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List of Top 20 IVF Specialists

List of Top 20 IVF Specialists/Top 20 IVF Specialists

Here is the list of top 20 IVF Specialists.

1.Dr. Sandeep Shah

Dr. Sandeep Shah IVF Specialists

Qualification:

  • MBBS
  • MS
  • Fellowship

Brief Profile:

Dr. Sandeep is a famous infertility specialist and Reproductive Medicine and has an experience of more than 20 years. After completing his MBBS and MS, in 1994, he completed training in Reproductive Medicine at Tuft University, Boston, USA. He has been establishing IVF and infertility centers at various places in Ghana, Kenya, India, and Bangladesh.

 

Hospital Website:https://www.novaivffertility.com/

 2.Dr. Indira Hinduja

Dr. Indira Hinduja

Qualification:

  • MBBS
  • MD
  • DNB

Brief Qualification:

Dr. Indira Hinduja is one of the famous Indian gynaecologist and infertility specialists and has an experience of more than 46 years in his field. In January, 1988she started the Gamete intrafallopian transfer technique resulting in the birth of India’s 1st GIFT baby. In August 1986 she delivered India’s s first test-tube baby. She developed an oocyte donation technique for menopausal and premature ovarian failure patients.

Her keen interests are:

  • High-Risk Pregnancy Care,
  • In Vitro Fertilization (Test Tube Baby),
  • Obstetrics / Antenatal Care,
  • Gynae Problems
  • High-Risk Pregnancy Care

Highlights:

Dr. Indira Hinduja is an active member of various famous associations such as

  • Bombay Obstetrics and Gynaecological Society
  • Indian Association of Gynaecological Endoscopists
  • Indian Association of Sex Educators
  • Counselors and Therapists
  • Indian Fertility Sterility Society

He got various prestigious awards such as

  • Young Indian Award – 1987
  • Outstanding Lady Citizen of Maharashtra State Jaycee Award – 1987
  • Bharat Nirman Award– 1994
  • International Women’s Day Award – 1995
  • International Women’s Day Award – 2000
  • Lifetime Achievement Award – 1999
  • Dhanvantari Award by The Governor of Maharashtra – 2000
  • Padma Shri-2011

 

Hospital Website:https://www.jaslokhospital.net/

 

 3.Dr. Nandita P. Palshetkar

Dr. Nandita P. Palshetkar

Qualification:

  • MBBS (Mumbai University)
  • MD (Mumbai University)
  • Fellowship in Reproductive Medicine (National Board)

Brief Profile:

Dr. Nandita P Paleshtkar is one of the famous Obstetrics & Gynaecology in India and has an experience of more than 20 years. She has completed training in IVF & Micromanipulation from the University of Ghent, Belgium. She is a part of the Infertility unit of many famous hospitals such as:

Dr. Paleshtkar worked as Senior Vice President of Federation at Obstetric and Gynaecological Societies of India. Dr. Nandita has established the spindle view technology, IMSI – a new technology for improving results in Male Infertility,  first time and first egg, assisted laser hatching, and ovarian tissue bank in India. She has also delivered the first laser hatching twins.

Highlights:

Dr. Paleshtkar received awarded the FCPS from the College of Physicians and surgeons Mumbai and with the ICOG from the MICOG Mumbai.

She has come to know in various noteworthy news media such as:

  • Bombay Times
  • Times Of India
  • NDTV
  • Indian Express

 

Hospital Website:https://www.fortismumbai.com/

 

4.Dr. Sonia Malik

Dr. Sonia Malik IVF Specialists

Qualification:

  • MBBS
  • MD
  • DGO

Brief Profile:

Dr. Sonia Malik is one of the famous Obstetrics & Gynaecologists in India who has experience of more than 33 years. She has executed more than 7000 ART Cycles. She has also performed more than 15-20 IUI Cycles and 20-25 IVF Cycles each month. She is the founder & director of IVF Centre brand -Southend Fertility & IVF and Scientific Collaborator at Reproductive Research Center, USA.

Her expertises are:

  • Advances in Assisted Reproductive Techniques
  • Reproductive Endocrinology & Immunology,
  • Genital Tuberculosis
  • Premature Ovarian Failure.

Highlights:

Dr. Malik is an active member of various famous organizations such as:

  • FOGSI
  • Association of Obstetrics and Gynaecology Delhi
  • Indian Society of Assisted Reproduction
  • Indian Menopause Society
  • Indian Medical Association
  • Indian Society for Study of Reproduction and Infertility
  • American Society for Reproductive Medicine
  • American Society of Reproductive Endocrinologists.

 

Hospital Website:https://www.fortismumbai.com/

 

5.Dr. Sulbha Arora

Dr. Sulbha Arora

Qualification:

  • MBBS
  • MD
  • DNB
  • Fellowship

Brief Profile:

Dr. Sulbha Arora is a famous gynaecologist and fertility specialist and has more than 17 years of experience. Her expertise includes:

  • Fertility medicine,
  • 3rd party reproduction
  • Fertility preservation.

She has done his fellowship at Chaim Sheba Medical Centre, Israel- the most comprehensive medical center in the Middle East.

Highlights:

  • Sulbha Arora has awarded the MOGS Dr. Shantabai Gulabchand Traveling Fellowship and MOGS Dr. Duru Shah Best Committee Award.
  • She is a life member of various organizations:
  • AFG
  • AMC
  • MOGS
  • ISAR
  • FOGSI
  • She was contributed more than 20 chapters in various textbooks, and he is also the Editor of the textbooks Nova Handbook on Ovarian Stimulation and Reproductive Medicine: Challenges, Solutions, and Breakthroughs.

 

Hospital Website:https://www.novaivffertility.com/

Know more about Infertility hospital in India.

6.Dr. Renu Misra

Dr. Renu Misra

Qualification:

  • MBBS
  • MS

Brief Profile:

Dr.Renu Misra is one of the famous Fertility Specialist in Delhi, NCR, and has experience of more than 22 years & has involved in the development of endoscopic surgery at the prestigious AIIMS College. She has done training in Reproductive Endocrinology and Infertility at the University of Manchester, UK. Dr. Misra has done teaching in some of the famous hospitals such as Whipp Cross Hospital, United Kingdom (UK), and AIIMS in India.

Highlights:

Dr. Mishra has successfully done live surgery in many endoscopic surgery workshops and conferences.

Dr. Mishra has done more than 57 publications in international and national journals such as the British Journal of Obstetrics and the British Medical Journal (BMJ). Her keen Interests are:

  • Endoscopic Surgery
  • Gynaecologic Oncology
  • IVF AND ART
  • Laparoscopic and Hysteroscopy Surgery in Gynaecology
  • Reproductive Endocrinology

Highlights:

Dr. Mishra is the writer of 6 books a textbook called ‘Ian Donald’s Practical Obstetric Problems’.

She is a lifetime member of various famous organizations such as:

  • Federation of Obstetricians and Gynaecologists of India.
  • Indian Society of Oncology.
  • Association of Gynaecologic Oncologists.

 

Hospital Website:http://www.miraclesmediclinic.com/

 

7.Dr. Pramod Kumar Sharma

Dr. Pramod Kumar Sharma

Qualification:

  • MBBS
  • MD
  • Fellowship

Brief Profile:

Dr. Pramod Kumar Sharma is a famous IVF specialist and chairman of Pratiksha hospitals and has more than 25 years of experience. In 1997 he guides the group’s 1st IVF baby was delivered.Dr. Sharma has provided his best quality services to people at subsidized rates and running 50 IVF cycles in each tear without any cost.

Highlights:

  • He did various publications.
  • He’s one of the famous papers was “Post-surgical Intra uterine adhesions-at second look hysteroscopy” which was selected by the selectors for presentation in Global Congress on Endoscopic Surgery at San Francisco, USA, in 2001.

 

Hospital Website:http://w-hospital.in/

8.Dr. Bindu Garg

Dr. Bindu Garg

Qualification:

  • MBBS (Lady Hardinge Medical College, New Delhi)
  • MD(Maulana Azad Medical College, New Delhi)

Brief Profile:

Dr. Bindu Garg is a famous Infertility and IVF Specialist and has experience of more than  30 years.Dr. Garg pursued her post-graduation in reproductive medicine from Monash University, Australia. Then, she has done training in Human Reproductive Sciences at Cleveland University, USA.

Highlights:

Dr. Bindu Garg has bagged various awards, including Swastha Bharat Samman, Mahatma Gandhi Samman held at House of Lords, London, India News Award for her contribution to infertility services.

