Book Clinic Appointment with Dr. Sujoy Dasgupta
Treatment of Premature Ejaculation
Treatment of Erection Problems
Treatment of Ovarian Cysts
Treatment of Low Sperm Count
In Vitro Fertilization (Ivf) Treatment
Treatment of Uterine Fibroids
Treatment Of Male Sexual Problems
Caesarean Section Procedure
Termination Of Pregnancy Procedure
Treatment of Delayed Ejaculation
Treatment of Endometriosis
Treatment of Retrograde Ejaculation
Treatment Of Pregnancy Problems
Treatment of Azoospermia
Treatment of Male Infertility or Impotency
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Patient Review Highlights
Dr.Sujoy Dasgupta has been much more to us than just a doctor, u have been a therapist, a supporter,a friend & a well-wisher.The period of my pregnancy with triplets could have been a nightmare without ur medical supervision. Thank u for making my journey to become a mother nothing less than a dream come true.I'll never be able to thank u enough for all ur treatment,support & advices.
We have seen many doctors but no one is like Dr Sujoy Dasgupta. He does not prescribe useless medicines and never asks for unnecessary testings. We were married for 3 years but never enjoyed our conjugal life due to erectile dysfunction of my hubby. He consulted many doctors but all were in vain. Finally when we planned to have a baby, it was found that I had PCOS problems. Many doctors prescribed numerous tests and medicines but nothing worked. Even somebody advised us test tube baby. Nobody addressed our issue properly. So we lost all hopes to conceive naturally. We consulted Dr Dasgupta at his Garia chamber as a last chance. On first consultation he discussed many issues giving us almost 45 minutes time. He prescribed drugs and some exercises to my husband, which worked like magic within few days. His performance improved a lot. He advised me few tests and gave much emphasis on weight loss (which nobody advised before). He said "I am not God. I cannot give you guarantee. But I can t
I was suffering from severe pain in lower part of my stomach for long time. I did not have any kids at that time. I consulted so many doctors but all in vain but finally one of my doctor advised me to have laparoscopy to treat this disease as I had cysts in my ovaries. But both my husband and I was not ready for the operation. We consulted Dr Dasgupta for second opinion, he said "we can operate at any time but why should not we try drug and then operate if the drug fails"? This comment seemed to be very much convincing for me. So, as per his instruction, I took 3 injections once in a month each and at that time he said that I will not have pain but my periods will remain stopped. His words came true and when I repeated ultrasonography after 3 months, my cysts disappeared. Then Dr Dasgupta started to give drugs for my infertility problems and within 6 months I conceived. Now I am enjoying motherhood, avoiding unnecessary surgery only because of him. I will always remain grateful to him.
I have no words to thank Dr Sujay Dasgupta. I had 3 miscarriages earlier and for this we consulted many doctors and they all advised number of tests and treatments but despite all these I had miscarriage. All the reports of me and my husband were normal except abnormal "TORCH IGG". Some senior doctor advised us not to conceive until the report becomes normal but we were desperate to conceive and so consulted Dr Dasgupta. He assured that TORCH tests means nothing and we can conceive without fear. He said he would put stitch to the mouth of my uterus after I conceive to prevent miscarriage. I conceived and he put stitches at 20 weeks. That small stitch appeared to change my life drastically. Finally my baby boy saw the light of this world in August 2015 in hands of Dr Dasgupta. Thank you doctor for helping us to enjoy the parenthood. Not to mention how he entertained my disturbing call to him in odd times whenever I felt any problems but he never got angry.
We are 2 Canadians, temporarily living in Kolkata. At age 43, I found myself pregnant! It was a natural (and surprise) conception after being diagnosed as infertile. Naturally, we were concerned given my age plus other risk factors. Dr Dasgupta was fabulous! He was patient, thorough and full of concern for us. He arranged an ultrasound within the hour and when there was trouble, had me referred to the best clinic in the city the very next day. He followed us through significant problems. Sadly, we miscarried, and he was there for us too. I highly recommend Dr Dasgupta. He's knowledgeable, compassionate and went "the extra mile" for two foreigners who knew nothing about how the Indian medical system worked. Thanks, Dr Dasgupta. We will never forget your kindness and care for both of us.
I went to Dr.Sujoy Dasgupta on Dec , 15 with my husband. We were planning for pregnancy. He listened all the details , gave some preliminary tests , advised to reduce obesity. Soon we got desired result within few months . After that we went to him for regular check up. Every time he gave utmost care and attention. Finally we became proud parents this May , 17. After successful operation , he visited for routine check up. We went to him for final check up yesterday , he was equally attentive and patient.I am speechless to express my gratitude towards Dr.Dasgupta. I will recommend every upcoming parents to visit Dr.Dasgupta for best treatment related to pregnancy and gynecological problems. Once again tons of thanks for Dr.Dasgupta and all the very best.
