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Good afternoon, I am Dr. Puneet Kocchar. I am a consultant gynecologist and a fertility specialist at Elixir Fertility Center, New Delhi. Today I will be talking about Recurrent miscarriages and abortions.
A positive pregnancy test is a very exciting news not only for the couple but for the entire family. However, sometimes there is a miscarriage and the chances of miscarriage in the normal pregnancy are about 10-15%. If you have had only one miscarriage, then the chances that you will carry on till term without requiring any medical extensive treatment in your next pregnancy are nearly 80% or more. For women who have had only one miscarriage, we will not recommend going for extensive testing or treatment.
What is recurrent abortion or recurrent miscarriage?
If a lady has had 3 or more repeated abortion, it is called recurrent abortions. Even these days we start doing test and treatment if a lady has had 2 abortions and we do not wait for third one to occur.
So, why does an abortion occur?
In simple terms, either it is a fetus, that is, an embryo is not normal or the womb which is going to carry the pregnancy has some problems in it. What happens to a fetus if you are carrying a genetically abnormal baby, that can lead to miscarriage. It is nature's way to take care of the pregnancy and not letting the abnormal baby come into life. So, we do tests called genetic tests to check the chromosomic make up of a baby. They can be done on the products of conception. We also recommend that we have complete parental care, that is the blood test of both mom and dad to check the both of the chromosomal content.
Sometimes, in2-5%of the cases, there is balanced chromosomal translocation. Now this translocation will not cause any problem to the person who is guiding translocation. But when you produce an egg or the sperm, the embryo can be abnormal and this will lead to a miscarriage.
What happens to a person carrying a translocation?
If you are carrying a translocation which is leading to repeated miscarriages, it is better to plan IVF cycle along with PGD or PGS rather than normal conception.
IVF is where we create an embryo using the eggs from the lady and sperm from the husband. When the embryo is ready, we take a small biopsy and we subject it to test and a complete chromosomal analysis. And once the results are back, the normal embryo is transferred back into the lady's womb resulting in healthy pregnancy. This is one factor that we just addressed.
The second factor that we talked about is abnormalities in the womb. Now, simple test to analyze hormonal balance from the blood taken from the lady will tell us about thyroid status, diabetes, abnormal prolactin. These are all hormones which if are elevated or below the range can lead to abortions. THis can all be treated by giving oral tablets. So, these are important to be tested for any women having recurrent abortions.
- Then we look into other factors such as autoimmune problems which are very common, occurring in about 20% of the patients. During pregnancy, we advise you to take low dose aspirin tablets and low molecular weight hampering injections for the entire duration of pregnancy. And this results in more than 60% successful pregnancies.
- Another important factor that leads to abortion, which is Thrombophilias. THese are inherited problem which increases the tendency of blood to clot. Since the blood flow to the uterus is not occurring properly, you might again need blood gain agents such as aspirin.
- Some of the other common factors are an anatomical factor. So, if the uterus or a womb is carrying a fibroid can also lead to abortions. Now, these can be easily diagnosed by doing an ultrasound either 2-dimensional or 3- dimensional. If such a problem is present, we can treat it by doing a hysteroscopic procedure.
- Another important factor that leads to Abortion, especially in our part of the country, that is North India, is Tuberculosis. This is one of the commonest cause of miscarriages especially in our part of the country. It can be tested by doing Biopsy. Take a small amount of tissue from the uterus and check whether the lady is carrying Tuberculosis or not. It can be treated by giving oral medication of tuberculosis that has to be taken for the period of 6-9 months.
- Another common cause is the imbalance of Th1 or Th2 cytokines. These are the cytokines present in the uterus which may not let the embryo or the pregnancy to grow. And if these are found to be positive, we recommend Immunomodulation.
So, these are the various causes due to which a lady can have an abortion. An important thing here is do not loose hope and do not give up treatment. If you have had 2-3 abortions, you need to get complete panel of tests done and with the help of a treatment, you have 60% of the chance to deliver a baby normally.
If you wish to consult me, please contact me through Lybrate or you can visit my clinic directly.
Nowadays IUDs devices are used to prevent pregnancy. Are using these devices safe? Are they totally reliable and prevent pregnancy? What are the side effects or changes a body undergoes by using it.
My wife has itching in her genital area for the past 3 weeks. She has irregular periods since October. Itching is very severe around that place. What is the proper treatment. Is it very serious?
What is erythroblastosis fetalis?
