What Is Ovulation Induction And Am I A Good Candidate?

Things you should know about Ovulation Induction

The basic requirement for conceiving is the egg and sperm. Many couple are not able to conceive because of so issues related to this. Ovulation commonly known as release of egg from the ovary. Anovulation is a very common issue leading to subfertility. Anovulation could be because of many different reasons, mainly due to hormonal imbalance. Most common cause is polycystic ovarian disease. It’s quite simple to understand that if we restore ovulation the chance of fertility is restored

If you are going through ovulation issues but still you want your own child, ovulation induction is the ideal treatment option to help you out!

Understanding ovulation induction…

As now we already know that ovulation is the most basic requirement for fertility. Ovulation induction means to restore the egg development and release of egg in women having anovulation. After proper investigation to explore the cause of anovulation, treatment can be planned. Treatment of anovulation is generally very simple with basic oral medication or sometimes combing with injections depending on the cause of the condition and the response of the patient to the above treatment.

Who would require ovulation induction?

Ovulation induction is one of the options offered to women if:

  • PCOS which is making your menstrual cycle irregular.
  • Other medical issues like obesity, overweight and hormonal dysfunction.
  • Irregular periods due to any reasons
  • Unexplained subfertility

These problems affect women from conceiving. Ovulation Stimulation is a good option for women with these problems as this increases the chances of being pregnant.

How can ovulation induction benefit you?

The process stimulates the development and release of eggs from the ovary in a natural way either through fertility pills or injections. The medications that are used for stimulation of eggs, increase the quality and quantity of eggs. Thereby the chances of conceiving become much higher.

And finally, the procedure is also used in the IVF cycle since stimulation of eggs helps to mature multiple eggs in just one cycle.

Why should you see a doctor if you surfer from pregnancy loss?

Expert guidance for pregnancy loss: Consult a doctor for personalized care - Motherhood Hospital India

ItŸ??s believed that 75percent of all pregnancies end in miscarriage. However, most miscarriages go unnoticed because they happen so early. The victim might feel it like a normal period, slightly delayed though says Dr.Mirudhubashini Govindarajan, Clinical Director, WomenŸ??s Center by Motherhood. Experts believe that 15 to 20 percent of women will experience a miscarriage which is clinically recognized. Ÿ??This happens due to genetic, infective, immunological, endocrine or environmental causes or structural defects,Ÿ? she adds. According to her, 50 percent of early miscarriages could be attributed to genetic causes when fetus cannot survive due to genetic or chromosomal defect.

This miscarriage is a random event. Ÿ??But, most such women will achieve normal pregnancy subsequently,Ÿ? avers Dr.Mirudhubashini. As for immunological causes, it is finally the clots in blood which result in the demise of the fetus. Ÿ??Antibodies which some women carry in their blood may attack their own cells,Ÿ? informs Dr.Mirudhubashini, adding Ÿ??some of these antibodies may attack the placenta or promote formation of blood clots in the placentaŸ?. The clots can slow down the fetal growth leading to eventual miscarriage.

Miscarriage can also occur due to anatomic causes because some women may have a septum (wall) within the uterus. It could come in the form of a double or half uterine cavity or a similar defect which leads to miscarriage. Presence of large fibroids, particularly, those encroaching upon the uterine cavity can also preclude a successful pregnancy outcome.

Miscarriage can also occur due to infections. Many types of bacteria, viruses or parasites can cause pregnancy loss. But, this is not very common.

Elaborating on endocrine causes, Dr.Mirudhubashini says that women with irregular periods or Polycystic Ovarian Syndrome (PCOS) run a higher risk of early pregnancy loss because the multiple maternal hormones fail to provide an ideal environment to the developing embryo.

We canŸ??t do much about many of these causes. But, miscarriages occurring due to certain environmental causes like intake of harmful substances like drugs, alcohol, smoking or excessive caffeine can definitely be prevented to a great through abstention.

Miscarriage is never a pleasant experience. The agony could have a prolonged effect. Bleeding is the first symptom of a miscarriage. It could range from spotting to heavy bleeding (haemorrhage). A miscarriage resulting in haemorrhage is generally not life-threatening if good medical help is available. Ÿ??But, in the long run, a woman could become anaemic due to blood loss. She needs to be given adequate iron supplements and vitamin-rich diet to take care of nutritional deficitŸ? advises Dr.Mirudhubashini.