 

Hospital Website:http://www.worldivfcentre.com/

 

9.Dr. Kaberi Banerjee

Dr. Kaberi Banerjee IVF Specialists

Qualification:

  • MBBS (AIIMS, New Delhi)
  • MD (AIIMS, New Delhi)
  • MNAMS
  • MRCOG

Brief Profile:

Dr. Kaberi Banerjee is a famous Obstetrician and Gynaecologist in India and has experience of more than 22 years. She has worked with various prestigious hospitals &centers. She has done training at the esteemed Guys and St Thomas Hospital, London. She is known for conducted over 53000+ IVF cycles.Dr. Banerjee is the established& Director of the famous Advance Fertility & Gynaecology Centre, New Delhi.

Highlights:

  • Kaberi Banerjee is an active member of various organizations.
  • National Academy of Medical Sciences (MNAMS),
  • Royal College of Obstetrics and Gynaecology, London.
  • She has achieved many prestigious awards such as Bharat Jyoti Award, and IMAAMS, Distinguished Service Award.
  • She has also spoken in her field in various National & International conferences.
  • Her core area is treating IVF failure cases & surrogacy.

 

Hospital Website:https://www.advancefertility.in/

 

10.Dr. Anoop Kr Gupta

Dr. Anoop Kr Gupta

Qualification:

  • MBBS

Brief Profile:

Dr. Anoop Kr Gupta is a famous Infertility specialist and has decades of experience. Successfully, he has delivered more than 10000 ART Babies up to March 2016. Dr. Gupta has done a training course on infertility & blastocyst culture at Singapore in Liverpool women hospital UK in & multiple fellowships in the US and Australia.

In 2002 he is famed for delivering 1st-millennium test tube baby and also deliver IVF triple.

Highlights:

Dr. Anoop Kr Gupta is an active member of some of the most famous organizations such as:

  • European Society of Human Reproduction & Embryology
  • American Society of Reproductive Medicine
  • United Nation Family Development Programme

He has done over 100+ publications in different Newspapers Magazines.

 

Hospital Website:https://www.delhi-ivf.com/

Know more about Infertility hospital in India.

11.Dr. Soma Singh

Dr. Soma Singh

Qualification:

  • MBBS (SN Medical College)
  • MS (SN Medical College)
  • DNB (National Board of Examination)
  • Fellowship

Brief Profile:

Dr. Soma Singh is a famous IVF & Infertility specialist having the experience of more than 11 years.  Her expertise in the management of Male and Female infertility problems. She is one of few IVF specialists in India, who has been working in an institute responsible for the birth of 1st two IVF babies in this world.

Highlights:

Dr. Singh is member of the following organizations:

  • AOGD
  • ISAR
  • IFS

 

Hospital Website:https://www.blkhospital.com/

 

12.Dr. Sandeep Talwar

Dr. Sandeep Talwar

Qualification:

  • MBBS (Medical College, Rohtak)
  • DNB (from Mahavir Medical College & Safdarjung Hospital)
  • Fellowship 

Brief Profile:

Dr. Sandeep Talwar is one of the famous Infertility Specialist in India and has an experience of more than 21 years in the field of Obstetrics & gynaecology. Dr.Talwar has been establishing the department of IVF & Infertility at B.L.K Super specialty hospital, Delhi. She has worked as an inspector for FNB accreditation of hospitals.

Highlights:

Dr.Talwar is an executive member of the famous organizations such as:

  • Indian Fertility Society
  • Fertility Preservation Society

 

Hospital Website:https://www.blkhospital.com/ 

 

13.Dr. Nymphaea Walecha

Dr. Nymphaea Walecha IVF Specialists

Qualification:

  • MBBS (MDS University, Rohtak)
  • MDGynaecology (MDS University, Rohtak)
  • Fellowship (Germany in endoscopy and reproductive medicine)

Brief Profile:

Dr. Nymphaea Walecha is a famous infertility specialist and has an experience of more than 10 years. Her expertise such as:

  • Management of all cases related to infertility
  • Corrective laparoscopic
  • Diagnostic and assisted reproductive techniques

Highlights:

  • In 2011, Dr. Walecha received Advanced Reproductive Care training at Assuta Hospital, Tel Aviv, Israel.
  • She has also join memberships of Delhi Medical Council.

 

Hospital Website:https://www.fortishealthcare.com/

 

14.Dr. Parul Katiyar

Dr. Parul Katiyar

Qualification:

  • MBBS (GSVM Medical College, Kanpur)
  • MS (Jawaharlal Medical College, Aligarh)

Brief Profile:

Dr. Parul Katiyar is a famous infertility specialist and reproductive endocrinologist in India having experience over 15+ years.

She is the part of a team of moreover 3,000+ assisted conception cycles for patients. Her expertise in

 Highlights:

Dr. Parul Katiyar received higher training at Lilawati Hospitals, Mumbai, and Yale Medical School, USA.

 

Hospital Website:https://www.novaivffertility.com/

 

15.Dr. Aanchal Agarwal

Dr. Aanchal Agarwal

Qualification:

  • MBBS (Lady Hardinge Medical College, Delhi)
  • DNB (Lady Hardinge Medical College, Delhi)
  • Fellowship (Sir Ganga Ram Hospital, Delhi)

Brief Profile:

Dr. Agarwal is a famous gynaecologist in Delhi with the experience of more than 18 years. She has helped many couples facing fertility problems. She has held the highest degree in Reproductive Endocrinology in India, which is a distinctive factor in her credit. Her expertises are in IVF & Infertility treatment in both males and females.

Highlights:

Dr. Agarwal has done articles in various print media such as E-Health. She has invited as a faculty member to many national & international institutes for lectures. She has achieved Gold Medal & Chattra –Rattan by Vangymya –Vimarsh.

She is an active member of various organizations:

  • Indian Fertility Society (IFS)
  • Indian Society for Assisted Reproduction
  • National Academy of Medical Sciences

 

Hospital Website:https://www.blkhospital.com/

Know more about Infertility hospital in India.

16.Dr. Nisha Bhatnagar

Dr. Nisha Bhatnagar

Qualification:

  • MBBS
  • MD

Brief Profile:

Dr. Nisha Bhatnagar is a famous Infertility Specialist, Gynecologist, & Obstetrician having an experience of moreover 19+ years.

Her expertise over the treatment is:

  • Fertilisation In Vitro
  • Natural Cycle IVF, IUI, PCOD & PCOS Treatment
  • Low Ovarian Reserve
  • Infertility Treatment Of patients With Endometriosis
  • Minimal Stimulation IVF
  • IVF
  • Infertility Treatment
  • Hysteroscopy

Highlights:

  • Nisha is an active member of the Delhi Medical Council.
  • She has published in several international and national medical journals.

 

Hospital Website:https://www.blkhospital.com/

 

 17.Dr. Aastha Gupta

Dr. Aastha Gupta

Qualification:

  • MBBS (Mauling Azad Medical College)
  • MS Obstetrics & Gynaecology (Delhi University)

Brief Profile:

Dr. Aastha Gupta is a famous infertility specialist in Delhi having the experience of more than 4years. Dr. Gupta has done her training in infertility & ART atCentre of human reproduction, New York, and National University Singapore. She has done over 5000+ ovum pick up procedure & has also assisted over 4200+ fertility-enhancing endoscopy procedures.

Highlights:

Dr. Gupta contributed to various studies in the research Centre the role of G-CSF in poor endometrial lining & response, repeated implant failure, the role of adjuvant therapies such as prophylactic curettage.

 

Hospital Website:https://www.delhi-ivf.com/

 

18.Dr. Yogita Parashar

Dr. Yogita Parashar IVF Specialists

Qualification:

  • MBBS (from Bangalore University)
  • DNB (GB Pant Hospital)
  • DGO (Army Hospital Research and Referral New Delhi)

Brief Profile:

Dr. Yogita Parashar is a famous Gynecologist and Obstetrician with an experience of more than 16 years in this field. Her expertises are like:

She has worked as a senior resident at Hamdard Medical College and she has also worked as a consultant at Rockland Hospital, Dwarka.

Highlights:

  • In 2013, Dr. Yogita Parashar participated in workshops for infertility and endocrinology.
  • She is a member of various organizations:
  • FOGSI
  • DGF Southwest
  • IMA Dwarka

 

Hospital Website:https://www.manipalhospitals.com/delhi/

 

 19.Dr. Bhavna Banga

Dr. Bhavna Banga IVF Specialists

Qualification:

  • MBBS
  • MS

Brief Profile:

Dr. Bhavna Banga is a famous IVF Specialist in India and has an experience of more than 8 years. Now she is associated as Consultant – Infertility & IVF at Max Super Speciality Hospital, Saket. Her Specialty interests are:

  • IVF & Assisted Reproductive Techniques
  • Male Infertility
  • Management of Poor Responder’s
  • Egg Donation & Surrogacy

Highlights:

Dr. Bhavna Banga is an active member of various famous organizations such as:

  • Federation of Obstetrics& Gynecology Society of India
  • Indian Society of Assisted Reproduction

 

Hospital Website:https://www.maxhealthcare.in/

20.Dr. Surveen Ghumman Sindhu

Dr. Surveen Ghumman Sindhu

Qualification:

Dr. Surveen Ghumman Sindhu is a famous Infertility Specialist with the experience of more than 25 years. Currently, she is working as Director and Head at IVF, Max Super Specialty Hospital, Saket.

