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Dr. Sunita Fotedar

Gynaecologist, Delhi

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Dr. Sunita Fotedar Gynaecologist, 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. Sunita Fotedar
Dr. Sunita Fotedar is one of the best Gynaecologists in Dilshad Garden, Delhi. You can consult Dr. Sunita Fotedar at Swami Dayanand Hospital in Dilshad Garden, Delhi. You can book an instant appointment online with Dr. Sunita Fotedar on Lybrate.com.

Lybrate.com has a number of highly qualified Gynaecologists in India. You will find Gynaecologists with more than 44 years of experience on Lybrate.com. You can find Gynaecologists online in Delhi and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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Chapped Lips - Natural Remedies That Can Help Remedy It!

MBBS, MD - Dermatology
Dermatologist, Vadodara
Chapped Lips - Natural Remedies That Can Help Remedy It!

You can get rid of your chapped lips by using various natural remedies which are readily available at anyone's home. A number of reasons can make skin and lips dry. The dryness and cracks that are caused to the lips may be painful and cause bleeding too. There are many remedies which are suggested such as the application of lip balm or moisturiser. But, these descriptions are not enough to fight chapped lips.

Here are a few unique and proven remedies that can produce significant results when it comes to solving the problem of chapped lips.

  1. Curing chapped lips using oils: Almond oil, castor oil, coconut oil and olive oil can be used to cure chapped lips
    1. Almond oil: This oil is a natural moisturiser with vitamins in it. This oil is very gentle in nature and helps in preventing damage to the lips making them soft and supple. It is a good idea to heat up the oil before application. Warming it up will increase the rate of absorption, thus providing desired results.
    2. Castor oil: Castor oil has numerous medicinal benefits, one of which is the treatment of chapped lips. Use castor oil on the lips followed by petroleum jelly and you can get rid of dry lips in a few days.
    3. Olive oil: Olive oil has Omega-3 fatty acids, which help a great deal in the treatment of dry lips. Not only to the lips, this can also be used in other parts of the body where dry skin is evident.
    4. Coconut oil: Application of coconut oil for lips and other dry parts in the night can cure the dryness as it has antimicrobial properties that help in retention of moisture.
  2. Curing chapped lips using fruits and vegetables
    1. Cucumber: Cucumber has water content of up to 90 percent approximately. Placing cucumber slices on chapped lips for 10 to 15 minutes, for several times can cure chapped lips.
    2. Avocado: Rich in antioxidants, this natural remedy provides the required vitamins that produce elastin as well as collagen to cure dry lips. It can also be used as an anti-ageing remedy.
  3. Other natural remedies to cure chapped lips
    1. Aloe vera: Aloe vera has both antifungal and antiseptic properties. This can be used to repair chapped lips as it helps in the rejuvenation of the dry skin.
    2. Rose petals: Chapped lips can not only be treated using rose petals, but it also makes the lips smooth and soft. Soak a few rose petals in milk for some time and make a paste of it. Apply it on the lips for curing dryness and bleeding.
    3. Milk cream: Rich in fat, milk cream is one of the best moisturisers. Apply milk cream for ten minutes and rinse. This treatment can cure chapped lips in a few days.
    4. Ghee: Application of ghee is also another way to keep dry lips moisturised. Apply multiple times, till the dryness vanishes.

The above are a few natural remedies to get rid of chapped lips and also dry skin. If you wish to discuss about any specific problem, you can consult a Dermatologist.

2699 people found this helpful

Hi I am Aruna. I got periods on August 6. I was expecting be pregnant the next month missing my periods. After 2 weeks of my period on august I was (am) suffering from severe left abdominal pain. Then followed by nausea bt dint vomit. And also suffering from loss of appetite during day time Bt very hungry during night. I thought I was pregnant and could test Bt sep 13 (1 week after missed period) Bt got periods by sep 11. Which started as dark brown spotting for first 2 days then continued as normal period. Since I was suffering from nausea and left abdominal pain yet and pregnancy urine test came out as negative my doctor advised me 2 take ultrasonic test in which nothing spotted out and everything is very normal. I thought I would b 5 weeks pregnant by now. But all results were negative and am still experiencing nausea. Is there possibility that am pregnant. What may be the reasons for my left abdomen pain and nausea. Pls some 1 help me.

