Vedhas Clinic

Routine diagnosis and tests are important to perform if you are diagnosed unexplained infertility. These diagnostic tests include assessment for Ovarian Reserve and other hormonal factors are involved which has to be assessed in order to treat infertility.

There are different tests for men and women, which helps the Fertility specialists to diagnose about the causes or reasons for the infertility. Some of them are briefly explained here:

Valuation of Male Infertility

In the infertile couple, the assessment of male factors like previous medical history, age, lifestyle of male and semen analysis has to be done. The evaluation of medical history includes prior paternity, surgical history, use of any medicines and sexual dysfunction. Physical assessment includes: abnormalities in testes i.e., Varicocele and absence of vas deferens could be detected.

Assessment of Female Infertile

Evaluation of female infertility included the assessment of ovulation or ovarian defects. A patient with menstrual abnormalities should be investigated for underlying causes such as polycystic ovarian syndrome, thyroid disease, and hypothalamic causes secondary to weight changes. Another test for the infertility in couples included the assessment of Ovarian reserve. the testing includes the Day 2 or day 3 serum AMH (Anti-Mullerian Hormone) or Serum FSH (Follicle stimulating hormone).

Kegel exercises can improve your sex life and help with pelvic floor problems, including urinary and fecal incontinence. The key is to get in the habit of doing them every day so you start to see results.

Find your pelvic muscles by stopping the flow of your urine mid-stream. Before you do your Kegel exercises, it's important to find your pelvic muscles. These are the muscles that form the floor of your pelvic floor. The most common way to find them is to try to stop the flow of your urine midstream. This tightening is the basic move of a Kegel. Let those muscles go and resume the flow of urine and you'll have a better sense of where those Kegels are. Just remember to see a doctor before you begin your Kegel exercises if you have any medical problems that may prevent you from doing Kegels safely.

• However, don't stop urinating midstream as your regular Kegel exercise routine. Doing Kegels while urinating more than twice a month can actually have the opposite effect, weakening the muscle. It may also cause damage to your bladder and kidneys.

If you still have trouble finding your Kegels, place your finger in your vagina and squeeze your muscles. You should feel the muscles tightening and your pelvic floor move up. Relax and you'll feel the pelvic floor move back again. Make sure your finger is clean before you insert it into your vagina.

Use a hand mirror to find your Kegels. If you're still having trouble locating or isolating your Kegels, place a hand mirror below your perineum, which is the skin-covered area between your vagina and your anus. Practice squeezing and relaxing what you think are your Kegel muscles. If you do this correctly, you should see your perineum contracting with each squeeze. If you're a sexually active woman, you can also ask your partner if he can feel you "hugging" his penis and letting go during sex.

Make sure you have an empty bladder before you begin your Kegels. This is important. You don't want to do your Kegels with a full or a partially full bladder, or you may experience pain while you do your Kegels, as well as some leakage. Before you start your exercise routine, do a bladder check so you can perform those exercises as efficiently as possible.

Concentrate on only tightening your pelvic floor muscles. Your Kegel exercises should focus on these muscles only, so you should avoid flexing other muscles, such as your buttocks, thighs, or your abdomen, for best results. To help your concentration and the efficiency of your movements, make sure you breathe in and out as you perform each set of Kegels, instead of holding your breath. This will help you relax and get the most out of your pelvic floor exercises.

• One way to keep your muscles relaxed is to place one hand on your belly to make sure that your belly is relaxed.
• If your back or belly ache a bit after you complete a set of Kegel exercises, then it's an indication that you're not doing them correctly.

Get into a comfortable position. You can do these exercises either sitting in a chair or lying on the floor. Make sure your buttock and tummy muscles are relaxed. If you are lying down, then you should be flat on your back with your arms at your sides and your knees up and together. Keep your head down, too, to avoid straining your neck.

In a normal pregnancy, the baby develops with its head pointed down, and the head is usually the part which comes out first during normal delivery. However, in many cases, the baby could have its legs, feet, or buttocks pointing to the cervix. In a majority of cases, the baby may have this position, but rotates to have its head pointing down before the third trimester. However, this may not happen, and this is referred to as breech.

In a lot of cases, the doctor would try to move the baby’s head downwards usually around the 37th week, and this is referred to as external cephalic version (ECV) or even as version. The process is done externally by manipulation and hence the name external. It is done before labor and may allow for a vaginal birth. In very rare cases, it may be done during labor, but before the amniotic sac has ruptured. As a backup, there should be a provision for the patient to undergo C-section, if ECV is not successful.