Dr Dasgupta always gives time to his patients and listens all our conerns carefully, without being impatient or feeling distributed. Before any treatment, he explains in simple and clean language everything we want to know. We went for problems in having pregnancy. One of my tube was blocked in HSG and my husband's sperm had low motility. He never forced any treatment, rather he gave us options and explained merits and demerits of each option. He said we could try naturally, go for laparoscopy and IUi or directly IVF. Finally we agreed to try naturally and fortunately I conceived and delivery was conducted by his expert hand. He is very kuch sincere to his patients and always attends their phone calls.
A patient’s testimonial is less of a recognition of a doctor’s professional expertise, and more of a recommendation of a doctor’s ability to listen, care and heal. I can vouch for the fact that your abilities are unmatched. Before saying that you are an extraordinary doctor, I want to tell you that you are an extraordinary human being. Thanks for showing so much care and concernGoing through childbirth is a mix of immense pain followed by immense happiness. In this journey, the presence of a wonderful doctor is simply priceless. Thanks doctor, for comforting me and taking away all my stress. Wish u all the best in ur career. May u reachbto the zennith of glory n pinnacle of success.
I was married for 5 long years, yet could not conceive. I consulted many doctors but still no results. All my reports were normal. My husband was suffering from oligospermia (having less number of sperms in his semen). Many doctors gave him drugs but none worked. Finally I consulted Dr Dasgupta, who advised very few investigations to my husband and finally planned for IUI. He said that "I may not increase his sperm count but I can give you pregnancy using his sperms". And by God's grace, we conceived after 1st IUI. Now I'm enjoying my motherhood only because of Dr Dasgupta. My baby is one years old. Thank you so much for standing beside us through the whole journey.
From the very beginning Dr.Sujoy Dasgupta was there , caring , patient was very supportive. Initially my wife was having some difficulty. He treated - rectified. Within few months we got the result. After that we went to him for regular check up. Everytime he gave great attention and utmost care. Finally this 24th May we became proud parents. Even after the operation he came several times to the hospital for timely check up of my wife.I have no words to express my gratitude to Dr.Dasgupta - tons & tons of thanks and all the best. My suggestion for the to be father and mother - go to him and get the best treatment and result without any doubt.
I have no words to thanks Dr.SUJOY DASGUPTA.Only for his good suggestions and caring treatment me & my wife blessed with a baby girl on 15 th June 2017.My wife is under his treatment before her pregnancy.When we came to know that she is diabetic,we are very much worried but this doctor give us hope & guide us throug out this journey.Ultimately every thing done safely without any complication on 37th week.Most important character of this doctor is he always interact with his patient friendly and give them good hopes.So I always suggest everyone if anyone still searching for a good gyno then Dr SUJOY DASGUPTA is a very good option.
I have no words to thanks to Dr Sujoy Dassgupta. Only I can say that he is God for me. I am suffer from phimosis & early ejection from last 7 yrs. When I meet Dr Sujoy Dassgupta & taking medicine prescribed by him result is that I am totally fit now. He is vr vr nice gentle Dr who is never run for money likes other Dr who prescribed etc medicine & test which r not needed but they suggest only for money but Dr Sujoy Dassgupta never did this. He is vr genuine Dr. May God give him all happiness in his life.
I am really indebted to Dr. Sujoy Dasgupta. I became aware of my pregnancy much later and was totally confused as well as afraid. I was 6 months pregnant when I went to his chamber. He listened to me very attentively and assured me not to worry about anything. My haemoglobin was very low. But he managed to increase it to the normal level within just three months. And finally my healthy baby was delivered by him. Thank you Dr. Dasgupta.
Krishna Chandra Das
Dr. Sujoy Dasgupta is a young dynamic and experienced Doctor. He is very friendly to his patient and clarify everything very clearly if the patient has any query about his problem. It goes without saying that he is a brilliant Doctor in all respect. Being a patient, I am fully satisfied up on him.
I found the answers provided by the Dr. Sujoy Dasgupta to be knowledgeable. Sir.. im21yr old boy.. my penis size is too small about 4inch and my sex time is 40-50 second.. that's why my partner is satisfied with me so now what i do plzz help me
Thanks lybrate.this website is realy vry awsm.Dr sujoy is vry good in patient handling.he gives his answer vry quickly because he feels the condition of the patient's problm like his problem.thnks
Dr. Sujoy Dasgupta provides answers that are knowledgeable, well-reasoned, inspiring, sensible and very helpful. Really the amswer is very motivational, helpful, inspiring , & knowledgeable.
I found the answers provided by the Dr. Sujoy Dasgupta to be helped me improve my health and saved my life. Sir thanks a lot... U cant understand the tension i was feeling... Thank alot ..
I found the answers provided by the Dr. Sujoy Dasgupta to be knowledgeable. Thanks a lot doctor sujoy. So you mean that the size of the organ can be increased with some medical treatment?
I found the answers provided by the Dr. Sujoy Dasgupta to be knowledgeable. So what are the ways to stop this...and is it helpful to reduce diseases if yes what are that??
