Caesarean Section Procedure
Treatment Of Female Sexual Problems
Termination Of Pregnancy Procedure
Treatment Of Pregnancy Problems
Well Woman Healthcheck
Treatment Of Female Sexual Problems
Treatment Of Medical Diseases In Pregnancy
Treatment Of Menstrual Problems
Intra-Uterine Insemination (IUI) Treatment
Medical Termination Of Pregnancy (Mtp) Procedure
Gynecology Laparoscopy Procedures
Pap Smear Procedure
Urinary Incontinence (Ui) Treatment
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I've had a great experience with Dr. Shweta Goswami. Due to various gynaecological problems l couldn't conceive even after various treatments hence opted for surrogacy and visited her at Bournhall Clinic. We received all sorts of possible help from her and our experience was outstanding in every way. The IVF was successful the very first time and now I'm a proud mother of a 1 year old son. Dr. Shweta is just amazing. She kept constant rapport with us through out the procedure though it wasn't necessary and even efter my baby was born. I'm really grateful to her.
I am amazed that Dr Shweta Goswami is such a sweet doctor, even though she is so busy all the time. The best thing about her is that she prescribes limited no. of medicines. I was diagnosed with fertilization. The overall atmosphere in the Max Hospital Gurgaon is very soothing. I was quite concerned, as my health was degrading day by day, but due to my Shweta Goswami , I didn't lose hope.The fertilization treatment given by her was very effective.
I have had an experience with several IVF specialist , and so far I have not come across anyone so understanding and committed to me. Its like Dr Shweta feels the pain of all the patients visit her, unlike other doctors she takes the pain of replying to your queries taking personal call. You know the doctor is good when she remembers you a year after the procedure. I am not going to any more doctors after her. I completely trust her judgement.
Me and my wife were not able to conceive . When we consulted Dr Shweta Goswami, She told us about Embryo Donor program due to which we now ahve a beautiful daughter. I thank the doctor for helping us . She actually helped alot , she made our dream come true.
Dr Shweta is a very understanding person, extremely patient n very positive. She is very ethical n professional at the same time.
Dr shweta... U r the one who brought little pari in our life n made me nanu!!!!!!! Can't thank u enough..
She is an excellent doctor and very nice person.... We will always be thankful to her....
The concept of egg quality of a woman is derived from the belief that the embryo implantation probability is powerfully related to the age and ovarian reserve of the woman. Thus, it is regarded that the quality of the egg is almost synonymous with the chances of embryo implantation. Its quality cannot be assessed merely by looking at the egg or measuring its ability to receive the fertilization by sperm or simply observing the initial embryo division.
There are a few important factors that contribute to the success or failure of the embryo implantation and some of them are:
- Diminished ovarian reserve: A woman with an increased FSH level on the third day of the menses is regarded as having diminished reserve of ovary. This implies that her ovary is not competent in sending feedback signals to the pituitary gland and the body responds by producing an increased amount of FSH for stimulating the ovary. For more than 10 years, it has been found that in over thousands of fertility treatment cycles, women with an increased FSH level have a lower egg quality.
- Advanced age of maternity: Even though the FSH level is normal, the age of the mother who provides the eggs plays an important role to determine the quality of the egg. Quite like women with increased FSH levels, eggs obtained from women aged more than 40 years can have some problems at a later stage of fertilization. Normal FSH levels are not considered a reassuring factor, owing to the lower implantation rate in females aged over 45 years.
- Diminished quality of egg: With an increase in age, the capacity of the mitochondria in producing energy slowly decreases. The egg is linked to the circulation before ovulation, and it is linked again after the embryo implantation. But during the one week time ranging from ovulation to implantation, the egg and the resulting embryo are contained in the zona pellucida and function on the basis of mitochondrial energy supply. The older age of the woman doesn’t cause any problem at the initial stage of ovulation. Its fertilization and embryonic development are also normal. But soon, it runs out of energy and stops dividing before reaching the stage of implantation.
Therefore, it is important to have the eggs tested to find out any sort of chromosomal abnormality. In case the mother is deficient of producing high-quality eggs, the best option is to have donor eggs.
