandMe that India is witnessing a gradual shift in conversations surrounding reproductive health, with more women seeking fertility consultations proactively rather than after experiencing difficulty conceiving. As per the expert, this trend is particularly visible in metropolitan and tier-2 cities.

The reason? Increasing awareness regarding fertility, delayed parenthood, evolving lifestyles, and advancements in reproductive medicine have contributed to growing interest in fertility preservation across different age groups and professional backgrounds.

"Today, more women are prioritizing education, career growth, financial stability, and personal readiness before planning pregnancy," Dr. Tarang said.

According to the World Health Organization, around 17.5 per cent of the adult population globally, nearly 1 in 6 people, experience infertility at some point in their lives, highlighting the growing need for accessible fertility care and awareness.

Also read: High Prolactin Levels Behind 40% Surge In Female Infertility Cases, Warn Doctors

What Is Egg Freezing?

Dr. Tarang explained that egg freezing, medically known as oocyte cryopreservation, allows women to preserve healthier eggs at a younger reproductive age, potentially improving future reproductive opportunities. While it does not guarantee pregnancy later in life, it offers an additional reproductive option for women who may wish to delay childbearing for personal, social, or medical reasons.

According to current international fertility preservation guidelines, planned oocyte cryopreservation can be considered in appropriately counselled women, particularly when undertaken at a younger age and after proper fertility assessment.

Who May Benefit From Egg Freezing?

Dr. Tarang noted that egg freezing is increasingly being considered not only for social reasons but also for several medical indications.

Women who can benefit from fertility preservation include those:

• planning a delayed pregnancy due to career or personal circumstances, who have not yet found a suitable life partner,
• cancer patients undergoing chemotherapy or radiotherapy, women with severe endometriosis, patients undergoing ovarian surgeries,
• with diminished ovarian reserve
• with a family history of premature ovarian insufficiency

"In such situations, fertility preservation can provide psychological reassurance and reproductive flexibility before ovarian function declines further," Dr. Tarang said.

Read More: India Makes Significant Progress In Maternal Care, Nutrition And Child Immunization: NFHS-6

Why Timing Matters

Although egg freezing can be considered at different ages depending on individual ovarian reserve and reproductive goals, outcomes are generally better when eggs are frozen before the age of 35. Younger eggs tend to have better quality and chromosomal competence, which may improve future IVF outcomes.

The expert stressed the importance of early fertility counselling and ovarian reserve assessment. Tests such as Anti-Müllerian Hormone (AMH), ultrasound-based antral follicle count (AFC), and overall reproductive evaluation help determine whether a woman is an appropriate candidate for egg freezing.

Common Concerns About Egg Freezing

Addressing common concerns around the procedure, Dr. Shanujeet Kaur, Associate Director and Senior Gynecologist, Department of Fertility and Gynecology at Cloudnine Group of Hospitals, Chandigarh, told HealthandMe that some women may experience temporary mood swings due to hormonal medications used during ovarian stimulation.

Light to moderate exercise, including walking and stretching, is generally safe during treatment, though high-intensity workouts may be discouraged as the ovaries enlarge.

Current research suggests egg freezing is generally safe, with no strong evidence linking fertility medications used during the procedure to long-term health problems such as breast cancer, ovarian cancer, or infertility in most women.

Recovery after egg retrieval is typically quick, with most women able to resume normal activities within one to three days, though mild cramping, bloating, spotting, or fatigue may occur temporarily.

The expert also advised maintaining a balanced diet, staying hydrated, and following personalised medical guidance regarding birth control and lifestyle measures during treatment.

While conditions such as PCOS, thyroid disorders, and advancing age are well-known causes of infertility, doctors are increasingly flagging high prolactin levels as an overlooked contributor. The hormonal imbalance may increase a woman's risk of infertility by up to 40 per cent, experts warned.

Prolactin is a hormone produced by the pituitary gland in the brain and is primarily responsible for breast milk production after childbirth. When prolactin levels become abnormally high in women who are not pregnant or breastfeeding, it can interfere with reproductive health and make conception difficult.

Elevated prolactin levels can disrupt ovulation, cause irregular menstrual cycles, and contribute to infertility, making early diagnosis and treatment crucial.

“There is a 40 per cent surge in infertility cases linked to high prolactin levels. Nearly, in a month, 4 out of 10 women aged 25-35 presenting with irregular periods and infertility are found to have elevated prolactin levels,” Dr. Sumit Paranjpe, Gynecologist, Apollo Spectra Hospital, Mumbai, told HealthandMe.

