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Sai Krishna Super Speciality Neuro Hospital

Endocrinologist Clinic

#3-4-1, Vlr Complex, Station Road, Kachiguda. Landmark: Near Tourist Hotel, Hyderabad Hyderabad
1 Doctor · ₹300
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Sai Krishna Super Speciality Neuro Hospital Endocrinologist Clinic #3-4-1, Vlr Complex, Station Road, Kachiguda. Landmark: Near Tourist Hotel, Hyderabad Hyderabad
1 Doctor · ₹300
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We like to think that we are an extraordinary practice that is all about you - your potential, your comfort, your health, and your individuality. You are important to us and we strive to ......more
We like to think that we are an extraordinary practice that is all about you - your potential, your comfort, your health, and your individuality. You are important to us and we strive to help you in every and any way that we can.
More about Sai Krishna Super Speciality Neuro Hospital
Sai Krishna Super Speciality Neuro Hospital is known for housing experienced Endocrinologists. Dr. N.Sudhakar Rao, a well-reputed Endocrinologist, practices in Hyderabad. Visit this medical health centre for Endocrinologists recommended by 88 patients.

Timings

MON-SAT
11:00 AM - 03:00 PM

Location

#3-4-1, Vlr Complex, Station Road, Kachiguda. Landmark: Near Tourist Hotel, Hyderabad
Kachiguda Hyderabad, Andhra Pradesh
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Is it good to consume FENUGREEK Whole to treat diabetes. Can Karela juice in morning is beneficial for Diabetic. Can these both be taken entire year (summer and winter)

Nutrition - Management of Weight & Lifestyle Related Disorders
Dietitian/Nutritionist, Delhi
Is it good to consume FENUGREEK Whole to treat diabetes.
Can Karela juice in morning is beneficial for Diabetic.
Can ...
Yes, you should take both. You can take karela juice empty stomach in early morning and overnight soaked fenugreek seed can take before 20 minute of your meal.
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Please help me out with gap of time between ayurvedic tablet and allopathic tablets. Need specific gap for 1) thyroid tab eltroxin 112.5 mcg and gandhak rasayan tablet + mahamanjashthadi Kadha. 2) bp tablets betatrop + enam 5 and gandhak rasayan tablet + mahamanjashthadi Kadha.My Age 77 yrs. Thanks.

Homeopath, Hyderabad
Please help me out with gap of time between ayurvedic tablet and allopathic tablets. Need specific gap for 1) thyroid...
Hello Eltroxin tablet must be taken on empty stomach at the start of day followed later by any other medication Give a gap of an hour before taking g any other system of medicines alternately.
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I am prediabetes. My fasting sugar is between 110 to 140. My hba1c is 6.2. I walk 6 days a week for 1 hour. Do I need to start medication.

Diploma in Diet and Nutrition
Dietitian/Nutritionist, Hyderabad
I am prediabetes. My fasting sugar is between 110 to 140. My hba1c is 6.2. I walk 6 days a week for 1 hour. Do I need...
You are on Borderline. You don't need any medicine. You can do natural healing by controlled diet and regular exercise. Avoid medicines as far as possible. Take more grains like raagi and bajra/ brown rice / oats / multi grain Atta. Take less maida/ White rice /sugars / potatoes. Nature has best solutions. All the best.
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I am 38, diabetic 21 week pregnant I go in for a walk in the morning and evening for 45 minutes. I feel tired and feel the pain after the walk. I am worried. Kindly let me know whether I can go in for a walk.

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Surat
I am 38, diabetic 21 week pregnant I go in for a walk in the morning and evening for 45 minutes. I feel tired and fee...
Critical medical condition with 21 weeks pregnancy. Please Consul your gynaecologist for any type of complaint till delivery done. Afterwards you can go with any herbal or alternative therapy for Diabetes and general weakness.
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My age is 69 years, Male,Diabetic since 4 years. Taking Janumet 50/500 one morning, one evening since about 9 months. It is myth that constant use of same Diabetic medicines over longer period of time effect/control over disease is reduced/less effective. Can I switch to AMARYL M2 mg. One morning and one evening and regular monitoring of sugar and also further adjustment of Diabetic medicines. Devinder kumar MOB: 9872253630. Kindly advice. Regards &Thanks.

