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dr shivani bhutani

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

Polycystic Ovary Syndrome (PCOS): Symptoms, Causes, and Treatment

January 18, 2022March 29, 2024
by Eva Hospital

Overview

Polycystic Ovary Syndrome and Pregnancy is a condition that affects a woman’s hormone levels during their childbearing years. Women’s ovaries, the reproductive organs that produce the menstrual cycle regulating oestrogen and progesterone are affected in PCOS.

A small amount of male hormones called androgens is also produced by ovaries. An egg is released by the ovaries every month to be fertilised by a man’s sperm. This process is called ovulation.

PCOS affects the ovaries and ovulation. Its three main features are:

Cysts in the ovaries
Higher levels of male hormones
Erratic or skipped periods

Many small, fluid-filled sacs or cysts grow inside the ovaries in PCOS. The word “polycystic” infers “many cysts.” The cysts though not harmful otherwise, can lead to an imbalance in hormone levels.

These sacs are actually follicles, each one containing an immature egg. The eggs never mature enough to trigger ovulation.

The levels of oestrogen, progesterone, FSH, and LH are altered, making Progesterone levels lower than usual and androgen levels higher than usual. A disruption in the menstrual cycle is caused by higher male hormones, thus women with PCOS get lesser periods than usual.

Higher than normal amounts of male hormones in women cause them to skip menstrual periods and this imbalance makes it harder for them to get pregnant.

Hair growth on the face and body, baldness and long-term health problems like diabetes and heart disease are also caused by PCOS.

Women with PCOS have a higher incidence of miscarriage, gestational diabetes, pregnancy-induced high blood pressure and premature delivery if they conceive.

Causes

The exact cause of PCOS is not known by doctors. It is believed that elevated levels of male hormones prevent ovaries from a normal production of hormones and eggs.

Though the exact cause of PCOS is unknown, there is an indication that genetics play a major role.

Many other factors play a role in causing PCOS:

Higher levels of male hormones (androgens): Ovaries are prevented from releasing eggs (ovulation) due to higher levels of androgen, causing erratic menstrual cycles. High androgen might also cause acne and excess hair growth in women.

Insulin resistance: The hormone produced by the pancreas to help the body use sugar from energy foods is called insulin. Elevated insulin levels trigger the ovaries to make and release male hormones, which in turn, suppress ovulation and add to other symptoms of PCOS. Obesity can also cause insulin resistance and both are contributing factors to an increase in the risk for type 2 diabetes

Low-grade inflammation: A tendency of chronic low-grade inflammation has been noticed in women with PCOS. Blood tests that measure levels of C-reactive protein (CRP) and white blood cells, can reveal the level of inflammation in the body. Inflammation can also be caused because of being overweight. Excess inflammation is linked to higher androgen levels.

Common Symptoms of PCOS

Symptoms are noticed by some women around the time of their first period, whereas others discover they have PCOS after they have gained a lot of weight or there is trouble getting pregnant.

The most common PCOS symptoms are:

Irregular periods: Lack of ovulation inhibits the shedding of uterine lining every month, causing missed periods or lack of periods.
Heavy bleeding: The uterine lining builds up for a longer period of time, causing the periods (when they happen) to be heavier than normal.
Hair growth: Excessive hair growth on, the face, body, back, belly, and the chest is experienced by many women who suffer from PCOS.
Acne: The skin is oilier than usual due to male hormones, causing breakouts on areas like the face, chest, and upper back, which is usually difficult to treat.
Weight gain: Difficult to lose weight gain and obesity is experienced by 80% per cent of women with PCOS.
Male pattern baldness: Thinning of hair or falling out of the hair on the scalp
Darkening of the skin: Dark patches of skin especially in body creases like the neck, armpits in the groyne, and under the breasts is noticed in women with PCOS.
Headaches: Hormone changes cause triggering of excruciating headaches in some women
Skin tags: Little flaps of extra skin are often found in the armpits or on the neck in women with PCOS.
Infertility: PCOS is one of the major causes of female infertility. Decreased ovulation or lack of it can result in not being able to conceive as the woman is not able to produce enough eggs to be fertilised. PCOS is one of the leading causes of infertility in women.

Metabolic Syndrome

Most of the women with PCOS are overweight or obese. Both of these can increase the risk for:

Elevated blood sugar
Raised blood pressure
Low level of HDL “good” cholesterol
High level of LDL “bad” cholesterol

All these factors together are called metabolic syndrome, and can pose to be a high-risk factor for:

Heart disease
Diabetes
Stroke

Endometrial Cancer

The uterine lining sheds during ovulation. However, if the woman is not ovulating every month, it can cause the lining to build up.

This thickened uterine lining can cause an increase in the risk for endometrial cancer.

Depression

Hormonal changes and symptoms like unwanted hair growth negatively affect emotions, eventually causing depression and anxiety in many patients with PCOS

Pregnancy and PCOS

As the normal menstrual cycle is interrupted by PCOS, getting pregnant gets harder. Fertility problem is experienced by almost 70 and 80 per cent of women with PCOS.

The risk for pregnancy complications, premature delivery, miscarriage, gestational diabetes, high blood pressure also increases with PCOS.

