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Ectopic Pregnancy: Causes, Symptoms, Treatment and Cost

Last Updated: Jun 20, 2023

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What is Ectopic Pregnancy?

A fertilised egg that implants and develops outside the uterus, usually inside the fallopian tubes, is known as an ectopic pregnancy. This condition needs quick medical attention because it can be complicated.

Salpingectomy or salpingostomy, commonly known as ectopic pregnancy surgery, is a crucial surgical technique used to remove the ectopic pregnancy and restore the patient's health and well-being. In this article, we will examine ectopic pregnancy in depth and explain the surgical procedures used to treat this severe condition.

How common is Ectopic Pregnancy?

More than 90% of pregnancies are normal ones. Among those that are not, ectopic pregnancy instances are not the only complication. Statistically, about 1 in 50 or 2% pregnancies have been found to be ectopic pregnancies.

Where does an ectopic pregnancy happen?

Ectopic pregnancy may happen in any of the following parts of the female reproductive system:

  • The fallopian tube.
  • The ovary.
  • The abdominal cavity.
  • The cervix which is the lower part of the uterus connecting it to the vagina.

A vast majority of ectopic pregnancies are tubal ectopic pregnancies. The other ones are rare occurrences.

Types of Ectopic Pregnancy

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There are several types of ectopic pregnancy, including:

  1. Tubal ectopic pregnancy: This is the most common type of ectopic pregnancy, in which the fertilized egg implants in the fallopian tube.

  2. Ovarian ectopic pregnancy: In this type of ectopic pregnancy, the fertilized egg implants in the ovary.

  3. Intra-abdominal ectopic pregnancy: This is a rare type of ectopic pregnancy in which the fertilized egg implants in the abdomen outside of the uterus, fallopian tube, or ovary.

  4. Cervical ectopic pregnancy: This is a very rare type of ectopic pregnancy in which the fertilized egg implants in the cervix.

How serious is an ectopic pregnancy?

Ectopic pregnancies fall under the category of medical emergency. Among the parts of the female reproductive system, it is only the uterus that is able to stretch and expand to hold the growing foetus. The fallopian tubes or the ovary or the abdominal cavity or the cervix – none are flexible or can hold the foetus to support pregnancy.

The fallopian tubes or any of the other organs may simply burst as the fertilised egg grows and develops. An ectopic pregnancy is invariably fatal to the foetus barring a single exception known so far. Any rupture in the fallopian tubes or in any of the other organs for that matter, generates very large amounts of internal bleeding. Such bleeding is a threat to the life of the mother and needs immediate medical attention. Quick, fast response and treatment for ectopic pregnancy is essential to protect maternal life.

How is Ectopic Pregnancy symptomised?

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Symptoms of an ectopic pregnancy may include:

  1. Abdominal pain: This is often the first symptom of an ectopic pregnancy and may be felt on one side of the abdomen or the shoulder. The pain may be sharp and sudden or dull and constant.

  2. Vaginal bleeding: Vaginal bleeding during pregnancy is not always a sign of an ectopic pregnancy, but it is a possibility.

  3. Dizziness or fainting: An ectopic pregnancy can cause dizziness or fainting due to blood loss.

  4. Nausea or vomiting: Some people with an ectopic pregnancy may experience nausea or vomiting.

Ectopic Pregnancy - are there any signs as an early warning?

An ectopic pregnancy may reveal itself through:

  • Missed periods
  • Vaginal bleeding
  • Belly pain

Unfortunately, in most instances, very few women get all the three early warning signs.


What causes Ectopic Pregnancy?

