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.
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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.read more
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Caesarean Section Procedure
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Treatment Of Female Sexual Problems
Treatment Of Medical Diseases In Pregnancy
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Urinary Incontinence (Ui) Treatment
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She is very patient with all herpatients. The best thing about Jayanti Kamat is that she prescribes limited no. of medicines. The delay periods issue was increasing day by day. Even in case of long queues, the staff was managing people in a very positive manner. It was so quite pleasant in the Shrishti Fertility Care Center & Women's clinic. The complete process of delay periods treatment was so painless and quick, and i am so relieved that I chose to consult her. I consulted a number of specialists but the way she treated me was the best
Dr. Jayanti Kamat provides answers that are very helpful, knowledgeable and inspiring. Thank you so much mam.. definitely I will follow advice
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Dr. Jayanti Kamat provides answers that are very helpful. Thanku
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It is a well-known fact that the placenta is one of the most important organs related to pregnancy. However, it can also be said that when there is not enough placenta, the stage is set for a lot of complications.
This sort of condition goes by a variety of names. Among them are placental insufficiency, which is most commonly used, placental dysfunction as well as uteroplacental vascular insufficiency, which sounds like a mouthful to pronounce!
The condition refers to the case where the blood supply itself is not large enough. The placenta is the key connection, which exists between the mother and the developing child. By making use of this connection, the mother can transfer nutrients and oxygen to the child for it to develop in a sufficient manner.
Taking this into account, it can be imagined what a ruinous impact the shortage of these nutrients and even basic oxygen can have on the baby. In fact, there is a 1 in 300 chance of there being placental insufficiency for a woman who is expecting a baby.
What causes placental insufficiency?
Complications such as placental insufficiency are caused in a general sense, by some lifestyle bad habits such as smoking and the consumption of drugs. However, it also depends on the health of the mother when she conceives. Some women are already suffering from diseases, such as diabetes and chronic high blood pressure as well as disorders which relate to the clotting of blood when they get pregnant.
A case of placental insufficiency cannot be cured fully but the good news is that a lot can be done by the way of medication and practices to try to reduce the ill effects it has on the development of a baby. It can be said crucial for this purpose that the condition of placental insufficiency is detected well in advance of the expected date of delivery. When the case is such that there is a serious chance that the baby may be delivered prematurely, it is very important that a doctor is consulted.
The course of medicine, which is likely to be suggested is the administration of steroids by a qualified medical professional to the mother who is expecting a baby. The reason why this is done is so that the steroids can transfer from the mother to the developing child by making use of the placenta and can work to strengthen the lungs of the baby.
In medical terms, the pelvic floor refers to a group of muscles in the pelvic area. These muscles provide support to the organs in the pelvic region, including the bladder, uterus (women), prostate (men), and rectum.
What is pelvic floor dysfunction?
This is a medical condition that is used to refer to a situation when you are unable to control the functioning of the pelvic floor. It means you fail to control the bowel movement. People suffering from pelvic floor dysfunction use these muscles to contract rather than to relax. It is for this reason that they cannot have a bowel movement. They often have an incomplete one.
What causes pelvic floor dysfunction?
In most of the cases, the exact reason behind this dysfunction is unknown. It is often believed that this condition is caused due to traumatic injuries to the pelvic area. This can happen after an accident and due to complications aroused after vaginal childbirth.
What are the symptoms?
There are several symptoms that are linked to this medical condition. You must visit your doctor if you come across the following signs:
- The feel of having several bowel movements within a short period of time.
- If you feel that you cannot complete a bowel movement.
- When there is constipation pain linked with bowel movements.
- A frequent urge to urinate.
- Painful urination.
- Pain in lower back.
- Continuous pain in pelvic region, genitals, or rectum.
- Pain during intercourse in women
How is pelvic floor dysfunction diagnosed?