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Dehradun
Hi I am Aruna. I got periods on August 6. I was expecting be pregnant the next month missing my periods. After 2 week...
1st of all let me clear your doubt if a woman feels nausea it does not means she is pregnant. As you r hving your menses regularily there is no doubt of carrying a baby inside. Secondly the left abdominal pain, nauses,disturbed hunger pangs may be due to Simply Indigestion, mild underlying swelling in uterus or other organ which may nt be visible in USG so consult a gynae first then a physician.
1 person found this helpful
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I am not getting periods monthly and I got 3 times abortion what should I do now any future problems.

MBBS
Sexologist, Panchkula
I am not getting periods monthly and I got 3 times abortion what should I do now any future problems.
You are not getting your periods. I advise you to take proper balanced vegetarian diet. Take fruits and vegetables in daily diet. Take lots of water daily to detoxify body. Do meditation for mental strength daily. Avoid non veg and eggs and garlic and red chilly at home. Keep your weight normal as compared to your height. You can take Tablet Meprate 10 mg two times daily before meals for 5 days. Periods will start 7 to 10 days after stopping medicines.
50 people found this helpful
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Combat Summer

BHMS, MBA, pgdhdm, masters in psychology
Homeopath, Chennai
Combat Summer

Take more amount of buttermilk, tender coconut, water, and all juicy fruits to cool down your body.

I am 19 years old. I went on a europe tour for 21 days in the end of june. Since then I haven't had my periods. I frequently keep getting crams like I used to have before periods. I haven't had any physical interaction so there is no scope of pregnancy. The last period cycle that I've had was 19-27 june Also, I've gained 10 kgs weight in the last 4-5 months and my sleep cycle has also been affected.

MBBS, DGO, DNB (Obstetrics and Gynecology)
Gynaecologist, Chennai
I am 19 years old. I went on a europe tour for 21 days in the end of june. Since then I haven't had my periods. I fre...
Hi, change of place,climate,and atmosphere can affect the cycle.Try to shed your weight you gained.Your cycles will resume.Meanwhile consult a gynecologist to induce period.Too much of gap is not good.
3 people found this helpful
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I have recently married .First night to I have some problem my vagina .The problem is berth uren time .after toilet I have pain and suffering from sensitive. please suggest me.

GAMS-AYURVEDA, MD-TCM
Sexologist, Faridabad
Ms. Lybrate-user ji good afternoon you are suffering from vaginal pain don't worry please avoid the tension use the most popular ayurveda medicine 1 cap l 7 two bd 2 use the sex time lubricant no side effects enjoy sexual life.
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If somehow my precum gets in contact with vagina. Thn? ? Is precum enough to get pregnant. Though I urinated after my last ejaculation.

MD - Obstetrtics & Gynaecology, MBBS
Gynaecologist, Delhi
If somehow my precum gets in contact with vagina. Thn? ? Is precum enough to get pregnant. Though I urinated after my...
No. It hardly contains any sperm. So pregnancy chances r very rare and remote. But you never no. Pregnancies r reported even after ejaculation outside vagina. So better to use condoms. Condom not only avoids pregnancy but also protects from many infections.
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I din't had my periods last two month. Please can you subscribe me some medicine.

DNB (Obstetrics and Gynecology), PGDHHM, MBBS
Gynaecologist, Delhi
I din't had my periods last two month. Please can you subscribe me some medicine.
Menstrual irregularities can be caused by a variety of conditions, including pregnancy, hormonal imbalances, infections, malignancies, diseases, trauma, and certain medications. Polycystic ovarian syndrome also leads to irregular ovulation and an irregular menstrual cycle. Seeing a doctor in person really is the most important thing you can do to get your menstrual cycle regular again! And, the standard health advice always applies: to balance your hormones and regulate your menstrual cycle, get regular exercise (but don?t exercise excessively), eat a healthy diet, get the sleep your body needs, and deal with stress in healthy ways. And, if you?re taking prescription medication, find out if it affects your hormones (which affects your period).
1 person found this helpful
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I'm a 17 years old female. I always get my periods either 1 week late or 1 week early. I actually visited my doctor and she told me to attend some tests. All the reports were normal but still my periods are not regular. I'm very much worried. I don't understand what to do? Can you please help me?

