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Dr. Padma L Ravindran

Gynaecologist, Chennai

500 at clinic
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Dr. Padma L Ravindran Gynaecologist, Chennai
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I'm dedicated to providing optimal health care in a relaxed environment where I treat every patients as if they were my own family....more
I'm dedicated to providing optimal health care in a relaxed environment where I treat every patients as if they were my own family.
More about Dr. Padma L Ravindran
Dr. Padma L Ravindran is a renowned Gynaecologist in Indira Nagar, Chennai. You can visit her at Lakshmi Maternity Hospital in Indira Nagar, Chennai. Don’t wait in a queue, book an instant appointment online with Dr. Padma L Ravindran on Lybrate.com.

Lybrate.com has a number of highly qualified Gynaecologists in India. You will find Gynaecologists with more than 32 years of experience on Lybrate.com. You can find Gynaecologists online in Chennai and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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Lakshmi Maternity Hospital

No 20, 3RD Avenue,Indira Nagar,Adyar,Landmark: Near Water TankChennai Get Directions
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My friend is 44yrs old. Had gone through a hysterectomy 8 yrs ago and removed one ovary due to fibroids. Now her doctor has asked her to remove the second ovary too due to a cyst which is around 7 cms and causes a lot of pain every time she ovulates. My question is will she loose her sex drive and will she be unable to have an orgasm? Her doctor has also said he won't put her on hrt. But natural pills for hormones.

DHMS (Diploma in Homeopathic Medicine and Surgery)
Homeopath, Ludhiana
yes, your sexual desire may change. That’s because both testosterone and estrogen, hormones that are important in sexual desire and intercourse, are produced in the ovaries. These glands produce about half of testosterone and nearly all of estrogen. While testosterone is thought to contribute mainly to desire, estrogen is important for healthy vaginal tissue, keeping it thick, moist and flexible. Without estrogen, vaginal tissue becomes drier and thinner, more likely to tear and lead to painful intercourse. While supplemental estrogen can prevent or minimize this, without it you may find the fear of pain prevents you from having sex. Many studies, however, show an improvement in sexual function after a hysterectomy. This is likely because the surgery eliminates the pain, bleeding or other symptoms that may have caused problems with sex. Also, the surgery eliminates the possibility of pregnancy, thus making sex more gratifying for some women.
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I am 32 year old and my wife is 30 year old house wife, my wife is not taking interested physical with me from one year. We have one time physical from one year. Pls suggest. What should be done.

BASM, MD, MS (Counseling & Psychotherapy), MSc - Psychology, Certificate in Clinical psychology of children and Young People, Certificate in Psychological First Aid, Certificate in Positive Psychology
Psychologist, Palakkad
I am 32 year old and my wife is 30 year old house wife, my wife is not taking interested physical with me from one ye...
Dear user. There are many psychological causes of LOW SEX DRIVE, including: Mental health problems, such as anxiety or depression. Stress, such as financial stress or work stress. Poor body image. Low self-esteem. History of physical or sexual abuse. Previous negative sexual experiences. I suggest counseling for her. Take care.
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Sports Injury in Athletes - How Homeopathy Can Help You?

B.Sc. D.M.S.
Homeopath, Kolkata
Sports Injury in Athletes - How Homeopathy Can Help You?

Are you an athlete looking for an effective remedy for sports injuries and accidents? You should opt for homeopathy for treating sports injury of several kinds. In case of athletes, injuries of acute and chronic forms are quite common, and homeopathy offers a completely natural treatment without any side effects on your body that may affect your performance. Homeopathy provides you effective and rapid healing, and promotes natural healing of your injuries. Using homeopathic medicines for treating your sports injuries at the right time allows you to stay away from undergoing surgeries, which are inevitable in the case of serious injuries that progress over time.

Here is a list of the top homeopathic medicines that are beneficial for athletes who suffer from sports injuries of various forms:

  1. Arnica
    • This is one of the most popular and common homeopathic medicines that is used for treating sports injuries.
    • It is a part of all first aid kits at football grounds, at games of all levels.
    • Arnica is very effective when taken immediately after an injury. It is a legal medicine that can be taken by athletes and players after being inflicted with an injury in the field.
    • This medicine is ideal for dealing with bruising pain, that is a part of several sports and helps athletes in keeping fit for their upcoming events .
  2. Calcaera carbonica
    • This homeopathic medicine derived from calcium carbonate is used in case of long standing injuries, in which weakness lasts for more than two weeks in an affected athlete.
    • The medicine is effective for eliminating weakness and stiffness.
  3. Hypericum perforatum
    • This homeopathic medicine is useful in case you get your nerves crushed on account of injuries, such as dropping a heavy barbell on your toe.
    • In such cases, you should take Arnica first, and then take this medicine. It is beneficial for soothing nerve pain.
    • Such pains are common when your spine is injured.
  4. Ledem palustre
    • This is another effective homeopathic medicine for treating sports injuries in athletes.
    • It is used for curing puncture wounds and insect bites.
    • It is also used for treating a black eye and other injuries that are cold to touch. It is ideally used after taking Arnica first.
  5. Rhus toxidodendron
    • This homeopathic medicine is important for treating ligament and tendon injuries that cause intense pain, stiffness, as also when a person experiences strains and sprains.