MBBS, Diploma in Diabetology
Endocrinologist, Mumbai
My age is 69 years, Male,Diabetic since 4 years.
Taking Janumet 50/500 one morning, one evening since about 9 months....
no diabetes is progressive disease and as the duration of diabetes increases beta cell reserve of pancreas keep on reducing. so the medicine dosage increases. still there is no harm in switching diff brand with same content
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My thyroid TSH is 5.6 and T4 is 4.4. What does it mean. I am thinking for family planning, will it have any adverse effect on pregnancy?

MBBS, DNB (General Medicine)
Endocrinologist, Delhi
No, family planning won't have any adverse effect on your future prospective pregnancy or on your thyroid control.
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Hello. My grandfather (75 age and diabetic) was suffering from frequent motions from last 3 weeks. Whenever they eat something like cereal, any other foodstuff, they develop urge to go restroom. Normal antibiotics taken like ofloxacin with ornidazole. But condition still not much better. Case history: suffered from hyponatremia about 1.5 years ago. Proper recovery took about an year with loss of body mass. Looking forward for able guidance and appropriate solution.

Bachelor of Ayurveda, Medicine and Surgery (BAMS), Masters in Healthcare Services
Ayurveda, Una
Hello.
My grandfather (75 age and diabetic) was suffering from frequent motions from last 3 weeks. Whenever they eat ...
Hello Sir, I just read your query. As he has been suffering with frequent motions and cereals are not digesting, then give him foods which are easy to digest and will help him in getting rid of loose stool too. *First of all add curd to his diet as it is a rich source of probiotics. Probiotics are intestinal friendly bacteria which help to maintain normal environment of intestine and also helps in maintaining intestinal motility, as a result will control his motions. * Give him apples, bananas, pomegranate, khichdi, yellow moong dal and more of semi solid diet for some time as all these things help in binding stool and are easily digestible too. * Give him boiled water only. * I hope you find my answer helpful. For more queries you can consult me. Thank you.
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Hi I am recently been diagnosed with Diabetes from the HBa1c value 8.22,doctor has prescribed Januvia 50 mg and Metamorhin 500 mg, would like to know can I take these tablets? I usually avoid tablets, Can I take only one out of these which is metamorphin which is cheaper, Current prescription is to take Januvia 50 mg in early morning half an hour before breakfast and Metamorphin to be taken at night after finishing the dinner I would like to change the schedule to Metamorphin in the morning half an hour before breakfast thats it, I do not want any other medicine apart from it, I am Fitness freak and I take care of my diet with millets recently I had stopped medicine for 15 day the symptom I had is frequent urination, then I consulted a Junior doctor who suggested for a fbs and ppbs test in which the result was fbs 97 and ppbs 193, based on which junior doctor suggested to take metamorphin tablet alone in the morning then no further tablets in day can you help me here which schedule to follow, appreciate your response as I need a super expert advice on this Hi I am recently been diagnosed with Diabetes from the HBa1c value 8.22,doctor has prescribed Januvia 50 mg and Metamorhin 500 mg, would like to know can I take these tablets? I usually avoid tablets, Can I take only one out of these which is metamorphin which is cheaper, Current prescription is to take Januvia 50 mg in early morning half an hour before breakfast and Metamorphin to be taken at night after finishing the dinner I would like to change the schedule to Metamorphin in the morning half an hour before breakfast thats it, I do not want any other medicine apart from it, I am Fitness freak and I take care of my diet with millets recently I had stopped medicine for 15 day the symptom I had is frequent urination, then I consulted a Junior doctor who suggested for a fbs and ppbs test in which the result was fbs 97 and ppbs 193, based on which junior doctor suggested to take metamorphin tablet alone in the morning then no further tablets in day can you help me here which schedule to follow, appreciate your response as I need a super expert advice on this.

Diploma in Diet and Nutrition
Dietitian/Nutritionist, Hyderabad
Hi I am recently been diagnosed with Diabetes from the HBa1c value 8.22,doctor has prescribed Januvia 50 mg and Metam...
Its quite surprising that with a report of 97/193 some one has prescribed Diabetic medicines for you. Kindly repeat all your tests again from a different lab. Take your reports to a different doctor. Diabetes medicines should not be taken in this manner. They can create problems in case your body doesn't need them. Better to be sure.
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A Healthy Amla Drink to Manage Your Blood Sugar Level

Non-invasive Cardiology
Cardiologist, Thane
A Healthy Amla Drink to Manage Your Blood Sugar Level

An easy to make recipe which taken regularly helps manage blood sugar levels. The antioxidant property of amla helps boost immunity and metabolism.

