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Infertility: Diagnosis, Prevention and Treatment

March 28, 2022November 16, 2023
by Eva Hospital

Introduction: An Infertility

If one is under 35 years of age and unable to get pregnant after having unprotected, regular sex for six months to one year, it can be a sign of infertility.

There are no definite symptoms of infertility. However, Women with infertility may sometimes have irregular or absent menstrual periods and some men with infertility may show signs of hormonal problems, such as changes in hair growth or sexual function.

The good news is that many safe and effective treatments are available nowadays and they can considerably improve the chances of pregnancy in couples who have been trying for a long time without success and a couple should immediately seek the consultation of a competent fertility specialist if they are facing issues in getting pregnant. The correct diagnosis and timely treatment can help couples in successfully achieving pregnancy.

When to See An Infertility Doctor?

Women Should Consult An Infertility Specialist if:

They are 35 years or older of age and have been trying to get pregnant for six months or longer
They have irregular or no periods
Their periods are painful
Have fertility problems they are aware of
They have been diagnosed with endometriosis or a pelvic inflammatory disease
They have a history of multiple miscarriages
They have at some point in life undergone the treatment for cancer

Men Should Talk to An Infertility Doctor if:

They have a low sperm count or other sperm-related issues.
They have a history of testicular, prostate, or sexual issues, they are aware of or suspect
Have at some point undergone treatment for cancer
They have small testicles
There has been a history of infertility problems in the family

How is Female Infertility Diagnosed?

The doctor may initially ask the couple to record the signs of ovulation. These signs include basal body temperature and cervical mucus.

There are a few tests that can also help diagnose infertility issues in females:

Pelvic examination: A pelvic examination, including a Pap smear, is performed to check for any structural issues or signs of disease.
Blood test: Blood tests can help to check hormone levels, including thyroid function tests.
Transvaginal ultrasound: An ultrasound wand is inserted into the vagina to establish problems with the reproductive system if any.
Hysteroscopy: A thin, lighted tube (hysteroscope) is inserted into the vagina by the doctor, to examine the uterus.
Saline sonohysterogram (SIS): The uterus is filled with saline and transvaginal ultrasound is conducted.
Hysterosalpingogram (HSG): An injectable dye performs an x-ray as it travels through the fallopian tubes, looking for blockages if any
Laparoscopy: A laparoscope i.e. a thin tube with a camera is inserted into a small abdominal incision. The pelvic laparoscopy in females helps to identify issues like endometriosis, fibroids, and scar tissue.

How is Male Infertility Diagnosed?

The following tests can help diagnose infertility issues in males:

Semen analysis: It helps to establish semen-related issues in men, such as low sperm count, poor morphology, and poor mobility. Needle biopsy is sometimes needed in some men to collect the sperm for testing from the testicles and this is the only test needed in the workup of infertility for most men.
Blood test: Testosterone, thyroid, and other hormone levels are checked through a blood test. Genetic blood tests help find out chromosomal abnormalities.
Scrotal ultrasound: Varicoceles or other testicular problems, if any can be identified with the help of the ultrasound of the scrotum.

Besides all these tests, the patient should listen to their body and inform the doctor if at any time they notice a sign or a symptom. The earlier an infertility problem is diagnosed, the more are the chances of getting pregnant.

How Can Infertility Be Prevented?

Some types of infertility are not preventable. However, many techniques may increase one’s chance of getting pregnant.

Following steps can be taken by both men and women to protect their fertility, particularly while trying to conceive:

They must eat a well-balanced diet and maintain a healthy weight.
They must avoid smoke, drugs, or excessive alcohol consumption.
They must take treatment for STDs.
The exposure to toxins must be limited.
Physical activity is important but overdoing exercise must be avoided.

Additionally, the men must:

Avoid high temperatures found in hot tubs and hot baths as they can have a temporary effect on sperm production and motility.
Avoid exposure to industrial or environmental toxins as they can sometimes affect sperm production.
Try to maintain a healthy weight as being both overweight and underweight can affect hormone production and cause infertility.

What Is The Treatment For Female Infertility?

The usual treatment for infertility in women include:

Medications: Fertility drugs are prescribed to alter hormone levels to stimulate ovulation.
Surgery: Blocked fallopian tubes can be opened and uterine fibroids and polyps can be removed through surgery. Surgical treatment of endometriosis can increase a woman’s chances of pregnancy by almost two times.