Indications:

1. Single pregnancy, into 36 weeks of pregnancy, with no complications, and preferably not the first pregnancy
2. No engagement of the fetus (any part) in the uterus
3. Adequate amniotic fluid, which will provide a good environment to move the baby with minimal injury

Contraindications:

1. Suspected/known birth defects
2. Multiple pregnancies (twins/triplets)
3. Ruptured amniotic sac
4. Fetus with a hyperextended neck
5. Mother’s health is not optimal and is on cardiac medications
6. Condition that mandates a cesarean section (placental separation from the uterus, placenta covering the cervix, etc.)

Procedure

The fetal position is first estimated using an ultrasound. The position of the placenta and the amount of amniotic fluid are also closely monitored. Under constant monitoring, the uterus is relaxed through medications. With one hand on the fetal head and another on the buttocks, the doctor tries to rotate the fetus. Depending on how much pressure the mother is able to tolerate and how flexible the uterus is, version may be successful (success rate is about 60%).

A second attempt under epidural anesthesia may be done, if the first one did not succeed. However, the chances of success with subsequent attempts is very doubtful. The fetus is constantly monitored through ultrasound and fetal heart rate monitoring. A fetus is considered healthy if the heart rate moves up during this procedure. However, if the heart rate seems abnormally high, the procedure would be abandoned.

After the procedure, the mother and the fetus would be monitored for a while before being sent home. As the fetus is constantly monitored throughout pregnancy, the doctor would be able to tell if this procedure is required.

Your genetic background influences where your body fat is stored. In case your mother or father has fat stored in the abdomen, hips, waist or in the thigh, it is likely for you to develop deposits of fat in the same regions.

Circumstances of genetic fat

1. You may have a proper or a balanced BMI (body mass index) but still tend to develop bulges in areas, which are likely to make you look disproportional.

2. You may become obese by development of excess fat accumulation in the lower abdomen region, referred to as pannus. Extra fat may accumulate in your lower back and hips as well, which cannot be lost in spite of taking weight losing measures.

Liposuction to get rid of extra fat

Liposuction is a cosmetic surgery that allows you to remove genetic fat or any extra fat from the body, in order to change the body's shape. Liposuction does not remove cellulites and tightening of loose skin cannot be done.

Liposuction removes excess fat from the body by suction. Small, narrow tubes with blunt tips known as the cannulae are inserted through incisions in the skin surface. The tubes are moved under the skin to target the suction of fat deposits.

There are several types of liposuction techniques.

1. Tumescent liposuction: In this form of liposuction, a wetting solution such as lidocaine with a local anesthetic is injected into the patient before surgery. This causes the shrinking or constriction of blood vessels due to which it allows liposuction to be performed while the patient is under local anaesthesia. Blood loss and post surgical pains are reduced.

2. Suction assisted liposuction:This mode of liposuction also known as SAL is the most primary form of liposuction. It involves drawing out of fat using a vacuum.

3. Power assisted liposuction: This liposuction technique called PAL in short involves the process of SAL with an extra tool for increasing the motion of the cannula. The process is faster.

4. Ultrasound assisted liposuction: This process (UAL) involves the transmission of energy via a specialized hand piece for loosening and melting of fat. A greater volume of fat can be removed via UAL. VASER is a variation of the UAL method where an ultrasonic cannula with grooves helps in energy disruption to improve removal of fat.

5. Laser assisted liposuction: LAL is a newly developed liposuction technology where a laser works like an ultrasound for disruption and removal of fat cells. This mode is more efficient and involves less trauma.

Liposuction is an effective way to remove unwanted, genetic fat from your body, which may be harming your body image. However, liposuction is associated with severe side effects.

Contraception refers to something, which works to prevent a pregnancy from occurring. But what is emergency contraception? This sort of contraception is made use of in case other methods of birth control do not work or a woman has had unprotected sex.

This sort of contraception is also referred to as the morning after pill and postcoital contraception, which effectively means that it is taken after sex. Well, if while having sexual intercourse, there is a breakage of the condom or it slips off the penis, then it is a good idea to make use of emergency contraceptives, as should a woman if it so happens that she misses two or more birth control pills over the course of her monthly cycle.

While it is true that a large majority of emergency contraceptives, which are available in the market today are in the form of pills, note that this is not the only form of emergency contraception. As a matter of fact, copper containing intra uterine devices (IUDs) happen to be the most effective way to prevent a pregnancy from occurring, but this is only true if they are fitted within five days of unprotected sex. Again, even in this case, the sooner, the better!