Mitochondrial replacement (MRT, sometimes called mitochondrial donation) is a special form of in vitro fertilisation in which the future baby's mitochondrial DNA comes from a third party. This technique is used in cases when mothers carry genes for mitochondrial diseases. The two most common techniques in mitochondrial donation are pronuclear transfer and maternal spindle transfer.
Cells are the tiniest part of any organism including the human body, but has various parts within, which have specific functions. The mitochondria, for instance, are the batteries of the cells and produce energy for all functions, including cellular movement and adequate cellular function.
The egg, being a single cell, also is highly dependent on the mitochondria for its optimal function. For an egg to be healthy, it should have optimal energy, and that comes only when the mitochondria is functioning at its best. This determines the overall quality of the egg too. Poor eggs, it is well established, is one of the major cause of infertility, as it cannot implant itself and sustain the entire term of pregnancy.
Studies have confirmed that eggs have more mitochondria than normal cells, as their energy requirements are higher.
The ovaries have cells called precursor cells, which eventually can become eggs and get fertilized. Studies have shown that when mitochondria from these precursor cells are infused into the fertilized egg, the overall quality of the egg improves and therefore improves chances of fertilization.
Mitochondrial transfer is the new technique which is being developed and has resulted in a baby but involves third party IVF and hence is in a ethical debate. If you wish to discuss about any specific problem, you can consult a IVF Specialist.
The uterine cavity has a tissue base that is known as the endometrium. When this endometrium spills over or spreads to the other parts of the reproductive organ, it begins to punch through the uterine lining. Such a condition creates complications and even infertility, and is known as endometriosis.
Read on to know more about endometriosis and how it can cause infertility.
When the endometrium tissue spreads to areas like the ovaries, and the abdominal cavity, it can lead to numerous complications. Apart from pain, this may also cause infertility. 5 to 10% of the women worldwide suffer from this condition and have trouble conceiving. Additionally, about 30 to 40% of the infertility cases are due to endometriosis, not all cases. These figures are all confirmed by various medical studies.
How does it cause infertility?
Endometriosis can prevent ovulation, which is the process that occurs every month. During the ovulation process, the ovaries release eggs that may be fertilised in order for the woman to conceive. In this condition, the fimbria of the fallopian tubes also has trouble in capturing the egg, which prevents conception from taking place. This leads to infertility in the long run. Endometriosis also interferes with the proper production of the hormones that are required for normal ovulation and fertilisation of the egg.
Diagnosis: The diagnosis of the condition can be done with the help of lab tests and ultrasounds as well as imaging tests that can create the image of the womb and the endometrium lining. This will help in showing the severity and damage caused by the tissue. A surgical procedure called a laparoscopy may be carried out by the doctor to ascertain whether the patient is suffering from this condition. In this procedure, a small incision will be made and a camera will be inserted to view the insides on a screen, to learn more about the tissue’s spread and the kind of treatment that will be required. The doctor will also diagnose the condition on the basis of various symptoms like irregular and heavy bleeding.
Treatment for endometriosis associated with infertility needs to be individualized for each woman. There are no easy answers, and treatment decisions depend on factors such as the age of the woman, the severity of the disease and its location in the pelvis, the length of infertility, and the presence of pain or other symptoms. Some general issues regarding treatment are discussed below.
Treatment for Mild Endometriosis
Medical (drug) treatment can suppress endometriosis and relieve the associated pain in many women. Surgical removal of lesions by laparoscopy might also reduce the pain temporarily.
However, several well-controlled studies have shown that neither medical or surgical treatment for mild endometriosis improving the pregnancy rates for infertile women as compared to expectant management (no treatment).
For treatment of infertility associated with mild to moderate endometriosis, controlled ovarian hyperstimulation with intrauterine insemination - IUI is often attempted and has a reasonable chance to result in pregnancy if other infertility factors are not present.
Details about IUI success rates with endometriosis
IUI and endometriosis
Success rates with IUI for endometriosis have been variable in studies, showing:
- A pregnancy rate of 6.5% for women with endometriosis vs. 15.3% per cycle for unexplained infertility
- A pregnancy rate of 5.6% for women with advanced endometriosis vs. 22.7% per cycle for mild endometriosis vs. 25.7% for no endometriosis
- Pregnancy chances with insemination for natural cycle IUIs (no drugs) with endometriosis are about 2% per cycle vs. 11% with injectables plus IUI for endometriosis
Treatment for severe endometriosis
Several studies have shown that medical treatment for severe endometriosis does not improve pregnancy rates for infertile women.
