Common Specialities
{{speciality.keyWord}}
Common Issues
{{issue.keyWord}}
Common Treatments
{{treatment.keyWord}}

Dr. Kusum Jindal

Gynaecologist, Delhi

500 at clinic
Dr. Kusum Jindal Gynaecologist, Delhi
500 at clinic
Submit Feedback
Report Issue
Get Help
Feed
Services

Personal Statement

Our team includes experienced and caring professionals who share the belief that our care should be comprehensive and courteous - responding fully to your individual needs and preferences....more
Our team includes experienced and caring professionals who share the belief that our care should be comprehensive and courteous - responding fully to your individual needs and preferences.
More about Dr. Kusum Jindal
Dr. Kusum Jindal is an experienced Gynaecologist in Bapa Nagar, Delhi. You can meet Dr. Kusum Jindal personally at Citizen Hospital in Bapa Nagar, Delhi. Save your time and book an appointment online with Dr. Kusum Jindal on Lybrate.com.

Lybrate.com has an excellent community of Gynaecologists in India. You will find Gynaecologists with more than 37 years of experience on Lybrate.com. You can find Gynaecologists online in Delhi and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

Info

Specialty
Languages spoken
English
Hindi

Location

Book Clinic Appointment

Citizen Hospital

#B 2/7, Phase 2, Landamark:-Near Sagar Ratna Restaurant, DelhiDelhi Get Directions
500 at clinic
...more
View All

Consult Online

Text Consult
Send multiple messages/attachments
7 days validity
Consult Now

Services

View All Services

Submit Feedback

Submit a review for Dr. Kusum Jindal

Your feedback matters!
Write a Review

Feed

Nothing posted by this doctor yet. Here are some posts by similar doctors.

I had sex with a girl on 8 april while last she had period on 5-6, and I haven't used condom while intercourse. Is there any chances of pregnancy. As I have heard that you can do sex with a girl without condom within 6 days before her period and at least 8 days after her period stops. Please guide me.

MD - Obstetrtics & Gynaecology
Gynaecologist, Mumbai
I had sex with a girl on 8 april while last she had period on 5-6, and I haven't used condom while intercourse. Is th...
Practising safe days for sex is highly reliable and has high failure rate as sperms can live upto 7 days. If she was in menses then she can not get pregnant, but for the safer side you should give her ipill asap as menses must have been very less by the time you had sex.
1 person found this helpful
Submit FeedbackFeedback

Treating Female Orgasmic Disorder - The Ayurvedic Way!

MD-Ayurveda, Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Sexologist, Haldwani
Treating Female Orgasmic Disorder - The Ayurvedic Way!

Female orgasmic disorder is now quite common in women of all ages and there are innumerable therapies that can treat this trouble efficiently. This trouble mainly leads to lowering of sexual desire, mainly due to lower production of testosterone. On the other hand, libido also gets decreased as a result of which lubrication gets hampered a lot.

Major therapies for treating FOD:

  • Counselling therapy: This kind of therapy has currently gained popularity as a sex therapy. This therapy is useful among all and can offer optimized benefits in treating FOD. The root troubles of FOD can be easily and accurately detected by this therapy. Some commonest troubles are relationship issues, past abuse, depression, anxiety and other related ones. In this case, you have to consult any experienced counsellor who has specialization in conducting the concerned therapy.
  • Hormonal-replacement therapy: This is also quite a popular therapy that can help in increasing the sexual drive in females. This therapy is mainly conducted for increasing the efficiency of the sexual hormones in women so that they can take part in sexual interaction with their partners actively without any hindrances. Menopause symptoms can be completely eliminated using this therapy so that you can fully concentrate on your sexual desires. There are some specific medications that are used in this therapy so that hormonal efficiency can be boosted.
  • Taking supplements: You can now take different kinds of organic or natural supplements that can increase your sexual drive and enhance your testosterone levels. Make sure that only herbal ingredients have been included in the supplements so that unwanted adverse effects can be easily curtailed, and you can only get the real effects. Arginmax is a common supplement which is highly enriched with nutrients and thus your body will get all kinds of essential nutrients, especially amino acids that not only increase the sexual arousal but also the blood flow.

