Doctor in Dr. Rama's Fertility IVF Centre
Caesarean Section Procedure
Treatment Of Female Sexual Problems
Termination Of Pregnancy Procedure
Treatment Of Pregnancy Problems
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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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The term infertility in females explains a wide range of disorders but in order to simplify things, lets’ just say, infertility in women is a condition in which women are unable to conceive. There are numerous reasons that can be responsible for this situation and although some are preventable or curable, most others have no specific cure or treatment.
Primary or secondary ovarian failure leads to lack of ovulation and PCO imbalance of hormones. Chocolate cyst or unruptured follicles or continuation of corpus lutiem can have disruptive ovulatory function.
One of the most common reasons for infertility is an ovulatory disorder. Almost 30 percent of female infertility is caused due to this reason. 70 percent of such infertility is treatable with drugs such as Reprones/Menogan and Clomiphene. Here is a list of causes of failed ovulation-
Disruption in the complex hormonal balance.
Ovaries fail to produce mature eggs. Polycystic ovarian syndrome is the most common disorder causing this problem. This syndrome has reduced FSH production and increased production of LH, Oestrogen and Testosterone. Suppressed FSH production may cause the partial development of ovarian follicles.
Hypothalamus may malfunction thereby causing the pituitary to malfunction, thus losing control over the process or FSH and LH production.
Physical damage to the ovaries by multiple surgeries or due to the formation of cysts.
A rare case of premature menopause.
Problems of the follicle.
Poor functioning of fallopian tubes
Diseases or disorders in the tube have been another major reason of infertility in women. Almost 25 percent of women infertility occurs due to this reason. Although treatments exist, success rates of the treatments are as high as 30 percent.
The causes of tube damage may be as follows-
Infection caused by bacteria or viruses
Previous pelvic or abdominal surgeries.
A condition called ectopic pregnancy which occurs in the tube, and even if very carefully but successfully overcome, may leave permanent damage.
Rare congenital defects in which women may be born with tube anomalies.
This is the condition where the endometrium expands excessively thereby preventing individuals from getting pregnant. This affects almost 10 percent of the population of infertile women. Almost 40 percent of women with endometriosis are infertile.
Other additional factors may include:
Behavioural factors like personal habits, lifestyle and health factors.
Cigarette smoking reduces the chances of conceiving by one-third.
Alcohol increases the chances of birth defects.
Hence, pregnancy is tougher than it might really seem.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Gestational diabetes is a kind of diabetes that happens during pregnancy. Diabetes is referred to a condition where your blood glucose or blood sugar is very high. Although, glucose is good as it used by your body for energy, but excessive glucose in your blood can be harmful for both you and your child. Gestational diabetes is mostly diagnosed in the later stages of pregnancy. If gestational diabetes is diagnosed in the early stages of pregnancy, then it is quite possible that you may have had diabetes before you became pregnant. Treating gestational diabetes can help both you and your baby stay fit and healthy. You can protect both, yourself and your baby by controlling your blood glucose levels.
Problems with gestational diabetes in first 3 months prem can lead to abortion or congenital authorities in baby. Mid trimester abortions, urinary and vagina infection can occur. Preeclampsia , chorioamnionitis also possible. In 3rd trimester preterm Labour, intrauterine death, large baby or small for dates can happen. Neonatal hypoxia, respiratory distress are common. So it has to be controlled strictly throughout pregnancy with diet, exercise and medicines.
Here are 7 things that you need to know about Gestational diabetes:
- Every three to eight out of 100 ladies tend to develop diabetes during pregnancy, a condition known as gestational diabetes. Fortunately, it can be dealt with and even kept away by maintaining healthy lifestyle choices. Eating leafy foods and avoiding sugar-rich things, is a vital step for both control and counteractive action. Exercise, after consulting your doctor can guarantee that you have a healthy pregnancy.
- In diabetes, when your body's glucose or sugar levels get so high that the carbohydrates and sugars cannot be converted into energy, the excess starts accumulating in your body. This additional glucose can harm the vessels in your kidneys and all through your body, particularly in organs like eyes.
