I am Dr. Ruchi Malhotra from FS IVF Centre, Delhi. I am a senior consultant. I’ve been working with Lady Hardinge medical college for many years as a senior consultant. Thereafter I worked at All India Institute of Medical Sciences, after which I came into this infertility practice. Today I am going to discuss about Artificial Reproductive Techniques or ART. Now ART is a technique which is used for patients who are suffering from infertility. What is infertility? We define infertility when a couple is living together without any precautions and is unable to conceive after one year without any precautions. When such couple comes to us we need to find what is the cause? why they are not conceiving? and furthermore how do we need to treat them? So there are certain basic tests when the patient comes to us for such a complaint. Most important is the history, whether the couple is living together or not. Sometimes it happens when couple comes to us but the husband is travelling, husband is not living so they are not having a normal sexual activity because of which may be they are missing the ovulation period and may be they are not conceiving.
May be there is some kind of sexual problem with in the couple which also comes out in the history or there could be a problem with the hormones in the female. She might be having delayed periods or early period or prolonged cycle or maybe she is having no cycles at all. So these are the main causes which we find out in the history from the couple and then further we need to decide how we need to treat these patients. So ART includes many methods, most important of which are IUI (Intrauterine Insemination) and IVF (In-Vitro Fertilization ). So first we will discuss about IUI. In IUI, the method is, first we stimulates the ovary of the patient by giving them tablets or by giving them some injections. We make the eggs ready which is called as the follicle which finally give us the baby. These follicles are then followed by a transvaginal ultrasound. In this once we reach the particular follicle size then we give them a trigger injection so that the follicle can rupture and comes out of ovary.
Following which we take the husband’s sperm and we segregate the best sperm and we inject them into the uterus of the female. So this is the process of IUI. Now if we discuss about IVF, it is totally different process and in which basic treatment is we give injections and we will make the eggs ready. Now IVF is all about the number of eggs which we get from the ovaries. We give them gonadotropins and we increase the number of eggs and when these eggs reach a particular size, we under anesthesia need to take out these eggs. These eggs are taken out in a test tube in specific conditions of temperature, air and lab. Then we take the husband’s sperm and we inject the sperm into the eggs.
We leave the eggs and sperm together outside in a lab environment and let the embryos grown. Embryos can grow to stage 3 or stage 5, day 3 or day 5. So the transfer is then prepared, the uterus is prepared and these embryos are then transferred into the uterine cavity. This is the entire process of IVF. After 14 days of transfer we can look for a positive result. Aap bhi is infertility ki samasya se pareshan hain aur apko iska koi ilaj samaj mein nahi aa rha toh aap mere pass visit sakte hain. Mera centre Azadpur Sabzi Mandi ke samne hi hai. Ye adarsh nagar metro station ke paas padta hai. Aap directly bhi yahan aa sakte hain aur via Lybrate bhi aakar mere se mil sakte hain. Online consultation bhi ho sakte hai aur Video Conference bhi ho sakte hai.read more
Mai Dr. Ruchi Malhotra FS IVF Centre mei infertility specialist consultant hoon. Mere paas bahut mariz jinke har jagah treatment fail ho chuki hai voh ate hain or unko yahin success mila hai. Aaj main aapko bataongi ki infertility kya cheez hoti hai aur uska treatment ke liye hamare paas kya kya option hai. Aajkal ke time mein jab mahila aur uska husband saath mein rehte hain or ek saal tak pregnancy nahi ho pati hai toh hum usko infertility kehte hain. Infertility jab patient hamare paas aata hai to hame kuch testing karni hoti hai jis se hame ye pata lagta hai ki usme kya problem hai jis wajah se us couple ko pregnancy nahi ho pa rahi hai. Iske baare mein kuch aap ko samjhana chahungi.
