The Express Tribune hi five - November 23

Ms NOVEMBER 23, 2014

ISSUE NO. 127

An alternate approach to tackling infertility

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A Floral Affair page

inside lifestyle —

Jewellery must-haves for the winter season

domestic goddess —

Tantalise your tastebuds with Namkeen Gosht

Section In-Charge: Sarah Munir Sub-Editors: Amna Hashmi Nisma Chauhan Feedback: women@tribune.com.pk

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The mesmerising Urwa Hocane

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the buzz

THE EXPRESS TRIBUNE, NOVEMBER 23, 2014

By Razya Siddiqui Design by Mohsin Alam

Can a fertility treatment improve your chances of having a baby?

Imagine longing for exhausting, sleepless nights with cranky babies, milk bottles and soiled diapers. Picture yourself praying to be blessed with a child of your own, despite hearing your peers complain about the trials of motherhood regularly. Worst still, imagine waiting to be blessed with the good news, only to be told that you can never conceive due to inexplicable reasons.

This was precisely how British homemaker Lesley Brown had felt for a long time before she met Professor Robert Edwards and Dr Patrick Steptoe in 1976. They combined their research and pioneered what is now a go-to treatment for infertility in women, commonly known as In-Vitro Fertilisation (IVF). Lesley became the first woman to undergo a successful pregnancy initiated by the process, giving birth to a beautiful baby girl on July 25th, 1978.

Together, the trio revolutionised human reproduction forever and made not just Lesley’s but countless other women’s dreams of motherhood a reality. Since then, nearly four million babies have been born through IVF and considering the on-going medical advancements, the number is only expected to rise.

According to the American National Institute of Child Health and Developement, IVF is just one of the various infertility treatments in the Assisted Reproductive Technologies (ART) category.

Treatment options include various medical, surgical and hormonal treatments to enable pregnancy in infertile couples who have been trying to conceive for over a year or more. Any one of the ART treatments may be considered — depending on each couple’s specific problems — but IVF remains most commonly sought-after, often administered alongside male fertility treatments.

In a nutshell, the process involves withdrawing sperms and eggs from the man and woman and incubating them in a Petri dish with hopes to produce an embryo. The fertilised egg will then be inserted back into the woman’s uterus for pregnancy. The entire treatment can be summarised into four broad stages: 1. The patient is given hormone injections (fertility drugs) which

mimic hormones that occur naturally in the female body, such as follicle-stimulating hormones (FSH) and the luteinizing hormone (LH). She is also monitored regularly via ultrasounds to gauge the best time for egg retrieval. This is generally when the egg releases from the follicle and travels to the ovaries.

2. Once the timing is determined, the eggs are given a hormonal drug called Human chorionic gonadotropin (HCG) to help ripen the egg for fertilisation. The egg is then located and retrieved using a hollow needle.

3. If the male sperm count is low, doctors may inject the sperm directly into the egg as opposed to allowing it to find its own way.

4. The fertilised embryo is then set aside to incubate in a Petri dish for about five days, until it becomes ready for implantation. It is then inserted back into the uterus using a catheter. Some medical facilities also offer the option of freezing unused embryos and storing them for later implantation.

The single, biggest risk of any fertility treatment — IVF included — is that of multiple births. According to the Human Fertilisation and Embryology Authority (HFEA) in the UK, IVF often causes Ovarian Hyperstimulation Syndrome wherein the patient produces more than one egg, resulting in twins, triplets and so on. According to Dr Sethna, Consultant of Obstetrics and Gynaecology at Concept Fertility Clinic and Lady Dufferin Hospital in Karachi, “Some countries like the UK restrict the number of eggs replanted using controlled drug dosage and monitoring.”

Others like the US and Pakistan have incorporated no such practice yet.

For most patients, however, the actual procedure of egg retrieval, impregnation and implantation is less debilitating that the emotional roller coaster of being unable to conceive and trying to make it happen. “People taunted me about how many doctors I would see and how long I would keep trying,” shares Zoya Mehmood* who underwent several failed IVF treatments before finally conceiving a

The first ‘IVF baby’ in Pakistan was delivered

by Professor Dr Rashid Latif Khan at the Infertility Advisory Clinic Lahore in 1989.

It wasn’t until 1997 that Karachi saw its first successful IVF treatment at the Baqai Institute of Research and Developement.

