Do’s During Pregnancy
1) See your doctor regularly. Prenatal care can help keep you and your baby healthy and spot problems if they occur.
2) Continue taking folic acid (or any other medicine if prescribed) throughout your pregnancy. All women capable of pregnancy should get 400 to 800 microgram of folic acid every day. Getting enough folic acid lowers the risk of some birth defects. Taking vitamin with folic acid will help you to be sure you are getting enough.
3) Eat variety of healthy food. Include fruits, vegetables, whole grains and calcium-rich foods.
4) Get all essential nutrients, including iron, every day. Getting enough iron, every day. Getting enough iron prevents anaemia, which is linked to preterm birth and low weight births.
5) Drink extra fluids, especially water.
6) Get moving! Unless your doctor tells you there wise, physical activity is good for you and your baby.
7) Gain a healthy amount of weight. Check with your doctor to find out how must weight you should gain during pregnancy.
8) Wash your hands especially after handling raw meat or using bathroom.
9) Get enough sleep. Aim 7 to 9 hours every night. Resting on your left side helps blood flow to you and your baby and prevents swelling. Using pillows between your legs and under your belly will help you get comfortable.
10) Avoid any type of stress. Do meditation and breathing exercises regularly.
11) Make sure health problems are treated and kept under control. If you have diabetes, control your blood sugar levels. If you have high blood pressure, monitor it regularly.
12) Ask your doctor before stopping any medicines.
13) Wear comfortable clothes.
14) Join childbirth or parenting classes.
Don’ts During Pregnancy
1) Don’t smoke tobacco. Smoking during pregnancy passes nicotine and cancer causing drugs to your baby raises the risk of miscarriage, preterm birth and infant death.
2) Avoid alcohol intake during pregnancy.
3) Avoid exposure to toxic substances and chemicals, such as cleaning solvents, lead and mercury, some insecticides and nad paint. Pregnant women should avoid exposure to paint fumes.
4) Protect yourself and your baby for food-borne illness, which can cause serious health problems. Clean, cook, eat and store food properly. So avoid eating out.
5) Don’t clean or change a pet’s box. This can lead to infection, and can be harmful to the fetus.
6) Don’t take very hot baths or use hot tubs or saunas. High temperature can be harmful or cause you to faint.
7) Don’t use scented feminine products. Pregnant women should avoid scented spray, sanitary napkins, and bubble bath. These products might irritate your vaginal area and increase your risk of urinary tract infection.
8) Avoid X-Rays. If you must have dental work or diagnostic test, tell your dentist or physician that you are pregnant so that extra care can be taken.
1. What Is ICSI?
Severe male-factor infertility is treated very successfully by a relatively new laboratory technique called ICSI. ICSI involves injecting one sperm directly into the egg using a microscope with specialized micromanipulation equipment. ICSI is always used in conjunction with in vitro fertilization. For ICSI various sperm retrival techniques are used like PESA, MESA, TESA, and TESE.
2. If Sperm Count reports are Very Low what can be done?
Treatments for male factor infertility vary from intrauterine insemination (IUI) to in vitro fertilization with Intracytoplasmic Sperm Injection (ICSI). Individualized Medical treatment protocols are provided by the physician after the diagnostic evaluation is completed.
3. What is azospermia and oligospermia?
The term “oligo” means few. Oligospermia is the presence of fewer than the normal number of sperm in the semen. Men with fewer than 20 million sperm/ml are usually defined as having oligospermia, or a low sperm count. Azoospermia is the complete lack of sperm in the ejaculate.
4. What is azoospermia?
Azoospermia is the complete lack of sperm in the ejaculate
5. What Are Treatment Azoospermia?
Yes. There are two different types of azoospermia. Obstructive azoospermia is the complete lack of sperm in the ejaculation due to a blockage in the male reproductive tract or the absence of the part of the reproductive tract that carries sperm from the testicle to outside the body. A blockage, or obstruction, may have been present at birth or may have occurred as a result of an infection or severe trauma to the testicles or the tubules surrounding the testicles that transport the sperm out of the body. Men with obstructive azoospermia almost always have some sperm in their testicles, but these sperm are not found in the semen because of the blockage or absence of part of the reproductive tract.
