Shrishti Fertility Care Center & Women's clinic

Hello friends,

I am Dr. Jayanti Kamat, director of Srishti Fertility Care Centre and Women's Clinic I am an IVF Consultant, an obstetrician and gynecologist practicing for the last 20 years.

So today I will be talking about Cancer of the cervix, Cancer cervix is the commonest cancer found in Indian women after breast cancer. Every year according to WHO studies 1, 24,000 cases have been detected and annually there are 64,000 deaths, so cancer cervix is a very deadly disease. So what is this cancer cervix, the cervix is the mouth of the uterus? Now, what are the causes of Cancer cervix there are many causes of Cancer cervix but the commonest cause is a virus called as HPV or Human Papilloma Virus, now this virus is responsible for 70% of cases of Cancer cervix. HPV is a very common virus it is usually contracted during sexual intercourse so what does this HPV virus do, it enters into a normal cell and it changes the mechanism and the machinery inside the cell and once it changes the mechanism in machinery of the cell, the cell start behaving little differently and then these abnormal cells they multiply and once they multiply they form a tumor called as cancer cervix. Now, what are the other causes of Cancer cervix that is an early age of marriage then repeated pregnancies the more the number of pregnancies more is the incidence of Cancer cervix, then sexually transmitted diseases, smoking also increases the incidence of cancer cervix? Now this HPV virus it is not that every woman who is infected with HPV virus will develop cancer cervix it all depends on the dose of the virus which infects the cells and the immunity of the person as well. In some women the HPV infection becomes a self-limiting disease in the sense, it gets cured by itself. And in some women say after the period of 5, 10 or 15 years it can cause dysplasia or changes in the cells which later on formed cancer cervix. Fortunately, friends, cancer cervix is one of the few cancer which can be detected at an early stage very easily and how can we do it, there is the simple test called for Pap Smear and also we do have vaccines as of today or HPV vaccines which helps to prevent this HPV infected cells to get converted into cancer. HPV vaccine, now this HPV vaccine is one of the few vaccines which have been invented for the prevention cancer, so we are lucky to have such a vaccine. So this vaccine it has to be given to all girls between the ages of 9 and 26 days before they become sexually active. So this vaccine will prevent the HPV cells from HPV infected cells from developing into cancer there are three roses of this vaccine which have to be completed within 6 months. Now what is this Pap test is a very simple test it can be done on a small clinic or in a big hospital it can be done anywhere, it is an OPD procedure the patient does not have to go for fasting nor it is painful, nor does it required anaesthesia. So when should this Pap test is ideally done, Pap test should be ideally done after menses preferably between the 5th and 10th day of menses and what should you expect during the Pap test procedure the gynaecologist will examine you and take a few cells from your cervix with the help of a spatula and then send those cell to the pathologist for examination. So by examination these cells the pathologist will know whether the cells are normal or abnormal. So what are the advantages of Pap smear so when the gynaecologist examine you she or he will also find out whether