Management and Treatment

The treatment is based on the symptoms of the patient, medical history and other health conditions, and if the patient wishes to get pregnant.

Dr Shivani Bhutani at Eva Hospital says that the Management of PCOS includes medications, lifestyle changes or a combination of both.

Weight loss

Lifestyle changes like weight loss, diet, and exercise are the first step to treating PCOS

Losing bodyweight can help regulate the menstrual cycle and improve PCOS symptoms besides improving cholesterol levels, lowering insulin and reducing the risk of heart disease and diabetes.

Cosmetic Treatments

Excessive hair growth or acne can sometimes lower confidence and self-esteem. Cosmetic treatments or consultations with a dermatologist might prove helpful in this respect.

For ones trying to get pregnant

Dr Shivani further adds that for the ones trying to conceive after having been diagnosed with PCOS, the first thing to keep in mind is to Eat healthily and lower the stress levels. These can go a long way in helping one manage PCOS.

The treatment options for patients wanting to conceive are-

Patches, shots, a vaginal ring or an intrauterine device (IUD) can help regulate the menstrual cycle, improve acne help with excess hair growth and protect against endometrial cancer

Surgery

As an option to improve fertility, surgery is usually recommended when other treatments don’t work.

Surgical options include:

Ovarian drilling: A procedure in which tiny holes are made in the ovaries to reduce the levels of androgens being produced.
Oophorectomy: Surgery for removal of one or both ovaries.
Hysterectomy: Removal of whole or part of the uterus.
Cyst aspiration: A procedure to remove fluid from the cyst.

Drugs to induce ovulation

Ovulation is a prerequisite for a successful pregnancy. Certain drugs can help to induce ovulation in women with PCOS. Clomiphene (Clomid), a combination of clomiphene and metformin, or injectable gonadotropins, such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH) medications are generally recommended by Gynaecologist in Ludhiana In some cases, letrozole (Femara) may also be recommended.

In vitro fertilisation (IVF)

The woman’s egg is fertilised with the partner’s sperm in a lab and then transferred to the uterus. IVF is a highly recommended and viable option with a substantial success rate for women with PCOS who wish to get pregnant and medication doesn’t help with ovulation.

Conclusion

PCOS can play havoc with a woman’s menstrual cycles making it harder to get pregnant. Elevated levels of male hormones cause unwanted symptoms like hair growth on the face and body.

Lifestyle modifications are the first steps recommended to manage PCOS by the doctors, and they are highly effective too.

Weight loss helps to treat PCOS symptoms, improving the odds of getting pregnant.

However, if lifestyle changes do not work, medications are a viable option. Pills and metformin restore normal menstrual cycles to help relieve PCOS symptoms.

Early diagnosis can help alleviate symptoms, reducing the risk of complications. A timely consultation with a doctor helps to manage the symptoms of PCOS and treatments like Ovulation medicines and IVF Process Start to Finish can help the patients with PCOS to get pregnant and start a family.

Eva Hospital

Pregnancy after 40. Benefits and Risks

November 5, 2021March 29, 2024
by Eva Hospital

Pregnancy & childbirth after the age of 40 has become an increasingly common affair. The number of first-time births among women ages 40 to 44 has increased substantially.

But many questions come to mind when couples decide to have a baby at a later age.

What are the Benefits?

Having a baby later in life can have more advantages than having children early, sometimes.

Already having established a career, you may be able to dedicate more time to raising children or the financial situation can be more favorable.

Steady relationship status may make you want to have a baby at this age.

These are some more possible benefits, of having babies after 40 including:

Reduced mental decline
extended life span
better academic outcomes in children, such as higher test scores and graduation rates

What Will the Pregnancy Be Like?

The advances in technology concerning fertility, pregnancy, and delivery, have made it possible to safely have a baby at the age of 40.

Nonetheless, Conception and Pregnancy can be more challenging as you age this pregnancy after age 40 is deemed as high risk.

It’s important to talk to your gynecologist in Ludhiana about what you can expect during your pregnancy based on your age and overall health.

How Does Age Affect Fertility?

Women’s fertility rate drops considerably after a certain age and they experience fertility issues due to the following risk factors that increase with age:

More chances of health conditions that can inhibit fertility
Significant decrease in Ovarian Reserve or egg cells.
Improper release of eggs by the ovaries
An age-based decline in egg quality lessens the viability of fertilization for the eggs released by the ovaries as women age.
Chromosomal abnormalities due to the age of the egg may result in incorrect implantation of the embryo in the uterus causing miscarriage or Down syndrome in pregnancy.

Conception can take some time, regardless of age. But most women after 40 can’t get pregnant naturally and for those who have been trying unsuccessfully to have a baby naturally for more than six months, it may be time to see a fertility specialist.

An experienced fertility specialist like Dr. Shivani Bhutani at Eva Hospital can run tests to discern whether there are factors that are affecting one’s ability to get pregnant, and can suggest treatments to increase the chances of getting pregnant.

Genetic conditions

There are more chances of older women to give birth to a child with a genetic condition such as Down syndrome.

Talking to the doctor about the possibilities of these problems will help you ascertain what can be done about it.