I found the answers provided by the Dr. Sujoy Dasgupta to be professional. Tell that person condoms never break they rip, don't use expired condoms or wild sex
Soumya Ranjan Moharana
I found the answers provided by the Dr. Sujoy Dasgupta to be very helpful. Thanks for ur reply sir. But my friend addicted with this. So how can he stop it.
When couples start their family, they have many dreams. Subsequently many of them, if not all, plan to extend their family to give a sense of accomplishment. That is a journey from being couples to being parents. But unfortunately, in some couples the journey is not smooth and some of them have to struggle a lot for it. Yes, you are right. We are talking about difficulty to conceive, popularly known as “Infertility”.
To achieve successful pregnancy, there must be production of sperms, transport of them and proper deposition of them into the vagina by the male partner. In female partner, the deposited perms must travel through vagina and uterus to 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 ovum is produced by the ovary and released 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, which 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.
Perhaps you have heard that infertility may be due to problems in male (defect in production, transport or deposition of sperms) or female (defect in ovaries or ovulation, bock in the tubes and defects in the uterus). But sometimes there may be more than one problems in either of the couples or apparently no reason is found (everything is normal, so pregnancy depends on chance factor). To clarify the latter, in normal healthy couples with regular unprotected timely intercourse, the chance of pregnancy in one menstrual cycle is only 15%, so it may be matter of time for some couples to conceive. But another important reason for infertility in female is endometriosis.
What is endometriosis?
Endometrium is the inner lining of the uterus. It responds to hormones secreted by the ovaries during normal menstrual cycle. It tends to thicken from the time of ovulation (as described above) and if pregnancy occurs, it continues to grow and supports the embryo to help in continuing pregnancy. If pregnancy does not occur, it is shed off outside the body and is seen as “menstrual Bleeding” or “Period”. Unfortunately, in some women, the endometrium may be present outside the normal position. That condition is called endometriosis. It is commonly present around the ovaries, tubes, surrounding the uterus (outside normal lining) but may be present anywhere in the body (even in lungs, urinary system and rectum). As this endometrium (outside the uterus lining) also responds to the hormones in the same way as normal endometrium (that lines the uterus), there will be bleeding around this abnormal endometrium at the time of menstruation. But this bleeding, unlike normal menstrual bleeding cannot come outside the body and so the blood accumulates and forms a chocolate coloured material (old blood is chocolate coloured) and leads to adhesion between organs. Adhesion is a condition where different organs of our body attaches abnormally with each other leading to various problems. Sometimes this chocolate coloured blood may be surrounded by a membrane formed by body tissue and is then called “Chocolate Cyst” that is found around the ovaries.
What is the reason for endometriosis?
Unfortunately, despite extensive research throughout the world, the reason for endometriosis is not known. It is said to be due to some genetic factors or some environmental factors. Sometimes, delaying pregnancy is stated as the reason. In some women, however, it is caused by backward flow of menstrual blood (that enters into the tubes during menstruation). Usually these women have abnormal development of uterus (problems in uterus since birth), so that all the menstrual blood cannot come outside the body)
What is the problem with endometriosis?
Endometriosis usually causes pain. The pain may be long standing and usually occurs at the time of periods (dysmenorrhoea) or sometimes even between periods. The nature and site of pain depends on where it is located. If it is located very deep inside abdomen, it can cause pain during sexual intercourse (dysparaeunia). In some cases there may be pain during passing urine or stool or bleeding during urination or with stool.
In around 50% cases, it can cause infertility. The cause of infertility is not always properly understood. But it has been seen that endometriosis can cause adhesion and thus can makes it difficult for the Fallopian tubes to pick up the ovum from the ovaries. Apart from this pain during intercourse often makes the woman avoid intercourse. In addition, it can interfere with ovulation, sperm transport, meeting between sperms and eggs and also the process of attachment of uterus with the embryo.
However, endometriosis does not always cause pain or infertility. In some women, there may be both pain and infertility, some women only one symptom and in some women no symptom is found but endometriosis is discovered accidentally during treatment for other purpose (like during laparoscopy for appendicitis or during Caesarean Section).
How endometriosis is diagnosed?
Endometriosis is suspected by history of pain or infertility and examination findings. Like some women may have pain during examination of abdomen or vagina by doctors, even sometimes vaginal ultrasound causes pain. In ultrasonography (or sometimes CT scan is done) there may be presence of cysts or adhesion can be detected. But the “Gold standard” of diagnosis is laparoscopy. It is an operation where (“Microsurgery”), making a small opening in the abdomen under anaesthesia, a telescope is introduced and the area is seen through camera in a television monitor. At that time the chocolate cysts, adhesions and condition of the organs can be seen and diagnosed and if there is any doubt, biopsy can be taken. But in all cases, laparoscopy is not needed and treatment is started after the doctors presume the diagnosis by history from the patients, examination and the ultrasonography reports.
Endometriosis is a peculiar condition in the sense that women with severe endometriosis may not have any symptoms, while women with very mild disease may have severe pain or infertility.
