The fallopian tubes are not mere passages for the egg to travel from the ovaries to the uterus. It is here that conception occurs and hence healthy fallopian tubes are essential for the fertilization of an egg. 

Damaged fallopian tubes are the most common cause of infertility. This damage can fall under three categories. 

 Blocked fallopian tubes
 One blocked and one open fallopian tube
 Tubal scarring

The third is usually an effect of pelvic infections or natural healing after a pelvic surgery. Sadly, in most cases, this condition is discovered only after infertility has been diagnosed. Other causes of fallopian tubal scarring include:

 Stds such as chlamydia trachomatis and neisseria gonorrhea
 Adhesions caused by ruptured ovarian cysts
 Appendicitis
 Peritonitis
 A history of ectopic pregnancies

Fallopian tubal scarring has no recognizable symptoms. Chronic pelvic pain is the only known symptom of this damage and that too can be seen only in severe cases of tubal scarring. On diagnosing infertility, your doctor will perform one of these tests to determine the condition of your fallopian tubes.

 Hysterosalpingogram: this is a type of x-ray. Your doctor will open the vagina with a speculum and inject a liquid into the uterus with the help of a catheter. If the liquid does not pass through the fallopian tubes, it is said to be blocked. This however, does not say much about tubal scarring.
 Laparoscopy: a small incision is made below the belly button and a slim, flexible tube with a camera is passed through the incision. This gives your doctor a clear view of the condition of your fallopian tubes. A laparoscopy can also be used to rule out other causes of infertility such as endometriosis or blocked fallopian tubes. 

Treatment for infertility caused by tubal scarring is of two types:

 Surgery: this is suggested in cases where tubal scarring is minimal. Depending on the intensity and placement of scar tissue, your doctor may decide to perform one of many types of surgeries. He may choose to remove the scarred section of the fallopian tube, create a new opening (in case of blockages) or rebuild the damaged edges of the fallopian tubes.
 In vitro fertilization (ivf): women with badly scarred fallopian tubes usually have poor chances of conceiving naturally. Hence, ivf is the preferred treatment route. However, your doctor may still advise you to undergo surgery and remove the damaged tubes prior to ivf to prevent the tubes from filling with fluid.

Tubal Scarring and Infertility

Reasons for spotting during pregnancy and what you can do about it

Seeing spots of blood during pregnancy is usually a cause for concern. However, it is not uncommon. The light bleeding, which is known as spotting may occur for a number of reasons.

Bleeding during the first trimester

Spotting is most likely to happen during early pregnancy and the reasons could be many, such as:

- implantation bleeding occurs during the first month of pregnancy when the fertilised egg gets attached to the wall of the uterus.

- cervical polyps ( a tumour that form on the surface of the cervix) or yeast infection may also cause episodes of spotting.

- miscarriage may be another possible reason for spotting

- ectopic pregnancy is another cause. It is the condition in which the embryo plants itself in either of the fallopian tubes instead of the uterus.

- molar pregnancy is a rare condition associated with spotting during pregnancy. When this is the case, instead of your baby, an abnormal tissue grows inside the uterus. Sometimes it can be cancerous too.

Bleeding during the second or third trimesters

Spotting may also occur during late pregnancy and the possible reasons are listed below.

- problems related to placenta like placenta previa placental abruption can also result in spotting. These are serious conditions when the placenta either covers the cervix or it gets detached from the uterine wall respectively.

- uterine rupture is the rare and unfortunate event when a scar from a previous surgery (like the removal of fibroid or previous caesarean scar bursts open and the baby slips into the pregnant woman's abdomen.

- premature labour occurs when your body is too eager to deliver the baby, usually one month before the due date of delivery.

- vasa Previa is another rare condition when a baby who is still developing has his blood vessels entangled in the umbilical cord or placenta-crossing the cervix. It is extremely dangerous because the blood vessels may burst open thus causing the baby to bleed and lose oxygen.

Here's what you can do about spotting

It is strongly recommended that you should immediately see your doctor as soon as you detect any spotting during your pregnancy. Only a well-qualified medical expert can suggest the appropriate steps to be taken, depending on your individual reasons and symptoms related to spotting.

If you would like to consult with me privately, please click on 'consult'.
Related Tip: 6 Changes You Can Expect During the 2nd Trimester of Pregnancy

Reasons for Spotting During Pregnancy

Caesarean section or C-section is fairly common today and most mothers do not realize that once their incision has healed completely, the scar tissue problems can still occur. Unfortunately, there are no instructions for how to heal and care for C-section scars after they go home. The general post-operative instructions from hospital include a list of activities to avoid like lifting heavy articles and driving.

Caesarean scars can cause pain well after they've healed. This happen at the site of incision, but in other areas as well. It's important to remember that the scar you see on a mother's lower abdomen is just one spot that scar tissue has formed. There are also internal scars which can spread throughout the body over a time period. This scar tissue can cause lingering pain and dysfunction well after delivery.