Some tests can be recommended by the doctor but they’re a personal choice. These tests include screening like an early ultrasound and a blood test.

In case of heightened likelihood of the problem, one can have a diagnostic test such as chorionic villus sampling and amniocentesis.

Genetic counseling can also be arranged, where a specialist counselor talks about family and about what might happen with your baby, and about how the situation can be handled.

Treatment

An urgent and individualized treatment approach is important for women who are trying to conceive and are over 40 years of age. The sooner treatment is started, the higher are a woman’s chances of pregnancy are.

Among the several types of infertility treatment available to women over 40, it is important to remember that some of the treatments offered by fertility centers may not be the best option for women over 40 due to.

IVF and donor eggs are far more effective treatments for women over 40 than “mini IVF” and IUI that give vastly poorer pregnancy likelihood for older women.

IVF is a proactive and contentious treatment philosophy to maximize each woman’s chance of pregnancy.

For women looking to conceive with their own eggs after age 40, IVF with ovarian preparation stimulation is the fastest and most credible treatment option.

The women older in age opting for IVF need a different treatment than the younger women. Eva Hospital has had very impressive pregnancy rates even at very advanced maternal ages, as well as for those with largely diminished ovarian reserve

Other Risk Factors

Also chances of Vaginal delivery decrease after the age of 40, primarily due to the fertility treatments that can enhance the risk of premature birth.

There may also be an increased risk of preeclampsia, which may make cesarean delivery imperative to save both mother and baby.

The process of vaginal delivery can also be more challenging after 40 and there is an increased risk of stillbirth.

However many women deliver healthy babies at or over the age of 40 successfully. A doctor can guide you about what to expect, and come up with a backup plan.

Like, in case you’re planning a vaginal delivery, discuss it with your doctor.

Takeaway

Giving birth to a baby at 40 is very common these days, so if you’ve postponed having children until now, you can plan one.

Despite the challenges it may take to conceive, having healthy children in their 40s is certainly a possibility with a well-formulated IVF plan by a competent doctor.

Talk to your doctor about all your risk factors before starting a family at this stage in your life.

Dr. Shivani Bhutani at Eva Hospital has been assisting many couples over the age of 40 to have healthy children and she can guide you about the pregnancy at the age of 40.

Eva Hospital

11 Tips to Increase Male Infertility

September 28, 2021March 29, 2024
by Eva Hospital

Male infertility-An Introduction

Fertility means a person’s ability to reproduce without medical assistance.

When a man has a poor chance of making his female partner pregnant, it’s termed Male infertility. It is usually dependent on the quality of his sperm cells.

Occasionally infertility can be linked to sexual function, and at other times it could be linked to semen quality.

Most couples who are ready to conceive or have been trying for a long time, probably think often about their fertility and if there is anything that can be done to improve it.

Fertility issues related to the female reproductive system are most difficult to treat, but most of those associated with male infertility can be managed by changing health habits and lifestyles.

Causes of Male Infertility

Male infertility is usually linked to sexual function or to semen quality.

Libido: Also known as sex drive, libido is related to a person’s desire to have sex. Foods or supplements that can increase libido are called aphrodisiacs.

Erectile dysfunction: When a man is unable to develop or maintain an erection, it is termed erectile dysfunction or impotence.

Sperm count: The concentration of sperm cells in a given amount of semen is an important aspect of semen quality.

Sperm motility: The ability to swim is an essential function of healthy sperm cells. Sperm motility is calculated by the percentage of moving sperm cells in a sample of semen.

Testosterone levels: Low levels of male sex hormone or testosterone can also be responsible for infertility in some men.

There can be multiple causes of Infertility and it may depend on genetics, general fitness, diseases, and dietary adulterations.

Antioxidants: Well-known for fighting the free radicals in our bodies that cause cancer and other diseases antioxidants can also help in boosting male fertility. Taking it in a supplement form can reduce the amount of damaged sperm. The best sources of antioxidants for sperm health are zinc, vitamin C, selenium, vitamin E, folic acid, Coenzyme Q10, and carnitine.

Quit smoking: Fertility is one more reason to quit smoking other than many more. Smoking reduces sperm count, sperm motility, alters its shape, and can also cause DNA damage. Quitting will not only improve all of this but also your general health.

Exercise regularly: Regular exercise can boost testosterone levels and improve fertility. Studies indicate that men who exercise regularly have higher testosterone levels and better semen quality than those who don’t. But also be careful to avoid too much exercise, as it can have an adverse opposite effect and potentially reduce testosterone levels.

Having sex frequently: Getting pregnant requires couples to have sex around the time of the woman’s ovulation. But having regular sex for the rest of the month can also help improve the sperm. Studies show that the sperm performs best after one day of abstinence. So, having sex every few days can help improve the sperm-health.

Reduce soy intake: High amounts of soy in men’s diet tend to lower the sperm count. The amount of reduction though not huge can make a difference in men who already have a low sperm count. Overweight men react more strongly to soy and need to limit it more than the men with normal weight.

