Book Clinic Appointment with Dr. Sameer Pahlajani
Treatment Of Erectile Dysfunction
Treatment Of Male Sexual Problems
Treatment of Infertility
In Vitro Fertilization (Ivf) Treatment
Treatment Of Female Sexual Problems
Intra-Uterine Insemination (IUI) Treatment
Urinary Incontinence (Ui) Treatment
Sperm Donor Program
Natural Cycle Ivf Treatment
Management of High-Risk Pregnancy
Artificial Insemination Treatment
Preimplantation Genetic Diagnosis (Pgd)
Egg Donation Procedure
Treating Disorders of The Unborn Child
Fertilisation In Vitro - Embryo Transfer (Ivf - Et
Intracytoplasmic Sperm Injection (Icsi) Procedure
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Patient Review Highlights
In today’s modern, fast paced society, it is easy for people to become stressed. In fact, one would almost think that being stressed is the “in” thing, and if you aren’t stressed it must mean there is something wrong with you! Realistically however, stress is not a good thing for our bodies in general, and has a very real impact on your fertility.
Can Stress Have an Effect on Your Fertility?
If your mind and body is under stress your body is signaled to release a hormone - Adrenalin. This is a stress relieving hormone and gives your body the rush to face the stress. This hormone inhibits the utilization of the hormone Progesterone, which is essential for fertility. Also during stress Prolactin, another hormone, is relapsed which also interferes with infertility. Hence to conceive its essential that your anxiety levels are under control.
How Stress Impacts Fertility?
Recent research tells us that stress boosts levels of stress hormones, such as adrenaline, catecholamines and cortisol, which can inhibit the release of the body’s main hormone, GnRH (gonadotropin releasing hormone), which is responsible for the release of sex hormones. Subsequently this may suppress ovulation in women, reduce sperm count in men and lower libido in both women and men.
Chronic Stress also decreases libido:
Chronic stress may cause lack of libido as well as a decrease in general fertility. This has become such a common issue that they have created a name for it Stress Induced Reproductive Dysfunction. These facts are very important to consider if you have been trying to conceive with no results. It also shows that stress relief should be a part of every couple's conception plan even if they are going through IVF.
Ways to reduce stress & improve fertility:
If you are having difficulty to conceive, it's imperative that you get fertility tests done and also evaluate your life. Look out for the stress points that may be hindering a relationship. Remember defeating the stress may be the solution to your worries.
- Reduce stress in your life: The issues in your life may be work or result related. You need to learn to balance your personal and professional life. The sooner you do it the better; after all you are preparing yourself to welcome a new born in your life.
- Change your reactions: Get a hang of the situation and react accordingly. Over reaction to a situation can harm your body and mind. Stop bothering so much about the future.
- Let few things be the way they are: Stop getting bothered about people. Remember by nature everything will fall in place. Let few things be the way they are.
- Make it your habit to reduce stress: Call it an obsession or a practice, train your mind to choose options where there is less stress.
- Sleep well: A good rest is essential for a healthy mind and body. Meditate, do yoga or seek counseling. Go for facials if it sooths you.
Please note that if your fertility reports are normal, then it's just a matter of time. Give you, your partner and your body time. There are certain medical complications or disorders that can also be responsible for infertility. Be calm and composed so that you are able to face the rough waters clearly with your partner.
In case you have a concern or query you can always consult an expert & get answers to your questions!
One of the major milestones in a woman’s life is the entry into motherhood. For most women, when this does not happen in the natural logical sequence of things, there is anxiety and lot of pressure from family and friends.
However, with advancements now, there are options like intrauterine insemination and in vitro fertilisation (IUI and IVF) available, which can help increase the chances of conception and pregnancy. IVF is where the egg is retrieved from the woman’s womb, fertilised externally and then transplanted back into the uterus where it grows to full term. However, there are always unanswered questions like how long to wait before going for IVF, is it the right procedure for me, etc.
Read on to know to find answers to some of these.