When our body tissue gets damaged, scar tissue forms. After a C-section, scar tissue forms along the abdomen and uterus as part of the natural healing process. Caesarean scars can be painful and mothers feel pain or tightness in their scars when they are reaching, leaning, lifting or standing up straight. The scar can cause muscle, connective tissue, and nerve damage in areas adjacent to scarred area. Over time this can lead to pelvic pain, bowel problems like constipation and irritable bowel syndrome and painful sex.

C-section scars are typically located in an area where they can entrap nerves. This can cause pain and also create an urgency or frequency to urinate. The best thing for a new mother is rest and recovery and doing too much, too soon, after a caesarean is a health risk. It is important that to keep incision clean, eat well and avoid lifting heavy articles to support healing. It is recommended that mothers have lymphatic and myofascial massage two days prior to surgery and as soon as possible post-surgery. Lymphatic massage is a light massage assisting in drainage and allows the collagen to align with the incision.

At three months post-caesarean mothers can begin scar tissue release therapy that involves massaging of the scar tissue so it becomes softer and more flexible like the surrounding skin and internal tissues. It needs to be done with three dimensional focus, slowly and gently separating the adhered tissues in all directions. The scar tissue release therapy painful with a burning sensation for some mothers, while some only feel mild discomfort or no pain at all.

Regardless of the age of the scar, one could get benefits from scar tissue release therapy from injuries to burns to surgical scars. Surface and internal scarring from surgeries could be contributing to many of the issues. Sometimes scarring is just a piece of the puzzle of your pain and so a pelvic floor physiotherapy in addition to scar tissue release therapy is recommended. The scar tissue release therapy reduces the appearance of C-section scars. It softens tissues and increases circulation, which all lead to a lightening in colour of the C-Section scar.

Tips to Deal with Caesarean Section Stiches

Frozen Embryo Transfer or FET is an extremely effective method to conceive a pregnancy. Recent studies have proved that there is a increased chance for pregnancy when the embryos, which get used are frozen and get placed inside the uterus at a time right after the ovaries are stimulated. Still, certain issues can arise with the transfer of frozen embryo, such as:

A Thin Lining of the Uterus
Research has shown that there are not many women who get pregnant if the lining in their uterine does not tend to thicken enough. It is not clear exactly why this problem occurs in most women and moreover there is no sure shot treatment to make the lining of the uterine thick. The experts on fertility would try out different methods like increasing the amount of estrogen or change the way how estrogen is given. There are other instances when women might be given supplemental medicines, while for some, the problem will continue to exist.

What Should Be Done In Case The Problem Persists?

In case the problem continues for some women, then there are certain approaches which experts might look to adopt. The first one is to cancel the transfer of embryo and try once again at any later stage, that too with a different treatment method.
The second option which they could think of is to go ahead with the transfer, wherein they might feel that a thin lining does not necessarily mean that it is impossible for a woman to get pregnant but definitely the efficiency would be reduced.
One last option is to make use of the opportunity for undergoing additional tests which would help them to assess the ability of the uterus to allow implantation of the embryos.
Unexpected Ovulation
For enabling the embryos to get implanted into uterus, placing them very precisely and at the appropriate time is important. This is regarded as the window of implantation. The time taken, is based on the time frame since progesterone reaches the lining of the uterine.

Doctor knows the exact time to place the embryos, right from the time he or she instructs a woman to start having progesterone supplements. In case a woman was to ovulate, the production of progesterone would begin earlier than the normal time and would lead to the shift of the window of implantation. As identifying the correct time of ovulation is almost impossible, so that would lead to some sort of uncertainty into the timing.

Due to this reason, there are doctors who would use medication in order to prevent unexpected ovulation from occurring. Generally an injection called Lupron is usually used as medication.

Timing for the Embryo Transfer is Inappropriate
This is a problem related to early ovulation. There are case when the implantation window is shifted, still the timing of the transfer becomes accurate. Recent studies have shown that quite a nominal percentage of women might have a window of implantation, which could be either earlier or later than normal time. A test called the Endometrial Receptivity Array can help determine at what time is the window of implantation open.

Frozen Embryo Transfer - Complications Associated With It!

Use of contraceptives is really important to avoid unwanted pregnancy. Countries like China and India, facing the problem of population explosion lay more stress on the use of contraceptives. However, you must always use or take oral and barrier contraceptives following the advice of a medical practitioner unless it is absolutely necessary to go ahead without consultation. The reason behind medical assistance is your own health. Contraceptive methods do have a vast range of side effects that can result in health hazards. There are various kinds of contraceptives; each having its own set of advantages and disadvantages. Being acquainted with the side effects of some contraceptive methods can help you choose wisely in times of need.