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The following are considered as some of the causes for an ectopic pregnancy:

  • Partial or complete blocking of the fallopian tube due to infection or inflammation.
  • Impediment to the movement of the fertilised egg arising from scar tissue from some earlier infection of the fallopian tube or arising from any surgical procedure therein is an ectopic pregnancy cause.
  • Previous surgery in the pelvic area or on the tubes may cause adhesion. This too results in ectopic pregnancy.
  • A defect at birth or abnormal growths may distort the shape of the fallopian tube resulting in ectopic pregnancy.
  • Having contacted sexually transmitted infections like:
    1. Chlamydia.
    2. Gonorrhoea.
    3. Human Papillomavirus (HPV).
    4. Herpes.
    5. Syphilis.
    6. Human Immunodeficiency Virus (HIV).
  • Pelvic inflammatory disease e.g. an infection of the uterus or of the fallopian tubes or of nearby pelvic structures.
  • Endometriosis (a condition whereby uterus lining tissues get outside it) finds uterine tissues on the ovaries, the fallopian tubes, and on other pelvic structures.
  • Age factor as a cause for ectopic pregnancy increase at the age of 35 and beyond.
  • The habit of smoking.
  • A background or history of infertility.
  • Pregnancy is achieved through assisted reproductive technology i.e. those treatments for infertility that fertilise an egg with a sperm outside the body and thereafter transfer the egg to the uterus, e.g. the IVF method (in vitro fertilisation).
  • Previous history of ectopic pregnancy.
  • Your intrauterine birth control device (IUD) being present when the conception happened.
  • Undergoing treatment or medication for infertility at the time of conception becomes a cause for ectopic pregnancy.
  • History of abortions.

You may get in touch with specialist doctors at Pristyn Care for more and detailed information on ectopic pregnancy causes.

How can you prevent Ectopic Pregnancy?

There are no known risk factors associated with more than half of the women incurring ectopic pregnancy. However some do’s and don’ts may help reduce the chance of having an ectopic pregnancy.

Dos in Ectopic Pregnancy

  • Maintaining a healthy diet reduces chances of an ectopic pregnancy.
  • Gain control over your body weight and maintain a healthy weight.
  • If you are a smoker, give up on smoking.
  • Keep number of sexual partners at a minimum.
  • Prevent STIs (sexually transmitted infections) through use of condoms.

Don’ts in Ectopic Pregnancy

  • Do not smoke. Quit smoking when you decide to get pregnant.
  • Do not have sex with too many partners. Too many partners increases the risk of getting infected with pelvic inflammatory disease and other sexually transmitted infections.
  • Do not indulge in bad lifestyle habits.

Ectopic Pregnancy: Who carry the most risks?

You are more prone to the risk of having an ectopic pregnancy under any of the following conditions:-

  1. If you are aged 35 and more.
  2. You have had surgery on your fallopian tube(s).
  3. If you have had tubal ligation.
  4. If you have conceived with an intrauterine device (IUD) in place or have been using one until recently prior to getting pregnant.
  5. If you have had a prior ectopic pregnancy.

Check if you run the risk of getting an ectopic pregnancy by speaking to an expert doctor at Pristyn Care either in person or through on-line consultation. You may seek an appointment instantly.

Is it possible that pregnancy continues despite an ectopic pregnancy?

Most unfortunately, ectopic pregnancy is always fatal for the foetus. External to the uterus, the foetus does not survive. The tissues outside the uterus do not possess any capacity for necessary blood supply. Nor are they capable of providing the necessary structural support that is essential for promotion of placental growth as well as circulation to the gradually developing foetus.

Thus, an ectopic pregnancy cannot survive its full term i.e. till birth. In case of tubal ectopic pregnancy, which is the most common ectopic pregnancy, the fallopian tube ruptures anywhere between 6 to 16 weeks. It becomes life-threatening and may assume dangerous proportions for the mother if treatment is not given on an immediate basis.

Ectopic Pregnancy - Diagnosis and Tests

A visit to your gynaecologist to know about your pregnancy care sets the ball rolling. An expert and experienced doctor, as those available at Pristyn Care, will subject you to several tests, firstly to confirm your pregnancy, and thereafter to check for ectopic pregnancy. Your doctor will subject you to a complete pelvic examination to identify your areas of pain, check for tenderness, and feel for a mass in the fallopian tube or ovary. Your doctor however will not be able to precisely diagnose an ectopic pregnancy through the pelvic examination.

How is Ectopic Pregnancy diagnosed?

You are usually made to go through a urine examination, some blood tests and an ultrasound sonography (USG). The urine test determines your pregnancy. The blood test, serum beta-hCG level, checks the extent of human chorionic gonadotropin (hCG) in your body. This is a hormone produced during pregnancy. The USG checks where the fertilised egg has got planted in your body.

