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Management of Abortion
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
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I am Dr Tripti Raheja, I am working as senior consultant gynaecology in Max Super Speciality Hospital in Shalimar Bagh. Today, we are going to discuss fertility Problems and their treatment. Inability to conceive or reduce fertility is a very common problem it affects 15% of the couples. This reduce fertility can be due to male factors, female factors or unknown factors. In man we have reduced fertility because of poor quality of sperm or poor sperm count in their semen, women may have reduced fertility because ovaries do not produce eggs regularly or there can be some blockage in the fallopian tube so that the sperms cannot reach eggs in around 25% of couple the reason for reduced fertility remains unknown this is known as unexplained infertility. There are certain lifestyle changes which are likely to improve fertility, these are- stop smoking, reduce alcohol intake to less than 1 to 2 units, not more than once or twice a week, reduce intake of tea coffee or soft drink, do regular exercises, then maintain a healthy body with BMI should be between 20 to 25. It is a well-known factor if you are underweight or if you are overweight you are likely to suffer from infertility related problems. Men are advised not to wear a tight undergarment because they increase the temperature in the scrotum around the testis, so it deteriorates the sperm quality. If a couple is trying to conceive for more than 1 year and if they are unable to conceive so they are offered the certain test. So in men, we use really advice semen analysis to know the quality of sperms and to know the sperm count. If the first semen analysis report come out to be abnormal then again you will be advised to have it again after the gap of 3 months or maybe earlier as advised by your doctor if the repeat test also comes out to be abnormal then you will be advise, some blood test like hormone test and ultrasound of the squadron. So if you have low gonadotropic hormones levels in your blood, you will be given gonadotropic injections to improve sperm count. If you have some blockage in the flow of sperm from the testicles then a surgery may be beneficial for you to correct that blockage. Otherwise, if you have male factor infertility and if you are unable to conceive for more than 2 years it is advisable to go for In Vitro Fertilization or you normally called a test tube baby.
A woman may have reduced fertility because of reduced production of or irregular production of egg in their ovary. So they are advised to go for the test to know the ovulation and this test can be in the form of a blood test to check hormone levels or ultrasonography, this test also helps us to know how well your ovary will respond to fertility drugs. There is 1 more test which is usually, advised to women that is tubal patency test to check whether your fallopian tubes are blocked or then missed and that this can be done by x-ray or ultrasound even the sometimes an operation is necessary, operation laparoscopy is necessary to check the pregnancy of your fallopian tube. So, if there is some problem in the production of eggs by ovaries, you will be given some treatment in the form of tablets usually to stimulate the formation of the egg from the ovary in few women however gonadotropic injection may lead to be given to stimulate the formation of eggs in the ovary. If you have a blockage in fallopian tubes and if the blockage is my mild, then you will be advised to undergo surgery to correct the blockage. But if the blockage is serious, surgery is usually not helpful and in such circumstances, you are advised to go for In Vitro Fertilization. In cases of unexplained fertility, the cause is unknown and the couple is unable to conceive for more than 2 years they are advised usually, to go for In Vitro Fertilization. So in end, I would like to say, that the fertility-related problems, reduce fertility is a very common problem and in most of the cases are easily treatable. So do not lose hope, consult a qualified gynaecologist and after having the proper treatment you should be able to conceive.
If you want to consult me further you can text me via Lybrate you can have a text consultation or you can come to visit me at my clinic in Vijay Nagar, North Delhi. Thank you.
Hi. I am 23 years old female. I had intercourse with my bf 3 months back. After which I got periods after 10 days. But I have been missing my periods for two months now. I had used I- pill in feb after which my menstruation cycle was fine. Also, I used pregnancy kit and the result was negative. Now I have again got my pregnancy test done. My reports says that my human chorionic gonadotropin, serum is less than 2.0. The method used was Eclia. So if you could please tell me what my report suggests. Also, if I am not pregnant then why I have been missing my periods.
I take 4 time clomiphene and 2 times hormonal injection Lupi FSH but not conceive. My Dr. tell me for laparoscopy. What to do. I go for laparoscopy or any other treatment.
I am 6 weeks 6 days pregnant. I had my sonography yesterday. A septum is found out in it. Will I have a safe pregnancy. Please suggest something what should I do.
My sister is having irregular periods and acne all over her face (jawline basically) and she watched a video on pcod and the symptoms were same as she is suffering with now. Now she is scared that she is suffering from pcod. Please help .
I had sex on 10 june and I had my periods on 12 june with normal flow and for normal 4 days. What are chances of pregnancy and I had my periods in may on 5 may and in this month awaited. Plzzz guide me I am so much tensed and plzz tell me the MTP cost so if I pregnant then I can arrange the money please answer my questions please.
I have a problem if white discharge n I feel wet while sitting on table at ma school time what can I do to get rid from this thing.