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THE EXPRESS TRIBUNE, NOVEMBER 23, 2014

As women are born with a set number of eggs which decline and deteriorate in quality as we grow older, many doctors believe the chances of an IVF pregnancy are higher in younger patients baby boy. “People at work, home and other social gatherings would ask questions and offer unwanted advice, albeit in the kindest possible way,” she adds. “I felt humiliated, exhausted and depressed each time but I persevered.” On the other hand, lawyer Alya Karim* found it extremely difficult to organise her hospital visits around a nine-to-five job. “Since the eggs must be retrieved before ovulation, doctors must track the eggs regularly,” explains Alya. “This means trekking back and forth for ultrasounds. Your work colleagues will understand but only for so long.”

Now a mother of a beautiful boy, Alya adds that it was most difficult to keep her hopes high and not let successive futile IVF experiences affect her work. Nonetheless, Zoya, Alya and their fellow IVF patients made it through, finding support from doctors, nurses, and of course, compassionate family members.

It would be incorrect, however, to assume that every woman who undergoes the treatment gets the desired results. “It is a painstaking process, that gives no guarantees,” says homemaker Bina Shahid*, who eventually decided to adopt a baby girl after an unsuccessful attempt at IVF. “They planted three embryos into me but it just didn’t work. Another patient next to me, however, went on to have a baby.” Age, unfortunately, is the main factor which affects the outcome of IVF treatments. “The older a woman is, the less likely it is that she will get pregnant or complete the pregnancy successfully,” explains Dr Sethna. As women are born with a set number of eggs which decline and deteriorate in quality as we grow older, many doctors believe the chances of an IVF pregnancy are higher in younger patients. In fact, studies reveal that the chances of a successful treatment falls from about 40% for women under 35 to just 10% for those over 40.

According to research conducted by Dr Howard Jones, who ‘created’ the first American IVF baby Elizabeth Carr in 1981, IVF treatments generally result in childbirth for just one in five couples, closely mirroring nature. “The

take-home baby rate at Concept Clinic is about 32%,” Dr Sethna points out.

As the human population ages and social dynamics change, more and more women are delaying motherhood in favour of thriving careers. As a result, infertility appears to be becoming increasingly common in women these days, thereby increasing the demand for IVF and other fertility measures.

“It is a problem faced by the old, young, rich and poor across cultures and races,” says Alya. “The only difference is that the more affluent couples can afford a medical treatment.” In Pakistan, the cost of each IVF session generally falls between Rs200,000 to Rs400,000, depending on the hospital and doctors involved. This, coupled with the toll hormone injections take on the patient can make their experience quite traumatic. “Intense mood swings, anxiety, weight gain, bloating and excessive hair growth are just some of the side effects of IVF,” says Alya. “And they are all very unpleasant!”

Unfortunately, the greater half of the Pakistani population remains largely unaware or wary of treatments like IVF and infertility in general, believing it to be a result of contraception, God’s will and even attribute it to superstitous beliefs. Dr Sethna cites internal infections and endometriosis — a hormonal disease wherein cells similar to those that line the uterus grow outside the uterine cavity — as some of the main causes of infertility in Pakistan. Many infertile couples, however, resort to homeopathy or faith-healers to cure themselves, often aggravating their situation further. According to Zoya’s experiences at the hospital, “Some people reject IVF assuming it involves the use of sperm donated by third parties, especially those in the rural communities.

Other worry artificial treatment will lead to genetic abnormalities, miscarriages and even difficult babies!” But in a country where over 22% of all married couples find it difficult to conceive naturally but aren’t brave enough to speak about it, Zoya often wonders if the social pressure to start a family was greater than her own desire for a child. “Our social system does nothing for working women,” she says. And Alya agrees with her, saying that, “Infertility is always the woman’s fault. Our culture says that a man can take another wife and if he doesn’t, he must be good. But male infertility is never considered. God forbid a woman leave her husband to pursue her dreams of motherhood!” According to Dr Sethna, “Male infertility accounts for 30% of total infertility problems.”

He advises both couples to get tested for infertility to detect any problems they might have — the man and woman, alike.

“Infertility is a hidden disease,” says Dr Sethna. “It is virtually impossible to know just how many couples are affected by it.” Keeping this in mind, one can safely conclude that raising awareness regarding infertility and how it can be countered is imperative in Pakistan. In fact, the need for awareness is even greater considering everyday practices like smoking, stress, lack of hygiene and poor dietary habits are some of the main causes of infertility. *Names have been changed to protect privacy.