Her Interests are:

  • Infertility Treatment
  • Egg Donor
  • Gestational Surrogacy
  • Donor Egg
  • IVF Intracytoplasmic sperm injection
  • Invitro fertilization
  • Intrauterine Insemination
  • Ovulation induction and follicular monitoring Advanced Semenalysis
  • Hormonal tests
  • In Vitro Fertilization (Test Tube Baby)
  • Caesarean Section/ C-Section Vaginal Hysterectomy Laparoscopic Surgery
  • Oophorectomy / Ovariectomy / Ovarian Ablation Endoscopy Pre-Marital Counselling
  • Natural Cycle IVF.

 

Highlights:

  • Surveen Ghumman Sindhu Published more than 100+ journals and books.
  • She has invited at national and international conferences as speaker and chairperson.
  • She has also Invited to peer review journals for Systems Biology in Reproductive Medicine
  • Journal of Indian Medical Association
  • Journal of Obstetrics and gynaecology of India
  • Editor for the association of Obst & Gynecology and Secretary
  • Infertility committee of AOGD
  • She has achieved Award of Best worker of IMA – NDB which awarded on doctors day in 2013 by Delhi Medical Association.

 

Hospital Website:https://www.maxhealthcare.in/

Know more about Infertility hospital in India.

Above mentioned is the list of top 20 IVF Specialists.

 

Healthy Pregnancy through IVF

 

 

 

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Infertility Treatment: Procedure and Treatment

Popular Infertility Treatments in Men and Women

 

What is Infertility?

Infertility refers to the inability of a couple to conceive. More simplistically, it refers to the inability of the woman to become pregnant. Medically speaking, when the couple is unable to conceive or produce children even after 1 year of unprotected sexual cohabitation is called infertility. For women over 35 years of age, the period is 6 months of cohabitation. Women who conceive but are unable to carry the pregnancy till the period of viability may also be termed infertile.

Primary infertility refers to a complete lack of conception. Secondary infertility is for those women who had a successful pregnancy in the past but are unable to conceive now.

The causes are varied- physical, congenital, diseases, drugs, immunological or even psychological. It may involve both the partners, the male and the female. According to studies on reproductive health, half of the times men are responsible, while for the rest half, women are to be held responsible.

Causes of Male Infertility

Infertility Treatment

A normal sperm count ranges from 15 million to 200 million sperms/ml. A low sperm count is called oligospermia (less than 15 million/ ml). Absence of sperm production is called azoospermia.

However, a sperm count in the normal range does not rule out infertility.

Sperm morphology and motility are equally important.

Movement of the sperm includes both, the wiggling movement of the tail of the sperm along with the peristaltic movements of the male genital tract, especially epididymis.

A variety of risk factors, medical conditions, and medications can also affect fertility.

Risk factors

  1. Older age
  2. Smoking cigarettes
  3. Heavy alcoholism
  4. Obesity
  5. Exposure to pesticides, herbicides and other heavy metals in contaminated food.

Medical conditions responsible for Infertility in Men

  1. Retrograde (Or reverse) ejaculation
  2. Varicocele (Swelling of the venous plexus around the testicles)
  3. Undescended testis in the scrotum.
  4. Auto-immune antibodies against sperms.
  5. Inadequate testosterone production.

Medications and drugs

Medications and drugs which affect male fertility include:

  • Chemotherapy and radiotherapy as a part of cancer treatment.
  • Drugs used in inflammatory diseases like rheumatoid arthritis, ulcerative colitis and Crohn’s’ Disease including sulpha drugs.
  • Calcium channel blockers (verapamil, diltiazem, etc) which are used in heart diseases, hypertension.
  • Tricyclic (typical anti-depressants)
  • Anabolic steroids, which are used for improving athletic performance.
  • Hormonal imbalances leading to delayed puberty.
  • Abusing drugs such as cocaine and marijuana.
  • Any of the factors, in combination or together, may lead to the development of infertility.

Causes of female infertility

Let us understand the process of ovulation, fertilization, implantation and the development of the embryo.

  • Ovulation: Release of the mature ova from the ovary in the middle of the 28-day cycle.
  • Fertilization: Union of the sperm and ovum in the fallopian tube. The sperm has to traverse the vagina, cervix and the uterus to finally reach the ampulla of the fallopian tube.
  • Implantation: Implantation refers to the attachment of the blastocyst (about 250 cells) into the endometrium (lining of the uterine cavity)
  • At birth, the ovaries of a female contain about 1-2 million immature ova. By the time, the female reaches puberty, only 4-5 lac ovarian follicles remain in the ovary. Around 1000 follicles undergo regression every month. As a result, in the normal reproductive span of a female (15-45 years), about 500 ova are released.
  • Normally, in a normal menstrual cycle, one ovum is released on the 14th day of the cycle. Fertilization occurs within the next 12-24 hours. Implantation begins by the 21st-22nd day when the blastocyst (a zygote after divisions which has resulted in 32 cells) implants into the endometrium. Implantation is completed by the 24th day.

A variety of factors interfere with these normal process, which may contribute to the development of infertility in females.

Know more about Top 20 IVF Specialists in India

Risk factors

Risk factors for female infertility include:

  1. Older age
  2. Smoking cigarettes
  3. Heavy alcoholism
  4. Obesity
  5. Sexually transmitted infections (STIs) which lead to fibrosis of the genital tract.

Medical conditions:

The medical conditions which can lead to infertility in women include:

  • Ovulation disorders: Ovarian cysts or teratomas or hormonal imbalances leading to ineffective ovulation.
  • Pelvic inflammatory disease (PID), which causes scarring and pre-disposes to infections.
  • Endometriosis: Normal endometrium in an abnormal location other than the uterus. Know more about Endometrial Cancer
  • Uterine fibroids: They refer to hypertrophy or increased whorls of smooth masses in the uterus.
  • Premature ovarian failure, when the ovarian reserve of ova is finished.
  • Scarring or adhesions from a previous surgery

Medications and drugs:

Certain medications and drugs that can affect female infertility include:

  • Prolonged use of Non-steroidal anti-inflammatory drugs including aspirin, ibuprofen.
  • Antipsychotic and anti-depressant medications.
  • Abusing drugs such as cocaine and marijuana.
  • Chemotherapy and radiotherapy as a part of cancer treatment.

Ovulation problems are responsible for about 25% of the infertility issues seen in couples. An irregular or absent menses warrants medical attention for infertility.

Infertility Testing

There are various indications for which both men and women may see a fertility expert. It may be primarily because, even after sexual activity, the couple would be unable to conceive.

Men:

Men should consult a medical professional if one of the following troubles them:

  1. Erectile dysfunction (ED)
  2. Delayed or retrograde ejaculation.
  3. Low sex drive
  4. Impotency
  5. Pain/Swelling in the groin area
  6. Previous surgery in the genital area

Your doctor will first take your medical history. During this Following a thorough medical history and appropriate medical examinations, a semen analysis is likely to be performed. The sperms will be checked for the adequacy of number, morphology and motility.

Additional testing may include:

  1. Hormone assays
  2. Ultrasonography of the genitals
  3. Genetic testing

Women:

  • After 30 years of age, fertility usually starts decreasing. Women below 35 years should visit after 12 months of trying cohabitation while those above 35 years should pay a visit after 6 months.
  • Present medical history, sexual history and presence of other illnesses or chronic diseases will be taken into account before proceeding for further investigations.
  • An abdominal examination for checking the pelvic adequacy, PID, fibroids or endometriosis may be done.
  • An ultrasound may also be used to examine the ovaries and uterus.

Other testing includes:

Contrast Hysterosalpingography: X-ray of the pelvic area by injecting a contrast dye into the fallopian tubes to evaluate the fallopian tubes and uterus.

  • Laparoscopy, which may be used to visualize the pelvic viscera along with the internal reproductive organs.
  • Ovarian reserve testing: Hormone tests to check for the level of 2 main hormones: Follicle-stimulating hormone (FSH) and LH (Luteinizing hormone).

Infertility treatments

The type of infertility treatment depends upon various factors, biological, personal, affordability and availability in the given healthcare-setting. They include:

  1. The cause of infertility. In 10-15% cases, the cause is unknown, also known as primary idiopathic infertility.
  2. Age of the male and the female couple.
  3. Time since which they have been trying to conceive
  4. Health status of the couple.
  5. Personal preferences of the couple.

Assisted reproductive technologies may prove to be a boon for such couples. There are two primary modalities: In-vitro (fertilization outside the body) or in-vivo (fertilization within the body) methods.