6. IVF Definition
In vitro fertilization (IVF) is a process by which egg cells are fertilized by sperm outside the womb, in vitro. IVF is a major treatment in infertility when other methods of assisted reproductive technology have failed. The process involves hormonally controlling the ovulatory process, removing ova (eggs) from the woman’s ovaries and letting sperm fertilise them in a fluid medium. The fertilised egg (zygote) is then transferred to the patient’s uterus with the intent to establish a successful pregnancy.
-The first “test tube baby”, Louise Brown, was born in 1978 and she herself is a mother of a healthy baby boy now.
7. Indications for IVF
There are a variety of indications for IVF.
– Male Factor Infertility : Male factor infertility includes low count and motility, high number of abnormal forms, ejaculatory dysfunctions, Failed reversal of Vasectomy/ Tubectomy , obstructive azoospermia etc.
– Age-Related Infertility : higher the age lesser the chances of conception. The fertility index keeps on decreasing after the age of 30 – 35.
– Reduced ovarian reserve, which means lower quantity (and sometimes quantity) of eggs. A day 3 FSH and estradiol test, antral follicle counts and AMH hormone levels are often done as screening tests for egg quantity. Reduced egg quantity and quality is usually treated with either IVF, or with IVF with egg donation.
– Absent or Damaged Fallopian Tubes : Rarely the fallopian tubes are found absent since birth. Many causes lead to blockage and damage of tube like severe adhesions, surgical procedures, infections etc.
– Endometriosis: The presence of tissue that normally grows inside the uterus (womb) in an abnormal anatomical location. Endometriosis is very common and may not produce symptoms, or it may lead to painful menstruation. It has also been associated with infertility.
– Unexplained Infertility: Sometimes inspite of being absolutely normal male and female with normal hormonal assays, regular sexual intercourse and with all normal reports the couple is unable to conceive, this condition can be termed as unexplained infertility.
– Recurrent Intrauterine Insemination Failure : repeated failure of IUI trials is also an indication for IVF. Inspite of good IUI trials with gonadotrophins and good post wash, if conception does not take place IVF is a better option.
– Tubal and Pelvic Adhesions : pelvic adhesions and tubal adhesion may make tube incapable of nurturing the eggs and conception fails. Blockage of tubes arises due to pelvic adhesions
– Preimplantation Genetic Diagnosis (PGD) – In cases of repeated abortions and neo natal death PGD becomes necessary. PGD can be done only after IVF. [ PGD also helps in diagnosing several genetic diseases.
– Premature Menopause: Also termed as premature ovarion failure, where the function of ovaries stops before the age of 30, Egg donation proves a better option which is possible only with IVF, menopause : Menopause is stage of life when a woman can no longer bear a child. With IVF, this is now a false saying.
8. How does IVF improve fertility?
– We force the body to produce multiple follicles and eggs (only one follicle with one egg inside develops in a natural menstrual cycle)
– We take the eggs out of the ovaries when they’re ready (release and tubal pickup of the egg can be inefficient naturally)
– We coerce fertilization in the lab (sperm or egg issues can cause fertilization problems in a natural situation)
– We culture the embryos for several days and then pick the best one (or more) for transfer to the female (selection of the best one(s) increases the chance of success)
– We transfer the embryo(s) to the best location in the middle of the uterine cavity (tubal transport of the embryo to the uterus is bypassed)
– Implantation rates are used by fertility doctors when talking with couples about their chances for IVF success rates and multiple births. Implantation rates are also used in IVF clinics as a measure of internal quality control.
– The first “test tube baby”, Louise Brown, was born in 1978 and she herself is a mother of a healthy baby boy now.
9. Female Partner Examination
– Clinical Examination
– Lab Investigation Then We Plan Treatment Protocol
– After a detailed history & physical examination, few basic laboratory investigations & a sonological evaluation is very significant to choose the modality of treatment for infertility as it affects the success rate of the treatment.
