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Dr. Sukanya Patra

Gynaecologist, New Delhi

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Dr. Sukanya Patra Gynaecologist, New Delhi
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My favorite part of being a doctor is the opportunity to directly improve the health and wellbeing of my patients and to develop professional and personal relationships with them....more
My favorite part of being a doctor is the opportunity to directly improve the health and wellbeing of my patients and to develop professional and personal relationships with them.
More about Dr. Sukanya Patra
Dr. Sukanya Patra is a renowned Gynaecologist in New Delhi, Delhi. You can consult Dr. Sukanya Patra at Dr Sukanya Patra's Clinic in New Delhi, Delhi. Don’t wait in a queue, book an instant appointment online with Dr. Sukanya Patra on Lybrate.com.

Lybrate.com has a number of highly qualified Gynaecologists in India. You will find Gynaecologists with more than 27 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.

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Recently I have done USG of whole abdomen. Result shown that enlarged ovary with suggestive chocolate cysts. One cyst in each ovary. Right oavry measures 3.8 cm x 4.2 cm and left one measures 2.7 cm x 4.4 cm. Pouch of Douglas is free written. No ascites and lymphadenopathy is seen. No size of the cyst is mentioned in report. Can the cyst be cured with medicine?

MS - Obstetrics and Gynaecology, MBBS
Gynaecologist, Karnal
Recently I have done USG of whole abdomen. Result shown that enlarged ovary with suggestive chocolate cysts. One cyst...
yes you can try medical treatment, which is taking continuous progesterone for 6 months at least and then a follow up ultrasound to see the size of chocolate cysts.
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Acute Respiratory Distress Syndrome - 10 Things You Might Not Know About It!

MBBS, MD - Pulmonary Medicine, DNB - Pulmonary Medicine, MD - Internal Medicine, Diploma in Tuberculosis and Chest Diseases (DTCD)
Pulmonologist, Delhi
Acute Respiratory Distress Syndrome - 10 Things You Might Not Know About It!

If you are experiencing difficulty in breathing or rapid breathing, shortness of breath and low blood pressure, you might have been affected with acute respiratory distress syndrome or ARDS. This is a fatal lung condition in which the supply of oxygen to the lungs and into the blood gets prevented. The symptoms of this syndrome develop within two days of the illness. Here are 10 important facts about ARDS you should know about:

  1. Because of the low level of oxygen in the blood, the organs of the body may not function properly. The kidneys and brain require constant oxygen-rich blood supply and there are chances of organ failure due to ARDS.

  2. Commonly, people who get ARDS are already in hospital for some other health problem. People who are not hospitalised may get ARDS because of conditions such as pneumonia.

  3. In ARDS, the tiny blood vessels of the lungs leak more fluid than usual into the air sacs of the lungs. This happens because of infections, injuries or some other condition. The lungs cannot get filled up with air and sufficient oxygen is prevented from getting pumped into the bloodstream.

  4. Several factors also lead to ARDS. These include sepsis, severe bleeding due to any injury on the head or chest, breathing in harmful smoke, or inhaling vomited content of the stomach from the mouth.

  5. People who are prone to ARDS have some condition that may injure their lungs directly or indirectly.

  6. The initial symptoms of ARDS include a feeling of not getting sufficient air in the lungs, low oxygen levels in the blood and rapid breathing. The diagnosis of ARDS depends on your medical history and the results from several tests and physical examinations.

  7. The treatment of ARDS is undertaken by oxygen therapy, medicines and fluids. A patient with ARDS is likely to develop some other health condition while in the hospital, such as lung scarring, blood clots, infections and pneumothorax.

  8. Many people recover from ARDS completely while others keep on facing certain health problems, such as shortness of breath, muscle weakness, depression and fatigue. Problems related to memory and clear thinking are also indicated.

  9. By improving your quality of life, you can recover from ARDS. You need the support and encouragement of your family and friends. You must avoid smoking and keep away from any kind of lung irritant.

  10. The treatment for ARDS has showed progress in the recent years. Hence, more people are recovering from this condition. New treatment procedures are being researched on. If you wish to discuss about any specific problem, you can consult a pulmonologist.
2755 people found this helpful

Is a Low Sodium Diet Good or Bad?

B.Sc - Home Science, PG Diploma - Dietics, M.Sc - DFSM
Dietitian/Nutritionist, Faridabad
Is a Low Sodium Diet Good or Bad?

Most dieticians are of the opinion that limiting your salt intake is essential, as an increased amount of salt in the system can damage your kidneys, heart and may increase your blood pressure, and chances of stroke. On the other hand, decreasing it beyond a point can prove to be detrimental to your health in various ways as well.

However, when relating to blood pressure, an increased salt intake can prove harmful to you only if you already have high blood pressure. In the case of normal levels of blood pressure, excess salt consumption will not prove to be too dangerous. Here are the ways in which low salt intake can prove to be detrimental for your health:

  • Increases chances of heart diseases: Having a lower amount of salt in your diet - i.e. less than 2000 mg per day increases the risk of heart-related disorders, which include, but may not be limited to, strokes or heart attacks, exponentially.
  • Decreases the body's level of sodium: Decreased levels of sodium in the body, often a direct byproduct of a reduced salt intake, can lead to a number of complications. Sodium is essential for maintaining electrolyte and mineral balance in the body. A decrease in sodium levels in the system, in extreme cases, can lead to hyponatremia, which can prove detrimental for the kidneys or liver.