Infertility Treatments: In-vitro (IVF)

If the fertilization occurs outside the body of the female and after it, the embryo is transferred into the uterus or fallopian tube of a surrogate mother or same mother, this is called embryo transfer. Two types of in-vitro fertilization:

  • ZIFT (Zygote-intra-fallopian tube transfer): The zygote or early embryo up to the 8 cell stage is transferred into the fallopian tube of the surrogate or same mother. This is called a ZIFT.
  • IUT (Intra-uterine transfer): If more than 8 cell-stage (commonly up to 32 cell stage) are transferred into the uterus, this is called as IUT.
  • ICSI (Intra-cytoplasmic sperm injection): The sperm is directly injected into the cytoplasm of the ova via a micro-needle. This is referred to as ICSI.

The embryos are generally allowed to develop outside the body into appropriate culture media. They can be frozen for implantation at a later stage.

Or after development up to the 32 cell stage and checking for the genetic makeup ( to rule out genetic abnormalities), the embryos are inserted into the uterus.

ICSI is further divided into percutaneous epididymal aspiration or direct testicular aspiration.

Percutaneous Epididymal Sperm Aspiration (PESA):

It is indicated when the vas deferens (a connecting tube) is absent or blocked. In cases of infections as well, there may be obstruction and inflammation leading to a seminal fluid which does not contain sperms.

Testicular Sperm Aspiration (TESA):

It is done usually when the epididymis itself has lost its patency or does not contain sperms.

Assisted Hatching:

At times the zona pellucida (a protective covering around the fertilized ovum .i.e the zygote may be too thick. This prevents implantation. It can be overcome by assisted hatching.

A hole is made in the wall of the embryo using a special needle or a chemical or a laser beam. The embryo can now be transferred into the uterus for implantation. This is especially used when there have been previous instances of repeated implantation failure.

Freezing:

Either the embryo may be frozen (embryo freezing) or the oocyte may be frozen (oocyte-freezing) to be used at a later stage.

Usually, during the in-vitro techniques, 4-5 embryos are allowed to mature up to the 32 cell stage and one or two are implanted int eh uterus. The rest are frozen, which can be used later, in case of failure of development.

Oocyte freezing is still under research as oocytes reportedly get destroyed during freezing.

Seminal fluid and testicular tissue may be frozen as well. This is indicated for those men who have a problem giving sperms on the day of retrieval of the oocyte. Secondly, when the seminal fluid or the epididymis lacks sperms, the sperms or the testicular tissue may be frozen to be used at a later stage. It can also be used in men who have the testicular disease and would require removal of testis. It may also be employed for patients who would undergo chemotherapy or radiotherapy which would damage the sperms.

In-vivo Fertilization

If the fertilization process occurs within the body of the female (mother/surrogate) via natural or artificial methods, this is known as in-vivo fertilization. This method tends to fertilize the ova in the fallopian tube while mimicking the natural process of fertilization.

The two widely employed methods are:

  1. GIFT (Gamete intra-fallopian tube transfer): Transfer of an ovum collected from the ovary into the fallopian tube of the same female or of a female who can provide an appropriate environment for fertilization is called GIFT.
  2. AI (Artificial Insemination): If the male is unable to inseminate the semen into the vagina, then the semen is artificially introduced either into the cervix or into the uterus of the female (intrauterine insemination)

The main complications include miscarriage (the pregnancy may be aborted prematurely), multiple pregnancies (if all the implanted embryos survive), ectopic implantations (implantation at other sites instead of the uterus, most commonly in the fallopian tube) and increased risk of prematurity.

List of Top 20 IVF Specialists

 

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Vaginal Infection: Signs, Symptoms and treatment

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Genital Infections: female needs to talk about it!

Genital/vaginal infections are prevalent, and every woman experiences them at some point in her life. Most infections require medical attention, but few clear out on their own. Vaginal infections are classified into three types.

  • Yeast Infections: Caused by excessive growth of yeast in the vagina, which irritates. The most common symptom is itching. Vaginal discharge in such cases tends to be white and thick.
  • Bacterial Infections: Caused by excessive growth of bacteria. Its symptoms typically include greyish white vaginal discharge which smells fishy and a burning sensation during urination.
  • Trichomoniasis: Caused by a parasite name Trichomonas vaginalis. Symptoms include itching and a greyish-white frothy vaginal discharge.

Genital infections: The most common symptoms include

  • Vaginal itching
  • Change in the color or smell of vaginal discharge.
  • Change in the amount of vaginal discharge
  • Painful sensation or burning sensation while urinating
  • Pain during intercourse
  • Vaginal bleeding/spotting

Genital infections: When you should see a doctor immediately

  • If you have never had a vaginal infection before
  • If you have had an infection in the past but are experiencing new symptoms
  • If you are pregnant
  • If you have multiple sexual partners
  • If you develop a fever
  • If the symptoms return after treatment

Sexual Health: Physical, Mental and Social well-being

Genital infections: The causes

Poor hygiene is one of the primary causes. An overgrowth of bacteria can also cause them due to changes in the vaginal environment. Certain times antibiotics can reduce the antifungal bacteria in your vagina. This can lead to yeast infections. Unprotected sex can make the woman susceptible to contracting the Trichomonas parasite leading to Trichomoniasis. Soaps, body washes, special ‘vaginal cleaners,’ and vaginal contraceptives tend to disrupt the normal pH and cause a disturbance in the natural environment. This is one of the leading causes of contracting vaginal infections.

Vaginal atrophy, which usually happens after menopause, can also happen to a woman of reproductive age. It can happen due to a decline in estrogen levels, for example, during breastfeeding. Reduces hormone levels lead to vaginal dryness and a thinning of the vaginal wall, leading to vaginal inflammation.

It is relatively easy to self-diagnose for any infection presence, keep track of the color, and the consistency of your vaginal discharge and its smell. Check for any vaginal irritation or discomfort such as itching, painful urination, or dryness.


Medically, these infections are diagnosed by a simple medical history check which requires you to provide information about any past infections and their frequency, the number of current sexual partners, any history of sexually transmitted infections (STIs) with a general overview of your health history. Certain times, the doctor may also carry out a pelvic exam, and a sample of your vaginal discharge may be collected.

Treatment for vaginal infections includes

  • completing the prescribed dosage of medication. These medicines include antifungal creams, estrogen creams or tablets, metronidazole cream or tablets, or tinidazole tablets.
  • Although medicines can be bought as over-the-counter, a doctor’s prescription is recommended so that the wrong medication doesn’t get a pair with the wrong infection. For example, antifungal creams for yeast infections are bad combinations as they are generally prescribed for bacterial infections.
  • Infections can be prevented quite easily. Firstly, always have protected sex (unless you’re trying to conceive). Using condoms during sex not only reduces the chances of infections but also protects you from STIs. Proper hygiene can also keep the infections at bay.
  • Do NOT wash your vagina with soaps or fill them up with water. This will cause an imbalance in the natural pH and can lead to vaginal infections. Whenever possible, wear cotton underwear as this provides a breathable environment for the vagina and keeps the outer regions dry and clean.
  • Treatment of vaginal infections is reliable, quick, and generally effective. A proper diagnosis will make sure that you get the proper medication and the needed treatment. Do not hesitate to consult your doctor for any unusual and/or regular symptoms.

Microbes and Female Reproductive Health

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Birth Control or Contraception: Temporary and Permanent Methods

Birth Control or Contraception: Temporary and Permanent Methods

Birth control or contraception includes various methods that can be used in order to prevent pregnancy. It can be broadly categorized into temporary and permanent methods, that are as listed below :

Birth Control

1.TEMPORARY METHODS

  • Natural methods (behavioral) – not recommended as there are high chances of failure.
  • Barrier methods
  • IUCDs
  • Hormonal control

2.PERMANENT METHODS

  • Female sterilization – includes tubal ligation.
  • Male sterilization – Vasectomy
VARIOUS METHODS OF BIRTH CONTROL

There indeed are a wide range of options for birth control, and you may select the most suitable one, according to your preferences:

BARRIER BIRTH CONTROL

  • This method of birth control act by creating a barrier to prevent the sperm from reaching the egg.
  • Most of the barrier contraceptives do not require a prescription and are easily accessible.
  • Most common barrier contraception methods include :
  1. MALE CONDOM– These are most commonly made of latex rubber and may either be dry or pre-lubricated.
    • It is the most commonly practiced method of birth control by males.
    • Durable, reliable and affordable.
    • Also protective against sexually transmitted disorders.
    • NIRODH is the free condom supplied by the Government of India.
    • If used with utmost perfection, it offers almost 98% of protection against pregnancy.
  1. FEMALE CONDOM– It is a thin, flexible, polyurethane tube that is partially inserted into your vagina, creating a barrier.
    • Similar to male condoms, female condoms also provide protection against sexually transmitted infections.
    • These offer almost 80% efficiency against pregnancy.
    • It must be remembered that it is completely inadvisable to use male and female condoms together, as this increases the chances of slippage, breakage, and displacement.
  1. DIAPHRAGM– It is an intravaginal device made of latex.
    • A medical or paramedical professional is required for the accurate measurement of the diameter that is required.
    • A diaphragm is inserted 2 hours before sexual intercourse and is to be kept for at least 6 hours after the last coital act.
  1. VAGINAL CONTRACEPTIVE SPONGE– This too is an option of birth control that doesn’t require a prescription.
    • It’s basically a small piece of foam that is treated with spermicide and is inserted high up into the vagina.
    • It can be inserted up to 24 hours before intercourse.
  1. CERVICAL CAP– Dome-shaped reusable appliance that acts by preventing the entry of sperm into the cervix.
    • It is used along with a spermicide and can be inserted anytime before intercourse.
INTRA-UTERINE CONTRACEPTIVE DEVICE (IUCD)
  • IUCD is a small device that is inserted into the uterus in order to prevent pregnancy.
  • It offers almost 99% efficiency in the control of pregnancy.
  • IUCDs are basically a form of long-acting reversible birth control.
  • It requires a doctor or a nurse for the proper insertion of an intrauterine device and the procedure involved is quite simple and quick.
  • IUDs can be non-medicated (made of plastic or stainless steel) or medicated (that involves copper-containing IUDs and hormone-releasing IUDs).
HORMONAL CONTROL

Birth control

  • The main action of this method of birth control involves the release of hormones that prevent the fertilization of an egg by the sperm.
  • With proper and adequate use, hormonal birth control is more than 90% effective.
  • It requires a prescription for using this method of contraception.
  • Various types of hormonal contraceptives include:
  1. Oral contraceptive pills– It must be noted that combined OCPs are the most effective reversible methods of birth control.
  2. Injectable – DMPA is available in India and the dose has to be repeated every 3 months.
  3. Subdermal implants – injected into the upper arm and are active for many years.
  4. Transdermal patch
  5. Vaginal ring

PERMANENT BIRTH CONTROL

  • If you are certain that you don’t want to have a baby in the future, permanent birth control methods can be brought into use.
  • Each of these offers 99-100% efficiency.
  • In the case of females, tubal ligation is the method of choice in which the fallopian tubes are closed in order to prevent eggs from reaching the ovaries.
  • An ideal time of tubal ligation is following the menstrual period, in the proliferative phase.
  • This process is done under general anesthesia.
  • For males, the method used for permanent birth control option is vasectomy.
  • During this procedure, a permanent interruption is created in the vas deferens (the tube that allows the sperm to enter into the semen).
  • It is advisable to use additional contraceptive methods for 3 months until the semen becomes free of sperm.
What is Emergency Contraception?
  • This method is used in order to prevent pregnancy after unprotected sexual intercourse and should not be considered as a form of regular birth control.
  • Also known as ‘morning after contraception’.
  • Most of the methods of emergency contraception involve post-coital pills; however, copper-containing IUCDs can also be used for this purpose.
  • An IUCD needs to be inserted within 5 days of unprotected intercourse and is by far the best method of emergency contraception.

 

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Microbes and Female Reproductive Health

Microbes and Female Reproductive Health: Good Vs. Bad Bacteria

The female genital tract is home to a wide array of microbes that play a major role in both maintenance of health as well as the development of various diseased conditions. Is there any correlation between microbes and female reproductive health?

While some microbial flora colonized in the female genital tract form a protective mechanism and can be referred to as the “friendly” ones, the other type may produce enzymes and various other virulent factors of destructive nature, leading to life-threatening infectious diseases including malignancy.

What is the role of “friendly” microbes?
  • A healthy vaginal flora plays the role of protecting the body from urogenital infections. The vaginal flora is basically composed of numerous different kinds of bacteria (good and bad bacteria), of which Döderlein’s bacilli(or commonly known as lactobacilli) is the commonest type.
  • Researchers have repeatedly found pieces of evidence that certain parts of the vagina are dominated by Döderlein’s bacillus (Lactobacillus bacteria), which is basically the same family of friendly bacteria that are found in fermented foods like yogurt.
  • However, in cases of other parts of the reproductive tract like the mucus lining of the cervix portion of the uterus and the fallopian tubes, had only trace amounts of Döderlein’s bacillus (Lactobacillus), and a large number of bacteria of the family known as Pseudomonas.
  • These “good” bacteria are beneficial for the body and play a key role in defending against any kind of urogenital infection.
  • Lactobacillus not only provides protection against invading abnormal microbes (bad bacteria) from the external environment, but also from microbes that reside inside the vagina and tend to multiply very rapidly under specific conditions.
  • Döderlein’s bacilli also play an important role in maintaining an acidic vaginal pH between 3.8 and 4.5.
  • In a normal healthy state, the good and bad vaginal bacteria coexist in a state of equilibrium and this balance is very fragile. The shortage of lactobacilli causes elevated levels of Vaginal pH (becomes alkaline). This causes an imbalance thus providing an opportunity for the “bad” bacteria and fungi to reproduce inside the vagina and cause infection.
“Bad” microbes and their significance

Reproductive Health

The group of “bad” bacteria or not so friendly bacteria are responsible for giving rise to genital infections, under various circumstances. The most common types of genital infections encountered are as mentioned below:

  1. Bacterial Vaginosis
  • Overgrowth of a variety of bacterial species such as Gardenerella Vaginalis (most common), Bacteroids and Mycoplasma hominis causes bacterial vaginosis.
  • Characteristic features include:
  • White, thin and watery discharge
  • A fishy or musty odor
  • Accompanied by mild irritation or itching.
  1. Candida or “yeast” infections
  • Caused by Candida albicans, which flourishes in an acid medium and an abundant supply of carbohydrates. This type of infection is more common in pregnancy and diabetes.
  • Characteristic features include:
  • White discharge with thick, curdy consistency
  • Extreme vulvar itching
  • White patches adherent to the vagina which may cause bleeding on removal.
  1. Chlamydia
  • Usually a “silent” infection.
  • May lead to PID (Pelvic Inflammatory Disease), if left untreated.
  1. Trichomonas Vaginalis
  • This sexually transmissible disease occurs in the presence of elevated vaginal pH. (5-6 as during menstrual period).
  • Characteristic features include:
  • Copious, greenish, frothy discharge
  • May be associated with a foul odor and vulvar itching
  1. Herpes Genitalis
  • Caused most commonly by Herpes Simplex Virus(HSV)
  • Symptoms usually noticeable within 7 days of sexual contact.

 

Vaginal Prolapse: understand it before you regret

Genital Infections: A concern females needs to talk about

 

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Vaginal Prolapse: understand it before you regret

Vaginal Prolapse: Risk factors, Diagnosis, and Treatment

Protrusion of pelvic organs into or out of the vaginal canal is called VAGINAL PROLAPSE. Uterine prolapse can occur along with the prolapse of the anterior or posterior vaginal compartments. There are basically 3 levels of vaginal supports that are described by De Lancey’s classification. Weakening of the muscles or ligaments that support the vagina, lead to the consequent protrusion of uterus, urethra, bladder or rectum into the vagina.

Why does Prolapse occur? 

  • Prolapse can be both congenital as well as acquired.
  • Congenital prolapse is usually seen in young nulliparous women.

Causes are as mentioned below :

    1. Spina bifida occulta
    2. Ehler Danlos syndrome
    3. Marfan’s syndrome
  • On the other hand, major causes for acquired prolapse are:
    1. Repeated child birth
    2. Menopause
    3. Traumatic deliveries
    4. Faulty birth practices
    5. Precipitate labor
    6. Iatrogenic (vaginal hysterectomy)
    7. Increased intra-abdominal pressure (as in COPD, obesity, constipation etc.)
Vaginal prolapse can be broadly classified into:
  • Anterior vaginal prolapse (cystocele, urethrocele or cystourethrocele)- occurs when the bladder droops into the vagina.
  • Posterior vaginal prolapse (Enterocele or rectocele) is when the pouch of Douglas or the rectum protrudes into the vagina.
  • Apical prolapse (vaginal vault prolapse) is referred to the bulging of cervix or upper part of the vagina.
  • Uterine prolapse is when the uterus protrudes into the vagina.
Symptoms: 
  • Sensation of fullness in the vagina and heaviness in the pelvis.
  • Pain in lower back might be present, that gets better on supporting the back or when lying on it.
  • Frequent urge for urination.
  • Intercourse may be painful for some.
  • Unfinished sensation after stool or urination.
  • Increased tendency to bladder infections is seen.