your cervix is normal or whether the cervix has Erosion. So this erosion can also cause white discharge so what is that erosion the cells from inside the cervix they just come out so the treatment for this erosion can be done by cautery or just burning the tissue. The gynaecologist will also see that if you have some cervical polyp that also will be visible during the Pap test procedure. So if the polyp is there the polyp can be removed at the same sitting. Now, what is the Pap test come abnormal, the next step will be colposcopy. What is colposcopy? Colposcopy is when the cervix is visualized with an instrument called as colposcope which magnifies, which gives a very magnify review of the cervix. So what does the doctor see through the colposcope, the doctor will see whether the cells are normal or abnormal, there are different criteria blood vessels, the pattern of blood vessels etc and by observing all these things the doctors will be able to make out whether there is some suspicious area which is indicative of malignancy. So from such a suspicious area the biopsy is taken and the biopsy is again sent to the pathologist, so ensure the biopsy will be the test in which we can find out whether the lady has cancer or not. So now what are the symptoms of cancer cervix, so cancer cervix in its early stage has no symptoms at all and that is why we do Pap smear? Pap smear my dear friends is a screening method and not a diagnostic method, what is the screening method that we try to find out the early stages of the disease even before the patient has symptoms and why do we do that because if this cancer is detected in early stage the treatment is very simple and if it is detected in the later stage, the treatment can get complicated and goes much agony and pain to the patient. Now cancer in the little later stage will give rise to symptoms such as white discharge, blood stained discharge, discomfort, pain during sex, bleeding immediately after sexual intercourse and even with the small gynaec examination also the patient may start bleeding, patient may have swelling of feet, sudden loss of weight or pain during urination so all these can be the symptoms of cancer cervix. So whenever lady has these symptoms she has to go and consult her gynecologist. Now what if the biopsy report comes as positive for malignancy there are various methods in which cancer cervix is treated, one is surgery where we remove the cancerous part. The next is radiotherapy, radiotherapy can be two types of radiotherapy, one is external radiotherapy whereas the radioactive source is kept outside the body of the uterus and there is another method called as the intracavitary radiotherapy whereas the radioactive source is kept inside the body of the lady. Then we have chemotherapy as well or sometimes the patient may require a combination of various therapies. So, friends, it is my earnest request to you please get a Pap test done today itself and Pap smear has to be done once in every 3 years for all women under the age of 40 and after 40 it has to be done every year, the Pap test has to be done every year after the age of 40 combined with the HPV testing as well. So we can reduce the incidence of Cancer cervix by being very vigilant, by following safe practices, by avoiding things like smoking and of course getting a Pap smear and an HPV testing done just as we have eradicated polio from India, I strongly believe that if all of us are vigilant we can surely reduce the incidence of cancer cervix in India today, thank you.

