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Dr. Renu Chandana

Gynaecologist, Dehradun

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Dr. Renu Chandana Gynaecologist, Dehradun
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Hello and thank you for visiting my Lybrate profile! I want to let you know that here at my office my staff and I will do our best to make you comfortable. I strongly believe in ethics; a......more
Hello and thank you for visiting my Lybrate profile! I want to let you know that here at my office my staff and I will do our best to make you comfortable. I strongly believe in ethics; as a health provider being ethical is not just a remembered value, but a strongly observed one.
More about Dr. Renu Chandana
Dr. Renu Chandana is an experienced Gynaecologist in Chakrota Road, Dehradun. She is currently associated with Dr Renu Chandana's Clinic in Chakrota Road, Dehradun. Don’t wait in a queue, book an instant appointment online with Dr. Renu Chandana on Lybrate.com.

Lybrate.com has a number of highly qualified Gynaecologists in India. You will find Gynaecologists with more than 41 years of experience on Lybrate.com. Find the best Gynaecologists online in Dehradun. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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My wife is blooding in vagina .its start from our married life first night .so what should I do?

MD-Ayurveda, Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Sexologist, Haldwani
Hello- this is due to improper perforation of hymen. 1) drink milk with turmeric powder. 2) wash the vaginal area with fitkari water. 3) start ayurvedic medicines as soon as possible to avoid infection.
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I am 25 weeks pregnant and during motion shows greenish what is the reason for that ?

DGO, MD, MRCOG, CCST, Accredation in Colposcopy
Gynaecologist, Kolkata
I am 25 weeks pregnant and during motion shows greenish what is the reason for that ?
Greenish stool may be related to vegetable intake. A blackish tinge may be due to iron tablets. However it is best to go to a doctor personally so that if needed you can be examined and further tests ordered.
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There is itching and pain in her private parts. She is pregnant and she do not prefer to take tablets. Is there any home remedies for this infection?

MD - Dermatology , Venereology & Leprosy, Diploma In Dermatology And Venerology And Leprosy (DDVL), MBBS
Dermatologist, Udupi
There is itching and pain in her private parts. She is pregnant and she do not prefer to take tablets. Is there any h...
you can apply Propyderm-NF cream twice daily for 5 days and candid cream twice daily for 2 week and keep the part clean and dry.Mycoderm-c powder twice daily for one month.
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I am suffering from fibroadenoma since a long time but I have been taking homeopathy medicine since last six months. The time I take medicine my tumour is in small size but if I stop taking it, my tumour grows. What should I do to remove the tumour completely except having a surgery?

M.CH - Surgical Oncology
Oncologist, Visakhapatnam
Dear there is no other option than getting it removed surgically for complete relief. There is always a chance given your age and description that the lump may subside by itself over a period of time (usually years). But it also possible that it may not regress on its own. If it is causing you distress, surgical removal is ideal.
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Detoxification Through Ayurveda

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Navi Mumbai
Detoxification Through Ayurveda

You might have indulged in various types of detox regimes, but have you tried the Ayurvedic detox yet? This regime is short, simple and very easy to follow but the benefits it proffers are not possibly limited to a particular aspect of well-being. You can undertake it at any time of the year, but it would be extremely advantageous if you select the juncture between two seasons when your body has already got an alert about the imminent change in the surroundings.

The importance of detoxifying the body: The practice of cleansing the mind and body is considered to be one of the most crucial aspects of Ayurvedic lifestyle. It offers a valuable way of cleaning away all the accumulated toxicity and wastes from the tissues, which ensures optimal health. Modern lifestyle that leaves people stressed out at most times makes it even more necessary to include an overall detoxifying regime in the fitness routine. Today people have to undergo an endless variety of harmful inputs such as environmental pollution, junk food, sedentary lifestyle, psychological stress and anxiety and unresolved emotions. If they are allowed to accumulate within the body, over time they can be deposited in the tissue, and compromise on healthy living.