Diagnosis

Vaginal Prolapse

  • Pelvic examination is the initial step towards the diagnosis of prolapse, in which the patient is usually asked to bear down (as if during stool).
  • For any issues with urination, urodynamic tests are used for assessing the functioning of your bladder. It usually consists of uroflowmetry and cystometrogram.
  • Other than that, ultrasound of pelvis, MRI of the pelvic floor and CT scan of the abdomen/pelvis might also be suggested by the physician.

Treatment

  • Anterior colporrhaphy- for repair of cystocele and urethrocele.
  • Posterior colpoperineorrhaphy- for repair of lax perineum and rectocele.
  • Repair of enterocele- Abdominal repair (Moscowitz repair) or vaginal repair (Mc Call culdoplasty).
Prevention
  • There are a lot of ways through which one can try to tighten their pelvic muscles and lessen the risk of prolapse. For example, Kegel exercises can help reinforce the nerves and muscles of the pelvis. Making certain changes in the lifestyle may help, as well.
  • In case you’re overweight, attempt to shed a few pounds. Overweight ladies are more prone to suffer from prolapse than the individuals who maintain their weight. Drinking a lot of fluids and eating high-fiber diet works miraculously as well and also helps in avoiding obstruction.
  • Try not to lift anything heavy and learn how to lift the correct way – with your legs, not your back or abs.
  • Stop smoking as it is associated with higher risk.
  • Consult the doctor about any medical problems, like a cough that just would not go away. Cough puts pressure on the pelvic muscles and can aggravate prolapsed of pelvic organs.
Kegel exercises

These can help make the muscles below the uterus, bladder, and bowels (large intestine) even stronger. They can support people of both sexes who have urge incontinence of urine or faeces or both.- A Kegel exercise resembles the process of micturating and then holding it by relaxing and then tightening the muscles that control urine flow. Repeat these Kegel exercises 3 times a day:

  1. Ensure your bladder is empty, and then sit or lie down.
  2. Tighten the pelvic floor muscles. Hold tight for about 3 to 5 seconds.
  3. Now relax the muscles and wait for 3 to 5 seconds.
  4. Repeat the exercise 10 times, 3 times a day (morning, evening, and night).

-Improvement is evident after 4- 6 weeks of regular exercise. Continue doing the exercises, but don’t increase the number of repetitions because over exercise can lead to straining while urinating or defecation.

 

Ehlers-Danlos Syndrome

 

 

 

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Endometrial Cancer- Diagnosis and Treatment

A brief overview of Endometrial Cancer-Risk Factors, Diagnosis, Management

Endometrial cancer or uterine cancer refers to the abnormal growth of the epithelial cells, resulting in a tumour, which invades the local tissue and spreads or metastasizes to distant sites or organs.

The uterus is a pear-shaped organ in the pelvic cavity, the main function of which is to carry the foetus until it develops enough to be delivered out into the world. It is a muscular organ which is lined by epithelium, known as the endometrium. In the endometrium, the zygote is implanted and successively develops into an embryo and then a foetus. Beneath it lays the myometrium, made of smooth muscle cells, which provide the power for contraction during childbirth. It is covered on the outside by a fibrous tissue known as the serosa.

Symptoms:
  1. Abnormal uterine bleeding (It may be in-between menses, spotting of inner garments or irregular menstrual periods. In post-menopausal women, any bleeding is abnormal.
  2. Any abnormal vaginal discharge
  3. Pelvic pain
  4. 4. Loss of appetite
  5. Fatigue and Exhaustion
  6. Abdominal cramping and bloating
  7. A quick feeling of satiety on eating

Risk Factors:

Endometrial Cancer

Non-Modifiable Risk Factors:
  1. Age
  2. Genetic Composition
  3. Females with BRCA 1 and BRCA 2 mutation are more at risk for developing endometrial cancers.
  4. Lynch Syndrome
  5. Family History
  6. Early beginning of menstruation and late menopause
  7. Ovarian Tumours
Modifiable Risk Factors:
  1. Late pregnancy and having no child poses a higher risk
  2. One or more full-term pregnancies reduces the risk
  3. Exclusive breastfeeding for at least 6 months reduces the risk
  4. Hormone Replacement Therapy post menopause increases the risk
  5. high-fat diet leads to increased risk of hyperplasia and development of cancer.
  6. Research has shown that highly active females have lower risk while idle females have a higher risk.

Diagnosis:

  1. Ultrasonography
  2. Biopsy
  3. Dilatation and Curettage (D&C)
  4. CA-125
  5. CT Scan

Treatment:

Endometrial Cancer

  1. Surgical excision: Removal of the uterus along with ovaries and fallopian tubes.
  2. Concurrent chemotherapy
  3. Targeted Therapy
  4. Radiation: With or without surgery.
  5. Immunotherapy
  6. Hormonal Therapy: With progestins

 

(Know more about Best Oncologists/Oncosurgeons in India.)

Check here: Top 38 Accredited Cancer Hospitals from India

Prevention:

There are no definite ways to prevent endometrial cancer. However, the person must report early bleeding and any indicative signs. Genetic counselling for Lynch Syndrome may also be done to prevent its transmission to progeny.

Obesity, hypertension and diabetes can contribute to long-term health risks for women with type 1 endometrial cancer. A healthy diet and regular exercise can help one to lower these risks.

 

Ovarian Cancer- The What, Why and How?

Cancer Hospitals and Institutes in India

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Ovarian Cancer- The What, Why and How?

What is Ovarian Cancer?

Females have two ovaries situated in the pelvis, which are the primary sites of production of female gametes known as ova/eggs. The ovaries have the germinal lining which gives rise to ovarian follicles, containing the gametes. Besides, they have a cellular stroma /connective tissue which fills the substance of the ovary. Ovarian cancer refers to the malignant transformation of cells resulting in unrestrained proliferation and the formation of a tumor. When detected early, it is possible to have a good prognosis with a better quality of life. If detected in its late stages, for example, when it has spread to the abdominal cavity or the adjacent pelvic organs, it is difficult to treat.

Ovarian Cancer Symptoms

Ovarian Cancer

The symptoms of ovarian cancer overlap with many other benign conditions and thus, it is difficult to attribute them to ovarian cancer. They arise in the late stages of cancer when there is involvement of the uterus, bladder or rectum. They are common to premenstrual syndrome, irritable bowel disease, etc and include:

  1. Unexplained weight loss
  2. Loss of appetite
  3. Fatigue and Exhaustion
  4. Breathlessness
  5. A quick feeling of satiety on eating
  6. Lower back pain
  7. Abdominal cramping and bloating
  8. Nausea and vomiting

Persistence of these symptoms, despite taking basic treatment should raise a red flag and warrant medical attention.

Ovarian Cancer: Causes and Risk Factors

Ovarian Cancer

  1. Post-menopausal women, generally during 50-60 years
  2. Genetic Composition
  3. Family History
  4. Early-onset of menarche
  5. Late menopause or cessation of menstruation
  6. Not having children at all
  7. Employing hormone replacement therapy post-menopause
  8. Women with a BMI of over 30
The diagnostic tests include:
  1. Transvaginal Ultrasonography
  2. Biopsy
  3. CA-125
  4. CT Scan

Ovarian Cancer: Treatment

Ovarian Cancer

Treatment depends on multiple factors:

  • Tumor characteristics: Size, Spread, Invasion, etc
  • Patient Factors: Age, Immune and functional status
  • Economic factors: Cost of therapy and affordability.

They include:

  1. Surgical excision
  2. Concurrent chemotherapy
  3. Targeted Therapy
  4. Radiation
  5. Immunotherapy

Check here: Top 38 Accredited Cancer Hospitals from India

(Know more about Best Oncologists/Oncosurgeons in India.)

Prevention and Consultation

There are no screening methods that have emerged currently which would specifically detect ovarian cancer in its early stages.

A healthy diet and weight control are primary preventive measures.

If the symptoms persist for 2 or more weeks despite basic treatment, do not hesitate to visit your physician. Cancer mortality is continuously decreasing worldwide and ovarian cancers generally have a good prognosis.

Early detection and prompt treatment remain therapeutic cornerstones.

 

Endometrial Cancer- Diagnosis and Treatment

 

Cancer Hospitals and Institutes in India

 

Information Center and References:

 

 

 

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Medical Problems During Pregnancy

Medical Problems During Pregnancy

Pregnancy precedes the gift of childbirth and motherhood and extends from conception. The typical nine months duration of pregnancy can conveniently be divided into three trimesters (3 months each). Medical Problems During Pregnancy can be divided broadly into maternal and fetal complications.  One of the goals of ante-natal care is ‘ Healthy Mother and a Healthy Baby.’