Possible side-effects of using condoms: Some men are allergic to latex. Using condoms can lead to heightened sensitivity. It can also lead to rashes in your genitals. Condoms are not foolproof. They do not provide total protection against sexually transmitted infections, HPV or against Syphilis and Herpes. These diseases can be contracted by coming in contact with genital skin that is not covered by a condom.
Possible side-effects of a Contraceptive Film: A contraceptive film might act as an interruption in your sexual activities if it is not placed properly, that is to say it must come in contact with the cervix to be effective. Using the film nonoxynol- very frequently can make you susceptible to life threatening diseases like HIV and other STIs.
Possible side-effects of a Cervical Cap: A cervical cap has to be inserted by a clinician and requires immense care to be fitted in later. Some of its side - effects can be of serious concern. If it is left inside for more than forty eight hours, it can result in toxic shock syndrome. Toxic shock syndrome is an infection that mars your overall health. It is also known to increase the chances of inflammation of the surface of your cervix.
Possible side-effects of Progestin only pills: Progestin only pills or mini pills can subject you to long- lasting depression. It can make you feel bloated and can actually increase your weight to a great extent if used on a regular basis. Minipills lead to irregularities in your menstrual cycle and might also make bleeding during menstruation scanty.
Possible side-effects of combined oral contraceptives: If this is your first month on combined oral contraceptives, you might feel nauseous and they can give you a terrible headache. Women taking these pills have a higher chance of developing cervical dysplasia. If you wish to discuss about any specific problem, you can consult a gynaecologist and ask a free question.

Side Effects of Different Contraceptive Methods

Cervical Cancer is most treatable when it is diagnosed and treated early. Problems found can usually be treated, depending on their severity and on the woman's age, past medical history, and other test results. Most women who get routine cervical cancer screening and follow up as told by their provider can find problems before cancer even develops. Prevention is always better than treatment.
Other HPV cancers are also more treatable when diagnosed and treated early. Although there is no routine screening test for these cancers, you should visit your doctor regularly for checkups.
Your doctor might recommend the HPV test if:
Your Pap test was abnormal, showing atypical squamous cells of undetermined significance (ASCUS)
You're age 30 or older
The HPV test is available only for women; no HPV test yet exists to detect the virus in men. However, men can be infected with HPV and pass the virus along to their sex partners.
What is a HPV Test?
The HPV test is a screening test for cervical cancer, but the test doesn't tell you whether you have cancer. Instead, the test detects the presence of HPV, the virus that causes cervical cancer, in your system. Certain types of HPV - including types 16 and 18 - increase your cervical cancer risk.
Knowing whether you have a type of HPV that puts you at high risk of cervical cancer means that you and your doctor can better decide on the next steps in your health care. Those steps might include follow-up monitoring, further testing, or treatment of abnormal or precancerous cells.
Pap- HPV Test:
HPV spreads through sexual contact and is very common in young women, so, frequently, the test results will be positive. However, HPV infections often clear on their own within a year or two. Cervical changes that lead to cancer take several years - often 10 years or more - to develop. For these reasons, you might follow a course of watchful waiting instead of undergoing treatment for cervical changes resulting from an HPV infection.
A combination Pap-HPV test is performed in your doctor's office and takes only a few minutes. You'll lie on your back on an exam table with your knees bent, your doctor will gently insert an instrument called a speculum into your vagina. The speculum holds the walls of the vagina apart and a flat scraping device called a spatula or a soft brush is used to take samples of your cervical cells. This doesn't hurt, and you may not even feel the sample being taken.
Results of your HPV test are given as positive or negative 
Positive HPV test:A positive test result means that you have a type of high-risk HPV that's linked to cervical cancer. It doesn't mean that you have cervical cancer now, but it's a warning sign that cervical cancer could develop in the future. Your doctor will probably recommend a follow-up test in a year to see if the infection has cleared or to check for signs of cervical cancer.
Negative HPV test: A negative test result means that you don't have any of the types of HPV that cause cervical cancer.
Depending on your test results, your doctor may recommend one of the following as a next step:
Normal monitoring:If you're over age 30, your HPV test is negative and your Pap test normal, you'll follow the generally recommended schedule for repeating both tests in five years.
Colposcopy: In this follow-up procedure, your doctor uses a special magnifying lens (colposcope) to more closely examine your cervix.
Biopsy:In this procedure, sometimes done in conjunction with colposcopy, your doctor takes a sample of cervical cells (biopsy) to be examined more closely under a microscope.
Removal of abnormal cervical cells:To prevent abnormal cells from developing into cancerous cells, your doctor may suggest a procedure to remove the areas of tissue that contain the abnormal cells.
Seeing a specialist: If your Pap test or HPV test results are abnormal, your healthcare provider will probably refer you to a gynecologist for a colposcopic exam. If test results show that you might have cancer, you may be referred to a doctor who specializes in treating cancers of the female genital tract (gynecologic oncologist) for treatment.

Cervical Treatment Diagnosis, Tests and Treatment

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