A woman suffering from miscarriage must get adequate rest and if she is working, it is advisable to take a few days off thus allowing the bleeding to taper off in a week. But, persistent bleeding or heavier than normal period is a definite indication that you should visit a doctor, says

Dr.Mirudhubashini. Ÿ??You should also avoid intercourse during this time. This is not good because the uterus is still healing. One should remember that infection might occur at any point because the mouth of the uterus is open from a few hours to days making it vulnerable to bacterial attack. Frequent change of sanitary napkins should be strictly followed. This along with adequate rest prevents infection in most casesŸ? she explains.

So, how would one know in the case of infection?
Ÿ??ItŸ??s a good question. ThereŸ??re a few symptoms which include pelvic pain, fever, foul-smelling discharge, burning and/or pain while passing urine besides vomiting, body ache or lethargy,Ÿ? she confirms.

So, how long one should wait before attempting the next pregnancy after a miscarriage?
Experts says a couple should plan their next pregnancy from the third month after the miscarriage since it takes about six weeks for a womanŸ??s body to come back to normal after the miscarriage. Ÿ??But before that the couple should undergo a thorough medical investigation to rule out any possible causes of repeated miscarriages,Ÿ? cautions Dr.Mirudhubashini. In the event of detecting the cause, it should be treated before attempting another pregnancy. In the case of a first miscarriage, basic testing is done to rule out infection or endocrine causes. A second miscarriage, however, will need a detailed testing while a third miscarriage warrants detailed counselling including genetic counselling and detailed probe to detect possible causes.

A woman who has suffered from miscarriage in the past should undergo pre-pregnancy counselling and start on folic acid supplements. The physician treating her should also need to correct her nutritional and mental health as the situation demands. In essence, any woman with a past history of miscarriage would do better in her next pregnancy with extra medical monitoring.

For Contact: 146B, Mettupalayam Road, Coimbatore Ÿ?? 641043
For Appointment: 0422-4201000

Best Maternity Hospital In Electronic City

Any pregnant woman would like to be treated well, especially
while she is in labour. With this in mind, most hospitals today have customized
packages which are sketched out, keeping the basic needs of the newborn and the
new mommy as their primary motto.

Sarjapur has a whole lot of hospitals which are well known
for their infrastructure and experience. So if you are also planning to deliver
your little one in the best maternity hospital in electronic city, here’s where
you must head!

We all know that during pregnancy, the women is neither ill nor injured, but she needs more care which is provided by maternity hospitals. The best maternity hospital in Electronic City like Motherhood Hospitals taking care of women during pregnancy and childbirth. The couples who can’t take care of baby and mom, always look for the best hospitals. It is said by many specialist from the best maternity hospital in Sarjapur that women should go for regular check-up from the initial stage of pregnancy. By regular check-up, doctors of maternity health care centres can understand her condition and treated her according to it. These Maternity hospitals in electronic city have the best obstetricians and paediatrician for treatment. Motherhood is a one stop maternity care center for a safe pregnancy and delivery. While providing premier comprehensive services so that even women journey right from conception to delivery is pleasant, enjoyable and memorable. The friendly atmosphere, the warmth and the protection provided at the hospital gives the mother-to-be a comfortable and stress-free delivery experience. Even the team always ensures that you receive the best care and proper guidance on after birth care and parenting. Daily visits from paediatricians to check on your little one’s health, advice on breastfeeding, nutritious diet and care at home etc. are a few extra special cares you receive.

PAP Smear

Pap Smear also known as Papanicolaou smear is a screening test for cervical cancer. It is a microscopic examination of cells scraped from the cervix and is used to detect abnormal cervical cells (precancerous cells) which helps to treat cancer in early stage.

