Dr. Jagdip Shah

Infertility refers to being able to get pregnant after one year of trying. Women who can get pregnant but are unable to stay pregnant are also termed as infertile. Ovulatory disorders are one of the most common reasons why women are unable to conceive and is presen in 30% of women suffering from infertility.

1. Hormonal problems: Ovulation is linked with a complex balance of hormones and any disruption in the process can hinder ovulation. The disruption includes the fact that the ovaries are not producing normal follicles in which the eggs can mature. Ovulation is rare if the eggs are immature and there are no chances of fertilization. Polycystic ovary syndrome is the most common disorder responsible for infertility. Malfunction of the hypothalamus leading to failure in triggering hormonal stimulus to ovaries for egg maturation leading to immature eggs and ovarian failure. Malfunction of the pituitary gland leading to imbalance in hormonal secretion thus causing disturbance in ovulation. This can occur due to physical injury, a tumour or a chemical imbalance in the pituitary.
2. Scarred ovaries: Ovulation failure can also be due to a physical damage to the ovaries. Invasive surgeries involving ovarian cysts leads to damaging or scarring of capsule of the ovary to become due to which follicles cannot mature leading to disruption of ovulation.
3. Premature menopause: Early menopause or premature menopause before the normal age means that the natural supply of eggs has been depleted. This is most common in extremely athletic women with a history of low body weight and extensive exercise.
4. Follicle problems: Infertility is also caused due to non-ruptured follicle syndrome in which women who produce a normal follicle, with an egg inside of it, every month but the follicle fails to rupture. This leads to disruption of ovulation as the egg remains inside the ovary.
5. Others: Treating female infertility by chemotherapy is next to premature ovarian failure by loss of primordial follicles. Sexually transmitted infections are a leading cause of infertility. Tobacco smoking is detrimental to the ovaries and the amount of damage is dependent upon the amount and length of time of exposure of smoke in the environment. Nicotine in cigarettes interfere with the body’s ability to create oestrogen, a hormone that regulates ovulation. In addition, blocked fallopian tubes due to pelvic inflammatory disease or surgery for an ectopic pregnancy also causes infertility. Infertility can also be due to physical problems with the uterus or fibroids of uterus where non-cancerous clumps of tissue and muscle on the walls of the uterus.

Women with infertility should consider making an appointment with a reproductive endocrinologist—a doctor who specializes in managing infertility. Reproductive endocrinologists may also be able to help women with recurrent pregnancy loss, defined as having two or more spontaneous miscarriages.

Pregnancy is the result of a process that has many steps.

To get pregnant

• A woman’s body must release an egg from one of her ovaries (ovulation).
• A man’s sperm must join with the egg along the way (fertilize).
• The fertilized egg must go through a fallopian tube toward the uterus (womb).
• The fertilized egg must attach to the inside of the uterus (implantation).

Prevention-
If you're a woman thinking about getting pregnant soon or in the future, you may improve your chances of having normal fertility if you:

• Maintain a normal weight
• Quit smoking. 
• Avoid alcohol.
• Reduce stress.
• Limit caffeine.

Breast cancer is a type of cancer which occurs due to the development of cancerous cells in a person's breasts. Women are usually affected by breast cancer and breast cancer is one of the most common forms of cancer after skin cancer. Usually fatal if not diagnosed in its early stage, breast cancer is a very serious medical ailment. Read on more to find all about the different symptoms, causes, preventive measures and treatment of breast cancer.

1. Symptoms

Breast cancer has a few distinct characteristics and if you have a few or all the following symptoms you could be more likely to suffer from breast cancer. 

a) The formation of a lump in your breast which is different from the surrounding tissue and usually more thickened.

b) The discharge of bloody fluid  material from the nipples.

c)  Sudden change of the size, shape and appearance of the breast.

d) Certain distinct changes to the skin over the breast for example an indentation in the skin similar to that of a dimple.

e) Appearance of an extra nipple which is inverted.

f)  If the darkened area around the nipples known as the areola is flaking or peeling off.

2. Causes

Studies and researches remain inconclusive on what causes breast cancer. Breast cancer occurs due to abnormal division of the cells located in the breast which over time accumulate and form lumps. They
might spread to other parts of the body. Breast cancer is caused mainly due to a complex interaction of personal genetics, environment and lifestyle choices. Breast cancer can also be caused due to genetics as about 5% to 10% of cases are due to gene mutations which pass onto generations.