Keep Cool: Sperm can be damaged by high temperatures (over 98.6 degrees Fahrenheit). Sperm should be protected from harmful heat by avoiding the hot tub and long hot baths. Staying in the same position for a long time like at a desk working can also raise the scrotal temperature. Sitting with a laptop on your lap also produces more heat. Always try to keep the computer on a desk and get up and move around at regular intervals to cool things off.

Weight Management: Over or underweight men can have imbalanced hormones in the body and affect sperm. Obesity has a great negative effect on testosterone levels and fertility in both men and women. If you are overweight, start an exercise regimen and get your BMI within a normal range.

Limit alcohol: Heavy drinking can affect fertility. Restrict your intake to a few drinks per week. When it comes to choice, wine is the smartest option as it’s less fattening and comes with a fee of its own health benefits.

Get enough sleep: Inadequate sleep can increase cortisol levels in the blood, lowering testosterone. Try to get at least seven hours of sound sleep every night for good health, general well-being, and vitality.

Avoiding Certain medications: Healthy sperm production can sometimes be decreased by some prescription medications like antibiotics, anti-androgens, anti-inflammatories, antidepressants, anabolic steroids, etc. Seek the consultation of Dr. Shivani Bhutani if you think that a medication you are currently taking may be reducing your sperm count or affecting fertility.

Treat Underlying Medical Conditions: Few Medical conditions and infections also affect fertility. One of the causes of infertility in men can also be undiagnosed or untreated infection of the reproductive system or urinary tract. Sexually transmitted infections can also lead to reduced sperm motility. Always be honest to your doctor about your current and past health history.

Bottom line

Male infertility is mostly linked to lifestyle and a few underlying conditions. Few lifestyle modifications in consultation with a good fertility specialist can help overcome these conditions.

Dr. Shivani Bhutani has been for many years successfully treating couples with infertility issues. Contact to book appointment

Eva Hospital

Why Knee Pain Can Signal Other Health Problems?

July 6, 2021March 29, 2024
by Eva Hospital

Although knee pain is localized in the leg joints, it gives you a signal about other health problems in your body you may not know of.

Whenever you have knee pain, take a thorough look and get yourself investigated to know the root cause of the problem. Your pain might be a consequence of one or a combination of the following health conditions:-

An injury
A mechanical problem
Kinds of arthritis
Other problems.

Knee Pain Could Signal an Internal/ External Injury

If you are experiencing knee pain it could be due to a recent or chronic injury such as :

ACL tears
Meniscus tear
Fracture
Bursitis
Patellar tendinitis

Also Read: Post-Surgical Joint Replacement Precautions & Tips

You must understand the KNEE STRUCTURE and the terms. This joint joins the thigh with the leg and consists of two joints- the tibiofemoral joint & the patellofemoral joint.

The tibiofemoral joint is the one between the femur(thigh bone) and the tibia (shin bone). The patellofemoral joint is the one between the femur and patella ( knee cap).

The joints contain ligaments, tendons, and cartilage. It permits both flexion and extension along with slight internal & external rotation.

Your knee is vulnerable to injury, mostly affecting ligaments, tendons, or its fluid sacs or bursae that surround the joint. Let us give a look.

ACL Tears. The ACL or the anterior cruciate ligament is one of four ligaments that connect the shinbone to the thigh bone. An ACL tear is a common sports injury in persons who indulge in sports such as basketball or soccer that require abrupt changes in direction.
Fractures. Fracture pain is very acute, causes swelling and the patient cannot move the part. An accident or a fall can cause the patella or kneecap to break. Another reason for fracture can be severe osteoporosis. People with weak bones as a consequence of osteoporosis may fracture themselves simply by stepping wrong.
Meniscus Tear. The tough, spongy cartilage that acts as a shock absorber between your shinbone and thighbone is the meniscus. You may tear it if you twist your leg the wrong way with a strong force or weight.
Bursitis. There are small sacs of fluid called bursae that cover the knee all around to give the joint a cushioning. An inflammation in them is called bursitis and is painful.
Patellar tendinitis. Tendinitis causes tenderness & inflammation in the tendons – the patellar tendon in this case. It is a fibrous tissue that connects your kneecap to the tibia and allows you to kick, run and jump. an injury to his tendon causes bursitis and eventual pain.

Mechanical Problems

The musculoskeletal structure is after all a piece of machinery, and any part can dislocate or behave in an unaligned way. Such mechanical problems may happen in the knee as well- causing pain. Some examples of mechanics problems include:

Loose body. Sometimes a piece of bone or cartilage might break off or float in the joint space. It could be the result of an injury or deterioration. It is something like an object being caught in a door hinge, not allowing it to close properly.

IT band Syndrome. IT Band is the tough band of tissue that stretches from the outside of your hip to the outside of your knee. When it becomes so firm that it rubs against the outer portion of the femur, it is called the Iliotibial Band Syndrome. Runners & cyclists are particularly susceptible to iliotibial band syndrome.

Kneecap Dislocation. This happens when the triangular bone that covers the face of your joint slips out of place, normally to the outside of the knee. In most cases, you are able to see the dislocation.

Hip or foot pain. Your pain might be connected to a problem in the hip or foot. Hip and foot pain usually makes you change your gait to save yourself from foot pain. Your altered way of walking puts more stress on your knee & causes pain.

