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Overview

Reproduction: Treatment, Procedure, Cost and Side Effects

What is the treatment?

Infertility is a condition where the woman is unable to get pregnant due to pressing problems persisting in her reproductive organs. This includes her inability to ovulate due to conditions such as polycystic ovaries that causes irregular menstruation, damaged or blocked fallopian tubes, or a condition called endometriosis due to which an extra tissue develops outside the uterus. (This condition can be cured through surgery). Defects related to reproduction equally exist in men and this happens when the man has low or poor sperm-count.

Though there are treatments available for both men and women, the couple has to make sure that they do not procrastinate, as post 35, a woman gradually loses her ability of becoming pregnant. Treatment for women includes the consumption of fertility drugs which induce ovulation. Artificial Insemination is another process and in some cases surgeries are also recommended for women before conception.

Costlier treatments are available for those who do not obtain success from the regular methods. The umbrella term under which such procedures are constituted is called Artificial Reproductive Technology (ART). In vitro fertilization is the most common type of ART. Techniques that constitute in vitro fertilization include Intracytoplasmic sperm injection, assisted hatching and surrogacy.

Infertile men may be asked to alter their life-style to stimulate a surge in sperm-count; some might have to undergo a surgery while for others sperm-count stimulating medicines might work. In such cases where the level of sperm found in the ejaculated fluid is zero, a technique called sperm retrieval can be implemented where sperm is retrieved from the testis through surgery.

Modern methods do encourage the process of reproduction but neither of them vouches for the fact that the woman will get pregnant. However, in recent times improved technology has caused inflation in the rates of success.

How is the treatment done?

Reproduction is a major component in the entire spectrum of a human life and the inability to procreate often takes a toll on a person’s emotional health. But there are lots of treatments that a couple can consider to overcome infertility.

Fertility drugs that might come in the form of injection shots or pills are the most common measures that help a woman to reproduce. These medicines encourage egg production and make the uterus fit for the artificial placing of embryo. In many cases these drugs are enough to make a woman pregnant. They are cheaper in price when compared to other reproduction-inducing treatments.

Artificial Insemination or Intrauterine Insemination is another process that goes hand in hand with the consumption of fertility pills. Washed or purified sperms are injected into the woman’s uterus via a catheter. It is best for those women whose partners suffer from low-density sperm count. It is also a good option for those women whose cervical mucus is too dense or acidic to allow sperm to travel. In most cases pregnancy occurs after the sixth cycle of treatment.

Other formats of fertility treatments where the physiological (reproductive) samples of either of the parents or both are replaced by samples of someone other than the biological parent(s) include Donor Eggs, Donor Sperm, Donor Embryos and Surrogacy. These are best for those who suffer from unexplained infertility or anomalies that they do not wish to pass on to the children.

In vitro fertilization is the most talked-about and expensive among all the fertility treatments. In this the egg of a woman is retrieved and it is practically incubated in a lab with the help of a healthy sperm. Once it develops into an embryo it is placed in either the uterus or the fallopian tubes.

Who is eligible for the treatment? (When is the treatment done?)

A woman who suffers from the inability to become pregnant after a couple of trials is fit for undergoing fertility treatments. Similarly a man who is affected by low-density sperm count, owing to which his partner fails to conceive, might consider fertility treatment.

Who is not eligible for the treatment?

Women post the age of 35 are usually dissuaded from undergoing fertility treatments as with age women lose the ability to become pregnant. Despite the existence of various methods cases of unexplained infertility are not uncommon. For these people nothing might work. Those women who are disinclined toward conceiving multiple babies shall not go for fertility treatments, as, multiple birth is a common side effect of these treatments.

Are there any side effects?

The most common side effect of infertility treatments is multiple births resulting in premature delivery. Other factors include fatigue, nausea, bloating and development of ovarian cysts that could result from the intake of fertility drugs. Insertion of developed embryos into the fallopian tubes could be a risky process and recovery time might be longer than usual. Processes like surrogacy, donor embryo and donor eggs entail a lot of legal miscellanies, not to mention the personal stress. Apart from that these treatments often come with a rigorous regimen that patients need to follow in order to attain success. Moreover, fertility treatments do not warrants positive result. In some cases they just fail to work.

What are the post-treatment guidelines?

Women undergoing fertility treatments face higher chances of giving birth to premature babies. In such cases the baby needs to be kept under special care, often, under the guidance of the obstetrician for quite a few days before it is handed over to the parents. Even the mother can face certain problems after undergoing fertility treatments, like she can develop ovarian cysts or unexplained bloating. To combat these conditions dosages of medicines might continue for long even after pregnancy. To get proper post-pregnancy guidelines the concerned doctor(s) who have performed the fertility treatment need to be consulted.

How long does it take to recover?

Women who undergo such treatments where the embryo or embryos are placed in the fallopian tubes utilizing laparoscopic surgery have higher chances of facing assisted medical problems and often the recovery time in such cases become longer than usual. In many cases fertility treatments just do not work. In a circumstance like that recovery in terms of getting back ones psychological integrity and stability become more of a challenge than recovering health-wise. Therefore, couples must look in to both the advantages and downsides of fertility treatments before stepping out.

What is the price of the treatment in India?

The cost of In Vitro Fertilization starts from Rs. 65,000 and can go up to Rs. 3, 00000 based on the kind of facility and the reputation of the facility. Artificial Reproductive Technologies are often assisted by the prescription of fertility drugs which can be as low as 415 Rupees or as high as 6000 Rupees depending upon the requirement of the patient. Procedures such as surrogacy, donor sperm, embryo eggs etc could be of any range and is subject to the demands of the donor.

Are the results of the treatment permanent?

If the fertility treatment works and everything goes fine with the health of the baby secured, the result will have permanency. However, in some scenarios it has been observed that children born out of fertility treatments have developed anomalies in their later lives. But the argument has no valid ground as this can occur in anyone, naturally born or otherwise.

To be precise, the result of fertility treatments could be either positive and enduring, or negative, bringing about no result at all.

