Dr. Mala Sinha

There are a number of ways in modern day medical science for helping couples conceive, in case they are not able to do so in a natural way. Apart from IUI, IVF and other forms of artificial insemination, one such way is ovulation induction. In this procedure, the ovaries are stimulated to release an egg which can maximize the chances of natural conception, or even through IUI. This is an effective process that works well, provided there are no other infections and diseases at play. It basically works by stoking the relevant hormones with the help of tablets and injections. Let us find out more about the process.

Varied Tests: Before embarking on the process, the doctor will conduct a number of tests to ensure that you are capable of conceiving by natural means or even with artificial insemination. These tests help in making sure that there are no other ailments in the picture, which may hamper the process of ovulation induction or affect the ovaries in general.

Ovulation Cycle: Thereafter, the doctor will take blood samples in order to study the exact ovulation cycle that the body follows. These blood samples will be studied to measure the level of hormones at different stages so as to find out the most opportune time when the situation may be congenial for the ovulation induction to begin. A transvaginal ultrasound will also be carried out so that the doctor may study the development of follicles within the ovaries. These follicles usually line the ovaries. This ultrasound will also study the thickness and appearance of the womb’s lining.

The Ovulation Induction Cycle: The ovulation induction cycle will begin with tests that will happen starting from day one to day four. Once the tests have ascertained that the body is ready to go through the process with maximum chances of conception, the process will begin on fourth day. On this day, the patient will be given medication like Clomiphene Citrate. This medicine is also usually given to patients who are undergoing IUI or artificial insemination as it is said to increase the likelihood of conception. The Follicle Stimulating Hormone injection will also be given to the patient on the same day.

After the Medication: Once the medication and injections have been administered, the patient will have to go through a test to study the hormone levels in the body. This usually takes place around day 10 or 11. Thereafter, two weeks later, the patient will go through an ultrasound to find out if the ovulation is about to begin.

Time: While this is an effective method, one must remember that the ovulation results may take time for women who do not have normal menstrual cycles.

Infertility is a medical condition in which the patient fails to conceive after one year of having unprotected sex. It is advisable that women who are above 35 years of age and often experience irregular menstrual cycles should consult a doctor on being unable to conceive within six months.

Is infertility a common issue?
Infertility has become a common problem for the new age women. Sedentary lifestyle and stress are believed to hamper the fertility of women nowadays. According to a report, about 6 percent women in US in the age group 15-44 years are infertile.

Infertility: It’s not just a woman’s problem
Infertility is not an issue with only women. Both, men and women can be infertile or are responsible for the condition. The process of reproduction requires mutual co-operation from both sexes. Therefore, they can together contribute towards infertility as well. It is wrong to blame the woman only. According to the 2002 National Survey of Family Growth data, it has been found that about 7.5 % men in the age group of 18-45 years (who have has sexual exposure) visited infertility clinics at least once in their lifetime. Of these men, about 18% were affected with male-related infertility issues.

Infertility in men: Men can suffer from infertility due to various factors. The infertility can be detected by analysis of the semen. A doctor can evaluate the concentration of the semen or determine the sperm count, the mobility of the sperm and its shape or morphology. These are important for fertility. Semen analysis can be hampered due to the following conditions:

1. Varioceles - The veins on the man’s testicles are unnaturally large and leads to overheating of the sperms
2. Diseases like diabetes, cystic fibrosis, trauma and infection.
3. Unhealthy lifestyle
4. Environmental toxins

Infertility in women: Women must have proper functioning of the reproductive organs to become fertile. The fallopian tubes, ovaries and uterus must be physically and physiologically fit for getting pregnant. A woman may get infertile due to following reasons:
1. Irregular periods that suggests the woman is not ovulating properly.
2. Polycystic ovary syndrome (PCOS)
3. Functional hypothalamic amenorrhea (FHA) or excessive physical or emotional stress causing missed periods
4. Diminished ovarian reserve (DOR) or inability of the ovary to produce sufficient eggs
5. Premature ovarian insufficiency: The ovary stops functioning properly before 40 years of age
6. Blocked, swollen or open fallopian tubes
7. Menopause