Ayurvedic Treatment: 

The physical desires of a woman fluctuate significantly from time to time and vary according to the different phases of her life. On experiencing hormonal changes in menstruation, pregnancy or menopause, there is a dramatic change in a female’s overall libido and leads to female orgasmic disorder. Factors such as aging, illness, trauma, low energy levels, effects of medications, reproductive system issues, lack of privacy, priority changes, job stress and bad lifestyle habits are also major reasons.

Sexual dysfuntion is a common problem among females as compared to males which is characterized by persistent lack of interest in engaging in intimate relations which can be a very frustrating situation for a married couple as it brings about dullness and stagnancy in their lives. There is no need of seeking medical help for this frigidity in women as low female libido can be easily cured by taking ayurvedic female libido enhancer pills. You can also take a health package - libido enhancement for women from an ayurveda sexologist.

Aphrodisiacs – Ayurvedic Understanding, Useful Herbs

Sex power boosting Ayurvedic herbs are called as aphrodisiacs. These are the herbs and medicines that promote sexual vigor in female.

  1. Shatavari- An aphrodisiac for women, it has tonic and calming properties. Besides increasing energy levels, it also helps to regulate the levels of the female hormones and thus, has a beneficial effect on the functioning of the reproductive system.  Although primarily prescribed for women, Shatavari is also considered useful to increase the sex drive in men too. Here’s more about the herb shatavari.
  2. Ashwagandha- Ayurveda identifies ashwagandha as a potent aphrodisiac, which is known to increase blood flow to clitoris and other female sexual organs, creating an intense sexual pleasure.
  3. Gokshura- Studies of women who use this herb report greater desire, increased arousal, lubrication, more intense orgasms and satisfaction. It is known to stimulate androgen receptors in the brain making a female’s body much more responsive to testosterone and other sex hormones.
  4. Maidenhair: Long been known as a women’s herb to increase all-round sexual function and health in women, maidenhair is known to help balance levels of estrogen and progesterone in the female body and can improve sexual drive and function.
8211 people found this helpful

I am 38 years female, with 70 kgs weight. I am bearing a burning sensation with pins and needles feelings on my feet since four months. Kindly suggest.

MD - Obstetrtics & Gynaecology
Gynaecologist,
I am 38 years female, with 70 kgs weight. I am bearing a burning sensation with pins and needles feelings on my feet ...
Ok you might have burning feet syndrome. So you must have multivitamin tablets for at least 1 month. Also dos vitamin b12 level a blood sugar level and vitamin d3 level.
1 person found this helpful
Submit FeedbackFeedback

Hello, my gf has been late fr three days of periods. We intimate with each other 20 days ago but only oral not sex n oll but our internal precum touches only and she is worried about pregnancy. She has fever now a days. Please suggest me what should we do?

BHMS PGCGO
Homeopath, Hubli-Dharwad
Hello, my gf has been late fr three days of periods. We intimate with each other 20 days ago but only oral not sex n ...
if you are sure that you not ejaculate your seamen in her vagina then No chances of pregnancy. anxiety May leading her this
2 people found this helpful
Submit FeedbackFeedback

In mornings near to my period days, my face, hands and foot got swelling. This lead to headache in the noon. Happens before and after the periods.

Advanced Aesthetics
Ayurveda, Gulbarga
In mornings near to my period days, my face, hands and foot got swelling. This lead to headache in the noon. Happens ...
Its due to harmonal imbalence use these medicenes and stop at that time of period and later continue for 3months 1. Ashokarista 3spoon 2 times a day 2. Punarnavasava 3spoon with water 2 times a day.
Submit FeedbackFeedback

Hi. I' m a 49 year old woman. I have a bad body pain, especially in my back and knee. They are also accompanied with irregular periods and indigestion.