What are the alternatives to the treatment?

There are many alternatives that may work to ease up the process of pregnancy; however, they are not foolproof methods assuring a positive result. Acupuncture is a very popular therapy and it can produce positive result when assisted with IVF treatment. Popular singer Celine Dion sought the help of acupuncture beside undergoing IVF treatment after a failed pregnancy and she gave birth to twin healthy babies as a result of it.

Other alternatives include meditation, yoga, crystal therapy, consuming soya supplements and most importantly leading a healthy life.

Safety: Treatment Effectiveness: High Timeliness: High Relative Risk: Low Side Effects: Low Time For Recovery: Medium Price Range:

Rs . 2000 - Rs 2,50,000

Popular Health Tips

How You Can Take Care Of Yourself During IVF Treatments

MD / MS - Obstetrtics & Gynaecology, MBBS
IVF Specialist, Delhi
How You Can Take Care Of Yourself During IVF Treatments

The In-vitro-Fertilization method has revolutionized reproductive technology and has made natural conception possible for so many expectant families. Despite its popularity, many individuals still fail to see to their well-being during treatment. Not only does it affect the probability and success of conception, it can also lead to further mental stress that can only be destructive towards your psychological health and perhaps your upcoming pregnancy. Here are a few ideas on how you can best take care of yourself during the treatment period:

1. Proper Sleep
A sufficient amount of sleep every night goes a long way to ensuring a peaceful state of mind. As you are anticipating conception, you should schedule your timings such that you can sleep for at least 8 hours every night. Additionally, adopt a nightly ritual so you can ease yourself into bed at a regular time every night. This allows your body clock to be standardized through the treatment period and provide you with optimal energy for the day.

2. Keep Hydrating
Fluids are ideal for flushing out the negative toxins from your body. As a result of the treatment, your body is going through a number of chemical and biological changes. Thus water and other fluids like vegetable and fruit juices help your body maintain a healthy count of blood cells and ward off side effects that may arise during the IVF treatment.

3. Acupuncture
Clinical tests have proven that certain acupuncture procedures strengthen the flow of blood into the uterus and the ovaries. Most specialists recommend that you undergo a session of acupuncture the day of the embryo transfer so that you do not activate your stress hormones. As IVF treatments often become quite trying for the couple in question, you might want to try this method to release anxiety.

4. Take Walks
Though it is not recommended that you exert yourself too much physically, engaging in light walks should only help you ease into your IVF cycle. Not only will it maintain your balance and coordination, it can also improve your mood and help you maintain an appropriate weight for conception.

5. Journal
Even if you may not realize it at the time, this period could turn out to be one of the most significant periods of your life. Becoming a mother is a complex challenge yet a wonderful privilege and you might want to document your experiences while you are going through the treatment. Not only is it incredibly soothing, it might help you prepare for your upcoming journey by letting you recognize and accept your emotions.

1 person found this helpful

Andrology - All The Issues That It Caters To!

DGO, MBBS
Gynaecologist, Delhi
Andrology - All The Issues That It Caters To!

Andrology is the male equivalent of gynecology, which refers to the study of the female reproductive system and sexual health. Unlike its female counterpart, andrology is not very widely used. Urology is a more popular known specialty for male urinary and reproductive issues.

Read on to understand some of the common issues and procedures that come under the purview of andrology.

  1. Vasectomy: One of the most effective methods of birth control, vasectomy is ligating the tubes so that the sperm does not enter the urethra. It is a definitive surgical contraceptive technique and is very simple, as compared to the other contraceptive measures.
  2. Circumcision: Surgical method of removing the foreskin, which may be done for medical or elective reasons, at birth or later in life. This is one of the most widely performed surgical procedures across the world.
  3. Prostatitis: The prostate gland is a walnut-sized gland located between the bladder and the penis. It can get inflamed as a result of infection, often bacterial. This can be acute or chronic and presents with painful urination and change in color of urine. The patient never has the feeling of having emptied the bladder fully, and there is a constant fullness. Urge to urinate is increased, especially at night. A course of antibiotics often helps in treatment.
  4. Impotence: The most common reproductive problem in males, impotence or erectile dysfunction is now known to have strong psychological and physiological components. In addition to male organ problems, there can be unhealthy relationships and performance anxiety which also could lead to impotence. In most cases, counseling will help in managing impotence.
  5. Epididymitis: In sexually active males, the epididymis which is located behind the testicles can get inflamed as a complication of gonorrhea or chlamydia. There can also be swelling of the testicles, frequent urination, and a burning sensation when urinating. Treatment includes pain killers and antibiotics.
  6. Phimosis: In a patient with phimosis, the foreskin cannot be pulled back beyond the glans. There could be a balloon-like swelling with urination under the foreskin. It is often painless, but with the erection, may be slightly painful. Seen in young children, usually resolves by the age of 7 years.
  7. Peyronie's disease: This is a connective tissue disorder, where fibrous plaques form in the soft areas of the penis. The penis develops a curvature which does not easily go away. It becomes common with age and interferes with urination and sexual intercourse. Though it resolves with time, there is no definitive treatment for this condition.

These are the major conditions encountered by andrologists. This specialty has gained popularity over the last few decades and is only set to get more popular in the coming years.

2675 people found this helpful

All You Need to Know About the Surrogacy Process

Advanced Infertility, Diploma in Obstetrics & Gynaecology, MBBS
IVF Specialist, Delhi
All You Need to Know About the Surrogacy Process

Surrogacy is a boon for couples who cannot conceive naturally or give birth to a child. Surrogacy is a process in which a woman's unfertilized eggs are implanted into the uterus of another woman who is called the surrogate mother. The egg is fertilized in the surrogate mother's uterus with the biological father's sperm. The surrogate mother lets the child develop in her womb and gives birth. Although, there are various medical treatments available, but not all of them have a high success rate.

