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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 Rita Bakshi, chairperson of international fertility centre situated in the Green Park, Delhi. I have been in the field of fertility for last nearly 18 years and I have found people very anxious for fertility, let me just tell then there is no way one cannot get pregnant nowadays if one decides to get pregnant because, so many donor services are available. So you can have donor sperm, you can have donor egg and you can have surrogacy and the replacement of sperm, egg or uterus. Let me talk of my topic and that my topic is AMH yes Anti Mullerian Hormone as a test of fertility for females the only important test that I look at in a couple is first and foremost is serum AMH that been serum Anti Mullerian Hormone. Now this test can be done on any day of the cycle, it is not important that one should be on day 2 or day 3 it can be done on any day of the cycle. Secondly, it is a blood test now this test tell us the number, the quantity of eggs a women has for example all females are born with a finite number of eggs unlike men who have sperms been produced all throughout their life. Women are born with a certain number of eggs which are fixed, so some are born with less eggs some are born with more eggs but why is it important, it is important to know because if you decide not to get married at 30 or 31 and you decide that ok I have children do I have how many years do I have before I can plan a marriage or the pregnancy. Then by doing this test I can say that yes your AMH is good you can wait or it is not that good please don't wait at all. It also indicate that of people who wants to postpone their pregnancy they are married, they are working, career are important, so they don't know how many years they can postpone. So by doing this test I can say that yes you can wait for may be a year, 2 years or no not do not wait at all. I can also say when people come for fertility whether they would require donor eggs or is there own fertile potential, the eggs good enough them or not by just looking at AMH. AMH normally is between 3 to 5 nanogram per ml. So if it is say very less .5, .4, .3 then you know it is very low she does not have a good quantity of eggs at all. She may require the help of a donor egg and if the AMH is just very high safe if it is 6, 7, 8, 9, 10 that means she probably is suffering from PCOS polycystic ovary. In these cases, it will be very important when I do IVF that she could hyper stimulate and therefore AMH is a very good indicator letting me know how much drug to use and how much not to use. So in a way, especially if ovarian cancers are there, there fertility preservation is there, the women who do not want to you know want to freeze their eggs. So we can make out that the eggs can be frozen for a limited number of time by looking at AMH. So in all to submit all AMH is very- very important fertility predictor of a woman of the number egg, quantity of an eggs a woman possesses and she can plan her fertility according to the AMH level. Thank you.
Dyspareunia (Painful Coitus)
Recurrent or persistent genital pain associated with sexual intercourse in either male or a female.
In females, the pain may be superficial during penetration or deep during penile thrusting. The intensity of pain may range from mild discomfort to sharp pain. On examination, no genital abnormalities are seen. Repeated genital pain during coitus may result in the avoidance of sexual activity, disrupting existing sexual relationships.
Females : Dyspareunia can be of psychogenic or organic in origin.
Pain in vaginal outlet and clitoris : If the hymen is intact, this is a source of irritation. Episiotomy scar can cause pain. Smegma accumulated under the foreskin of clitoris
Irritates the area and causes intense burning.
Pain in the vagina : One of the common causes is the failure to lubricate. This happens when the women have no affection, respect or understanding for her husband. Because of various fears like fear of pregnancy or of coitus, her natural response will be inhibited. Many women does not lubricate because of aging. Thin walls of vagina crack and bleed easily during the intercourse, causing discomfort that lasts for hours to days. Homosexual women will not lubricate in heterosexual activity. Infections of the vaginal or urinary tract will give rise to burning, itching or pain in the vagina. When there is itching and burning but no infection, sensitivity to the rubber of condom is a possibility.
Pain deep in the pelvis : Laceration or tears in the ligaments which support the uterus, caused by gang rape or criminal abortion may result into pain deep in the pelvis. It is associated with a backache, throbbing in pelvis, tired feeling
And painful menstruation . Endometriosis, infection in the cervix, uterus, and tubes cause pain during thrusting . Infection can be due to gonorrhea or of E.coil.Hysterectomy, tumors, and ovarian cysts can cause pain deep in the pelvis.
: Some men do not retract the prepuce during masturbation. Their glans of penis remains hypersensitive to touch. They find pain during coitus. In men with poor hygiene, the smegma accumulates on the glans, causing pain during coitus. Phimosis can cause pain during coitus. Allergy to condom rubber, jellies, foams and douching materials can give hypersensitivity reaction to the males. Infection of vaginal canal causes burning and itching. Fibrosis of penile tissue following a trauma causes pain during masturbation and intercourse.
: Reassurance, countering myths and misconceptions and supportive psychotherapy will be helpful in dyspareunia of psychogenic origin. Insufficient foreplay may lead to failure of lubrication in females. Thick hymen will need excision. Accumulation of smegma needs cleaning daily. Senile vaginitis requires hormonal replacement. Homosexual women are not amenable to any treatment.