Chocolate Cysts

Chocolate Cysts, treating the bitter problem at IFC

I do not know what is the rationale behind naming endometriosis as “chocolate cyst”? Perhaps it is because of the dark brown color of the old blood that appears exactly like chocolate during the ultrasound test.  It is quite disgusting that the word like chocolate that produces absolutely happy feeling to the females is used to describe the most annoying and problematic disease that becomes the major cause for female infertility.

The diagnosis

I recognize the presence of nasty cysts during the ultrasound examination, but they can be quite confusing and decisive. There is a detailed investigation if I suspect the minutest possibility of chocolate cyst in the ovaries.

Celebrity and IVF

Celebrity and IVF, a welcome relationship

It isn’t a long time when the turmoil of discussions and controversies about surrogate pregnancy of Amir Khan or Farah Khan got settled, yet another Khan (Shahrukh)  triggered it recently with the news of the expected arrival of his third baby in the coming July. Well, why there is all of a sudden so much craze about IVF and Surrogacy in the celebrities? As a matter of fact it may be a modern trend in Bolywood, but it has been prevailing from a long time in Hollywood and the other countries.

As an infertility expert, I perceive it as a good sign. We all know that celebrities govern the mindset and when they endorse something, there is a wide acceptance.  It would surely spread a positive wave across the society about the surrogacy and IVF. In spite of increasing awareness towards various aspects of infertility and childbirth, there is still a taboo about the ways we treat it.

How celebrities help it?

We know that the glamour world is the most uncertain and deceptive world. There is an absolute darkness behind the bright spotlight. Still, there is a tremendous craze about it in the common people. There is a great fascination to adopt everything from them, right from the hair style to the lifestyle. When we see our role models taking the bold steps like going for surrogacy and egg donation, there is a wide acceptance of it in the society.  There is a change in the perception and I think it is great

Are there any symptoms after embryo transfer?

Are there any symptoms after embryo transfer?

If someone asks me about the phase when there is the utmost anxiety and uncertainty during the infertility treatment, then I would promptly vouch for the phase when embryo plantation has been done and the couple is eagerly waiting for the pregnancy test. The touch time has been over, I have worked hard along with the infertile couple, the moments of agony and pain are now a history and there is an expectation of a new dawn! However, it is not as simple as it seems. The duration of 15 days between the embryo transfer and pregnancy test offers the most challenging time with a roller-coaster of emotions for the couple, especially for the mother. The father is busy in his daily routine and I am busy with the other patients waiting for their turn.

The lady goes in the state of utter confusion and dismay. She tries to seek help from the experienced ones, goes through the books and articles, Google the information and become part of the online support groups and forums. All these in vain due to the mutually contradictory information she gets.

The most commonly seen symptoms

When I implant the embryo after the fertilization and technically speaking it is no different from the normal pregnancy.  Therefore, the symptoms should also be the same. There is no doubt that the final confirmation will be done only when you go for the pregnancy test. However, there are a few signals that are very common after the embryo transfer.

Anejaculation

Anejaculation, the ejaculation disability!

In my opinion male infertility has more complex and strange dimensions as compared to female infertility. Strangely, the male sexual anatomy is much simpler and easy to understand. There is no complex structure, no critical balance (or imbalance) of sexual hormones and no menstrual cycle. Still, the infertility aspect is certainly very complicated.

Couples visit infertility experts when they feel they are unable to conceive. We treat them according to the symptoms and suggest the best methods after analyzing the case completely. Sometimes, there is no option other than going for ART (Assisted Reproductive Techniques) where we collect the sperm from the male partner and the egg from the female partner. Fertilization process may happen in the laboratory or in the uterus itself, and there is successful conception!

Sounds great, isn’t it? But, the situation is not that simple and straightforward always! There are a few cases of infertility where the male partner is suffered from such a problem that he can’t ejaculate at all! You can imagine that in absence of ejaculation, he will not be able to contribute by giving sperms for fertilization process. Te problem is known as Anejaculation, typically called as the inability to ejaculate.

5 facts about Anejaculation!

It is fairly uncommon problem and infertility experts hardly encounter with it. Also, it is not very easy and straightforward to diagnose.
This problem is sometimes misunderstood with erectile dysfunction. Although in this case the male is able to arouse, get an orgasm. The only thing is he can’t discharge semen.  In case of erectile dysfunction, there will not be sexual arousal at all.
The problem needs to be explained by the patient explicitly, otherwise the doctors will not be able to diagnose it.
The symptoms of Anejaculation and Retrograde Ejaculation are similar, but in the later case semen does get discharged and goes backward to the urinary bladder. In case of Anejaculation it does not come out at all.
It is extremely impossible to collect the semen sample for diagnosis or sperm donation and we need to collect it directly from the testicles.
The treatment

Well, there is no treatment for this problem and we treat the patient on the basis of symptoms. There are a few patients with situational Anejaculation where they are unable to ejaculate because of surrounding environment. Providing them supporting condition may lead to successful ejaculation. For a few patients we use vibrator or electrical stimulator to achieve ejaculation.

There are some cases where no ejaculation happens at all even after prescribing strong stimulating pills. We collect the semen sample directly from the testicles or the epididymis and use for the fertilization process.

AMH test

AMH test, a method to pinpoint the chances of pregnancy

The paper flattered slightly due to the mild flow of air through the air-conditioner and the slight sound broke the silence in the room. It was the test report of one of my patients trying hard to get conceived. I suggested her getting AMH test as the last resort and the bitter truth was revealed by the report. She was very disappointed and disturbed to know the strange fact that she had actually “ruined” her ovarian reserve of eggs. The result was equally shocking for me because the female was running in early thirties and there were brighter chances of getting pregnant through ART methods!