- Maternal age: As a woman reaches 35 and a man reaches 40, the fertility rates drop significantly. The chances that a woman at 35 will conceive is about 20%, which goes down to 5% if the woman is 40. However, this rate can be significantly increased by using IVF. The quality of the egg would gradually deteriorate, and so if a woman is nearing 40, it is better to consider IVF as the ovarian reserve would be optimal with IVF.
- Failed intrauterine insemination: In couples who have problems with the sperm reaching the uterus, intrauterine insemination (IUI) is first attempted. However, if 3 or more attempts of fail, it is time to consider IVF.
- Duration of inability to conceive: While some couples conceive quite promptly in a month or two, most take about 6 to 8 months of unprotected sex to conceive. Therefore, IVF can be an option if you are failing to conceive even after a year. Less than a year, don’t fret. Take it easy and it might just do the trick.
- Medical health: Both the partner’s medical health should be taken into account. Lifestyle changes like smoking, alcohol abuse, drug abuse should be considered, which can account for poor sexual performance and therefore lead to an inability to conceive. Health conditions like diabetes and heart disease can also lead to infertility. Hypothyroidism in women is another thing that must be ruled out, as it often leads to an inability to conceive.
- Sexual problems with the partner: One of the first things to do before going for IVF is to check that the male does not have any issues. Be it erection issues or ejaculation issues or sperm issues, they need to be ruled out. Sperm quality, quantity, and motility have to be analysed, and if they are optimal, IVF can be considered. In case you have a concern or query you can always consult an expert & get answers to your questions!
There are women who feel their looks are spoilt because of the presence of excessive body hair. While hair on women's body is common, excessive body hair isn't a normal condition and must be taken seriously. Women are generally unaware that the condition is known as Hirsutism.
What is Hirsutism?
Hirsutism can be defined as growth of excessive facial and body hair in women. With the world obsessed with flawless skin, such changes from feminine hair pattern (soft, fine, vellus hair) to masculine hair pattern (hard, dark, terminal hair) in a woman is generally unwelcoming and, hence, very distressing for the woman.
Why do some women develop Hirsutism?
In order to understand the reasons for such excessive growth in some women, it is important to understand the differences in the physiology of men and women. The male or female appearance of one's body is dependent on a delicate balance between male and female sex hormones. There is a predominance of the hormone estrogen in a woman's body, whereas androgens (testosterone) are the predominant sex hormones among men. However, some amount of androgens is secreted by the ovaries and adrenal glands (located next to kidneys) in women also. But, an excessive production of these hormones results in Hirsutism. Hormonal imbalance is by far the most common cause of Hirsutism.
Causes of Hirsutism
The common causes of hirsutism include:
1. Endocrine causes
- Polycystic Ovarian Syndrome (PCOS) - PCOS is a condition of hormonal imbalance in the body, which can result in an irregular menstrual cycle, enlarged ovaries with a cystic appearance on USG, infertility, obesity and hirsutism. For more information on the causes and management of PCOS.
- Cushing's syndrome - Excessive production of hormone Cortisol by the adrenal glands can lead to symptoms such as high blood pressure, abdominal obesity, skin discoloration, muscle weakness, irregular menstruation, and hirsutism etc. This syndrome is known as Cushing's syndrome.
- Congenital Adrenal Hyperplasia (CAH) - CAH is a condition of excessive production of hormones Androgens and Cortisol by the adrenal glands and generally manifests in childhood in the form of virilization. In such cases, CAH can present with symptoms such as ambiguous genitals, obesity, hypertension etc. However, sometimes the manifestation of CAH is deferred to early adulthood and results in milder symptoms, hirsutism being one of them.
2. Tumors - Tumors in ovary or adrenal glands can again cause hirsutism due to excessive production of androgens
- Long term steroid consumption (commonly used for immunosuppression, rheumatoid arthritis, and multiple sclerosis)
- Performance enhancing drugs (often used by athletes)
4. Idiopathic - the woman may be having hirsutism despite normal hormone levels
There are essentially two lines of treatment for hirsutism - one is medical management and the other is a cosmetic treatment.
