What is recurrent miscarriage?

If you have three or more miscarriages in a row, doctors call it recurrent miscarriage. If you have experienced recurrent miscarriage, your GP or midwife will refer you to a gynaecologist. Your gynaecologist will try to identify the reason for your losses.

Having miscarriage after miscarriage may leave you feeling utterly drained of hope. At times, it may be hard to keep trusting in the future. This experience affects every aspect of a woman s life from her mental and emotional health to her physical health and social well-being. 

If you can, try to draw comfort from the fact that most women who experience recurrent losses do go on to have a baby. This is especially the case if tests can find no reason for the losses. Six out of 10 women who have had three miscarriages will go on to have a baby in their next pregnancy.

Treatment of Recurrent Pregnancy Loss

Treatment for anatomic abnormalities of the uterus involves surgical restoration through removal of local lesions such as fibroids, scar tissue and endometrial polyps or timely insertion of a cervical cerclage (a stitch placed around the neck of the weakened cervix) or the excision of a uterine septum when indicated.

A thin endometrial lining has been shown to correlate with compromised pregnancy outcome. Often times this will be associated with reduced resistance to blood flow to the endometrium. Such decreased blood flow to the uterus can be improved through treatment with sildenafil (Viagra), Terbutaline and possibly aspirin.

Sildenafil (Viagra) Therapy Viagra has been used successfully to increase uterine blood flow. However, to be effective it must be administered starting as soon as the period stops up until the day of ovulation and it must be administered vaginally (not orally). Viagra in the form of vaginal suppositories given in the dosage of 25 mg four times a day has been shown to increase uterine blood flow as well as thickness of the uterine lining. To date, we have seen significant improvement of the thickness of the uterine lining in about 70% of women treated. Successful pregnancy resulted in 42% of women who responded to the Viagra. It should be remembered that most of these women had previously experienced repeated IVF failures.

Terbutaline this is a medication that relaxes the muscle in the uterine wall and so permits improved hormone delivery to the endometrium. The use of Terbutaline will often cause an increase in heart rate. It should not be prescribed to women who have irregular heart beats (arrhythmias), and women who have decreased cardiac reserve.

Aspirin this is an antiprostaglandin that improves blood flow to the endometrium. It is administered at a dosage of 81mg orally, daily from the beginning of the cycle until ovulation.

Selective Immunotherapy Using Intralipid, heparin, aspirin and corticosteroid

Many causes of pregnancy loss or failure can be treated with immunotherapy comprising combinations of aspirin and heparin and corticosteroids (dexamethasone or prednisone) and Intralipid (IL) to regulate increased NKa. Achievement of optimal success with Intralipid/corticosteroid therapy requires that the treatment be initiated well before ovulation takes place (about 7-14 days prior to anticipated implantation). Given the fact that only 10-15% of natural cycles (with or without the use of insemination and/or fertility drugs) will result in a pregnancy, it follows that repeated administration of Intralipid will be required in most cases before a pregnancy will occur. IVF achieves pregnancy rates that are often 2-3 times higher. This often makes IVF a treatment of choice in cases of immunologic recurrent pregnancy loss.

Role of IVF

Preimplantation genetic diagnosis (PGD) a procedure whereby the embryo can be tested for genetic or structural chromosomal abnormalities requires the use of IVF to select the best embryo(s) for transfer to the uterus. In cases of structural chromosomal (translocations) egg or sperm donation is often another option worth considering.

In those cases where due to intractable anatomical or alloimmune dysfunction IVF repeatedly is unsuccessful or is not an option, Gestational Surrogacy might represent the only recourse other than adoption.
If a couple with Recurrent Pregnancy Loss is open to all of the diagnostic and treatment options referred to above, a live birth rate of 70%   80% is ultimately achievable.

Recurrent Miscarriage - How to Deal With It?

Diabetes is something which has become so common over the past few decades and this is said to be a cause of worry as most people don't understand how to prevent and manage it. This has led to some myths, gaining more than their fair share of popularity. So, wouldn t it be a good idea to get to know a little more so as to separate the myths from the facts?