Hi doctor, I am 22 years old unmarried and I have PCO problem I had a physical relation with my Bf and now my parents are taking me for pcos treatment to gynecology treatment the doctor ask my mum that did I had any physically relation because my ovary in large before that he has given some test like usg pelvis and some more blood test doctor my mum is nurse I am very afraid that they will come to know about my relation as I am no longer with him last we got physical in August doctor I am very afraid that if they ill know my relationship it will be a big problem please help doctor.
Some tips from ayurveda -
1. Deafness – use 4 to 6 drops of bilvadi tail as ear drops. Take rasnadi gugal 4 tabs twice a day.
2. Child disease – give 500mg ativish churna with honey or give 5 to 10 ml bal chaturbhadra syrup twice a day.
3. Blood pressure – in high bp take sarpagandha tablet in observation of ayurveda doctor and in low blood pressure take pippli mool churna with milk.
4. Fistula – take 6 tablets of trifla gugal twice a day. And it needed to do regular dressing with jatyadi tail in observation on ayurveda doctor.
Medico legal aspects of sex therapy
Sex and human sexuality are sensitive subject. To deal effectively with any problem of human sexuality, one has to constantly evaluate its merits and demerits from social, scientific, moral, ethical and most importantly from the legal angle. Following are some of the guidelines for therapist to keep in mind while dealing with clients with sexual problems.
Taking informed and expressed consent is of utmost importance while managing any patient. Examining and / or treating a patient without consent would amount to assault and battery which is punishable under criminal law irrespective of absence of negligence or successful outcome of treatment. The consent should be free willed, informed, intelligent, specific and express. Person giving consent should be competent to do so, failing which, consent should be obtained from the lawful guardian of the patient (in cases of minor and/or mentally retarded).
Examinition of a female client
Besides obtaining a valid consent, in case of female patient, the therapist should always have a female assistant present when examining a female patient this is important for the therapist in order to protect himself from a possible charge of indecent behaviour molestation or even sexual offence like rape ect. Being llevelled against him. Mere presence of husband or any male companion of the female patient is not enough. A sex therapist, in particular, is most vulnerable and therefore should be most careful.
Use of surrogate partners
Use of surrogate partners for sex therapy is questionable both ethically as well as legally. Sexual involvement of the therapist is universally accepted as unethical. There have been a number of cases where the therapists themselves, having acted as surrogates, have been punished for sexual molestion of their patients. It may also invite a criminal charge of adultery in some countries, including india. There are cases on record where the therapists have been charged with and convicted of rape.
Unlike some other countries, the socio cultural set up in india is different. The laws governing sexual behaviour are neither liberal nor evolved as much as in some of the western countries. Besides, surrogacy is likened to prostitution by many. Even if one were to consider surrogate partner as a therapist, then the ethical code prevents a sexual relationship with a client. Moreover, there is every possibility of a disease being transmitted. Particularly the hiv infection, in view of sex with multiple partners by a surrogate person.
Therapist should have uppermost in mind the special values of intimacy and love that our culture teaches us to nurture.
It is the ethical responsibility of every sex therapist to maintain high standards of professional competence and integrity. Competence without integrity or integrity without competence is an unsatisfactory compromise of professionalism. It is most important to protect the public and the other professionals from persons who represent themselves as sex therapists who are in fact lacking in competence and intergrity.
Competence in another primary discipline such as psychology, psychiatry or counselling is not equivalent to competence in sex therapy.
A sex therapist should possess adequate knowledge of the following:
1. Sexual and reproductive anatomy and physiology.
2. Developmental sexuality from a psychobiological point of view.
3. Marital, family and interpersonal relationship and socio-cultural factors in sexual values
4. Physiological and medical factors that may influence sexual functions such as pregnancy, contraception and fertility, illness, disability, medications.
5. Multimodel techniques and theory of sex therapy and psychotherapy.
6. Pharmacology of the medications used to treat sexual dysfunctions particularly with respect to their adverse effects and interactions with the drugs being consumed for other ailments.
7. Ethical issues in sex therapy and principles of evaluation and referral.
8. Laws related to sexual behaviour.
Points to bear in mind
all forms of sex therapy which violate the local laws should be handled with care recommending oral sex as a part of therapy is violative of section 377 of the indian penal code which deal with unnatural sexual offences.
the hippocratic oath forbids the physician to take advantage of the therapeutic context in order to engage in either homosexual or heterosexual relationship.
it is a universal rule that whenever dealing with reproductive functions is involved, express consent of both the spouses should be obtained.
proof of competence is the ability to provide objective and responsible services to the clients.
there does exist a potential liability under the laws of the land prohibiting consensual conduct such as prostitution, fornication, lewd and lascivious behaviour and adultery which might arise from therapeutic or non- therapeutic sex research activities.
sex between therapist and client is always unethical. No matter how therapeutic the rationale might appear, there is no justification for a therapist having sex with a client. The purpose of sex therapy is to improve function, not to change values or beliefs of the client.