Dr. Shilpa Bansal Agrawal

Miscarriage is a spontaneous abortion that occurs around the first to second trimester of pregnancy; wherein the foetus is automatically expelled from the uterus due to its inability to survive because of environmental influences or chromosomal abnormalities.

Unless the miscarriage occurs due to a severe health issue, the fertility of the woman may not necessarily be compromised. Studies show that one miscarriage doesn’t predict the possibility of a future one. Once the bleeding and pain subside, it is the emotional trauma that must be addressed to begin with which poses a greater threat than the physical one.

The fertility of the woman remains unaltered and the body can be ready after the menstrual cycle returns to normal. However, it still requires some time for the woman to be physically and emotionally prepared to go through another pregnancy. The medical history and reasons behind miscarriage must be evaluated before the couple decides to try again.

Complications after miscarriage only occur if the woman is above 35 years of age or has a rather unhealthy lifestyle. The concept of fertility varies from person to person and it isn’t possible to pass a common judgement about fertility in this scenario.

The gynaecologist mostly suggests couple therapy after the trauma of the miscarriage. The psychological loss is given more importance before considering another attempt by most doctors. The fertility loss only occurs with age and unhealthy lifestyle and it is widely accepted and proven that a miscarriage has little or nothing to do with it.

Ways to Increase Fertility

If a couple is certain they are ready to conceive again, there are a few things a woman can do to help her chances of becoming pregnant-

1. The first thing to do is to stop any unhealthy habits. These include smoking, drug use, or alcohol abuse. It’s reported that high consumption levels of caffeine are detrimental to conception so that should also be limited.
2. Eliminating stress can also help. Eliminating stress is one of the most important factors in having a successful pregnancy. So, it makes sense that getting over-stressed can reduce fertility levels.
3. Eat healthy. If depression was experienced due to the miscarriage, it’s possible that the woman’s diet has not been the healthiest. It’s common for women who have experienced a miscarriage to have a loss of appetite and not eat enough or to eat out of sorrow, eating too much. More attention should be paid to the diet and more healthy foods added to meals.

Talk to a Doctor

If a couple is having issues with fertility after early miscarriage, they should talk to a doctor. There are many options available. More than likely, the first thing the doctor will do is to test fertility levels of both the man and the woman. If you don't want to visit a doctor for this, there is a new at-home kit available called Fertell. This test, retailing for approximately $100, measures fertility levels for both a man and a woman.

If it is found that there is a loss of fertility after early miscarriage, fertility drugs or therapies may be prescribed for a period of time.

The doctor may report that there are no issues with fertility. At this point, it would be a good idea to use an ovulation predictor in order to time effective intercourse. This isn't the most romantic idea, but it may well be one of the most logical ways for a couple to conceive.

Bottom Line

Fertility is not normally decreased after miscarriage. A woman's fertility levels return to normal as soon as her menstrual cycle returns. Fertility may be decreased due to emotional issues as a result of the miscarriage. However, if a couple is ready, both physically and emotionally, there should be no physiological hindrances to conception.

The decision to try again is not an easy one. However, fertility won't typically be an issue.

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

Babies can enter this world in one of two ways: Pregnant women can have either a vaginal birth or a surgical delivery by Caesarean section, but the ultimate goal is to safely give birth to a healthy baby.

A C-section, or Caesarean section is a surgical procedure to remove baby through an incision in the mother’s abdomen and then a second incision in the uterus.

A C-section may be a necessity in certain situations, such as delivering a very large baby in a mother with a small pelvis, or if the baby is not in a heads-down position and efforts to turn the baby before a woman gives birth have been unsuccessful.

Sometimes the decision by an obstetrician to perform a C-section is unplanned, and it is done for emergency reasons because the health of the mother, the baby, or both of them is in jeopardy. This may occur because of a problem during pregnancy or after a woman has gone into labor, such as if labor is happening too slowly or if the baby is not getting enough oxygen.