Most people believe that an emergency contraceptive is almost always successful in ending a pregnancy. This is quite inaccurate as the main intention of an emergency contraceptive is not to end a pregnancy, but to prevent it from happening in the first place. This is exactly why it is so essential to have an emergency contraceptive pill after sex as soon as possible. The longer a woman delays, the higher the risk of fertilisation taking place and pregnancy then being left to be a foregone conclusion.

It is important to keep in mind that emergency contraception is not a substitute for taking precautions when it comes to sex. As a matter of fact, it can be said that there is no substitute for being responsible and making use of condoms or birth-control pills in a prudent way. After all, who wants to have the stress and the repercussions of a potential unwanted pregnancy? It makes quite a bit of sense to take some extra care so that there is no need for anxiety, as it isn’t really required and sex remains as much fun as intended!

Trichomonas vaginalis is a sexually transmitted infection (STI). It is sometimes referred to as trichomonas or trichomoniasis, or shortened to TV. The term trichomonas is used here. 

If you are suffering from trichomonas vaginalis, it is important for you to know about protecting yourself against this condition. Trichomoniasis is a sexually transmitted disease (STD) that is caused by an organism known as trichomonas vaginalis. This disease is more common in women than in men. Men too can get infected and pass on the infection to their sexual partners.

Signs & Symptoms-

Up to half of infected men and women will not have any signs or symptoms at all. Signs and symptoms usually show up within a month of coming into contact with trichomonas. You might notice:

Women

1. Soreness, inflammation and itching in and around the vagina. This can cause discomfort when having sex.
2. A change in vaginal discharge – there may be a small amount or a lot, and it may be thick or thin, or frothy and yellow. You may also notice a strong smell that may be unpleasant.
3. Pain when passing urine.

Men

1. A discharge from the penis, which may be thin and whitish.
2. Pain, or a burning sensation, when passing urine.
3. Inflammation of the foreskin (this is uncommon).

Diagnosis
A physical examination and certain laboratory tests are carried out for the diagnosis of trichomonas’s. Tests are carried out on a sample of the vaginal fluid to find out disease-causing parasites. It is harder to detect the parasite in men, than in women.

Treatment
Commonly, a certain oral antibiotic is prescribed for treating trichomonas’s. It is the only medicine used for this purpose, but should be avoided by pregnant women. If you are infected, your partner should also be treated at the same time for the prevention of reinfection and further spreading. If you are undergoing treatment for trichomonas’s, it is advised that you avoid having sex until the treatment gets over and all symptoms get eliminated. You should take your medicine even if you improve and after the symptoms are gone. A retest should be carried out after three months to know about the infection’s status.

Prevention
You can prevent or protect yourself from trichomonas’s vaginalis by taking the following steps:

• Have protected sex by using condoms every time.
• Sexual abstinence or limiting your sexual contact to one partner is recommended.
• Avoid sexual contact if you think you are affected.

You should consult a doctor on experiencing any genital symptoms such as burning urination, discharge, and the development of sores or rashes. Also, you must stop having sex with anyone after experiencing these symptoms. 

Be it frequent urination, painful urination, or change in color of urine, you must not hesitate to visit a urologist, especially when the symptoms persist for more than two days. Typically, an abnormal urge to urinate is directly affected by any infection in the bladder or due to any underlying medical condition. A urologist who is specialized in the study and treatment of disorders related to the urinary system is the right person to diagnose the problem and put you on the right treatment. Read on to have an insight into symptoms that would necessitate a urologist visit.

Inability to urinate: Many people tend to have calcium depositions in their urinary tract. This is what is known as a stone. When this stone grows big in dimension, it can block the ureters or the urethra. In both these situations, the total urine output reduces to a great extent or can stop completely. The first symptom, in this case, will be an intolerable pain in the back or lower abdomen. This is also a common sign in males with an enlarged prostate.

As the prostate grows in size, it pushes onto the bladder, thus again making it difficult to release urine.

1. Pain in the lower abdomen: Pain in the lower abdomen is also a symptom of various kinds of urinary problems. If the pain is accompanied by urinary frequency or a burning sensation during urination, it inevitably prompts a visit to the urologist to check for bladder cancer or prostate.
2. Blood in urine: Irrespective of the gender of the sufferer, blood in the urine is never a good sign. An immediate visit to the urologist is suggested as he can order tests which can highlight an infection or a disease or in extreme cases, even the early signs of cancer in kidney or bladder.
3. Repeated urinary tract infections: Cases might arise, when a particular person is suffering from two or more infections in a span of 6 months. This situation should never be ignored, and immediately a doctor should be visited as this can be a serious health problem in both men and women. Prophylactic or some antibiotic treatments will be prescribed in this case.
4. Chronic pain in the pelvic region: This is again another urinary condition which can affect both sexes. This condition is characterized by increased frequency of urination and nocturia and pain in the lower abdomen are also reported. Nocturia is severe nighttime urination. The treatment for this condition depends on the reason. A series of tests and examinations have to be carried out to find out the reason, and accordingly, a treatment plan has to be charted out.