Medical treatments for hirsutism -
A. Birth control pills - It's possible to reduce the severity and intensity of hair growth using birth control pills- the most commonly prescribed medical intervention! The birth control pills help by decreasing the production of androgens by ovaries. Besides this, estrogen present in the pills also helps the liver to produce more of sex hormone binding protein- these proteins bind to circulating androgens, thereby reducing their action on the body. Both these actions help in reducing the growth of hair on the body.
B. Anti-androgen medications - There are three categories of anti-androgen medications, which are commonly used for the treatment of hirsutism.
- I. Spironolactone - Spironolactone is a diuretic medicine, which blocks the effects of androgens on the hair follicles, thus controlling hair growth.
- II. Finasteride - Finasteride works by blocking the conversion of body testosterone into its more potent chemical entity, thereby limiting the effect of testosterone on hair growth.
- III. Flutamide - Flutamide is a potent anti-androgen, which blocks the actions of androgens and helps in controlling the hair growth.
However, we have to ensure that the woman is not pregnant when taking any of these three medications. These medicines are often combined with oral contraceptives, which also have a synergistic effect in reducing the severity of hirsutism. One should also seek an expert opinion before starting these medications as there can be serious side effects, especially on liver.
C. Steroids - Low dose dexamethasone can be used to control the overactive adrenal glands when used carefully. However, long-term steroid therapy has got its own side effects and this therapy should only be considered under expert care and guidance.
D. Insulin sensitizing medicines - Medicines such as Metformin and Pioglitazone (Basically these are anti-diabetic medications) help in reducing insulin resistance in the body, which, in turn, helps in controlling the effects of excessive circulating androgens.
Cosmetic treatment for hirsutism -
One very important aspect of cosmetic management of hirsutism is self-care. This can include shaving, waxing, use of depilators and bleaching creams. All these measures help to reduce the amount of visible hair in undesired parts of the body. But, this needs to be done very frequently for a sustained visible effect.
Permanent hair removal is also possible using electrolysis or LASER treatment. In electrolysis treatment, electric current is passed into the hair follicle using a needle, which damages the root of the hair permanently. Similarly, LASER treatment uses LASER to destroy the hair follicle. Both these are effective methods to get rid of the undesired hair. However, we do not yet know if there are any long-term complications or side effects of these methods and these methods are not yet approved by the US FDA.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Related Tip: How Safe is Laser Surgery for Facial Hair Removal??
Infertility is a condition where a couple, trying to conceive in a natural way is not able to do so even after one year of trying. It is also a matter of worry for patients who are over the age of 35 years and those who are not able to conceive naturally even after 12 months of trying constantly.
Causes: There are many causes of infertility. It may be down to a condition present in one or both partners. Ovulation and fertilisation are the main elements of the conception process and any condition in the female or male can upset either function, which can make it difficult to conceive.
While abnormal sperm production and transport may be a common condition that leads to infertility in males, other factors like side effects of cancer treatments and too much exposure to toxins and chemicals can also play an important role in this regard. For females, the causes of infertility may range from ovulation disorders, uterine and fibroid tumours, uterine and cervical anomalies, damage to or blockage of the fallopian tubes, endometriosis, primary ovarian insufficiency and pelvic adhesions.
Infertility Symptoms in Women
In women, changes in the menstrual cycle and ovulation may be a symptom of a disease related to infertility. Symptoms include:
- Abnormal periods. Bleeding is heavier or lighter than usual.
- Irregular periods. The number of days in between each period varies each month.
- No periods. You have never had a period, or periods suddenly stop.
- Painful periods. Back pain, pelvic pain, and cramping may happen.
Treatment: Female patients can turn to medication that will stimulate ovulation, intrauterine insemination, and surgical processes to correct a uterine septum and remove endometrial polyps, or even a hysteroscopy surgery. Male patients can go through a treatment for any existing infections, hormonal injections and medication, surgical options like vasectomy reversal and art or assistive reproductive technology.