SOURCE: NATIONAL HEALTH SERVICES (NHS); LISTER FERTILITY CLINIC

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en vogue

Kayseria’s Master collection for winter 2014 combines pastel colours with beatuful floral prints.

Label: Kayseria Photographer: Abdullah Haris Make-Up: Hannan Siddiqui Models: Amna Babar And Sadia Khan

THE EXPRESS TRIBUNE, NOVEMBER 23, 2014

THE EXPRESS TRIBUNE, NOVEMBER 23, 2014

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lifestyle

THE EXPRESS TRIBUNE, NOVEMBER 23, 2014

By Tehmina Khan Design by Talha Khan For centuries, women have been enamoured with the concept of jewellery. From the Egyptian queen Cleopatra, known for her elaborate jewellery collection, to the women of the Indus Valley Civilisation who fashioned clay bangles — there is plenty of evidence for women’s timeless love affair with jewellery. Solitaire rings, charm bracelets and dazzling earrings etcetera, are everyday wardrobe staples for today’s average woman who uses them to stand out and symbolise her power and authority.

However, of late, the trend seems to have shifted from wearing multiple pieces of jewellery to one, bold item that stands out against a simple outfit. Usually, this item is an exquisitely-crafted necklace bearing a unique design which allows the wearer to make a statement without speaking a word. Big, small, real or fake, these statement necklaces not only lift our spirits but our entire look as well. The colourful beads, metals, precious and semi-precious stones that these pieces comprise of are just the thing to make an ordinary outfit outstanding. If you love jewellery, read on for tips on how to wear statement necklaces.

How to wear a statement necklace?

When it comes to signature neck jewellery, there are so many options that getting the right look can become daunting.

From simple chains to a band of pearls or wide, beaded and bedazzled bibs, statement necklaces can take any form — you just have to choose the best one for you. In some cases, loading up on sparkly accessories is a great way to accent an outfit but one must know when to stop. This is particularly important when it comes to desi wedding wear which tends to be heavily-embroidered and brightly coloured in general. A shiny, ruffled top, for example, could look great with a small chain but not a big, ornate number as together, the all the shine can make you appear cheap.

A layered pearl necklace

“Simplicity is beauty,” says Kiran Aman, designer and founder of Kiran Fine Jewellery. “Regardless of ongoing trends, a necklace should complement the overall look of your outfit which, to me, is the most important thing.” Of course, investing in a gorgeous, designer neck number will make you want to get noticed. “If you want to draw attention to your necklace, it is best to stick to a simple and classy outfit, preferably of one colour,” says jewellery enthusiast and collector, Farrukh Qamar. “The cleaner your clothes, the more noticeable your statement necklace will be.”

The best part about a statement necklaces — and costume jewellery in general — is that no matter how plain your outfit is, the jewellery automatically becomes the focal point of attention. If you are dressing down in a plain t-shirt with your favourite pair of jeans, just a glistening metal necklace and a dab of lipstick will give you the perfect, casual-chic look. On the other hand, you can enhance formal, evening attire by pairing your statement necklace with a matching clutch or stilettos.

“Personally, I think only one piece of statement jewellery should be worn at one time to create the right effect,” advises Kiran. You can also wear your hair in an up-do to give your necklace unob-

structed attention. Layering up necklaces of different shapes, colours and sizes looks great too, provided that you wear less than five strands to avoid looking too weighed-down.

Different types of statement necklaces To satiate the jewellery enthusiasts, there is a seemingly endless variety of necklaces available in the markets today.

Different lengths, materials, sizes, styles and adornments are available in local shops, catering to individual tastes. Highend fashion houses like Oscar De La Renta and Chopard design ornate items for those who can afford their hefty price tags while lower-end clothing giants like Forever 21 offer a cheaper range of beautiful pieces, some of which are exact replicas of the designer ones.

The key to sorting through the different styles is to know the look or vibe you are aiming to give out. Although jewellery is often a personal thing — often a gift from your significant other, parents or family heirlooms, etc — it should always showcase your personality and style spirit. Some women love to adorn themselves with necklaces while others prefer the sleek, band of pearls popularised by Audrey Hepburn. Whatever your preference, make sure each jewellery item reflects your desired look.