MBBS- 1996 & MD - (OBG)/DVD/DPM/Dip.Andrology.
Gynaecologist, Hyderabad
Hello it is one of allergic & also ostothretic infection symptoms. U strat: Tab. Pan-40 ( once in daily morning in empty stomach) for 1month. Tab:- Tab- Gestic (daily one) 1 Month Syp:- Aristozyame r Digiplex ( daily twice. 2-2 spoons w equal water). After the 10 days u write me. Ok.
28 people found this helpful
Submit FeedbackFeedback

I have doing sex with my fiance before 2 days but after 2 days she vomiting and not good health she is pregnant or not? I used the condom also.

MD-Ayurveda, Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Sexologist, Haldwani
I have doing sex with my fiance before 2 days but after 2 days she vomiting and not good health she is pregnant or no...
Hello- Vomiting does not denotes pregnancy. Its can her disturbed digestion, or probably gastritis that is causing problems. Skip dinner for few days and start moong dal khichadi, it will be alright on her behalf.
Submit FeedbackFeedback

I am 19 years old. My boyfriend and I had romance for sometime but after that we crossed our limits. He ejaculates on my breast I touched it and after few minutes I touched my vagina. I took niel72 pill after 24 hrs will there be a chance for my pregnancy.

MD - Obstetrtics & Gynaecology
Gynaecologist, Kolkata
I am 19 years old. My boyfriend and I had romance for sometime but after that we crossed our limits. He ejaculates on...
Dear please wait for your periods, if you have on time dont worry. If you dont have your periods then conduct one pregnany test and consult with result. One word of caution pregnancy can occur in this way, be careful in future.
1 person found this helpful
Submit FeedbackFeedback

Hello Dr. My periods have come after 2.5 months of delivery (cesarean), what does it mean.

MD-Ayurveda, Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Sexologist, Haldwani
Hello Dr. My periods have come after 2.5 months of delivery (cesarean), what does it mean.
Hello- according to ayurveda monthly periods and milk in breast are inversely proportional to each other. Increase in ones production decreases the output of the other.(due to hormonal changes) >after delivery milk appears in females breast to fulfill the appetite of the new born baby hence the menses reduces or becomes irregular. >when you stop feeding milk completely (after 1 year) your menses will be regular as before so there's no need to worry about.
3 people found this helpful
Submit FeedbackFeedback

Stay Healthy

MBBS, DPM (Psychiatry)
Psychiatrist, Thrissur
Stay Healthy

A huge haul of Hans and Pan Parag was seized from godowns in Kokkalai. This is a commendable jod done by our police.These substances are sold to small children at school gate by unscrupulous traders who have petty inhuman gain only in their mind. It is very risky as the children will grow up as hard drug addicts and criminals, and antisocials.
I have written so many letters to police authorities years back regarding the dangers of Pan Masala. Feels very happy now, as they have started acting positively about this grave social public health problem.

2 people found this helpful

How Exercising Outdoors Can Be Bad for You !

BPTh/BPT
Physiotherapist, Delhi
How Exercising Outdoors Can Be Bad for You !

Exercising outdoors is fun and refreshing in its own way. An early morning jog or doing pull ups on the goal post are fun ways of working out. Summers are usually the best time to take your workouts outside, as it decreases stress levels and revitalizes your body. It is also a good method to increase vitamin D levels in the body as the body is exposed to the sun.

In spite of this, there are some disadvantages of taking your workout outside. Let's focus on them:

1.Chances of accidents go up
It is very common to see people jogging on the road with their headphones plugged in. Incidents of joggers being hit by cars are fairly common, due to the fact that they are unable to hear the honking of a car or may change course along the road without realizing a vehicle is nearby.