If you have any queries about Cancer Cervix, please contact me on Lybrate.

Hello friends,

I am Dr. Jayanti Kamat, director of Srishti Fertility Care Centre and Women's Clinic I am an IVF Consultant, an obstetrician and gynecologist practicing for the last 20 years.

So today I will be talking about preconception care, the birth of a child is equivalent to planting a tree where we prepare the soil and then sow the seeds and that's not all we have to give it time and nourishment as well. In India, 70% of the pregnancies are unplanned this is occurred by a chance nobody plans for it just happens by itself. So these unplanned pregnancies can cause a lot of problems for both the mother and the baby. People still feel in India that we have to go to the gynecologist in the 7 months of pregnancy ke saatve mahine mein naam dalwane ka hai taki they have to go to the hospital to book themselves for delivery. This concept is not right, we all believe that healthy women make healthy babies so you have to make your body a safe place for your future baby to thrive. So first and foremost is you have to do a lot of introspection about yourself I will talk about age, so today there are a lot of women who are in the workforce they keep postponing the marriage and even if they are married they postpone the childbearing. Why is this a problem because what happens is has a woman grows older her fertility potential keeps on decreasing, her capacity to produce eggs decreases in addition to that the quality of the eggs also decreases. Moreover, if a woman conceives at a later age she has a lot of problems during the pregnancy such as pregnancy-induced hypertension, diabetes, preterm labor, difficult labor, there can be complications in the baby as well, the baby can be born premature or there is an increased incidence of congenital defects in the baby. So, women, today are not aware of all days they feel after they finish all commitments they can think about childbearing. Now when it comes to preconceptions you have to plan 3 months before your actually planning to conceive, so if you have any medical conditions such as hypertension, diabetes, seizure disorder or fit disorders, asthma, anaemia, so all these things have to be taken care of and get treated before you even plan to conceive. So don't just conceive preconceive. Then the next is medications ok, so some medication may be quiet safe during pregnancy, some medications are an absolute no-no during pregnancy because they may cause birth defects in the baby and some medications their doses need to be adjusted so as not affect the foetus. So you must be aware of all these things and you have to consult your treating physician and tell him or her that you are planning to conceive and whether the medication can be adjusted and the doses can be adjusted. The next is immunization, usually by this age women are more or less immune to all diseases but if she gets tested for rubella or she is not immunised to rubella then she should get immunised in this period, other immunizations are like Hepatitis B and chickenpox or varicella zoster is equally important because if the women contact these diseases during pregnancy, it is going to be very difficult. Then comes to the lifestyle factors, what are the lifestyle factors your food habits so if you have used to junk food you have to stop eating junk food, eat a very healthy diet, then exercise also exercise reduces the stress level and the fit women will be able to manage her labour pains in a better way. Now coming to weight issues, even if a person woman is underweight she has problem during pregnancy she can give rise to a growth retarded baby and if a woman is overweight before pregnancy again that also can lead to problems because every woman will put on certain weight during pregnancy that is normal that is physiological, but if a woman is overweight before pregnancy she has to compact her weight which is normal for her height by following a sensible diet and exercise regime because if she is overweight she is more prone for pregnancy complications like PIS or Pregnancy Induced Hypertension, diabetes, difficult labour etc. When they are planning to conceive you should also supplement takes supplements of Folic acid .4 milligram along with other multivitamins because this will help to prevent any neural defects because spine is the first thing which is formed in the body, so if there is deficiency of Folic acid there could be a problem in the sign of the baby. Last but not the least men also matter, preconceptional care is not definitely restricted to women alone men have to take care of themselves because their overall health will reflect on the sperm. So a man also has to take control or give up smoking and excessive alcohol or substance abuse, decrease stress levels and inculcate healthy food habits and exercise into its regime. So when it comes to substance abuse suppose a woman is used to smoking or alcohol she has to control this the smoking can have a detrimental effect on the baby, you have to even think about your work life balance how we are going to adjust once the baby comes and develop a good support system as well. You even have to think about your finances and have a proper financial planning in place before you have a baby. Then coming to a family history, family history is whether anybody in your family has had a congenitally abnormal child or whether there is any disease which runs in the family, for example, Thalassemia and your previous reproductive history, that suppose you have an abortion or repeated abortions so these things also have to be taken care off. Then your menstrual history, now menstrual history is very closely related to your fertility status so you have to keep a track of your menses. Nowadays we have so many apps which help you to keep a track you have to note whether your menses are regular or irregular if they are irregular that means that you are not ovulating properly it could be PCOS as well, then coming to the menstrual flow is it very scanty or very less or is it more, so if it is more if it is associated with pain it could mean that you could have a fibroid or suppose you have a very painful menses or you have pain which stops just before menses, it could mean you are suffering from endometrosis or a pelvic inflammatory disease. In spite of following all these precautions if a couple cannot conceive after one year they need to seek the services of a fertility specialist and if the women's age is more than 32 years and even if she's married for less than six months she has to get a fertility status evaluated and seek the help of the fertility specialist.

So friends don't conceive preconceived and before you think of a baby please do plan for it so that you can avoid complications during pregnancy, during labor and can have a healthy and bubbly child, happy parenting.

If you have any queries contact me on Lybrate.