Kinds of Arthritis

Maybe your knee pain is a signal for arthritis in the bones. There are several types of arthritic conditions. The most common ones are:

Osteoarthritis. Also known as degenerative arthritis, osteoarthritis is a wear-and-tear condition that occurs when the cartilage in the knee damages with use & age.

Rheumatoid arthritis. The most weakening form of arthritis, rheumatoid arthritis is an autoimmune condition that can affect any joint in the body, including the knees. It is a chronic disease, which keeps varying in severity. Also, it comes & goes.

Gout. This type of arthritis occurs due to uric acid deposits in the joint. While gout most commonly affects the big toe, it can also occur in the knee.

Septic arthritis. It occurs due to infection in the joints, causing swelling, pain, and redness.

Eva Hospital

Can Be Reverse Infertility in Women?

June 2, 2021December 12, 2023
by Eva Hospital

There are two approaches to reversing infertility in women. The first one focuses on alternative methods like ART for conception and the second one involves finding the underlying causes and correcting them.

Infertility is defined as the reduced ability or inability to get pregnant and have babies. More specifically, failure to conceive even after a year of trying or suffering miscarriage or stillbirth is what doctors call infertility.

It is becoming pretty common, almost like diabetes and obesity, affecting nearly 15 percent of couples. Luckily, it can mostly be reversed and women can go on to have children.

Causes

Depending on the cause, reverse infertility. can be reversed. In one-third of the total cases, the female has a fertility issue.

The bottom line of all causes in women is hormonal imbalance. These imbalances become apparent as polycystic ovarian syndrome (PCOS). Others are endometriosis, blocked fallopian tubes, or fibroids in the uterus.

Also Read: How PCOS/PCOD affects your fertility and how to manage it?

Infertility Reversal in Women

Fertility specialists use a number of approaches to reverse infertility. Treatment includes medicines, surgery, and assisted reproductive technology.

Ovulation stimulation uses hormones to help a female release an egg from her ovaries.

Surgical procedures help in opening up blocked or damaged fallopian tubes, endometrial growth, and removing fibroids in the womb.

Assisted reproductive technology helps those who have not benefited from surgery, have severe endometriosis, or have unexplained infertility.

ART such as IUI and IVF help bring the sperm and egg together for fertilization. IVF involves in vitro fertilization, where embryologists put an egg and a sperm together in a petri dish in the laboratory.

The procedure gives sperm the best prospect of meeting with the egg and fertilizing it. The embryos are then implanted in the uterus for a successful pregnancy.

Incidentally, it also helps couples overcome some reasons for male fertility issues, such as low sperm count or motility.

Lifestyle Modification- A Different Approach to Reverse Infertility

Simple modifications in lifestyle habits can also help reverse mild cases of infertility.

At Eva Hospital, we suggest associating with a specialist doctor to deal with fertility issues of all kinds- male or female.

Dr. Shivan Bhutani, leading IVF Specialist in Ludhiana, says, “Proper hormonal balance is very important for the reproductive system and overall health”. Try the following lifestyle tips:

Lower the glycemic index. Replace processed and sugary food items with a low-sugar diet that has many good fats and lean animal protein. Studies have shown that adopting a high-fat, low-sugar diet presents the simplest solution for this.

Supplement the diet for a healthy digestive system. Scientists have discovered many intestinal microbes in the intestines that contribute to obesity, PCOS, hormonal imbalance, and other problems.

Instead, tend your inner garden with beneficial bacteria by consuming gut-friendly foods such as fermented as well as fibrous foods and probiotics( such as curd). If you have IBS (irritable bowel syndrome), correct it first.

Exercise regularly. As we have stressed earlier, an active lifestyle and regular exercise for women play an important role in reversing infertility and reducing the risks too.

Especially for PCOS, maintaining ideal weight and insulin balance is crucial. Do not go too intense, even if you are a professional, find an effective and balanced workout plan for yourself.

Control stress. Amongst several other problems, persistent stress may cause insulin resistance, lower libido, and infertility.

We recommend yoga and meditation on a regular basis to distress and remove harmful toxins from the body. Many patients who are distressed have shown higher success rates with treatment.

Catch adequate sleep. Findings show sleep disorders lessen women’s health and wellbeing and can become one of the factors of infertility. Get sufficient uninterrupted sleep, up to 8 hours a day every night.

Sleep also heals the body and repairs cells and induces growth as well as restoration. You can sleep away a lot of disorders by allowing the body time to work on itself!

Protect yourself from environmental toxins.

You get exposed to toxins from environmental chemicals that disturb your hormonal balance and harm you in several other ways.

Stay away from food items packed in soft or opaque plastics, too much preserved and stale foods. For water, choose glass or durable metallic containers.

Soft plastics contain toxic chemicals, like phthalates and bisphenol A, which have been associated with hormonal syndromes & infertility.

Avoid these. Very important are restraining your alcohol use, and quitting tobacco/ illegal drugs as a couple.

Also Read: Is 40 too late for IVF?

Conclusion

Infertility can be reversed for women owing to advanced treatment options to conceive and carry a healthy pregnancy to full term. Many couples have done it, you can too. Do not be disheartened and contact Eva Consultant today!