What tests are done for Ectopic Pregnancy?

The USG examination uses sound waves to detect the structures inside your body. The USG examination reveals where the fertilised egg has got planted in your body. An ectopic pregnancy diagnosis is the revelation of the position of the fertilised egg outside the uterus. To be doubly sure, your doctor may resort to a trans-vaginal ultrasound scan. A small tube with a probe is inserted into your vagina. The extremely small probe is quite easily inserted without any need for local anaesthesia. This reveals the precise location of the egg inside your body.

What are possible complications of Ectopic Pregnancy?

A majority of maternal deaths in early stages of pregnancy are due to ectopic pregnancy. Of all extra uterine pregnancies, about 97% instances are implantation of the fertilised egg in the fallopian tube. Of the balance 3% cases of ectopic pregnancy, the egg gets implanted anywhere among the following:

  • The cervix.
  • The ovary.
  • The peritoneal cavity.
  • In uterine scars.

If ectopic pregnancy is allowed to continue, the worst complication is rupture of the tube leading to internal bleeding. This situation is a threat to life and calls for treatment as a medical emergency. In rare cases, the occurrence of an intra-uterine and extra-uterine pregnancy happens simultaneously. This is known as heterotopic pregnancy and poses a tricky situation for the medical team.

What to eat in Ectopic Pregnancy?

Considering the symptoms related to ectopic pregnancy like fatigue, nausea, dizziness etc. your diet plan requires consideration as follows:

  • Replace your three daily large meals with frequent small meals.
  • To avoid dehydration, increase your water intake as much as possible.
  • Your small meals should consist of mild foods like rice, dry toast or crackers, bananas, applesauce etc.
  • Ice cream, custards, gelatin and similar soft foods are well tolerated in ectopic pregnancy.

What not to eat in Ectopic Pregnancy?

  • Avoid use of medicines like ibuprofen and aspirin for relief from pain in the pelvic and other regions of your body.
  • Coffee to be avoided
  • Spicy and salty foods to be avoided
  • Citrus fruits to be avoided
  • Consumption of alcohol and dairy products are well avoided.

Ectopic Pregnancy Treatment

Ectopic pregnancy treatment centres around efforts to minimize risks to the mother’s health and save her life. The treatment plan considers the duration of pregnancy, the clinical condition, the fertility status of the mother, results of the blood test showing the level of b-hCG and the results of the USG and scan.

Ectopic pregnancy treatment is done through one of many options. An experienced practitioner, as those available at Pristyn Care, would choose the best suited one for the health and future child bearing safety of the mother. The options are:

Expectant management:

Waiting for thefertilised egg to move into the uterus and closely monitoring the situation rather than any immediate treatment forms the basis of expectant management. Your doctor will usually closely follow the positional change, if any, and development of the fertilised egg and condition of the tissues it has attached itself to. These are ascertained through weekly transvaginal ultrasonography tests and weekly b-hCG level measurements until the b-hCG level becomes lower than 10 mIU/mL.

Expectant management is usually advised in conditions where:

  • No bleeding into the abdomen happens despite an ultrasound scan revealing a small ectopic pregnancy and b-hCG values are low and declining. However, a primary consideration is that the patient is willing to come for close follow-up.
  • Your doctor suspects an ectopic pregnancy but an ectopic pregnancy is not yet revealed through clinical examinations.


The administering of a drug (systemic methotrexate) in very early stages of ectopic pregnancy is termed medication treatment for ectopic pregnancy. This is done when the tube is intact and not ruptured. Further development of the pregnancy is prevented and aids gradual reabsorption by the body. This leaves the fallopian tube intact. Medical treatment of ectopic pregnancy has a success rate ranging between 65 to 95%. The success rate depends to a large extent on the circumstances in which methotrexate is administered.

You are required, as a patient, to ensure a complete end to the pregnancy. This will require regular follow up visits to your doctor as advised. For three months or so, you may be advised to go for reliable contraceptives.