It is recommended for you to consult a homeopathic practitioner before starting to take homeopathic medicines for treating sports injuries on your own. A doctor will be able to prescribe you the best medicines based on your condition and symptoms.

4 people found this helpful

Mild Brown colour spotting occurs from a week in the evening between 8 to 9 pm for 2 or 3 minutes with several mild cramps in lower abdomen for 1 to 2 hr .I have pcos .and I was took 3 dosage of hmg injection and one dose of hcg injection. Please tell me what happened with my body.

DHMS (Hons.)
Homeopath, Patna
Mild Brown colour spotting occurs from a week in the evening between 8 to 9 pm for 2 or 3 minutes with several mild c...
Hello, ,  Brown  blood during your period is normal, the colour  and consistency of blood can change throughout your menstrual cycle. Sometimes, sporting  or brown discharge occurs in the middle of your cycle, during ovulation. Pcos, require thorough care. Tk, Homoeo medicine:@.Pulsatilla 30-6 pills, thrice. Tk, plenty of water to hydrate your body. Go for meditation to reduce your stress. Your diet be regular, easily digestible on time. Tk, care.
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Post 30 - What Will Change In Your Sex Life?

MD-Pharmacology, MBBS
Sexologist, Delhi
Post 30 - What Will Change In Your Sex Life?

While science might suggest that with age, one’s libido takes a nose dive, it does not necessarily have to be this way all the time. Here are a bunch of reasons why sexual intimacy and pleasuring your partner can be phenominal in your thirtirs:

  1. You only get better with age:  Sex is like wine, it just gets better with age. When you compare the sex in your teenage years to the sex in your 20s, you will have your answer. You were probably more nervous in those teen years, but in the 20s when you libido was at the optimum level, your confidence increased by scores.

  2. Asking for what you want gets easier: This comes from maturity. The older you get, your approach towards sex becomes more mature. You get more comfortable to ask for what you want and you have a better chance of really knowing what you want out of a person.

  3. More confidence: You are 30. You are probably settled and know exactly what you are doing with your life. And it is a well known fact that you look your best in your 30s. This ought to give you the boost you need.

  4. You can laugh it off: Sex can get awkward sometimes. It is not the most pleasant of things. And funny things can happen. With experience you get to know it. And you are in a better position to laugh off things, because you are simply more mature about it and you find the humour in it.

  5. Experience: At certain jobs, people will probably give a passing glance to your qualifications and concentrate more on your experience in that field. The same applies to sex. The more experienced you are, the better you get at the job. Your approach towards sex will be more mature emotionally as well as physically.

  6. Gets easier to stand up for what you want: In your 30s, your patience level may fizzle out. You concentrate more on the things you want rather than putting up with things that never interested you in the first place. If you wish to discuss about any specific problem, you can consult a Sexologist.

7393 people found this helpful

My period are 15 days delayed and pregnancy test is negative. Dr. prescribed me Regestrone 5mg for 3 days but still I have not got my periods. Please suggest what to do?

BHMS
Homeopath, Faridabad
My period are 15 days delayed and pregnancy test is negative. Dr. prescribed me Regestrone 5mg for 3 days but still I...
*Take pulsitila 1M ,5 drops daily morning empty stomach for 7 days. *take ferrum phos 6x, 5 tabs thrice a day. If u get the periods within 7 days then stop pulsitila and if not then get a USG lower abdomen done. Revert me with report.
2 people found this helpful
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Is this important for a mother to give her milk to his/her child upto three-four months and if she didn't give her milk to his/her child then what happen?

BHMS, Classical Homeopathy
Homeopath, Kolkata
Definitely it is important. Not only give immunity to child also enhances mother -child bonding relationship. So Mother's milk is essential and unparalleled to any other milk and chances of contamination is zero.
1 person found this helpful
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How to keep the vagina Clean so that there are no germs while having oral pleasure No obstacles or catching of infection.

MBBS, MD - Obstetrtics & Gynaecology
Gynaecologist, Gurgaon
Cleaning up with soap and water, and using V wash ,and also keeping hygeine like regular use of panty liners and keeping your cotton panties free from moisture. As regards oral pleasure you may also need to keep your oral hygiene intact.
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Respected Doctor. How to control or treatment for preeclampsia during pregnancy of 30 weeks.