Eva Hospital

Miscarriage And Infertility

May 24, 2021March 29, 2024
by Eva Hospital

Everyone’s experience of a miscarriage is different and often compared to fertility. It all depends whether it is the first pregnancy, a second or third miscarriage or a result of a mishap. Whatever the reason may be, it is painful for both parents.

However, the main concern of couples is how it affects their fertility and future pregnancies, should they plan to conceive immediately or wait, and what precautions they can take to safeguard their next child. We will try to learn all the facts about fertility and miscarriage.

What is Miscarriage?

Miscarriage is the term used to define sudden before-time termination of pregnancy. Nearly 20% of pregnancies get aborted.

The percentage is high because most women do not even know that they have miscarried. After all, it happens so early, in the 1st to 3rd month. 80% of miscarriages occur within the first 3 months.

Can Miscarriage cause Infertility?

It is the most frequently asked question. Does miscarriage affect your fertility in forthcoming pregnancies? “In most cases, it does not,” says Dr Shivani Bhutani, Eva IVF Hospital. If one of your foetuses is lost in the 1-3 months, it is unlikely to create problems with the womb to affect the next pregnancy.

In certain kinds of miscarriage, remaining tissue may have to be removed through a process called D&C.

When we weigh miscarriage and fertility issues, you must remember that miscarrying itself does not cause infertility. It may reveal a person’s existing reproductive issues though.

If you have had more than one such experience previously, it is important to talk to your doctor.

As such, there is no conclusive evidence to establish how miscarriages affect a person’s fertility.

It affects each woman differently, making it difficult to draw conclusions. As a matter of fact, some studies have shown that conception becomes easier after an early miscarriage.

However, another report has suggested that miscarriage may marginally decrease later fertility.

How Soon Should One Try for a Child After Miscarrying?

Going through the experience of miscarriage can become very taxing for the mother, both emotionally and physically. One may want to wait a while to recover from the ordeal and plan the next pregnancy carefully.

Dr Shivani advises that a woman who has miscarried should avoid sexual intercourse for the next 15 days to let the uterus and endometrium recover and also to avoid the risk of infection.

One can try and conceive in the very next menstrual cycle as you would be ovulating in the next ten days. If you wait a month though, it becomes easier to calculate the due date without confusion.

What Is the Chance of Miscarrying Again?

If a woman has 2 or more spontaneous miscarriages, it is called recurrent pregnancy loss. The percentage of repeated miscarriage is pretty low, only 1 per cent. It means that out of 100 women who miscarry in the first trimester, only one might have another miscarriage.

However, if it happens, one should consult a fertility specialist before planning the next pregnancy. She would use your blood tests, sonography results, hormone levels, MRI or endometrial biopsy to evaluate why the body is rejecting the foetus.

Recurrent pregnancy loss can also be due to a genetic chromosomal abnormality for which the father or the mother, anyone could be contributing.

In this condition, though the parent is normal he is carrying a gene that causes chromosomal abnormality on their egg or sperm cells.

Genetic Screening can diagnose this condition. You can opt for IVF using donor eggs or sperm for a successful pregnancy.

What Can We Do to Diminish the Risk of Miscarriage in the Future?

As the reason for unsuccessful pregnancy is not directly related to fertility and isn’t clear in every case, there are no fixed formulas to keep abortions from occurring. Nonetheless, you may decrease the number of probable factors.

Before getting pregnant, have a consultation with your gynaecologist about dietary and lifestyle changes you can adopt to substantially reduce the risk factors. These may include:

taking an everyday pre-birth vitamin tablet with folic acid for a month prior to attempting to conceive again. It not only reduces your risks but also corrects neurological defects.
staying away from liquor, cigarettes, and
restricting tea, coffee or caffeinated beverages. It is great for your fertility as well as for a better pregnancy generally.

Also Read:The Importance of IVF and The Possibilities it Offers

If you have encountered an unexpected abortion of your baby, remember that others have walked that road too, and there are people with whom you can connect and draw strength.

Dr Shivani says,” We counsel the patients and help couples connect. Sharing with other couples and with your partner helps your distress and be positive.

Eva Hospital

Fulfill your Dream Of Motherhood- Options & Affordability

May 5, 2021March 29, 2024
by Eva Hospital

Fertility Clinics are the bright silver lining for women wishing to fulfill the dream of Motherhood. At Eva IVF, all our endeavors are aimed at fulfilling the hopes and desires of childless couples.

When there are super advanced procedures and experienced fertility specialists available, no woman should be deprived of the joy of motherhood.

If you have been delaying treatment due to fear or apprehension, please do not. You deserve it. Contact us to soon hear a baby’s laughter in your home.

How do you know it is time to consult a fertility specialist?

Following are important pointers that make the choice easier for you

If You Are Below 35 & Healthy

It usually takes up to a year to conceive after you start trying. Count 12 months from the time you start having unprotected sexual intercourse.

If you are healthy but still not pregnant in this period, you should see a specialist. Dr. Shivani Bhutani, Eva IVF Hospital, Ludhiana advises that normal healthy couples should wait for a year and try for pregnancy naturally before coming to us.

“Time your intercourse properly and take care of your diet and lifestyle habits. It may happen for you in this period.”