Infertility mein bachha na hone mein 50% contribution husband ka hota hai aur 50% contribution wife ka hota hai. Husband ki testing main toh bahut simple cheez hai. Semen check kiya jata hai jis mein hum sperm ka number dekhte hain, uski motility dekhte hain ki woh kitne chalte hai, woh dekhte hain. But female mei, cheezein thodi si complicated hoti hai. Yahan pe main aapko samjha paongi. Yeh ek female reproductive system hai. Yeh do andedani hoti hain yani andkosh. Yeh do nalee hoti hain tubes jinko bola jata hai aur yeh bachedani hote hai. Normal course mein anda yahan se nikal kar tube k andar jata hai or yahan husband ke semen se mil k bachedani main tyar hoke bachha badta hai. In main se kuch bhi, kahin bhi agar problem ho to pregnancy age thahertei nahi hai ya badti nahi hai. Jaise ki ande. Ande main kahin khrabi hai. Jaise ajkal Polycystic ovary kafi logon ko hai.
Ya phir hormone ki koi aur kami ho, ya thyroid ho. In sab vajaha se anda nahi banta hai. Doosra agar anda ban raha hai aur tube main kahin bhi blockage hai, jaise TB k vajha se blockage hai, ya pehle kabi pregnancy hue uske vajha se blockage ho sakti hai. Tab yeh anda tube main se hoke is bachedani mein nahi jata. Jab anda yahan nahi paonchega toh pregnancy hone ke chances bilkul zero ho jate hain. Teesri cheez bachedani ke ander koi problem ho sakti hai. Jaise bachedani ke ander koi fibroid ho sakta hai, ya septum ho sakta hai, ya tuberculosis ho sakta hai ya endometerosis ho sakta hai. In sab situations mein bhi pregnancy aage nahi badd sakti.
Toh jab aap ek doctor ke paas jate hain, ek specialist ke paas jate hain toh vo apko identify kr ke btate hain ki apki problem kya hai or uss problem ka kya samadhan hai. Aaj ki date mein hamare paas most problems ka samadhan hota hai. Jaise ande nahi ban rahe hain to hamere paas injections hote hain jin se hum ande bana sakte hain. Tube blockage hoti hai to hame IVF karna padta hai. Bachedani mein koi problem ho to Histeroscopy kr ke hum bachedani thik kar sakte hain. Yeh sare cheezein specialist hi aapko guide kar sakte hain ki kaise aapko aage badhna hai apne treatment ke liye.read more
Lybrate.com has a number of highly qualified IVF Specialists in India. You will find IVF Specialists with more than 32 years of experience on Lybrate.com. You can find IVF Specialists online in Delhi and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.
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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
Family Planning Procedure
Management of Surrogacy
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Patient Review Highlights
Dr. Ruchi Malhotra provides answers that are very helpful. Thank you
Parth Dileep Tulsiani
I found the answers provided by the Dr. Ruchi Malhotra to be knowledgeable. Thank you Doctor. Your answer makes me feel very comfortable and easy going with thoughts in my head.
Overall experience is very good, nice doctor and staff. Best IVF Doctor! Highly recommend for IVF treatment
She was very helpful and cordial . A very skilled and understanding doctor . Overall good experience
Dr. Ruchi Malhotra provides answers that are very helpful. Thank you so much
Dr. Ruchi Malhotra provides answers that are well-reasoned. I am impressed..
I am very very Happy with all the staff members and doctor. They have done an excellent job. I felt FSIVF as my second home. I don’t have words to express my feelings and happiness. I got positive result, it Is like a dream coming out to be true. God bless all of you. I love you all. KEEP IT UP. Never visited any other IVF Center other than FSIVF
She is a very competent and compassionate doctor I sent couple of my friends too to her She provides rejoices in life of infertile couples She gives excellent results at an affordable package
My experience was very good. I had tried at many places but did not get any result and got positive result here by Dr Rushi's FSIVF and I am very happy Facilities.
After 2 miscarriages I'm finally able to hold my own baby in my arms. Words can't explain how grateful I am to Dr.Ruchi for making my dream come true.
Thank you FSIVF for our happiness. After a long journey now we are parents because of you. You are giving us a smiling face. Thanks a lot
Very Good staff and cooperative team of doctors, Everything is taken care of by doctors.Treated like a family
The most understanding, experienced and amazing Gynaecologist in the city. I would recommend her to everyone
Dr Ruchi is extremely comforting and one of the most friendly and skilled doctor I’ve consulted
It is one of the best IVF center in Delhi who have a very high ratio of success of IVF.