The two primary methods of surrogacy are:

  1. Traditional surrogacy: In this process, the surrogate mother is artificially inseminated with the sperm, which belongs to the biological father of the baby. The sperm gets implanted into the surrogate mother's uterus and the child develops in her womb.
  2. Gestational surrogacy: For women who want to have a biological child in spite of being incapable of pregnancy, the gestational surrogacy method is used. During the process, in-vitro fertilization is undertaken and the eggs from the woman who wants to become a biological mother are harvested. The eggs, along with the sperm from the biological father are implanted into the uterus of a surrogate mother, who will carry the embryo and will give birth to the child.

Process involved in surrogacy:
Here are the several processes and procedures, which need to be undertaken, after you have chosen a surrogate mother for carrying your child.

  1. Medical testing: After a surrogate mother is chosen, the woman goes through several health checkups, medical and psychological tests to ensure that she gives birth to a healthy child.
  2. Legal agreements: There are several legal considerations that have to be addressed for a surrogacy. All the legal requirements regarding the surrogacy should be written down. Some issues include both the surrogate mother and the biological parents. A financial contract must be presented as well, which will reimburse the medical expenses and requirements of the surrogate mother.
  3. Medical process: The medical processes required for surrogacy include in-vitro fertilization and the transfer of the eggs, which are done in a clinic under the supervision of a reproductive endocrinologist. The eggs are transferred to the uterus of the surrogate, where fertilization takes place after combining it with the sperms of the biological father.
  4. Pregnancy and birth: After successful fertilization, the surrogate mother gets pregnant. Proper care and precautions should be taken by her to ensure a successful birth. Finally, the surrogate mother gives birth to a child, who belongs to the biological parents.

This method of having a child has become very popular in the recent times. It is a great blessing for people who cannot conceive due to medical conditions or otherwise. If you wish to discuss about any specific problem, you can consult an IVF Specialist.

3304 people found this helpful

Know Everything About Fibroid

FRCOG (LONDON) (Fellow of Royal College of Obstetricians and Gynaecologists), CCT (Lon), DNB (Obstetrics and Gynecology), MD
Gynaecologist, Mumbai
Know Everything About Fibroid

Fibroids are the most frequently seen tumors of the female reproductive system. Fibroids, also known as uterine myomas, leiomyomas, or fibromas, are firm, compact tumors that are made of smooth muscle cells and fibrous connective tissue that develop in the uterus. It is estimated that between 20 to 50 percent of women of reproductive age have fibroids, although not all are diagnosed. Some estimates state that only about one-third of these fibroids are large enough to be detected by a doctor during a physical examination.

In more than 99 percent of fibroid cases, the tumors are benign (non-cancerous). These tumors are not associated with cancer and do not increase a woman's risk for uterine cancer. They may range in size, from the size of a pea to the size of a softball or small grapefruit.

Causes: While it is not clearly known what causes fibroids, it is believed that each tumor develops from an aberrant muscle cell in the uterus, which multiplies rapidly because of the influence of estrogen.

Risk Factors:

  • Age: Women who are approaching menopause are at the greatest risk for fibroids because of their long exposure to high levels of estrogen.
  • Obesity
  • Race: African-American heritage also seems to be at an increased risk, although the reasons for this are not clearly understood.
  • Parity: Some studies, of small numbers of women, have indicated that women who have had two liveborn children have one-half the risk of developing uterine fibroids compared to women who have had no children. Scientists are not sure whether having children actually protected women from fibroids or whether fibroids were a factor in infertility in women who had no children.

Symptoms:

Some women who have fibroids have no symptoms, or have only mild symptoms, while other women have more severe, disruptive symptoms. The following are the most common symptoms for uterine fibroids:

  • Heavy or prolonged menstrual periods

  • Abnormal bleeding between menstrual periods

  • Pelvic pain (caused as the tumor presses on pelvic organs)

  • Frequent urination

  • Low back pain

  • Pain during intercourse

  • A firm mass, often located near the middle of the pelvis, which can be felt by the doctor on examination

In some cases, the heavy or prolonged menstrual periods, or the abnormal bleeding between periods, can lead to iron-deficiency anemia, which also requires treatment.

Diagnosis: Fibroids are most often found during a routine pelvic examination. This, along with an abdominal examination, may indicate a firm, irregular pelvic mass to the physician. In addition to a complete medical history and physical and pelvic and/or abdominal examination, diagnostic procedures for uterine fibroids may include:

  • Transvaginal ultrasound (also called ultrasonography). An ultrasound test using a small instrument called a transducer, that is placed in the vagina.

  • Magnetic resonance imaging (MRI). A non-invasive procedure that produces a two-dimensional view of an internal organ or structure.

  • Hysterosalpingography. X-ray examination of the uterus and fallopian tubes that use dye and is often performed to rule out tubal obstruction.

  • Hysteroscopy. Visual examination of the canal of the cervix and the interior of the uterus using a viewing instrument (hysteroscope) inserted through the vagina.

  • Blood test (to check for iron-deficiency anemia if heavy bleeding is caused by the tumor).

Treatment: Since most fibroids stop growing or may even shrink as a woman approaches menopause, the doctor may simply suggest "watchful waiting." With this approach, the doctor monitors the woman's symptoms carefully to ensure that there are no significant changes or developments and that the fibroids are not growing.

In women whose fibroids are large or are causing significant symptoms, treatment may be necessary. Treatment will be determined by the doctor based on:

  • Your overall health and medical history

  • Extent of the disease

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

  • Your desire for pregnancy

In general, treatment for fibroids may include:

  1. HysterectomyHysterectomies involve the surgical removal of the entire uterus.

  2. Conservative surgical therapy. Conservative surgical therapy uses a procedure called a myomectomy. With this approach, physicians will remove the fibroids, but leave the uterus intact to enable a future pregnancy.

  3. Gonadotropin-releasing hormone agonists (GnRH agonists). This approach lowers levels of estrogen and triggers a "medical menopause." Sometimes GnRH agonists are used to shrink the fibroid, making surgical treatment easier.