Hi,

I am Dr. Jayanti Kamat. I am an IVF consultant, obstetrician and gynaecologist practicing for the last 20 years, I am practicing at Shrishti Fertility Care Centre and women's clinic. Today I will be talking about vaginal discharge, now vaginal discharge is a very common complaint, women of all ages complain of vaginal discharge. So what exactly is it, sometimes it is usually termed as Leucorrhea also. Now the complaint of discharge depends very much on the ideas, observation power and fascinated illness of individuals with women, now this vaginal discharge normal or abnormal should there be vaginal discharge at all. so scientifically the private parts that are the vulva and vagina are normally moised to some extent and this makes the woman comfortable, usually does not stain the under clothing but there are certain conditions in which the vaginal discharge is increased due to hormonal imbalance. So what are those conditions that is at the time of ovulation the discharge suddenly becomes watery a few days before menses it may also become then it becomes thick then it becomes take during pregnancy, after sexual intercourse and excessive discharge is seen in young girls just before they start their first menstrual period and a few years after they start their menstrual period. It is also increased in women who take oral contraceptives or birth control pills. A word about regular douching some women are under the misconception that regular douching improve genital hygiene, however washing away of natural discharge encourages the cervix to produce more discharge. Women magazines sometimes they advocate Deodorant product to sprayed on the private parts and vagina and valva to promote sexual attractiveness but on the contrary the chemicals which are present in this deodorant sprays, they irritate the skin and douching washes away all the protecting lactobacilli alters the pH and there are more chances of the women getting infection. Now what is abnormal discharge, so when can we say that the discharge is abnormal, if the discharge is accompanied with itching or redness, it causes a lot of irritation, unpleasant order or smell, burning sensation during urination, whether the colour of discharge if it is curd-like or yellow or yellowish green and if it is associated with pain during intercourse or dyspareunia. Now what are the causes of this abnormal discharge lot of women ask me why do we get this discharge and I keep myself so clean, so some of the causes are one, of course, it is poor hygiene then sexual intercourse with the Infected partner, public toilets repeated use of public toilets then douching has I have already mentioned, once you start destroying the natural perry of the vagina the women will be more prone to infection and cancer that we should never forget cancer or cancerous growth also give rise to discharge, so if the discharge is blood stained you have to be careful. Now, why should we pay so much attention to vaginal discharge because if this discharge is not treated, it can lead to complications? So what are those complications one is the pelvic inflammatory disease called as PID so here the uterus the tube and the entire reproductive tract gets infected? Then abnormal changes in cervix or mouth of the uterus now this abnormal changes can cause cellular changes, dysplastic changes and later on lead to cancer changes. Now, what about abnormal vaginal discharge in pregnant women does that affect them, yes, of course, it affects then it can cause premature rupture of membrane or the rupture of a bag of water even before the labor pain start or even before delivery. Now, this pack of water is supposed to be a protective shock absorber for the foetus and it protects the foetus from external infection. So when this bag of water ruptures the foetus will be prone to infection and the pregnancy will be at risk. The preterm delivery, what is preterm delivery? if the women deliver before nine months obviously she is going to run into complications, then chorreoamnoities i.e. infection of the Placenta and the fluid which is surrounding the foetus, endometriosis that is an infection of the lining of the uterus. Now, what is the treatment first and foremost self-medication is a straight no why you cannot see your neighbors prescription or your friends prescription and get yourself treated for vaginal discharge no, you have to get examined by a gynecologist she will ascertain the cause for your discharge and treat you accordingly. So how do we treat we usually give antifungal tablets or antibiotic tablets depending upon the cause of the infection, sometimes the treatment of the partner is also necessary to avoid the Ping Pong of infection between the partners. Then suppose a woman is suffering from chronic cervicitis or cervical erosion there are other modalities of treatment such as cryotherapy, laser cautery, then if a malignancy is discovered the treatment of malignancy will be something which is very specialized. Now what you have to do to prevent such type of vagina infection first and foremost routine cleanliness always use cotton underwear which can absorb the discharge avoid synthetic material nylon and avoid douching as I already mentioned because douching destroys the normal barriers of the vagina and makes it more prone for infection, you should avoid any type of sprays, deodorant sprays, safe sex practices and of course general health care and good nutrition which will allow you, which will give you immunity against the diseases. The very important point do not use very hot water to clean your private parts some people feel that if they use hot water they can clear away the infection very easily no and because of vaginal skin and mucosa is very delicate you can use lukewarm water or the tap water. Similarly, do not use medicated soaps like Dettol or Savlon, you can use a mild to mild soap. The thing here is you have to keep the area dry so you can just use a soft tissue paper and just pat it dry, you should not rub the private parts because again it cause the excoriation of the skin and make it more prone for infection.

So please do keep these tips in mind.

Thank You.