I found the answers provided by the Dr. Ruchi Malhotra to be very helpful. Good
Dr. Ruchi Malhotra provides answers that are knowledgeable. Thanx mam
Doctor Ruchi is very caring and understanding. My experience has never been this good with any other doctor. She is very dedicated to her work and is very professional. She understands the problem completely to provide the best suitable treatment. I had several previous failed IVF cycles in other centres, but when I came to her, I conceived in the first time. Thank you so much doctor.
Dr Ruchi is one of the great gynecologists. Perfect analysis of the problem of patients. Nice experience. Staff is cooperative and very positively helpful for the patients. Thank you.
PGS or Pre-implantation Genetic Screening is a test conducted to decipher the chromosome count of the embryo. Today, if you are planning to get pregnant or using alternative technologies for pregnancy; there are several tests that need to be conducted so that the child is born healthy and stable.
One such test is the PGS, it determines whether or not the count of chromosomes is normal, which is forty six, is present in the embryo. If there are abnormal numbers of chromosomes present in the embryo then it might lead to additional problems in the future. In such cases, special treatments and procedures are conducted.
There are several advantages of PGS. Some of them are highlighted in details below.
- Healthy pregnancy: Interestingly, a man can produce sperms throughout his lifetime. But a woman is born with the eggs already created. The chances of producing a healthy baby with those eggs decrease as the age of the woman increases. It is seen that those women who think of delivering a child in their older ages are often found with chromosome deficiencies in the embryo. Thus, to avoid such a situation, it is best to perform PGS.
- Reduces the chance of miscarriage: Pregnancies which occur without having performed any prior tests like the PGS have high chances of resulting into a miscarriage at the slightest of carelessness. But research has found that those pregnancies which take place after considering the chromosomal health of the embryo have reduced the risk of being abnormally terminated.
- Time reduction between two IVF Circles: For those who do not know IVF stands for In-Vitro Fertilisation. It is a process which aids a woman in becoming pregnant. It is often opted by those who are having issues in naturally conceiving a child. PGS here plays an important role. If the test detects abnormal embryo, then the next IVF circle can be started right away without wasting any time. But if the PGS detects a normal embryo then the IVF circle is deemed to be successful and the woman can continue with the pregnancy.
Thus, these are some of the main advantages of Pre-Implantation Genetic Screening. This helps to determine whether the embryo is of the desired choice or not and whether the baby born out of it would be healthy and normal. It is one of the tests which need to be conducted preceding implantation to provide better results after the implantation process is carried out.
Cervical cancer refers to the type of cancer that spreads through abnormal cells, which may be found in the lining of the cervix. This affects the lower part or the womb of the body. This may also be medically known as the uterine cervix. This kind of cancer is considered one of the most preventable ones. There are various kinds of screening tests that can help in early detection so that the symptoms become clear and the problem can be treated before the cancer spreads or malignancy sets in.
Read on to know more about the various screening measures that can help in treating and preventing the same.
- Pap smear test: This is one of the most recommended and easiest tests conducted for cervical cancer screening. The pap smear test is recommended for all women who have been through child birth. In this form of screening, the doctor usually takes a sample from the cervix of the patient. This will be then be put through a lab test to find any kind of anomalies in the cells of the cervix. This test is also strongly recommended on an annual basis for women who are going through menopause, as this is the time when the cells undergo maximum changes.
- HPV test: The HPV test can be conducted along with the pap smear test so as to find out if the HIV virus is active as well.
- Pelvic exam: In order to conduct screening for cervical cancer, the doctor may also ask the patient for a pelvic exam. In this test, the doctor checks the various areas like the uterus, the cervix and ovaries so as to ensure that there are no anomalies and irregular changes in these areas or organs of the body. This exam can help the doctor in finding any changes that may point at the risk of developing cervical cancer.
- Reading the test results: The doctor will usually take a look at the test results before making a clear diagnosis and recommending a course of medication or other kinds of treatment so as to prevent the spread or onset of cancer. For cases where this type of cancer has already progressed to a great degree, the doctor will usually recommend chemotherapy as well as radiation and sometimes, even surgery.