MD - Obstetrtics & Gynaecology, DGO
Obstetrician, Vadodara
Respected Doctor. How to control or treatment for preeclampsia during pregnancy of 30 weeks.
Hello Nilasundar Preeclapsia is pregnancy induced Hypertension in last trimester of pregnancy.ts common in first pregnancy and in Multiple twins pregnancy .To prevent we used to advise restrict common salt indiet Yoga and regulat stretching exercise. However it can happen then one has to take Antihypersensitive drugs to control BP with salt restriction. Preclamsia carries risk of fits, early delivery and growth retarded baby.or death of baby. Thanks
1 person found this helpful
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I am currently on femilon and this is my third sheet. I had unprotected sex with my partner on 4th day of my period exactly a month ago. Then started femilon 2nd sheet the next day. But I feel like my stomach size is increasing. Am I pregnant. Need help. I am unmarried.

M.B.S.(HOMEO), MD - Homeopathy
Homeopath, Visakhapatnam
I am currently on femilon and this is my third sheet. I had unprotected sex with my partner on 4th day of my period e...
Many people think that they cannot get pregnant if they have unprotected sex while on their period. In reality, pregnancy depends on ovulation- the process in which an egg is released. Ovulation can happen at any time during someone’s period, making pregnancy possible during the period. Unless you are practicing the natural family planning method, it can be extremely difficult, if not impossible, to know when exactly you are ovulating. This means that even if you keep a period calendar, you need to be also keeping track of ovulation by doing things like taking your temperature and checking your cervical mucus daily. This method is often used after consulting a doctor. A doctor would advise you on how to correctly use this method. With that being said, it’s important to say that pregnancy is possible whenever semen comes in contact with the vagina. If you are having unprotected sex, there is a risk for pregnancy. The length of time between the beginning of menstruation and ovulation can vary from month to month based upon a person’s hormonal balance. In some people, ovulation can occur before menstrual bleeding has stopped, allowing that person to be fertile during their period. Did you know that sperm can also survive inside the vagina for 2-3 days under normal conditions? If that person ovulates several days after bleeding has stopped, they may become pregnant from sperm left in the vaginal canal during intercourse. Many people may also experience bleeding during ovulation, which can be mistaken for menstruation. The best way to avoid pregnancy is to use forms of birth control consistently and correctly. You can take a pregnancy test 14 days after your most recent sexual contact to get an accurate result.
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Hi I got my last period on 23/2/16 which was delayed and we consulted a Dr. and she asked us to maintain relationship from 14th day to 20th on alternate days. Bt we had maintained relationship from 14th day to 27th daybi was expecting pregnancy but it failed and I got my period on 24/3/16. Pls advise why it happened?

MD - Obstetrtics & Gynaecology
Gynaecologist, Mumbai
Hi I got my last period on 23/2/16 which was delayed and we consulted a Dr. and she asked us to maintain relationship...
Treatment for getting pregnant is started 1 year of marriage with regular intercourse. Ovulation occurs only one day in a full monthly cycle. So your body need more time to exactly match that timing with intercourse. To get pregnant you need to have regular sex i. E. 3-4 times a week for one full year before you start seeking medical help. If you want to make her pregnant fast then you can follow this calender method. If a women’s menstrual cycle varies from 26days to 31days cycle, The shortest cycle (26 days) minus 18 days = 8th day. The longest cycle (31 days) minus 10 days=21st day Thus, 8th to 21st day of each cycle counting from first day of menstrual period is considered as fertile period.
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I have got my period on 30 Dec I checked on kit nd result is positive but not show anything in ultrasound what can I do.

MS - Obstetrics and Gynaecology
Gynaecologist, Varanasi
I have got my period on 30 Dec I checked on kit nd result is positive but not show anything in ultrasound what can I do.
Wait for 15 days and repeat ultrasound it will clear you out, and prefer transvaginal ultrasonography this time.
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After having 2 miscarriage in Jan 2016 and March 16 I am trying for a baby. Since nov 17 I am taking treatment I was on 4 cycle of clomid ,duphaston but unable to conceive even after that than in march 17 got to know that I have Pulmonary TB, I have completed my course for the same .And had 3 cycle of letrozole and duphaston too. Since last 2 cycle I am not taking any medicine but trying for natural conception. But since 2 cycle after quiting medicine my periods are scanty and remain for 3 days only .Earlier it was for 6 days with normal clots anc bleeding. M scared, Is it because of medicine that I am having scanty period. Pls help.