The best and most established form of treatment for ectopic pregnancy is an operation for removal of ectopic pregnancy. Failure of expectant management or medical management are resolved through surgical management of ectopic pregnancy. Pristyn Care has excellent arrangements for complete preoperative through postoperative surgical treatment of ectopic pregnancy

There are two types of surgical procedures called salpingostomy (also known as fimbrioplasty) and salpingectomy that are done to remove an extra uterine pregnancy. Either Laparoscopy or Laparotomy are applied for these procedures.

  • Laparoscopy (keyhole surgery) is a procedure involving less incision. It has advantages of being less painful and also has a faster recovery time in comparison to laparotomy.
  • Laparotomy, which is an open surgery, is adopted in an emergency situation. It is also inevitable for cases of heavy internal bleeding arising from rupture (an emergency situation by itself) or presence of previous scar tissue.
  • Salpingostomy: Done for cases where rupture has not occurred, removes the products of conception with a small lengthwise incision of the fallopian tube (linear salpingostomy). Salpingostomy runs the small risk of some of the products of pregnancy remaining in the tube even after the surgery. Your hCG levels need to be monitored via weekly blood tests. Full resolution of the ectopic pregnancy is confirmed by decreased levels of hCG.
  • Salpingectomy: Salpingectomy removes the damaged fallopian tube completely as ruptured ectopic pregnancy treatment or even when the tube has been damaged. You are left with one fallopian tube only after a salpingectomy procedure. The healthy fallopian tube that remains is reconnected. If you have completed childbearing and no longer wish to retain your fertility, total salpingectomy, i.e. removal of both fallopian tubes, may be performed.

If facilities exist, tissue removed during surgery may be sent to a laboratory for tests.

Which doctor to consult for Ectopic Pregnancy?

An Obstetrician and Gynecologist is the best doctor to consult in cases of ectopic pregnancy or simply connect with Pristyn Care for being put to one of the best specialists in the field to take complete care of your condition.

When should I seek a doctor's help for Ectopic Pregnancy?

If you incur heavy vaginal bleeding, light-headedness, dizziness, fainting spells, shoulder pain, severe pain in your belly (especially on one side), it is time for you to rush to your doctor on an urgent basis.

Ectopic Pregnancy Treatment without surgery

Early ectopic pregnancy is known in some cases to end on its own through miscarriage. Most women unfortunately do not have such fortune. For them, medical intervention becomes necessary. In fortunate cases, an ectopic pregnancy is seen to migrate into the uterus on its own with time. If you desire to avoid surgery, although it is by far the best and most sure-shot way to treat an ectopic pregnancy, methotrexate medication may be used. It is administered as an ectopic pregnancy treatment injection.

Which are the best medicines for Ectopic Pregnancy?

When the diagnosis of ectopic pregnancy is certain, and is detected in its early stage without any unstable bleeding, methotrexate medication is prescribed. This medicine stops the growth of cells and dissolves the existing cells.

Ectopic Pregnancy Surgical Procedures

The surgical treatments, which are the most reliable treatment for ectopic pregnancy, are two laparoscopic surgeries, salpingostomy and salpingectomy. Emergency surgery is called for when heavy bleeding has started. This surgery is done laparoscopically or with laparotomy which involves incision of the abdomen. Attempt is always to save the fallopian tube but there is no way out but to remove a ruptured tube.

What procedure comprises surgery for Ectopic Pregnancy?

Two laparoscopic surgical methods, salpingostomy and salpingectomy, are used for removal of ectopic pregnancies. Both procedures involve a small incision in the abdomen, in the navel or near it. A camera lens attached to a thin tube and light (laparoscope) are used to view the tubal area.

The ectopic pregnancy is removed in a salpingostomy procedure. This procedure leaves the fallopian tube and it heals by itself.

Salpingectomy involves removal of both - the ectopic pregnancy as well as the tube.

In cases of ruptured or damaged tubes, emergency surgery needs to be done. Either an abdominal incision (laparotomy) or laparoscopy is performed. The tube needs complete removal in either method of surgery.