How endometriosis is treated, in general?
As mentioned earlier, endometriosis does not always cause symptoms and so, it does not always need treatment. The common reason for treatment is presence of pain and infertility. Endometriosis-related pain is usually treated by medicines or sometimes by surgery. Before surgery, usually medicines are given to reduce the size and to reduce the blood loss during surgery. All these medicines can cause hormonal imbalance and thus deprives the endometriosis tissues of hormonal stimulation and thus reduces pain. As a result, during the treatment, patients usually cannot conceive because of this intentional hormonal deprivation. Unfortunately after stoppage of medicines, often the symptoms of pain come back.
Surgery for endometriosis is usually done under laparoscopy but it needs properly trained and skilled surgeons to do these operations. Operations can range from “minor” (like separating the adhesions, draining the chocolate coloured fluid) and “major” (like removing the cyst or removing major organs). The surgery has the advantage over medicines is that it confirms the diagnosis and removes the diseased tissues. But there are problems with risks related to anaesthesia and surgery. In particular, there is risk of injury to intestine and urinary tracts, even with the best hands, that may increase patient’s sufferings. Apart from this, even after surgery, the disease can come back again after few months or years.
What is the cure for endometriosis?
Only cure for endometriosis is total deprivation of hormones. That is possible if the woman attains menopause (permanent cessation of menses). This is possible by natural way (around 45-50 years of age when menses cease permanently) or by operations to remove the ovaries and uterus. Another simpler way is achieving pregnancy, as usually after pregnancy most endometriosis patients feel better in relation to pain.
What happens if it is not treated?
Endometriosis is not like cancer. It is not life threatening usually. That means it will make you suffer in the worst way by causing severe pain and infertility but cannot endanger your life. So, you can have the options of not treating it, even if you have the symptoms. And of course, if you do not have symptoms, endometriosis may not require any treatment.
What is the treatment for endometriosis with infertility?
First of all, you have to make sure that you have difficulty in conception (that means you have given sufficient time to attempt but failed). Then we have to see whether there is any pain or other problems and what the condition of the disease by examination or ultrasonography is. We also have to look for any additional problems like problems in male partner, problems in uterus or ovaries or the hormones (like FSH, LH, prolactin, thyroid etc).
Then we have to plan the treatment. As there is no hard and fast rule, your doctor will explain you the options for you and you can decide what suits you the most, after judging merits and demerits of every option.
You may choose directly for surgery. In that case, you may be offered medicines for 2-3 months before surgery to make surgery safer for you and easier for the surgeon. The extent of surgery varies, depending on the disease status and your opinion. Remember, your opinion is important. You can choose for extensive operation (that may mean removal of both the tubes, that may be needed in advanced disease, leaving only option for IVF for pregnancy in future) or only diagnosis (just introducing the telescope and see) or minor operations (like separation of adhesions or removal of the cysts), after judging the merits and demerits of each options. But remember, you should not have any medicines for endometriosis after operation as most of the medicines (with some exceptions) interfere with pregnancy. This is, because, after operation is the best time to conceive and that time gives you the highest chance for pregnancy. If natural conception (or 1. ovulation induction- giving medicines to stimulate growth of your eggs, or 2. IUI- inserting your husband’s sperms by special process inside your uterus) does not occur within 12 months after operation, that’s probably the best time to consider IVF (“Test tube baby”). Of course, if you had extensive surgery or have advanced age (more than 35 usually), your doctor may advise you to go for IVF directly after operation without wasting the time.
You can opt for trial of treatment by medicines. You must know why I have used the word “Trial”. This is because, during medicine treatment, you cannot conceive. But you will be seen after 2-3 months to see if the disease has disappeared or decreased in size significantly. If this is the case, you can start infertility treatment (Ovulation Induction or IUI or IVF in some cases) directly. But if the disease did not respond to medicines by this time, you may need surgery, the extent of which has been described above.
You also have the options of not treating endometriosis at all. In that case, you can request your doctor to start infertility treatment directly. But remember, endometriosis (even treated endometriosis- after medicines or surgery) can interfere with any form of infertility treatment. It can lead to decreased response to medicines used for ovulation induction, thus reducing success rate(normal success rate is 20-25% in a menstrual cycle- that is without endometriosis). It can lead to low success rate after IUI (normal success rate is 25-30% in a menstrual cycle). Even with IVF (where normal success rate is 40-50% per cycle of IVF), the effectiveness of IVF may be reduced in presence of endometriosis.
What if I do not go for any treatment at all?
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 meantime, they conceive naturally. That means even without treatment, there is some chance of pregnancy. But that chance decreases in presence of any disease (like endometriosis) or increased age. And of course, nobody usually relies on chance. But the important message is that do not forget to have regular sexual intercourse eve if you are awaiting any test or endometriosis treatment. 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.
How to make your menstrual cycles regular- 8 simple ways
How to make your menstrual cycles regular?