Some C-sections are considered elective, meaning they are requested by the mother for non-medical reasons before she goes into labor. A woman may choose to have a C-section if she wants to plan when she delivers or if she previously had a complicated vaginal delivery.

Reasons for a C-section may include-

1. Health problems in the mother
2. The mother carrying more than one baby
3. The size or position of the baby
4. The baby’s health is in danger
5. Labor is not moving along as it should

The surgery is relatively safe for mother and baby. Still, it is major surgery and carries risks. It also takes longer to recover from a C-section than from vaginal birth. It can raise the risk of having difficulties with future pregnancies. Some women may have problems attempting a vaginal birth later. Still, many women are able to have a vaginal birth after cesarean (VBAC).

How You Might Feel-

You won’t feel any pain during the C-section, although you may feel sensations like pulling and pressure. Most women are awake and simply numbed from the waist down using regional anesthesia during a C-section.

That way, they are awake to see and hear their baby being born. A curtain will be over your abdomen during the surgery, but you may be able to take a peek as your baby is being delivered from your belly.

However, women who need to have an emergency C-section occasionally require general anesthesia, so they’re unconscious during the delivery and won’t remember anything or feel any pain.

Recovering from a C-section-

After a C-section, a woman may spend two to four days in the hospital, but it may take her up to six weeks to feel more like herself again.

Her abdomen will feel sore from the surgery and the skin and nerves in this area will need time to heal. Women will be given narcotic pain medications to take the edge off any post-surgery pain, and most women use them for about two weeks afterward.

A woman may also experience bleeding for about four to six weeks after a surgical birth. She is also advised to not have sex for a few weeks after her C-section and to also avoid strenuous activities, such as lifting heavy objects. In case you have a concern or query you can always consult an expert & get answers to your questions!

Not getting your period on the expected date can make a woman nervous, especially if she is not planning a family. However, there is more than one reason for periods to be delayed or to be skipped. If this happens once in a while, you need not worry, but if your periods do not follow any sort of a schedule, you should see a gynecologist at once. Your body may be trying to tell you something. Here are a few of those messages that you may be missing.

1. You may be too stressed out: In most cases, irregular menstrual cycles are triggered by high-stress levels. Stress makes the body produce cortisol which has a direct effect on the production of estrogen and progesterone. It also interferes in the communication between the hypothalamus and the pituitary gland. This causes the hormone communication system in the body to shut down.
2. You aren’t having a balanced diet: Your diet also plays an important role in your menstrual cycle. If you have gained excessive weight recently or indulge in a carb heavy diet, the hormone levels in your body will fluctuate thereby, changing your ovulation date. In order to maintain a regular menstrual cycle, a woman’s BMI should be between 17-22 percent.
3. You are exercising too much: Sudden weight loss, excessive exercising and being underweight can also affect the body’s hormone levels just as being overweight affects them. Some hormones are produced only in fatty tissue and a sudden drop in fatty tissues can lower the production of these hormones leading to irregular periods. A sudden spurt of excessive exercising can also drain your body of energy leaving it with no energy to menstruate.
4. You may be suffering from polycystic ovarian syndrome: Missed or late periods are often also a sign of polycystic ovarian syndrome or PCOS. Look out for other symptoms of this condition such as weight gain, dandruff or excessive hair growth to diagnose this condition. PCOS needs medical attention so it is best to get yourself diagnosed correctly by a gynecologist.
5. Your medication may be interfering with your hormones: Many types of medication interfere with the body’s production of estrogen and progesterone. Even simple over the counter medication can make your periods late by a few days.
6. You may be menopausal: Lastly, if you definitely aren’t pregnant and are above the age of 40, you may be turning menopausal. As a woman turns menopausal, ovulation becomes sporadic and in turn influences periods to be irregular as well. In case you have a concern or query you can always consult an expert & get answers to your questions!