My uric acid level is 7.5, what can I do? What type of food should intake or not.

BSc - Food Science & Nutrition, PGD in Sports Nutrition and Dietitics
Dietitian/Nutritionist, Mumbai
My uric acid level is 7.5, what can I do? What type of food should intake or not.
Hello, Avoid high purine diet which is very high in animal sources of proteins,lose weight to minimise pressure on your knees.
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My fasting sugar 135 and Pp 150 Checked by glucometer. How to control provide Diet chart.

Diploma in Diabetology, Pregnancy & Diabetes, Hypertension, Cardiovascular Prevention in Diabetes ,Thyroid
Sexologist, Sri Ganganagar
My fasting sugar 135 and Pp 150
Checked by glucometer.
How to control
provide Diet chart.
Dear lybrate-user you are a cade of fasting Hyperglycemia. Most probably you are obese .if so please decrease weight by exercise and diet control. Take small frequent meal. Take full plate salad before each of Three meals. Take fruits in between meal. Brisk walking daily .More ask on line.
8 people found this helpful
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Intracytoplasmic Morphologically Selected Sperm Injection (IMSI) - To Help You Live Your Dream!

MD - Obstetrtics & Gynaecology, DGO
IVF Specialist, Mumbai
Intracytoplasmic Morphologically Selected Sperm Injection (IMSI) - To Help You Live Your Dream!

Of a million sperms released in one ejaculation, a single sperm manages to fertilize the egg, which grows into an embryo and then a baby. Due to various reasons, when this does not happen, it is termed as infertility and is currently on the rise.

With In-vitro fertilization (IVF), couples sometimes go through multiple sessions to ensure fertilizationICSI or intracytoplasmic sperm injection improved this chance of fertilization. It is where a single sperm is used to fertilize an egg in an artificially controlled environment and then injected into the uterus where it grows further.

The next step in this technique is IMSI, where the chances of successful pregnancy are further enhanced and also promises improved quality of the embryo. IMSI, as it stands for, has “morphologically selected” which means under a highly powerful microscope, the best sperms are selected and then used to fertilize the egg. Morphology stands for shape, and the shape of the sperm is a direct indicator of the sperm quality. This not just ensures good success rate but also ensures the sperm which is used produces a high-quality embryo.

Features

  1. High success rate of fertility
  2. Reliable and efficient method of ART (assisted reproductive technology)
  3. More expensive than traditional IVF methods or ICSI
  4. Requires complex equipment, training, and set-up

Indications:

  1. Useful in couples who have failed IVF previously
  2. Male infertility with unidentifiable cause
  3. Poor sperm quality

What to expect?

Both partners are prepared both physically and mentally prior to IMSI.

Before the procedure - men:

  1. A screening is first done to decide if the sperms can be used directly
  2. In case of hereditary diseases, a donor is preferred
  3. The first technical step involves sperm collection, either directly or through a donor
  4. Sperms are collected either through masturbation or through a small incision in the testicles
  5. Sperms used could be fresh or frozen; fresh ones may be stored for later use also

Before the procedure – women:

  1. The woman is put on some ovulation therapy to ensure the release of multiple eggs, so a good one is picked. These high doses of hormones ensure multiple eggs are released.
  2. Egg release is monitored through blood and urine tests
  3. They are collected within after 36 hours of release

During the IMSI procedure:

  1. A healthy egg is chosen and placed in a glass container containing hyaluronidase
  2. Sperms are placed in a medium which will slow their movement, which enables picking a good sperm for fertilization
  3. The dual advantage of this is that in addition to a high success rate of fertilization, the quality of the embryo is also assured 

    If you wish to discuss about any specific problem, you can consult a gynaecologist.

175 people found this helpful

I am thyroid patient and rate 12.5.I am taking medicine regularly but would like to opt for alternative one so as to control on permanent base.