"Excess prolactin can suppress the hormones responsible for ovulation, resulting in irregular menstrual cycles or even the absence of periods. Without regular ovulation, the chances of conception decrease significantly," he added.

Symptoms Women Should Not Ignore

According to Dr. Paranjpe, apart from infertility, women with high prolactin levels may experience:

• Irregular periods
• Milky nipple discharge despite not being pregnant or breastfeeding
• Reduced libido
• Headaches
• Emotional distress

The expert said that factors such as pituitary gland disorders, certain medications, thyroid problems, chronic stress, and hormonal imbalances can contribute to elevated prolactin levels.

Early Diagnosis Can Improve Fertility Outcomes

Dr. Paranjpe said high prolactin levels can usually be diagnosed through simple blood tests and managed effectively with appropriate treatment.

“Women should not ignore symptoms such as irregular periods, unexplained nipple discharge, or difficulty conceiving. Timely evaluation can help identify the underlying cause and restore normal ovulation. In many cases, medications can successfully lower prolactin levels, regulate menstrual cycles, and improve fertility outcomes.”

He added that maintaining a healthy lifestyle, managing stress, and undergoing regular health check-ups can help support hormonal balance.

Other Causes Of Infertility

Dr. Sneha Sathe, Clinical Director and Fertility Specialist, Nova IVF Fertility, Chembur, Mumbai, said many women continue to struggle with infertility without realizing that a hormonal imbalance may be the underlying reason.

“At times, women belonging to the age group of 25-35 seeking fertility consultations report symptoms such as irregular periods or ovulation-related issues. The most common cause of ovulatory dysfunction is PCOS (now known as PMOS). Other causes include thyroid problems, high prolactin, chronic illness, and hypothalamic issues,” she told HealthandMe.

Treatment may involve medications to induce ovulation, along with advice regarding diet and exercise in women with PCOS. In cases where an underlying condition, such as elevated prolactin or a thyroid problem, is identified, targeted treatment can help normalize hormone levels and regulate menstrual cycles.

“Early diagnosis and treatment can improve fertility outcomes and prevent unnecessary delays in family planning. Raised prolactin level is not a common isolated cause for infertility, but treating it in women identified to have high levels can help,” Dr. Sathe said.

Thyroid problems are giving a tough time to many women. Are you aware? More women planning pregnancy are now being diagnosed with borderline thyroid levels. Here, the expert sheds light on the importance of early screening and timely care for better fertility outcomes. It is imperative for women to manage their thyroid health by following the vital tips.

Thyroid issues are commonly seen in a large number of women. Currently, a large number of women who are planning pregnancy are being diagnosed with subclinical hypothyroidism.

This condition is identified when thyroid-stimulating hormone (TSH) levels are slightly high, while other thyroid hormones remain within the normal range. Although it may not cause obvious symptoms, it can still impact fertility and pregnancy outcomes if left unmanaged.

Understanding The Link Between Thyroid And Fertility

Thyroid hormones play an important role in regulating metabolism, menstrual cycles, and ovulation. Even a small amount of imbalance can interfere with the release of eggs, making it harder for women to conceive. Subclinical hypothyroidism can be detected by the expert during routine blood tests, that is, when women undergo pre-pregnancy check-ups or even fertility evaluations. The diagnosis can be surprising for women.

That is the time some women may come to know about their compromised thyroid levels. So, the causes behind the rise in borderline TSH levels are lifestyle-related factors. You will be shocked to know that stress, poor diet, lack of sleep, and sedentary habits can affect hormonal balance.

Even conditions such as Autoimmune Thyroiditis and iodine imbalance may also contribute to thyroid dysfunction. Since symptoms are usually mild or absent, many women will end up ignoring the symptoms and suffer in silence.

While subclinical hypothyroidism may not always require aggressive treatment, it becomes important when a woman is trying to conceive. As even mildly elevated TSH levels can increase the risk of irregular ovulation, early pregnancy loss, and complications during pregnancy, prompt monitoring and, in some cases, low-dose thyroid medication can be recommended by the doctor to maintain optimal hormone levels.

Women Must Follow These Tips:

• Women should opt for regular thyroid function tests before planning pregnancy to know the status of their thyroid health.
• It is necessary to consult an expert and follow a balanced diet with an adequate amount of iodine and nutrients.
• Strictly avoid junk, processed, and sugary foods, stay hydrated, quit smoking, and limit alcohol.
• It is also necessary to sleep well, exercise daily, and follow the doctor’s instructions regarding medication and follow-ups.

So, women, stay vigilant and prevent thyroid problems.

(By Dr Swati Rai, Consultant-Gynecologist and Laparoscopic Surgeon at Motherhood Hospitals, Noida.)