Apart from the symptoms mentioned above, if you experience uncontrolled urine leakage or any sediments in urine or if you sense any abnormality concerning the lower abdominal area a urologist visit is warranted. No need to shy away from reporting even such minor discomfort as it could help avoid dire consequences.

There are diseases which affect us in spite of us trying to keep them away as far as possible and then there are lifestyle diseases, for which we are largely to blame. It can be said that lifestyle diseases are those, which occur on account of the decisions we make and the actions we commit. Having said that, would it not be interesting to know more about lifestyle diseases?

There are various kinds of lifestyle diseases, which affect various parts of the body. For instance, if a person drinks a significant amount of alcohol, more than what he or she should, then he may soon be affected by a lifestyle disease in the form of liver cirrhosis. Apart from just the alcohol, this condition can also be caused on account of chronic hepatitis.

1. Stroke: A lot of people are of the opinion that a stroke is something, which only strikes old people. However, this is not correct. In fact, there is quite a bit of trouble can be caused if this opinion is held and people allow themselves to not care enough about their health using this as justification. Statistically, up to 15% of the cases of stroke in a country such as India occur to people who have not even reached the age of 40. Surprising and scary at the same time, isn’t it?
2. Kidney problems: When people think of lifestyle diseases, they most likely think of problems, which are related to the heart. While it can be said that a heart attack on account of bad lifestyle choices has the highest visibility, even parts of the body, which are rarely thought of like the kidneys, can kick up trouble in the form of nephritis. So, what exactly happens when a person has nephritis? Simply put, the kidneys swell up and this causes a lot of pain, which could have been avoided with a reasonable amount of foresight and effort. When this occurs, kidneys create trouble when they need to perform their primary function of purifying blood and complications related to the kidneys can really have a magnified impact on other parts of the body.
3. Heart disease: Finally, addressing the elephant in the room, when it comes to lifestyle diseases - heart disease. Around 31% of people who die every year worldwide fall prey to it and the main culprits behind heart failures include smoking, diabetes, and very high cholesterol levels.

Vaginal Vault Prolapse is the condition where the upper portion of vagina may lose its normal shape and drop or sag down into the vaginal canal or maybe even outside the vagina. This may occur after a hysterectomy or even simultaneously with uterine prolapse.

The treatment of Vaginal Vault Prolapse varies with the severity and extremity of your symptoms. Your healthcare provider may suggest medications and physical therapy to treat your condition, if you feel that the prolapse is not bothersome. However, you might have to undergo surgery later if your symptoms worsen and the prolapse affects your quality of life and hinders functional ability.  You must keep in mind that usually more than one area is affected by weakness in your pelvic floor. 

The symptoms of Vaginal Vault Prolapse include, backache, pelvic heaviness, bulging mass into or sometimes outside your vagina that hinders normal activities such as walking and sitting, vaginal bleeding and releasing urine involuntarily. 

Treatments:

1. Medication: Most of the women with this condition usually go through menopause around the same time. Since the estrogen levels are severely lowered during menopause, it causes vaginal dryness. Discussing about estrogen therapy with your healthcare provider is a must if you wish to remedy your vaginal dryness. Not every woman should take estrogen so it is imperative to talk to a medical expert first. Usually women are treated with estrogens before they go into surgery.
2. Physical therapy: Most healthcare experts recommend pelvic floor exercises as physical therapy using biofeedback so as to strengthen the specific muscles of your pelvic floor. Biofeedback is the usage of monitoring devices that contain sensors and are placed either in your rectum, vagina or on your skin. Biofeedback is very important because it tells you the strength of each muscle you are squeezing i.e. contractions, and if you are squeezing the right muscles in order to perform the exercise correctly. Long term usage of biofeedback in physical therapy leads to strengthening of your muscles and a reduction in your symptoms. 
3. Surgery: Corrective surgery may be performed on you by the surgeon either through the abdomen or vagina. If the surgeon is performing the corrective surgery through the vagina, he will use the ligaments, which support the uterus to solve the problem.