Weight & watch: One of the most common myths when it comes to diabetes is the belief that a person is going to have his or her life adversely affected if he or she is overweight. While it is true that being overweight happens to be one of the risk factors related to diabetes, it is important to keep in mind the fact that there are other risk factors which are responsible, as well. Some of these factors are age and family history, as well as the ethnicity of the person. Taking this into account, it should not come as too much of a surprise to know that there are quite a few people who are not overweight, but are still fighting diabetes.
Packaged tricks: Considering the rise in the number of people who are suffering from diabetes, this has led to food being marketed specifically for their consumption. However, in reality, whatever represents a healthy diet is sufficient for a person who is diabetic. So a diet which does not have a high amount of saturated fats and trans fats and does not go overboard with starch and sugar, but features a fair amount of lean protein works well too. All the fancy diabetic food, which a person buys, is only likely to drive a great hole in the wallet and not have any additional health benefits. Therefore, the extra spending is nowhere close to being worthwhile and should be avoided.
Fruits punch: Many people are of the opinion that it is the processed and sugary food items, which cause diabetes and this is true to a significant extent. However, some people are of the view that since fruit is natural, diabetics can eat as much of it as they like. This is where the thinking gets dangerous. Some fruits are rich in carbohydrates and so it should be consumed in a reasonable quantity, as part of the daily meal plan. After all, too much of any good thing is bad!

Diabetes - 3 Myths Decoded!

Does watching porn together help you have a better sex life?

It is often said that the couples who do most day-to-day activities together are more committed towards each other. But does the same stand true when it comes to watching sexual content or pornography? Well, research certainly seems to indicate that, with a whopping 96% couples watch pornography together. Here are some pros and cons of viewing porn with your partner.

PROs-

1.  It may help you both in discovering your sexual preferences
It is important for both you and your partner to be on the same page when it comes to discovering your sexuality and figuring out each other’s sexual preferences. Just like adolescent sex education, pornography too educates you about the mechanics of sexual play. It is a useful tool that brings out the kinky side in you and makes you more open to discussions on things that pique your curiosity in the bedroom. As and when you see such visual imagery, it may appeal to you enough to try it out with your partner. Discuss such desires with your partner. This may help you in discovering what really turns you and your partner on.

2. It may help you in maintaining sexual fidelity in your relationship
Watching porn together with your partner can potentially increase the intensity of physical attraction between the two of you.This, as a result, leads to greater gratification for both of you, and if you are sexually satisfied by your partner, you are less likely to look for pleasure outside your relationship. Also, it is way healthier to indulge in it as a team rather than discovering your partner watching porn alone.

3. It may help both of you to pick up newer positions
Porn has the ability to expose you to new and exciting positions you never knew. About 58% of couples who viewed pornography claimed that the shared activity had a positive effect on their sex lives. New moves and unique positions are known to spice up sex lives. Men can surprise their women (or vice versa) with an exotic move or two. Porn may also help in decreasing shyness and in opening up your minds so that you can pick up and practice new moves.

CONs-

Although porn viewing may consist of potential benefits, it may also affect your relationship adversely. When watched in excess, porn may cause certain problems in your relationship, which are-

1. It might set up wrong expectations in reality
Porn movies give you a warped view of what beauty is. It may cause you to have unrealistically higher expectations from your partner, whereas the reality may not match your imaginative hopes and standards. As a result, it may also lead to frustration, aggression and infidelity.

2. It may lead to pornography addiction
 The visual and physical appeal of porn may impact a person’s mental or social well-being. Increased porn viewing may hint at a person’s social isolation, loss of interest in career and other activities etc. It may also make you highly dependent on it, as it allows immediate sexual gratification. As a result the usage may go out of control and relate directly to compulsive behaviour.

3. It may affect your sexual drive and libido
Making love to your partner in real-life may become a foreign concept, as porn can decrease your physical drive with the possibility of making you sexually lazy. Porn may also have certain side effects including probable loss of libido and even difficulty in lasting longer. It may also make regular intercourse seem boring as it may not have the same sensual and visual appeal as pornography.
After realising its various pros and cons if you want to use porn, it is advisable to not use it as replacement but as an accessory for better sexual well-being.

If you would like to consult with me privately, please click on 'Consult'.

Does Watching Porn Together Really Help You Have a Better Sex Life?

In today's world, the number of working moms all over the world is more than ever. Such women have a huge two-fold task of balancing between work and home, which includes looking after their children and managing their work at office. Balancing the two ends can make life hard for a working mother.