WHO SHOULD UNDERGO PAP SMEAR AND HOW FREQUENT

-All women aged more than 20 years and below 65 years

-Pap Smear done once in 3 years

-HPV Liquid based cytology is done once in 5 years

However in some conditions, if recommended once a year in following people

On abnormal Pap Smear

  1. HIV Patients
  2. Weak immune system due to organ transplant, chemotherapy,

Chronic corticosteroid use

  1. Smoking women

Pap Smear not to be done in following

After total hysterectomy, where uterus with cervix fully removed for non-cancerous indication. If hysterectomy done for precancerous and cancer indication, then routine PAP Smear has to be done.

-Age 65yrs and above

Draw back of PAP smear test are

The false negative results, because of the following reasons

-Inadequate collection of cells

-Blood or inflammatory cells obscuring the abnormal cells.

Although it’s possible for abnormal cells to go undetected, time is on your side as cervical cancer takes several years to develop and if one test doesnŸ??t detect the abnormal cells, the next test most likely will detect.

How to prepare

To ensure that your PAP smear is most effective, follow these tips prior to your test.

Avoid intercourse or any vaginal douching or medicine for 2 days before having a PAP smear, as these may wash away or obscure abnormal cells.

-Not to do during menstrual periods.

If abnormal cells were seen in PAP smear

A colposcopy examination done for cervical tissue biopsy to diagnose cancer.

Breast Cancer: What Every Women Should Know About It

Lumps in the breast are common problems in females. Only 20% of these breast lumps are cancerous. Breast cancer has replaced cervical cancer and now ranks first in cancers seen among females. The incidence of breast cancer is on the rise among Indian females, especially among younger generations. In spite of various treatment options available for treating breast cancer, the survival rates are less among Indian population compared to western population due to the presentation in advanced stages, lack of awareness about presenting symptoms and social stigma among village population.

Breast Cancer Screening
Screening is a method to diagnose an illness in its early stages with the goal to prevent death and suffering with timely medical interventions. Detection of breast cancer in the early stage has survival rates of above 95% which drops to 50% in stage III. So Screening for Breast cancer plays a major role in early detection and better treatment outcomes. Mammography, self-breast examination and examination of Breast by a trained medical professional are various screening options available.

American cancer society recommends clinical Breast Examination as the best screening modality for early detection. In India, mammography and clinical breast examination are most commonly followed modalities. Mammography is an imaging technique which helps to detect lesions in early stages which could not be appreciated by clinical palpating. Every female above 40 years of age is recommended to undergo annual screening in the form of mammography and clinical breast examination. Females with other risk factors like family history of breast and ovarian cancer, previous breast lesions are advised to undergo screening from an early age than the regular population.

Am I at Risk of Developing Breast Cancer?
In India, nearly 40 out of 1 lakh females develop breast cancer. There is a significant increase among younger females in the past few years. Risk factors for developing breast cancer can be broadly divided into modifiable and non-modifiable risk factors. Hormone replacement therapy, family history of breast, ovarian or male breast cancer, previous breast biopsy, exposure to ionizing radiation, not bearing children are all non-modifiable risk factors. Smoking, obesity, alcoholism are modifiable risk factors.

We advise to lead a healthy active life style and avoiding Smoking and alcoholism. People with non-modifiable risk factors are advised to get counselled by a doctor regarding the precautions and should understand the presenting symptoms. People with a strong family history should undergo frequent screening than people with normal risk. Strong family history can be due to an inherited genetic mutation, such individuals can undergo genetic testing only after a proper counselling with a geneticist. Genetic testing without people counselling is not advisable.

Self-Breast Examination
A self-breast examination is one of the options for females to keep themselves on a regular check. Every female should be aware of the presenting symptoms of breast cancer like a lump in the breast, bleeding from the nipple, Ulcer (wound) over the breast skin or nipple area, dimpling of the skin over the breast etc.

Self Breast Examination Includes 2 Steps :-
1) Looking at the breast in a mirror for any skin or nipple changes, any visible swellings in the breast and axillary.
2) Feeling both the breasts in lying down position on a flat surface. Feeling the breast should follow a regular pattern not to miss any part of the breast.

A self-breast examination should be done after 3-5 days of the beginning of your monthly menstrual bleeding. Females who have attained menopause can examine the same any particular day of a month.

