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Treatment of No Periods
Management of Pregnancy Query
Management of Abortion
Avoiding Pregnancy Procedures
Treatment of Pregnancy Symptoms
Treatment of Cervicitis
Treatment of Delayed Periods
Management of Fertile Period
Caesarean Section Procedure
Treatment of Lactation problems
Antenatal Care Management
Treatment Of Female Sexual Problems
Treatment Of Menstrual Problems
Treatment of Fibrocystic Breast Disease
Treatment of PID
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Hello doctor. I am 28 year married woman and planning for baby. Recently 2 month ago I got married. Usually my periods use to last for 4-5 days, but now this month it last only for 2 days. My back is paining continuously from then. So please tell me is there any chances of pregnancy?
My wife are 8 month pregnant if she gets normal delivery can I live with at the delivery time with doctor in the delivery room because my wife are weak.
I am 24 working girl. I had unprotected sex with my fience. My period cycle is 33 to 35 days. Earlier it used to be 40 days but she I was sexually active cycle length was reduced. I had my periods starts on 4th Feb and previous period was on 30 dec (usually 4 to 5 days). I had sex on 25 Feb night. Was it safe or I am in danger zone. Please help. I hadn't taken any contraceptive due to hesitation but now I am afraid.
Hi am usha got married on last year December. My husband is in malaysia. My periods started at jan3rd last month and we have sex every day up to jan 17 th. This month also I got menses at 2nd feb. Please tell me which are the dates to have sex and to tell me tips to get faster pregnancy.
Nipple discharge is a common part of breast functioning, which normally occurs during breast-feeding or pregnancy. It is often associated with the changes of menstrual hormone. The milky discharge post breast-feeding usually continues for up to two years after stopping nursing. The condition normally gets resolved on its own but if the situation persists for a long time resort to medical assistance.
The following are some of the causes of normal nipple discharge:
- Stimulation: Normal nipple discharge can arise due to stimulation; chafing of your breast skin due to tight bras or vigorous exercises.
- Pregnancy: Most women tend to witness clear nipple discharge in the early stages of their pregnancy. Towards the later stages, this discharge usually turns watery and becomes milky in color
- Stopped Breast-feeding: In some cases, nipple discharge continues for some time after the mother has stopped breast-feeding her newborn
- Hormonal Imbalance: Some women notice tenderness in breasts and nipple discharge during their menstrual cycle
What is an abnormal nipple discharge: An abnormal nipple discharge is usually bloody in color and is accompanied with tenderness of the breast. Papilloma is a non-cancerous tumor that is often responsible for bloody nipple discharge. Continuous nipple discharge from one of the breasts or nipple discharge that arises without any stimulation or external irritation is abnormal in nature.
The possible causes of abnormal nipple discharge include:
- Abscess: It is an assortment of pus that get accumulated within the tissues of your body. It is usually accompanied by redness, pain and swelling. Boils and carbuncles are types of abscess. Formation of abscess in breasts may result in nipple discharge.
- Breast cancer: Breast cancer often results in bloody nipple discharge and is often found with a presence of lump in one of the breasts.
- Mastitis: It is a breast infection that affects the tissues of the breast and is usually prominent during breastfeeding. Fatigue, fever and body aches are common in this situation.
- Ductal carcinoma in situ (DCIS): Normally characterized by the growth of cancerous cells in the milk ducts of your breasts, it is generally identified through mammography screening.
- Fibroadenoma: In this situation most young women witness an appearance of solid, tumor like structure
- Galactorrhea: Galactorrhea is nipple discharge of milk when not pregnant or breastfeeding. The discharge can vary in color and can be expressed from either or both breasts.
What Causes Galactorrhea: Galactorrhea is commonly caused by hyperprolactinemia, especially when it is associated with amenorrhea. Hyperprolactinemia is most often induced by medication or associated with pituitary adenomas or other sellar or suprasellar lesions.