  4. Anti-hormonal agents. Certain drugs oppose estrogen (such as progestin and Danazol), and appear effective in treating fibroids. Anti-progestins, which block the action of progesterone, are also sometimes used.

  5. Uterine artery embolizationAlso called uterine fibroid embolization, uterine artery embolization (UAE) is a newer minimally-invasive (without a large abdominal incision) technique. The arteries supplying blood to the fibroids are identified, then embolized (blocked off). The embolization cuts off the blood supply to the fibroids, thus shrinking them. Health care providers continue to evaluate the long-term implications of this procedure on fertility and regrowth of the fibroid tissue.

  6. Anti-inflammatory painkillers. This type of drug is often effective for women who experience occasional pelvic pain or discomfort. In case you have a concern or query you can always consult an expert & get answers to your questions!

2407 people found this helpful

Everything You Want To Know About Endometriosis

FRCOG (LONDON) (Fellow of Royal College of Obstetricians and Gynaecologists), CCT (Lon), DNB (Obstetrics and Gynecology), MD
Gynaecologist, Mumbai
Everything You Want To Know About Endometriosis

Endometriosis is an often painful disorder in which tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus. Endometriosis most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis. Rarely, endometrial tissue may spread beyond pelvic organs.

With endometriosis, displaced endometrial tissue continues to act as it normally would — it thickens, breaks down and bleeds with each menstrual cycle. Because this displaced tissue has no way to exit your body, it becomes trapped. When endometriosis involves the ovaries, cysts called endometriomas may form. Surrounding tissue can become irritated, eventually developing scar tissue and adhesions — abnormal bands of fibrous tissue that can cause pelvic tissues and organs to stick to each other.

Endometriosis can cause pain — sometimes severe — especially during your period. Fertility problems also may develop. Fortunately, effective treatments are available.

Symptoms

The primary symptom of endometriosis is pelvic pain, often associated with your menstrual period. Although many women experience cramping during their menstrual period, women with endometriosis typically describe menstrual cramp that's far worse than usual. They also tend to report that the pain increases over time.

Common Signs and Symptoms of Endometriosis may include:

  • Painful periods (dysmenorrhea). Pelvic pain and cramping may begin before your period and extend several days into your period. You may also have lower back and abdominal pain.

  • Pain with intercourse. Pain during or after sex is common with endometriosis.

  • Pain with bowel movements or urination. You're most likely to experience these symptoms during your period.

  • Excessive bleeding. You may experience occasional heavy periods (menorrhagia) or bleeding between periods (menometrorrhagia).

  • Infertility. Endometriosis is first diagnosed in some women who are seeking treatment for infertility.

  • Other symptoms. You may also experience fatigue, diarrhea, constipation, bloating or nausea, especially during menstrual periods.

The severity of your pain isn't necessarily a reliable indicator of the extent of the condition. Some women with mild endometriosis have intense pain, while others with advanced endometriosis may have little pain or even no pain at all.

Endometriosis is sometimes mistaken for other conditions that can cause pelvic pain, such as Pelvic Inflammatory Disease (PID) or ovarian cysts. It may be confused with irritable bowel syndrome (IBS), a condition that causes bouts of diarrhea, constipation and abdominal cramping. IBS can accompany endometriosis, which can complicate the diagnosis.

When to see a doctor

See the doctor if you have signs and symptoms that may indicate endometriosis.

Endometriosis can be a challenging condition to manage. An early diagnosis, a multidisciplinary medical team and an understanding of your diagnosis may result in better management of your symptoms.

Causes

Although the exact cause of endometriosis is not certain, possible explanations include:

  • Retrograde menstruation. In retrograde menstruation, menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of out of the body. These displaced endometrial cells stick to the pelvic walls and surfaces of pelvic organs, where they grow and continue to thicken and bleed over the course of each menstrual cycle.

  • Transformation of peritoneal cells. In what's known as the "induction theory," experts propose that hormones or immune factors promote transformation of peritoneal cells — cells that line the inner side of your abdomen — into endometrial cells.

  • Embryonic cell transformation. Hormones such as estrogen may transform embryonic cells — cells in the earliest stages of development — into endometrial cell implants during puberty.

  • Surgical scar implantation. After a surgery, such as a hysterectomy or C-section, endometrial cells may attach to a surgical incision.

  • Endometrial cells transport. The blood vessels or tissue fluid (lymphatic) system may transport endometrial cells to other parts of the body.

  • Immune system disorder. It's possible that a problem with the immune system may make the body unable to recognize and destroy endometrial tissue that's growing outside the uterus.

Risk factors

Several factors place you at greater risk of developing endometriosis, such as:

  • Never giving birth

  • Starting your period at an early age

  • Going through menopause at an older age

  • Short menstrual cycles — for instance, less than 27 days

  • Having higher levels of estrogen in your body or a greater lifetime exposure to estrogen your body produces

  • Low body mass index

  • Alcohol consumption

  • One or more relatives (mother, aunt or sister) with endometriosis

  • Any medical condition that prevents the normal passage of menstrual flow out of the body

  • Uterine abnormalities

Endometriosis usually develops several years after the onset of menstruation (menarche). Signs and symptoms of endometriosis end temporarily with pregnancy and end permanently with menopause, unless you're taking estrogen.

Complications

Infertility

The main complication of endometriosis is impaired fertility. Approximately one-third to one-half of women with endometriosis have difficulty getting pregnant. Endometriosis may obstruct the tube and keep the egg and sperm from uniting. But the condition also seems to affect fertility in less-direct ways, such as damage to the sperm or egg. Inspite of this, many women with mild to moderate endometriosis can still conceive and carry a pregnancy to term. Doctors sometimes advise women with endometriosis not to delay having children because the condition may worsen with time.

Ovarian cancer

Ovarian cancer does occur at higher than expected rates in women with endometriosis. Although rare, another type of cancer — endometriosis-associated adenocarcinoma — can develop later in life in women who have had endometriosis.