Erythroblastosis fetalis is also known as haemolytic anaemia in the newborn. This occurs due to blood incompatibility in the mother and foetus. Due to this incompatibility, the antibodies present in the mother’s blood, will pass through the placental barrier and attack the blood cells of the foetus. This will lead to the destruction of the red blood cells of the foetus and it is likely to cause anaemia in the foetus. This condition varies from mild to very serious. In its moderate or severe stage, the erythroblasts or immature red blood cells are formed in the blood of the foetus and this disease is called erythroblastosis fetalis.
Why does it happen?
The two main causes of erythroblastosis fetalis are Rh incompatibility and ABO incompatibility.
- Rh Incompatibility: When the mother is Rh –ve and the father is Rh +ve, there is a good chance for the baby to be Rh +ve. The antigens present in the blood of the Rh +ve baby will behave like a foreign agent and the mother will produce antibodies against it. If it is the first pregnancy, then the child may not be at risk, however, if the second child ends up being of +ve blood group again, then the antibodies present in the mother’s blood will attack the baby and may result in a spontaneous abortion.
- ABO Incompatibility: This usually occurs when the mother’s blood group A, B, O does not match the baby’s. This causes fewer complications in comparison to Rh incompatibility, but it may be severe if the child has a very rare blood group.
How to avoid it?
It is a highly preventive condition. Firstly, you have not tested your blood group; it is advised to get it tested along with the blood group of the father. If you already know your blood group, then you must mention it to your doctor. If the father has negative blood group, then there will be no problem. However if the father is Rh positive, then it is advised to get routine tests done by the doctor.
The other preventive measure to take is a treatment called RhoGAM or the Rh immunoglobulin. It reduces the reaction of the mother to the baby’s blood cells. This shot is administered around the 28th week of the pregnancy. It is also administered 72 hours after the birth of the baby with the positive blood group. If you wish to discuss about any specific problem, you can consult a pediatrician.
You might be extremely conscious of our health and might be working out on a daily basis in order to be fit. However do you know, getting the best result from your workout depends on a number of factors, the most important being the food you consume right before exercise.
Having these 6 foods will give you the best results:
1. Chicken - It is a lean protein and is perfect to build muscle. Also, chicken is rich in healthy minerals and nutrients while being low in fat, thus making it one of the healthiest products to consume before your daily workout.
2. Nuts - Nuts are abundant sources of protein and healthy fats and thus no matter what kind of nuts you consume before working out; they are guaranteed to improve your exercise regime.
3. Milk and Cereal - Milk has the goodness of protein and being liquid it also keeps your body hydrated during the workout. Cereals, on the other hand, are rich sources of carbohydrates that promote muscle growth. Try to pick cereals that are made of grains and have low sugar content.
4. Pasta - It is filled with carbohydrates and rapidly travels through your digestive system, thus instantly giving energy to your body. Moreover, the starchy carbohydrates provide stamina to help build perseverance during the workout.
5) Peanut Butter - It has high calorie content and thus can easily help you build muscle. In addition, it is a rich source of fat and thus consuming peanut butter helps you get the required healthy fat to burn as fuel while you work out.
6) Yogurt - If you indulge in muscle-building exercises and strength training, yogurt can do you a lot of good. This is because it is an abundant source of protein and also contains an adequate amount of minerals and nutrients.
If you would like to consult with me privately, please click on 'Consult.
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Hi, we had unprotected sex! On 21st may! But he didn't Cum inside me! And my period usually comes on 4 t h to 6 th of every month! But yesterday I had pain in pelvic region and even had pain in the chest! And today morning I had blood stains in the pant! I am totally worried! Am I pregnant? I don't want to get pregnant! How may I save from getting pregnant? Any solution to it!
I am 24 years old. Before 2 years I got marriage after sex my wife complain burn inside pussy. So why it happened there is some problem its happen last 2 week. please give some suggestions.
I am 18 years old female. During sexual intercourse I found that some jelly like substance present in vagina which opposes the entry of penis. What is the treatment for this condition or it's going to be permanent?
There are a number of ways in modern day medical science for helping couples conceive, in case they are not able to do so in a natural way. Apart from IUI, IVF and other forms of artificial insemination, one such way is ovulation induction. In this procedure, the ovaries are stimulated to release an egg which can maximize the chances of natural conception, or even through IUI. This is an effective process that works well, provided there are no other infections and diseases at play. It basically works by stoking the relevant hormones with the help of tablets and injections. Let us find out more about the process.
Varied Tests: Before embarking on the process, the doctor will conduct a number of tests to ensure that you are capable of conceiving by natural means or even with artificial insemination. These tests help in making sure that there are no other ailments in the picture, which may hamper the process of ovulation induction or affect the ovaries in general.