Here are some effective ways to find balance in motherhood for working mothers:

Find good child care: While you are out for work all day, it is very important for you to get a good babysitter or nanny for your child. You could should seek references from people and find a patient and quality babysitter for your child. It is important to manage and evaluate the babysitter on all the criteria you require. An experienced and friendly sitter would make your child comfortable.
Keep the morning easy: Get things organized at night so that you can keep the mornings hassle free. Use the mornings to prepare your child s lunch and laying out clothes. Plan all kinds of family schedules during this time.
Maintain a family calendar: You should maintain a calendar to figure out the priorities of your family. You can maintain bill payment dates, a chore calendar for your kids, a list of all important events and other required charts. This will enable you to maintain everything, in spite of your busy schedule and enable you to strike a better balance.
Stay connected during daytime: You should try to stay connected with your children, even when you are away. You should call them frequently or send them cute messages or voice recordings and videos. This will keep them happy and they will miss you less. They will be more comforted and feel loved that you are near instead of being away at work.
Keep away from distractions and time wasters: You should stay disciplined and maintain a limit on making phone calls or checking mails. Try to do these activities when your children are asleep. Cut down your television watching time and spend the evenings with your partner. When you are spending time with your children, do not multitask and give them your total attention. At work, try not to waste time and return home as soon as work gets over.
Arrange family activities: You must make time for your kids in order to nurture your bond and get along with them. During their growing up phase, your child requires a major chunk of your time. Make special family dinners, watch movies with your family in the home theater and engross in different games. Spending time with your partner is also very important.
Life is quite difficult for working mothers who have to balance work and family together. In order to maintain a balance, follow the above-mentioned measures and lead a happy and fulfilling life. 

Lifestyle Balance Of A Working Mother!

Cancer is the abnormal, uncontrolled growth of cells in a particular body part. With continued growth, pieces of this tissue travel through the blood to different body parts and continue to grow in the new area. This is known as metastases. Breast cancer is one of the most common forms of cancer and affects about 1 in 8 women in the USA. Read on to know more details of breast cancer   breast anatomy, causes, symptoms, risk factors, detection, prevention, and of course treatment.

Anatomy: The main function of the breast is lactation through its milk-producing tissue that are connected to the nipple by narrow ducts. In addition, there is surrounding connective tissue, fibrous material, fat, nerves, blood vessels and lymphatic channels which complete the structure. This is essential to know as most breast cancers develop as small calcifications (hardened particles) in the ducts or as small lumps in the breast tissue which then continues to grow into cancer. The spread can happen through lymphatic or blood flow to other organs.

Warning signs/symptoms: The following are some symptoms that need to be watched out for if you have a predisposition to breast cancer.

    A lump in either of the breasts or armpits
    Change in size, shape, or contour of either breast
    Redness of your breast or nipple
    Discharge of clear or bloody fluid
    Thickening of breast tissue or skin that lasts through a period
    Altered look or feel of the skin on the breast or the nipple (dimpled, inflamed, scaly, or puckered)
    One area on the breast that looks very different from the other areas
    Hardened area under the breast skin

Either one or a combination of these should be an indication to get a detailed checkup done. Early diagnosis results in controlling the disease with minimal treatment and reduced complications.

Causes and risk factors: The exact cause for breast cancer is yet to be pinned down. However, risk factors are clearly identified, and women with risk factors need to watch out for warning signs.

    Family history: Of all the risk factors, the family history is the most important. Breast cancer runs in families, and if there is a first-degree relative with the breast cancer, the chances of developing it are almost double. Two genes BRCA1 and BRCA2 are the carriers of the disease, and this testing can be done in women to identify if they are at risk.
    Family history of other cancers: Even if there is no breast cancer, if there are other cancers that run in the family, watch out.
    Age: Women over 50 are at higher risk of developing breast cancer.
    Race: Caucasian and Jewish women are at higher risk of breast cancer than African-American women.
    Hormones: Greater exposure to the female hormone estrogen increases the chances of developing breast cancer. Women who use birth control pills for contraception and hormone replacement after menopause are at a higher risk of developing breast cancer.
    Gynecologic milestones: Women who have abnormal menstrual milestones need to watch out. These include those who attain menarche before 12 years of age, get pregnant after 30, attain menopause after 55, and have menstrual cycles shorter than 26 days or longer than 29 days.
    Obesity and alcohol abuse are also likely to increase a woman s chances of developing breast cancer.

Stages: Starting from stage 0, higher stages indicate advanced disease.