A fibroid tumour is the abnormal cell growth in the uterus and they are mostly benign. Fibroids usually affect women in the age bracket of 30 - 40. Fibroid tumours are of three types, depending on their location:

1. Submucosal fibroids: The tumour develops under the lining of the uterus
2. Intramural fibroids: The growth is found amongst the muscles in the wall of the uterus
3. Subserosal fibroids: The growth develops on the wall of the uterus right in the pelvic cavity

Causes behind it
The exact cause of fibroids in not known clearly. But certain factors have been discovered that might influence their formation. These factors include:

1. Hormones: Progesterone and estrogen are the hormones responsible for recreating the uterine lining during every menstrual cycle. These hormones might trigger the formation of tumour.
2. Family history: If any member in your family; your mother, grandmother or sister has/had fibroids in their uterus, you may also develop it.
3. Pregnancy: Your body produces excessive progesterone and estrogen when you are pregnant, which may cause an increase in the size of a pre-existing small fibroid. Myomectomy can be done by giving incision on the abdomen or by laparoscopy depending on the size and location of the fibroids.

Signs You are suffering from it

1. Heavy bleeding along with blood clots during or between your periods
2. Lower back or pelvic pain
3. Elevated menstrual cramping
4. Frequent urination
5. Pain during sex
6. Longer than normal periods
7. Bloating or pressure in lower abdomen
8. Enlargement or swelling of the abdomen

How it can be treated?
Your doctor will formulate the right treatment depending on your age, the mass of the fibroids and your overall health. Your doctor may choose a combination of treatment to cure your fibroids, and they include:

1. Medication: Gonadotropin releasing hormones (GnRH) agonists, birth control pills and ibuprofen (anti-inflammatory medicine) are prescribed. GnRH agonists reduce the level of progesterone and estrogen in your uterus.
2. Surgery: Myomectomy and hysterectomy are two common surgical procedures to treat fibroids. Myomectomy is performed by removing the fibroids only by making an incision on the abdomen. But hysterectomy completely removes the uterus. The latter is reserved for serious cases.
3. Non-invasive surgery: Forced ultrasound surgery, myolysis (shrinking fibroids with laser or electric current), cryomyolysis (fibroids are frozen) and endometrial ablation (an instrument uses heat, hot water, microwaves or electric current to destroy fibroids) are some non-invasive surgical procedures.

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

Polycystic ovary syndrome (PCOS) is a disorder of the endocrine system in women. It has been found that women suffering from PCOS have enlarged ovaries. These bigger ovaries contain fluids called follicles. During an ultrasound examination, these follicles are seen. If you are suffering from irregular or prolonged menstrual periods, acne, obesity and uncontrolled hair growth, you can get yourself tested for PCOS. However, doctors have failed to determine the exact cause of PCOS. This condition can have dangerous consequences and affect the overall health of the patient. If left untreated, it can cause type 2 diabetes or heart diseases.

What happens in PCOS?
Women suffering from this disorder experience a hormonal imbalance in their body. The hormone changes triggers multiple issues in the body. Sometimes, the body produces an excess of sex hormone. Women may develop masculine features due to overproduction of male hormones or androgens. There might be an imbalance in insulin levels, increasing the risk of developing diabetes.

What causes PCOS?
Surprisingly, the exact cause of PCOS is not known. Researchers have not been able to pinpoint the exact cause for developing PCOS. However, some believe that the cause has hereditary links. People with a family history of diabetes are more prone to have PCOD.

Symptoms of PCOS
The symptoms of PCOS are usually mild in nature during the initial stage. In the beginning, only a few symptoms are detectable. These include acne, obesity and extra hair growth on the face, thinning of hair on the scalp and irregular periods. The symptoms often get unnoticed by the patient first.

The uterus or womb is a strong structure that is held up by the pelvic muscles and tendons. In case that these muscles or tendons extend or get distinctly powerless, they are no longer ready to support the uterus, bringing about prolapse. Uterine prolapse happens when the uterus hangs or slips from its ordinary position, into the vagina or birth channel.