Advantages of taking part in detoxifications: A simple detoxifying plan that incorporates eating mono-diet, fresh fruits, drinking plenty of fluids in the form of water and other detoxifying fluids along with taking Triphala in the evening helps in supporting the digestion as well as the detoxifying system present within the body. It can also alleviate the physiology by slowing down the flood of damaging inputs and by allowing the body to rest and repair itself.
A plain cleanse can aid in:

  • Improving digestion and metabolic function
  • Promoting regular as well as balanced elimination
  • Supporting the maintenance of proper body weight
  • Nurturing the improved sense of vitality, energy and enthusiasm of life
  • Encouraging a balanced rest cycle
  • Promoting improvement of overall health

When you are willing to take part in Ayurvedic detoxification, it is important that you prepare your body well before the schedule and expose yourself to as less amount of stress as possible. It is advised to take a break from the social sites and electronic devices as they increase the stimulation and don't allow the mind to rest. If you have a habit of drinking or smoking, it is necessary to bid a temporary goodbye to them and follow the detoxification regime as suggested by your physician as closely as possible. If you wish to discuss about any specific problem, you can consult an ayurveda.

7844 people found this helpful

The 3 Doshas- Vata, Pitta and Kapha

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Ambala
The 3 Doshas- Vata, Pitta and Kapha

Ayurveda basics

Ayurveda (pronounced i-yer-vay-da) is a rich and holistic nature based medical system designed to prevent disease, promote health, and unlock the potential for living beings to thrive. It is the oldest surviving medical system in the world, dating back over 5, 000 years to ancient india. “ayurveda” is derived from the sanskrit words “ayus” (life) and “ved” (wisdom). Ayurvedic medicine is a complete system because is rooted in all 4 dimensions of health: physical, mental, emotional, and spiritual. One of the main premises of ayurveda is that each person has a unique constitution of doshas, or elemental vital bioenergies, known as vata (air and space), pitta (fire and water), and kapha (earth and water). By assessing a person’s unique combination of these elements, we can help determine their individual physical and mental characteristics and detect imbalances that may be contributing to disease. Using this information, we can customize a plan to optimize the patient's health and well being so they can reach their highest potential. The sister science to yoga, ayurveda teaches us how to live in balance with nature, and learn how to be at peace with ourselves so we can then reflect that happiness and abundance to those around us. 
Click here to receive free recipes, seasonal recommendations, home remedies and more!

-the 3 doshas- vata, pitta and kapha

Have you ever wondered why each person is so unique?

  • Some people just look at a slice of cake and gain a pound while others can eat mountains of food and stay as thin as a rail. Why do some people have excessive anxiety and fear while others trend towards anger and irritability? ayurveda answers these questions with the concept of the three doshas: vata, pitta, and kapha. The doshas are biological energies that control all of the functions in the body and have a powerful effect on the mind. They are comprised of the five basic elements and their individual properties. Vata is composed of air and space, pitta of fire and water, and kapha of earth and water. 
  • Ayurveda is based on the premise that we are all born with a unique constitution comprised of these five elements, and that constitution will remain the same throughout our entire lives. Although our basic constitution does not change, the three doshas are in a constant state of flux. For example, a person living a chaotic lifestyle who is constantly on the move, eating too much cold, dry and raw food, drinking coffee and not sleeping enough will eventually experience an increase in vata dosha (air and space). If this intensive diet and lifestyle is maintained for some time, the person will eventually develop certain symptoms that are associated with an excess of air and space in the body. In the beginning, symptoms may be mild such as constipation, anxiety or pain in the body. However, if the imbalance is not addressed by altering the diet and lifestyle to bring the body back to a state of equilibrium, more advanced excess-vata-related diseases may occur such as osteoporosis or parkinson's disease. 
  • The best way to keep your body properly nourished and balanced is to know your basic constitution, and your current imbalances so you can eat, drink, sleep and exercise to best suit your needs. There are tests and quizzes available online that can help to give you a basic idea of any current imbalances. However, in order to get a true assessment, it is best to make an appointment with a well trained ayurvedic practitioner because there are many factors in the diagnostic process that a computerized test cannot determine.
     
1 person found this helpful

Lately my wife has developed lack of interest towards having sex. Kindly prescribe some medicine or some procedures to keep up the passion.

MD - Obstetrtics & Gynaecology
Gynaecologist, Mumbai
Lately my wife has developed lack of interest towards having sex. Kindly prescribe some medicine or some procedures t...
Failing to do Foreplay can ruin mood or leave you unsatisfied. Sex without foreplay means you’re not taking your needs into consideration, because foreplay is much more important to women than to men. Foreplay is a set of emotionally and physically intimate acts between couple meant to create sexual arousal and desire for sexual activity. Vagina secretes natural lubricating solution which is secreted by bartholin's gland. Foreplay also helps in secreting natural lubricant which will improve sex life.
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Hi, I am 23 years old girl and my question is related to sexual relationship after the marriage. As my body condition is not very good and weight is just 40 will the man satisfied with that if I decided to marry? Or do I need to delay marriage? As my family is compelling me to marry i am getting tensed whether the guy will be pleased with me or not? Please suggest me.