If you are above 35

For women above 35 years of age, do not wait beyond 6 months. It is not that 35 is old, but it is a pivotal age for reproductive ability when the chances of conception start becoming lesser.

The egg supply starts dipping. So, if six months have passed in trying naturally, see an infertility specialist/reproductive endocrinologist.

If you are above 40

Still, struggling with conception at 40? See your doctor immediately. Eggs quantity and quality both decrease after 40, so you may need assistance or specialist advice on getting pregnant.

There are chances of chromosomal abnormalities in the embryos too which requires screening.

If you have PCOS or Endometriosis

In case you have an issue that you are aware of, then see your specialist right away. Women who have polycystic ovaries (PCOS) or endometriosis, must get an evaluation even before they start trying for pregnancy.

According to Dr. Shivani, “In a known reproductive abnormality, there is no point in wasting precious time.

Polycystic women do not ovulate, so they require medications. Endometriosis also may have caused a blockage in fallopian tubes or other problems, or maybe nothing. Better get yourself evaluated right away.”

If you have other Issues or Symptoms

No matter what your age or health, to fulfill your dream of motherhood, look at each aspect carefully.

Thyroid problems, overweight, irregular periods, and pelvis pain indicate that you must consult a fertility clinic at once.

Enormous Options for Motherhood

Your dream of motherhood is within reach, thanks to Assisted reproductive techniques or ART, there are plenty of doors open for people with all sorts of fertility issues.

The options that suit you depend on your situation and the reasons for infertility.

Maybe you require treatment, or your spouse or both of you need to undergo a mix of treatments together. Treatments involve medicines to help with the sexual hormones and minor procedures to help in conception.

The main two types of procedures are:

IUI- Short for Intrauterine Insemination wherein sperm is obtained from the male and inserted directly inside the women’s uterus in the ovulation period for pregnancy.

IVF- Short for In-vitro Fertilization, it is commonly known as the test tube baby method. In this process, the eggs and sperm are retrieved, combined, and fertilized in the lab.

The resulting embryo is grown for three days and implanted in the womb for successful conception.

ICSI – A very popular male infertility treatment is Intracytoplasmic sperm injection or ICSI. It is a very credible Assisted Reproductive Technique, with a high success rate.

Of all the infertility treatments, In Vitro Fertilization is the most effective fertility treatment that takes the least time in pregnancy compared to other treatments or natural ways.

Although it is a detailed scientific process, basic knowledge is important for both of you to understand. The entire process of IVF can be simply distributed into 4 steps.

Ovarian Stimulation: Medication containing hormones are given to the female to increase the quantity and quality of eggs.

Egg Retrieval: Released eggs are retrieved from the ovaries via a minor procedure under local or mild anesthesia.

In-vitro Fertilization: In the Embryology Lab, fertilization of eggs with sperm takes place after which embryos are developed.

Embryo Transfer: The embryos are laden into a flexible tube and implanted into the woman’s womb. This completes one cycle of IVF.

Male Fertility Treatment

You do not have to go to a different clinic for your parenthood journey as a couple. At Eva, we offer you complete solutions for having a baby.

Both the partners need to undergo evaluation together. Four out of ten times, malefactors are responsible for not being able to conceive.

Eva Hospital

What are the Alternate Treatments to Cure Infertility?

June 24, 2020March 30, 2024
by Eva Hospital

Getting married at the age of 32, Shiva, tried her best to mother a baby. After a few months of unsuccessful attempts, she consulted a gynecologist who recommended In-vitro fertilization (IVF). But Shivia knew she could not afford the cost of IVF at any point in time. Shattered, she was upset for a long time. Little did she know that there are alternate treatment therapies that can help the body gain the vitality to nurture a baby.

Dr. Shivani Bhutani, an expert gynecologist in North India, says that getting pregnant is the process of mating two healthy bodies and two healthy minds.

The onus lies in creating a sound body where the embryo can grow and stay. Dr. Bhutani suggests a few alternative therapies that can aid the body to get its nutrients and gain strength to bear a baby.

What are the Safest Alternative Therapies to Get Pregnant?

Dr. Bhutani says that the following alternate therapies are mechanisms, which along with medical treatment, can ensure a healthy and sound body to get pregnant and fight infertility:

Yoga

Yoga is an age-old therapy from the yore of the yogis of the bygone era. Yoga was the secret of their ageless skin and health. Dr. Bhutani says the specific asanas in yoga can help increase the libido, make your body and mind stress-free, improve the blood circulation and heal the vices (doshas) in the body which prevent you from getting pregnant.

The calming techniques in yoga are good for all age groups for holistic development in the body and definitely make you calm enough to deal with the stress of infertility.

Acupuncture

The age-old Chinese practice of using needles and energy, Acupuncture, has now proved that this can be an effective aid to help avoid miscarriages and enhance the success rate of IVF. The anecdotal success of acupuncture as an alternate source of treatment is commendable. Studies have shown that IVF patients can get huge success with the help of acupuncture treatments done at the hands of specialists.

Dr. Bhutani, an experienced infertility expert, says that cases of unexplained infertility, where the cause of infertility or miscarriages cannot be known, can be dealt with with this alternate therapy.