Salt, which mainly contains two radicals - sodium and chloride ions, are essential for life. However, they can be obtained only through food as it is not manufactured intrinsically. There are several essential reasons for why salt intake in the optimal amounts is absolutely crucial in maintaining healthy body functioning:

  • It is an essential component of blood plasma, as well as several other crucial body fluids such as extracellular fluid, lymphatic fluid, and amniotic fluid.
  • It is important for maintenance and regulation of a proper level of blood pressure.
  • Sodium, in the context of body physiology, is critical in maintaining a proper acid-base level in your system and in controlling the levels of your body fluid.
  • The exchange of sodium and potassium ions, both obtained from salts, is also essential for muscle movement and in sending signals from the brain to the muscles. If you wish to discuss about any specific problem, you can consult a Dietitian/Nutritionist.
3371 people found this helpful

I am soo worried regarding irregular periods. Only 2 days is bleeding flow. Pls give me some more information.

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Pune
I am soo worried regarding irregular periods. Only 2 days is bleeding flow. Pls give me some more information.
Following periods paricharya during period days is very important avoid heavy food heavy work bathing travelling exercise during period days eat healthy food in non mentural days for proper regular mentural flow consult privetly for more details and medications.
1 person found this helpful
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Hello doctor I am 23 years old 7 months pregnant I have done encircularge in 5th month can I do sex know is it safe or not please suggest me thank u.

Bachelor of Ayurveda, Medicine and Surgery (BAMS), PGCRCDM, PDCR, MBA
Ayurveda, Ghaziabad
Hello doctor I am 23 years old 7 months pregnant I have done encircularge in 5th month can I do sex know is it safe o...
Better to avoid the main activity if possible as that can be risky. There are many other ways to be together with your partner and enjoy physically.
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IUI (Intrauterine Insemination)- Treatment Option for Infertile Couples

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

Introduction

When couples get married, they often view parenthood as the next stage in their family life. They want to have a child, they want to be “mom” and “dad”, they cannot imagine that this may be hard to achieve or may not be a natural process. When several trials to conceive fail, they are shocked. Their basic expectation about family life gets shattered. Most of the couples are desperately looking for medical therapy that will end into a misery. Clearly this is not a struggle to survive; it is a struggle to fulfill a dream, to achieve what they view as a “full life”.

What is needed for pregnancy?

In the male partner, sperms are normally produced in the testes after puberty (after attainment of characters like growth of beard, moustache etc). From the testes, they are carried through the sperm conducting ducts (epididymis, vas, seminal vesicle and prostate gland). Then during sexual stimulation, after proper erection and ejaculation, they come out through penis. During sexual intercourse, these sperms, present in semen, are deposited inside the vagina. 

 In female partner, the deposited sperms must travel from vagina through the cervix (the mouth of the uterus). The cervix acts as gate-keeper, a it prevents entry of dead and abnormal sperms as well as bacteria present in semen, in the uterus. From uterus, sperms reach the Fallopian tubes (the tubes that are attached to the both sides of the uterus) where the sperms must meet the egg (ovum). The eggs are produced only before birth and so, there are fixed number of eggs inside the ovary. The ovum released from the ovary, into the abdomen at the time of ovulation (rupture of the surface of ovary to release the ovum). That ovum must be taken by the tube and thus inside the tube an embryo (earliest form of the baby) is formed, by meeting of the egg and the sperm. 

It should be mentioned that out of nearly 200-300 million sperms, in average, deposited in vagina, hardly 500- 800 sperms can reach near the eggs and only one will succeed to form the embryo. The embryo then travels through the tube into the uterus and the uterus attaches the embryo firmly with it and thus the pregnancy starts. So, if there is defect in any one of them there will be difficulty in achieving pregnancy.

Thus, to summarise, pregnancy requires

  1. Production of healthy (“Normal Morphology”) and movable (“Normal Motility”) sperms in adequate number (“Normal Count”) in the testes
  2. Transport of these sperms through the sperm conducting ducts from testes to penis
  3. Successful Erection and Ejaculation during Intercourse to deposit adequate number of these sperms in the vagina
  4. Transport of these sperms from vagina through cervix to the uterus and the tubes
  5. Presence of sufficient number of eggs inside the ovary and ability to release the eggs from the ovaries
  6. Pick up of the eggs by the tubes 
  7. Approximation of eggs and the sperms to form the embryo
  8. Transport of embryo from the tubes into the uterus
  9. Acceptance of the embryo by the uterus and its growth

What is Infertility?

 

Literally, the word “Infertility” means inability to conceive. But in reality, there are very few couples, who have no chance of natural conception and are called “Absolutely Infertile”. In fact, in many couples who present to infertility clinics, pregnancy may be the matter of time, thus the chance factor. 

It should be kept in mind that, if there is factors to question fertility of either male or female or the female is of age less than 35 years; after one cycle (one month) of regular frequent intercourse, the chance of conception in human being is only 15%. That means, out of 100 couples trying for conception, only 15 will be able to succeed after one month of trying. The word “Regular” and “Frequent” are important; because to achieve pregnancy, couples are advised to keep intimate relationships for at least 2-3 times a week and this should be increased particularly around the time of ovulation (Middle of the menstrual cycle). Thus chance of pregnancy after 6 months, 12 months and 24 months of regular trying are respectively 60%, 80% and 100%. 

The word, “Subfertility” seems better and more scientific than “Infertility”, to describe the couples who have reduced chance of conception, due to any cause. However, the word “Infertility”, seems more popular, although it puts pressure on the couples. In most cases, usually we advise to investigate after one year of regular and frequent intercourse, when the couples fail to conceive. However, if there are factors to question fertility; for example female with age more than 35 years, or with previous surgery in tubes/ ovaries/ uterus or known diseases like PCOS or endometriosis; or male partner having surgery in scrotum or groin or any hormonal problems or sexual dysfunctions- the wait period is usually reduced and couples can be investigated, even soon after marriage. 

What causes Infertility?

Please look at the point “Thus, to summarise, pregnancy requires” where 9 points have been mentioned. 