MBBS (Gold Medalist, Hons), MS (Obst and Gynae- Gold Medalist), DNB (Obst and Gynae), Fellow- Reproductive Endocrinology and Infertility (ACOG, USA), FIAOG
Gynaecologist, Kolkata
I'm a 17 years old female. I always get my periods either 1 week late or 1 week early. I actually visited my doctor a...
It can happen at this age. Mostly it normalizes with time. All tests normal- that's a good thing. Just avoid gaining weight.
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Hi. I need advice from female homeopathic doc. I am 27 year old girl and have been married for 11 months. I am facing this strange problem where while having intercourse I feel as if my vagina is shut, preventing the penetration. No matter how many times we try, it doesn't yield any result. I feel very sensitive down there (at certain point, while in the act) and also feel the problem is increasing as the time passes. Earlier it was not as sensitive but now I have to ask my husband to stop and lay still on me until that feeling subsides. After a lot of internet research, I feel I am suffering from vaginismus. I have had only 2-3 intercourse when the penetration happened successfully (which were around 4 months back) At that time I did not have any such sensitive feeling. After that it just used to get stuck at the vagina, not moving further in. But now the vagina just doesn't allow and as soon as I experience that sensation I have to ask my husband to stop and be perfectly still. Now I don't look forward to sex. Kindly diagnose and prescribe. I feel so low that all problems I have are of such nature where I cant even openly talk about them.

MD Gynaecology, MBBS
Gynaecologist, Ahmedabad
Hi. I need advice from female homeopathic doc.
I am 27 year old girl and have been married for 11 months. I am facing...
You are having what is called dyspareunia. I am not sure if homeopathy is an answer for you, as according to your history you might be having a narrow vaginal opening which might need surgical correcttion, or vaginal infection or lack of lubrication. There is a specific treatment of all of the above.
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My period delayed by 45 days TSH 1.401 μIU/mL, Blood Sugar Fasting 110, Wei 71 kgs pregnant test negative reason for delay, when I will be getting the period.

MBBS, MD (PSM), M.F.Hom (London)
Homeopath, Nagpur
My period delayed by 45 days TSH 1.401 μIU/mL, Blood Sugar Fasting 110, Wei 71 kgs pregnant test negative reason for ...
It is possible that as you are 42 years so may be approaching menopaus. Before menopause period get disturbed menses will be stopped for few months and again it will start with more bleeding Consult gynaecologist for check up.

Last time I got my periods on 16th Jan and had unprotected intercourse on 25th Jan. He got discharged inside me, so I had ipill the same day. After that on 1st Feb, I got my periods again but the flow is like once a day. Its too thick and brown or sometimes black n dark reddish in colour. Since 1st feb till now, I get flow one time a day and its colour is described above. Is it a side effect of ipill? What's the cure? And I would like to mention that every time I have an intercourse and he gets dc inside me, I take ipill. I am too afraid regarding this.

Diploma In Postpartum Depression, Formerly , House Job , Gynecology, MBBS
Gynaecologist, Delhi
Last time I got my periods on 16th Jan and had unprotected intercourse on 25th Jan. He got discharged inside me, so I...
This is a side effect of I pill I pill is only an emergency contraceptive pill. It should be used maximum 1-2 times a year it has a lot of side effects like pain abdomen, menstrual irregularity. Pls use other method like condoms.
4 people found this helpful
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Fallopian Tube Block In Infertility - What Can You Do?

MBBS (Gold Medalist, Hons), MS (Obst and Gynae- Gold Medalist), DNB (Obst and Gynae), Fellow- Reproductive Endocrinology and Infertility (ACOG, USA), FIAOG
Gynaecologist, Kolkata
Fallopian Tube Block In Infertility - What Can You Do?

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. Examples 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 Fallopian Tube(s)?

Fallopian tubes (commonly called “the tubes”) are the structures that are connected to the both sides of the uterus, as mentioned above. Each tube is of 10 cm length. The part attached to the uterus is called the “cornu” and the part remaining free is called the “fimbria”. It’s the fimbria, that is present near the ovary and picks up the ovum and transports it inside the tube. The cornu received the sperms from the uterus and passes it inside. Inside the tube, the sperms and the egg meet to form the embryo, which then travels down the tubes into the uterus and then the pregnancy starts.