BHMS
Homeopath, Chennai
After having 2 miscarriage in Jan 2016 and March 16 I am trying for a baby. Since nov 17 I am taking treatment I was ...
Abortion refers to expulsion of the fetus from uterus before the 20th week of gestation. When abortion occurs spontaneously, it is referred to as spontaneous abortion or miscarriage. Vaginal bleeding occurring during the first 20 weeks of pregnancy is referred to as threatened abortion. Bleeding varies from light spotting to heavy bleeding. This may or may not be attended with abdominal pain. Recurrent or habitual abortion refers to three or more spontaneous abortions occurring one after the other without any intervening pregnancy. Homeopathy is a highly advanced science known to effectively treat many gynaecological and obstetric conditions. Homeopathy remains very successful in treating the tendency towards recurrent abortion and threatened abortion. Homeopathic medicines to treat these conditions are prescribed based on the individual symptom presentation. Each case and its symptoms are studied in detail before a prescription is decided. The month during which miscarriage occurred previously, the character of bleeding, accompanying pains, menstrual history are noted down. A homeopathic constitutional treatment will give you best results naturally You can easily take an online consultation for further treatment guidance and permanent cure without any side effects Medicines will reach you via courier services.
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In which age usage condoms in person in daily life Please age confirmed use condom in full details.

MBBS
Sexologist, Gurgaon
Hi Mr after 18 years use condom for prevention of STD,VD, And sexual disorder disease and pregnancy , it's safe and strile procedure of sex .
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All About Pregnancy!

MBBS (Gold Medalist, Hons), MS (Obst and Gynae- Gold Medalist), DNB (Obst and Gynae), Fellow- Reproductive Endocrinology and Infertility (ACOG, USA), FIAOG
Gynaecologist, Kolkata
All About Pregnancy!

Introduction

When couples get married, they often view parenthood as the next stage in their family life. They want to have a child, they want to be “mom” and “dad”, they cannot imagine that this may be hard to achieve or may not be a natural process. When several trials to conceive fail, they are shocked. Their basic expectation about family life gets shattered. Most of the couples are desperately looking for medical therapy that will end into a misery. Clearly this is not a struggle to survive; it is a struggle to fulfill a dream, to achieve what they view as a “full life”.

What is needed for pregnancy?

In the male partner, sperms are normally produced in the testes after puberty (after attainment of characters like growth of beard, moustache etc). From the testes, they are carried through the sperm conducting ducts (epididymis, vas, seminal vesicle and prostate gland). Then during sexual stimulation, after proper erection and ejaculation, they come out through penis. During sexual intercourse, these sperms, present in semen, are deposited inside the vagina.

 In female partner, the deposited sperms must travel from vagina through the cervix (the mouth of the uterus). The cervix acts as gate-keeper, a it prevents entry of dead and abnormal sperms as well as bacteria present in semen, in the uterus. From uterus, sperms reach the Fallopian tubes (the tubes that are attached to the both sides of the uterus) where the sperms must meet the egg (ovum). The eggs are produced only before birth and so, there are fixed number of eggs inside the ovary. The ovum released from the ovary, into the abdomen at the time of ovulation (rupture of the surface of ovary to release the ovum). That ovum must be taken by the tube and thus inside the tube an embryo (earliest form of the baby) is formed, by meeting of the egg and the sperm.

It should be mentioned that out of nearly 200-300 million sperms, in average, deposited in vagina, hardly 500- 800 sperms can reach near the eggs and only one will succeed to form the embryo. The embryo then travels through the tube into the uterus and the uterus attaches the embryo firmly with it and thus the pregnancy starts. So, if there is defect in any one of them there will be difficulty in achieving pregnancy.

Thus, to summarise, pregnancy requires:

  1. Production of healthy (“Normal Morphology”) and movable (“Normal Motility”) sperms in adequate number (“Normal Count”) in the testes
  2. Transport of these sperms through the sperm conducting ducts from testes to penis
  3. Successful Erection and Ejaculation during Intercourse to deposit adequate number of these sperms in the vagina
  4. Transport of these sperms from vagina through cervix to the uterus and the tubes
  5. Presence of sufficient number of eggs inside the ovary and ability to release the eggs from the ovaries
  6. Pick up of the eggs by the tubes
  7. Approximation of eggs and the sperms to form the embryo
  8. Transport of embryo from the tubes into the uterus
  9. Acceptance of the embryo by the uterus and its growth

What is Infertility?

Literally, the word “Infertility” means inability to conceive. But in reality, there are very few couples, who have no chance of natural conception and are called “Absolutely Infertile”. In fact, in many couples who present to infertility clinics, pregnancy may be the matter of time, thus the chance factor.

It should be kept in mind that, if there is factors to question fertility of either male or female or the female is of age less than 35 years; after one cycle (one month) of regular frequent intercourse, the chance of conception in human being is only 15%. That means, out of 100 couples trying for conception, only 15 will be able to succeed after one month of trying. The word “Regular” and “Frequent” are important; because to achieve pregnancy, couples are advised to keep intimate relationships for at least 2-3 times a week and this should be increased particularly around the time of ovulation (Middle of the menstrual cycle). Thus chance of pregnancy after 6 months, 12 months and 24 months of regular trying are respectively 60%, 80% and 100%.

