Lybrate.com has a number of highly qualified Gynaecologists in India. You will find Gynaecologists with more than 34 years of experience on Lybrate.com. Find the best Gynaecologists online in Delhi. View the profile of medical specialists and their reviews from other patients to make an informed decision.
Book Clinic Appointment
Submit a review for Dr. Neeti ChabraYour feedback matters!
Hi Doctors, I am 8 week 6 day pregnant and on Monday brown discharge came like little and done scanning baby was OK and doctor gave me system tablet today that is Wednesday dark brown discharge coming help me please no pain and giddiness is there.
I always find wet vagina of my partner which irritate me while having sex? please advise me what to fo?
Hi My Age is 29 year and my wife age is 25 year. I am married from last three years and I don't have baby. All the test (my and my wife) is positive. We have taken treatment from PGI Chandigarh and all the tests dine from there only. Still we waiting for results but not get any positive results. One of my friends suggested me about IUI treatment. I need suggestions from the expertise of IUI. If any expertise is there please suggest me about IUI treatment and if it is ok then wt is the success rate and tell me the best and cheapest IUI treatment center nearby the Chandigarh and panchkula.
Hello doctors I am in my 7th month of pregnancy. And I am stressed about labour pain. Please doctors suggest me some tips to stay relax about pain and how to manage it.
We all want to look our best. Being well dressed and presentable boosts our confidence and equips us to deal better with any professional or personal obligations that we may have. Someone who’s sharply dressed, well done hair, properly done eyebrows, no trace of facial or body hair, will make a better first impression than someone who’s unkempt. And it is a commonly agreed upon fact that the first impression on someone will speak volumes about our future interactions with them.
One of the most observable feature of our entire getup is facial and body hair. Imagine being completely updated with the latest trends while choosing an attire, but then your body hair shows through! It will be a little disconcerting and plays down all our efforts. Understandably, going to salons for waxing/threading or even tweezing on a regular basis can be time consuming and many times, we might also feel too lazy to step out for the sole purpose of hair removal. Rather than going to the parlour for hair removal every month (and in some case, once in every two weeks even), it makes more sense to find a more permanent solution to this. Opting for laser hair removal can rid us of this headache (Learn more about headache/migrain problem).
Laser hair removal is a modern technology developed for the increasingly chic and conscious population that likes to be always ready to go out without worrying about a disturbing view of stubble spoiling their look. Laser hair removal is a non-invasive procedure that removes unwanted hair from our body without major side effects, by using a long pulsed laser. Lasers can cause localized damage by selectively heating dark matter or melanin. Hence, it targets the hair follicle, while not heating the rest of the skin. General side effects include mild itchiness, temporary redness and swelling, pain, tingling or a temporary feeling of numbness. (Learn more about Laser Hair Removal Treatment)
But, be careful as to do careful research before finalising your specialist. It’s imperative to hold thorough discussions with the team that carries out the hair removal and be assured of their competence.
i have undergone the uterus removal surgery in the year 2012. now i am suffering from vaginal dryness and sweating in the whole body. what can i do for this problem
I want to postponed my periods by 15 days because of my marriage. Last periods date was 28 july. My marriage is on 5 september. Can I consume tablets for 15 days continuously upto 10 september. Is there any problem.
While having sex the Condom Burst, my wife is near her period days, I am worried. Pls suggest me some contraceptive/ birth control pills. Can I go to any medical store and ask for any birth control pill?
I am trying for pregnancy from last 8 months. Doctor prescribed me first come300 and progesterone supplement for 3 months. Then he prescribed fineova40 and progesterone supplement again. But still I have not conceived. All my reports are normal. Husband's also. Is my treatment is proper? I become very frustrated. please reply.
Dear Sir / madam Is oral sex make problem? Because my wife likes this only. She is not interested in the vagina penetration. Please.
Hallo doctor, my mother of two babies 5 n 4years. My husband always attracts towards other ladies who lives near us. So. I get hyper. What is the solution of my problem. AM in job he is also in job.
I am 26 year married woman I feel very elastic to my vagina from few months I want to be tightened it please give me a positive way to do.
HI sir my wife is now 6 months pregnant. She has a lymphadenitis on her neck since 1 month. Please advise the treatment.