– We, here at SFWH follow a basic protocol before commencing any treatment of infertility. History taking can be converted into a counseling session which works to break the ice between the couple & doctor. The initial shyness & awkwardness to talk on intimate issue is also lost. Trust & confidence develops which helps the couple to understand & participate in the treatment.
– Points to be highlighted in history are duration of infertility, menstrual history, coital frequency, past medical & surgical history, occupational history & history of allergy.
– We start the clinical examination of female by measuring her weight & height & then calculating her BMI. Our experience has shown that ladies who have normal BMI not only respond well to the treatment of infertility but also have a better outcome of pregnancy as compared to their obese or underweight counterparts.
– After recording the weight, the lady should be escorted into a comfortable examination room by a trained nursing staff where detailed general & systemic examination is done. Verbal consent should be obtained & procedure explained in detail. We need not stress that male doctors should do the examination in presence of a female nursing staff. During the examination findings of relevance are development of secondary sexual characters, presence or absence of galactorrhoea, signs of androgen excess like hirsuitism & thyroid enlargement. Sterile speculum examination is important to rule out vaginismus from other causes of dysparunia. This examination can also reveal any abnormality or discharge from the cervix. Bimanual examination gives idea about the size & mobility of uterus. Any abnormal finding in physical examination should be supported by laboratory & radiological evidences & should be treated before the treatment of infertility commences.
– Trans vaginal sonography has become the most important tool in the armamentarium of the physician to diagnose & treat infertilit. TVS has a high sensitivity & specificity for follicular monitoring, prediction & conformation of ovulation.
– While evaluating the female genital system by TVS, the examiner should scan every part in detail.
– Cervix is evaluated for the length of the cervix, nabothian cyst & cervical mucous.
– Endometrial cavity is scanned for endometrial thickness, endometrial pattern, endometrial polyps & presence of any foreign bodies or synechia.
11. Male Partner Examination
– Detail History
– Clinical Examination
– Lab Investigation
– Semen Analysis
– IUI is defined as direct placement of the processed sperm into the uterine cavity at any point above the internal os.Intrauterine insemination is also called artificial insemination, or IUI. Human artificial insemination with the male partner’s sperm for infertility began being used in the 1940’s.
13. However, it is not effective for couples with:
– Tubal blockage or severe tubal damage
– Ovarian failure (menopause)
– Severe male factor infertility
– Advanced stages of endometriosis
14. Insemination for male factor infertility
– Studies have shown that intrauterine insemination can be effective for some cases associated with poor sperm quality. However, if the total motile sperm count at the time of insemination (after the processing) is less than 5 million, the chances for pregnancy are substantially lower. If the total motile sperm count is below 1 to 5 million, success rates are very low. Therefore, in vitro fertilization with ICSI (injecting sperm into the eggs) is usually done for these cases.
– IUI is most commonly used for unexplained infertility. It is also used for couples affected by mild endometriosis, problems with ovulation, mild male factor infertility and cervical factor infertility.
– Insemination is a reasonable initial treatment that should be utilized for a maximum of about 3-4 months in women who are ovulating (releasing eggs) on their own. It is reasonable to try IUI for longer than this in women with polycystic ovaries (PCOS) and lack of ovulation that have been given drugs to ovulate.
15. What are the types of surrogacy?
– Surrogates can be divided into natural surrogates and IVF surrogates.
16. IVF Surrogacy
– Women whose ovaries are producing eggs but they do not have uterus this could be because they have had a hysterectomy (removal of uterus) performed due to cancer, severe hemorrhage or ruptured womb, or they were born without a uterus. This is by far the most common indication for IVF surrogacy.
– Women who suffer from medical problems such as diabetes, heart and kidney diseases and in whom a pregnancy would be life threatening. However, their long term prospect for health is good.
– Repeated miscarriages where the causes of miscarriage have been fully investigated, may also suggest IVF surrogacy treatment.
17. Traditional Surrogacy
– Women who have no functioning ovaries due to premature menopause ( some may argue that the best option for these patients is egg donation).
– A woman who is at risk of passing on a genetic disease to her offspring, may opt for traditional surrogacy.
– As with IVF surrogacy, women who suffer from medical problems such as diabetes, heart and kidney diseases and in whom a pregnancy would be life threatening may select traditional surrogacy if their long term prospect for health is good.