2.Too much exposure to the sun
Long distance runners are mostly affected as they log plenty of miles. This can lead to ultraviolet ray exposure which increases the risk of skin cancer. It can also lead to sunburns and tanning of the skin. It is also known to suppress immune system and increase the risk of various infectious diseases.

3.Injury problems
Working outdoors increases your chances of injuries. Running on hard surfaces tends to cause damage your calf, hamstrings and thighs. It can put more stress on your knee, calf and cause various problems such as runner's knee and shin splints.

4.Difficult to find Help
If you suffer from a serious injury while exercising outside, then it may be difficult to find help. If you injure a joint and are unable to walk, then it may be a problem in getting you proper treatment. This delay in treatment may cause the injury to aggravate.

3601 people found this helpful

My wife's age is 42 and my age is 44. We have sex once in month. My wife not like sex. How interest is develop in her about sex.

MD - General Medicine
Sexologist, Nashik
My wife's age is 42 and my age is 44. We have sex once in month. My wife not like sex. How interest is develop in her...
Hi, I had gone through your question and understand your concerns, For women, sex is usually an emotional act as well as a physical act. The deeper the emotional connection, the better the sex will be for her and the deeper her desire for her lover will become. Share your feelings with your woman and express how you feel about her freely. For her, what goes on outside the bedroom is an important factor of what will occur in the bedroom. Women's bodies are fun to explore. Experiment and try things as she allows. She'll thank you later. Although this seems like a lot to remember, it will be worth it for you. Your pleasure is directly connected to how she feels. And trust me, if you’re not giving it to her how she likes it, she’s not going to want to give it to you at all. Couples who believe the sole reason for thrusting is to achieve orgasm often end up suffering from mechanical sex that is devoid of any emotional depth and lasting enjoyment.
32 people found this helpful
Submit FeedbackFeedback

I am carrying now 7 months. My hubby is asking that we can have intercourse or not.

PGD IN ULTRAASONOGRAPHY, Non invasive cardiology course, MD - Medicine, MBBS
General Physician, Narnaul
If you do want to have sex, embrace the ubiquitous three-word Nike slogan. As long as your pregnancy is progressing normally, you can have sex as often as you like (some exceptions may include a history of miscarriage or preterm labor). Be aware that it's pretty common for some women to experience bleeding during intercourse, especially in the first trimester. This is caused by the normal swelling of capillaries in the cervix, which can burst when irritated during sex. While such spotting or bleeding is generally nothing to worry about, you should still mention it to your doctor or midwife. What's more, there's typically no chance of hurting the baby during sex because the amniotic fluid and your cervix protect him. But one caution: If you have oral sex, your partner should not blow air into your vagina, as during pregnancy this can cause an air bubble to block a blood vessel.
1 person found this helpful
Submit FeedbackFeedback

My wife is 5 mths pregnant Please suggest me some good and healthy food for my baby so that baby will remain healthy.

MD - Obstetrtics & Gynaecology, MBBS
Gynaecologist, Delhi
My wife is 5 mths pregnant Please suggest me some good and healthy food for my baby so that baby will remain healthy.
Her diet should be protein rich diet and lots of fluids . We recommend small frequent meals during pregnancy . She should include dal , soybean, nutrela , egg , chicken etc . along with vegetables . She should also take seasonal fruits . AT least 8 to 10 glasses of water required daily.
Submit FeedbackFeedback

I had sex yesterday with protection but I don't want to take any chances so could I get a gynaecologist prescribed medicine to avoid pregnancy.

DGO, MBBS
Gynaecologist, Faridabad
u can take pill 72 but it shd not be a reg practice if u are sexually active and regular u shd use reg contraceptive
1 person found this helpful
Submit FeedbackFeedback

Last year I was carrying 2 months & has to abort because there was no cardiac activity found & now I have been trying to conceive & I'm not able to so which is the right time to have intercourse to conceive has I'm having scanty flow.