Thus the common causes may be

  1. Problems in male- total absence of production of sperms, less than adequate number of sperms, problems in morphology and motility of sperms (most sperms not healthy or movable), blockage in transport of sperms and inability to deposit sperms in the vagina (sexual dysfunction- Erectile Dysfunction or less commonly, Ejaculatory Dysfunction). Examples include hormonal problems (Testosterone, thyroid, prolactin), diabetes, liver problems, causes present since birth, chromosomal abnormalities, surgery, infection, sexually transmitted diseases, smoking, exposure of scrotum to high temperature, some medicines or psychological causes.
  2. Problems in female- total absence of less than adequate number of eggs in the ovaries, problems in ovulation, problems in picking of eggs by the tubes, blockage of tubes, problems in conduction of sperms or embryo by the uterus, problems in accepting the embryos by the uterus. Examles include causes present since birth, chromosomal abnormalities, polycystic ovarian syndrome (PCOS), old age, increased weight, fibroid, endometriosis, pelvic inflammatory diseases (PID), tuberculosis (TB), infections, smoking, surgery, some medicines, hormonal problems (thyroid, prolactin) or excessive stress.
  3. Unknown causes- Despite thorough investigations, 25-30% causes of infertility remain unknown. This is called “Unexplained Infertility”. The reason may be mere chance factors or there may be some causes which, still medical science has yet to discover. But this should be kept in mind while treating infertility. That means, even with correction of the possible factors (like improving sperm counts or thyroid problems etc) or with proper treatment (IUI, IVF or ICSI), unfortunately the treatment can fail and the exact reason, why the treatment failed, is sometimes difficult to find out.  

In general, what are the treatment options for infertility?

To start with, please remember there is no hard and fast rules for infertility treatment. Often medical science fails to understand why couples with very severe form of infertility conceive sooner than those who are having all tests normal. That means, whatever treatment is offered, it’s very important to continue regular sexual intercourse, as the chance of natural pregnancy is usually there in almost all couples. Your doctor will present the facts to you, without pressurizing you on a particular option. After coming to know all pros and cons of different treatment options, you can take decision. Do not hurry. It’s quite natural that you might be in stress. 

In general, after the initial tests, a few periods of natural trying is allowed. After that, ovulation induction (giving medicines to release eggs from the ovaries) is offered, failing which IUI and finally IVF is offered. What will be the preferred treatment for you, will depend on your age, duration of marriage, male and female factors and of course, your age. For example, a woman with both tubes blocked or a male with very low sperm count, IVF would be the first line of treatment.

What is insemination?

Insemination literally means putting semen in a particular place. Various forms of insemination exist in fertility treatment. First one is “Intravaginal Insemination (IVI)”, where the raw semen, collected by the husband can be put inside the vagina, taking precautions (to prevent infection) by the husband himself or by the wife. Rarely, it needs medical assistance from a doctor. It’s usually advised to couples having sexual disorders where full penetrative intercourse is not possible (erectile dysfunction of the husband or very painful intercourse experienced by the wife) or where ejaculation cannot happen during intercourse (a very unusual problem). Thus, the success rate of IVI is no better than natural intercourse (success rate 15% per cycle), for those couples who can manage successful intercourse. 

“Intrauterine Insemination (IUI)” is the treatment where “prepared” semen is put inside the cavity of the uterus, near the Fallopian tubes. Thus, IUI bypasses some hurdles that can cause problems during natural intercourse. The vagina, cervix and the whole length of the uterus are bypassed, putting the sperms near the eggs. Thus it increases the success rate compared to natural intercourse or IVI.

However, to achieve pregnancy after IUI, the female partner must have open tubes, adequate number of eggs produced by ovaries, eggs must be released by the ovaries and sperms must meet the eggs. And, thus nature plays important role, as in natural intercourse.

Please note, we used the word “prepared” semen. In natural intercourse, as mentioned earlier, the dead sperms and bacteria cannot enter the uterus, because cervix prevents their entry. If they are put artificially by IUI inside the uterus, severe reaction can happen. So, after collection, the husband’s semen is processed in the laboratory to remove all those impurities and to select only the best number of healthy and movable sperms and it definitely increases success rates of IUI

When IUI is generally advised?

As you can understand, to perform IUI, there must be minimum number of sperms in the semen, the tubes must be opened, the ovaries must be releasing eggs. If these are present, IUI is usually advised 

  • Less than adequate number of sperm counts, morphology or motility
  • Couples who cannot perform full penetrative intercourse but refuse or unable to conceive by IVI
  • Unexplained infertility- although IVF is better than IUI, but considering the cost, many couples in our country opt for 2-3 cycles of IUI before IVF
  • PCOS and Mild Endometriosis- where natural intercourse or ovulation induction failed
  • Couples in whom only one partner is positive for HIV or Hepatitis B or C- where transmission from one partner to another by unprotected sexual intercourse is not preferable.

What are the tests done before IUI?

The basic infertility evaluation is done before IUI include husband’s semen analysis, assessment of ovarian function (blood tests, ultrasound) and uterus (ultrasound). In some cases, laparoscopy (putting camera to see inside the abdomen by operation) or hysteroscopy (putting camera through vagina inside the uterus, by operation) may be required. Now, if the tubes are blocked, IUI is of no use. So, testing the tubes is advisable before IUI. But some women, who are at low risk of tubal disease (no history of pelvic pain, infection or surgery), one or two cycles of IUI can be done, failing which tubes must be checked by tests like HSG or SSG or in some cases by laparoscopy. 

What IUI actually involves?