Diet rich in Nutrients

The old saying –

‘You are what you eat, holds true in magnanimous proportion in pregnancy and fertility.

Also, read- What is the right diet to boost fertility?

IVF alone cannot help you get and stay pregnant if your body has been exposed to too many vices like alcohol and cigarettes. A sound body can be prepared by incorporating healthy nutrients, vitamins, minerals, and herbs that promote fertility.

Healthy oils, Omega-3, flaxseeds, green vegetables, sesame, plant-based proteins, and dairy products help in controlling hormones production, keeping insulin in check, and enhancing regular ovulation.

Dr. Bhutani advocates a healthy diet much before you even plan to get pregnant. She emphasizes a healthy diet for both the man as well as the woman to be able to conceive a baby.

Exercise and Meditation

You need to gain control over your lives before entering parenthood. Exercise stimulates the pregnancy hormones and meditation helps alleviate stress due to infertility and other tensions. You need to be at peace to get pregnant soon. Shiva realized that stress was the most important factor that was curtailing pregnancy. Meditation helped her gain peace of mind to welcome the baby and get pregnant.

Last Words

Pregnancy is a feeling of utmost joy in the world. The thought of parenting the little bundle of joy can be the happiest feeling.

If infertility or miscarriage are the obstructions, get in touch with Punjab’s best and the most reliable gynecologist, Dr. Shivani Bhutani at EVA Hospital, Ludhiana and seek consultation regarding IVF and effective alternate sources of treatment to enter the world of parenthood.

IVF

How quickly can you Expect to get Pregnant?

December 10, 2019March 30, 2024
by Eva Hospital

Your world changes the moment you think of planning a baby. Getting pregnant becomes the most prior thing once the idea of entering the threshold of motherhood enters your mind. The factors which determine the time it takes to get pregnant are usually age, well-timed intercourse, and a body ready to accept the pregnancy.

What is the best time for intercourse to get Pregnant?

Best time to get Pregnant: Some women get pregnant very quickly. Nearly 1 out of every three women can get pregnant within a month if they time the intercourse around ovulation days.

Ovulating days or fertile days have to be calculated and having unprotected intercourse during the fertile days increases your chances of getting pregnant.

It is important to know when you ovulate each month to get pregnant quickly. Dr. Shivani Bhutani, the leading infertility expert of Punjab, says that having unprotected intercourse on the days of ovulation leads to the best results.

Ovulation happens 10 to 16 days before the start of your next period. This will help you determine the cycle length before planning pregnancy. When an egg is released from the ovary, calculate the day before that and the day after that as the most fertile days.

Some factors that may help you calculate Ovulation are:

Release of Eggs

The egg lives for nearly 12-24 hours after it is released and if it comes in contact with the sperm during this time, you can get pregnant instantly. You may also note that the life of the sperm is about 5 days inside a female body and if intercourse takes place around the ovulation days, chances are that sperm in the body can fertilize the eggs.

Body Temperature

Note your body temperature each morning when you wake up and you will notice a rise of about 0.2 degrees Celsius when the ovulation has taken place. Though this is not a conclusive means to get pregnant, yet you may monitor body temperature to assess the fertile window.

Changes in Mucous

A sticky, white mucus is secreted by the cervix throughout the menstrual cycle. Gauge the secretion and as it becomes thinner, clearer and increases in secretion, ovulation is either going to start or it is going on. The best time to have intercourse or the ‘peak day’ is when you experience the wetter secretions.

There is an ovulation test kit that also detects a particular hormone in urine that signifies the onset of ovulation. After you calculate ovulation, the position of intercourse will also determine how quickly the sperm and the egg can mate.

The man should be able to ejaculate sperm into the vagina and the position of the intercourse doesn’t matter. However, it is advisable that the woman raises her leg upwards for a while post-intercourse so that the sperm can travel to the womb and is not ejected from the body.

How long will it take to get Pregnant?

If you have had regularly unprotected (without the use of contraceptives or condoms) vaginal intercourse every two to three days, the chances are that under the age of 40, more than 8 out of every 10 women can get pregnant within one year. 90% of the couples can conceive within 2 years of unprotected intercourse.

The age of the couple is very significant. Beyond 35 years of age, the fertility quotient goes lower. The number of eggs and sperm production decreases with increasing age. Beyond 40 years of age, you may be advised of particular fertility treatments.

You must seek advice from the best gynecologist around you if you do not get pregnant within one year of unprotected intercourse at the time of ovulation. Dr. Shivani says, stressing too much about getting pregnant also delays your chances of getting pregnant. So you must enjoy and have stress-free intercourse while you plan a baby.

The doctor will analyze the causes of your not getting pregnant and thus may vary with age, fertility timings, weight, infertility symptoms, or maybe just a ‘matter of time’.

Last words

Dr. Shivani from EVA Hospital advises women to be active, have a normal weight, avoid alcohol and smoking, and follow a healthy, balanced diet to get pregnant quickly.

A healthy body with a stress-free mind has better chances of conception. For any queries or suggestions to get pregnant quickly, contact Dr. Shivani Bhutani for the most genuine advice.