Medical Problems During Pregnancy- First Trimester Complications:
  • Bleeding: Spotting may occur in some women as a result of the implantation, post the seventh day of fertilization. However, bright red vaginal bleeding may be a sign of miscarriage. Accompanied by lower abdominal cramps, it may be a sign of ectopic pregnancy.
  • Nausea and Vomiting are Fairly common during the first trimester. This is due to the expansion of uterus as well as gastric irritation by iron-folic acid supplementation. It subsides as the pregnancy progresses and does not warrant medical attention.
  • High-Grade Fever: Indicative of infection, TORCH ( Toxoplasma, Rubella, Cytomegalovirus, and Herpes Simplex) are common perinatal infections. Vaccinations remain definitive prophylaxis.
  • Vaginal Discharge and Itching: Whitish discharge is most likely of Candida infection. In comparison, a foul-smelling discharge may point to Pseudomonas Infection. It is essential that smear and antibiotic susceptibility testing is performed before initiating treatment.
  • Urinary Tract Infection is characterized by burning micturition. Usually, a urine alkalizer in the form of sodium bicarbonate is advised.
  • Pedal edema/ swelling: Since pregnancy is a hypercoagulable state, blood clots may form in the gravity-dependent lower extremities, which may lead to thrombosis and embolization.
Medical Problems During Pregnancy- Second Trimester Complications:

Pregnancy Problems

  • Per vaginal bleeding: It differs from that in the first trimester by its etiology: Placental malformation, placental abruption, cervical incompetence, uterine fibroids, etc. USG Scans are, therefore, essential.
  • Preterm Labour: Before 38 weeks of gestation, due to chronic conditions like diabetes, or kidney diseases, excessive accumulation of amniotic fluid (twin pregnancies), autoimmune diseases, etc. Uterine relaxants like isoxsuprine, ritodrine may be useful.
  • Premature Rupture of Membranes: Mostly due to infection of amniotic membranes. It is a medical emergency requiring hospitalization and steroids (for lung maturity of the baby)
  • Cervical incompetence: This occurs due to cervical trauma, biopsy, smoking( collagen strength reduction). It requires a cervical stitch in a few of the cases.
  • Pre-eclampsia and Eclampsia: Gestational Diabetes accompanied by proteinuria is Pre-eclampsia. Pre-eclampsia, along with seizures, is eclampsia.
Medical Problems During Pregnancy-Third Trimester Complications:

  • All the complications of the second trimester along with fetal malpresentation ( transverse lie/ breech presentation)
  • Decreased fetal movements and heart rate

Top 10 Infertility Treatment Clinics from India

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Pelvic Inflammatory Disease: Diagnosis and Prevention

Pelvic Inflammatory Disease: Diagnosis and Prevention

Pelvic Inflammatory Disease is also known as Pelvic Inflammatory Disorder or PID.  PID is the infection of the upper part of the female reproductive system, namely the ovaries, fallopian tubes, and the uterus. It is a bacterial infection that spreads upwards from the vagina and the cervix. It further infects the upper parts of the reproductive system. Women with more than one episode of Pelvic Inflammatory Disease are at a greater risk of infertility and should consult their gynecologist for an infertility evaluation.

Symptoms:

The early onset of PID exhibits almost no signs and symptoms. While the following symptoms are observed in severe infection cases.

  • Lower abdominal pain
  • Heavy, unpleasant vaginal discharge
  • Irregular bleeding between periods
  • Pain during intercourse
  • Fever, and chills
  • Pain while urination

Severe infections give rise to complications such as
  • Endometritis
  • Tubo-ovarian abscess (fluid build-up in fallopian tubes and ovaries),
  • Chronic pelvic pain
  • Infertility and
  • an increased chance of Ectopic Pregnancy
Risk Factors:

The chances of having Pelvic Inflammatory Disorder might increase if the woman has

  • Multiple Sexual Partners
  • Being in a sexual relationship with a person who has multiple sexual partners,
  • Unprotected Sex
  • Douching (vaginal rinsing)
  • Having a previous history of PID.
  • Sexually Active Females aged below 25 years are at higher risk.

Diagnosis

Prevention:

Prevention is possible for pelvic inflammatory disorder and is generally simple. It includes having protected sex, having a single sexual partner, regular screening for STIs, using barrier methods of protection such as condoms while performing intercourse, avoid douching, and abstinence.

Treatment:

Treatments options include

  • Antibiotic therapy depending upon the infectious agent.
  • In the case of no relief of symptoms, a stronger course of treatment is needed.
  • Intravenous antibiotic therapy followed by regular oral antibiotics
  • Surgery in cases of abscess and rupture in the fallopian tubes or ovaries.
  • Avoiding sexual intercourse until the complete recovery.

How does Endometriosis affect a woman’s life?

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Ectopic Pregnancy: Signs and Symptoms

Ectopic Pregnancy: Diagnosis and Treatment

Ectopic Pregnancy (m. out of place) is when the embryo gets attached outside of the uterus (for example, in the fallopian tube, ovaries, interstitially, or cervix). It is a complication in pregnancy with classical symptoms including abdominal pain and vaginal bleeding.

In certain cases, the pain may also spread to the shoulder if there is bleeding in the abdomen. The survival rate of foetuses is negligible and amount to 1% to 2% in developed countries. This is also risky for mothers as about 10% are reported to die in their first trimester.

The signs and symptoms of ectopic pregnancy include
  • Increased levels of hCG
  • Vaginal bleeding
  • Sudden lower abdominal pain (as cramps, sharp, or dull),
  • Pelvic pain,
  • Tender cervix,
  • Nausea, vomiting, and/or diarrhoea.

These symptoms most commonly resemble that of gastrointestinal disorders such as appendicitis, rupture of the corpus-luteum cyst, miscarriage, or a Urinary Tract Infection (UTI). It is diagnosed after 7.2 weeks (about 2 months) after the last menstrual period.

Rupture of an ectopic pregnancy leads to abdominal distension, tenderness, and hypovolemic shock. Death of the mother from rupture of such a pregnancy is the leading cause of death in the first trimester.

The most common causes of an ectopic pregnancy include

If pregnancy occurs in the presence of an IUD, it is likely to be ectopic in nature. A tubal pregnancy is commonly diagnosed in women who smoke. In tubal pregnancy, an embryo gets attached to the walls of the fallopian tube.

Diagnosis:

Ectopic Pregnancy

An ectopic pregnancy can be self-diagnosed when the woman experiences sharp abdominal pain and vaginal bleeding while having a positive result on a pregnancy test.

Clinically, it can be diagnosed by transvaginal Ultrasound Sonography, where the gestational sac is imaged showing a foetal heart in the fallopian tube. A Laparoscopy can also be performed to visually confirm an ectopic pregnancy.

Treatment:

Early treatment can be done by methotrexate (given as a muscular injection), which is a viable alternative to surgery. Methotrexate terminates the growth of the embryo, which is then either reabsorbed by the woman’s body or gets passed with a menstrual period.

If vaginal bleeding has already occurred, surgical intervention may be necessary. In such cases, the ectopic mass is removed laparoscopically.

When ectopic pregnancies are treated, the chances of maternal death are rare. In this case, most foetuses die or are aborted. If the woman is said to have had an ectopic pregnancy, the risk of developing one in her next pregnancy is about 10%.

 

Top 10 Infertility Treatment Clinics from India

Pelvic Inflammatory Disease: Diagnosis and Prevention

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How does Endometriosis affect a woman’s life?

Endometriosis and Woman’s Health

Endometriosis is the presence of endometrium-like tissue growth outside the uterus, which leads to a chronic inflammatory reaction, scar tissue, and adhesions that distort a woman’s pelvic anatomy. It occurs most commonly in young women and the rate of incidence is increasing steadily over the past few years. Do you know that 5-10% of women suffer from Endometriosis, during their reproductive-age?

SYMPTOMS:

The most common symptom associated are

  • Dysmenorrhea
  • Chronic pelvic pain
  • Painful intercourse
  • Infertility
  • Severe menstrual pain
  • Irregular flow during menstruation and/or premenstrual spotting
  • a continual or recurrent urge to evacuate the bowels
  • Straining during stool passing, sometimes associated with the passing of blood
  • feeling of constipation
  • painful urination
  • Blood in the urine
CAUSES:

Many theories have been put-forward and researched, to ascertain the causative factors of endometriosis.

COMPLICATIONS:

Commonest complications are

  • Infertility
  • Severe pain
  • Adhesions spreading to the peritoneum

Complications during pregnancy:

  • a hole in the wall of part of the intestinal tract
  • inflammation of the appendix
  • baby’s placenta may partially or totally cover the mother’s cervix
  • Miscarriage
  • Uterine rupture
  • Appendicitis
  • Narrowing of the ureter causing obstructed flow of urine
  • Fetal growth restriction
  • Bleeding in pregnancy that occurs before, during, or after childbirth
DIAGNOSIS:
  • A complete medical history and physical examination
  • Laparoscopy
  • MRI, cystoscopy, sigmoidoscopy or colonoscopy
  • Serum markers test
  • Endometrial biopsy
RISK FACTORS:
  • Family history of endometriosis.
  • Early-onset of menstruation.
  • Short menstrual cycles and long duration of menstrual flow.
  • Heavy bleeding during menses.
  • Delayed childbearing.
  • The uterus or fallopian tubes defects.