PCOD or polycystic Ovary Disorder is one of the most common disorders of hormones among women in the age of reproduction. It is yet not discovered why some women become susceptible to this disease and it is believed to be a genetic disorder. The word “polycystic” refers to multiple cysts and a woman suffering from PCOD has multiple cysts in her ovary. This is due to the imbalance of hormones, which don’t allow the ovary to release eggs every month and these numerous unreleased eggs present in the ovary cause it to become polycystic.

What are the symptoms of PCOD?
The regular release of eggs from the ovaries directs a woman’s fertility and allows her to have a normal menstrual cycle. Therefore, women with PCOD face difficulty in conceiving along with irregular, low and absent periods. Some of the most common symptoms of PCOD include infertility and even miscarriage, elevated insulin levels, high blood pressure, diabetes, acne, unhealthy weight gain and obesity. It also leads to loss of hair from the scalp and excessive growth of hair on the body. This is due to over production of male hormones that lead to male pattern of growth of hair, such as on chest, cheek, chin and inner thighs. The hormonal imbalance leads to weight gain and obesity makes the hormonal imbalance even worse, turning it into a vicious cycle.

How is PCOD diagnosed and treated?
Your gynaecologist would be able to determine whether you have PCOD by checking your symptoms. Then she would recommend you to do a few blood tests along with a pelvic ultrasound scan to confirm whether you have PCOD. Though this disease is not reversible, its symptoms may be reduced or minimised. Most women can lead a trouble-free and healthy life if they take proper precautions at the right time.

It has been pointed in several studies that reduction in weight can help in the improvement of most PCOD symptoms because fat contributes to the production of certain hormones. Your doctor will prepare a treatment plan depending on the aspect from which you are suffering. For instance, if you are suffering from irregular periods, your doctor may prescribe you some contraceptives which can help in restoring normal menstrual cycle. But this treatment is definitely unsuitable for those who are trying to conceive. The infrequent and irregular ovulation can make it difficult to conceive and it can be artificially induced with the aid of medications. So, you must consult a gynaecologist to help your situation.

A breast examination is a way of detecting early changes that may find lumps of other growth in the breast. This is a manual form of examination that may be carried out by the doctor or even by the patient. This kind of examination helps in detecting the onset of breast cancer and helps in successful treatment of the same. It is an essential screening strategy that all women must go through. Let us cast a glance on the various details regarding this examination, and also how frequently it must be conducted.

1. Age: Women who have reached the age of 18 are said to have matured physically and sexually. They should perform this examination once they have reached the said age in order to detect any anomalies in the way the physical changes occur in the breast tissue.
2. Procedure: One should begin by looking at one's reflection in the mirror to find any rashes or dimpling in the breasts. The shape, size and colour of the breasts and nipples must also be studied so as to check for any anomalies. Inverted nipples, redness and soreness must also be reported to the doctor. Once you are done checking the visuals, you can raise your arms and look for any changes. Then, you will need to lie down and feel your breasts by using a circular motion. The finger pads must be used in order to check for any lumps. One must start from the centre and move the breasts sideways. Any wet and slippery feeling must be reported to the doctor immediately.
3. Pressure: During the breast examination, you must use light pressure for the skin and tissue that lie beneath the breasts, while medium to moderate pressure should be used for the middle portion of the breasts. One must use a firm hand to check the tissue that lies at the back of the breasts, near the rib cage.
4. Frequency: One must get into the habit of conducting a breast examination at least once a fortnight or once a month, without fail. You can also go to the gynaecologist for an examination in case you are not confident of conducting it on your own with proper movements and accuracy. You may also journalise your breast examination findings.
5. Menstrual Cycles: When you are going through your menstrual cycle or period, it is important to remember that your breasts can become tender just before or after the start of the cycle. So, do not panic if you think you have found a lump or any other growth at this time. It is best to check again after a week and then visit the doctor about checking the same. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

During the natural course of events, a women's body starts its reproductive phase with menarche and at about 50 years of age, attains menopause. This is when the reproductive function ceases and the ovaries stop producing the hormone estrogen and progesterone. In some cases, for various reasons including medical, the ovaries stop functioning earlier, and this is medically termed early or premature menopause. Menopause that occurs before 40 years of age is termed premature menopause; it is due to primary ovarian insufficiency and occurs in 1% of the women.  If it occurs between 45 to 50 years, it is termed early menopause.