Diagnosis: To diagnose endometriosis and other conditions that can cause pelvic pain, the doctor will ask you to describe your symptoms, including the location of your pain and when it occurs.

Tests to check for physical clues of endometriosis include:

  • Pelvic exam. During a pelvic exam, the doctor manually feels (palpates) areas in your pelvis for abnormalities, such as cysts on your reproductive organs or scars behind your uterus. Often it's not possible to feel small areas of endometriosis, unless they've caused a cyst to form.

  • Ultrasound. A transducer, a device that uses high-frequency sound waves to create images of the inside of your body, is either pressed against your abdomen or inserted into your vagina (transvaginal ultrasound). Both types of ultrasound may be done to get the best view of your reproductive organs. Ultrasound imaging won't definitively tell the doctor whether you have endometriosis, but it can identify cysts associated with endometriosis (endometriomas).

  • Laparoscopy. Medical management is usually tried first. But to be certain you have endometriosis, the doctor may advise a surgical procedure called laparoscopy to look inside your abdomen for signs of endometriosis.

While you're under general anesthesia, the doctor makes a tiny incision near your navel and inserts a slender viewing instrument (laparoscope), looking for endometrial tissue outside the uterus. He or she may take samples of tissue (biopsy). Laparoscopy can provide information about the location, extent and size of the endometrial implants to help determine the best treatment options.

Treatment for endometriosis is usually with medications or surgery. The approach you and the doctor choose will depend on the severity of your signs and symptoms and whether you hope to become pregnant.

Generally, doctors recommend trying conservative treatment approaches first, opting for surgery as a last resort.

Pain medications

The doctor may recommend that you take an over-the-counter pain reliever, such as the nonsteroidal anti-inflammatory drugs (NSAIDs) ibuprofen (Advil, Motrin IB, others) or naproxen (Aleve, others), to help ease painful menstrual cramps.

If you find that taking the maximum dose of these medications doesn't provide full relief, you may need to try another approach to manage your signs and symptoms.

Hormone therapy

Supplemental hormones are sometimes effective in reducing or eliminating the pain of endometriosis. The rise and fall of hormones during the menstrual cycle causes endometrial implants to thicken, break down and bleed. Hormone medication may slow endometrial tissue growth and prevent new implants of endometrial tissue.

Hormone therapy isn't a permanent fix for endometriosis. You could experience a return of your symptoms after stopping treatment.

Therapies used to treat endometriosis include:

  • Hormonal contraceptives. Birth control pills, patches and vaginal rings help control the hormones responsible for the buildup of endometrial tissue each month. Most women have lighter and shorter menstrual flow when they're using a hormonal contraceptive. Using hormonal contraceptives — especially continuous cycle regimens — may reduce or eliminate the pain of mild to moderate endometriosis.

  • Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists. These drugs block the production of ovarian-stimulating hormones, lowering estrogen levels and preventing menstruation. This causes endometrial tissue to shrink. Because these drugs create an artificial menopause, taking a low dose of estrogen or progestin along with Gn-RH agonists and antagonists may decrease menopausal side effects, such as hot flashes, vaginal dryness and bone loss. Your periods and the ability to get pregnant return when you stop taking the medication.

  • Progestin therapy. A progestin-only contraceptive, such as an intrauterine device (Mirena), contraceptive implant or contraceptive injection (Depo-Provera), can halt menstrual periods and the growth of endometrial implants, which may relieve endometriosis signs and symptoms.

  • Danazol. This drug suppresses the growth of the endometrium by blocking the production of ovarian-stimulating hormones, preventing menstruation and the symptoms of endometriosis. However, danazol may not be the first choice because it can cause serious side effects and can be harmful to the baby if you become pregnant while taking this medication.

Conservative surgery

If you have endometriosis and are trying to become pregnant, surgery to remove as much endometriosis as possible while preserving your uterus and ovaries (conservative surgery) may increase your chances of success. If you have severe pain from endometriosis, you may also benefit from surgery — however, endometriosis and pain may return.

The doctor may do this procedure laparoscopically or through traditional abdominal surgery in more extensive cases.

Assisted reproductive technologies

Assisted reproductive technologies, such as in vitro fertilization (IVF) to help you become pregnant are sometimes preferable to conservative surgery. Doctors often suggest one of these approaches if conservative surgery doesn't work. If you wish to discuss about any specific problem, you can consult a gynaecologist.

2750 people found this helpful

Popular Questions & Answers

I usually masturbate 2 times a weak, I have been masturbating for 9 years. 2 times a weak. Is it bad? Does it affect on ageing? I can not control my self. please say, does it harm our reproductive system?

M.D. Consultant Pathologist, CCEBDM Diabetes, PGDS Sexology USA, CCMTD Thyroid, ACDMC Heart Disease, CCMH Hypertension, ECG
Sexologist, Sri Ganganagar
No not at all. But after marriage you should not do masturbation. Then you should do regular intetcourse.
3 people found this helpful

Table of Content

What is the treatment?
How is the treatment done?
Who is eligible for the treatment? (When is the treatment done?)
Who is not eligible for the treatment?
Are there any side effects?
What are the post-treatment guidelines?
How long does it take to recover?
What is the price of the treatment in India?
Are the results of the treatment permanent?
What are the alternatives to the treatment?
Play video
Egg Freezing
Hello everyone!

My name is Dr. Sulbha Arora. I am the clinical director of Nova IVI Fertility, Mumbai. I have been practicing as an IVF specialist for the last 14 years. Today I am talking about a topic called egg freezing. What is Egg freezing? Why is it becoming common? and who should consider doing it? Now women are unfortunately born with a fixed number of eggs and throughout our lifetime we never make new eggs. When we are born we have about 1-2 million eggs in ovaries. By the time we hit puberty and get our first period this number is already reduced to 400,000. After that in a woman's life, she only keeps losing eggs month after month. The best eggs quantity wise and quality wise are usually given out in the 20s.