What Is The Treatment For Male-Related Infertility?

The recommended treatments for male infertility include:

Medications: Testosterone or other hormone levels can be raised with the help.of medications. There are a few drugs that can help with erectile dysfunction.
Surgery: Blockages in the tubes that store and carry sperm can be opened surgically.

What Are The Fertility Treatment Options For All Genders?

Although the above prevention and treatments can help some couples to conceive successfully, others might need more treatment options to increase their odds of pregnancy. Some medications may be prescribed to women to stimulate ovulation, before trying one of the following options:

Intrauterine insemination (IUI): A long, thin tube is used to place sperm directly into the uterus.
In vitro fertilization (IVF): A kind of assisted reproductive technology, it implicates harvesting the eggs at the end of the stimulation and placing sperm and eggs together in a lab dish. These eggs are then fertilized by the sperm and one of the fertilized eggs (embryo) is placed into the uterus.
Intracytoplasmic sperm injection (ICSI): In a procedure similar to IVF, a single sperm is directly injected into each of the harvested eggs by an embryologist and then an embryo is transferred into the uterus.
Third-party ART: Donor eggs, donor sperm, or donor embryos are recommended to be used by Some couples may also need a gestational carrier or surrogate, who agrees to carry and deliver their baby.

Outlook For Couples With Infertility

Dr. Shivani Bhutani at Eva Hospital has been dealing with patients of both genders with infertility. She explains that almost 90% of couples succeed in getting pregnant after undergoing fertility treatments. However, the success rates of these treatments depend on the cause of infertility, the couple’s ages, and other aspects.

Although Infertility can pose many challenges and can sometimes affect relationships as well as emotional health, infertility treatments these days are proving highly successful in helping couples to eventually

start a family. An accurate diagnosis and appropriate treatment is the right step in this direction.

If you and your partner have been facing problems in conceiving despite trying for more than 6 months to a year, you may book an appointment here with Dr. Shivani Bhutani.

Eva Hospital

Tendinitis: Symptoms, Causes and Treatment

February 18, 2022November 16, 2023
by Eva Hospital

Tendinitis- An Introduction

Tendons are Cabled shape Bands of collagen fibers that attach muscles to bones. They are flexible yet tough so that they can stretch and withstand tension.

Though taking some of the strain off the muscles is one of their main functions, they can also be injured by too much activity.

Inflammation of a tendon is known as Tendinitis. It is usually caused by overuse or injury of a tendon during physical activity.

A tendon can be inflamed by repetitive, overly strenuous exercise. This inflammation can occur anywhere in the body, including the elbows, ankles, or knees, and is known as tendinitis.

The name of the injury is given according to the body part affected, for example, Achilles tendinitis.

Most cases of tendinitis can be managed with rest, ice, and over-the-counter pain relievers.

Tendinitis can be either acute which is short-term or chronic in nature.

Types of Tendinitis

Any tendon in the body can be affected by Tendinitis, but there are certain types of tendinitis, which are particularly common.

Achilles Tendinitis Treatment

The thick band of tissue attaching the heel to the calf muscle is known as Achilles Tendon. This tendon helps a person walk, run, jump, and withstand a great deal of stress.

Achilles tendinitis is a common sports injury due to the stress this tendon endures. People with rheumatoid arthritis are also at a higher risk of Achilles tendinitis.

To Know More: Achilles Tendon Injuries- Symptoms, Causes & Recovery

Supraspinatus Tendinitis

The inflammation of the tendon at the top of the shoulder joint causing pain when moving the arm is called Supraspinatus tendinitis. It can make lying on the affected shoulder at night very uncomfortable.

Injuries of the other tendons in the same area can cause a condition called rotator cuff syndrome.

Tennis or Golfer’s elbow

Commonly known as tennis elbow, Lateral epicondylitis can cause pain radiating towards the wrist on bending it outwards.

Medial epicondylitis commonly known as a golfer’s elbow causes pain when bending the wrist towards the inside, which is more acute when trying to lift against a force.

De Quervain’s Tenosynovitis

Inflammation of the sheath surrounding the tendons between the thumb and wrist causes de Quervain’s stenosing tenosynovitis. Thickening and swelling of the tendon sheath make it painful to move the thumb.

Trigger Finger or Thumb

Trigger Finger is a common condition that happens on a finger-clicking when straightened, becoming fixed in a bent position because of the inflammation and thickening of the tendon sheath in the palm. This causes restriction of the tendon’s movement, making it unable to move smoothly.