In our clinics everyday some patients at different ages will come with complaint of irregular menstrual cycles. But there are other patients who feel embarrassed to seek doctor's help for this problem. While it seems to be a simple problem related to reproduction only, often it is associated with diseases that are matter s of concern.
First, you should know what is meant by the word "irregular"? In most women period occurs at interval of 28 to 30 days. But it is said to be normal if it happens every 21-35 days. That means you should have periods not more frequently than every 3 weeks or not less frequently than every 5 weeks. But if you had previous cycles at interval of every 4 weeks but now you are having periods every 5 weeks, that is ABNORMAL, although it is occurring every 35 days. In other words change in interval up to 7 days is normal, nit beyond that. For example, if you had periods every 30 days previously and for last 2 months it is happening every 33 days or every 25 days, then it's normal. But if it happens at interval of more than 37 days (30 + 7) or less than 23 days (30- 7) then it's of course abnormal.
So what are the things you can do for regular periods.
1. Normal weight
Ideal weight varies according to the height. We express it in terms of BMI (Body Mass Index) that is the weight in Kg divided by square of the height in centimeters. Ideal BMI should be between 19 to 25. If it's more than 25, reduce weight by diet and exercise. IT can resume normal menstruation without any drugs. IF despite your sincere efforts, you are unable to lose weight or even after normalization of weight menstruation remains irregular, you must consult your gynaecologist for treatment.
On the other hand very low BMI can also cause irregular menses. Treatment is weight gain. This is often seen in athletes and they are even at risk of losing bone calcium because if excessive exercise and strict diet control. If gaining weight does not help, you must consult your doctor for having regular periods.
2. Stress, Anxiety, Tension, Depression
These are inevitable part of modern lifestyle. These may not only cause mental problems but will also cause physical problems by altering the hormone levels. The result is abnormal menstrual cycle. Try to avoid them by relaxation, counseling and if necessary by taking help of doctors.
3. Thyroid disorders
4. Pituitary disorders
Pituitary gland is a gland situated inside the brain that controls hormone of other gland s of the body. If there is some tumour or some abnormalities in its function, there will be high lebel of prolactin hormone secretion or there will be deficiency of hormones like FSH and LH. As a result ovaries cannot produce enough hormones and you will have irregular menstruation. So in case of abnormal menstruation, please Check your prolactin level.
Polycystic Ovarian Syndrome is common nowadays. Apart from causing abnormal menstruation, it increases risk of infertility, high blood pressure, diabetes, heart disease and even cancer. It is diagnosed by clinical features, hormonal tests and ultrasonography. It may also cause weight gain, male like growth of hairs in body and oily skin. The treatment is weight control and drugs to regularize menses. This is particularly important in young women an teenagers, in whom timely treatment can prevent many serious consequences.
6. Premature Ovarian Failure
In some women menopause can come earlier and irregular menstruation may be the early indication of this. This may be followed by permanent cessation if periods. So if you are planning for family expansion but have irregular menses, do not delay pregnancy.
7. Problems in uterus
Excessive trauma to uterus by repeated surgical abortion or infections like STD r tuberculosis can damage the lining of uterus. The result is irregular menses followed by total cessation of menses. But this problem can be easily treated if you consult your gynecologist in time.
8. Systemic diseases and drugs
Irregular menses should never be ignored. Sometimes it may be because if so e undiagnosed diseases like diabetes, diseases if heart, liver, kidney, chest etc. Often it may be the side effect if the drugs you are taking- like antacids containing domperidone, psychiatric drugs, Steroid s or chemotherapy.
In conclusion, irregular menstruation may sometimes warn you about serious disease s and may be associated with infertility and early menopause. Stay health y, have health y diet and lifestyle, maintain normal weight, get rid of tension and attend your doctor's clinics in time.
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
What is Infertility?
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. Examples 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.
How Sexual Disorders are related to Infertility?
Sex and fertility are not the same thing. Couples with normal sex life may have difficulty in conception (for example couples with PCOS or low sperm count). On the contrary, couples with normal fertility may have sexual disorders. Sexual Disorders and infertility may be related in two ways.
Firstly, the stress of infertility starts to exert its adverse effects in conjugal relationships. Most of the couples, who had very satisfactory sex life, start to lose interest in sex. They feel sex as a “mechanical” tool whose sole aim is only to achieve pregnancy, in contrast to their life just after marriage, when sex was perceived as an expression of love-making process. The continuous advice from doctors, “you should have regular intercourse” makes the scenario worse. Some of them can feel other problems like erectile dysfunction, ejaculatory problems, painful sex, vaginal dryness etc. Remember, this group of couple never faced sexual dysfunction in earlier part of their life.
But, here we concentrate on second group of couples, who had sexual dysfunction from the very beginning. They did not have penetrative intercourse long time after marriage. Initially they ignore the problems because of pressure from professional field and some of them feel too shy to consult doctor for this problem. But when they themselves want to plan for a baby, or due to pressure from the family, they start to realize the importance of having a good sex life. At this point, most of them consult doctor to find the solution. But the problem seems more complicated than the couples in the first group (above paragraph). This is because, the doctors have to treat two problems together- sex and fertility. Apart from the problems in sex life, the stress factors also come into play.