In general, surgical procedure will go along the following lines:

  • You will be administered general anesthesia and you will be asleep through the surgery.
  • Your tummy will get incisions / small cuts.
  • A laparoscope which is a thin viewing tube will be inserted through the incision along with small surgical instruments.
  • The entire fallopian tube with the pregnancy within gets removed in this procedure. If your remaining fallopian tube does not appear in good health, an attempt is made to remove the pregnancy without removal of the whole tube.

Surgery for an ectopic pregnancy: What to expect thereafter?

Submit to the need for recovery and healing of your body after surgery. This submission is similar to almost all other surgery. Rest for a week although you may feel better sooner. Let your family or friends assist you with your chores and errands during your recovery. Exercise and other strenuous activities are ruled out until advised by your doctor.

How long does it take to recover from Ectopic Pregnancy?

Apart from the physical and medical issues involved, loss of pregnancy takes a toll on your mental health as well. You may feel devastated, even if your pregnancy has been for a very short time. It is all right to allow yourself some time to recognise the loss that is best known to you, and to grieve over it. Your partner will be there to support you, as will be your friends and the ones that love you. Have no hesitation in seeking the help of a support group. If need be, go for counselling. If necessary, get advice from a mental health provider. Do all it needs to come out of the loss and any trauma building over it.

After a laparoscopic ectopic pregnancy surgery, you usually get permission to resume normal activities within a week. A laparotomy, on the other hand, may require you to give two to six weeks before resumption of normal activities depending on your health condition.

Some abdominal soreness and swelling is to be expected. Follow your prescribed pain medication regime as instructed. It is normal to feel mildly nauseous for a day or two after surgery. Restrict your diet to bland food. You may have some light foods like toast. You may also have some crackers as a change, if you so desire. Chicken broth or very light soup are good for rejuvenators. All the named foods aid in your recovery. Expect some bleeding from your vagina over one to four weeks after your surgery. This does not imply that something has gone wrong, so have no fear. You are likely to be advised against use of tampons to help prevent infection for some period of time by your doctor.

For the surgical wound, follow the advice of your surgeon regarding resumption of your showers. Make sure to be gentle while you wash your incision site(s). Use a clean, disinfected towel to pat them dry after your shower. Avoid powdering or applying lotions on and around your incision site(s). Once dry, apply new dressings over the incision site(s) following the advice of your doctor about the “how to do’s” associated with it.

Your activity guidelines to follow after surgery would have been specified by your doctor. Ensure that you do not swim until cleared by your doctor. The same applies for bathing and engaging in sex. Driving is off-limits as long as your post-surgical medication continues and until cleared by your doctor to do so.

Do not miss your follow up appointment date after your surgery. A thorough check of your incision site(s), removal of non-absorbable sutures, and monitoring of conditions for complications will happen during this visit.

If you experience any of the following symptoms before or after your follow up visit, do not hesitate to seek another appointment:

  • Fever
  • Any vaginal discharge or heavy vaginal bleeding with clots
  • Fainting, dizziness or light-headedness
  • Pain that does not ease even after medication
  • Nausea and vomiting that happens persistently
  • Redness, swelling, or abnormal drainage at the incision site(s) indicating infection
  • Swelling of the abdomen that is getting worse.

As part of long-term care after a salpingostomy, you will be required to visit your doctor on a weekly basis to check on your hCG level to confirm that it is declining to zero. This signals that the ectopic pregnancy is completely gone and no pregnancy tissue remains in the fallopian tube.

What is the price of Ectopic Pregnancy treatments in India?

The cost of ectopic pregnancy in India involving surgery, which is the best and most effective method of treatment, varies between Rs. 73,000/- and Rs. 2,50,000/- depending on the complications and state of the patient. Pristyn Care offers one of the most cost-effective complete treatments and care for ectopic pregnancy.

Are the results of the Ectopic Pregnancy treatment permanent?

Surgery offers permanent, comprehensive treatment for ectopic pregnancy.

Who is eligible for the Ectopic Pregnancy treatment?

Pregnant women with extra uterine pregnancy become eligible for treatment.

Who are ineligible for treatment of ectopic pregnancy?

Where ectopic pregnancy is not confirmed, treatment does not commence.

What are the post-treatment guidelines Ectopic Pregnancy treatment?