Hi,

I am Dr. Jayanti Kamat. I am an IVF consultant, obstetrician and gynaecologist practising for the last 20 years, I am practicing at Shrishti Fertility Care Centre and women's clinic. So today I will be talking about what to do if you are planning to have a baby, but have a difficulty in conceiving. If you're married for more than 1 year you are being tried for a baby for more than 1 year having regular sexual intercourse and not using any contraceptive then it is defined as infertility, at that time you should seek the help of infertility specialist or if the women’s age is more than 35 years and if she is married for 6 months she should seek the services of an infertility specialist. So why do we say the age of 34 years or 35 years is important that is because after the age of 30 a woman's reproductive capacity keeps on declining, so when the woman who is over 35 years it will affect her quality of oocytes, the quantity of oocytes and even if she gets pregnant there are more chances of genetic abnormalities in the baby like down syndrome, besides this she can have complications in pregnancy like pregnancy-induced hypertension, gestational diabetes, preterm delivery, premature rupture of membranes and difficult labour. So age is very important as far as infertility management is concerned. Now, why is infertility increasing has of today that is because of increasing age of marriage, postponement of childbearing, increased incidence of sexually transmitted diseases? Women today are very much into the workforce and they want to settle their career before they are planning to marry or even have a baby. Now there are two types of infertility that is one is primary infertility when the couple has never conceived and secondary infertility when the couple has conceived a child maybe it could be an abortion, it could be a miscarriage but they cannot conceive again. So when you go to an infertility specialist what do you expect firstly the doctor will take a detailed history, history of your age, your lifestyle habits and the number of times you have relations in a week, any previous treatment, any previous illnesses etc for the women a detailed menstrual history will be taken. So menstrual history like the date when you had the last menses whether your periods are regular. What is the interval between the periods, what is the blood flow during the periods is it less, scanty or excessive or is it painful or do you have pain before menses, all these things will be asked. It’s very important for a woman who is planning to conceive to keep a detailed menstrual calendar. So today we have a lot of apps on your mobile so it's very easy to keep track of your menstrual cycle. Then the doctor will ask you about the number of times you have relations in a week then about your lifestyle habits, diet etc. The next will be a physical examination, now in this physical examination we have a general examination and your specific examination so general examination will be the doctor will examine your blood pressure, pulse, whether you have anaemic or whether you are in a best of health, then a specific examination will be a per vaginal examination. So after finishing this she may advise you ultrasonography, ultrasonography is to know the structural defect in the uterus and as we all know the tubes, the reproductive system in a woman consists of a uterus, the tubes and the ovaries at the sides. Now all of us know that these tubes play a role in reproduction because they are the ones who which transport the oocytes and a fertilization takes place inside the tubes the tubes are very important so we cannot take out whether there is a block in the tubes or not just by doing a play ultrasonography. So there a specific test for that and those test are one is hysterosalpingography, where a die is injected inside the uterus and then an x-ray is taken to know whether the tubes are blocked, whether they are patent or not. In some certain cases when the doctor feels that they need more information about this, he may advise you a history of hysterolaparoscopy. Hysteroscopy is when we put an endoscope inside the uterus through the mouth of the uterus and see the inside part of the uterus, so what do we see when we first see the opening of the tubes, whether the uterus is normal, whether it has a symptom, whether it has a polyp, whether it has a fibroid so all these things can be seen. Laparoscopy is we put in another endoscope through the umbilicus of the women to see whether the tubes are patent, whether the shape of the uterus is normal, whether the surrounding organs are normal. Now this procedure of hystrolaparoscopy is preferably done under general anesthesia, at the most a woman will have to stay for few hours in the hospital or she can stay for the one whole day based on a comfort level. Then the doctor will also advise certain blood, certain blood test one are the general blood test that is the haemoglobin, the urine routine micro examination and the few other test and the specific blood test such as FSH, LH, serum prolactin, your thyroid relating hormone then AMH, so all these tests tell us the capacity of the women to produce eggs and the hormonal status in our body.

If you need any help in trying to conceive, you’re planning to conceive, you're trying to conceive for more than one year but you have not gained any success please contact me at lybrate.com.

Hi, I am Dr Jayanti Kamath. I am an IVF consultant, practising at Srishti Fertility Care Center and Women's Clinic, Mumbai. So today, I will be talking about the physiology of conception or how babies are made. Before we begin I will tell you about few things about the female reproductive system.