When should you get a screening test done?
Once you are above 21 years of age or have had a baby, it is imperative to get a screening test done at least annually. It is also important to get this done once a year if you are going through menopause. The doctors may ask you not to go through a test, if your previous three tests have been clear.
With infertility now impacting many patients, they are now choosing to engage in different ways of conception, such as Assisted Reproductive Technology such as in vitro fertilization (IVF). However, IVF treatment can be actually psychologically and economically challenging for most people, therefore, before you opt for this choice, it’s essential that patients must know about this process in detail.
Research the process
Before patients go for IVF treatment, they should understand the treatment pattern and stages of treatment and also what is involved in each phase. Being well advised is the best way to be psychologically prepared for the psychological and physiological changes that IVF can bring.
Make sure that you’re as healthy as possible
Adopting a healthy diet and fitness program is the best way to start any fertility journey. Studies have shown that women who are in better physical and emotional health have the maximum chance of success with IVF.
What causes should be considered while going for IVF?
The problems such as Endometriosis where the endometrial lining of the uterus gets inflammation and does not allow the mother to conceive a baby, other conditions such as when there is a very low sperm count. Also, there are problems associated with the functioning of fallopian tubes or the uterus, the formation of antibodies in the mother’s blood which causes harm to egg or sperms, the sperm motility is low or when the complications related to fertility cannot be determined correctly.
Success rates are not designed to your exact conditions and so can give a deceiving picture about the chances of your success. It is also essential to look carefully at exactly what is being calculated. On average the success rate of IVF is around 35%, a significance that most people will have to endure a number of treatments before accomplishing a successful pregnancy.
IUI- IUI is a procedure during which processed and concentrated motile sperm are inserted directly into a woman’s uterus. This procedure is timed according to a woman’s ovulation, and may be performed one to two times in the days immediately following the detection of ovulation. After ovulation a woman’s egg is picked up by the fallopian tube and waits there for the sperm. Since the IUI procedure deposits higher concentrations of good quality sperm close to where the egg is waiting, the chances that the egg and sperm will find one another are increased.
IVF- IVF is the most successful method of fertility treatment utilized today to help couples to conceive. The basic components of the IVF process include stimulation of the ovaries to produce multiple eggs at a time, removal of the eggs from the ovary (egg retrieval), fertilization of the eggs in the laboratory, and subsequent placement of the resulting embryos into the uterus (embryo transfer). The chance of pregnancy from IVF depends primarily on the age of the woman, the cause of infertility, and factors related to the quality of the IVF laboratory.
Success Rates Of Both Treatments
IUI Treatment: There is a marked difference between IVF and IUI pregnancy rates. IUI has a success rate between 5% and 20%, but it can even be as low as 1-2 %, depending on the woman’s age and fertility levels. The chances of conceiving through IUI is higher if fertility drugs are administered along with the treatment.
IVF Treatment: IVF has a high success rate – between 20% and 35% and it can even go as high as 40%. This may not seem like a lot, but it is very high, considering that an average young and fertile couple has only a 15-20% chance to conceive in a month. It is important to understand what IVF and IUI success rates mean and the factors that affect it before deciding on a fertility treatment. You can also use any reliable online IUI vs IVF comparison tool to determine your approximate success rates with each of these treatments, depending on your age, lifestyle, and medical history.
You should use online sources of information to understand more about fertility problems, how age affects fertility levels, and whether freezing your eggs is a good option for you. However, discuss all these issues with your doctor to ensure that you have the right information and that you have understood it correctly. Fertility specialists provide you with personalized fertility plans based on your health which is why you should always talk to them before you make any decision.
There are two types of abortion, namely medical and surgical. In case of medical abortion, pills are taken to terminate the pregnancy; whereas surgical abortion is done if the pregnancy has reached an advanced stage when pills are ineffective. While generally there are no health risks or negative effects of abortion on fertility, there are rare cases of complications, which can give rise to severe symptoms post abortion. Following is the information you need to know about abortion and its effects on fertility:
When to seek medical assistance ?