Unfortunately, infertility in women with severe endometriosis is usually resistant to treatment with ovarian stimulation plus intrauterine insemination. If the pelvic anatomy is very distorted, artificial insemination is unlikely to be successful. These women often require in vitro fertilization in order to conceive.
Although the studies of in vitro fertilization for women with severe endometriosis do not all show similar results, pregnancy success rates are usually good if the woman is relatively young (under 40) and if she produces enough eggs during the ovarian stimulation. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
What is IVF?
IVF stands for In Vitro Fertilization and is a method of artificial insemination that dramatically increases the chances of pregnancy. It is one of the assisted reproductive technologies methods used as fertility treatment across the world where other methods have had drastic results.
In simpler terms, a man's sperm is inserted in woman's egg using controlled laboratory environment to proceed with fertilization. These embryos are then carefully put back into the mother's uterus after 4 to 5 days of fertilization in incubator in hopes that the embryo would grow in a full baby. The embryo transfer process needs to be carefully done in order for successful fertilization in the mother's womb.
There are many reasons why IVF is conducted:
- Poor sperm quality - Males having poor sperm quality are unable to achieve fertilization and increase the chances of conception with their female partners. This is male factor infertility due to which people move towards IVF.
- Fallopian tube problems - This is a female factor infertility, in which fallopian tubes either get blocked, or damaged making it complicated and stressful for the embryo to travel to the uterus.
One must approach IVF treatment with patience and a willingness to comply with all the tenets that the treatment is built upon. IVF clinics may vary the treatment a little according to what the patient's condition demands and different clinics may have different methods. The basic methods of IVF treatment however, remain the same. The first step to the treatment is to find the right clinic which complies with factors like availability of resources, cost and quality of treatment. After deciding the clinic, the next step is to understand that IVF treatment happens in cycles and the success rate of conception varies. Patients must also be ready to face any disappointment.
Here’s the short version of the steps involved in an IVF treatment cycle:
- Ovarian stimulation. Your doctor prescribes a course of drugs for you to take to stimulate your ovaries into hopefully producing 12 to 15 mature eggs.
- Monitoring of your drug response. To monitor the progress of your ovarian stimulation you undergo an ultrasound examination and blood tests.
- Egg maturation. Two days before your eggs are due to be collected you have a hormone injection, which triggers maturation of the eggs.
- Egg collection. You receive a light general anaesthetic for this simple, short procedure, and your doctor retrieves your eggs using an ultrasound-guided technique.
- Sperm production. On the day of egg collection, your partner provides a sperm sample.
- Fertilisation. The embryologist puts sperm and eggs together in the lab and, if all goes well, the eggs fertilise and early embryo development begins.
- Embryo transfer. Two to five days after egg collection, your doctor places one or two embryos in your uterus. Frozen transfer can be planned after a gap of 1 month.
- Embryo freezing. If you have additional embryos suitable for use, they can be frozen and kept for future transfers. Also, frozen embryos are available.
- Pregnancy test. About two weeks after embryo transfer you have a blood test to find out whether the treatment worked.
- If the test is positive, you have your first pregnancy scan two weeks later.
- If the test is negative, you and your partner need to talk to your doctor and decide whether to try the treatment again.
First time IVF - tips for men
Preparing for an IVF cycle physically as well as emotionally is as important for men as it is for women. Additionally, if it's the first time you are opting for an IVF then it will help a lot if you prepare for it in advance. There are many issues to consider like your hormonal balance, sperm count, your general health, physical and emotional issues experienced by you and your partner during the process etc. Read on to find some effective tips that will ensure that you can smoothly complete the procedure and support your partner in doing so.
1. Gather information about the process
If you and your partner are opting for IVF for the first time then it will be beneficial for you both to know about the process first. It always helps if you are familiar with the uncertainties involved and prepare yourself to face any complexities arising during the cycle.
2. Seek emotional support from family and friends or join a support group
You should build a small supportive social circle of family and friends for yourself and your partner to deal with the stress and emotional changes experienced during the process. Alternatively, joining an online infertility support group also proves to be effective.