If these methods fail, the patient or the couple can always turn to methods like in vitro fertilisation. For other mild reasons, lifestyle changes along with a stress free environment can help in increasing the chances of conception.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Pregnancy can be easy and smooth, while on the other hand, it might be time consuming, marred with conception difficulties all along the way. Pregnancy may seem exciting to some, whereas it can be stressful for others. Regardless of whether it is the first child you are planning or have had a successful pregnancy previously; there are some tips you need to keep in mind in order to improve fertility and give birth to a healthy child.
Some fertility boosting factors are:
These fantastic swimmers are at the very root of male fertility. Some important components which need to be taken into consideration are sperm count, sperm motility (the ability of the sperm to swim around the female reproductive tract) and morphology (shape and size of a sperm). In order to have all these parameters in check and working fine, one needs to abstain from smoking and limit alcohol consumption among many other lifestyle modifications.
Having unprotected vaginal intercourse during the woman’s fertile days in a month helps improve chances of conception.
Fertility becomes a challenge when you are either overweight or underweight. The weight of a woman affects ovulation (The release of eggs from the ovaries) and causes hormonal imbalance; factors which make it very difficult to conceive. Keep your weight levels in check and that could prove primarily essential in bettering your fertility.
Staying well nourished boosts your odds of conceiving! Make sure to include enough protein, iron, zinc, vitamin C, and vitamin D in your diet, because deficiencies in these nutrients have been linked to lengthened menstrual cycles (and therefore less frequent ovulation) and a higher risk of early miscarriage. Ask your gynaecologist if you should take a daily multivitamin supplement. And be sure to eat protein-rich foods, such as meat, fish, low-fat dairy products, eggs, and beans.
Beware of STDs or Sexually Transmitted Diseases. One is the most prone to STDs of any kind if he/she happens to engage in unprotected sexual intercourse; having a number of sexual partners just ups the chances of getting afflicted by STD. Protected vaginal intercourse helps prevent STDs, thus enhancing fertility and subsequently, chances of conception.
According to several studies, the lubricant one chooses surprisingly plays a significant role in determining fertility. Not all lubricants boost fertility and sperm motility (sperm count). Baby oil or egg whites are a few good examples of such lubricants.
While a limited amount of caffeine consumption is good, overdoing it might spoil and hamper fertility. Limit caffeine intake and keep it within a level of 200-250mg a day.
Smoking, besides playing havoc with every organ in the body, affects the reproductive organs and thus fertility. In men, it leads to reduced sperm count and in women, it causes DNA damage. Stub the bud right now and never get back to it.
Certain toxic chemicals can lead to female and male infertility. So it is advisable that you stay away from chemicals such as pesticides, organic solvents and lead, the primary toxins which pose a severe threat to fertility.
- Exercising regularly can never go wrong. It gives you the strength and stamina, boosting your overall health. However, vigorous exercises, especially when you are trying to conceive, will do you no good. It might adversely lead to the suppression of certain hormones such as progesterone (pregnancy stimulating hormone) and might affect ovulation, hence affecting fertility. Aim at a regular 20 minutes session of light exercises; mild cardiovascular exercises such as walking can work wonders, especially in such circumstances. In case you have a concern or query you can always consult an expert & get answers to your questions!
I have sex 3 days ago before egg rapture. Can I conceived baby? Please suggest me what is the process.
What is IVF?
IVF stands for In Vitro Fertilization and is a method of artificial insemination that dramatically increases the chances of pregnancy. It is one of the assisted reproductive technologies methods used as fertility treatment across the world where other methods have had drastic results.
In simpler terms, a man's sperm is inserted in woman's egg using controlled laboratory environment to proceed with fertilization. These embryos are then carefully put back into the mother's uterus after 4 to 5 days of fertilization in incubator in hopes that the embryo would grow in a full baby. The embryo transfer process needs to be carefully done in order for successful fertilization in the mother's womb.
There are many reasons why IVF is conducted:
- Poor sperm quality - Males having poor sperm quality are unable to achieve fertilization and increase the chances of conception with their female partners. This is male factor infertility due to which people move towards IVF.
- Fallopian tube problems - This is a female factor infertility, in which fallopian tubes either get blocked, or damaged making it complicated and stressful for the embryo to travel to the uterus.