MD-Pharmacology, MBBS
Sexologist, Delhi
Dear lybrate-user, Your TSH level is very high. Only medicine could not help alone, you have to take care of your diet along with exercise. Get yourThyroid free levels and normal test done on every 3 months. For more queries elated to thyroid you can consult me on private questions. Thank you.
1 person found this helpful
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Meri fasting ke sugar 102 thi uske baad mane 1 bowl rice liya, 1 glass milk with proteinix  ,phir uske 2 hr baad check ke 139 aaye kya mujhe diabites hai agar hai tho kya medicine le please pescribe me.

Certificate in Basic Course on Diabetes Management, CCEBDM Certificate in Diabetes, MBBS
General Physician, Pune
Meri fasting ke sugar 102 thi uske baad mane 1 bowl rice liya, 1 glass milk with proteinix  ,phir uske 2 hr baad chec...
Aapko subah 75 G glucose 2 glasses paanime lena hoga. 1 1/2 ghanteke baad sugar level test karna 120 mg se bhi jyaada hai aur 140 se kum hai to wo impaired Glucose Tolerance hoga. Sugar nahi lenese aur exercise karanese shyaayad dawaaki zaroori nahi padegi. Har mahine khaneke 2 ghante baad sugar test karate rahan. Reportme aur zyaada hua to specialist doctorse milana.
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My father is having gol bladder stone, many of them, he is also suffering from diabetes for the last 13 years and had a bypass surgery done 7 years back, so is it advisable to get a micro surgery done to remove the stone, pls advice.

MBBS, CCEBDM, Diploma in Diabetology
Endocrinologist, Hubli-Dharwad
My father is having gol bladder stone, many of them, he is also suffering from diabetes for the last 13 years and had...
Hello, Thanks for the query. If his blood glucose is well controlled with fasting<100 mg, PP 160 to 180 mg & HbA1c% <7, then getting a surgery done is fine. The surgeon would be the best judge to give an appropriate advise on the spot. Thanks.
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I am 34 female having tsh 6.88 t3 1.11 t4 9.49 pl suggest remedies and precautions for me to take and solutions for it.

BHMS
Homeopath, Thane
I am 34 female having tsh 6.88 t3 1.11 t4 9.49 pl suggest remedies and precautions for me to take and solutions for it.
Good evening Lybrate user. You are really having a high level of tsh. You can consult an endocrinilogist for it. The regular precautions that you can take are very simple.
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Hi, my age is 62 years old. I had been diagnosed with type II diabetes and the medicines I have been taking are as follows:- Metformin 1000 mg 1xod Metformin 500 mg 1xhs glimepiride 2 mg 1xbd clopid 75 mg 1xod atorvastatin 20 mg 1xhs The above medicines have been taken regularly for past three months. Now I have taken the blood test two days ago. The result is as follows:- FBS 149 PPBS 235 HbA1c 6.0 Serum urea 24 mg/dl serum creatinine 0.89 serum Uric acid 5.3 Liver Function Test Total Bilirubin 0.78 SGOT 50 SGPT 58 LIPID Profile Total cholesterol 135 Triglycerides 121 HDL 46 LDL 65 I request a diagnosis of my status of health. I go for swimming once in a while and find no problem in swimming for about 700 metres in about one hour (that is 14 lengths in a lap of 50 metres each) I am muscular and have a athletic body and have no other symptoms. I love drinking alcohol and have about three pegs of 60 ml each every night most days. Should I stop drinking. I can muster enough will if the kind doctor says so. Thanking you in anticipation.

MBBS, CCEBDM, Diploma in Diabetology
Endocrinologist, Hubli-Dharwad
Hi, my age is 62 years old. I had been diagnosed with type II diabetes and the medicines I have been taking are as fo...
Mr. lybrate-user, Thanks for your query. I have gone through all the details given including lab values. All the values seem to be well within normal limits, except SGOT & SGPT. Both are slightly high, signifying some affection of liver functions. It points to one thing clearly that is to reduce alcohol intake. It should be preferably one or two days in a week plus much lesser in quantity. Thanks.
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Meri fasting ke sugar 102 thi uske baad mane 1 bowl rice liya, 1 glass milk with proteinix ,phir uske 2 hr baad check ke 139 aaye kya mujhe diabites hai agar hai tho kya mesicine le please pescribe me.