For example, multicoloured, beaded pieces are ideal for a beachy, bohemian look while silver is the way to go for a grungy, rockstar vibe.

Get the right inspiration for the right necklace If you are still unsure as to what type of necklace will look best with your outfit, you can always browse the internet for inspiration. Ever since statement jewellery was introduced to the global fashion world a few years ago, trendy necklaces have become a regular feature of catwalk shows and red-carpet events from Hollywood to Lollywood. Popular celebrities like Emma Stone, Anne Hathaway, Jennifer Lawrence, Kate Middleton, Sonam Kapoor and Deepika Padukone, etc, are unofficial brand ambassadors for statement jewellery which they flaunt at international events.

For ideas on how you can look as great as them, try browsing celebrity style magazines and online fashion portals on Facebook and Pinterest. Who knows, you might end up pulling of an elaborate, unique necklace better than your favourite celebrity.

Meesha Shafi — The Queen of Statement Accessories Why seek inspiration from international celebrities when local ones like Meesha Shafi are turning heads with their own statement accessories? The sultry singer, artist, fashionista and mother of two is known for making each public appearance count, thanks to her unique and edgy sense of style. Her collection of statement jewellery, bags, belts and other accessories is simply divine. In a nutshell, Meesha is living proof of the ideology of Yves Saint Laurent: “Fashion fades but style is eternal”.

domestic goddess 7

THE EXPRESS TRIBUNE, NOVEMBER 23, 2014

By Shahab Pappa

Indulge the meatloving with this delicious desi treat.

Red meat can be made tender and delicious with the right techniques.

Tenderising involves breaking down the muscle fibres in the meat to soften the texture, making it easier to chew. The application of tenderisers also enhances the taste of the meat. Here are a few ways to make your meat dish succulent.

Fruits: If you want to make a specific recipe, but don’t have time to marinate the meat, a simple and unexpected solution is fruit. Some fruits, like kiwi, pineapples and papayas contain enzymes that break down the collagen in meat, making it much more tender. Peel and mash the fruit of your choice and spread the pulp over the meat about 15 minutes before cooking.

• White zeera (ground) 3 tsp • Onions (finely chopped) 2-3 • Oil 2 ½ cups • Beef (finely chopped) 1 kg • Ginger-garlic paste 1-2 tbsp

Heat: Heating the meat to around 71.1oC or more can also tenderise it, albeit slowly. You may use a grill to heat it before cooking.

Using tools: Use a knife to make cuts or scores that go across the muscles fibres of the meat. Your cuts should be long and thin but not too deep.

Baking soda: Measure one teaspoon of baking soda in your palm and sprinkle it over the meat, creating a thin layer all around. Leave it on for at least an hour and then rinse if off before cooking.

• Salt to taste

• Heat oil in a large pan and add the chopped beef strips. The oil should be just enough to cover the meat completely.

• Add in onions, zeera, ginger-garlic paste and salt and mix thoroughly.

The best part about Namkeen Gosht is that it can be eaten sans rice or roti, meaning all you need to prepare is the meat itself. However, the salty taste can get a bit much at times. You might want to pair it with something cool to balance it out, like this soothing cucumber raita. It is quick and easy to make and will help you enjoy this desi delicacy even more!

• Cucumber (peeled and diced) 1 • Plain yogurt 1 cup

• Combine all the ingredients in a small bowl and mix thoroughly to blend the flavours together.

• Fresh mint leaves (chopped) 2 tbsp • Cook the mixture for about one and a half hour, until the beef becomes tender.

• Lemon juice 1 tbsp • Small garlic clove (minced) 1

• Serve warm with salad, rice or roti.

• Cumin seeds (ground) 1/2 tsp • Salt 1/4 tsp • Pepper 1/4 tsp

• Serve immediately if the yogurt is cold. In case the yogurt is warm or at room temperature, cover the raita with cling foil and refrigerate for about 30 minutes before serving.

woman of the week 8

Have you struggled to be where you are today or has life been a series of fortunate events?

My life has been a mix of both hard work, followed by many fortunate events.

How was your experience working in Na Maloom Afraad?

Oh, it was wonderful! There has been lots of learning and lots of fun.

e world A glimpse into th rhouses we of Pakistani po

Why did you choose to become a VJ? Basically, I chose to be a theatre actor.