Once women cross 30s and enters the fourth decade of life the quantity and quality of egg start declining. Although we come across sensational celebrity success stories that make women believe it is perfectly alright to postpone childbearing to later in life. This is actually far from the truth. So today because there are so much of focus on education, on career, it is not always possible to keep everything aside, get married and start having babies in the 20s. But by the time the new age, career-oriented, educated urban Indian women have started to get married or settle down and start planning a family, her biological clock has already slowed down. This puts a lot of pressure on her during her younger years whether to focus on career or to get married.

Fortunately now, there is an answer for this and the answer lies in egg freezing. When we do investment for our future, for our retirement to take care of old age then why not do in investment for our future fertility. So egg freezing is an option where a young woman who has not yet found a right partner or does not wish to start having children yet can take some of these eggs, freeze them and then later on when she wants to have children she can take these frozen eggs and use them when her own biological clock has slowed down. It is a very simple process. When a woman gets her period for 10 or 11 days, there is a course of injection set is given to her. These injection help her to produce multiple eggs in both ovaries. Once the eggs are ready which takes about 10 or 11 days, the eggs are then removed by a procedure called ovum pick-up which is done under complete anaesthesia so she is completely comfortable. She does not have any pain and the process takes hardly 15 to 30 minutes. It is not a surgery. There're no cuts and stitches involved. The eggs are removed through the vagina.

The best eggs are then sorted out. The mature ones can be frozen and kept for extended duration of time. Now the duration does not impact the quality of the eggs. So whether she wants to thaw these eggs or use them to 2 years later or 10 years later the duration does not cause any deterioration in their quality and neither does this procedure called cause any harm to her health. Just because she has undergone and egg pick up or frozen some eggs at a young age it does not mean that later on in life she will not be able to conceive naturally. It does not mean that she will have a Menopause earlier but now she has an investment for her future. Her subsequent cycles and periods will continue regularly like earlier always coming. But suppose at the age of 28 of 30 she has frozen her eggs and kept for future then later on supposing at the age of 40 or 42 she is now married and wants to start having children. Her biological clock would have slowed down but she can use these eggs which she had frozen even 10 years back. So at the age of 40 as far as far as her fertility is concerned she is 30 years old.

Egg freezing started initially as an option for women who have been diagnosed with cancer and need to undergo chemotherapy and radiotherapy because these procedures will destroy her egg cells but it has now become a very common procedure for social fertility preservation. That is for women who are not yet planning a family and they want to preserve their fertility for future. So if you are a young woman who has not yet found a right partner or does not want to get married and having babies yet due to other priorities this is a good option for you. If you would like to know more about this option or undergo the process you can get in touch with me through Lybrate.com .
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Importance Of Sonography In Pregnancy
Hello friends,

Dr Jayanti, IBS consultant obstetrician and gynaecologist practicing at srishti fertility care centre and women's clinic Mumbai.

Today I will be talking on a very hot topic is sonography really needed in pregnancy whenever patients are advanced sonography they always have this fear is sonography harmful to my baby and doctor why are you advising so many sonography. So friends today I'll be clearing your doubts about sonography. Believe me sonography is a very safe investigation because in sonography only sound energy of sound waves called Ultrasonic waves are used and these are very harmless and patient have developed this fear about sonography because in ancient times sometimes pregnant patient is used to be advised to take an x-ray and the doctor is not sure whether there is enough space for the baby to come out during normal delivery.

So to assess that when there was no sonography sometimes a patient should be advised X-rays and X rays are harmful to the foetus but today we are not doing X-rays anymore we are using for sonography and sonography is very safe at any time of pregnancy for when should the first sonography be done lot of people have this may babies small small doctor why are you advising sonography at this stage so when is when should ideally with the first sonography done in pregnancy in the first sonography has to be done between 6 to 8 weeks.

Why you should not do it very early because we won't be able to see anything you should Ideally be done between 6 to 8 weeks and why should we do it so early first of all to confirm the pregnancy and for fetal wellbeing whether the baby is growing well and thirdly we need to see the Heartbeat of the baby I am seeing the habit of the baby is sheer bliss for us and IVF consultant and patience keep calling me experticaly saying that doctor why UPTU has come positive my pregnancy test has come positive so should we do a sonography. I always tell them to be patient weight for 6 to 8 weeks and then do a sonography to see the heartbeat other thing is weather the foetus is single or multiple whether it is only one baby or more than one baby.

The last but not the least to rule out ectopic pregnancy whether the pregnancy is growing inside the uterus which is normal or the pair pregnancy is growing outside the uterus so what happens if the pregnancy is going outside the uterus opos chef in the tubes because tubes is the commonest site for ectopic pregnancy week pregnancy in grows at a site other than the uterus it can cause a lot of complications and life threatening problem suppose it grows in the tube that you can rupture that can be a lot of bleeding the patient can go into shock so for all this things we need to do sonography at early stage between 6 to 8 weeks then when should be the next sonography be done the next sonography is should be done.

I really between 11 to 13 weeks we call it has the early anomaly scan what do you mean by Anomalous the various abnormality is which we can see at that stage of life so 11 to 13 weeks will be the early anomaly scan after that the patient needs to do sonography at 18 to 20 weeks of this is the late anomaly scan so what we do in this sonography is actually a special sonography takes a lot of time on the relations path because the patient needs to see all parts of the baby in the heart the spine the fingers and all these things to know whether the baby is normal or not and then the latest can select 26 to 28 weeks of 34-36 weeks for every time we do a solo graphy it is true in East sonography is it different parameters we don't be the same thing cause has the baby grows that a different things which need attention for Friends rest assured whenever you are doctor advice is sonography please get it done because it is actually a boon for a speak and diagnose so many things by doing sonography and help the mother and the baby to be healthy.

And wish you all a safe and Happy pregnancy thank you if you have any doubt about prgnancy you can contact me at lybrate.com

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Healthy Reproductive System
Hi friends, I am Dr Ekta Singh, Gynaecologist in Noida. Aaj hum baat karenge ke reproductive tract ki care kaisi karni chahiye, kyunki aap jaante hai prevention is always better than cure.