Causes: Normal ageing, family history, genetic disorders, autoimmune disorders, toxins, and surgery are some reasons that could lead to premature menopause.

Effects: Estrogen and progesterone have a lot of beneficial effects on a women's body. Reduction in their levels leads to some of the below changes:

• Emotional changes like mood swings, irritability, and in some cases depression, especially in premature menopause.
• Irregular cycles before complete cessation of the menstrual cycles.
• General mucosal dryness leading to vaginal dryness, dry skin, dry eyes.
• There also would be urinary incontinence and reduced sex drive due to reduced hormone levels.
• For women who still would want to have children, infertility would be a big cause for concern. This could lead to other emotional issues, worsening the depression.
• Osteoporosis - Bones lose their density and get weak and are more prone to fracture.
• Cardiovascular health - Post menopause, women are more prone to heart attacks and stroke. Though not fully proven, this is believed to be true as the good role that estrogen plays on blood vessels is negated with menopause.
• Accelerated ageing - Menopause leads to accelerated damage of genetic structures, thereby leading to faster ageing. This also leaves a feeling in the women of being less attractive and less desirable.

There is also a good news, that after menopause women are at lesser risk of cancer - especially breast and ovarian. 

It is not easy for women to handle premature menopause. The body undergoes some changes much earlier than expected, and it requires a lot of support and caring and comforting to come to terms with it - especially if associated with infertility or chemotherapy for cancer. Emotional issues of not being able to have children and feeling less attractive require frank talks to boost the person's confidence and increase self-worthiness.
It is easier said than done, but one of the key ways to handle premature menopause is an open discussion. If you wish to discuss any specific problem, you can consult a gynaecologist.

A rising number of teenage girls in the country are getting affected with Poly Cystic Ovarian Disease or PCOD. Though an advanced menarche has become very rampant these days, there are many young women who are suffering from a delay in menarche, which in turn is leading to PCOD as opined by gynaecologists. Obesity and sedentary lifestyle among young people have caused a rapid doubling of PCOD cases in the past five to eight years.

Occurrence and Symptoms:

Gynaecologists report that they get at least 15 fresh instances of PCOD cases and a considerable number of teenagers aged 16-17 are not getting their menarche. Such patients are recommended to take a strictly balanced diet, which will help them to lose weight. Initially, their mothers think that they would experience their menarche in proper time, but some girls are diagnosed with PCOD when taken to a family gynaecologist. Even worse, they could never imagine that their obesity can pave the way for such a grave health issue. PCOD can cause numerous other problems like delayed and irregular menses, rapid weight gain and tremendous difficulty in losing weight, developing acne and blocked skin pores. Furthermore, it leads to thinning of hair and excessive growth of hair on chest, back and face. Infertility, continual miscarriage, high blood pressure and high blood sugar are also common with PCOD.

Help yourself with the right diet:

There is no proven evidence regarding the cause of PCOD though gynaecologists are of the opinion that some females possess a predisposition to this disease and it may run hereditarily in the family. You can alleviate your PCOD symptoms to a considerable extent by regulating your diet properly. Have loads of fruits and green leafy vegetables and try to abstain from dairy products as many experts believe that dairy products are a direct cause of an increase in insulin levels, which can aggravate skin troubles along with other PCOD symptoms. Avoiding red meat and eating lean meat instead will help the condition and reduce the chances of infertility. It is always recommended to avoid hydrogenated and saturated fats, which are normally found in animal and dairy-based food. Try to put a stop to cheese, cottage cheese, clarified butter, pork, lamb, beef, etc. and certain baked products like cookies, cakes and fudges as they will trigger a rise in your blood sugar and cholesterol levels.

PCOD is such a condition, which you can never afford to overlook. If you had been facing any of the common symptoms, then it is probably time to pay a consult to a responsive gynaecologist.