18. To become a surrogate the woman should fulfill the following criteria:
– Age between 21 & 35 years old.
– A non smoker, on drug user who maintained a healthy life style.
– Must have successfully carried at least one pregnancy till full term.
– In a stable living situation.
– If married, have a spouse who is supportive of her decision to become a surrogate mother.
– Have a healthy, weight/height ratio.
– Should have a healthy life style and no addictions and no genetic diseases. Steps for Surrogacy Programme :
Steps for Surrogacy Programme:
– First a consultation of intended genetic parents (IGPs) with doctor.
– Detailed examination and counseling.
– Giving various options of surrogate and IGPs should select a surrogate of their choice.
– Consultation with legal adviser. Form J : Agreement of surrogacy Form U : Contract between patient and surrogate. Surrogacy agreements are the first stage in a two step process .The purpose of the surrogacy agreement is to allow each party to state their intentions,& their responsibilities to one another
-The agreement will clearly state that the surrogate does not intend on parenting any resulting children & does not wish to have physical or legal custody of any children. The surrogacy agreement will also define the right & responsibilities of the assisted parents.
– Synchronization of donor recipient cycle : One cycle before actual IVF procedure we bring the menstrual period as close as possible to both donor and recipient. Preferably recipient gets period, a couple of days earlier than donor. The recipient will require estradiol & progesterone to help prepare her uterine lining for implantation of the transferred embryos. management. Our goal is to see your complete family through surrogacy. We shall be with you and guide you till your dream turns into reality.
– Actual treatment
– We at motherhood womans and child care hospital doing surrogacy for needy couple after complete screening of surrogate mother and genetic parents. It has been done after doing all legal contract between them trough lawyer, several babies have been born through this procedure at our hospital.
20. What is surrogacy? Types of surrogacy? Who needs surrogacy?
Surrogacy is agreement, always supported by a legal agreement, whereby a woman (the surrogate mother) agrees to bear a child for couple who will become the child’s parents after birth.
Types of surrogacy:-
1) Gestational surrogate:- Where woman carries pregnancy created by the egg & sperm of genetically related to the child.
2) Traditional surrogate:- The surrogate is inseminated sperm from the male partner of an infertile couple. The child that results is genetically related to the surrogate & to the male partner but not to the commissioning female partner.
- Who has uterine malformations absent uterus, hypo plastic uterus.
- H/O hysterectomy due to some disease related to uterus.
- Uterus having multiple fibroids or huge adenomyoma resection may lead to multiple miscarriages.
- Recurrent abortion, recurrent implantation failure severe endometrial adhesions.
- Patient having systematic disorder, coagulation disorder, heart dieses, renal dieses may put female at risk during pregnancy.
- Pts is on some medication may lead to congenital malformation to fact us.
21. What is the best method of contraceptive? Types of contraceptive.
Each Patient requires different contraceptive.
Types of contraception:-
3)Oral Contraceptive pills / Birth control pills
4) Intra uterine device
5) Bemire contraception
6) Hormonal pills/Injection/Implants
22. Tips for family planning and right age to conceive and gap between 2 pregnancy.
- Right age to conceive depend upon couple and Individual choice but Ideally couple should plan around age 30 To avoid complication.
- Before start family planning couple should go for basic investigation, blood report, USG with the advice of Gynecologist.
- Ideally gap between 2 kids is 3 to 4 yrs again depends of couple choice and interest
23. Importance of menstruation hygiene? Right way to use pad and other option for menstruation.
- Menstruation hygiene right from the puberty to avoid skin irritation, Infection and wellness of female, So If you are using pad then change it frequently every 6 hr.Apply any lotion and moisturizer on skin of vagina to avoid skin irritation.Other Option:- You can use Tampons, Menstruation cup with the guidance of your gynecologist before use the product learn to how to use change and remove.
24. What is pap test? What is right age should done and which frequency require for pap test?
- A Pap test also called a Pap Smear, is a procedure to screening test for cervical cancer in women. A Pap test involves collecting cells from your cervix.
- Detecting cervical cancer early with a pap test gives you grater chance at a cure.