First of all, hume apna proper hygiene maintain karni chahiye private parts ki. For that water wash is good enough. Soap ka regular use karna is not good actually. And then jab humare menses aate hain, then we should change our pads in every 3 to 4 hours, and we should practise safe sex practices. Aap jaante hai bahut saare sexually transmitted diseases hai, jese ki, HIV, AIDS, Hepatitis B, Hepatitis C, Herpes, Syphilis etc. So there are barrier methods that you can use. Then you have, Contraceptive care, ya fir hum ise birth controlling method bhi kehte hai, jo ki humein use karna chahiye.

Kabhi kabhi, hum regularly use karte hain emergency contraceptive ka, that is not good. Not a healthy practice. There are barrier methods such as IUCT, jisse Copper T kehte hain, ya birth controlling pills hote hain jo aap regular basis pe letey ho, that are healthier alternatives.

And then, aap ko shayad pata ho, that every lady should do and know breast self examination. Humein aapne har mahina after menses, every month, we should select a date, after our menses, we should do, aapne breast ka self examination karna chahiye. Jab hum bath le rahe hotey hain, uss samay with soapy hands, with three fingers we should do the breast self examination. And then, aapne shayad Pap Smear ka naam suna hoga. Pap smear is a test jisse hum apne uterus ke mouth ka test karte hain. Womb ke mouth ko hum cervix kehte hai. Woh healthy hai ya nahin, woh ek chhote se test se, jab aap OPD mein jaate ho, aapne gynaecologist ke paas, ek simple test hai, woh aap le saakte ho, karwa sakte ho, Liquid based cytology kehlate hai. Agar hum sexually active hai, lag bhag, sexually active huye hume 3 saal huye hai toh hum karwa sakte hai. Hume shuru karwa dena chahiye, every 3 years mein ya 5 years mein, ya humari umaar 21 years se zyada hai, to hi. Aur agar humare umaar 35 years se zyaada hain, toh ek Human Papilloma Virus test hota hai, woh bhi bahut zaroori hai karana.

Iske alava kuch general advices hai jo aap follow karenge toh bahut achha hoga. Jaise, simple, humein paani dher saara peena chahiye. Aap jaante hain humaare blood mein, kareeb 50 to 60% water content hota hai. Ye water humare body ke har cell tak nutrition pahuchata hai, aur toxins remove karke urine ke raaste yeh remove karte hai. Toh water aapka lena, kareeb 3-4 litre lena is very good. Depends ki agr summer hai toh thoda zada pani lijiye, winter mein thoda kam bhi chalega.

And then, high fibre diet, nutritious diet humein lena chahiye. Woh diet, jisme minerals, vitamins zyada hai aur fibres hai. Yeh aapke constipation ko rokegi aur nutrition pahuchayegi body mein.

Then, oxins avoid karna chahiye. Aajkal bahut saare advanced bachhe hain, smoking karte hain, alcohol is a status symbol, and drugs. These are actually not good at all. Other toxins jo hum bahut zyada use karte hain, jse ki:

Microwave ka use, that is not good.
Plastic wares mein hum khaana paakate hai microwave ke andar.
Hum bottles le jaate hain plastic ki, usse car mein rakhkhe rakhkhe garam ho jaate hain and that water is really dangerous.
And then aapko exercise, regular exercise is very good. Lekin aap agar gym mein bahut intense exercise karte ho, that is sometimes, not very good.
Swimming, walking, is all good.
And iske alava, last but not the least, humein positive thinking karni chahiye.
Jaise aap jaante hain, stress is absolutely, absolutely unhealthy for us, for our health. And agar aapko lagta hai ki kahin koi abnormalities nazar aatey hai, toh aap apne gynaecologist se mil sakte hain. Aur agar kuchh bhi nahin nazar aatey hain to sb normal hain, toh bhi aap ek routine check up ke liye apne gynaecologist se mile toh aap apne health ko leke sure ho sakte hai.

Aur agar aap mujhse consultation lena chahte hain, toh aap Lybrate se le saakte hai. Otherwise you can come to my clinic, which is situated in Noida, 61 sector, C 20.

Thats all, Thank You. Bye.
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Ovulation Process


Hello to everybody. I am Dr Vandana Hegde. I am practising reproductive medicines in the Hegde Medical Centre from the last 10 years.

As I had explained the entire cycle. Two important things are there for the couple to plan pregnancy

One is the Ovulation time. When the ovulation happens, the female eggs that releases out. Its life is approximately 24 hours. And the male's sperm, once the ejaculation happens, its life span is 3-5 days upto the maximum of 7 days. So for couples to plan fertility naturally, it is important to conceive during the period of female ovulation time. And now ideally the female ovulation happen around the 14th day, it is best for the couple to plan intercourse atlreast 3days prior to the ovulation time. So, if they are ovualating on 14th day, so they can start planning the intercourse on around 10th day and upto a period of 16th day. Ideally, intercourse beyonf the period of Ovulation does not help the couples in conceiving. So, it is always better to plan before the ovulation time. Alternate intercourse is much better than having a daily intercourse during the ovulation time.

Now, coming to the Evaluation of Fertility.

When a couple comes to us when they are unable to conceive a child naturally even after one year. Then we do certain basic things as I have mentioned that it is very important to fid out that how the egg is finally to form an embryo. Yu need egg from the female partner and sperm from the male partner which are diffused internally. So what is important is the normal sperm and a normal tube in the uterus. So we do assessment in that order. So ideally we get the male partner 7 testing time to see the sperm count, the sperm motality and the sperm morphology. The sperms should be genetically fit to give a healthy child. So this is assist by doing semen analysis where the male partner will give the semen sample for about 3-4 days. And this semen sample is examined under the micrscope where the assessment is done on the basis of count, mortality and Morphology. If the semen criteria is normal then we evaluate the female partner.

Now the female partner, if she has regular cycle, we assume that the ovulation is happening normally. But there are certain girls who has irregular periods. Some have early periods and sme have quite delayed cycle. Now, what is the main issue here is Ovulation. Probably they are not ovulating around the 14th day. But there are 2 disfunctions.