What happens if tubes are blocked?

If both the tubes are blocked completely, anywhere along the length (cornu, fimbria or the middle), pregnancy is not possible. This is quite obvious, because either the sperm cannot enter or the egg is not picked up or they cannot meet.

However, if any of the tubes are partially blocked, then the sperms and egg can pass and meet but the embryo cannot come down into the uterus. As a result, the pregnancy continues inside the tube, which is called “Ectopic pregnancy” that is life-threatening for the mother. It’s important to remember that ectopic pregnancy can happen even if both the tubes are open.

What are the reasons for tubal blockage?

Often, the exact cause is not known. Infection is the commonest cause. The infections may be due to sexually transmitted infection (STI), particularly Chlamydia infection or infection from bowel or appendix. Tuberculosis is very common in our country and can affect the tubes, silently, without affecting any other parts (not even the lungs) of the body. Endometriosis is also a common reason for tubal blockage. Any pelvic surgery (surgery in ovaries, tubes, uterus, even appendix) can block the tubes by “adhesion”. This means the tube may be open but attached to the bowel or rotated on itself, so that the tube cannot pick up the eggs from the ovaries. Sometimes fibroid of uterus can compress the tube and cause blockage. Women, with previous history of ectopic pregnancy, are at risk. Uncommonly, some abnormalities, present since birth can block the tubes.

What are the types of tubal blockage?

Tubal block may be one sided or both sided. It may involve only a particular part of a tube or multiple parts of a tube. The site of the block may be the cornu, the fimbria or the middle portion.

Hydrosalpinx, is a thing that you must know. In this condition, the tube is blocked but the mid-portion is dilated and contains some fluid (often infected). This tube is not functional. And the problem is even if there is pregnancy by IVF inside the uterus, this fluid from the tube may trickle down, coming in contact with the embryo and can potentially kill the embryo!

How can I understand that the tubes are blocked?

Unfortunately, very few women have signs or symptoms indicating tubal block. However, if you had previous infections in pelvis, tuberculosis in any part of the body, appendicectomy or other gynaecological surgery, there is chance of tubal block. Patients with fibroid and endometriosis are also at risk of tubal block. If you feel severe pain during periods or during intercourse, there is a chance that the tubes may be blocked.

When the tubes should be tested?

As mentioned earlier, the routine investigation of infertility includes testing for the ‘open-ness’ of the tubes- “Tubal patency tests”. That means if pregnancy does not come within 12 months of regular intercourse, then we usually advise the tests. Sometimes, tests are needed, after 6 months of trying (see above). However, in some women, with low risk of tubal block (no risk factors as mentioned above), it may be appropriate to start treatment and continue it for few cycles and if no response, then tubes should be tested.

How the tubes are tested?

The method of tubal patency test depends on your risk of having blocked tubes and also your wishes, availability of resources, other fertility factors and of course the affordability.

Routine ultrasound (like TVS) cannot detect tubal patency. However, it can detect the hydrosalpinx in most of the cases.

If you do not have any risk factors (like pain during periods, endometriosis, previous infections or surgery), you can choose either HSG or SIS. These are done in out-door basis, without any need of anesthesia.

HSG (Hystero-salingogram) is a method by which, your tubes will be seen under Xray. After visualizing your cervix (mouth of the uterus) by a speculum (instrument inserted in the vagina) a small screw will be inserted inside the cervix and a contrast material (which can be seen by the X ray) will be given through it. If tubes are open, the Xray will show that the contrast material will be going through the tubes into the abdomen.

The advantage of HSG is that, a test showing open tube has good correlation with tubal patency (if HSG shows the tubes are open, it’s likely that tubes are open). It is widely available and also cheaper.

However, the problem is that most of the women feel it painful, although they are given pain-killers for it. In addition, there is small risk of infection, for which antibiotics are prescribed. The contrast material can rarely give rise to allergy in some sensitive women and it may be life-threatening in very rare cases. Another problem is the false positive result. That means if tubes are found to be blocked in HSG, in 50% cases, they will be found to be open subsequently in laparoscopy. This is mainly because of some spasm of the muscles of the tube during the test.