If you have been treated with methotrexate medication, you will be advised to use reliable contraceptives for at least three months. Methotrexate is harmful for your baby if you conceive during this period and its effects do not get washed out of your body sooner. You will also be required to abstain from alcohol as it harms your liver while the drug remains within your body.

What are side-effects of Ectopic Pregnancy treatments?

Side effects of methotrexate, i.e. medical treatment for ectopic pregnancy, include:

  • Mild tummy pain that passes within a day or two
  • Dizziness
  • Feeling and being sick
  • Diarrhoea
  • Chance of rupture of your fallopian tube

Side effects of surgical treatment of ectopic surgery include:

  • Fever
  • Any vaginal discharge or heavy vaginal bleeding with clots
  • Fainting, dizziness or light-headedness
  • Pain that does not ease even after medication
  • Nausea and vomiting that happens persistently
  • Redness, swelling, or abnormal drainage at the incision site(s) indicating infection
  • Swelling of the abdomen that gradually gets worse

Ectopic Pregnancy - Outlook / Prognosis

An ectopic pregnancy is unfortunately fatal for the foetus. Survival of the foetus outside of the uterus is a miracle although the world has known at least one such rarest of rare instances. Considering the safety of the life of the mother, quick and fast treatment of an ectopic pregnancy is of utmost importance. Severe internal bleeding to the extent of fatality may happen if the fallopian tube bursts open with the growth of a fertilised egg implanted within. The incidences of ectopic pregnancies are on the rise. However, fatality rate has been substantially lowered with advancement in diagnostics and treatment facilities.

Frequently Asked Questions (FAQs)

Can Ectopic Pregnancy pain come and go?

Yes, ectopic pregnancy is symptomized by abdominal or pelvic pain in the lower abdomen. The pain is often sudden and sharp and without any apparent reason. It may seem to come and go by itself, often occurring on only one side.

Is Ectopic Pregnancy dangerous?

Yes. Ectopic pregnancy is fatal if not detected and treated early as it may cause rupture of the fallopian tube causing heavy bleeding leading to death. It is a leading cause behind early death of mothers from pregnancy.

How to check for Ectopic Pregnancy at home?

At home, an ectopic pregnancy expresses itself through the following -
  • (a) Abnormal vaginal bleeding that is different from your normal bleeding during periods.
  • (b) Sudden pain in the pelvic or lower abdomen region, often on one side, that comes and goes.
  • (c) Pain in the shoulders, on one side.
  • (d) Rectal pressure and pain during bowel movement.
  • (e) Feeling of weakness, dizziness, or even fainting.

What causes Ectopic Pregnancy in a child?

Ectopic pregnancy in a child, entering the age of puberty, may occur from repeated sexual abuse. The under-developed or developing organs and hormones of her reproductive system are not yet fully developed into child bearing stage and are most likely to lead to an ectopic pregnancy.

Why does Ectopic Pregnancy occur?

The most common type of ectopic pregnancy – a tubal pregnancy often happens due to damage by inflammation or mis-shape of the fallopian tube. This obstructs normal movement of a fertilised egg to the uterus, and the egg remains within the tube. An extra uterine pregnancy may also result from hormonal imbalances in the body. It may also be due to any abnormal development of the fertilized egg.

Can you get Ectopic Pregnancy more than once?

Yes, there are fair chances of repeat ectopic pregnancy depending on factors like age, history, lifestyle, use of contraceptives, use of IUD, adoption of IVF techniques etc.

Does Ectopic Pregnancy make you pee a lot?

Frequent urination is associated with pregnancy and is duly associated with ectopic pregnancy as well.

Hospitalisation for abdominal pain - when should I go for it?

You should seek an appointment with the doctor soon as you develop any signs or symptoms of an ectopic pregnancy, like:
  • normal vaginal bleeding accompanied by pain in the abdomen or pelvic region
  • Feeling of extreme light-headedness, dizziness, fainting
  • Shoulder pain


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Written ByDr. Anand Bhatt MS - Obstetrics and Gynaecolog,PG Diploma in IVF & Reproductive Medicine,Advanced Infertility & ART trainin,MBBS,Diploma in Minimal Access SurgeryGynaecology
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