So as you can see in this picture this is a picture of the uterus and these are the tubes, the fallopian tubes and this whitish structure over here it is called as ovary. Now this part is the vagina and this is the mouth of the uterus it is also called as the cervix so once again this is the uterus these are the fallopian tubes on either side this is the ovary this is the mouth of the uterus called as the cervix and this is the Vagina. so how babies are made first of all babies are made by the fertilization of an ovum or the female egg by a sperm from the male. So the female eggs are produced in a structure called as the ovary. So what happens every month, the egg is released from the ovary into the fallopian tube and the egg grows throughout his journey through the fallopian tube and after sexual intercourse, the sperms enter through the vagina and they meet the egg in the tube and the egg gets fertilized. It keeps on growing and then the embryo or the baby gets implanted inside the uterus and this baby grows up till nine months till the woman delivers. So this is the physiology of conception now why is this important cause when a woman cannot conceive there can be problems in this entire process. For example where the egg is manufactured that is the ovary.

There can be a problem in the ovary, the woman can have a hormonal imbalance such as polycystic ovarian disease where many eggs are produced but they do not grow or they do not become mature then there can be cysts in the ovary such as endometriotic cyst or any other cyst so these are the problems with the ovary. Then coming to the tubes. If there is any blockage in the tubes the oocyte or the XL will not be able to reach the sperm.

Why the blockage occurs?

Blockage can occur due to any infection called as pelvic inflammatory disease or tuberculosis which is a very common disease in our country. So because of that, the tubes can get blocked. So once the tubes are blocked the oocyte has a problem in meeting the sperm, then the main region that is the inside of the uterus, so there can be problems there also. There Can be fibroids, there can be a septum, there can be polyps or there can be the uterus itself can become a tumour called as adenomyosis. So these are the uterine problems which interfere with conception. Now coming lower down there is a mouth of the uterus which is very important. Suppose the mouth of the uterus is closed or there is a very narrow space over there then again the sperms will have difficulty in entering the uterus.

So these are the various problems in the female reproductive system which interfere with conception.

For more information about this or if you have a problem in conceiving please consult me at lybrate.com.

Thank you.

Causes, symptoms and treatment of Infertility

Hi, I am Dr. Jayanti Kamany. I am an IVF Consultant practicing at Srishti Fertility Centre and Women's Clinic in Mumbai. So, today i'll be talking about Infertility. The problem of infertility is on a steep rise. Some of the causes for the rise in inferility are increased age at the time of marriage for women, postponement of child bearing. Even if a women gets married earlier she postpones her child bearing for various purposes like her career.

Increased stress levels today, increased levels of sexually transmitted diseases and of course Tuberculosis, which is a very common disease in our country. So, who is to be blamed for the infertility. We have found that 3 out of 10 couples are battling with this problem of infertility. 30% of the faults is found in the female, another 30% is found in the male partner, again 30% is found in both partners and about 10-15% cannot be explained because inspite of all the tests being normal, there is no problem which can be found and we call it unexplained infertility.

There are two types of infertility:

1. Primary infertility- Primary infertility is when the couple has never conceived

2. Secondary infertility-  Secondary infertility is when the couple had a child but cannot conceive again, or the couple has conceived, has had an abortion but there is no conception again.

When should a couple consult or take treatment for infertility? 

Usually if the ovum is young, if she is below 28 years she can wait for one year after trying to consult an Infertility Specialist. Even after one year if the couple doesn't conceive inspite of having regular sexual intercourse without having birth control measures they should see an Infertility specialist.

Now there are certain conditions where a couple irrespective of the duration of marriage or age should see a doctor immediately. So, what are those conditions? In the female, if she is having any problems regarding her menstrual cycle, suppose her menstrual cycles are irregular or she is getting very scanty bleeding or scantimensis or she has very severe pain during mensis or otherwise if she had a surgery where her one ovary is removed or a problem of polycystic ovarian disease which is very common today the she needs to see a Gynaec immediately. If she has recurrent abortions, that is, she can conceive but cannot carry the pregnancy to 9 months then definitely there is something wrong with her so she has to consult an Infertility specialist.

What are the causes in a male?

A male, if he has had a surgery in the testes or if he has a history of a disease called mumps in his childhood, or if he has a low sperm count or he cannot feel his testis in his scrotum then he needs to see a Fertility specialist.

For further information on this topic of Infertility or if you are planning to conceive, you can consult me on Lybrate.com.