- Two or three factors might cause danger for creating gestational diabetes, both inside and outside of your control. If you are overweight before you get pregnant or while you are pregnant or your family history shows that you are hereditarily inclined to the sickness, you will probably build up the condition.
- One will have to stay on the right path as far as medication and insulin goes. Your specialist may prescribe that you require diabetic pills or insulin to help you control your glucose levels.
- Your weight can bring about complexities during the delivery in case of gestational diabetes. So it is best to keep your weight in check in order to have a smooth sailing pregnancy and delivery.
- Gestational diabetes can likewise put ladies at risk of contracting preeclampsia, which can bring about a number of side effects and complexities. Side effects brought on may start from swollen feet, legs, fingers, and hands to hypertension and even seizures or strokes.
- Apart from the risks of having gestational diabetes during your pregnancy, it might affect the child later on. Your baby may have a higher danger of obesity as it develops, both in the teenage years and youth. Youngsters who are overweight may suffer from type 2 diabetes in the long run.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Ovaries are a part of a woman’s reproductive system. The primary function of ovaries includes producing ‘ova’ or eggs and secreting hormones such as progesterone and estrogen. Cysts are fluid-filled sacs that form the ovaries; they usually do not cause any symptom and are not painful.
There are primarily two types of ovarian cysts:
1. Follicle cysts: During a woman’s menstrual cycle, the egg develops in a sac known as the follicle. Under normal circumstances, the sac breaks open and releases the egg. When this doesn’t happen, fluids start accumulating in the follicle to form a cyst.
2. Corpus luteum cysts: Follicle sacs dissolve after releasing the egg, but in some cases, these sacs remain and the opening of the sacs gets sealed. It again results in fluid accumulation, leading to the formation of corpus luteum cysts.
Usually, cysts do not cause any symptom. If the size of the cysts increases, they may cause symptoms such as stomach pain, pain during bowel movements and sex as well as pelvic floor pain. The breasts may become tender and one may experience rapid breathing. Other symptoms of ovarian cysts are fever, nausea and dizziness. Usually, rupturing of a cyst leads to these symptoms surfacing; hence you would know when exactly to call the doctor.
The treatment options for ovarian cysts are:
- Laparoscopy: Laparoscopy is carried out if the cysts are small in size. An incision is made close to the navel, through which an instrument is inserted to get rid of the cyst.
- Birth control pills: For chronic ovarian cysts, oral contraceptives are prescribed to stop the ovulation process in order to arrest the formation of cysts.
- Laparotomy: In case of large cysts, this procedure is recommended. A relatively bigger incision is made in the abdomen, through which the cyst is removed.
Ovarian cysts, if left untreated, can certainly cause infertility. Pre-menopausal women and who suffer from frequent hormonal imbalances in the body are the most vulnerable to this condition.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Endometriosis is an often painful disorder in which tissue that normally lines the inside of your uterus the endometrium grows outside your uterus. Endometriosis most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis. Rarely, endometrial tissue may spread beyond pelvic organs.
With endometriosis, displaced endometrial tissue continues to act as it normally would — it thickens, breaks down and bleeds with each menstrual cycle. Because this displaced tissue has no way to exit your body, it becomes trapped. When endometriosis involves the ovaries, cysts called endometriomas may form. Surrounding tissue can become irritated, eventually developing scar tissue and adhesions — abnormal bands of fibrous tissue that can cause pelvic tissues and organs to stick to each other.
The primary symptom of endometriosis is pelvic pain, often associated with your menstrual period. Although many women experience cramping during their menstrual period, women with endometriosis typically describe menstrual cramp that's far worse than usual. They also tend to report that the pain increases over time.
Common Signs and Symptoms of Endometriosis may include:
Pain with intercourse. Pain during or after sex is common with endometriosis.
Pain with bowel movements or urination. You're most likely to experience these symptoms during your period.
Infertility. Endometriosis is first diagnosed in some women who are seeking treatment for infertility.