Again, there are some couples, who come to our clinics earlier. They find problems in sexual intercourse but are not planning for pregnancy right now. In these cases, the treatment is relatively simpler, as we get ample time to correct the problems, to help them conceiving naturally.
What are the common types of sexual disorders that can prevent conception?
In simple words, absence of penetrative intercourse will prevent pregnancy. It may be problems due to lack of desire or problems in physical performance.
Few men and women do not feel any urge (libido) to have intercourse. Others may have the libido but find problems because of erectile dysfunction (lack of hardness) during intercourse. Uncommonly, some men may be able to insert the penis inside the vagina but cannot ejaculate (discharge) the sperms during intercourse. Some women may feel severe pain during attempted intercourse, that prevents them to participate in it.
What are the reasons behind sexual disorders?
It’s a common misconception that all the sexual dysfunctions are due to psychological factors. Indeed, most of such problems may be related to some physical factors.
Life-style factorscontribute a lot. Stress due to various reasons (financial, professional, family related) affect sexual performance and libido. People working in stressful life, particularly marketing, banking and IT sectorsare badly affected. Previous “bad” experience with sex (like previous history of erectile problems, pain, bleeding) often come into play and this performance anxiety makes the situation worse. Relationship conflict also plays important role. Excessive use of alcohol can affect the orgasm and erection. Smoking, apart from its harmful effect on fertility, can affect libido, erection and orgasm. Excessive use of caffeine can also be responsible. Some medicines, particularly medicines used to control blood pressure and abusive drugs like cannabis can create such problems. Excessive weight can affect libido, erection, ejaculation, vaginal dryness and orgasm; in addition to delay in conception.
Sexual dysfunction can be the first sign of serious diseases like diabetes. Other hormonal problems like imbalance in sex hormones (low testosterone in male and female, low estrogen in female, high estrogen in male), high prolactin, thyroid diseases can be responsible for sexual problems and are easily treatable.
Diseases of heart (high blood pressure, heart failure), liver (cirrhosis), kidney (renal failure), nerves (diseases in brain, spinal cord) and blood (sickle cell disease, anaemia) can be responsible for sexual problems. This is another reason, why people with sexual disorders should not think that it’s a disease of reproductive system only.
Some operations (in spine, abdomen, pelvis, hernia, vagina, scrotum) and injuries (spine, pelvis) can have long-lasting serious side-effects on sexual function.
Infections, tumours, endometriosis can be responsible for pain and bleeding during intercourse.
Finally, lack of proper technique, improper knowledge and unrealistic expectations are also responsible.
In general, what are the treatment options for sexual disorders?
The first and foremost action is to find out the underlying cause responsible for sexual dysfunction. That’s why its important to have thorough check up by doctor to find out the cause. The check up includes asking question by the doctor (history taking), physical examination and then if needed, some tests (like blood, ultrasoundetc). It’s important for you to be honest and to disclose all your problems and raise any concerns to the treating doctors.
If the cause is found, the treatment is simply, the correction of the cause, if possible (like correction of blood sugar in diabetic patient).
Even if no cause is found or when the cause cannot be corrected, the couple can have satisfactory sexual life. It involves proper counseling and sometimes “sensate focusing” (initial focusing on perception of the touch, rather than intercourse). Stress reduction and life-style modification (controlling weight, stopping smoking, reducing alcohol) cannot be overemphasized.
Pelvic floor exercise (“Kegel’s exercise”) can help both men and women to improve blood flow to pelvic organs and optimize the pelvic muscle functions, thus in turn, improving sexual function.
Next comes the role of medicines. There is a common misbelief that sexual dysfunction can ne corrected by steroids only. This is totally wrong, because steroids can rather worsen the sexual problems. Another misconception is that, once started, you need to take medicines throughout the life. The fact is that majority of the patients need medicines only for the time being. Majority of the couples respond well to these methods of treatment.
In very few cases, some additional measures can be needed like corrective surgery or vacuum device for erection problems.
What are the options for fertility treatment in presence of sexual disorders?
As mentioned before, if a couple with sexual problems want pregnancy, the doctors have to deal with two problems- sexuality and fertility. So, proper investigations are needed for both, to find out the cause. Then the treatment decision is taken, based on age and weight, underlying problems, how severe is the sexual problems, the treatment response, affordability and of course, the wish of the couples.
The first step treatment, is obviously to trying for natural conception, by regular penetrative penile-vaginal intercourse. So, the first line of treatment is to correct the sexual problems, as mentioned in the above section. Majority of the couples can have successful sex life after proper treatment and a large number of them conceive in the course of time, provided there is no major fertility problems (sperm, fallopian tubes, uterus, ovaries). If they fail to conceive, the treatment is just like other couples (those without sexual problems). That is, they can be offered ovulation induction, intrauterine insemination (IUI) and in vitro fertilization (IVF).