3. Opt for fertility cleansing
Fertility cleansing for men is as important as it for women as it ensures a healthy hormonal balance. The simplest steps would be to abstain from using plastic containers for eating and drinking, consuming organic food and fertility boosting foods as well as not having soy-based food products or alcohol.
4. Provide proper nourishment to your body
For this ask your doctor to suggest a diet which will boost male fertility and ensure better sperm health. Moreover, you can have multivitamin supplements to get essential minerals, vitamins and antioxidants. Also, keep yourself hydrated by consuming at least 8 glasses of clean water every day.
5. Look after yourself and your partner
Ensure that you and your partner remain fit and healthy during the cycle by consuming a healthy diet. To keep stress at bay try exercising for 30 minutes daily or opt for fertility yoga or regular meditation. You may also think about seeking the help of a counsellor to strategically deal with the process. According to your preferences decide whether you want to have the counselling session with or without your partner.
In today’s modern, fast paced society, it is easy for people to become stressed. In fact, one would almost think that being stressed is the “in” thing, and if you aren’t stressed it must mean there is something wrong with you! Realistically however, stress is not a good thing for our bodies in general, and has a very real impact on your fertility.
Can Stress Have an Effect on Your Fertility?
If your mind and body is under stress your body is signaled to release a hormone - Adrenalin. This is a stress relieving hormone and gives your body the rush to face the stress. This hormone inhibits the utilization of the hormone Progesterone, which is essential for fertility. Also during stress Prolactin, another hormone, is relapsed which also interferes with infertility. Hence to conceive its essential that your anxiety levels are under control.
How Stress Impacts Fertility?
Recent research tells us that stress boosts levels of stress hormones, such as adrenaline, catecholamines and cortisol, which can inhibit the release of the body’s main hormone, GnRH (gonadotropin releasing hormone), which is responsible for the release of sex hormones. Subsequently this may suppress ovulation in women, reduce sperm count in men and lower libido in both women and men.
Chronic Stress also decreases libido:
Chronic stress may cause lack of libido as well as a decrease in general fertility. This has become such a common issue that they have created a name for it Stress Induced Reproductive Dysfunction. These facts are very important to consider if you have been trying to conceive with no results. It also shows that stress relief should be a part of every couple's conception plan even if they are going through In-vitro fertilization (IVF).
Ways to reduce stress & improve fertility:
If you are having difficulty to conceive, it's imperative that you get fertility tests done and also evaluate your life. Look out for the stress points that may be hindering a relationship. Remember defeating the stress may be the solution to your worries.
- Reduce stress in your life: The issues in your life may be work or result related. You need to learn to balance your personal and professional life. The sooner you do it the better; after all you are preparing yourself to welcome a new born in your life.
- Change your reactions: Get a hang of the situation and react accordingly. Over reaction to a situation can harm your body and mind. Stop bothering so much about the future.
- Let few things be the way they are: Stop getting bothered about people. Remember by nature everything will fall in place. Let few things be the way they are.
- Make it your habit to reduce stress: Call it an obsession or a practice, train your mind to choose options where there is less stress.
- Sleep well: A good rest is essential for a healthy mind and body. Meditate, do yoga or seek counseling. Go for facials if it sooths you.
Please note that if your fertility reports are normal, then it's just a matter of time. Give you, your partner and your body time. There are certain medical complications or disorders that can also be responsible for infertility. Be calm and composed so that you are able to face the rough waters clearly with your partner. If you wish to discuss about any specific problem, you can consult a gynaecologist.
IUI- IUI is a procedure during which processed and concentrated motile sperm are inserted directly into a woman’s uterus. This procedure is timed according to a woman’s ovulation, and may be performed one to two times in the days immediately following the detection of ovulation. After ovulation a woman’s egg is picked up by the fallopian tube and waits there for the sperm. Since the IUI procedure deposits higher concentrations of good quality sperm close to where the egg is waiting, the chances that the egg and sperm will find one another are increased.
IVF- IVF is the most successful method of fertility treatment utilized today to help couples to conceive. The basic components of the IVF process include stimulation of the ovaries to produce multiple eggs at a time, removal of the eggs from the ovary (egg retrieval), fertilization of the eggs in the laboratory, and subsequent placement of the resulting embryos into the uterus (embryo transfer). The chance of pregnancy from IVF depends primarily on the age of the woman, the cause of infertility, and factors related to the quality of the IVF laboratory.