TREATMENT:
  • Pain killers
  • Combined oral contraceptives and progestins
  • Hormone based treatment:
  • Non-hormone treatments: Immunomodulators, Antiangiogenic agents
  • Surgical management like
    • lysis of adhesions,
    • removal of visible implants
    • laparoscopic uterine nerve ablation
    • Hysterectomy in severe cases of endometriosis

Pelvic Inflammatory Disease: Diagnosis and Prevention

 

Gonorrhea: Risk Factors, Diagnosis and Prevention

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OLIGOHYDRAMNIOS: Causes and Treatment

OLIGOHYDRAMNIOS: Causes and Treatment

Oligohydramnios is the condition where the level of the amniotic fluid decreases during the gestation period. It is associated with maternal and fetal complications.

During pregnancy, the volume of amniotic fluid gradually increases until 33 weeks of gestation period. It increases from 33-38 weeks and then decreases. Approximately the volume of amniotic fluid is 500ml. It mainly comprised of fetal urine output, placenta and fetal secretions.

The fetus inhales and swallows the amniotic fluid. It gets to sort out, fills in the bladder and is excreted this cycle repeats. Any obstructions in this cycle lead to either increased or too little fluid.

Anything which decreases the production of urine or obstructs the output from the fetus or rupture of the membrane can lead to oligohydramnios.

Causes of oligohydramnios
  1. Post-term pregnancy
  2. Preterm prelabour rupture of membranes
  3. Renal agenesis (potter’s syndrome)
  4. Placental insufficiency
  5. Viral infections
  6. Non-functioning fetal kidneys
  7. Fetal chromosomal abnormalities
  8. Premature rupture of membranes
  9. Idiopathic
  10. Drugs like angiotensin-converting enzyme inhibitors, NSAIDs.
Can it be treated?

OLIGOHYDRAMNIOS

oligohydramnios is a serious condition, and one must be in regular consultation with the doctor. The following options are generally explored by a doctor in such cases.

  1. If observed before 36 weeks of the gestational period- the doctor will advise to increase fluid intake and monitor fetal growth on a regular basis. USG is also advised.
  2. If observed after 37 weeks- delivery is the safest option.
  3. Low amniotic fluid during labor- amnioinfusion may be considered, wherein the fluid is infused in the amniotic sac.

Medical Problems During Pregnancy

Healthy Pregnancy through IVF

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Gonorrhea: Risk Factors, Diagnosis and Prevention

Gonorrhea: Risk Factors, Diagnosis and Prevention

Gonorrhea is caused by an infection with Neisseria gonorrhea a bacterium that can infect both sexes alike. The disease usually affects the genital tract, urethra, rectum, throat, and eyes. Transmission of the disease is usually the result of vaginal, anal or oral sex. Gonococcal conjunctivitis can occur as a result of accidental infection from contaminated fingers.

In females, gonorrhea causes infection of the cervix. Untreated mothers may infect their babies during childbirth causing ophthalmia neonatorum. In babies, gonorrhea most commonly affects the eyes.

RISK FACTORS

  • Age: a majority of cases of gonorrhea are seen at a young age
  • Sexual contact with multiple partners
  • Unprotected sex
  • Previous history of gonorrhea or other STDs
  • A new sex partner
  • A sex partner who has concurrent partners
CLINICAL MANIFESTATIONS
  • In Males:
  • Painful and frequent urination
  • Pus-like or greenish urethral discharge
  • Pain or swelling due to inflammation in one or both testicle
  • inflammation or swelling of the foreskin
  • In females: About 80% of women show no symptoms. The commonly found symptoms are:
  • Painful and frequent urination
  • Increased vaginal discharge
  • Vulvar swelling
  • vaginal bleeding between periods
  • Painful sexual intercourse
  • Post-coital bleeding
  • Lower abdominal or pelvic pain
  • Gonococcal Arthritis

DIAGNOSIS

Gonorrhea

  • Urine tests
  • Taking a swab of the affected area followed by culture of the bacterium:
    • For heterosexual males: Urethral swab for gonococci
    • For homosexual males: Pharyngeal, urethral and rectal swabs for gonococci
    • For females: Urethral and cervical swab for gonococci
COMPLICATIONS

Untreated gonorrhea can cause significant complications, such as:

  • In males: inflammation of the prostate, Infertility, Increased risk of HIV/AIDS
  • In females: Pelvic Inflammatory Disease (PID), Infertility, Ectopic pregnancy, Increased risk of HIV/AIDS
  • Babies who contract gonorrhea from their mothers during birth can develop blindness and sores on the scalp.

PREVENTION

To avoid or reduce your risk of sexually transmitted diseases, one needs to exercise the following caution.

  • Avoid sex with multiple partners
  • Get yourself and your partner tested for STIs
  • Protected sexual intercourse
  • Go for Regular screening

 

Gonococcal Arthritis- symptoms, causes and complications

 

Pelvic Inflammatory Disease: Diagnosis and Prevention

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Healthy Pregnancy through IVF

Healthy Pregnancy through IVF

IVF, in-vitro fertilization, is a technique of fertilizing a human egg with a sperm in a laboratory. This fertilized egg is then implanted into the female uterus for the rest of the gestation period.

During IVF, the regular menstrual cycle of the woman is turned off by injections and she is given fertility treatment and her eggs are then harvested. These are then fertilized with the sperm collected from her partner/donor. These fertilized eggs (embryos) grow in an incubator for a couple of days and are then transferred to the woman’s uterus. If an embryo successfully implants, the woman gets pregnant. Although, she needs to wait for 2 weeks before taking a pregnancy test. Any remaining healthy embryos can be frozen and stored for later use.

Top 10 Infertility Treatment Clinics from India

On average, a woman has a 1 in 5 chance of getting pregnant in one cycle of IVF.  This is higher for women younger than 35, and it decreases with an increase in age. IVF usually guarantees higher multiple pregnancy rates (chances of twins) but is usually associated with preterm delivery and increased neonatal morbidity and mortality. Therefore, females who conceive via IVF are told to be extra careful with their health and diet.

IVF treatment has a major psychological impact on couples, specifically females. As it is a long and cumbersome process of taking multiple treatments for altering the menstrual cycle and increasing fertility, couples usually get disheartened when they are not able to conceive in the first try. Which is why doctors recommend freezing the extra healthy embryos for future use.

Know more about Infertility treatment

IVF

No smoking and no drinking policy applies to all pregnancies, females with IVF should also keep an eye on their vitamin levels and follow a diet recommended by their doctor. Along with this, light exercise will not only help with a better mood but it will also keep the mother and the baby healthy. They should also take care of their psychological well being along with their physical well-being.

The average cost of IVF though is expensive and the whole process is time-consuming (about 2 years), couples who conceived children through this process are happier.  Know more about Top 20 IVF Specialists in India With increasing advancements in the medical industry, the process is now becoming easier and gaining a higher success rate. Because of the increased popularity of the treatment, many insurance companies also cover partial costs (check with your insurance provider for the same).

Top 10 Infertility Treatment Clinics from India

 

Intrauterine Insemination (IUI) for Infertility Treatment

Frozen Embryo Transfer or Cryo-preserved Embryo Transfer Procedure

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UTERINE FIBROID AND UTERINE POLYPS- SIMILARITIES AND DIFFERENCES

UTERINE FIBROID AND UTERINE POLYPS- SIMILARITIES AND DIFFERENCES

Uterine fibroids are thick muscle tissues, produced under the effect of hormones, This non-cancerous growth on the walls of the uterus, is called as fibroid. Fibroids may vary in size and are not considered life-threatening.

Uterine polyps are in round or oval shapes, that grow upon the uterus wall (also known as the endometrium). The growth happens after each period cycle ends, hormones urge endometrium to grow again. It can develop both premenopausal and postmenopausal women. Polyps can pose serious health issues like cancer and infertility.

Similarities:

UTERINE FIBROID

  1. Difficult to urinate or frequent urination
  2. Excessive vaginal bleeding
  3. Irregular menstruation
  4. Pain near the hips and abdomen
  5. Pain during sexual intercourse.

Differences:

Sl. no Uterine polyps Uterine fibroids
01 Polyps grow from endometrial tissue that attaches to the lining of the uterus. Fibroids may grow upon wall of uterus, inside the lining of the uterus or may be outside of the lining of the uterus.
02 Small in size (a couple of centimeters) Vary in size- minuscule to extremely large and may shrink
03 Invasive and surgical methods may require to remove the polyps Noninvasive methods to remove fibroid tissues
04 They can regress They do not regress
05 Can be controlled by hormone-balancing drugs It cannot be controlled by medications.
06 Potentially cancerous Non-cancerous

 

 

 

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