The word, “Subfertility” seems better and more scientific than “Infertility”, to describe the couples who have reduced chance of conception, due to any cause. However, the word “Infertility”, seems more popular, although it puts pressure on the couples. In most cases, usually we advise to investigate after one year of regular and frequent intercourse, when the couples fail to conceive. However, if there are factors to question fertility; for example female with age more than 35 years, or with previous surgery in tubes/ ovaries/ uterus or known diseases like PCOS or endometriosis; or male partner having surgery in scrotum or groin or any hormonal problems or sexual dysfunctions- the wait period is usually reduced and couples can be investigated, even soon after marriage.

What causes Infertility?

Please look at the point “Thus, to summarise, pregnancy requires” where 9 points have been mentioned.

Thus the common causes may be:

  1. Problems in male- total absence of production of sperms, less than adequate number of sperms, problems in morphology and motility of sperms (most sperms not healthy or movable), blockage in transport of sperms and inability to deposit sperms in the vagina (sexual dysfunction- Erectile Dysfunction or less commonly, Ejaculatory Dysfunction). Examples include hormonal problems (Testosterone, thyroid, prolactin), diabetes, liver problems, causes present since birth, chromosomal abnormalities, surgery, infection, sexually transmitted diseases, smoking, exposure of scrotum to high temperature, some medicines or psychological causes.
  2. Problems in female- total absence of less than adequate number of eggs in the ovaries, problems in ovulation, problems in picking of eggs by the tubes, blockage of tubes, problems in conduction of sperms or embryo by the uterus, problems in accepting the embryos by the uterus. Examles include causes present since birth, chromosomal abnormalities, polycystic ovarian syndrome (PCOS), old age, increased weight, fibroid, endometriosis, pelvic inflammatory diseases (PID), tuberculosis (TB), infections, smoking, surgery, some medicines, hormonal problems (thyroid, prolactin) or excessive stress.
  3. Unknown causes- Despite thorough investigations, 25-30% causes of infertility remain unknown. This is called “Unexplained Infertility”. The reason may be mere chance factors or there may be some causes which, still medical science has yet to discover. But this should be kept in mind while treating infertility. That means, even with correction of the possible factors (like improving sperm counts or thyroid problems etc) or with proper treatment (IUI, IVF or ICSI), unfortunately the treatment can fail and the exact reason, why the treatment failed, is sometimes difficult to find out. 

In general, what are the treatment options for infertility?

To start with, please remember there is no hard and fast rules for infertility treatment. Often medical science fails to understand why couples with very severe form of infertility conceive sooner than those who are having all tests normal. That means, whatever treatment is offered, it’s very important to continue regular sexual intercourse, as the chance of natural pregnancy is usually there in almost all couples. Your doctor will present the facts to you, without pressurizing you on a particular option. After coming to know all pros and cons of different treatment options, you can take decision. Do not hurry. It’s quite natural that you might be in stress. 

In general, after the initial tests, a few periods of natural trying is allowed. After that, ovulation induction (giving medicines to release eggs from the ovaries) is offered, failing which IUI and finally IVF is offered. What will be the preferred treatment for you, will depend on your age, duration of marriage, male and female factors and of course, your age. For example, a woman with both tubes blocked or a male with very low sperm count, IVF would be the first line of treatment.

What is insemination?

Insemination literally means putting semen in a particular place. Various forms of insemination exist in fertility treatment. First one is “Intravaginal Insemination (IVI)”, where the raw semen, collected by the husband can be put inside the vagina, taking precautions (to prevent infection) by the husband himself or by the wife. Rarely, it needs medical assistance from a doctor. It’s usually advised to couples having sexual disorders where full penetrative intercourse is not possible (erectile dysfunction of the husband or very painful intercourse experienced by the wife) or where ejaculation cannot happen during intercourse (a very unusual problem). Thus, the success rate of IVI is no better than natural intercourse (success rate 15% per cycle), for those couples who can manage successful intercourse.

“Intrauterine Insemination (IUI)” is the treatment where “prepared” semen is put inside the cavity of the uterus, near the Fallopian tubes. Thus, IUI bypasses some hurdles that can cause problems during natural intercourse. The vagina, cervix and the whole length of the uterus are bypassed, putting the sperms near the eggs. Thus it increases the success rate compared to natural intercourse or IVI.

However, to achieve pregnancy after IUI, the female partner must have open tubes, adequate number of eggs produced by ovaries, eggs must be released by the ovaries and sperms must meet the eggs. And, thus nature plays important role, as in natural intercourse.