3. Risk factors

There are certain factors which increase the probability of contracting breast cancer. Increasing age, personal and family history of breast cancer, obesity, radiation exposure, pregnancy at an older age, post-menopausal hormone therapy are some of the factors that increase the chances of breast cancer.

4.  Treatment

Several forms of surgical methods exist to treat breast cancer. Depending on the condition and spread of the disease a suitable surgery is performed. These include mastectomy, lumpectomy, axillary lymph node dissection and removal of both breasts. Other forms of treatment include chemotherapy or the use of high doses of drugs to destroy cancerous cells. Radiation therapy where X-rays are used to destroy the cancer cells is also effective.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Both women and men suffer from infertility troubles. There are a host of causes that may lead to infertility in men such as lifestyle choices and obesity. Male infertility is characterized by irregular sperm function or reduced sperm count. Infertility has emerged as a common problem as a result of the modern day lifestyle. Extremely hectic schedules, stress, burnout, depression, unhealthy diets; all of these can contribute to fertility issues.

The various reasons for infertility in men are:

1. If you are overweight, then it is time to lose those extra kilos. Obesity leads to a number of health problems, one of them being erectile dysfunction.
2. Various hormonal problems such as complications of the hypothalamus, pituitary and adrenal glands may lead to low testosterone levels in the body.
3. Various infections such as inflammation of the testicles and epididymis that causes blockage of the tubes carrying the sperm can be a cause.
4. Various medications such as using anabolic steroids, antifungal medications and chemotherapy may hamper production of the sperm and thus hit fertility.
5. Both alcohol and cigarettes may cause problems in sperm production, and cause erectile dysfunction. Excessive drinking may lead to complications in the liver resulting in infertility.

The reasons of infertility may range from medical causes to lifestyle choices; some of the causes may be related to the environment. A common cause of infertility is due to problems with transportation of the sperm. These are mainly due to blockages in the tubes that carry the sperm.

Symptoms of infertility in men are:

1. You may experience low libido.
2. Your sperm count may be low.
3. You may experience lumps or swellings in the testicles.
4. Chromosomal complications such as reduced body hair.
5. You may have chronic respiratory problems.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Galactorrhea is not a disease per se, but more of an underlying medical condition or a symptom that involves discharge of a milky fluid from the nipples, which is not the breast milk. It becomes especially crucial owing to the similarity of the two, when breastfeeding the baby is concerned. It may happen even while you are not lactating or not even pregnant, mostly in menopausal women. Strangely, the syndrome has also shown to have occurred to men and children, irrespective of gender.

What are the contributing factors to the development of Galactorrhea?

1. Galactorrhea is a major side effect of certain kinds of medication that leads to hormonal imbalance and ultimately leads to quasi-lactation.
2. Increase in the levels of prolactin can result in Galactorrhea which may be due to a number of reasons ranging from excessive stimulation in the nipples and chest area (during sexual activities), or pituitary and thyroid problems. The former is not a major cause of worry. The latter can be fixed with proper medication.
3. Kidney disease and spinal cord surgery may also result in this phenomenon.
4. Substance abuse and birth control pills may also be responsible for breast discharge.
5. At times, the causes for Galactorrhea may not be certifiably determined.

Various symptoms of Galactorrhea include:

1. Milky discharge from one or both breasts simultaneously.
2. Discharge may be continuous or intermittent.
3. Density and amount of discharge may also vary.
4. In case of women, this may have a direct effect on periods, leading to irregular menstruation.
5. The discharge may occur without pressure or when an external agency is involved.
6. Headaches and worsening vision are also said to occur.

When you experience a nipular discharge, the most common tests you should undergo include a pregnancy test, prolactin level exam, mammography, ultrasounds, even an MRI for the pituitary gland evaluation. Based on the result, your physician prescribes the required medicines or advises you to stop taking a particular medicine that might be causing this discharge in the first place.

In case you have a concern or query you can always consult an expert & get answers to your questions!

The fallopian tubes are not mere passages for the egg to travel from the ovaries to the uterus. It is here that conception occurs and hence healthy fallopian tubes are essential for the fertilization of an egg.  Damaged fallopian tubes are the most common cause of infertility. This damage can fall under three categories-

1. Blocked fallopian tubes
2. One blocked and one open fallopian tube
3. Tubal scarring

The third is usually an effect of pelvic infections or natural healing after a pelvic surgery. Sadly, in most cases, this condition is discovered only after infertility has been diagnosed. Other causes of fallopian tubal scarring include:

• STDs such as chlamydia trachomatis and neisseria gonorrhea
• Adhesions caused by ruptured ovarian cysts
• Appendicitis
• Peritonitis and
• A history of ectopic pregnancies

Fallopian tubal scarring has no recognizable symptoms. Chronic pelvic pain is the only known symptom of this damage and that too can be seen only in severe cases of tubal scarring. On diagnosing infertility, your doctor will perform one of these tests to determine the condition of your fallopian tubes.