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Zirakpur
Hi, I am 23 years old girl and my question is related to sexual relationship after the marriage. As my body condition...
Go ahead. Start practice of pranayam and meditation, walks, light nutrients containing food, keep digestion well and of course socialize. No tension needed. Do not delay marriage. I recommend female sex desire booster pkg for u. Additionally I suggest high end, embelic based, enriched with gold, corals, pearls containing antioxidant lehyam made by us. This will enhance your internal power.
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I am having pcos and size of right ovary is 45x23 mm (32 cc) and left ovary is 45x25 cc mm (20 cc). I had an ectopic pregnancy in last year november and treated with methotrexate. Diagnosed with tuberculosis (test tb gold positive) since last year December I am on tb medication (ATT). I am having lower abdomen pricking pain on right side which goes off in a few seconds and having lower abdomen pain while bowel movement. Done whole abdomen and tvs ultrasound. Everything is normal except minimal free fluid in POD. I need to urinate frequently (sometimes 3 times in half an hr) and bladder never seem to be empty. What should I do?

MD
Gynaecologist, Mumbai
I am having pcos and size of right ovary is 45x23 mm (32 cc) and left ovary is 45x25 cc mm (20 cc). I had an ectopic ...
Dear lybrate-user, you should complete your akt course for tb. A urine culture report can rule out any possibility of urine infection for frequent urination and if possible consult urologist if frequency is too bad. After akt if you do not conceive in 6-8 months a laparoscopy can be done to assess the tubal status and treatment for fertility will be as per the status of fallopian tubes.
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I'm 29 yo female 5'2, 82 kg. Have pcos but is resolved through taking vitex supplements. However I'm gaining 1 kg every week even though my eating habits are the same. I suspect of insulin resistance to be sure cause of this. I'm also taking soaked fenugreek to reverse this but to no avail. I want to lose weight and return to normal body state. Kindly advise.

BHMS
Homeopath, Chennai
I'm 29 yo female 5'2, 82 kg. Have pcos but is resolved through taking vitex supplements. However I'm gaining 1 kg eve...
Diet and lack of exercise are the two most important factors that contribute to obesity. While the modern day diet is becoming more and more full of fats, sweets and empty calories, it is becoming devoid of nutritious vitamins and minerals. The fibre content is also decreasing. One tends to stack up on junk food in an effort to take a quick bite while on the go. At the same time, physical activity is on the decline. One has increased access to vehicles and the need to walk or cycle is almost not present. Even for commuting short distances, one uses cars or two wheelers. All these things are readily contributing to this epidemic of obesity. When it comes to getting rid of the excess fat, one needs to work conscientiously and consistently on both the counts mentioned above. One’s diet has to be altered so as to include more and more natural fruits and vegetables. Processed food and junk food should be cut down to the minimum. A daily exercise regimen needs to be adopted. Exercising for 30-40 minutes for a minimum of 5 days a week is necessary. Homeopathy helps by regulating the metabolic system of the individual. There are more than 100 medicines listed in the Homeopathic literature for obesity. It is a tough job selecting the right medicine for a particular patient. One needs to take into account a lot of things before selecting the right course of treatment. These things relate to other symptoms or conditions that may be present or the person may be suffering from. A lot of importance is given to the reason, if any can be found that stimulated weight gain. This reason could be a particular illness or an event or some psychological setback in life. The general reaction of the person to extremes of temperature, his or heating habits also need to be taken into account You can easily take an online consultation for further treatment guidance.
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Irregular Menstrual Bleeding

Minimal invasive surgery in gynaecology, MD - Obstetrtics & Gynaecology, DNB, MBBS
Gynaecologist, Mumbai
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Hello, I am Dr. Pooja Sharma Dimri. I'm a gynecologist occupation and an infertility specialist. I also specialized in minimally invasive surgery, gynecology including operative laparoscopy and histroscophy copy. Now I'm going to talk about a very common complaint with women present with us, which is irregular menstrual bleeding. Irregular menstrual bleeding may be in the form of delayed or irregular periods or heavy menstrual bleeding or frequent menstrual cycles. Most of the common cause of this irregular menstrual bleeding is hormonal issues like polycystic ovarian disease or hyperthyroidism.