Please note, we used the word “prepared” semen. In natural intercourse, as mentioned earlier, the dead sperms and bacteria cannot enter the uterus, because cervix prevents their entry. If they are put artificially by IUI inside the uterus, severe reaction can happen. So, after collection, the husband’s semen is processed in the laboratory to remove all those impurities and to select only the best number of healthy and movable sperms and it definitely increases success rates of IUI

When IUI is generally advised?

As you can understand, to perform IUI, there must be minimum number of sperms in the semen, the tubes must be opened, the ovaries must be releasing eggs. If these are present, IUI is usually advised

  • Less than adequate number of sperm counts, morphology or motility
  • Couples who cannot perform full penetrative intercourse but refuse or unable to conceive by IVI
  • Unexplained infertility- although IVF is better than IUI, but considering the cost, many couples in our country opt for 2-3 cycles of IUI before IVF
  • PCOS and Mild Endometriosis- where natural intercourse or ovulation induction failed
  • Couples in whom only one partner is positive for HIV or Hepatitis B or C- where transmission from one partner to another by unprotected sexual intercourse is not preferable.

What are the tests done before IUI?

The basic infertility evaluation is done before IUI include husband’s semen analysis, assessment of ovarian function (blood tests, ultrasound) and uterus (ultrasound). In some cases, laparoscopy (putting camera to see inside the abdomen by operation) or hysteroscopy (putting camera through vagina inside the uterus, by operation) may be required. Now, if the tubes are blocked, IUI is of no use. So, testing the tubes is advisable before IUI. But some women, who are at low risk of tubal disease (no history of pelvic pain, infection or surgery), one or two cycles of IUI can be done, failing which tubes must be checked by tests like HSG or SSG or in some cases by laparoscopy.

What IUI actually involves?

In the cycle, in which IUI is planned, the woman is asked to take some medicines (or injections) in particular days of the periods as a part of “ovulation induction”. She is then advised to have ultrasound monitoring (TVS- transvaginal sonogram- where ultrasound probe is placed inside the vagina for better accuracy) to see if eggs are growing in response to the medicines or not. If eggs are growing, IUI is planned in a particular time when the egg(s) is more likely to rupture, so that the tie interval between sperm entry and egg release can be kept as minimum as possible.

Is ovulation Induction necessary for IUI?

Frankly speaking, IUI can be done without any medicines (as in case of natural intercourse or IVI), which is called “Natural Cycle IUI”, where only TVS monitoring is done to see how the eggs are growing. This may avoid some side effects of ovulation induction (see below) but is associated with low success rate than IUI done along with ovulation induction.

Is TVS necessary before IUI?

TVS is, undoubtedly, uncomfortable for the woman. But it gives better picture than ultrasound done conventionally. Now, the question is, whether ultrasound monitoring is at all needed or not. TVS directs the doctor how eggs are growing and at what number and size and when they are likely to rupture. Moreover, the rupture can also be confirmed by TVS. Again, the uncommon side effect of ovulation induction can be detected by TVS. That is called OHSS (“Ovarian Hyperstimulation Syndrome”) where excessive eggs can grow inside the ovaries and this can lead to collection of fluid inside abdomen and lungs and can turn very serious. Although very rare, it can be detected by TVS and early actions can be taken to prevent the progress of this condition.

In rare cases, where TVS cannot be done or patient declines, only option is to check urine by LH kit to predict the likely timing of ovulation and at that time IUI is planned. However, it is less accurate than TVS monitoring and is associated with less success.

What, if eggs are not growing in the ovaries?

In some women, particularly those who are overweight, aged or some cases of PCOS, eggs may not respond initially to one medicine. There are various forms of ovulation induction medicines (tablets, injection). If one is not working, your doctor can try increasing the dose of that medicine or add or replace it with other medicines. Please remember, it’s difficult to predict what medicine will be best suited for a particular patient. So, it’s basically a trial and error process.

What is done on the day of IUI?

As timing is important, the couples are requested to stick to the timing, advised by the doctor. The husband will be asked to collect the semen by masturbation, using clean technique (to avoid contamination by germs in the semen container). The semen is then prepared by the embryologist and will be checked to see the final number of sperms and their motility and morphology.

The wife is asked to lie down in the IUI table. After cleaning, a sterile speculum (instruments to separate walls of the vagina to see the cervix) is introduced inside the vagina and then 0.4-0.6 ml of the prepared semen is inserted inside the uterus with the help of a small catheter (fine tube). IUI done, under ultrasound guidance, gives better result than IUI done without it. The patient is asked to lie down few minutes after taking out the catheter and the speculum. The medicines are advised and then they can go home. 

Is IUI painful?

Most women feel little discomfort during IUI but it should not be painful. If there is technical difficulty while putting catheter inside the uterus, your doctor will discuss it with you and in the next cycle, will plan management to solve this issue.

What happens if husband cannot collect semen?