The severity of your pain isn't necessarily a reliable indicator of the extent of the condition. Some women with mild endometriosis have intense pain, while others with advanced endometriosis may have little pain or even no pain at all.
Endometriosis is sometimes mistaken for other conditions that can cause pelvic pain, such as pelvic inflammatory disease (PID) or ovarian cysts. It may be confused with irritable bowel syndrome (IBS), a condition that causes bouts of diarrhea, constipation and abdominal cramping. IBS can accompany endometriosis, which can complicate the diagnosis.
When to see a doctor
See the doctor if you have signs and symptoms that may indicate endometriosis.
Endometriosis can be a challenging condition to manage. An early diagnosis, a multidisciplinary medical team and an understanding of your diagnosis may result in better management of your symptoms.
Although the exact cause of endometriosis is not certain, possible explanations include:
Retrograde menstruation. In retrograde menstruation, menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of out of the body. These displaced endometrial cells stick to the pelvic walls and surfaces of pelvic organs, where they grow and continue to thicken and bleed over the course of each menstrual cycle.
Transformation of peritoneal cells. In what's known as the "induction theory," experts propose that hormones or immune factors promote transformation of peritoneal cells — cells that line the inner side of your abdomen — into endometrial cells.
Embryonic cell transformation. Hormones such as estrogen may transform embryonic cells — cells in the earliest stages of development — into endometrial cell implants during puberty.
Endometrial cells transport. The blood vessels or tissue fluid (lymphatic) system may transport endometrial cells to other parts of the body.
Immune system disorder. It's possible that a problem with the immune system may make the body unable to recognize and destroy endometrial tissue that's growing outside the uterus.
Several factors place you at greater risk of developing endometriosis, such as:
Never giving birth
Starting your period at an early age
Going through menopause at an older age
Short menstrual cycles — for instance, less than 27 days
Having higher levels of estrogen in your body or a greater lifetime exposure to estrogen your body produces
Low body mass index
One or more relatives (mother, aunt or sister) with endometriosis
Any medical condition that prevents the normal passage of menstrual flow out of the body
Endometriosis usually develops several years after the onset of menstruation (menarche). Signs and symptoms of endometriosis end temporarily with pregnancy and end permanently with menopause, unless you're taking estrogen.
The main complication of endometriosis is impaired fertility. Approximately one-third to one-half of women with endometriosis have difficulty getting pregnant. Endometriosis may obstruct the tube and keep the egg and sperm from uniting. But the condition also seems to affect fertility in less-direct ways, such as damage to the sperm or egg. Inspite of this, many women with mild to moderate endometriosis can still conceive and carry a pregnancy to term. Doctors sometimes advise women with endometriosis not to delay having children because the condition may worsen with time.
Ovarian cancer does occur at higher than expected rates in women with endometriosis. Although rare, another type of cancer — endometriosis-associated adenocarcinoma — can develop later in life in women who have had endometriosis.
Diagnosis: To diagnose endometriosis and other conditions that can cause pelvic pain, the doctor will ask you to describe your symptoms, including the location of your pain and when it occurs.
Tests to check for physical clues of endometriosis include:
Pelvic exam. During a pelvic exam, the doctor manually feels (palpates) areas in your pelvis for abnormalities, such as cysts on your reproductive organs or scars behind your uterus. Often it's not possible to feel small areas of endometriosis, unless they've caused a cyst to form.
Ultrasound. A transducer, a device that uses high-frequency sound waves to create images of the inside of your body, is either pressed against your abdomen or inserted into your vagina (transvaginal ultrasound). Both types of ultrasound may be done to get the best view of your reproductive organs. Ultrasound imaging won't definitively tell the doctor whether you have endometriosis, but it can identify cysts associated with endometriosis (endometriomas).
Laparoscopy. Medical management is usually tried first. But to be certain you have endometriosis, the doctor may advise a surgical procedure called laparoscopy to look inside your abdomen for signs of endometriosis.
While you're under general anesthesia, the doctor makes a tiny incision near your navel and inserts a slender viewing instrument (laparoscope), looking for endometrial tissue outside the uterus. He or she may take samples of tissue (biopsy). Laparoscopy can provide information about the location, extent and size of the endometrial implants to help determine the best treatment options.