1. Hysterosalpingogram: This is a type of X-ray. Your doctor will open the vagina with a speculum and inject a liquid into the uterus with the help of a catheter. If the liquid does not pass through the fallopian tubes, it is said to be blocked. This however does not say much about tubal scarring. 
2. Laparoscopy: A small incision is made below the belly button and a slim, flexible tube with a camera is passed through the incision. This gives your doctor a clear view of the condition of your fallopian tubes. A laparoscopy can also be used to rule out other causes of infertility such as endometriosis or blocked fallopian tubes. 

Treatment for infertility caused by tubal scarring is of two types. 

1. Surgery: This is suggested in cases where tubal scarring is minimal. Depending on the intensity and placement of scar tissue, your doctor may decide to perform one of many types of surgeries. He may choose to remove the scarred section of the fallopian tube, create a new opening (in case of blockages) or rebuild the damaged edges of the fallopian tubes.
2. In vitro Fertilization(IVF): Women with badly scarred fallopian tubes usually have poor chances of conceiving naturally. Hence, IVF is the preferred treatment route. However, your doctor may still advise you to undergo surgery and remove the damaged tubes prior to IVF to prevent the tubes from filling with fluid.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Menopause is a natural change in a female body that occurs after or around the age of 45, when the ability to bear children stops permanently. The fertility diminishes and the menstrual cycle stops. A decrease in hormone production, especially in the levels of estrogen, happens after the onset of menopausal years.

During this time, there are a number of physical changes that take place inside the woman’s body. The noticeable changes happen in the female breasts.

Some visible changes to breasts during menopause

1. Non-cyclical breast pain is mostly not related to menstrual cycle and slowly stops with time.

2. Loss of glandular tissues is common and causes shrinkage in size.

3. With age, the connective tissues also lose elasticity and causes sagging

4. Breast pain could also be due to fibrocystic breast changes

5. There could be a chance of developing breast cancer

6. Density of the glands decreases inside the breasts and fat develops.

It is advisable to get any kind of discomfort examined by the doctor to make sure you are in the safe zone. Hormone replacement therapy (HRT) is not generally advised as it may create hormonal issues in the long run.

It is also important to follow a healthy diet comprising of protein, calcium , magnesium and other vital nutrients as advised by your doctor. Reduction in smoking and alcohol intake is highly beneficial and cuts down risk of major diseases. It is also necessary to exercise, remain physically active and maintain a healthy body weight during this time.

Regular check-ups, mammograms and self-examination of breasts help to diagnose and detect early signs of breast tumours and cancer and are highly recommended, especially for women who are in the perimenopausal and menopausal years. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

There are a few very common things that a man consumes or does every day without even realizing, that they have a tendency to reduce his fertility. These causes start from drinking and could end with something as harmless as caffeine.

Let's see which habits can cause reduction in sperm count thereby reducing fertility of a man.

1. Eating processed meat harms sperm quality.
2. Excessive usage of laptop can also lead to reduction in sperm count because of the heat that a laptop releases.
3. Hormonal imbalance also causes low sperm production.
4. If a man is underweight or overweight, this could also lead to less production of sperm. So, a man should watch his weight before thinking of extending his family.
5. Exposure to too much heat for a prolonged time leads to reduction in sperm count.
6. Regular smoking also leads to reduction in sperm count.
7. Excessive stress also causes reduction in sperm count.
8. Regular and continuous exposure to chemicals like xylene, painting material and metal like lead also leads to low sperm count.
9. Chemicals present in sunscreen lotion can harm a man's sperm count so one should be alert while using a sunscreen lotion.
10. Sex toys also cause infertility in men because of presence of phthalates in  them.
11. Regular intake of canned food can also contribute in low sperm count.
12. Regular drinking habits reduce testosterone levels thereby reducing the quality and production of sperm.
13. Excessive intake of canned food leads to intake of bisphenol A which lowers down the quality of the sperm.
14. Excess intake of caffeine also leads to reduction in sperm count.
15. Lack of exercise and laziness also reduces sperm count to a great extent.