- Even pap test can defect pre cancer stage.
- Most women should start getting regular Pap Smear test after getting sexually active Generally repeat test advice every 3 yrs.
- Cervical vaccine should advice to prevent cervical cancer.
25. What is PCOD and PCOS?
PCOS full form:- Polycystic Ovary Syndrome.
PCOD Full form :- Polycystic Ovarian Disease
Symptoms of PCOS or PCOD:-
1) Excessive body hair growth.
2) Weight changes and trouble losing weight.
3) Ovarian Cysts.
4) Low sex Drive.
5) Irregular or missed periods.
6) Male pattern Baldness thinning hair.
7) High Testosterone levels.
8) Insulin Resistance.
11) Mood changes.
12) Trouble conceiving or infertility.
26. What is recurrent pregnancy loss and solution?
If there is loss of two or more pregnancy then its called recurrent pregnancy loss. There are multiple reasons behind it like and its solution,
- Chromosomal abnormality can be prevented from transfer to fetus by IVF-PGS. Which is latest treatment in medical science, that we do provide at Motherhood Hospital as we have experienced embryologist and IVF Specialist and we have been successful for this treatment since years.
- We recommend avoid bad habits like alcohol, caffeine, drug to have healthy pregnancy.
- We do laproscopy surgery of uterus for fibroid and adenomyosis before planning So, pts can cross 9 month of pregnancy smoothly.
- In case of short cervix, encirclage before 20 weekspregnancy is advisable.
- We provide hormonal balance treatment and some supportive medicine in initially part of pregnancy.
- Life style and nutrition has a big role in achieving healthy pregnancy and good out come.
- Consultation before planning pregnancy and evaluation of whole case and all reports including genetic analysis is essential for achieving goal of healthy pregnancy outcome.
27. What is menopause and age? Methods ways to control menopause symptoms?
Menopause start around age of 45 yrs -50 yrs. Its depend of our lifestyle and fitness, we cannot stop menopause but we can control menopause symptoms with proper counseling, medication, HRT(Harmon Replace Therapy),Intake of healthy nutrition food, yoga and meditation can play major role to control menopausal symptoms.
28. What type of surgery can be done with 3D Laparoscopy? Benefits of 3D laparoscopy surgery?
3D Laparoscopy surgery perform with the 3D Laparoscopic instruments & camera.
Like Uterus removal, ovarian cyst, fibroid, any tumor in uterus, Ectopic pregnancy surgery, Chocolate cyst, mayoma resection, diagnostic hysteroscopy, and many more.
- It is almost scar less surgery.
- Speedy recovery and healing.
- Required minimum bed rest around 5-7 days.
- Female start her routine work and job very soon
- Very less chances of infection after surgery.
- Minimum blood loss.
1. What are the symptoms of asthma?
Asthma symptoms can include:
- Wheezing, or noisy breathing
- Coughing, often at night or early in the morning, or when you exercise
- A tight feeling in the chest
- Trouble breathing
Symptoms can happen each day, each week, or less often. Symptoms can range from mild to severe. Although rare, an episode of asthma can lead to death.
2. Can asthma symptoms be prevented?
Yes. You can help prevent your child’s asthma symptoms by giving your child the daily medicines the doctor prescribes. You can also keep your child away from things that cause or make the symptoms worse. Doctors call these “triggers.” If you know what your child’s triggers are, you can try to avoid them. If you don’t know what they are, your doctor can help figure it out.
Some common triggers include:
- Getting sick with a cold or the flu (that’s why it’s important to get a flu shot each year)
- Allergens (such as dust mites; molds; furry animals, including cats and dogs; and pollens from trees, grasses, and weeds)
- Cigarette smoke
- Changes in weather, cold air, hot and humid air
If you can’t avoid certain triggers, talk with your doctor about what you can do. For example, exercise can be good for children with asthma. But your child might need to take an extra dose of his or her quick-relief inhaler before exercising.
3. Why should my child get vaccinated?
Getting vaccinated can help keep your child from getting sick. If your child does get sick, being vaccinated can keep them from getting severely ill. Plus, being vaccinated also helps protect the people around your child from getting sick.
