Vaginismus

Vaginismus, the strange face of infertility

It is quite incredible to be an infertility expert sometimes. As you go deeper and deeper there are new discoveries about the unknown facets of the infertility problem. Although many of these facets are very rare and sometimes never encountered in a long career as well, but they are quite strange and horrifying if they appear in front of us!

There are a few problems that we study in the books and journals and even experienced doctors also never get a chance to encounter that problem. Recently I handled a case that gave me an opportunity to handle a rare problem that causes infertility in females. The couple had got married two years back and there was a huge pressure from the parents and close relatives to expand the family. The real problem was known to the couple only and now they were sitting in my cabin seeking help for a very unusual problem, “Vaginismus”!

What is it?

This is a typical condition in women when there is  reflex action in the vaginal muscles while intercourse. The reflex action closes the vaginal opening so tightly that the penetration becomes impossible. In some cases, the penetration is possible, but it is extremely painful for the woman. You can understand the gravity of the problem now. It might sound ridiculous and strange, but unfortunately it is true.  Without penetration it is impossible to conceive and there is the actual problem!

Sperm testing

Sperm testing

Sperm testing, the toughest challenge of infertility treatment

Do not get mistaken by the heading! I am not talking from the technical point of view. There are many other difficult things in the process of infertility treatment.  Sperm testing is one of the easier processes in the treatment of infertility and sperm testing, on the contrary is much easier. The challenging part of the sperm testing process is the male ego and as an infertility expert I need to put a lot of energy in it.

Why there is reluctance?

Well, actually there are multiple reasons behind it and we need to understand the male psychology behind it.

(a) It is humiliating: Most men consider it absolutely humiliating. They feel that sperm testing is a direct suspicion about their masculinity. They feel that if their sexual life is normal, then there is not at all a question on their ability.
(b) It is scary: It is very strange, but most of the males are not aware about the procedure of sperm testing. They feel it is a surgical process and could harm their masculinity. That is the reason they try to avoid it.
(c) It is unnecessary: In our country, still there is very less awareness about sex education and majority of people consider childbirth as a responsibility of a woman exclusively. Therefore, they never feel a need to get the sperm tested.  They feel that there is no need to get involved into it.
(d) It reveals the truth: For some men, it is a matter of utter disappointment and frustration to know about the low sperm count or weak mobility of the sperms. They try to hide the things under the carpet and therefore never agree to perform sperm testing. The poor quality of sperm is a direct hit on their masculinity and social image.
(e) It is stressful: Males have a natural tendency to avoid medical professionals and they feel extremely stressful and distressful to visit a doctor especially for the problems like semen testing.
How to deal with the situation?

Premature ejaculation

Premature ejaculation, the hidden cause of male infertility!

It was already 10PM in the night and it was nearly two hours I was waiting for the semen report of a couple undergoing treatment for infertility. I was suspecting male infertility in this case and therefore, told the male partner to undergo semen testing. I was almost sure about a report of less sperm count or mobility issues with the sperms. Finally, the report came and to my surprise, it was absolutely normal. I was in a state of utter confusion and dismay.

However, I called up the couple once again and had detailed counseling sessions and then revealed something that is perhaps the most hidden aspect of an infertility problem. It is premature ejaculation, one of the common causes of male infertility. The male partner in the above-mentioned couple was suffering from the problem of premature ejaculation. I analyzed the root cause and started the appropriate treatment. Very soon the couple departed from my room with a positive report of pregnancy!

What is premature ejaculation?

The process of ejaculation happens after a certain time of vaginal penetration or manual stimulation. It causes the release of sperms along with semen fluid in the form of a powerful jet spray so that the sperms go deeper in the vagina and start the journey of fertilization. Normally it takes one to two minutes for a man to ejaculate.

Pelvic pain

Pelvic pain, the loyal companion of infertility

We can never generalize the symptoms of various problems that females face because every problem has a separate set of symptoms. It is not possible for an infertility expert like me to diagnose only on the basis of a few symptoms. It is compulsory to go for detailed examination to derive a conclusion. Infertility is a complex area and we need to look at every aspect of it before starting the treatment. People come with so many different problems, but one thing is always common among all, the pelvic pain!