In the cycle, in which IUI is planned, the woman is asked to take some medicines (or injections) in particular days of the periods as a part of “ovulation induction”. She is then advised to have ultrasound monitoring (TVS- transvaginal sonogram- where ultrasound probe is placed inside the vagina for better accuracy) to see if eggs are growing in response to the medicines or not. If eggs are growing, IUI is planned in a particular time when the egg(s) is more likely to rupture, so that the tie interval between sperm entry and egg release can be kept as minimum as possible. 

Is ovulation Induction necessary for IUI?

Frankly speaking, IUI can be done without any medicines (as in case of natural intercourse or IVI), which is called “Natural Cycle IUI”, where only TVS monitoring is done to see how the eggs are growing. This may avoid some side effects of ovulation induction (see below) but is associated with low success rate than IUI done along with ovulation induction.

Is TVS necessary before IUI?

TVS is, undoubtedly, uncomfortable for the woman. But it gives better picture than ultrasound done conventionally. Now, the question is, whether ultrasound monitoring is at all needed or not. TVS directs the doctor how eggs are growing and at what number and size and when they are likely to rupture. Moreover, the rupture can also be confirmed by TVS. Again, the uncommon side effect of ovulation induction can be detected by TVS. That is called OHSS (“Ovarian Hyperstimulation Syndrome”) where excessive eggs can grow inside the ovaries and this can lead to collection of fluid inside abdomen and lungs and can turn very serious. Although very rare, it can be detected by TVS and early actions can be taken to prevent the progress of this condition. 

In rare cases, where TVS cannot be done or patient declines, only option is to check urine by LH kit to predict the likely timing of ovulation and at that time IUI is planned. However, it is less accurate than TVS monitoring and is associated with less success.

What, if eggs are not growing in the ovaries?

In some women, particularly those who are overweight, aged or some cases of PCOS, eggs may not respond initially to one medicine. There are various forms of ovulation induction medicines (tablets, injection). If one is not working, your doctor can try increasing the dose of that medicine or add or replace it with other medicines. Please remember, it’s difficult to predict what medicine will be best suited for a particular patient. So, it’s basically a trial and error process.

What is done on the day of IUI?

As timing is important, the couples are requested to stick to the timing, advised by the doctor. The husband will be asked to collect the semen by masturbation, using clean technique (to avoid contamination by germs in the semen container). The semen is then prepared by the embryologist and will be checked to see the final number of sperms and their motility and morphology.

The wife is asked to lie down in the IUI table. After cleaning, a sterile speculum (instruments to separate walls of the vagina to see the cervix) is introduced inside the vagina and then 0.4-0.6 ml of the prepared semen is inserted inside the uterus with the help of a small catheter (fine tube). IUI done, under ultrasound guidance, gives better result than IUI done without it. The patient is asked to lie down few minutes after taking out the catheter and the speculum. The medicines are advised and then they can go home.  

Is IUI painful?

Most women feel little discomfort during IUI but it should not be painful. If there is technical difficulty while putting catheter inside the uterus, your doctor will discuss it with you and in the next cycle, will plan management to solve this issue.

What happens if husband cannot collect semen?

Collection of semen in unfamiliar environment is understandably a matter of discomfort and seems awkward. Proper counseling and maintenance of privacy can help. Stress-free approach is needed. If it fails, do not hesitate to inform your doctor. Some medicines can help. But in those, who are unable to masturbate, there are some instruments, like ejaculator, can help to solve this problem.

What happens if sperm count is low?

IUI can be successful if sperm count is minimum more than 5 million per ml and there is reasonably good morphology and motility. If not, IVF or ICSI would be the better option. But IUI can serve as trial also. That means before putting the semen, the prepared sperms can be examined and it can be predicted what is the success rate of IUI in this particular case and whether IVF or ICSI would be needed. In rare occasions, where sperm count is extremely low but the couple do not wish for IVF or ICSI, pooled semen IUI can help- where the semen is collected in number of occasions and is preserved and the final pool is used for insemination, to give a reasonable success rate.

When donor sperm is used and how?

If a man does not have any sperms or too few sperms to do IUI, IVF or ICSI is not affordable, donor IUI is an alternative. But it is not done without consent from both husband and wife. The donor is not known to the couple or the doctor and no identity of the donor is revealed. No relative or friend can serve as donor. Donor semen is frozen semen, collected 6 months ago and the donor is tested for diseases like STD, HIV, Hepatitis B or C. Usual attempt is taken to chose donor having blood group and skin colour similar to those of the husband. But remember, it’s only given after discussion and written consent by the couple. 

Can a couple have intercourse in the cycle where IUI is advised?

Intercourse around IUI increases the number of sperms available at the time of ovulation.

When should one check for pregnancy?

Usually if period does not come within 18 days after IUI, pregnancy test is advised. It can be done at home. If negative, then the cause of not having periods is sorted out.

What is the chance of success after IUI?

In one cycle, chance of success is around 20-25%. Most of the couples conceive after 3rd or 4th cycle of IUI. The chance of pregnancy after 6th cycle is low, so, usually IUI beyond 6 cycles is not advised.

The factors where IUI gives better results include unexplained infertility, sexual dysfunction of any of the partner, PCOS and male subfertility (low sperm count or motility)

What happens if IUI fails?

As said earlier, you should think about further treatment, if 3rd or 4th cycle of IUI fails. There is no use of doing IUI beyond 6 cycles, unless natural intercourse is not possible and the age is favourable. IVF gives better result. 

Is there any harmful effect of IUI?

Very few harmful effects have been noted, for examples, hazards of ovulation induction (OHSS< twin pregnancy), pain, infection and discomfort. As mentined, if raw semen is given, unusual allergic reaction can happen.

How IUI is being done in your particular centre by Dr Sujoy Dasgupta?

We believe in patient’s autonomy. So we want to give time on discussion and presentation of facts and figures to the couples. We encourage questions from the couples and take utmost care so that no question remains unanswered.