DGO, MD, MRCOG, CCST, Accredation in Colposcopy
Gynaecologist, Kolkata
Last year I was carrying 2 months & has to abort because there was no cardiac activity found & now I have been trying...
If you have regular 28 days periods then the best time to have intercourse is mid cycle around day10 to day 17 of cycle.
1 person found this helpful
Submit FeedbackFeedback

Periods Aane Ke Gharelu Nuskhe - पीरियड्स आने के घरेलू नुस्खे

MBBS, M.Sc - Dietitics / Nutrition
Dietitian/Nutritionist, Delhi
Periods Aane Ke Gharelu Nuskhe - पीरियड्स आने के घरेलू नुस्खे

अमूमन पीरियड यानि महिलाओं को होने वाले मासिक धर्म से हम सभी वाकिफ़ होते हैं .यह महीने में एक बार होता है इसीलिए इसे मासिक धर्म कहा जाता है. महिलाओं के लिए यह भले असुविधाजनक होता है पर हर एक के जीवन में इसका बहुत महत्व है. क्योंकि मासिक धर्म का होना और खासकर नियमित होना एक महिला के सहज माँ बनने और स्वस्थ होने की निशानी होती है. करीब १२-१३ की उम्र से ५० साल की उम्र तक आने वाले इस मासिक धर्म में अगर कभी रुकावट आ जाए या यह अनियमित हो जाए तो इसे गंभीर समस्या के रूप में लेनी चाहिए. और समय रहते इस समस्या से निजात पाने की कोशिश करनी चाहिए. एक खास बात  की एक स्टडी के अनुसार इस समस्या से 5 में से 3 लड़कियां परेशान हैं. यह खास समस्या आम हो चली इन दिनों . अब हम आपको मासिक धर्म की अनियमितता को सुधारने के लिए घरेलु उपाय बताएं इसके पहले हम आपको बताते हैं इसके लक्षण और कारण. 

पीरियड्स की अनियमितता के लक्षण 
गर्भाशय के हिस्से में दर्द, भूख न लगना, छाती में दर्द, दूध कम निकलना, दिल धड़कना, सांस लेने में तकलीफ, कान में तरह-तरह की आवाजें सुनाई पड़ना, नींद न आना, दस्त लगना, पेट में दर्द, शरीर में सूजन, मानसिक तनाव, हाथ, पैर व कमर में दर्द, थकावट, शरीर में दर्द जैसी स्थिति पीरियड रुकने के लक्षण होते हैं .

मासिक धर्म की अनियमितता के कारण 
स्मोकिंग, तम्बाकू, कॉफ़ी  या दुसरे प्रकार के नशे करना, ज्यादा व्यायाम, थायरोइड, ज्यादा दवा खाने, आलसपन, खून की कमी, पीरियड के दौरान ठंडी चीजें खाने, ठंड लगने, पानी में ज्यादा समय तक भीगने, ज्यादा घुमने, मानसिक तनाव, शुगर एनीमिया और पीरियड के समय खाने-पीने में लापरवाही जैसे कारणों से मासिक धर्म रुक जाता है या अनियमित हो जाता है.

सही समय पर माहवारी आने के लिए अब हम आपको बताएंगे नीचे कुछ  घरेलू नुस्खे जिसे इस्तेमाल करके आपको जरुर फायदा होगा . 

1. दालचीनी 
दालचीनी की तासीर गरम होती है, साथ ही इसमें ऐसे गुण पाए जाते हैं जो पीरियड में देर की प्राब्लम को कम करते हैं और मासिक धर्म के लक्षणों से भी बचाते हैं. एक हालिया से  शोध पता चला है की दालचीनी में पाया जाने वाला हाइड्रोक्साइकलोन  मासिक धर्म को रेगुलर करने में सहायक होता है. इसलिए इसे अपने भोजन में शामिल करें. इसके अलावा आप इसे खा भी सकती हैं . अगर आयुर्वेद की माने तो आधा चम्मच दालचीनी रोजाना रात को एक ग्लास दूध में घोल कर पीने से काफी फ़ायदा मिलता है.