SIS (Saline infusion sonography) or HyCoSy (Hystero-Contrast-Sonography) is the method by which tubal patency is checked by ultrasound (TVS) along with water like material inserted inside the uterus through a small tube. If tubes are open, the passage of water can be seen going into the abdomen through the tubes, in the ultrasound.

The advantage of HyCoSy is that it’s much less painful than HSG, although mild discomfort may be there. Pain-killers and antibiotics are prescribed usually. Additionally, problems inside the uterus can be better visualized, even better than normal TVS. In addition, the false positive result is much lower, only 7%. That means if HyCoSy suggests that the tubes are blocked, in most cases, the tubes will be found to be blocked at laparoscopy.

The problem with HyCoSy is mainly the cost and it’s not available everywhere.

An important merit of doing the tubal test is that, sometimes the water or the contrast material used in these tests can open the “mild” block. That’s why we often find patients who conceive spontaneously with pregnancy inside the uterus, after apparently “blocked” tubes in HSG or HyCoSy.

Now, laparoscopy is reserved for those, who are at high risk of tubal block. This includes women with risk factors (pain, surgery, infection etc) o women having “blocked” tube in HSG or HyCoSy. Clearly, it’s done after hospitalization under general anaesthesia inside the OT. Two or three small opening (key-hole surgery) will be put inside the abdomen and through vagina a coloured material (“dye”) will be given inside the uterus. If the tubes are open, the laparoscopic camera will show that dyes coming out of the tubes inside the abdomen.

The advantage is that it’s a definitive test, can help you to make final decision. It also provides the options of treatment. If there is corneal block in HSG, we can make attempt to open the tubes using laparoscopy (see below). In addition, if there is hydrosalpinx, where the tube serves no function, the tubes can be removed (salpingectomy) or clipped (we put clips to block the tubes) to improve the chance of pregnancy if IVF is the only option left for you. In addition, laparoscopy helps us to see whether there is any other diseases that have been missed by routine tests and that may account for infertility. We can treat the cysts of PCOS (by applying current to destroy some cysts), remove any large cysts, remove any adhesion, treat endometriosis etc.

The disadvantage of laparoscopy is of course, the need of anaesthesia and associated surgical and anaesthetic risks, although in modern era, the serious complications are uncommon.

What are my options if tubes are found to be blocked in HSG?

There are simply two options. It depends on your age, fertility factors and affordability. Number one is directly, you can go for IVF. In that case, you can save time and cost. It may be a preferred option, if you are aged or have some other fertility factors (low sperm count, endometriosis etc). The chance of pregnancy per cycle of IVF is usually 40%.

Another option is that you can confirm the block by other tests, keeping in mind that you may need IVF if the tubes are found blocked ultimately. We usually advise to have laparoscopy. However, some women want to give a trial with HyCoSy, because if HyCoSy shows the tubes are open, then you can avoid laparoscopy and you can try different fertility treatment options.

In laparoscopy, first we see if tubes are open or not. If open, there is no need of further treatment in laparoscopy. However, if tubes are found blocked, especially if the block is in cornu, we can try “hysteroscopic tubal cannulation”, where we put a small catheter through hysteroscope (a telescope, like endoscope, put inside the uterus through vagina so that we can see inside the uterus using a camera) to open the tubes. If tubes can be opened, you have all options for fertility treatment open. However, if we fail to open the tubes, the only option left is IVF. In addition, if there is fimbrial block, it can be released and new opening in the fimbria can be made. The treatment of hydrosalpinx by laparoscopy has already been discussed (see above).

Having said that, there are some group of women, who conceive while waiting for IVF or laparoscopy after a blocked tube found in HSG.

What can I do if tubes are blocked in Hycosy?

In this case also, there is choice between the two- laparoscopy first and IVF directly.

What can I do if laparoscopy suggests tubal block?

Unfortunately, in that case, the only option left is IVF. As mentioned before, if hydrosalpinx is found it must be treated before IVF. However, sometimes we find hydrosalpinx in laparoscopy but cannot cut the tube of clip it, simply because you did not give consent to us for doing so. In that case, we can suck out (“aspirate”) the fluid from the hydrosalpinx under ultrasound guidance (no need of further laparoscopy) using the needle.

How tubal block is dealt in your particular centre?