IUI Treatment: There is a marked difference between IVF and IUI pregnancy rates. IUI has a success rate between 5% and 20%, but it can even be as low as 1-2 %, depending on the woman’s age and fertility levels. The chances of conceiving through IUI is higher if fertility drugs are administered along with the treatment.
IVF Treatment: IVF has a high success rate – between 20% and 35% and it can even go as high as 40%. This may not seem like a lot, but it is very high, considering that an average young and fertile couple has only a 15-20% chance to conceive in a month. It is important to understand what IVF and IUI success rates mean and the factors that affect it before deciding on a fertility treatment. You can also use any reliable online IUI vs IVF comparison tool to determine your approximate success rates with each of these treatments, depending on your age, lifestyle, and medical history.
You should use online sources of information to understand more about fertility problems, how age affects fertility levels, and whether freezing your eggs is a good option for you. However, discuss all these issues with your doctor to ensure that you have the right information and that you have understood it correctly. Fertility specialists provide you with personalized fertility plans based on your health which is why you should always talk to them before you make any decision.
Pregnancy can be easy and smooth, while on the other hand, it might be time consuming, marred with conception difficulties all along the way. Pregnancy may seem exciting to some, whereas it can be stressful for others. Regardless of whether it is the first child you are planning or have had a successful pregnancy previously; there are some tips you need to keep in mind in order to improve fertility and give birth to a healthy child.
Some fertility boosting factors are:
These fantastic swimmers are at the very root of male fertility. Some important components which need to be taken into consideration are sperm count, sperm motility (the ability of the sperm to swim around the female reproductive tract) and morphology (shape and size of a sperm). In order to have all these parameters in check and working fine, one needs to abstain from smoking and limit alcohol consumption among many other lifestyle modifications.
Having unprotected vaginal intercourse during the woman’s fertile days in a month helps improve chances of conception.
Fertility becomes a challenge when you are either overweight or underweight. The weight of a woman affects ovulation (The release of eggs from the ovaries) and causes hormonal imbalance; factors which make it very difficult to conceive. Keep your weight levels in check and that could prove primarily essential in bettering your fertility.
Staying well nourished boosts your odds of conceiving! Make sure to include enough protein, iron, zinc, vitamin C, and vitamin D in your diet, because deficiencies in these nutrients have been linked to lengthened menstrual cycles (and therefore less frequent ovulation) and a higher risk of early miscarriage. Consult gynaecologist if you should take a daily multivitamin supplement. And be sure to eat protein-rich foods, such as meat, fish, low-fat dairy products, eggs, and beans.
Beware of STDs or Sexually Transmitted Diseases. One is the most prone to STDs of any kind if he/she happens to engage in unprotected sexual intercourse; having a number of sexual partners just ups the chances of getting afflicted by STD. Protected vaginal intercourse helps prevent STDs, thus enhancing fertility and subsequently, chances of conception.
According to several studies, the lubricant one chooses surprisingly plays a significant role in determining fertility. Not all lubricants boost fertility and sperm motility (sperm count). Baby oil or egg whites are a few good examples of such lubricants.
While a limited amount of caffeine consumption is good, overdoing it might spoil and hamper fertility. Limit caffeine intake and keep it within a level of 200-250mg a day.
Smoking, besides playing havoc with every organ in the body, affects the reproductive organs and thus fertility. In men, it leads to reduced sperm count and in women, it causes DNA damage. Stub the bud right now and never get back to it.
Certain toxic chemicals can lead to female and male infertility. So it is advisable that you stay away from chemicals such as pesticides, organic solvents and lead, the primary toxins which pose a severe threat to fertility.
- Exercising regularly can never go wrong. It gives you the strength and stamina, boosting your overall health. However, vigorous exercises, especially when you are trying to conceive, will do you no good. It might adversely lead to the suppression of certain hormones such as progesterone (pregnancy stimulating hormone) and might affect ovulation, hence affecting fertility. Aim at a regular 20 minutes session of light exercises; mild cardiovascular exercises such as walking can work wonders, especially in such circumstances.