We do not take decisions and impose it on the couples. We advise the couples to take time before taking decision on a particular treatment. If the couple decides, we respect and support their decision.

We try to take nominal charges and help couples to collect medicines (particularly injections) at lower prices than MRPs.

After thorough evaluation of both the partners, we plan for ovulation induction drugs, with consent from them and advise them to come for TVS. After each day TVS, we explain the progress and probable timing of IUI.

On the day of IUI, after requesting the couple to maintain punctuality, we advise the husband to collect semen, in comfortable atmosphere, maintaining the privacy. If there is problem in semen collection, we provide support to him and address his issues in sensitive way.

Our expert trained embryologist then prepares the semen. We always encourage the couples to see the condition of raw and prepared semen under microscope to maintain the transparency. 

We advise the woman to fill up the bladder (to take water and not to urinate) to facilitate the passage of IUI catheter. Unlike other places, we perform IUI inside OT to prevent unwanted infection. 

Again we maintain our uniqueness in the sense that we perform it under ultrasound guidance. The ultrasound guidance has been scientifically proved to increase the success rate of IUI. Moreover, we show the woman in the ultrasound (real time) how the catheter has been put inside the uterus (to make sure that we are not doing IVI or have placed it in wrong position). This also helps to reduce patient’s anxiety and uncertainty. After that, our nurse takes care of the patient and observes her when she takes rest. 

Then we advise the post-IUI medicines and advise them what to expect and when they can go home. Again, this time we try to answer all questions the couples can ask.

 

Conclusion

Infertility is a peculiar thing. Very few men or women are absolutely infertile. That means they do not have ability to achieve pregnancy naturally. Majority of them are subfertile. That means most of them have lower than normal chance (compared to healthy couples) to achieve pregnancy in a normal menstrual cycle. Often we find that patients planning for treatment and in the mean time, they conceive naturally. That means even without treatment, there is some chance of pregnancy. Of course, it’s stressful situation for both the partners. Stress affects conjugal relationships and lead to many couples avoiding conjugal life. Indeed stress can affect the hormone levels in females and affects sexual performances in males. It’s easier for us to advise you to stay stress-free but is difficult to practice. Nevertheless, try relaxation as much as possible. Think that majority of the couples ultimately conceive by some form of treatment. Have faith in yourself and have faith in your doctor.

29 people found this helpful

I missed my period for 13 days with negative home preg test. I am trying to conceive. Could I be pregnant or not.

DNB (Obstetrics and Gynecology), MBBS
Gynaecologist, Mumbai
I missed my period for 13 days with negative home preg test. I am trying to conceive. Could I be pregnant or not.
Sometimes it can take time to show on the home kit test ; best way to know is by blood test for pregnancy.
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I have a sex with my boyfriend without protection. He said we have done it only 50 % what does that means. And my time is shifted 1 week. So is it safe.

CCEBDM, PG Diploma In Clinical cardiology, MBBS
General Physician, Ghaziabad
50 % sex does not mean any thing and is not relevant, if your date is delayed by 7 days get your urine tested for pregnancy, there are kits available at chemist shop and you can do it your self at home. Do it urgently donot delay.
1 person found this helpful
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Excessive Bleeding During Menses - 8 Things That May Cause It!

MD - Obstetrtics & Gynaecology, MBBS
Gynaecologist,
Excessive Bleeding During Menses - 8 Things That May Cause It!

Excess bleeding or menorrhagia is a common kind of abnormal bleeding occurring at the time of menstruation. Menorrhagia causes more blood loss which leads to anaemia. fatigue and breathlessness are common symptoms of anaemia.

Symptoms of excess bleeding

A few of the common symptoms of excessive bleeding are: 

  1. Discharge of large blood clots is a sign of heavy bleeding 
  2. Bleeding during the night which causes disruption in sleep as one has to wake up several times in the night to change the sanitary napkin 
  3. Menstruation lasts longer than usual or more than 5 to 7 days. 
  4. Any menses requiring excess change of pads than usual 

Causes of excess bleeding 

  1. Imbalance of hormones: During adolescence and when nearing menopause, the female body undergoes some imbalance in oestrogen and progesterone hormones. At these points of time, heavy bleeding is common among women. But it’s abnormal. So get it evaluated. 
  2. Abortion / Ectopic pregnancy: Conception occurs in mid cycle and so by the time a menses start, one could be a pregnant too. So excess bleeding occurring at menses could be also due to an abortion or miscarriage. Unlike the usual course of pregnancy, if the fertilised egg gets stuck in the fallopian tubes and develops there, It results in Ectopic pregnancy. Excess bleeding can be a sign of ectopic pregnancy too.
  3. Fibroids: Growth of fleshy solid tumours in the wall of uterus namely Fibroids can lead to excess bleeding. 
  4. Cancer: Cervical, ovarian and uterine cancers are rare causes of heavy bleeding, but it is possible. So early detection of these conditions is better for treatment. 
  5. Adenomyosis: This is common in middle-aged women who have given birth to more than two children. In this case, the glands that appear in the lining of the uterus become deeply embedded in the muscle of the uterus wall. These women with adenomyotic uterus have severe dysmenorrhea ( pain during menses ) and excess bleeding. 
  6. Intrauterine device: IUD used for birth causes more bleeding during menstruation. In some the bleeding reduces over time, but if in excess one must get evaluated. 
  7. Pelvic inflammatory disease: PID is an infection that occurs in the uterus, other reproductive organs and the fallopian tubes. Inflammed reproductive organs bleed more and hence cause menorrhagia. 
  8. Other diseases and disorders: Diseases like that of liver, kidneys and thyroids can cause excess bleeding. Disorders in blood levels or platelets can also be a cause. 