It may be diagnosed through a physical examination by the doctor. You will ask several questions to know the case history and find out the cause. You may also be asked to take pelvic muscle control test by placing surface electrodes on the perineum or sacrum. A small device called a perineometer is also used for the same.
What are the best ways for treating pelvic floor dysfunction?
It can be treated without surgery. There are several techniques. Some of these are as follows:
- Biofeedback: It is done with the help of a physical therapist.He uses special sensors to watch and monitor the muscles.
- Medication: A low-dose muscle relaxant is prescribed to treat the same.
- Relaxation techniques: Your therapist may ask you to take up techniques for relaxation such as warm baths, yoga, and exercises.
- Surgery: If your physician finds out that the dysfunction is caused by a rectal prolapse or rectocele, he or she will take up surgery.
Pelvic Floor Dysfunction results in Urinary Dysfunction. Urinary incontinence is the unintentional passing of urine. It's a common problem thought to affect millions of people. There are several types of urinary incontinence, including:
- Stress Incontinence – when urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh
- Urge Incontinence – when urine leaks as you feel a sudden, intense urge to pass urine, or soon afterwards
- Overflow Incontinence (chronic urinary retention) – when you're unable to fully empty your bladder, which causes frequent leaking
- Total Incontinence – when your bladder can't store any urine at all, which causes you to pass urine constantly or have frequent leaking
It's also possible to have a mixture of both stress and urge urinary incontinence.
Pelvic Organ Prolapse
Pelvic organ prolapse is a condition in which structures such as the uterus, rectum, bladder, urethra, small bowel, or the vagina itself may begin to prolapse, or fall, out of their normal positions. Without medical treatment or surgery, these structures may eventually fall farther into the vagina or even through the vaginal opening if their supports weaken enough.
In case you have a concern or query you can always consult an expert & get answers to your questions!
In a normal pregnancy, the baby develops with its head pointed down, and the head is usually the part which comes out first during normal delivery. However, in many cases, the baby could have its legs, feet, or buttocks pointing to the cervix. In a majority of cases, the baby may have this position, but rotates to have its head pointing down before the third trimester. However, this may not happen, and this is referred to as breech.
In a lot of cases, the doctor would try to move the baby’s head downwards usually around the 37th week, and this is referred to as external cephalic version (ECV) or even as version. The process is done externally by manipulation and hence the name external. It is done before labor and may allow for a vaginal birth. In very rare cases, it may be done during labor, but before the amniotic sac has ruptured. As a backup, there should be a provision for the patient to undergo C-section, if ECV is not successful.
- Single pregnancy, into 36 weeks of pregnancy, with no complications, and preferably not the first pregnancy
- No engagement of the fetus (any part) in the uterus
- Adequate amniotic fluid, which will provide a good environment to move the baby with minimal injury
- Suspected/known birth defects
- Multiple pregnancies (twins/triplets)
- Ruptured amniotic sac
- Fetus with a hyperextended neck
- Mother’s health is not optimal and is on cardiac medications
- Condition that mandates a cesarean section (placental separation from the uterus, placenta covering the cervix, etc.)
The fetal position is first estimated using an ultrasound. The position of the placenta and the amount of amniotic fluid are also closely monitored. Under constant monitoring, the uterus is relaxed through medications. With one hand on the fetal head and another on the buttocks, the doctor tries to rotate the fetus. Depending on how much pressure the mother is able to tolerate and how flexible the uterus is, version may be successful (success rate is about 60%).
A second attempt under epidural anesthesia may be done, if the first one did not succeed. However, the chances of success with subsequent attempts is very doubtful. The fetus is constantly monitored through ultrasound and fetal heart rate monitoring. A fetus is considered healthy if the heart rate moves up during this procedure. However, if the heart rate seems abnormally high, the procedure would be abandoned.
After the procedure, the mother and the fetus would be monitored for a while before being sent home. As the fetus is constantly monitored throughout pregnancy, the doctor would be able to tell if this procedure is required.