Collection of semen in unfamiliar environment is understandably a matter of discomfort and seems awkward. Proper counseling and maintenance of privacy can help. Stress-free approach is needed. If it fails, do not hesitate to inform your doctor. Some medicines can help. But in those, who are unable to masturbate, there are some instruments, like ejaculator, can help to solve this problem.

What happens if sperm count is low?

IUI can be successful if sperm count is minimum more than 5 million per ml and there is reasonably good morphology and motility. If not, IVF or ICSI would be the better option. But IUI can serve as trial also. That means before putting the semen, the prepared sperms can be examined and it can be predicted what is the success rate of IUI in this particular case and whether IVF or ICSI would be needed. In rare occasions, where sperm count is extremely low but the couple do not wish for IVF or ICSI, pooled semen IUI can help- where the semen is collected in number of occasions and is preserved and the final pool is used for insemination, to give a reasonable success rate.

When donor sperm is used and how?

If a man does not have any sperms or too few sperms to do IUI, IVF or ICSI is not affordable, donor IUI is an alternative. But it is not done without consent from both husband and wife. The donor is not known to the couple or the doctor and no identity of the donor is revealed. No relative or friend can serve as donor. Donor semen is frozen semen, collected 6 months ago and the donor is tested for diseases like STD, HIV, Hepatitis B or C. Usual attempt is taken to chose donor having blood group and skin colour similar to those of the husband. But remember, it’s only given after discussion and written consent by the couple.

Can a couple have intercourse in the cycle where IUI is advised?

Intercourse around IUI increases the number of sperms available at the time of ovulation.

When should one check for pregnancy?

Usually if period does not come within 18 days after IUI, pregnancy test is advised. It can be done at home. If negative, then the cause of not having periods is sorted out.

What is the chance of success after IUI?

In one cycle, chance of success is around 20-25%. Most of the couples conceive after 3rd or 4th cycle of IUI. The chance of pregnancy after 6th cycle is low, so, usually IUI beyond 6 cycles is not advised.

The factors where IUI gives better results include unexplained infertility, sexual dysfunction of any of the partner, PCOS and male subfertility (low sperm count or motility)

What happens if IUI fails?

As said earlier, you should think about further treatment, if 3rd or 4th cycle of IUI fails. There is no use of doing IUI beyond 6 cycles, unless natural intercourse is not possible and the age is favourable. IVF gives better result.

Is there any harmful effect of IUI?

Very few harmful effects have been noted, for examples, hazards of ovulation induction (OHSS< twin pregnancy), pain, infection and discomfort. As mentined, if raw semen is given, unusual allergic reaction can happen.

How IUI is being done in your particular centre by Dr Sujoy Dasgupta?

We believe in patient’s autonomy. So we want to give time on discussion and presentation of facts and figures to the couples. We encourage questions from the couples and take utmost care so that no question remains unanswered.

We do not take decisions and impose it on the couples. We advise the couples to take time before taking decision on a particular treatment. If the couple decides, we respect and support their decision.

We try to take nominal charges and help couples to collect medicines (particularly injections) at lower prices than MRPs.

After thorough evaluation of both the partners, we plan for ovulation induction drugs, with consent from them and advise them to come for TVS. After each day TVS, we explain the progress and probable timing of IUI.

On the day of IUI, after requesting the couple to maintain punctuality, we advise the husband to collect semen, in comfortable atmosphere, maintaining the privacy. If there is problem in semen collection, we provide support to him and address his issues in sensitive way.

Our expert trained embryologist then prepares the semen. We always encourage the couples to see the condition of raw and prepared semen under microscope to maintain the transparency.

We advise the woman to fill up the bladder (to take water and not to urinate) to facilitate the passage of IUI catheter. Unlike other places, we perform IUI inside OT to prevent unwanted infection.

Again we maintain our uniqueness in the sense that we perform it under ultrasound guidance. The ultrasound guidance has been scientifically proved to increase the success rate of IUI. Moreover, we show the woman in the ultrasound (real time) how the catheter has been put inside the uterus (to make sure that we are not doing IVI or have placed it in wrong position). This also helps to reduce patient’s anxiety and uncertainty. After that, our nurse takes care of the patient and observes her when she takes rest.

Then we advise the post-IUI medicines and advise them what to expect and when they can go home. Again, this time we try to answer all questions the couples can ask.

 

Conclusion

Infertility is a peculiar thing. Very few men or women are absolutely infertile. That means they do not have ability to achieve pregnancy naturally. Majority of them are subfertile. That means most of them have lower than normal chance (compared to healthy couples) to achieve pregnancy in a normal menstrual cycle. Often we find that patients planning for treatment and in the mean time, they conceive naturally. That means even without treatment, there is some chance of pregnancy. Of course, it’s stressful situation for both the partners. Stress affects conjugal relationships and lead to many couples avoiding conjugal life. Indeed stress can affect the hormone levels in females and affects sexual performances in males. It’s easier for us to advise you to stay stress-free but is difficult to practice. Nevertheless, try relaxation as much as possible. Think that majority of the couples ultimately conceive by some form of treatment. Have faith in yourself and have faith in your doctor.