However, if the sexual problems cannot be corrected, this is not the end of the world. If the man can collect sperm by masturbation, he or the female partner can perform self-insemination. This can be done at home by the couples and can be coordinated with ovulation time and, even with ovulation drugs. This has success rate of 15% per cycle per couple (if 100 couples are trying it, in one month, 15 can conceive).
If self-insemination fails, or is not possible (for ejaculation problems), or is not acceptable to the couple, the option is IUI. For men with ejaculatory problems, sperms can be collected by Vibro-ejaculation (putting a simple instrument over penis, without pain) or by collecting sperms from the urine which is taken immediately after masturbation (‘post-masturbation urine’- for retrograde ejaculation). IUI has the success rates of 20% per cycle, depending on the age, sperm count and other fertility factors. For women feeling severe pain during intercourse, IUI can be done under anaesthesia.
Self-insemination and IUI can only be successful in couples with normal fallopian tubes (at least one tube must be open), normal perm count or sperm counts mild to moderately abnormal, normal ovulation or ovulation done with medicines (as in PCOS). However, if these are not possible, because of fertility factors (very low sperm count, tubes blocked) or IUI fail, then the option is IVF. In one IVF cycle, 40% of the couples conceive in average. IVF can even be done, in men having no ejaculation but who can produce sperms inside the testes (by putting needle in the scrotum).
In very few cases, when these treatment options are not feasible, donor sperm, donor ovum or surrogacy treatment can be done.
What are the reasons behind low sex desire (Libido) in men or women?
The main reasons are life-style factors, hormonal imbalance and anxiety for poor performance.
How low libido is treated?
Treatment is simple, as stated above. It includes life style changes, sensate focusing and correction of the underlying disease.
How can a person with low libido become a parent?
Majority of the couples can conceive naturally after successful treatment of low libido. If the above-mentioned measures fail to correct the libido, then self-insemination, IUI or IVF can be done, depending on the cause.
What are the reasons behind Erectile Dysfunction (ED) in men?
The main reasons are life-style factors, hormonal problems, disorders in heart/ nerve/ blood, operations or injury; as mentioned earlier.
How ED is treated?
Majority of the men respond well to the correction of underlying cause, stress reduction, life style changes, Kegel’s exercises and medicines.
How can a man with ED become a father?
If the treatment of ED is successful, the couples can conceive naturally. However, if these fail, they can try self-insemination, failing which IUI, and occasionally IVF need to be done.
What are the reasons behind Ejaculatory Problems in men?
Ejaculatory dysfunctions are not common, apart from premature ejaculation (discussed below). It can be due to anxiety, diabetes, problems in nerves or prostate gland, after surgery or operation in spine or pelvic area and sometimes infection.
Majority of such men are able to ejaculate during masturbation or are feeling normal nocturnal emission (“night fall”) but fail to do so during intercourse. In these cases, usually no definite cause is found. This is called “situational anejaculation”. A portion of them can have ejaculation with some particular partner, but not with other(s).
Few men are suffering from “absolute anejaculation”. This means, they cannot have ejaculation during masturbation or intercourse. The cause is usually related to problems in nerve, diabetes, surgery or injury. A portion of them may have “retrograde ejaculation”, that is, during orgasm, the sperms are carried back towards urinary bladder (the sac that stores urine), rather than towards the penis. A post-masturbation urine sample can reveal sperm in such cases and diagnoses this condition.
How ejaculatory problem is treated?
Unfortunately, ejaculation problem is somehow difficult to cure. Some medicines can help few men. Vibroejaculatorcan be helpful in some men.
How can a man with ejaculatory problem father a baby?
Ejaculatory problems may not be cured, but such men can father their own baby. This is possible by collecting sperms by various means. If he can masturbate, self-insemination is possible. Alternatively, with vibroejaculation, sperms can be collected at home and self-insemination can be done. IUI and IVF are also possible in such cases.
However, if there is no ejaculation during masturbation, post-masturbation urine can be tested and if there is adequate number of sperms (Retrograde Ejaculation), IUI can be done. If the sperm counts are not enough, a special form of IVF (ICSI- Intra-cytoplasmic sperm injection) can be done.
Even if post-masturbation urine reveals no sperms, the sperms can be collected from the testes and ICSI can be done successfully.
Thus, although ejaculatory problems are uncommon and are difficult to treat itself, successful conception is quite possible.
Can Premature Ejaculation (PE) be related to Infertility?
Premature ejaculation is usually not a cause for infertility, though it can cause inadequate satisfaction during intercourse.
However, if the PE is severe degree, that means the sperm is discharged before vaginal penetration, it ca cause problems in conception. Sometimes, it can be due to some problems in the penis (opening not in proper place- hypospadias). In such cases, if conventional treatment of PE (exercise and medicines) are not helpful, self-insemination, IUI or IVF can be done successfully.
What are the reasons behind painful intercourse in women?