Ovulation Cycle: Thereafter, the doctor will take blood samples in order to study the exact ovulation cycle that the body follows. These blood samples will be studied to measure the level of hormones at different stages so as to find out the most opportune time when the situation may be congenial for the ovulation induction to begin. A transvaginal ultrasound will also be carried out so that the doctor may study the development of follicles within the ovaries. These follicles usually line the ovaries. This ultrasound will also study the thickness and appearance of the womb’s lining.
The Ovulation Induction Cycle: The ovulation induction cycle will begin with tests that will happen starting from day one to day four. Once the tests have ascertained that the body is ready to go through the process with maximum chances of conception, the process will begin on fourth day. On this day, the patient will be given medication like Clomiphene Citrate. This medicine is also usually given to patients who are undergoing IUI or artificial insemination as it is said to increase the likelihood of conception. The Follicle Stimulating Hormone injection will also be given to the patient on the same day.
After the Medication: Once the medication and injections have been administered, the patient will have to go through a test to study the hormone levels in the body. This usually takes place around day 10 or 11. Thereafter, two weeks later, the patient will go through an ultrasound to find out if the ovulation is about to begin.
Time: While this is an effective method, one must remember that the ovulation results may take time for women who do not have normal menstrual cycles. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.
My wife is 37 weeks pregnant so when we can expect our baby plg suggest n what to be taken into care and when to go to hospital kindly brief about it.
Hello Doctor, I am 34 years age my married had completed 1 and half years but when I was trying to sex with my wife I was try to penetrate but can't. Please give me suggestion.
Me and gf had sexual activities 2 months ago. I was afraid thai she could get preg. We did not had sexual intercourse. We had stimulation to each other and I had fear that bcz of my finger sm sperms have transfered to her vagina. But later she did not missed any of her periods. Now. Then before 5 days we again had those activities (fingering and oral) after the act soon in 2 hrs she started feeling weakness and nausea. Then nxt day she had fever with nausea and headaches then she vomited. The she went to Dr. He gave sum medicines and she was fine after 2 days she was normal and now again yesterday she started feeling nausea ans she had her face swollen up why is this soo? Today she is having head aches can she be preg? Due to sm sperms got transfered to her by my fingers? Her expected dates of periods are 11 th of may.
I want to sex with my gf she is virgin if I use only condom as precaution is this sufficient to prevent pregnancy.
She is 20 years old, We had sex 4 days before her period and she got her period too, which lasted 4 days but usually she gets her period for 6-7 days. She felt some symptoms of pregnancy so she took a pregnancy check 16 days after we had sex, bt the result was negative. She was not pregnant. Again after 5 days, she took another pregnancy test to confirm whether she is pregnant or not, the test came positive. She is pregnant. Today, its 21 days after we had sex. What should I do? Is she pregnant? What medications should I choose. Reply Thankyou.
Dr. 30 Days had been completed sooo medical abort is best or wch one is best. And medicine fees totally how much is cost please suggest me.
What to expect when marrying a 25 yrs old diabetic girl diagnosed with type 2? and the complications related to pregnancy?
Loss of sexual desire is more common in women than in men. As many as 3 in 10 women have reduced or limited sexual interest in any kind of sexual activity. While the medical term for this problem is Hypoactive Sexual Desire Disorder (HSDD), it is generally understood as a loss of libido.
Following are the causes of less libido in females:
1. Hormonal Disorders:
- Dryness of the vagina and pain during sexual intercourse may affect sexual drive both mentally and physically.
- After menopause, drop in the count of testosterone hormone also affects sexual drive which can result in loss of libido.
- With advancing age, the level of androgens decrease, and hence results in a lack of sexual desire.
2. Lifestyle Disorders:
- In some of the cases, lack of emotional support in a relationship plays a significant role in the loss of libido. Post baby 'coolness' may also act as a driving force for loss in libido.
- In today's era, changing lifestyle is drastically affecting our lives. Following an unhealthy lifestyle may result in increased weight that may affect self-image, and indirectly may also affect the sexual desire.
- Stress and job, family pressure and exhaustion may also influence sexual desire of a woman.
3. Medical Disorders:
- There are conditions such as endometriosis, fibroids and thyroid disorders that may have a negative impact on the sexual drive of a woman.
- Certain medicines such as antidepressants, oral contraceptives, and medicines that lower blood pressure may also negatively impact the sexual drive in women.
4. Psychological factors:
- Increasing cases of depression, anxiety, frustration, stress is also an important cause of loss of libido in the contemporary society.
- After childbirth, new moms tend to suffer from lack of sleep, insufficient lubrication of the vagina and exhaustion, which may affect her sexual desire. If you wish to discuss about any specific problem, you can consult a Sexologist.