I am undergoing treatment for Infertility and PCOD since last 2.5 yrs. Had been facing problems in egg formation previously. Have started consulting new doc who suggested to get the HSG test done which diagnosed slight blockage in right fallopian tube and hydrosalpinx therefore the doc has suggested for laparoscopy and Hysteroscopy to check Tuberculosis or other factors. Kindly suggest the other possibilities or whether it's appropriate to go by this surgery.
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
- Production of healthy (“Normal Morphology”) and movable (“Normal Motility”) sperms in adequate number (“Normal Count”) in the testes
- Transport of these sperms through the sperm conducting ducts from testes to penis
- Successful Erection and Ejaculation during Intercourse to deposit adequate number of these sperms in the vagina
- Transport of these sperms from vagina through cervix to the uterus and the tubes
- Presence of sufficient number of eggs inside the ovary and ability to release the eggs from the ovaries
- Pick up of the eggs by the tubes
- Approximation of eggs and the sperms to form the embryo
- Transport of embryo from the tubes into the uterus
- Acceptance of the embryo by the uterus and its growth
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
- 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.
- 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.
- 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.
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.
Ladies, it is important that we must take good care of our body, but most of all we must pay specific attention to the health of our vagina. The vagina is a tube-like muscular structure of the female genital tract that extends from the cervix to the vulva. It is a delicate organ which is prone to injuries and infections. Complications related to urination, menstruation and sexual intercourse, all affect the vaginal health.
Here are five questions associated with vaginal problems that are commonly experienced, but rarely discussed:
- Why does it feel itchy before menstruation?
The hormonal cycle reduces the amount of estrogen secreted right before the period starts. This reduces the moisture content of the inner membranes of the vagina; the skin becomes thinner and slightly dry, which can cause itching. However, if the itching and burning sensation is too severe, it could be an infection and should be checked out.
- What is the white discharge?
The greasy white discharge is due to the ovulation cycle. It usually occurs once a month because the amount of secretion increases right before ovulation. Some women may experience this discharge more frequently, but it is nothing to worry about unless there is an unpleasant odor. Odorous discharge could be a sign of bacterial infection.
- How often should you have a vaginal examination?
You should get a vaginal examination at least once a year. This is important for a general health assessment and the prevention of sexually transmitted diseases. If you are using birth control medication, there might be irregularity in the hormonal cycles and this can lead to a number of conditions, another reason to get an annual vaginal examination.
- Does it smell differently at different times?
It usually smells differently for every woman and even that unique smell changes with the cycles of ovulation and menstruation due to changes in the pH level of the vagina. The normal vaginal pH value is between 3.8 and 4.6. Before menstruation, it may smell acidic followed by a bitter smell for a few days after menstruation. It may also smell differently after a workout (due to sweat) or after sex (due to lubrication). However, a foul smell accompanied by discharge, might be a cause for concern.
- Why does it feel dry sometimes?
Vaginal dryness is normally experienced by women after the age of 45 or after pregnancy. However, dryness is also common just before menstruation. It also happens in women who use anti-allergy medications or birth control pills because they cause dryness in all the mucous membranes of the body. If you wish to discuss any specific problem, you can consult a gynaecologist.
Hello Dr. My sister suffers from terrible pain during periods. She is 24 years old unmarried. She had pcod but now it is completely cured but she still feels lot of pain that she gets unconscious because of pain. Is there anything that can cure this permanently.
Ø Do not Listen So Loud – Use the “60-60 Rule:” Limit listening level to 60 % of the maximum volume for 60 minutes a day. Anything louder than that over an extended period is risky.
Ø Use Volume Control – Limit the volume to 80 percent of maximum and listen no longer than 90 minutes a day.
Ø Limit Your Listening – The length of time you listen, not just the volume, can contribute to hearing loss. Avoid prolonged, continuous listening.
Ø Limit Noisy Activities - At home, turn down the volume on the TV, radio, and stereo. Reduce the number of noisy appliances running at the same time.
Ø Protect your Ears - Wear earplugs or muffs when exposed to loud Noise. Avoid medications that can be dangerous (ototoxic) to your ears. Ask your physician about possible effects on your hearing.