21 people found this helpful

Does Quality of Eggs Affect IVF Treatment

Health and Medical ARC Fertility
IVF Specialist, Chennai
Does Quality of Eggs Affect IVF Treatment

The concept of egg quality of a woman is derived from the belief that the embryo implantation probability is powerfully related to the age and ovarian reserve of the woman. Thus, it is regarded that the quality of the egg is almost synonymous with the chances of embryo implantation. Its quality cannot be assessed merely by looking at the egg or measuring its ability to receive the fertilization by sperm or simply observing the initial embryo division.

There are a few important factors that contribute to the success or failure of the embryo implantation and some of them are:

  1. Diminished ovarian reserve: A woman with an increased FSH level on the third day of the menses is regarded as having diminished reserve of ovary. This implies that her ovary is not competent in sending feedback signals to the pituitary gland and the body responds by producing an increased amount of FSH for stimulating the ovary. For more than 10 years, it has been found that in over thousands of fertility treatment cycles, women with an increased FSH level have a lower egg quality.
  2. Advanced age of maternity: Even though the FSH level is normal, the age of the mother who provides the eggs plays an important role to determine the quality of the egg. Quite like women with increased FSH levels, eggs obtained from women aged more than 40 years can have some problems at a later stage of fertilization. Normal FSH levels are not considered a reassuring factor, owing to the lower implantation rate in females aged over 45 years.
  3. Diminished quality of egg: With an increase in age, the capacity of the mitochondria in producing energy slowly decreases. The egg is linked to the circulation before ovulation, and it is linked again after the embryo implantation. But during the one week time ranging from ovulation to implantation, the egg and the resulting embryo are contained in the zona pellucida and function on the basis of mitochondrial energy supply. The older age of the woman doesn’t cause any problem at the initial stage of ovulation. Its fertilization and embryonic development are also normal. But soon, it runs out of energy and stops dividing before reaching the stage of implantation.

Therefore, it is important to have the eggs tested to find out any sort of chromosomal abnormality. In case the mother is deficient of producing high quality eggs, the best option is to have donor eggs.
 

4027 people found this helpful

My doc asked me to take pregahope vaginal gel for 3 days & both the times I inserted the tube the liquid spilled out maybe half was in & half was out. Is that okay. whats the right way because I inserted the nozzle of the tube inside. please suggest.

MD - General Medicine
Sexologist, Delhi
Sexual intercourse is an essential act for humans and therefore we should try and understand its mechanics. During copulation, the vagina releases a lubricant that it secretes which tackles vaginal dryness and assists both men and women in deriving greater pleasure from the sexual act. Albeit, natural lubricant is not the only option present. A woman can choose from three uniquely characterized lubricant options, namely - oil based, water based and silicone based. These lubes combined with moisturizers can help a couple derive immense pleasure from coitus. It is important to remember that lubricants for women are used on the most sensitive parts of their body and can prove harsh on their skin, if they fail to adhere to the guidelines before using the tube (s).
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I have irregular periods. Sometimes it is regular I.e every month and sometimes it skip for 2 to 6 months. My weight has also increased by 3 kg in last 2 months. And my period is missed from March.

BHMS, MD - Alternate Medicine
Homeopath, Nagpur
I have irregular periods. Sometimes it is regular I.e every month and sometimes it skip for 2 to 6 months. My weight ...
In majority of the cases irregular menses are accredited to hormonal imbalance, but in some cases it may be pathological and secondary to some pathology of ovaries mostly. Now if you want to regularized the menses then you must establish permanent balanced first and this can be achieved only with homoeopathy, because in modern medicine we get only a hormonal support with a very temporary relief. But with homoeopathy you can strike the hormonal balance permanently which later on also give you regular menses even if you stop the medicine.
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I had sex with my girlfriend and I gave her pill after 48 hours but till now she has not periods it have been 13 days and she is feeling unconscious having vomit after eating anything from 3 days and headache.

Gynaecologist, Mumbai
I had sex with my girlfriend and I gave her pill after 48 hours but till now she has not periods it have been 13 days...
Hello lybrate-user Do urine pregnancy test And confirm it Unwanted 72 should be taken between 12-72 hours after an act of unprotected penetration. The earlier it is consumed, the better the chances of preventing a pregnancy. Because it takes 72 hours for a pregnancy to take place after an egg gets fertilized in the womb, Unwanted 72 can prevent the same from happening when taken in the time frame of 12-72 hours.
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