Treatment for endometriosis is usually with medications or surgery. The approach you and the doctor choose will depend on the severity of your signs and symptoms and whether you hope to become pregnant.
Generally, doctors recommend trying conservative treatment approaches first, opting for surgery as a last resort.
The doctor may recommend that you take an over-the-counter pain reliever, such as the nonsteroidal anti-inflammatory drugs (NSAIDs) ibuprofen (Advil, Motrin IB, others) or naproxen (Aleve, others), to help ease painful menstrual cramps.
If you find that taking the maximum dose of these medications doesn't provide full relief, you may need to try another approach to manage your signs and symptoms.
Supplemental hormones are sometimes effective in reducing or eliminating the pain of endometriosis. The rise and fall of hormones during the menstrual cycle causes endometrial implants to thicken, break down and bleed. Hormone medication may slow endometrial tissue growth and prevent new implants of endometrial tissue.
Hormone therapy isn't a permanent fix for endometriosis. You could experience a return of your symptoms after stopping treatment.
Therapies used to treat endometriosis include:
Hormonal contraceptives. Birth control pills, patches and vaginal rings help control the hormones responsible for the buildup of endometrial tissue each month. Most women have lighter and shorter menstrual flow when they're using a hormonal contraceptive. Using hormonal contraceptives — especially continuous cycle regimens — may reduce or eliminate the pain of mild to moderate endometriosis.
Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists. These drugs block the production of ovarian-stimulating hormones, lowering estrogen levels and preventing menstruation. This causes endometrial tissue to shrink. Because these drugs create an artificial menopause, taking a low dose of estrogen or progestin along with Gn-RH agonists and antagonists may decrease menopausal side effects, such as hot flashes, vaginal dryness and bone loss. Your periods and the ability to get pregnant return when you stop taking the medication.
Progestin therapy. A progestin-only contraceptive, such as an intrauterine device (Mirena), contraceptive implant or contraceptive injection (Depo-Provera), can halt menstrual periods and the growth of endometrial implants, which may relieve endometriosis signs and symptoms.
Danazol. This drug suppresses the growth of the endometrium by blocking the production of ovarian-stimulating hormones, preventing menstruation and the symptoms of endometriosis. However, danazol may not be the first choice because it can cause serious side effects and can be harmful to the baby if you become pregnant while taking this medication.
If you have endometriosis and are trying to become pregnant, surgery to remove as much endometriosis as possible while preserving your uterus and ovaries (conservative surgery) may increase your chances of success. If you have severe pain from endometriosis, you may also benefit from surgery — however, endometriosis and pain may return.
The doctor may do this procedure laparoscopically or through traditional abdominal surgery in more extensive cases.
Assisted reproductive technologies
Assisted reproductive technologies, such as in vitro fertilization (IVF) to help you become pregnant are sometimes preferable to conservative surgery. Doctors often suggest one of these approaches if conservative surgery doesn't work.
For the benefit of couples suffering from infertility, modern medical science has introduced several innovative procedures. Some of the popular procedures are In-vitro Fertilization (IVF), Intra Uterine Insemination (IUI), Gamete Intrafallopian Transfer (GIFT), Intracytoplasmic Sperm Injection (ICSI), donor eggs and embryos and so on. In addition to these, there are several drugs and surgical procedures that help the couple in getting rid of infertility. Among all these procedures, IUI has gained popularity in the field of gynaecology and infertility treatment procedures. The IUI treatment is also popularly called as artificial insemination procedure. Although this is a popular procedure, it is appropriate that you should also understand its pros and cons.
IUI procedure in brief:
In simple terms, the IUI procedure involves placing the sperm inside the womb or uterus, which in turn would assist in fertilization of the egg. As a result of this procedure, the sperm reaches the fallopian tube, which enhances the chances or rate of egg fertilisation.
IUI is of two kinds -
IUI with donor sperm in case of azzospermia in husband semen parameters. Success per cycle varies 15 to 20% per attempt.