It is advisable to seek medical help if you have the following symptoms post abortion :
1. Persistent pain in the lower abdomen, which lingers even after taking medication
2. Excessive bleeding
3. A high temperature
Possible effects of surgical abortion on fertility :
1. Infection after abortion
Infections post abortion like Pelvic Inflammatory Disease (PID) if left untreated for long can spread and harm your reproductive organs, thereby impacting your fertility. It can cause complications like infertility or ectopic pregnancy.
2. Damage to the cervix during abortion
Damage to the cervix during an abortion can cause cervical incompetence and consequently increase the risk of miscarriage.
3. Damage to the womb during abortion
There are chances of damage of the womb (uterus) during abortion, resulting in scarring, which can cause fertility issues if not corrected. This is more likely in case you had multiple abortions.
Apart from the above mentioned complications there are a number of other complications, which can happen due to abortion, preterm birth, vaginal bleeding during pregnancy and low birth rate, etc. Further, infertility can also be a possible side effect of abortion pills, which happens due to scarring of the uterus during the procedure of forcible elimination of the fetus. In all such cases it is advisable to schedule regular check ups with your gynaecologist.
Pubic lice, also known as ‘crabs’, is a condition which occurs when certain parasitic insects are present in the genitals. These insects cause red spots to form on the vagina which result in itching. Crabs are also known to affect other parts of the body such as eyebrows, eyelashes and beards. This disease is extremely contagious in nature; it can be passed on from one person to another via sexual intercourse, hugging and kissing. In some cases, this condition can also be passed on from the parent to the child.
If you are affected by crabs then you will have itching and pain in the genitals. The saliva of the insect can cause allergic reactions on the skin, resulting in the itch. The itching tends to worsen at night. Bluish or red spots may appear on the affected area. The lice are usually around 2 cm long and can’t be spotted easily.
Contrary to popular belief, pubic lice or carbs are not caused by poor hygiene. This disease spreads via bodily contact with an infected person and they feed on human blood to survive. Lice usually spread via sexual intercourse which may be anal, vaginal or oral.
Treatment for pubic lice
Treatments for pubic lice involve shampoos, lotions and insecticide creams. Some of the treatments for pubic lice need to be applied locally while others require full body treatment. Apart from following the treatment procedures, you need to take preventive measures to prevent infestation. Avoid sharing personal items such as toiletries, as lice can spread through it.
Oh, it is that time of the month again! There are a lot of women (and men who deal with the women) who would have repeatedly said this when they are experiencing the premenstrual syndrome. Most women (and men!) get used to it and know how to deal with it. As the adage goes, this too shall pass!
The female body and mind are controlled by a whole lot of female hormones which affect her health. During the premenstrual phase, when there is a surge in the hormone levels, there are a set of symptoms which any woman dreads. These include increased mood swings, irritability, abdominal cramps, migraines, breast tenderness, food binging, and back pain to name a few. About 80% of the woman experience these, so it is common, yet easily manageable. Some of the best ways to deal with the PMS are listed below.
- Stay active: Moving in any way to keep the body in motion and energy flowing is the key to managing PMS. Whether aerobic exercise, dancing, jogging, swimming, or walking, whatever works for you, go ahead and take your pick. Getting at least 30 minutes of physical activity can help get rid of the anxiety and manage stress.
- Deep breathing: This is not just a way to give your body more oxygen and therefore energy, it also helps manage the abdominal bloating that is commonly seen during PMS. Deep breaths help in releasing the held up air, which causes the belly to soften.
- Quit smoking: Smoking women are twice as likely to experience PMS symptoms as nonsmokers. Period. Reason enough to quit smoking??!!
- Soak in the sun: The sun not just gives vitamin D, it also relieves PMS by soothing the effect of the hormones.
- Get creative: The reproductive organs are the ‘creators’ in you, so when the hormone levels are higher, your creative energies are higher too. Check out for yourself and you will find that you will be extra-good at drawing, singing, writing and painting during these days. They also take your mind off the stress and symptoms of PMS and make you feel good.
- Yoga: Yoga does wonders for PMS symptoms, and staying upside down works wonders for the woman’s body.