Treatment for excess bleeding 

Several treatments are available to treat heavy bleeding during menstruation. Choosing the right one mainly depends on the reasons that cause heavy bleeding.

Non-surgical treatments: 

  1. Hormonal therapy: This therapy is used as a treatment to stabilise the lining of the uterus (endometrium) and thus regulate the menstrual bleeding. 
  2. Non-hormonal medication: A tranexamic acid is a non-hormonal medication prescribed by the doctor that promotes clotting of the blood.
  3. Nonsteroidal drugs: Nonsteroidal medications that are anti-inflammatory like Ibuprofen, mefenamic acid helps to reduce the blood loss. 

Surgical Treatments 

  1. Hysteroscopy: A long and thin scope can be inserted into the uterus through the cervix and the vagina. The doctor observes the lining of the uterus, remove the excess lining or the endometrial polyps that cause bleeding. 
  2. Dilation and curettage: In this procedure, the mouth of the uterus (cervix) to be dilated and the lining of the uterus is scrapped off to make it shed all at once and stop bleeding. 
  3. Hysterectomy: This involves removing the uterus. It is mainly done for uterus having adenomyosis, fibroids, or cancers, or when the patient does not respond to medical therapies. 
  4. Ablation: Ablation or endometrial resection allows removal of the lining of the uterus. But it may be a temporary measure as the lining recurs. 

To conclude, proper diagnosis, choosing the right treatment for excess bleeding at menses needs to be done urgently as it affects the overall health of the women suffering from it. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

2699 people found this helpful

Hi doctor, I am on estrogen from the last 10 years. Now I want to plan my baby. What should I do? please help me.

F.MA.S. FELLOWSHIP IN MINIMAL ACCESS SURGERY, I.V.F. AND CLINICAL EMBRYOLOGY, FOETAL MEDICINE TRAINING, PREVENTIVE ONCOLOGY TRAINING, MS - Obstetrics and Gynaecology
Gynaecologist, Mumbai
Hi doctor, I am on estrogen from the last 10 years. Now I want to plan my baby. What should I do? please help me.
Hello, My best wishes are with you. You have to stop taking these pills and you can try for the baby immediate next month. For getting pregnant you have to know the days of ovulation. And by keeping relations in these days may give you a pregnancy. These facts you should know. 1. Normally in midcycle the egg comes out of ovary and waits for the sperms in the fallopian tube. If relation is there in this period and sperm reach the egg and fertilise it then pregnancy is there. 2. The days of ovulation can be made out by experiencing a midcycle increase in temperature and thining of cervical mucous which you can find on your fingers. 3. Not to mention that these pills have no effect on your future baby. So relax and try with a positive attitude and surely you will have a result soon. Thanks
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My friend is participated in sex with her husband when she is in menses. What will happen.

BHMS
Homeopath, Faridabad
My friend is participated in sex with her husband when she is in menses. What will happen.
Hello, there are more chances of infection if sex is performed during the menstrual cycle. Take care.
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Tulsi - The Amazing Healthy Herb

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Delhi
Tulsi - The Amazing Healthy Herb

The Tulsi plant or holy Tulsi has been an intrinsic part of Indian history. It runs so deep within the realm of our understanding and profession of Hinduism or of an overly eastern way of life, that you use it as a metaphor for sanctity. Most Hindu households, both rural and urban, worship this plant. The benefits of this herb have had the support of a huge mass of people who would not have settled for anything other than a scientific approval of their faith; the humor in this statement eludes most proving every bit of truth in it. Indeed, this healthy herb has been found to be helpful in more than a couple of ways and has thus, transcended the limits of domestic and cultural identities.

See for yourself how healthy is Tulsi:

  1. Fight off cancer with Tulsi leaves: Tulsi plant is widely sought after for its anti-carcinogenic properties. It is also known to counter bacteria and other viral infections. One may even use its leaves as an antibiotic. Regular consumption of its leaves on an empty stomach can rid you of recurrent problems like fever or cough and cold.
  2. Pamper your skin with a touch of health: Tulsi is known to detoxify and cleanse the human body. Most skin disorders arise due to underlying skin infections. These infections are usually the result of toxins. Applying a Tulsi pack or drinking herbal teas can therefore be effective.
  3. Say goodbye to crushing digestive problems: Tulsi can build up your immunity against common conditions like diarrhea or dysentery. People suffering from slow bowel movement have also gained from this herb. It propels good digestion.
  4. A big threat to mosquito borne diseases: Treatment of Malaria and dengue incurs thousands. Using Tulsi as a preventive herb can be of significant help. Tulsi is also known to cure hepatitis and tuberculosis.
  5. Bathe in Tulsi water to remedy rashes: Adding Tulsi leaves to your bathing water successfully deals with germs and bacteria. You can easily tackle itchy skin, rashes, and boils with this simple tip.
4666 people found this helpful

Doctor, I just want to know whether cystoscopy is painful process? Second. How much time does a doctor need to complete this test?

MBBS, MS - Obstetrics & Gynecology, Fellowship in Infertility (IVF Specialist)
Gynaecologist, Aurangabad
Doctor, I just want to know whether cystoscopy is painful process? Second. How much time does a doctor need to comple...
Hi Sanjiv cystoscopy is done under light sedation so it is not painful. If it is just Diagnostic then it takes 15minutes time.
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Advantages Of Homeopathic Treatment For Infertility!

BHMS, Certified in Aesthetic Skin Treatments, Certified in Applied Behaviour Analysis
Homeopath, Mumbai
Advantages Of Homeopathic Treatment For Infertility!

Starting a family and being people who you can completely rely on is something that may be a dream that most people nurture and work towards. While most couples are blessed with happy families, there are a lot of those couples who may have to rely on medicines and treatments to be able to conceive a child.