The release of prolactin from the pituitary is held in check by dopamine from the hypothalamus. Prolactin release is encouraged by serotonin and thyrotropin-releasing hormone. This balance can be disrupted by medication (ie. antipsychotics), underactive thyroid function, pituitary tumors, hypothalamic tumors, damage to the pituitary stalk, nipple stimulation, chest trauma, herpes zoster, and emotional stress as well as a variety of other factors.
Maine period ke ek din sex kiya aor period khtm hone ke agle din kiya kya main pregnant ho jaongi. please confirm me
If period come than there is any chance. Of pregnancy 10aug we have contact 23rd aug se had period From 23rd to 27thAug.
Dont8 - 8. Don't eat unpasteurized milk products
Calcium is very important for growing babies, but moms have to be careful how they get their calcium from dairy. Raw milk is not recommended for expecting mothers. Raw milk is unpasteurized. That means it has not been heated to kill bacteria that could make you ill.
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
- Production of healthy (“Normal Morphology”) and movable (“Normal Motility”) sperms in adequate number (“Normal Count”) in the testes
- Transport of these sperms through the sperm conducting ducts from testes to penis
- Successful Erection and Ejaculation during Intercourse to deposit adequate number of these sperms in the vagina
- Transport of these sperms from vagina through cervix to the uterus and the tubes
- Presence of sufficient number of eggs inside the ovary and ability to release the eggs from the ovaries
- Pick up of the eggs by the tubes
- Approximation of eggs and the sperms to form the embryo
- Transport of embryo from the tubes into the uterus
- Acceptance of the embryo by the uterus and its growth
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
- 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.
- 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.
- 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.
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.
14 weeks pregnancy, placenta is anterior lower end just reaching upto internal OS. Grade 1maturity. Is this cause of worry? / precautions? Wat grade 1means?
I Had sex the day before my period. Unprotected. Didn't take any emergency pill as well. The period was normal and of 4 days. I have a cycle of 34 to 35 days. Got my 2nd last period on 18th of Sep and last period which is after 16 hours of unprotected sex, was on 21st of october. Today is 6th of Nov and my due date is 24th of Nov. Can I be pregnant? If so from when in general people start feels all the sickness? Please help.. Still worried.
Hi sir. I had sex unprotected with my gf .and next day he gets her normal period. But he took unwanted 72. And then periods stops. Is any thing worried? Please suggest me is there any chance of pregnancy?
I-pill se periods delay ho jaati hai Kya. I have doubt that I might get pregnant after yesterday night.
I am at least 6 weeks pregnant. Still there is very faint line on hpt. .Is there something wrong.Please help.
My girlfriend took contraceptive at 5 p.m and had iron tablets at 10 p.m .will it occur any problem regarding pregnancy?
I am 13 week pregnant. How much water should I take this time. Please help me with your valuable advice.
8th month preg. Doctor given me iron injection. Can I take iron now. After injection. Please tell me.
Here are some effective types of contraception
Hello everyone I am Dr. Meenu Goyal, a consultant obstetrician gynecologist at Goyal medical center Vasant Vihar. Today we are here to discuss about Contraception.
Choosing an optimal birth control depends on a variety of factors like your lifestyle, your age and your requirement. That is whether you want to space your pregnancy or you want to delay your pregnancy or you have completed your family and you want to just wind up with the family planning issues. Now if you are a young girl and you don't want to think about the pregnancy in the near future you can easily use the birth Control pills. They are the best measure for you.
The newer alternatives are not easily available in India. But the birth control pills cannot be used in a breastfeeding mother because it interferes with the breast milk so at that time the injection depo provera is a good solution for the nursing mothers. As it also helps in delaying pregnancy intrauterine devices with or without hormones is also a good alternative for a long duration of delaying of pregnancy. In India people normally don't want to discuss about the contraceptive measures that is why it is not being commonly used also its surrounded by lots and lots of myths but if you choose it correctly and wisely it helps you a lot.
If you want to discuss about this issue you can visit your nearest gynecologist or you can meet me at the Goyal's Medical Center, Vasant Vihar. You can also chat with me or text me or make a video call with me at lybrate.com. Thank you.