- Healthy diet: Eat clean, green foods during your cycles. Whole grains, leafy vegetables, fresh fruits, legumes and nuts should find their way into your plates. Reduce the whites – sugar, salt, white rice, and even dairy if possible. Drink loads of water and keep above-average hydration levels.
- Limit alcohol and caffeine: They may boost your feeling temporarily, but do a lot of harm, so avoid them.
So, while PMS is not rare, there are simple effective ways to manage it too.
The concept of egg quality of a woman is derived from the belief that the embryo implantation probability is powerfully related to the age and ovarian reserve of the woman. Thus, it is regarded that the quality of the egg is almost synonymous with the chances of embryo implantation. Its quality cannot be assessed merely by looking at the egg or measuring its ability to receive the fertilization by sperm or simply observing the initial embryo division.
There are a few important factors that contribute to the success or failure of the embryo implantation and some of them are:
- Diminished ovarian reserve: A woman with an increased FSH level on the third day of the menses is regarded as having diminished reserve of ovary. This implies that her ovary is not competent in sending feedback signals to the pituitary gland and the body responds by producing an increased amount of FSH for stimulating the ovary. For more than 10 years, it has been found that in over thousands of fertility treatment cycles, women with an increased FSH level have a lower egg quality.
- Advanced age of maternity: Even though the FSH level is normal, the age of the mother who provides the eggs plays an important role to determine the quality of the egg. Quite like women with increased FSH levels, eggs obtained from women aged more than 40 years can have some problems at a later stage of fertilization. Normal FSH levels are not considered a reassuring factor, owing to the lower implantation rate in females aged over 45 years.
- Diminished quality of egg: With an increase in age, the capacity of the mitochondria in producing energy slowly decreases. The egg is linked to the circulation before ovulation, and it is linked again after the embryo implantation. But during the one week time ranging from ovulation to implantation, the egg and the resulting embryo are contained in the zona pellucida and function on the basis of mitochondrial energy supply. The older age of the woman doesn’t cause any problem at the initial stage of ovulation. Its fertilization and embryonic development are also normal. But soon, it runs out of energy and stops dividing before reaching the stage of implantation.
Therefore, it is important to have the eggs tested to find out any sort of chromosomal abnormality. In case the mother is deficient of producing high quality eggs, the best option is to have donor eggs.
Ovarian cysts are a common development in many women. Cysts are sacs filled with fluid which are formed in the female ovaries. Most cysts are harmless and do not even show any symptoms. However, some cysts do show outward symptoms like heavy bleeding, clotting, nausea, vomiting, stomach pain during the menstrual cycle, and pain during sex.
If you feel any of the above-mentioned discomforts, it will be in your best interest to book an appointment with your gynaecologist and get a check-up done. Most cysts are manageable unless they are very severe. In fact, it is best that cysts come to light at the right time and are efficiently managed, unless they develop into severe issues in the future.
Management of cysts
- Oftentimes, medical practitioners resort to what is called ‘watchful waiting’.
- At times, ovarian cysts disappear in a few months.
- It is recommended to take a blood test and an ultrasound to see the progress of the cyst.
- If you have already experienced menopause, then these tests are carried out every four months. This is because in such cases the risk of an ovarian cancer is at its highest and regular monitoring of the cyst is necessary.
Treatment of cysts
Ovarian cysts can be treated in their earlier stages. Here are some of the most popular treatments.
- Laparoscopy is one of the most popular treatments. It is a surgery carried out under general anaesthesia. The tummy is cut to a radius of a key hole and a laparoscope is inserted. This helps the doctor to see the internal organs, which is then used to remove the cyst. This method is less painful and has a quick recovery time.
- Laparotomy is the other method used for removing a cyst. In case the cyst is large, then one single large hole is made in the body to access the cyst. At times, the cyst and the ovaries are removed and sent for further laboratory inspection. This inspection is done to detect whether the samples are cancerous or not. This procedure is more complex than the previous one and might need the patient to stay in the hospital for a few days.
- In case you have a cancerous cyst, then your reproductive part itself would have to be removed rendering you barren for your life.
Ovarian cyst is very much treatable and is best to be detected at an earlier stage for better and faster treatment. Thus, it is best to go for regular check-ups and report in case of any disturbing symptoms.