Conditions precedent of IUI Procedure:
Before initiating the IUI procedure, the fast moving eggs are separated from the slow moving eggs. This separation is done in the laboratory. Further, in order to undergo IUI procedure, the women should be less than 40 years of age. On the other hand, apart from healthy fallopian tube, the women should also have higher ovarian reserves. Also, the sperm should have minimum mortality rate. However, IUI procedure is adopted only if the fallopian tube is healthy. IUI procedure is suggested in case the couple is having difficulty in vaginal intercourse, either because of psychosexual reasons or for reasons of physical disability.
The IUI procedure can be performed either with the partner’s egg or with the donor’s egg. Some of the other important aspects of IUI procedure are briefly discussed here:
- The IUI procedure is a short duration procedure and it can be completed within a few minutes. This procedure does not cause any discomfort or pain. The procedure does not require any hospitalisation or administration of anesthesia. Further, the procedure also does not cause any side effects. In fact, compared to the IVF procedure, IUI is cost-effective.
- In order to enhance the level of success, the gynaecologist may suggest IUI procedure every month. In some cases, the gynaecologist may also prescribe a few medicines to simulate the ovulation procedure. Except this, IUI may not involve extensive medication.
You may undergo the IUI procedure under the supervision of sufficiently experienced gynaecologist. Further, you may also ensure the hospital is equipped with modern state of art machineries for carrying out the IUI procedure.
Unexpected or abnormal vaginal bleeding usually refers to the kind of bleeding that occurs any time outside of the normal time of menstruation. Also termed as spotting, inter-menstrual bleeding or metrorrhagia, bleeding between periods always calls for extra measures to be taken against it, and is a matter of serious concern.
The primary causes for unexpected vaginal bleeding generally are:
- An imbalance of progesterone and estrogen levels triggered by a variety of causes like thyroid gland problems, dysfunctional ovaries and irregular doses of birth control pills, which may eventually lead to spotting. However, one must take note of the fact that hormonal contraceptives, in many cases, may cause abnormal bleeding for the first few months, after which it always subsides.
- Noncancerous growth such as uterine fibroids are also potential causes of spotting or abnormal bleeding.
- Miscarriages, ectopic pregnancy, and other kinds of complications involved during childbirth can cause abnormal vaginal bleeding.
- Infection of reproductive organs caused due to intercourse, vaginal douching, pelvic inflammatory disease, or STDs (sexually transmitted diseases) may lead to bleeding and inflammation.
- Cancer of the vagina, uterus, cervix, or ovaries, albeit extremely rare in nature, may cause abnormal bleeding of the vagina.
While in most cases, this type of bleeding is naturally corrected, some women might need to undergo treatments when the case is severe. Overlooking an otherwise minor issue might thrust you in the face of life-threatening circumstances, if it develops into a case of cancer, infection, or any other type of disorder.
‘Prevention’ of vaginal bleeding, as such, is indeed a narrow possibility and the measures will almost always vary since the factors that cause intermenstrual bleeding aren’t the same in all cases. However, what your doctor will always advise you in this regard will be to ensure that your diet is balanced, your weight under control and your lifestyle is essentially healthy. If you happen to be on birth control medications, be so while adhering to medical instructions. Resorting to taking aspirin doses often might also influence the incidence of such abnormal conditions. If your pain still persists after you experience unexpected bleeding, you must consult your doctor without any further delay.
Polycystic Ovarian Syndrome or Disease (PCOS) is a very common condition, wherein there are multiple cysts in the ovaries. As a result, there are many changes which the body undergoes and it is not limited to the gynecologic system. A woman with PCOS may also find it difficult to conceive, and so, once she is pregnant, precautions are essential to ensure there are no complications.
- Preeclampsia: When the blood pressure readings are high during pregnancy, it is known as preeclampsia. It brings with it a whole lot of complications including the need to cesarean section, premature birth, etc. So, it is best avoided, and diet can help to some extent.