With the changing lifestyle and the increasing amount of stress, a lot of couples are not able to conceive naturally. This is when they turn to medical help from professionals who may be able to suggest treatments and counselling. Even though the medications and treatments are sought very popularly, it is also a fact that couples have to go through painful procedures and unfruitful trials before they are able to get positive results, if at all that is possible. Not to mention the expensive treatment costs and the costly medicines that they have to invest in, apart from the mental and emotional trauma that is accompanied with it.

Causes of Infertility:

  1. Infertility in Males: Small/undescended testes, Testicular injury, Abnormal/Low sperm count, Erectile dysfunction, Premature ejaculation, Prostatitis, Orchitis, Varicocele, Infections(STD’S including Chlamydia, gonorrhoea), Vas deferns/Ejaculatory duct obstruction.
  2. Infertility in Females: Structural abnormality in uterus/cervix, Endometriosis, Polycystic Ovarian Syndrome(PCOS), Irregular periods, Hormonal imbalance, Pelvic Inflammatory disease(Chlamydia, gonorrhoea), Uterine fibroid, Pelvic T.B., Pelvic adhesions due to infection or following surgery, Blocked fallopian tubes due to salpingitis, or Thyroid disorders.
  3. Combined causes or risk factors in male/female that increase the risk of infertility: Advancing age, obesity, alcohol intake, smoking, diabetes mellitus, emotional stress, exposure to radiation, and intake of certain drugs are the primary causes for this condition.

A safer alternative:

One of the safest alternatives to conventional medicine and treatments is to opt for homeopathy. This is a style of treatment that works on the body using natural means such as plants extracts and other natural derivatives, in combination with medicinal properties in healthy portions. With the use of such treatments and medicines, it may be possible for aspirant couples to be able to work on their body systems to make them healthier and more responsive to conceiving a child.

Homeopathic treatment of infertility is mainly achieved through the administration of constitutional homeopathic medicines found most suitable after a detailed case analysis. A detailed case analysis includes the general physical and mental constitutional make-up of the patient plus the symptoms in the sexual sphere and the underlying cause that is hindering the fertility process and needs to be corrected. Homeopathic medicines for infertility are natural medicines that help by raising the patient’s immunity to remove the obstruction that is hindering the process of fertility in a couple. Homeopathic medicines for infertility are non-toxic and carry no risk of side-effects.

Some of the most important advantages of homeopathic treatment for infertility:

  1. The medicines make sure that they do not put the others aspects of health at jeopardy for the users of homeopathic medicines which means that the medicines do not have highly destructive side effects.
  2. The lack of side effects in the homeopathic medicines for infertility ensure that the couples remain mentally and emotionally strong enough to stick to the resolve of getting treated and that is something that may be helpful in the success of the treatment.
  3. Since the medicines are all organic, most of them are not as expensive as the conventional medicines.
  4. Choosing a safe stream of medication such as homeopathy may also help in ensuring that when the child is conceived, it does not get affected by the harmful medicines that may be administered to the couple.

When the future of your family and health is at stake, it is important that you take well thought out and wise decisions about what kind of treatments you should undergo.

Here is a very short list of commonly used remedies:

  1. Sepia: This type of homeopathy remedy is used to treat irregular or absent ovulation
  2. Sabina: Recommended for women who have experienced recurrent miscarriage
  3. Aurum: Used in cases when low sex drive and depression are the cause of infertility
  4. Phosphorus: Used when anxiety and stress are contributing to female infertility
  5. Silica: A type of homeopathy remedy used to boost the immune system in order to improve a woman’s chances of getting pregnant
  6. Pulsatilla and Sepia: Pulsatilla and Sepia are suitable homeopathic medicines for infertility in females due to irregular or scanty periods. 
  7. Calcarea Carb and Aletris Farinosa: Calcarea Carb and Aletris Farinosa used for infertility in females due to profuse menses. 

There needs also a discussion regarding potencies, repetition of dose, timing, and other supportive information like lifestyle nutrition, supplements like folic acid, exercise like yoga, etc. If you wish to discuss any specific problem, you can consult a homeopath.

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Top 10 Ginger Health Benefits

M.Sc. in Dietetics and Food Service Management , Post Graduate Diploma In Computer Application, P.G.Diploma in Clinical Nutrition & Dietetics , B.Sc.Clinical Nutrition & Dietetics
Dietitian/Nutritionist, Mumbai
Top 10 Ginger Health Benefits

Top 10 ginger health benefits


 

Here are the top ginger health benefits proven by medical studies:


 

1. Stroke and heart disease

Two of the biggest killers on the planet may be kept at bay with regular ginger use, especially when eaten with other key superfoods. Garlic, ginger and onions all have an anti-blood-clotting ability, yet when they’re eaten together they’re a powerful mainstay against heart attacks and stroke!


 

2. Indigestion and nausea

Whether we’re talking about curing a simple tummy ache or severe morning sickness, ginger has been used for thousands of years as an effective digestive aid and natural remedy for nausea. Recently, taiwanese researchers discovered that three capsules (1.2 grams total) of ginger can actually help the stomach release its contents into the small intestines in people with dyspepsia — a condition in which 40 percent of patients suffer from abnormally delayed gastric emptying.


 

This is one reason why ginger helps people who are bloated, constipated and have other gastrointestinal disorders. It relaxes the smooth muscle in your gut lining and helps food move along throughout the system.


 

Key takeaway: eating whole ginger, drinking fresh ginger juice and inhaling diffused ginger essential oil are all highly effective ways to curb stomach disorders.


 

3. Malabsorption

Proper food transport (and nutrient absorption) from the mouth out through your colon is the mainstay to health. If food gets stuck somewhere in between, it can ferment, rot or (even worse) cause obstruction, which is a life-threatening emergency.