Types of Hysterectomy Procedure by Dr. Suhasini Inamdar

Hysterectomy is the removal of the uterus (baby bag) surgically. There are various methods and approaches:

1)Laparoscopic hysterectomy:

This is minimally invasive surgery, it is done through keyhole openings, approximately 4-5 in number, on the skin surface of the abdomen. These are 2-3 cms in size. The uterus is detached of all the attachments and it is delivered out through the vaginal route.

2)Abdominal hysterectomy:

Here a bikini cut is given on the abdomen and the uterus is detached of attachments and removed through the abdomen.

3)Vaginal hysterectomy:

This is a common approach when the uterus is descending and coming down in or out of the vagina, which is called prolapse of the uterus. This approach is also used for some cases of non-descend, where the uterus is not very big, and no other abdominopelvic pathology is detected.

The laparoscopic family planning procedure

Family planning is a method which helps the couple plan the number of children in the family. This can be temporary like ORAK CONTRACEPTIVE PILLS, CUT, CONDOMS, VAGINAL CONTRACEPTIVE SPONGES. The permanent method is tying of the Fallopian tubes in ladies and of VAS DEFERENCE in men.

The best and minimally traumatic method of tying of fallopian is LAPAROSCOPIC TUBECTOMY

It is a day-care procedure, the patient gets admitted on fasting stomach. It is done under general anesthesia. The patient is started on liquids by mouth and made to walk and use the washroom 6 hours after the procedure. The patient walks home same evening and comes for review after a week

By Dr.Suhasini Inamdar

ANAEMIA & CERVICAL CANCER – THE UNNOTICED KILLERS AFFECTING INDIAN WOMEN

India has been making great headway in the eradication of diseases like Polio & Small Pox but this is just the tip of the iceberg. Certain conditions like Anaemia do not get the attention they deserve. Characterized by subtle symptoms, diseases of this nature can go untreated for a long period leading to serious complications or occasionally even death. Women may be totally unaware that they are suffering from such conditions.

Anaemia in varying degrees is widely prevalent amongst Indian women. Global Nutrition Report 2017 states that about 51% of women of reproductive age in India suffer from anaemia. It is predominantly due to nutritional deficiency. Women also have to cope with blood loss during their monthly periods which can further reduce their haemoglobin levels. It is prevalent across all socioeconomic strata and is a condition that can be easily diagnosed and treated.

Anaemia characterized by low blood hemoglobin levels increases the risk of infection, preterm delivery, and suboptimal fetal growth. In infancy and early childhood, Anaemia can cause recurrent illness, failure to thrive, poor performance at school and failure to participate in physical training and games at school. Analysis by a think tank, IndiaSpend, states that anaemia has remained the leading cause of disability across the ages in India for the past 10 years. Anaemia can be easily diagnosed by a simple blood test called Complete Blood Count.

Cervical cancer is a leading cause of death from cancer amongst Indian women. It runs parallel to breast cancer in incidence. A study on cervical cancer by ASSOCHAM-National Institute of Cancer Prevention and Research (NICPR) reveals India alone accounts for one-fourth of the total cervical cancer burden globally. Almost 17% of cancer-related fatalities in women between the age of 30-69 can be attributed to cervical cancer. Majority of cervical cancers in India even today are diagnosed at a late stage. There is, however, an opportunity to detect precancerous changes of the cervix at least 15 to 20 years ahead by a simple test known as the Pap Smear. This test, although widely available to the affluent classes, is not easily accessible to the lower social strata. Cervical Cancer, however, unfortunately, is more prevalent in this lesser privileged section of our society.

Simple tests such as Pap Smears & Complete Blood Count (CBC) can go a long way in not only saving the lives of many Indian women but also improving their quality of life. Due to the rapid changes in lifestyles as well as lack of awareness of such diseases, our mothers, sisters and daughters fall victim to these ‘unnoticed killers’. What is even more alarming is that due to the high cost associated with such tests many women from the underprivileged sections of our society may not have access to such lifesaving screening tests.

In an effort to create awareness amongst our women and in order to provide women from the underprivileged section of our society an opportunity to avail these tests Motherhood Women and Children hospital conducted a free medical camp for women in partnership with the Thuluva Vellala Association. Basic history, examination, blood counts, blood sugars, ECG and BP and Pap-smears test were performed and referrals to specialists were made if required. The camp was attended by more than 150 men and women. A significant number of women were benefited by the special services offered at this camp.