While pursuing that during my teenage years, I was asked to host a show in Islamabad. That’s how it all started!

What inspires you?

Love, travelling and nature inspire me. Of course, the people in my life that who I love, inspire me the most.

What sparked your interest in acting?

I think the realisation that I wanted to act came when I gave my first acting audition during my school days. I realised then that I was meant to do this.

How has the Pakistani television industry changed over the past years?

There are only a few quality projects that I see on television now which is truly sad.

It’s like most people are busy working building up the film industry and have forgotten about drama serials.

Your sister Mawra is your contemporary.

Does that hinder your relationship with her?

Yes, Mawra is my contemporary but that never can or will affect our personal relationship. We both believe that we will get whatever is meant for us and make each other proud. I couldn’t have asked for a better sister!

Are the audiences going to see more of you on the big screen?

Yes, of course! Films are my first love.

Enjoying the waterfall at M uzaffarabad.

What’s the best way to deal with failure?

I think it is best to learn from it and move on in life.

Who is your favourite co-star and why?

I am extremely lucky to have worked with many brilliant actors who are as wonderful in person as on television. It would simply be unfair to name only one.

Any advice to aspiring female actors and VJ? I believe that anything that you enjoy doing cannot be wrong so do what you love. You will end up enjoying yourself every time.

During the film promotion in Islamabad

Model, actor and VJ At the Karachi pr omotions of Na Maloom

Afraad.

Author and personal security expert Gavin de Becker has developed a free online tool called MOSIAC which allows users to anonymously review signs of an abusive relationship and ask for help, should they need to.

When you hear about of a woman being physically abused by her partner, the man rightfully becomes the victim of slander overnight. Our reaction is, however, less definitive when we see the woman choose to stay with the man, even after continual assault. We are left confused, wondering why anyone would willingly continue with a partner who doesn’t just mistreat but actually beats them up. There are always plenty of stories heard through the grapevine which make us question not only the emotional ineptitude of the offender but that of the victim as well.

After all, what kind of woman in her right mind wouldn’t save herself from domestic violence if she had the opportunity to, right?

This was precisely how the global media reacted to Janay Palmer’s decision to marry American footballer Ray Rice who played for the Baltimore Ravens prior to being suspended by the National Football League (NFL). The build-up started following the releases of a surveillance video which showed the 27-year-old Rice punching Palmer (his fiancé, at the time) in the face. Upon hearing of their marriage, the internet went ablaze with criticism for Palmer and her decision to tie the knot with her abuser, proving just how little the average person knows

about the cycle of physical abuse.

In order to counter the snarky comments being directed towards Palmer, writer and social activist Beverly Gooden started the #WhyIStayed and #WhyILeft campaigns on Twitter to encourage victims of domestic abuse to share their experiences. The campaign soon became viral and successfully exposed the inner feelings of women who had been abused, instead of blaming them.

For Gooden — a victim of domestic violence herself — it was the condescending tone with which everyone addressed Palmer that upset her. “I felt that people don’t realise that why she (victim) doesn’t leave is a simple question to a very complex issue,” said Gooden in an interview for The Washington Post. In fact, Gooden and Palmer are just two examples of women who find it difficult to leave their abusive partners, even after repeated episodes of violence.

According to the National Coalition for Prevention of Domestic Violence, roughly 25% of all women undergo intimate partner violence! Moreover, the National Domestic Abuse hotline reports that it takes an average of seven tries for a victim to finally let go of an abusive relationship.

The underlying problem with the blame game in cases of domestic abuse is that while the third-party observer admonishes abuse as wrong and believes the offender should

be penalised, they also show less concern for the victim. In other words, it is implied that if the victim chooses to stay with her offender, then she must take responsibility and be prepared to bear the consequences. It is this poor ideology that Gooden hopes to change through her campaign. “I really hope to move the conversation from ‘Why doesn’t she leave?’ to ‘Why does he hit her?’” she said. Other campaigns of this nature include the #YesAllWomen appeal which aims to counter misogyny and violence against women across the world.

Of course, we must remember that many victims don’t always realise they are being abused as the male aggression might have become too internalised and normal in the society they live in. This is particularly true of Pakistan where women face a lot of resistance while fighting for their rights. Nonetheless, people like Gooden are doing their part to bring about a positive change in the way this sensitive issues are addressed and handled.

Design by Omer Asim