Only those women who have experienced the immense sting and discomfort of the pelvic pain can tell about the severity. It is an unbearable pinch in the lower abdomen that just ruins the life completely if it remains untreated.

The faces of the monster

Pelvic pain shows its irritating presence in a wide variety of ways and the severity and intensity varies with the particular problem.

Laparoscopy

Laparoscopy, the pathway to painless surgery through a hole

Being an infertility expert, the surgeries have become part of my life, but I still remember the childhood days when surgery was perhaps the biggest fear in the world for me. I had never imagined that one day I will be performing multiple surgeries almost daily.  Surgical process (or operation in the more familiar term is a fearful matter. The thought of getting incision makes us uncomfortable and in a few cases it becomes a phobia when the patient is not ready to undergo any type of surgery. Thankfully the medical science has advanced so much and there are options like laparoscopy available where patients can undergo surgery with minimum discomfort and pain!

When do I go for Laparoscopy?

Laparoscopy or Laparoscopic Surgery, also called as a keyhole surgery; is an operation performed by us to inspect the organs around the pelvic area, such as ovaries, fallopian tubes and uterus, etc. Sometimes I am not able to find the exact cause of the problem by regular inspection then, I go for laparoscopy. The process becomes greatly useful for us and we are able to diagnose many problems with the help of it.

Cists (Ovarian Cists) or Tumors
Ectopic Pregnancy
Infertility
Pelvic Pains
Laparoscopic surgery is also used to do biopsy, to treat hernia or to take out or partial removal of some organs; such as ovaries, uterus, appendix and gallbladder, etc.

IVF: a journey of pleasurable ending through Painful injections

IVF:  a journey of pleasurable ending through Painful injections

What is the biggest cause of distress and anxiety while going through any of the medical procedures? If I ask this question in an open forum, then the most common is the fear of needles! Human beings have natural reluctance towards injection. Not because it hurts, but because you KNOW when it hurts! Nowadays technology and innovation in the field of medicines and medical sciences has come up with moderately painful. Still the fear associated with injections lingers in the mindset of almost all of us.

Being an infertility expert, I just can’t avoid this painful procedure. The process of IVF involves multiple occasions when I must insert painful injections in the body of my patient. I tell them to focus on the outcome rather than pain. It will give a sigh of relief because ultimately there is no gain without pain!

The painful experience of injections

As an IVF (In Vitro Fertilization) specialist pain is one of the most common worries I handle during the treatment.Almost every other patient has the same concern. While some would express it boldly, some would never let the fear come out. Every IVF patient knows that it is inevitable to have long course of injections during the IVF treatment. Though as a doctor I cannot avoid the injections, butsurely can try to make it the least painful.

Is it something like “follicles but not eggs”?

Is it something like “follicles but not eggs”?

Treating infertility is certainly very interesting. When I treat people for different types of infertility problems some questions are the most probable to be asked by my patients. These questions are normally overheard during discussions with the peer group, friends and family members. Sometimes the questions are very much logical and relevant whereas sometimes they are absolutely vague and ridiculous. They are based on half-cooked information received from the others and usually baseless and irrelevant.  However, I try to answer the questions with complete explanation so that there are no confusion and doubts in the mind of the patients.

“Follicles but not eggs”, the most common asked doubt!

Couples always ask this question to me and now I have been accustomed to the question so much that it is really something unusual for me if the infertile couple does not ask about it. It is a common misconception that there are few cases where females suffer from a peculiar problem when they have follicles inside the body, but there are no eggs! The follicles are absolutely empty and that is the reason the IVF egg retrieval done by their infertility expert has yielded fewer eggs than expected. In my opinion, there is nothing more generalization of a problem than this and doctors should actually refrain from doing this. The patients can’t perceive the things from the doctor’s perspective and they look at it from a layman’s angle. Taking the words by their direct meaning can lead to serious misinterpretations.

The myth and the reality