The reasons are mostly related to anxiety or fear. It can be due to some factors like vaginal dryness (when ovaries are not functioning properly, some medicines or local glands are not working) and infection (including sexually transmitted infections). If the pain occurs at deep penetration, it may be due to some tumours (occasionally cancers) in cervix, uterus or ovaries, infections, endometriosis and enlarged ovaries.
How painful intercourse is treated?
Again, the treatment depends on the cause. Counseling, sensate focusing, life-style changes play important role. Medicines and hormones are helpful in selective cases.
How can a woman with painful intercourse get pregnant?
It’s important NOT to use any vaginal lubricants (including saliva) as any lubricants can potentially kill the sperms. However, some external moisturizers are there, which are sperm-friendly. If the simple measures fail, IUI can be done under anaesthesia. IVF can be done if IUI fails or is unacceptable.
Will my problem in conjugal life remain confidential?
Yes, except you and your partner and the treating doctors, nobody else (even your parents or friends) have any right to know about your personal life. Self-insemination can be done at home, without going to clinic, thus maintaining your privacy. If you have to go for IUI or IVF, you will be treated just like other couples (who fail to conceive despite normal sexual life)
How such problems are treated in the clinic of 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.
We try to find out the root cause of the problems in the couples and try to solve them first. If that is possible we encourage them to try for pregnancy naturally. If these attempts fail, we discuss with the couple, the options, that include self-insemination, IUI, IVF and ICSI. We do not pose any of our decision on the couples, rather we discuss with them and help them to make their own decision.
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. Sexual problems are not uncommon but are easily treatable. Pregnancy is quite possible in couples who are not able to have penetrative intercourse.
Most of us have an idea that the couple should go to gynecologist only after they fall pregnant or when there is difficulty in conceiving. But we all know that prevention is better than cure. Then why should not we take precaution to avoid complications in pregnancy so that we can have healthy mother and healthy baby.
- Some of the diseases can manifest during pregnancy, like some diseases of heart, blood pressure, blood sugar etc. But if the couple comes to doctor when they are planning pregnancy, then we can diagnose it and start treatment so that pregnancy can be safe to both the mother and the baby.
- On the other hand, some pre-existing disease may turn serious during pregnancy and endanger life of both mother and baby. This includes thyroid disease, hypertension, epilepsy, renal disease, cardiac disease etc. If taken care of properly, the disease can be controlled before pregnancy so that the risk can be reduced. Again all the drugs are not safe for the baby. So, if treated before pregnancy, the mother can be put on safer but effective drugs before pregnancy.
- Some diseases may run in family and often goes undetected and can affect the baby. Thlassaemia, hemophilia etc are the best examples. So, if the couple comes to us before pregnancy, we can screen them to diagnose whether they are bearer of the disease or not and then we can take care to prevent birth of defective baby.
- Some diseases indicate that there may be problems in having pregnancy, like problems in periods or abdominal pain in female, sexual problems in male and female etc. If treated properly, it will avoid unnecessary time wastage for trying for pregnancy.
- The woman can be instructed how to remain healthy to have normal baby, before pregnancy. She can be advised some drugs (like folic acid), can be asked to avoid harmful drugs and substances (like drugs, excessive vitamin a, excessive vitamin d, excessive caffeine, smoking etc). Even the husband can be asked how to improve his fertility (by avoiding heat exposure to his scrotum).
- Again some infections can be dangerous for the baby. So, before pregnancy we can treat the women for the infections and in some cases we can vaccinate her to prevent infection.
- "a stitch in time saves nine. So, why don't you consult your gynecologist when you are planning for pregnancy? have smooth journey throughout pregnancy and enjoy parenthood.
Today 25th May is the World Thyroid Day. Thyroid disorders are one of the most common disorders of hormones in our body. Thyroid is a small gland situated in front of the neck and secretes hormones like thyroxine (T4) and tri-iodo-thyronine (T3). These hormones control various functions of our body like heart, blood pressure, digestion, metabolism, growth, blood formation, brain function etc. But one of the most important function is its association with reproduction.
In both sexes, T3 and T4 are needed for sexual development during puberty so that full maturation from a child to adult occurs. That means development of hair (pubic and axillary hair), beard and moustache in boys, breast in girls, genital organ development in both sexes and menstrual function are dependent on thyroid gland. Finally production of eggs (rather maturation and release) and sperms are also related to it. In adults, thyroid function is needed to maintain the functions of sex glands particularly ovaries and testes. Desire for sex (libido) and performance of sex are also related to thyroid function.
The thyroid glands in turn is regulated by a hormone secreted from pituitary gland, located inside the brain. That hormone- TSH (thyroid stimulating hormone) controls secretion of T3 and T4., Thyroid gland may be affected by various diseases like autoimmune diseases (body itself destroys its organs), deficinecy of iodine, radiation, tumour, congenital causes (cause present from birth) and certain drugs. The result is that thyroid hormone seceretion may be reduced (hypothyroidism) or increased (hyperthyroidism). As a result, blood tes