MBBS, CCEBDM, Diploma in Diabetology
Endocrinologist, Hubli-Dharwad
Meri fasting ke sugar 102 thi uske baad mane 1 bowl rice liya, 1 glass milk with proteinix ,phir uske 2 hr baad check...
Mr. lybrate-user, Thanks for the query. Following are the criteria to decide if one is normal or otherwise: 1) Normal: Fasting Glucose: 70 to 110 mg, PP:<140 mg & HbA1c% <5.9 2) Pre-diabetes: FBG: 108 to125 mg, PP: 141 to199 mg, & HbA1c% 5.9 to 6.4. 3) Diabetes: FBG: 126 mg and above, PP: 200 mg and above, HbA1c%:6.5 and above. Your blood glucose levels are absolutely normal. Thanks.
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What is Infertility?

DHMS (Diploma in Homeopathic Medicine and Surgery)
Homeopath, Jhansi
What is Infertility?

1. What is infertility?
Infertility is a term that is used to describe the inability of an individual to successfully contribute to the process of conception. In females, it refers to their lack of ability to conceive post having regular, unprotected intercourse. In some cases, it also refers to their inability to carry a pregnancy to its full term. A normal fertility helps conception in the first 12 months of trying for almost 86% of couples, with around 7-8% couples conceiving in their second year, depending on their age. Hence, many practitioners also treat an inability to conceive within the first 12 months as infertility. 

2. Is infertility a global problem?
Sub-fertility as well as infertility are a global public health issue affecting approx. 8-12% couples, worldwide. It is prevalent in both males and females. While over 10% of women world-wide, who have been in stable relationships for over 5 years yet been unsuccessful in conceiving, have been estimated to be inflicted with this problem; the count is much smaller in the case of men, primarily because of non-acknowledgement, even though it contributes to almost 50% of reported cases.

3. Do infertility problems occur only among women?
No, infertility problems are as common in men as they are in women. Almost 50% of cases of infertility are attributable to male infertility related issues. However, due to the social structure prevalent, most of such male infertility related issues go unacknowledged.

4. What could be the probable symptoms that suggest a possibility of infertility related problems?
Though the process of conception and the possibility of infertility related problems could be time-driven factors, some symptoms could indicate a bent towards infertility and could be medically examined and addressed in time to curb the problem at the very onset. Some of these indications include:

Indications in Females:
Infertility symptoms in females can be related to either one of multiple of these problems:
Changes in menstrual cycle: Irregular or infrequent periods mean that the number of days between two cycles varies each month. This is a common indication of infertility as it reflects that the ovulation cycle is not stable, i.e. the body is not producing ovules (egg) regularly or at times not at all. 
Abnormalities in periods: Sudden changes in the bleeding pattern – heavier periods, no period or cramping and pelvic pain associated with periods – could also be indicative of an underlying fertility related problem.
Hormonal Disturbances: Sudden changes in skin like more than usual acne, changes in sexual drive, unexplained and sudden growth of facial hair, excessive weight gain/loss, etc. 
Other Symptoms: Other symptoms such as pain during sex, milky-white discharge from breast/nipples (unrelated to lactation) can also be indicative of infertility and one should seek medical advice at the earliest.
Age-related: As one advances in age, the egg count decreases rapidly along with a related deterioration in the egg quality. Hence, if a woman is in her early 30s and is failing to conceive, it could be related to a fertility problem. 

Indications in Males:
Infertility symptoms in men can be quite elusive as they are very closely related to the cause of infertility. These often go unnoticed until the point that the couple start trying for a baby. Some of these are: 
• Sudden changes in sexual drive.
• Pain, inflammation or lump in the testicles or if the testicles are small and firm.
• Problems related to ejaculation and erection
• Sudden, unexplained changes in hair growth patterns.
• Known semen abnormalities

5. Who are at risk of infertility problems?
Age is one of the most crucial risk involved in fertility related matters. For couples who start trying for a baby later in age, the chances of infertility increases manifolds. Couples where either partner is in their mid-30s or into 40s are at higher risk of infertility problems. While a man’s overall lifestyle, health and other factors can affect his chances of contributing to a successful conception, in a woman age and chronic health conditions play a major role.