    Stage 0: The growth which has begun in the milk-producing tissue or the ducts has remained there (in situ) and not spread to any other area, including the rest of the breast.
    Stage I: The tissue slowly becomes invasive and has begun to affect the surrounding healthy tissue. It could have spread to the fatty breast tissue and some breast tissue may be found in the nearby lymph nodes.
    Stage II: The cancer at this stage grows considerably or spreads to other parts. There are chances that cancer may grow and also spread.
    Stage III: It may have spread to the bones or other organs but small amounts are present in up to 9 to 10 of the lymph nodes in the armpits and collar bones which makes it is difficult to fight.
    Stage IV: The cancer is widespread to far-flung areas like the liver, lungs, bones, and even the brain.

Screening: This is one of the most effective ways to identify the disease in its early stages. This will help in controlling cancer from spreading with minimal treatment.

    Self-examination: A thorough self-examination to look for changes in terms of shape, size, colour, contour, and firmness should be learned by all women. Watch for any discharge, sores, rashes, or swelling in the breasts, surrounding skin, and nipple. Examine them while standing and when lying down.
    In most women, annual screening mammograms are advised after the age of 40. However, in women who have a strong family history or genetic makeup, it is advisable to have screening mammograms starting at age 20 every 3 years and then annually from the age of 40.
    Women in high-risk categories should have screening mammograms every year and typically start at an earlier age.
    Ultrasound screening can also be given in addition to mammograms.
    Breast MRI is another way to screen for breast cancer if the risk is greater.

Breast Cancer Prevention: Now that there is so much awareness about causes and risk factors, there are definitely ways to prevent or delay the onset of the disease.

    Exercise and a healthy diet with reduced amount of alcohol are definitely effective in minimising the chances of developing cancer.
    Tamoxifen is used in women who are at high risk for breast cancer.
    Evista (raloxifene) which is used to treat osteoporosis after menopause. It is also widely used in preventing breast cancer.
    In high-risk women, breasts are surgically removed to prevent the development of cancer (preventive mastectomy).

Treatment: As with all cancers, treatment would depend on the stage at which it is identified and include a combination of chemotherapy, radiation, and surgery. As noted earlier, if you are at risk, look out for warning signs as early diagnosis is the key to maximum recovery.

Breast Cancer - Know More to Say 'No' More!

The abnormal growth of the endometrium tissue outside the uterus is known as endometriosis. Ideally, the abnormal tissue is supposed to break down and exit the body. However, in this condition, the tissue is unable to pass out of the body. As a result, the surrounding tissue tends to get irritated and leads to the formation of scar tissues.

The various causes of endometriosis include:

Immune system disorder: Complications in the immune system might render it incapable of destroying the endometrial tissue that grows outside the uterus.
Surgical scar implantation: Certain surgeries such as a C-section may result in the attachment of endometrial cells to the incision area.
Embryonic cell transport: These cells may be transported to other parts of the body by the blood vessels which may lead to endometriosis.
Retrograde menstruation: Instead of passing out of the body, under this condition, the blood flows back into the pelvic region via the fallopian tubes. When these cells attach themselves to the pelvic cavity, it causes endometriosis.
Symptoms
1. Pain during sexual intercourse
2. Pain during periods including pelvic pain, especially during periods, lower back pain and abdominal pain.
3. Excessive bleeding during periods
4. Fatigue
5. Constipation
6. Bloating

The major complication that results is fertility problems. Endometriosis may prevent the combination of the egg and the sperm and thus, impairs your ability to conceive. It is recommended not to delay pregnancy if you have endometriosis. This disorder also tends to increase the risk of ovarian cancer in some women.

How can it be treated?

Endometriosis is usually done using surgery or medications. 

Medication: It usually involves painkillers.
Hormone therapy: Some of the hormonal therapies include:
Hormonal contraceptives
Progestin therapy
Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists
Conservative surgery: If a patient wants to become pregnant, surgery is done as much as possible without harming the uterus and ovaries. Suggested procedures include laparoscopy and traditional abdominal surgery.
Assisted reproductive technologies: An example of this form of treatment is In Vitro Fertilization.
Hysterectomy: Under severe circumstances, total hysterectomy is conducted in order to facilitate the removal of cervix and uterus. If you wish to discuss about any specific problem, you can consult a gynaecologist and ask a free question.

Endometriosis - 4 Reasons Behind it!

Don't wait any longer, manage your Sonologist online with a Lybrate doctor today

Consult for Sonologist - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES