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Caesarean Section Procedure
Treatment Of Female Sexual Problems
Termination Of Pregnancy Procedure
Treatment Of Pregnancy Problems
Well Woman Healthcheck
Treatment Of Female Sexual Problems
Treatment Of Medical Diseases In Pregnancy
Treatment Of Menstrual Problems
Intra-Uterine Insemination (IUI) Treatment
Medical Termination Of Pregnancy (Mtp) Procedure
Gynecology Laparoscopy Procedures
Pap Smear Procedure
Urinary Incontinence (Ui) Treatment
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Hlo dr, I am 14 th week pregnant, how many ultrasounds are usually recommend during pregnancy as my 2 ultrasounds already done? please reply?
Hello doctor its about my wife. We are newly married. Just 2 months have passed of our marriage. During sex my suffers from a lott of pain and she can not handle that pain. Why is it happening please advice what should we do! Marital status: Married Are you sexually active? Somewhat Timing during intercourse/ masturbation: 1-5 minutes Any other symptoms/ issues: due to her pain. Sometimes I also ejaculate early!
Hello Doctor, I was using Novelon tablet for my hormone imbalance problem as suggested by doctor. I have been suggested to take this medicine for 2 months. I finished 1st month (21tab) course on 13th mar 16. On 19th mar I had my period and it is still have bleeding. But as suggested by doctor I should have started the 2nd month course after 9 days i. E 23rd mar, but I have still bleeding. Should I start the 2nd month course or should wait for till bleeding stops, then start. Please suggest. Thanks Rekha Subudhi.
I am a unmarried girl. I Have to go vaishno Devi on coming Monday and I am afraid of my periods because there is chances of having my dates today kr tomorrow. So please suggest me a medicine that can postpone my date for 1 week.
Sir 20/3/16 ko periods date tha jo miss ho gya, ab kitne din ke bad test kerna chaiya? Pregnancy ka at first symptoms kya hoge?
Hye Dr. I am pregnant so I can ask you something. My body was very paining at tha night. During the sleeping. My hair also falling so tell me what can I do.
I have irregular periods I had 4 months back till now I didn't get. Thyroid report was nill. There are pcos in ovaries and am suffering from over weight too help me iam UN married.
Hello doctor, I'm 24 years old and I have pain in my breast. Which started from left breast. Now the nipples in my left breast pain and prick when I raise my hands. And my right nipple pain when touched .i missed my periods for than one month. And I'm not pregnant. What may be the reason behind it.
My wife is 37 years old. She is suffering from lower abdomen and back pain and the pain is stretching up to my limb. Did X ray and USG for lower abdomen. Kidney is clear. Left Ovary showing chocolate cyst. Doctor has prescribed medication for the same and suggested that it can be recovered medically. After that had done stool examination twice. Both occasion occult blood was found. I am very concerned now. Please suggest.
I am 22 year old female. Had sex with my bf on the 6th day of my period and had ipill immediately.(date-17th jan). Had ipill bleeding till 27th Jan. My periods haven't come yet. Are there chances of me being pregnant. How can I resolve it.
How to keep the vagina Clean so that there are no germs while having oral pleasure No obstacles or catching of infection.
How can I have more fun with myself what are the homemade things pls suggest something to have fun now I am bit bored doing same everyday.
I am 29 years old married women, its being 2 years completed to my marriage, que is just now we had sex and today I had my 8 day of menstrual cycle. As long as we had sex it started bleeding and we have done it with out condom as we usually do. Its a second time that while doing sex we had this problem. Now we both husband and wife are bit tensed about this thing. Kindly revert me back urgently.
Surgical Sperm Retrieval (TESA/PESA/MESA)
The main methods of surgical sperm retrieval available include:
PESA: percutaneous epididymal sperm aspiration.
MESA: microsurgical epididymal sperm aspiration.
TESA: testicular sperm aspiration. This includes testicular fine needle aspiration (TFNA).
TESE: testicular sperm extraction.
Perc biopsy: percutaneous biopsy of the testis.
Which method is used depends on the nature of the problem in the male partner, which needs to be explored carefully first.
Tests required before surgical sperm retrieval
A man that produces no sperm in his semen is said to have azoospermia. This may be because of a blockage in one of the tubes that carry sperm from the areas of the testes where they are produced, out to the penis during ejaculation. Obstructive azoospermia can be caused by testicular cancer, as the tumour presses on the vas deferens. This type of cancer is common in young men and can be treated successfully. It can, however, lead to infertility, so surgical sperm retrieval may be performed to store some sperm before treatment begins.
Other conditions cause non-obstructive azoospermia, including having an abnormal cystic fibrosis gene. Men with this condition may not show all the symptoms, but they often have no vas deferens. Surgical sperm retrieval is possible but there is a 50:50 chance that the embryos produced by subsequent ICSI and IVF will have the same genetic abnormality. Options then include using a sperm donor and intrauterine insemination (IUI) or IVF, or having pre-implantation genetic diagnosis (PGD) performed on the embryos to select ones that carry the normal gene.
If the problem that underlies poor sperm production is physical rather than genetic, or if a couple wants to have children after the male partner has had a vasectomy that cannot be reversed, surgical sperm retrieval can go ahead
Surgical sperm retrieval techniques used when obstruction is the problem
When the release of sperm is prevented by a blockage in the vas deferens, or by a vasectomy, several techniques can be used to retrieve the large numbers of sperm that remain inside the testes. The first three involve aspirating sperm using needles or tubes placed through the skin of the testis and are carried out under local anaesthetic. The fourth requires open surgical sperm retrieval and is usually carried out under general anaesthetic.
Some small studies have been done to compare success rates after the different types of surgical sperm retrieval. These concluded that MESA gives the highest number of sperm, with a hundred times more sperm being recovered compared to TESA and perc biopsy.
MESA also produced sperm that were better swimmers and therefore more useful for infertility treatments, including IVF and ICSI.
Surgical sperm retrieval techniques when there is no obstruction
Men who have no sperm in their semen, despite having clear tubes in their testicles, usually have a problem with the process of sperm production. It is unlikely that sperm are present in large numbers, so the surgical sperm retrieval techniques required are more invasive
TESE: Testicular sperm extraction. This involves opening up the scrotum and taking a large volume of testicular tissue, perhaps from several regions of the testicle. Sperm are then retrieved using a microscope to identify individual sperm.
Microdissection TESE: A similar technique but a microdissecting microscope is used to pinpoint the tissue to be removed. This aims to cause less damage to the structure inside the testicle, and to therefore have fewer after effects such as blood supply problems caused by tiny blood vessels being cut. It also appears to increase the number of sperm that can be retrieved.