6. What increases infertility risk in men?
While health and lifestyle are the most important factors that contribute to their fertility levels, including their sperm quality and count, there are many other factors that affect fertility and push towards higher infertility risk among men. Some of these include:
• Age
• Alcohol and tobacco consumption
• Excessive physical exercise, especially excessive cycling
• Weight related issues 
• Exposure to toxins at workplace or as part of a medical treatment like chemotherapy/radiation
• Surgical procedures like vasectomy or its reversal
• Family history of infertility or fertility related disorders or other genetic medical conditions like cystic fibrosis
• Medical history of sexually transmitted infections (STIs)
• Certain chronic problems like high blood pressure, diabetes, renal or hormonal problems 

7. What can increase the risk of infertility among women?
Ovulation related issues contribute to over 25% of female infertility cases, with tubal blockage and uterine problems coming in as the other infertility causes in women. However, some other factors like the ones enlisted below also put females at risk of infertility:
• Advanced age
• Frequent or heavy alcohol or caffeine consumption
• Cigarette smoking
• Weight-related issues
Eating disorders and lack of balanced healthy diet
• Intense and extended athletics or no exercise at all
• History of STIs, endometriosis, polycystic ovarian syndrome (PCOS) or fibroids
• Chronic health issues like high blood pressure or diabetes. 
• Hormonal problems like thyroid etc. 
• Mental stress and fatigue

8. How is age related to a woman’s ability to conceive or infertility aspects?
A woman’s fertility rate begins to recede with her age. As a woman nears her mid-30s, her natural fertility starts to fall and many experience difficulties in conception as well as multiple pregnancy failures. The reason for this is that the ovarian reserve in women is fixed since birth and as they age it starts to fall drastically as the follicles keep leaving the reserve in a continuous flow (menstrual cycle). This follicular depletion accelerated as she approaches 40s and decreases not just her egg count but its quality too, as she ages. For men, this progressive drop in fertility rate hits after the age of 40. 

9. What are common causes of infertility in men?
One of the most common causes of infertility in men are semen disorders. The semen comprises a milky white fluid and sperms that are ejaculated during orgasm. Abnormal semen contributes to over 75% cases of male infertility. The common semen related disorders include:
i. No sperm presence in semen
ii. Low sperm mobility
iii. Abnormal sperm shape/size
iv. Low sperm concentration (under 10 million/milliliter) in the semen (Ideal: 20 million/milliliter of semen)
 

The major causes of these abnormalities and a consequent infertility in men are:
1. Ejaculation Disorders
2. Frequent use of saunas, hot baths etc. that lead to overheating of testicles.
3. Testicular infections
4. Testosterone deficiency
5. Deformed or undescended testicles that usually happens as a birth defect or abnormal fetal development.
6. Genetic disorders like Klinefelter's syndrome that lead to abnormally developed testicles.
7. Very frequent intake of medications like Sulfasalazine, Anabolic steroids (frequently taken by athletes), etc. or exposure to chemotherapy/radiation.
8. Conditions like hypospadias (a condition where the urethral opening is not at the tip of the penis but at its underside) or cystic fibrosis.

10. What are common causes infertility in women?
There are a number of conditions that lead to fertility among women, such as:

1. Ovarian Disorders: The most commonly reported reason for infertility among women is a disorder in the ovulation process. 
Ovulation involves the production and release of egg. This cycle happens on a monthly basis. However, certain situations lead to a malfunctioned ovulation. These causes include:
i. Polycystic ovary syndrome (PCOS) which lead to mal function of ovaries
ii. Very high prolactin levels in non-lactating females
iii. Damaged or abnormal eggs – Poor egg quality is common in older women
iv. Thyroid disorders
v. Medical conditions like cancer, diabetes, AIDS, etc. 
vi. Premature (before the age of 40) ovarian failure 

2. Uterine Disorders: Once fertilized, the egg travels from the ovary to the uterus and it is important that the uterus be healthy to receive and nurture the fertilized egg. However, at times, disorders of the uterus lead to infertility problems in women. Uterine disorders can be attributed to one or more of these reasons:
i. Pelvic or cervical surgery that may cause scarring or damage of the uterus or fallopian tubes or at times shortening of the cervix which serves as the mouth of the uterus.
ii. Endometriosis – a condition where the cells that line the uterus start growing outside the uterus.
iii. Sterilization treatments like tying of tubes, etc.
iv. Uterine fibroids or endometrial polyps

3. Medications: Certain medications like those used in chemotherapy or certain NSAIDS like aspirin and ibuprofen lower fertility rates in females.

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