Hypothyroidism Treatment By Dr. Archana Pathak

Hypothyroidism is a condition in which the thyroid gland produces an abnormally low amount of thyroid hormone. Hypothyroidism symptoms usually develop incredibly slowly; it can take years for them to show up. Also, some symptoms mimic symptoms of other diseases, such as fibromyalgia and rheumatoid arthritis. Hypothyroidism symptoms include constipation, depression, and fatigue. Pale, dry skin; sensitivity to cold; joint pain; elevated cholesterol levels, irregular periods; brittle fingernails and hair; and unexplained weight gain are other common symptoms. Thyroid can be detected by thyroid test. If these tests show an elevated thyroid-stimulating hormone (TSH) and low levels of thyroid hormones, like free T4, total T3, or free T3, it may be an indication that you have hypothyroidism. Typically, if you have a low level of T4 along with a high level of TSH, you have hypothyroidism. Hypothyroidism can be easily treated with thyroid hormone replacement. At Motherhood Bangalore and Chennai, with a team of thyroid experts and specialists, we provide the best endocrinology treatment with world class state of the art facilities. With the best Hypothyroidism treatment at Motherhood at the right time, you can lead a healthy and happy life. Consult our experts today for the Hypothyroidism treatment. ByDr. Archana Pathak

Multiple Pregnancy

Multiple pregnancy is when there are more than one embryo getting attached to uterine lining and developing into multiple foetuses. This can be twins, triplets, quadruplets or higher order pregnancies. The incidence of twins is gone up from 18.9/1000 live births in 1980 to 32.1/1000 live births.

How multiple pregnancy happens?

One baby growing in the womb (uterus) on its own is called a singleton pregnancy. By far the most common type of multiple pregnancy is a twin pregnancy when there are two babies. Having three babies in the same pregnancy is known as triplets and having four is known as quadruplets. It is very rare to have more than four. Multiple pregnancy happens because two to three eggs get fertilized with two to three sperms or when one fertilised egg make two to three instead of one embryo.

Let us understand about TWINS as this is the commonest of all multiple pregnancies. Also, it is important to understand that the placenta is crucial to the pregnancy – it is the place where your body ‘meets’ your baby directly to pass across the nutrients your baby needs to grow. When an egg is fertilized it starts dividing till it convert itself into a zygote. If split occurs in early stage of cell division identical twins are formed. This cell division continues until it converts into a ball of cells and starts implanting itself in the lining of womb and becomes an embryo. The cells will form distinct areas like central group forms the baby and outer lining form the amniotic sac.

Types of twins:

  • Dichorionic diamniotic (DCDA): Two placenta and two amniotic sacs.
  • Mono chorionic diamniotic (MCDA): One placenta and two sacs.
  • Mono chorionic mono amniotic (MCMA): One placenta and one sac

Causes of multiple pregnancy:

  • Maternal age: women more than 35 are more prone to conceive multiple.
  • Fertility medication: These drugs stimulate ovaries to produce multiple eggs
  • Family history: History of multiple gestation in the family makes one prone for the same.
  • Had a history of twin in the past.

Risks to foetuses

  • premature birth
  • low birth weight
  • Twin to twin transfusion
  • Discordant growth
  • Miscarriages

RISKS TO MOTHER

  • Gestational diabetes
  • Preeclampsia or hypertension
  • Severe hyperemesis

Management

  • Foetal reduction: this is termination of one or more foetuses after the NT USG . Proper understanding of the procedure from parental side is very important. Risk of abortion needs special attention.
  • More frequent visits to obstetrician
  • Cervical encircalage / stitch: It’s role in preventing miscarriage is doubtful
  • Vaginal progesterone: this is known to help keep cervical integrity
  • Dietician advice to help prevent GDM
  • Ecosprin can be advised for prevention of preeclampsia
  • More frequent scans to understand the growth pattern.
  • Intervention by foetal Medicine expert if required
  • Vigilant postnatal care as the chances of post-natal depression is high
  • Avoid alcohol, smoking as advised with any singleton pregnancy.
  • Steroid injection: these injections are given to mother to help the maturity of foetal lungs, by doing this we can avoid/ decrease the stay of babies in NICU