Some of the above mentioned things can be unavoidable, but point here is that taking everything in moderate quantity doesn't do any harm but problem occurs when the intake is excessive, regular and beyond limit. So, it's better to reduce the quantity and regular use of such things than letting it affect your sperm count. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

Infertility is defined as a condition where a woman is unable to conceive a child despite having 1-2 years of unprotected sexual intercourse with a male partner but help for conception can be sought after 6 months of trying pregnancy. In over half the cases, infertility is usually with the male partner which is characterised by a low sperm count. Infertility causes social anxiety as well as relationship problems among couples and can severely affect the self-esteem of the person.

Symptoms

Male infertility tends to have certain tell tale signs some cases or no apparent reasons in other cases. In some cases, male infertility occurs due to underlying medical conditions like genetic problems, widened veins around the testicle or hormonal imbalances and some of the symptoms could be like:

1. Recurrent problems during sexual intercourse due to severe pain in the testicular zone.
2. You might lose your ability to smell due multiple instances of infections of the respiratory system.
3. There might be a reduction in the body hair.
4. Abnormal sperm count.
5. Lack of sexual desire

Causes

Some of the common causes of male infertility could be:

1. Past injury or surgery of the testicles.
2. Erectile dysfunction.
3. Premature ejaculation.
4. Sexually transmitted infections.
5. Testicular deformation along with low sperm count.
6. Blockage of the ejaculatory

In other cases, the reasons could be:

1. Obesity
2. Old age
3. Mental anxiety
4. Excessive alcohol consumption
5. Diabetes or as a
6. Side effect of radiation therapy
7. Prescribed medications to treat other existing ailments within the body

Diagnosis and Treatment

The infertility of the male partner is usually diagnosed by your specialist by evaluating the medical condition and past histories of surgical procedures, sexual practices etc. Infertility can also be diagnosed by analysing the semen.

The treatments for male infertility are varied and depend on the severity and the exact cause of the condition. Male infertility can be treated by hormonal replacement therapies and procedures, counselling or medication (for erectile dysfunction and premature ejaculation) and procedures to retrieve sperm which is then used for artificial insemination.

In case you have a concern or query you can always consult an expert & get answers to your questions!

The term infertility in females explains a wide range of disorders but in order to simplify things, lets’ just say, infertility in women is a condition in which women are unable to conceive. There are numerous reasons that can be responsible for this situation and although some are preventable or curable, most others have no specific cure or treatment.

Ovulatory Disorders

One of the most common reasons for infertility is an ovulatory disorder. Almost 30 percent of female infertility is caused due to this reason. 70 percent of such infertility is treatable with drugs such as Reprones/Menogan and Clomiphene. Here is a list of causes of failed ovulation-

1. Disruption in the complex hormonal balance.

2. Ovaries fail to produce mature eggs. Polycystic ovarian syndrome is the most common disorder causing this problem. This syndrome has reduced FSH production and increased production of LH, Oestrogen and Testosterone. Suppressed FSH production may cause the partial development of ovarian follicles.

3. Hypothalamus may malfunction thereby causing the pituitary to malfunction, thus losing control over the process or FSH and LH production.

4. Physical damage to the ovaries by multiple surgeries or due to the formation of cysts.

5. A rare case of premature menopause.

6. Problems of the follicle.

7. Poor functioning of fallopian tubes

Diseases or disorders in the tube have been another major reason of infertility in women. Almost 25 percent of women infertility occurs due to this reason. Although treatments exist, success rates of the treatments are as high as 30 percent. The causes of tube damage may be as follows-

1. Infection caused by bacteria or viruses

2. Abdominal diseases like colitis and appendicitis

3. Previous pelvic or abdominal surgeries.

4. A condition called ectopic pregnancy which occurs in the tube, and even if very carefully but successfully overcome, may leave permanent damage.

5. Rare congenital defects in which women may be born with tube anomalies.

Endometriosis

This is the condition where the endometrium expands excessively thereby preventing individuals from getting pregnant. This affects almost 10 percent of the population of infertile women. Almost 40 percent of women with endometriosis are infertile.

Other Factors

Other additional factors may include:

1. Abnormal uterus

2. Congenital diseases

3. Behavioural factors like personal habits, lifestyle and health factors.

4. Exercise and diet- extremely overweight or underweight women may have problems in conceiving.

5. Cigarette smoking reduces the chances of conceiving by one-third.

6. Alcohol increases the chances of birth defects.

Hence, pregnancy is tougher than it might really seem. If you wish to discuss about any specific problem, you can consult a gynaecologist.