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 prefer to have SIS or Hycosy, rather than HSG, to reduce the pain to the women. We discuss all the options if tubes are found blocked.

Conclusion:

Tubal factor can account for 20-25% cases of female infertility. It’s more common in secondary infertility (women who conceived earlier- whatever be the fate of the pregnancy). Tubal test is a part of infertility investigation. The choice between HSG and HyCoCy is open to you. If tubes are found blocked, the options are IVF directly or confirming the block by laparoscopy.​

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I do not know the size of PCOD, but I having this in before 4 years, still I do not take any medicine, I just want to reduce the problem, so please help to reduce pcod in simple and natural way?

DGO, MD, MRCOG, CCST, Accredation in Colposcopy
Gynaecologist, Kolkata
You can keep it under control by optimising your body weight. However, if your periods are irregular I would advice you to start taking a low dose pill. Also it is best to repeat a hormonal assay, lipid profile and blood sugar if you have not done them recently.
2 people found this helpful
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Beat The Heat - 5 Foods That Help You Keep Cool!

M.Sc - Dietitics / Nutrition
Dietitian/Nutritionist, Pune
Beat The Heat - 5 Foods That Help You Keep Cool!

As much as you would like, an ice cream can't help you cool down in the scorching heat of this summer. Although one may argue that one feels just fine after an ice cream, the truth is that it's only temporary. Cooling foods are what you should have as they help to cool heat and cleanse toxins from the body.

Here are some of the foods that help cool down your body naturally:

  1. Cucumber: Not surprisingly, being 'cool as a cucumber' actually holds true. Cucumbers are fruits that help keep the body hydrated. Keeping your body cool during hot days is vital to your health as it can help prevent a number of complications such as heat strokes and dehydration. Munching on cucumber slices and hummus is a good way to beat the heat and stay cool.
  2. Watermelon: This quintessential beach fruit is yet another one which would help you beat the heat. This seasonal fruit acts like an internal air-conditioner, and is rich in water, helping in reducing body heat to a large extent while keeping you hydrated.
  3. Peaches: Peaches are not only delicious but are very rich in vitamins A and C, which help in keeping your body cool. Besides, these vitamins also help in maintaining healthy skin and provide useful calories to the body.
  4. Citrus Fruits: Citrus fruits, including oranges, grapefruit, lemons and limes, are among the most cooling of all fruits. Aside from their delicious taste, citrus fruits can keep you healthy and looking younger. Citrus is also considered to be especially important in digestion as it helps aid in the breakdown of rich and fatty foods. Start every day with a tall glass of lemon water. This slightly acidic drink helps to cleanse your system and energize your body. 
  5. Pineapple: Along with banana, cucumber, and some other fruits, pineapple helps to make a healthy smoothie. These ingredients have cooling properties, which hydrate the body and help to clear the heat. Also, pineapple contains an enzyme called bromelain, which reduces inflammation in the body. If you wish to discuss about any specific problem, you can consult a dietitian-nutritionist.
3636 people found this helpful

Health tips for healthy lifestyle

BHMS
Homeopath, Solan
80 people found this helpful

I have one problem at the time of periods my breast is painful and it's become very hard and after periods it's become smooth. Please give me the reason.

BHMS
Homeopath, Faridabad
I have one problem at the time of periods my breast is painful and it's become very hard and after periods it's becom...
Dear, no need to worry about it as these are Pre-menstrual symptoms which is due to fluctuation of female hormones. Would like to recommend you for breathing exercises (Pranayam, Anulom-Vilum) for releasing the excessive stress!
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Hello, me and my had oral sex with protection though ve do not have any intercourse other than rubbing my penis using protection. She had her last periods during the period 5-8 of april, and ve had oral sex on 15th april, and now she is having itching on her boobs and nipples. Is that a symptom of pregnancy? If yes the how to avoid?

MD - Obstetrtics & Gynaecology
Gynaecologist, Mumbai
Hello, me and my had oral sex with protection though ve do not have any intercourse other than rubbing my penis using...
She can not get pregnant with the act you described and pregnancy symptoms starts 15 days after the missed period. These symptoms are there because of hormonal changes and fluid collection as a result of hormones and not related to pregnancy.
1 person found this helpful
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