Uterine prolapse might be fragmented or complex. A deficient prolapse happens when the uterus is just halfway drooping into the vagina. An entire prolapse depicts a circumstance in which the uterus falls so far down that some tissue rests outside of the vagina.

The danger of having a prolapsed uterus increases as a woman ages and her estrogen levels diminish. Estrogen is the hormone that keeps the pelvic muscles solid. Harm to pelvic muscles and tissues during pregnancy and labor may likewise lead to prolapse. Women with more than one vaginal birth and in their postmenopausal period are under the most significant risk. Any action that puts weight on the pelvic muscles can expand your danger of a uterine prolapse. Different variables that can increase your risk for the condition include:

1. Obesity
2. Constant coughing
3. Constipation

Women who have a minor uterine prolapse might not have any side effects. Direct to serious prolapse may bring about side effects, for example:

1. Having an inclination that you are sitting on a ball
2. Vaginal bleeding
3. Expanded discharge
4. Issues with sex
5. Feeling the uterus or cervix leaving the vagina
6. A pulling or substantial feeling in the pelvis
7. Constipation
8. Bladder infections

In case that you experience these symptoms, it is important to see your specialist. Without appropriate diagnosis, the condition can weaken your vagina, bladder, and sexual capacity. Treatment is not generally fundamental for this condition. In case that prolapse is serious, talk with your specialist about which treatment choice is suitable for you. Nonsurgical medicines include:

1. Shedding pounds to take the strain off of pelvic structures
2. Maintaining a strategic distance from truly difficult work
3. Doing Kegel works out, which are pelvic floor exercises that strengthen the vaginal muscles
4. Taking estrogen substitution treatment
5. Wearing a pessary, which is a device embedded into the vagina that fits under the cervix and pushes up and settles the uterus and cervix

Surgical medications include uterine suspension or hysterectomy. During uterine suspension, your specialist puts the uterus once again into its normal position by reattaching pelvic tendons or utilizing surgical materials. During a hysterectomy, your specialist expels the uterus from the body through the stomach area or the vagina. Surgery is usually successful; however, it is not suggested for women who anticipate having a baby later on.

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

Pregnancy is a normal life function that many women go through. Yet, this is a part of life where one has to take special care of one’s health and condition as there are many biological changes that happen in one’s body. Swollen legs and ankles are a common part of one’s pregnancy. This condition is most commonly known as edema and it usually occurs when fluid collects in the tissue. This, in turn, happens when the blood chemistry changes and the fluid get routed to the tissue. This is a common occurrence due to the hormonal changes that one goes through during pregnancy. The condition usually troubles pregnant ladies during their third trimester.

Read on to find out the various ways in which one can deal with it.

1. When to call a doctor: Call a doctor or a midwife for a thorough check up if you happen to see any puffiness or swelling in your face and eyes. This could point at a more serious problem like the onset of preeclampsia. Also, if you happen to notice that one leg is more swollen than the other, then you may want to see a doctor about it, as it could mean that there is a blood clot in the leg.
2. Put your feet up: This is especially important if you are at a desk all day. The best way to deal with such swelling is to put your feet up every once in a while, so that the swelling may reduce. You can use a foot stool or even a pile of books for this purpose.
3. Breaks: If you are constantly sitting or lying down, it would be a good idea to give it a break and walk around a little so that there is better blood circulation. This also keeps the blood from pooling into the lower regions of the legs, which can prevent an increase in the swelling.
4. Comfortable footwear: One should stick to flat and comfortable footwear with an even elevation as well as foam soles so that the comfort level while walking and standing is optimum. Choose your shoes so that they can accommodate your swelling instead of pinching your feet. Also, you can choose to wear snug socks and stockings, which will form a band around your feet. This will ensure that the swelling does not increase to a painful level. At the same time, you must avoid socks that have bands, which are too tight as this may lead to blood pooling and subsequent swelling in the legs and ankles.
5. Water: Drinking plenty of water ensures that there is less fluid retention. This is one of the best ways of fighting edema whether or not you are pregnant.

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