Mode and time of delivery

Chances of Normal Vaginal Delivery is high under following conditions:

  • The babies are growing properly
  • Position of babies in the womb normal and conducive for normal delivery

LSCS would be a method of choice for:

  • MCMA twins
  • Pprom: water break/ leaking prematurely before term
  • Unfavourable position
  • CPD wherein the birth passage is narrow
  • Second twin after vaginal birth of first baby, if vaginal delivery not possible due to abnormal lie and position of baby, decreasing heart rate, placental abruption

As per guidelines the ideal time of delivery is around 38 weeks, any time before is 32 weeks has high risks for babies

Special attention

Genetic screening: Please talk to your obstetrician and opt for amniocentesis if indicated, double/quadruple marker, CVS and NIPT screening methods are not conclusive

Bed rest: not indicated

Eat for three: not required, should get consultation with dietician

Breastfeeding: no issues and both the babies can be fed properly

ENJOY YOUR PREGNANCY AND FEEL FREE TO ASK FOR HELP FROM FAMILY AND FRIENDS DURING PREGNANCY AND POST YOUR DELIVERY AS MULTIPLE PREGNANCY IS A VERY DEMANDING CONDITION PHYSICALLY AND MENTALLY.

By,
Dr. Suhasini Inamdar

 

ECTOPIC PREGNANCY

By Dr. Suhasini Inamdhar

An ectopic pregnancy is an early pregnancy that occurs outside of the normal location (uterine lining) for a developing pregnancy. The vast majority of ectopic pregnancies are so-called tubal pregnancies and occur in the Fallopian tube. An ectopic pregnancy occurs in about one in 1%-2% of all pregnancies.

These other places can be:

1) Fallopian tubes
2) Ovaries
3) Cervix
4) Cornua of uterus
5) Abdominal Cavity

The major health risk of ectopic pregnancy is rupture leading to internal bleeding. Before the 19th century, the mortality rate (death rate) from ectopic pregnancies exceeded 50%. Statistics suggest that with current advances in early detection, the mortality rate has improved to less than five in 10,000. The survival rate from ectopic pregnancies is improving even though the incidence of ectopic pregnancies is also increasing. The major reason for a poor outcome is failure to seek early medical attention. Ectopic pregnancy remains the leading cause of pregnancy-related death in the first trimester of pregnancy.

Causes of Ectopic pregnancy:
1)LAZY EMBRYO

The embryo does not travel till the cavity of uterus, but gets attached in the ovary, tube or cornua of uterus .
2) PELVIC INFLAMMATORY DISEASE (PID) : infection because of :

1) chlamydia,
2) bacteria
3) acute appendicitis
4) recurrent D & C/ MTP
5) pelvic surgery

inflammation of the pelvis sets in and the fallopian tubes get damaged, form adhesions, get partially /completely blocked and impede the movement of embryo. This makes embryo to get settled in the tube.

3) ENDOMETRIOSIS
Here the anatomy of Fallopian Tubes and Pelvis gets distorted and tubes do not function to the full potential.

4) TUBAL LIGATION OR REVERSAL OF THE SAME
Family planning procedure where the tubes are tied sometimes fails and this can lead to partial blockage of tubes.
5) IUCD
It is sometimes the cause of genital tract infection and can lead to damaged tubes.

6) PREVIOUS ECTOPIC PREGNANCY

7) EMERGENCY CONTRACEPTIVE PILL
Here the egg is already fertilised and it’s movement is hampered because of change in the hormonal miluea
8) PROGESTERONE ONLY PILL (MINI PILL)
Here the mucus membrane of tubes gets altered and the motility of tube also is affected
9)CIGARETTE SMOKING
It is known to increase the level of protein PROKR1 in the fallopian tube and this protein is known to help in implantation of embryo.
Please remember: ectopic pregnancy is not your fault and it just happens, one needs to be vigilant and aware.

By,
Suhasini Inamdar