2. अदरक 
अदरक में पीरियड आने में देरी या अनियमितता को दूर कर उन्हें फिर से शुरू करवाने में हेल्प करने वाले गुण समाहित हैं . साथ ही अदरक के औषधीय गुण पीरियड के समय होने वाले पेट  दर्द, मरोड़ आदि को होने से भी रोकते हैं. पीरियड में देरी हो या कोई और समस्या अदरक का इस्तेमाल है अचूक उपचार . बस एक चम्मच सुखी अदरक को या फिर अदरक की पेस्ट को एक कप पानी के साथ कुछ देर उबालिए और इसमें थोड़ी सी चीनी मिलाकर दिन में ३ बार पिएं . तो अब से नियमित करें अदरक का इस्तेमाल . अदरक हर किसी के लिए लाभदायक है  .

3. एलोवेरा 
एलोवेरा में मौजूद होते हैं हॉर्मोन्स को सही स्तर पर रखने वाली क्वालिटी . इसके ताजे रस को शहद के साथ मिलाकर रोज सुबह अपने  ब्रेकफास्ट के साथ लें, जल्द ही आपके पीरियड रेग्युलर हो ज़ाएँगे.पर हाँ ध्यान रहे की इसका इस्तेमाल भी पीरियड के दौरान न करें.

4. हरा या कच्चा पपीता 
वैसे तो पपीता बहुत सी चीजों के लिए फायदेमंद होता है पर कच्चे हरे पपीते में गर्भाशय को सुन्कुंचित करने की क्षमता होती है . और इसी वजह से इसे खाने से आपका पीरियड सही समय पर आने लगता है. ये मानसिक तनाव और रजोनिवृत्ति के कारण मासिक चक्र में देरी होने को सही करने के लिए काफी अहम माना जाता है. पीरियड्स के दौरान परहेज बस उसके वाला आप कच्चे पपीते का जूस भी रोजाना पी सकती हैं. 

5. गुड़ और तिल के दाने
तिल के बीज और गुड इन दोनो का नियमित इस्तेमाल शरीर के हॉर्मोन स्तर को बैलेंस   करके पीरियड के अनियमितता की तकलीफ को ठीक करता है. तिल में पाए जाने वाले लिग्नांस आपके शरीर में सामान्य से अधिक पाए जाने वाले हॉर्मोन्स को बंद कर उनके असर को ख़तम करते हैं. तो आप बस इतना करें की  एक मुट्ठी तिल के दानो को भुन कर उनका पाउडर  बना लें  और एक चम्मच गुड को पाउडर के साथ मिला मिलाएं. इस मिश्रण का एक चम्मच रोजाना अपने पीरियड शुरू होने के दो हफ्ते पहले से खाना शुरू कर दें. गुड की गरम तासीर से आप मासिक धर्म को नॉर्मल कर सकती हैं. पर ध्यान दें की इस मिश्रण का सेवन पीरियड के दौरान न करें .

इन घरेलु नुस्खों को अपनाकर आप जरुर पीरियड को नियमित करने में कामयाब होंगे और अगर फिर भी समस्या बनी रहे तो डॉक्टर सालाह जरुर लें . 

17 people found this helpful

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.

20 people found this helpful

Before 2 months I consulted to a Dr. Then she told me that I have ovarian cyst in left ovary. It creates problem in pregnancy?

MBBS, DGO, FGO
Gynaecologist, Jalandhar
Before 2 months I consulted to a Dr. Then she told me that I have ovarian cyst in left ovary. It creates problem in p...
Most of small ovarian cysts resolve by itself and don't create any problem, very occasionally a cyst of medium size if persists may undergo torsion and cause pain , then it may have to be removed
1 person found this helpful
Submit FeedbackFeedback
View All Feed