Tendinitis of Wrist

Anyone who performs the same movements repeatedly with the wrist can become affected with Tendinitis of the wrist. It is most common in people who type and write a lot or play sports like tennis.

Symptoms of Tendinitis

Tendinitis has varying symptoms but they usually include:

Pain at the site of the tendon and surrounding area.
Pain that may gradually buildup or be sudden and severe
Tenderness and pain on moving the joint
Grating feeling
Swelling

Causes of Tendinitis

Usually caused by repeated, minor injury or impact on the affected area, Tendinitis can also be caused by a sudden, more serious, or acute injury.

Result of repeated stress or overuse, causes of tendinitis could include:

Repetitive motions, such as chopping or typing for long periods
Poor posture
Unsupportive shoes
Excessive exercise or work

Tendinitis Risk Factors

Though anyone can get tendinitis, it is usually more common in those who do some kind of repetitive activity. The risk factors include:

Profession: The people whose job involves repetitive movements, are at higher risk of tendinitis for example gardening, woodwork, painting, scrubbing, and playing sports like Tennis, golf, skiing, baseball, etc
Certain diseases can weaken muscles, like Rheumatoid arthritis, Gout, and certain Blood or kidney diseases.
Age: People with age 40 years or above because tendons tolerate less stress, lose elasticity and tear more easily as they age
Certain Medications like Fluoroquinolone antibiotics or drugs that lower cholesterol can cause tendons to tear.

When Should a Doctor Be Consulted?

One should immediately consult a doctor if:

The pain suddenly worsens or one is unable to move a joint
One develops Fever over 100 degrees Fahrenheit
There is Swelling and redness
One develops multiple sites of pain

How is Tendonitis Diagnosed?

After a complete assessment of symptoms, the doctor carries out a physical examination to identify tenderness and a creaking sound if any, which can happen because of thickening and inflammation of the tendon sheath.

Dr. Tanvir Bhutani at Eva Hospital says that usually rest, ice, and OTC pain relievers are recommended.

However, if symptoms do not improve, additional tests like an X-ray to show calcium deposits around the tendon, are recommended.

These help to confirm a diagnosis. Swelling of the tendon is revealed by imaging tests like ultrasound or MRI scans.

Tendonitis Treatment

The First-line of treatment for tendinitis aims to relieve pain and reduce inflammation and includes:

Avoid activities that exacerbate the issue.
Rest can help the inflammation of the affected tendon to reduce.
A bandage, splint, or brace to help restrict movement.
Hot and Cold Therapy can decrease swelling in the affected area
Over-the-counter anti-inflammatory medicines and nonsteroidal anti-inflammatory drugs to reduce inflammation

However, if there is no relief or improvement in the condition for more than three weeks, more advanced treatments are recommended which include:

Corticosteroid injections help to quickly decrease inflammation and pain.
Physical therapy includes a variety of motion exercises and splinting of the thumb, forearm, hands, etc.
Surgery, though rarely required, is recommended for serious issues that fail to respond to other treatments.
Some specific stretching and exercises are sometimes suggested by a physical therapist to strengthen the affected tendon and muscle.

Prevention of Tendonitis

A common condition, tendonitis is usually difficult to prevent. Whereas avoiding overuse can reduce the chance of getting tendinitis, this can also be difficult if one has an occupation that requires repetitive movement.

However, the chances of getting tendinitis can be lowered by:

Adequate warming up before exercise
Gradual building up of the intensity of an activity
Playing sports regularly, rather than only occasionally
Wearing proper shoes and appropriate gear
Stopping if a certain movement causes pain
Working on strengthening the surrounding muscles to reduce the strain on tendons
Taking periodic breaks from repetitive activities
Learning proper posture positions for all activities.

Recovery

It usually takes weeks to a few months to fully recover from Tendinitis. The recovery also depends on the severity of the injury.

Summary

A common overuse injury causing inflammation of a tendon, Tendinitis is more common in people who have jobs or play sports that involve repetitive motions.

Though in most cases the condition is managed with rest, ice, and OTC painkillers, additional treatments, therapies, and surgery may become necessary to support the healing process.

Dr. Tanvir Bhutani says that timely action is a prerequisite to a speedy healing process and freedom from pain.

One must consult the best orthopedic doctor near me on time to manage the condition and start the treatment.

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