- Diabetes: Gestational diabetes which manifests as higher sugar levels only during the pregnancy is very common in women with PCOS. The increased hormone levels in PCOS increase insulin resistance, thereby increasing sugar levels. This needs to be managed through a combination of diet, exercise, and lifestyle changes.
- Preterm labor: Women with PCOS are at a slightly higher risk of premature labor.
- Weight-related issues: PCOS leads to weight gain, and this could be a problem during pregnancy. It is essential to discuss with the doctor as to what would be a good weight range and stay within that range throughout pregnancy. Weight gain brings with it a host of complications and so best avoided.
With PCOS, during pregnancy, strict cautious diet planning can help in avoiding complications and allow for an easier pregnancy. Though they may not solve every problem associated with PCOS, dietary modifications can have a significant effect on the overall health and well-being.
Listed below are some easy-to-make changes:
- Increase consumption of fibres like greens, nuts, pumpkin, berries, whole grains, almonds, etc. are included. This ensures that digestion is a prolonged and gradual spike in blood sugar levels.
- Increase protein-rich foods like soya, tofu, eggs, and chicken, which help in avoiding binging. They are light on the stomach and help in weight management.
- Foods which are generally anti-inflammatory including tomatoes, olive oil, spinach, fresh fruits, and omega-3 fatty acids help in controlling blood pressure and cholesterol levels.
- Supplements to include omega-3 fatty acids, prenatal vitamins, vitamin D, and calcium if required ensure that the baby gets the required nutrients for optimal growth.
What to avoid:
Anything that can spike up calories and is of low nutritional value should be avoided.
- Avoid whites – pasta, rice, and bread
- Baked and processed foods
- Candies, chocolates, snacks
- Salty and spicy fried snacks
- Aerated drinks and soda
PCOS in pregnancy presents a combination risk, and dietary changes and weight management are essential for a safe pregnancy.
Premenstrual syndrome or PMS is a common phenomenon that happens to over 75% of menstruating women. It refers to a set of symptoms that a woman experiences 7 to 10 days within the onset of her monthly period. The symptoms often cause great discomfort to the woman, but disappear soon after the period gets over.
The symptoms include muscle cramps, headache, body ache, nausea, dizziness, fatigue, mood swings and a lot more. This is not a pathogen related disease. It is caused due to hormonal imbalance before the start of menses in women. The level of female hormones i.e. estrogen and progesterone fluctuate inside a woman’s body prior to the menses. They are believed to have an impact on certain chemicals released by the brain. Therefore, women experience these symptoms during this time of their monthly cycle.
You don’t need to depend on strict medication to get rid of these symptoms. They can vanish if you make some changes in your lifestyle.
Here are some natural ways to get rid of these symptoms:
- Check your diet: In order to enjoy a healthy period, you need to avoid certain food items. Trans fats and hydrogenated fats can increase these symptoms. Cut down on the sugar content of your meal as high sugar level can give birth to some of these symptoms like mood swings, headache, nausea, etc. It is also important to check the water content in your body. It is advisable to avoid salt as too much water retention can be bad. Too much consumption of caffeine can cause depression and anxiety.
- Go for a holistic and balanced diet: Women must include sufficient amounts of minerals and vitamins in their diet to avoid PMS. Try eating foods that are rich in magnesium such as bananas and leafy green vegetables. Also consume Vitamin A rich foods, mainly yellow and orange vegetables.
- Take up some light exercises: Light aerobic exercises may help you in getting some relief from bloated stomach and pain. But, don’t exert yourself in doing stressful exercises.
- Try some heat: Applying a heat pad can provide relief from muscle cramps and abdominal pain. Heat dilates the blood vessels and improves flow of blood through them. This provides relief from any sort of pain.
- Drink right: It is true that too much retention of water in the body can worsen PMS. But it is advisable that you drink sufficient amount of water during the periods or before it starts. As experts say, water itself can hinder water retention in your body. Besides water, go for herbal drinks like a cup of hot ginger tea. Some herbal drinks can work wonders in preventing PMS.
- Sleep well: Adequate night sleep is a must for menstruating women.
- Oil message: Use lavender oil and cypress oil to avoid muscle cramps and tension.