4. Is there a benefit to delaying vaccines until my child gets a little older?
No! Some parents think it helps to let children get older than the recommended vaccination ages before giving them too many vaccines. The truth is, studies show that delaying vaccines could actually have downsides. For example, one study found that children who got their first MMR vaccine later than they were supposed to had a higher risk of fever-related seizures. The vaccine schedules doctors recommend have been carefully studied. Do not delay your child’s vaccines.
5. What side effects can vaccines cause?
Often, vaccines cause no side effects. When they do cause side effects, they can cause:
- Redness, mild swelling, or soreness where the shot was given
- A mild fever
- A mild rash
- Headache or body aches
Most of these side effects happen within 1 to 2 days of getting the vaccine. But they can happen 1 to 2 weeks after the getting shot for chickenpox or the shot for measles, mumps, and rubella.
Vaccines also sometimes cause more serious side effects than those listed, such as severe allergic reactions. But serious side effects are rare.
Ask your child’s doctor or nurse what side effects to expect each time your child gets a vaccine. If your child has a reaction or a problem after a vaccine, let the doctor or nurse know.
6. How often should I breastfeed and how long should a feeding last?
A woman should breastfeed when her baby shows signs of being hungry. A baby can show that he or she is hungry by:
- Waking up from sleep
- Moving the head around as if he or she is looking for the breast
- Sucking on his or her hands, lips, or tongue
Babies can breastfeed on different schedules and for different amounts of time. For example, some babies finish a feeding in 5 minutes, but others might take 20 minutes or longer.
Doctors recommend letting the baby finish breastfeeding on one side so that he or she gets all the milk from that breast. Then, you can see if your baby wants to drink from the other breast. The next time you breastfeed, try to remember which breast your baby started on the last time, and start on the other side. Switching the side you start with each time will help both your breasts continue to make milk.
7. How do I know if my baby is getting enough breast milk?
You can tell if your baby is getting enough breast milk by:
- Checking his or her diapers – By day 4 or 5 after birth, babies should have at least 6 wet diapers a day.
- Checking his or her bowel movements – By day 4 after birth, babies should have 4 or more bowel movements a day. By day 5, their bowel movements should be yellow.
- Having your doctor or nurse check to see if your baby is gaining weight
8. Is it normal for my child to wet the bed at night?
Yes, it can be normal. Wetting the bed at night is common in young children. By age 4, most children can control their bladder when they are awake. But it can take longer for children to have control over their bladder when they are sleeping. Some children do not stop wetting the bed at night until they are 5 to 7 years old. Bedwetting is more common in boys than in girls, and can run in families.
Most children will stop bedwetting on their own and do not need any treatment. But if you are worried or have questions about your child’s bedwetting, talk with your child’s doctor or nurse.
9. When should I see a doctor or nurse?
You should see your doctor or nurse if your child:
- Feels the need to urinate more than usual
- Is more thirsty than usual
- Has a burning feeling when he or she urinates
- Has swelling of the feet or ankles
- Starts wetting the bed again after being dry for weeks or months
These symptoms can be a sign of a medical problem. Your child’s doctor will want to check him or her. The doctor will do an exam and might order tests, including a urine test.
10. How can I tell if my baby has jaundice?
You can tell if your baby has jaundice by pressing 1 finger on your baby’s nose or forehead. Then lift up your finger. If the skin is yellow where you pressed, your baby has jaundice.
i) What are the symptoms of jaundice?
Jaundice causes the skin and the white parts of the eyes to turn yellow. It often happens first in the face, but can spread to the chest, belly, and arms. It spreads to the legs last.
Sometimes, jaundice can be severe. A baby with severe jaundice can have orange-yellow skin, or yellow skin below the knee on the lower part of the leg. The “whites” of the eyes might look yellow, too. A baby with severe jaundice might also:
- Be hard to wake up
- Have a high-pitched cry
- Be unhappy and keep crying
- Keep bending his or her body or neck backward
II) When should I call my doctor or nurse?
Call your doctor or nurse if:
- Your baby’s jaundice is getting worse
- Your baby has symptoms of severe jaundice