One must approach IVF treatment with patience and a willingness to comply with all the tenets that the treatment is built upon. IVF clinics may vary the treatment a little according to what the patient's condition demands and different clinics may have different methods. The basic methods of IVF treatment however, remain the same. The first step to the treatment is to find the right clinic which complies with factors like availability of resources, cost and quality of treatment. After deciding the clinic, the next step is to understand that IVF treatment happens in cycles and the success rate of conception varies. Patients must also be ready to face any disappointment.
Here’s the short version of the steps involved in an IVF treatment cycle:
- Ovarian stimulation. Your doctor prescribes a course of drugs for you to take to stimulate your ovaries into hopefully producing 12 to 15 mature eggs.
- Monitoring of your drug response. To monitor the progress of your ovarian stimulation you undergo an ultrasound examination and blood tests.
- Egg maturation. Two days before your eggs are due to be collected you have a hormone injection, which triggers maturation of the eggs.
- Egg collection. You receive a light general anaesthetic for this simple, short procedure, and your doctor retrieves your eggs using an ultrasound-guided technique.
- Sperm production. On the day of egg collection, your partner provides a sperm sample.
- Fertilisation. The embryologist puts sperm and eggs together in the lab and, if all goes well, the eggs fertilise and early embryo development begins.
- Embryo transfer. Two to five days after egg collection, your doctor places one or two embryos in your uterus. Frozen transfer can be planned after a gap of 1 month.
- Embryo freezing. If you have additional embryos suitable for use, they can be frozen and kept for future transfers. Also, frozen embryos are available.
- Pregnancy test. About two weeks after embryo transfer you have a blood test to find out whether the treatment worked.
- If the test is positive, you have your first pregnancy scan two weeks later.
- If the test is negative, you and your partner need to talk to your doctor and decide whether to try the treatment again.
In vitro fertilisation (IVF) is a medical procedure followed for those women or couples suffering from infertility or for certain specific genetic problem. In the normal course, women or couples experience positive results within a few IVF cycles. However, in spite of reasonable pregnancy rates, some women may require few more cycles to achieve pregnancy. In such cases, in order to ensure a healthy pregnancy, the gynecologist may suggest the women undergo Endometrial Scratching before IVF.
Endometrium explained in brief:
The uterus is located in the pelvic region and it is in the size and shape of a pear. The inner cavity of the womb or uterus is protected by the tissue lining called endometrium, also called endometrial. The endometrium plays a significant role in supporting the pregnancy.
The enhanced success of achieving pregnancy:
The endometrial scratching procedure is a very simple one, which is resorted, so as to improve the results of IVF procedure. In this procedure, the gynecologist uses a very fine catheter and makes a small scratch on the endometrial lining. In fact, the scratch causes a kind of inflammatory reaction in the uterus. This inflammatory reaction induces the endometrium to be highly receptive to embryos during the successive menstrual cycle. This added receptivity enhances the success of pregnancy during the next menstrual cycle.
Considering the higher level of success in achieving pregnancy, the endometrial scratching procedure has gained popularity in the IVF procedure. However, some of the other issues related to endometrial scratching may be as follows:
- Endometrial scratching optimises the uterine lining and thereby, makes it easier to continue the embryo implanting procedure. Normally, before the endometrial scratching procedure, the gynecologist may suggest endometrial biopsy.
- The endometrial procedure is usually suggested for those women who had two or more unsuccessful IVF procedures, despite having good quality embryos. However, in some cases, depending on the health of the patient and various other factors, the gynecologist may suggest this endometrial scratching at the very first IVF procedure. This procedure can be availed either for fresh embryos of the couple or frozen embryos or for the donor egg.
- Although this is a part of a surgical procedure; endometrial scratching is very simple and painless and it is done without administering anesthesia. The procedure does not require any hospitalisation. In fact, the patient can go home soon after the procedure. Except for a few pain killers, this procedure does not require any extensive medication.
This is a safe and easy procedure. Neither does it lead to any side effects, nor is the procedure burdensome for your wallet. Many couples have been benefited by this endometrial scratching procedure.