 

Improper digestion can also cause improper assimilation of the nutrients in your food. Either way, both cause malabsorption, and your body suffers from nutrient deficiencies. This is why ginger is so important. Like we’ve seen above, it helps promote regular digestion and metabolism of your food and is largely responsible for promoting a strong immune system.


 

4. Compromised immunity and respiratory function

Ayurvedic medicine has praised ginger’s ability to boost the immune system before recorded history. It believes that because ginger is so effective at warming the body, it can help break down the accumulation of toxins in your organs. It’s also known to cleanse the lymphatic system, our body’s sewage system.


 

Dr. Oz says, “by opening up these lymphatic channels and keeping things clean, ginger prevents the accumulation of the toxins that make you susceptible to infections, especially in the respiratory system.” combining ginger oil and eucalyptus oil is an effective remedy to boost immunity and improve breathing.


 

5. Bacterial infections

The journal of microbiology and antimicrobials published a study in 2011 that tested just how effective ginger is in enhancing immune function. Comparing the ability of ginger to kill staphylococcus aureus and streptococcus pyogenes with conventional antibiotics, nigerian researchers discovered that the natural solution won every time!


 

The drugs — chloramphenicol, ampicillin and tetracycline — just couldn’t stand up to the antibacterial prowess of the ginger extract. This is important because these two bacteria are extremely common in hospitals and oftentimes cause complications to an already immune-compromised patient.


 

Key takeaway: if you ever need to go to the hospital for surgery or to visit a friend, make sure you bring some ginger essential oil with you and add a couple drops to your water. You’re less likely to get a dangerous staph infection, and it can help speed the healing process! other healing remedies that are effective against infections include oregano oil, clove oil and melaleuca oil.


 

6. Fungal infections

One of the trickier issues to control because they’re increasingly resistant to conventional medicine, fungal infections don’t stand a chance against ginger. Of the 29 plant species evaluated in a carleton university study, ginger won the prize for having the extract most effective at killing fungus.


 

Key takeaway: for a powerful antifungal punch, mix several drops of pure ginger essential oil with tea tree oil with one teaspoon of coconut oil, and apply up to three times a day.


 

7. Ulcers and gerd

Since the 1980s, researchers have known that ginger can cure stomach ulcers. More recently, indian scientists have been able to more closely quantify this medicinal effect. In a study published in the journal molecular nutrition and food research, they discovered the ginger was six to eight times more potent than prevacid, the drug of choice to treat gerd!


 

8. Pain

Ginger is known for its anti-pain property. Very similar to how capsaicin works to relieve pain, gingerol acts on vanilloid receptors, which are located on sensory nerve endings. Similar to the initial intense burning feel you get when you consume spicy pepper, ginger’s burn only lasts but a second, and researchers discovered that it “affects the pain pathways directly but also relieves the inflammation, which in itself causes pain.”


 

9. Cancer

Working with mice without immune systems, university of minnesota scientists discovered that three weekly feedings of [6]-gingerol delayed the growth of colorectal cancer cells. University of michigan researchers confirmed these results with ovarian cancer. In fact, they found that “ginger treatment of cultured ovarian cancer cells induced profound growth inhibition in all cell lines tested.”


 

Key takeaway: the executive director of the herbal medicine research and education centre, basil roufogalis, advised that, “the most likely way to administer ginger as a painkiller would be in the form of a tea taken several times a day, but more work needs to be done on the amount of ginger powder needed per dose to take effect, and the time required between doses.” for most people, taking 1,000 milligrams of powdered ginger root is effective — or two drops two times daily of ginger essential oil.


 

10. Diabetes

Gingerols are widely known to naturally improve diabetes and enhance insulin sensitivity. Building off this knowledge, a 2006 study out of the journal of agricultural and food chemistry discovered that they could also suppress sorbitol accumulation in human blood cells and sugar-fed rats. Simply put, ginger not only helps prevent and reverse diabetes itself — it protects against and improves diabetic complications like diabetic retinopathy!

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I'm 30 year girl heaving multiple fibroids in uterus .now uterus size is enlarged 13.6*7.7.8*6 can you suggest me if I'll go for surgery could I conceive baby.

MBBS, MD - Obstetrtics & Gynaecology
Gynaecologist, Gurgaon
I'm 30 year girl heaving multiple fibroids in uterus .now uterus size is enlarged 13.6*7.7.8*6 can you suggest me if ...
Yes if surgery is done successfully and all due Medications are taken post that you will be able to concieve.
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Using of candid Cl for fungus infection of vagina may cause problems in conceiving baby.

MBBS, DGO, MD, Fellowship in Gynae Oncology
Gynaecologist, Delhi
Using of candid Cl for fungus infection of vagina may cause problems in conceiving baby.
Hello, No, it will not affect your conception chances as it is for local use and if you have an infection, you should treat it first.
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I am 29 years old female married n having kids of 4 years. I'm missed my period for this month delayed by 15 days, my pregnancy test also negative. I consult doctor also she advice to have mensil n for 2 days n ull get period but 1week over still I didn't start the period could you suggest me what to do to get my period.

BHMS, MD - Alternate Medicine
Homeopath, Nagpur
Check your hemoglobin and also stress might suppress the menses. Take homoeopathic treatment accordingly.
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We trying for baby and Want to be pregnant but unable to be pregnant. There is some issue of tiny nabothian cyst of size 2 mm. Notes in posterior lip of cervix Please suggest regarding matter.

MBBS
Gynaecologist, Chennai
We trying for baby and Want to be pregnant but unable to be pregnant. There is some issue of tiny nabothian cyst of s...
Dear Monika Jhamnani, Thanks for your enquiry. This is not a major problem. Take proper Infertility treatment.
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