In other cases, the cause of heavy or irregular menstrual bleeding maybe some pathology in the uterus like fibroids, polyps, abnormalities in the uterine lining or the endometrium to diagnose the cause of the regular or the heavy menstrual bleeding.

Before we go on to treatment we may need to do certain investigations like the hormonal profile to her on hormonal issues, sonography of the uterus and the pelvis to see for any nutrient pathology but sometimes all pathology may not be detected by the imaging studies and the blood investigation and we may require a hysteroscopy or a minimally invasive surgery to diagnose and treat these pathologies. Now hysteroscopy is a minimally invasive technique in which a specialized scope or telescope is put inside the uterine cavity in which we can directly visualize any pathology like a small uterine polyp or thickened endometrium at the same thing. That pathology can be removed and the endometrial lining can be sent for a biopsy.

In cases of older patients and specially in the ferryman age group, it is very important to rule out chances of cancers of the uterus. So in case of in irregular menstrual bleeding it is better to consult your gynecologist to rule out abnormal pathology.

For more details you can contact me on Lybrate.com.

 

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IUI (Intrauterine Insemination)- Treatment Option for Infertile Couples

MBBS (Gold Medalist, Hons), MS (Obst and Gynae- Gold Medalist), DNB (Obst and Gynae), Fellow- Reproductive Endocrinology and Infertility (ACOG, USA), FIAOG
Gynaecologist, Kolkata
IUI (Intrauterine Insemination)- Treatment Option for Infertile Couples

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.

29 people found this helpful

Had sex on 20 march on 21march her periods are expected they not come on 23 march again have a sex and taken ipill (first time ever in her life) still on 27march periods not came is ipill normal effect?

DHMS (Diploma in Homeopathic Medicine and Surgery)
Homeopath, Ludhiana
Had sex on 20 march on 21march her periods are expected they not come on 23 march again have a sex and taken ipill (f...
Although failure chances are less but accidents do happen and moreover taking 2 ipills in a span of 3-4 dayss is dangerous and I think this is the reaon for delayed periods -------------you can just check for home urine pregnancy test and if it is negative, then wait for 3-5 days, you will get back the periods but do not try to have unprotected sex during this time------------
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M having pcod. But since 2 years I was not on medication. But from last 3months im facing d problem again. I hvnt gt d periods for 1.5mnth. My doc suggested me to take sysron ncr for 3 days. Still hvnt gt d periods. Please help.

MD - Obstetrtics & Gynaecology
Gynaecologist, Mumbai
M having pcod. But since 2 years I was not on medication. But from last 3months im facing d problem again. I hvnt gt ...
U need to take these medicine for 5 days and wait for 7 days to get menses after stopping these medicines. As your weight is normal, you need to maintain weight and do not treat unless you do not get menses for 3 months.
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HiMy mother (age 62) has been done Ultrasound scanning of abdomenthat report was ovaries: Right ovary measures: 36*28 mm.(Increased in size) left ovary measures: 28*16 mm.(normal) PLease let me know info about this report except this everything is fine.

MBBS
Sexologist, Panchkula
Right ovary is increased in size. This increase could be due to number of diseases. I advise you to do laparoscopic test to find out the cause for increase in size.
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I went for the check up 3 days before. because the movement of the baby was less then expected. My doctor checked the heartbeat n growth. Everything was fine but she said to have an ultrasound so as to know the blood supply of the baby. that day I dint get the ultrasound cz the movement started. So tell me should I still go for the ultrasound?

M.D. - Ayurveda, B.A.M.S (Bachelor of Ayurvedic Medicine& Surgery), N.D.D.Y(Diploma in Naturopathy,Diploma in Yoga)
Ayurveda, Pune
I went for the check up 3 days before.
because the movement of the baby was less then expected.
My doctor checked the...
Yes its better to do it once. It will enable you to know whether the foetus is getting adequate blood supply or not. No harm in getting it done.
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MD PULMONARY, DTCD
Pulmonologist, Faridabad
Smoking in pregnant mother can cause preterm delivery,low birth wt baby and chances of asthma are more in new born.Even passive smoking have same effect.
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