One is anovulatory, there are certain girls whoch are not ovulating at all. There is no egg formation, there is no ovulation. Now this criteria of girls manage in a different way.
Now there are other type of girls, who are probably having a shorter cycle, they are ovulating very early.
Now, we need to differentiate between these two types. The whole management depends upon correcting these abnormality.

Now, coming to the other part of the tubes. Once the sperm is there and the egg is there, one should have patent fallopian tube for them to meet. So, ideally what we do is, when the couple comes to us, we evaluate the spem parameters, the female ovum parameters and then we do a time intercourse for them.

We start basic tracking of the follicle growth. The best thing is the follicle is seen in the ultrasound reports. So the basic ultrasound is done initially to diagnose. If the female uterus, the ovaries are normal then they should not be ahving any fiberoids and ovarian cyst. So Fiberoids are basically tumours in the uterus which can prevent implantation of the embryo and there may be some ovarian cyst which may be preventing normal ovulation and there are other cyst which require surgical removal. We do basic ultrasound scan to roll out all other major thing and then proceed to Folliculat tracking.

Follicular tracking is seen on the scan. Though the egg can not be seen on the scan so follicles can be seen. So, when the couple ccomes to us in initial part, we track the follicle growth and this is the time, the female is ovulating and we give them the dates to meet. This is done on the monthly basis for atleast 2-3 cycles. Now, inspite of tracking natural cycle follicular growth and at the time intercourse if the couple is not able to conceive then we go for other evaluations. Like, is the tube open? Is the uterine cavity normal?

So there are tests to check if the fallopian tubes are open. Now it is very important for the tube to open because all the activities are happening inside the tube. so there is a test called "Hysterosalpingographie", where the die is pushed through the uterine end. This die is travelling around the cavity and coming into the tubes and then comes out.

All this is recorded in teh X-ay film. This film records this passage of the dia nd we find out the tubal blocks. If the tube is blocked then the egg and the sperm do not meet. So there comes fertility issues.

We do other assessments also like Diagnosis hysteroscopy and laparoscopy for infertility. So this is a surgical process which we do when couples are not able to conceive even after 6 months of fertility planning.

There are small tumours in the cavity which can prevent embryo from Implanting and these are absolutely necessary to be removed if the couple is not conceiving with these.

And the other things we diagnose is the laparoscopy in which we put the camera inside to record if te tube and ovary are in normal position and HYsteroscopy is a process done under the anesthesia only. Then we proceed with further treatment with fertility planning.

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Process of Fertility
Good morning everybody. I am Dr Vandana Hegde. I am practising reproductive medicine, the department of Hegde fertility centre for the last 10 years. Today I would be speaking about the various aspects of fertility. So I will start from the basics to know what happens exactly and what are the problems that arise.

So here is a normal menstrual cycle of the female. There are certain things you need to know. What happens is during the onset of the periods, when the menstrual cycle starts, the eggs start maturing. Now, this egg grows in a wall filled substance which is called Follicle. So normally when the egg starts maturing, it reaches the complete maturity level on the 14th day of the cycle, an average of 12-16 days. As the egg starts maturing, the follicle size increases. Now when the maximum diameter of an egg is reached, the follicle burst and egg comes out. This process is called Ovulation.

If this ovulation happens on the correct 14th day of our cycle, over the next 14th day if there is no pregnancy then a girl will resume her menses which is a failure to conceive. If it happens regularly then the girl will have a regular menstruation cycle of 28-30 days. And if a girl is having the irregular menstrual cycle, then the ovulation is not happening correctly on time. So this is known as Ovulatory disorders. Now, what happens after the ovulation round.

Once the egg is released, it is caught by fallopian tubes. Fallopian tube has finger like projection and the eggs are normally kept on the last part of the tubes. Now when the couples meet, the sperm is released in the vagina. The sperms have basically the head, body and the tale. As I had mentioned earlier, once the ovulation happens, the eggs do not have any tale, so it needs a tube to collect it an d store it in the tube. The sperms will move into the uterine cavity and move into the fallopian tube and have to reach the other part of the tube. So at this point, the sperms will be reaching the egg.

There are certain criteria for normal semen. So when do we know that it is a fertile semen for which there are some criteria like the volume should be atleast more than 1.5 ml ejaculate.And the sperm count should be more than 15 million per ml of sperm. Because of the tale fraction of the mortality, there should be active mortality of the sperm for more than 30%. So when the sperm enters the egg, the process is called Fertilization. And the egg and the sperm will fuse to form an Embryo. The early embryo is called Zygote which is a single cell. So when this forms, the embryo has to divide. In that tube the embryo undergoes division. So in that cell, the embryo will divide into 2 cells, 4 cells, 8 cells. As the embryo is progressively dividing, the tube is going to push the embryo back slowly into the uterine cavity. During this process of egg maturation, the follicle growth, the ovulation, there is another process happening in the uterus.

So here is the uterus and this is the Uterine bed. So, as the follicles are increasing in size, so it produces a hormone called estrogen which is actually acting on the uterine bed. And the uterine bed is ready, there is an increase in thickness for an embryo to come here. And once the ovulation happens, there is a pregnancy favouring hormone called Progesterone which is increasing in the second half of the menstrual cycle. When this comes, there is a lot of blood flow coming to the uterine bed. So this is the time when the embryo is actually reaching the uterine bed. This process, when the embryo reaches the uterine bed and when the embryo sticks to the uterine bed, this process is called Implantation. Basically what is happening here is the blood collection between the uterus and the embryo. That is how the nutrients from the mother's body are transferred to the embryo which grows further and establishes a pregnancy.

So when the couples conceive, these are the things which have to happen in a natural way for them to conceive. Now what happens when they do not conceive when they try for more than a year after the marriage and still unable to conceive, so we evaluate the problems. Evaluation of problem depends on the steps which I have told.
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