What is ovarian reserve?

Every woman gets a fixed quota of eggs and the number is decided when she is in the womb of her mother. Sounds very strange, but it is absolutely true! Unfortunately there were no methods available earlier to find it out resulting in many attempts of natural and assisted efforts of pregnancy yielding nothing. The modern science has changed the scenario and there are tests like AMH available to determine the exact chances of a woman getting pregnant.

How does AMH help?

AMH or Anti-Mullerian HormoneTest is a special test performed on the blood sample collected from the patient. The test measures the level of AMH hormone in the blood that directly corresponds to the number of eggs available in the ovaries. It is typically called an “ovarian reserve” and has a definite correlation with the age. However, there can be large variations in the number of eggs left in the ovaries of different females irrespective of the other factors like age, physique and health condition being the same. It is absolutely individualistic factor. Factors like heredity, history of radio therapy and chemotherapy may drop the ovarian reserve drastically.

AMH certainly helps my patients to plan for pregnancy and most importantly it sets the expectation just right. A good ovarian reserve indicates brighter chances of pregnancy and we both start working enthusiastically towards achieving it.

AMH is really effective!

AMH has surely come as a great tool. There were methods available in the earlier times, but the validity and reliability of the result was always a big question mark. AMH gives a much clearer picture and we can decide the plan of action in a more precise manner. Experts appreciate the test because of the fact that it gives a definite idea about the probability of getting pregnant and women can be made well-aware about the fertility status much accurately. In a few cases, it is an eye opener for the patient and me because it gives us a clear indication to speed-up the efforts in case the patient is “about to finish” the quota of egg reserve.

AMH has become a true friend of infertility experts because it helps in setting the correct path of action. It is indeed a precious piece of information and there are certain benefits of it. Even if it shatters the dreams of a couple trying hard to conceive, it is better to know the bitter truth early and seek the other alternatives instead of wasting time in the fruitless efforts.

Amenorrhea, the absence of menstrual

Amenorrhea, the absence of menstrual

There are various aspects of human reproduction system and some of them occur very rarely. As an infertility expert, I get a chance to encounter a wide variety of problems. It is essential to continuously study the vivid topics related to infertility and human reproduction, undoubtedly a practical scenario throws much light on the subject.
The recent example of a couple provided a brilliant chance for me to study an unusual problem that occurs in the females. The lady was complaining about absence of periods and suspecting pregnancy. I performed the pregnancy test and the result was negative. Further diagnosis revealed the presence of something else, Amenorrhea!

What is it?

You might get confused when you hear about it for the first time from the infertility expert. We know that females start menstrual periods as they achieve puberty. The cycle is continued for many years until she achieves another milestone in the life, the menopause! If a female experiences absence of three or more consecutive menstrual cycles at any phase other than pregnancy during this period, then technically it is termed as Amenorrhea. I would say it is certainly a rare phenomenon and that’s why you will not even hear about it in the normal scenario.
There are two types of Amenorrhea exist:

Primary Amenorrhea: Usually girls experience the first menstrual cycle between 13 to 16 years of age. If menstrual cycle does not start in a girl even if she reaches to the age of 16, we call it a Primary Amenorrhea.

Secondary Amenorrhea: If the menstrual cycle starts in the appropriate age, continues for a few years and then stops intermittently without a pregnancy, then we term the problem as Secondary Amenorrhea. It is required that there is a gap of three or more months in a row.

What is the root cause?

Well, the reasons are different in case of primary and secondary Amenorrhea.
The primary Amenorrhea causes due to failure of female reproductive organs like the ovaries, problem on the nervous system or problem in the pituitary gland that is responsible for secretion of hormones that help in triggering menstruation.
The secondary Amenorrhea can be triggered due to malnutrition, stress, problems in thyroid gland, depression, etc. Typically breast feeding mothers also experience it after starting the menstrual cycle. This happens because of hormonal imbalance. In a few cases family history, eating disorders and rigorous physical training has also been observed as the root cause behind this problem.



The symptoms and treatment

The primary symptom of Amenorrhea is obviously the absence of menstrual cycle, there can be many other symptoms like severe headache, loss of hair, heaviness in the voice and secretion from the breasts can be observed. Some of these symptoms are often misunderstood as the symptoms of pregnancy and the absence of periods adds to the confusion.
Treatment of Amenorrhea lasts for some time and apart from the hormonal treatment, I advice lifestyle changes to the couple and lowering the calorie intake, stopping rigorous exercise, reducing stress level and stopping the medicines that contain steroids. This will certainly help in bringing back the hormonal imbalance and triggering the menstrual cycle!

Excess Weight during Pregnancy

Excess Weight during Pregnancy

When you are expecting, you get to eat as many inflatable donuts and Chips as you want, right? Wrong! You only need about 300 extra calorie consumption a day during maternity to support your child's growth. So you do not need to be chowing down everything in sight!


Be cautious about the quantity of pounds you obtain during your maternity. Getting too much or too little pounds can be dangerous to you and your child.


Is gaining the right quantity of pounds essential during pregnancy?You bet. It's essential to obtain the right quantity of pounds for your system. Doing so can help secure the wellness of your child. In comparison to females who obtain a proper and balanced quantity of pounds during pregnancy:Ladies who obtain too little are more likely to have a child with low birthweight (less than 5 pounds, 8 ounces), Ladies who obtain too much are more likely to have a large child or an early child. An early child is created too early, before 37 finished several weeks of maternity. These mothers also may also have wellness issues, like diabetic issues and hypertension. These circumstances can cause problems during maternity.


How much pounds should you obtain during pregnancy?