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Endometriosis – Symptoms, Risk Factors, and Treatment

December 27, 2020
by Eva Hospital

Endometriosis is a gynecological condition wherein the endometrial tissue that grows normally in the uterus, starts to grow outside of it.

This kind of abnormal growth may occur anywhere but usually, it is found in the pelvic region, affecting the fallopian tubes, ovaries, peritoneum, and lymph nodes.

The tissues are not as much a problem as their behavior. The cells in these endometrial tissues respond to the hormonal cycle and shed blood during menstruation.

Since there is no outlet for this blood, it gets trapped inside.

Secondly, it makes the organs stick to each other, causing disorders and pain. For example, it may block the fallopian tubes and affect a woman’s fertility. In rare cases, tissue growth may spread to other parts of the body.

Endometriosis affects 5-10 percent of women of their reproductive age. It

is difficult to diagnose because the symptoms are very generalized but controllable with treatment.

Symptoms

Endometriosis is a painful condition, with symptoms similar to those of irritable bowel syndrome (IBS), ovarian cyst, or pelvic inflammation. The common symptom of the disorder is pelvic pain, just like in periods.

Symptoms include:

Blockage of fallopian tubes or ovary function.
Extreme menstrual cramps, difficult to control with NSAIDs
Long-term lower-back and pelvic pain
Long periods extending to seven days and more.
Hemorrhagic- extremely heavy menstrual flow requiring changing the pads after every hour or two.
Bowel and urinary problems including pain, diarrhea, constipation, and bloating
Pain during sexual intercourse
Inter-period spotting or bleeding
Traces of blood in urine or stool
Nausea and vomiting

Although all women experience menstrual cramps, the pain in endometriosis is very intense and severe. Symptoms get eased when hormone levels fall, such as in pregnancy or menopause.

Risk factors

Infertility – The most common risk associated with endometriosis is infertility. 30 percent of females suffering from the condition have problems in conception. IVF provides a solution for endometriosis women to get pregnant.

The tissue growth in fallopian tubes can prevent the egg from reaching the uterus and get fertilized by sperm.

Infertility also may result from damage caused to the egg or sperm cells.

Nevertheless, women with mild or severe endometriosis can become pregnant and deliver a healthy child. Dr. Shivani Bhutani, Infertility, and IVF specialist advises patients to not delay childbirth as the symptoms usually deteriorate with time.

Cancer

Although low, there is a risk of developing ovarian cancer for those with endometriosis. Another kind of cancer called adenocarcinoma is associated with it too, though less prevalent.

Altogether, the risk of ovarian cancer is pretty low in women, it gets enhanced.

Causes

There are several reasons for endometriosis and the resulting abnormal cell growth. Possible causes include:

Retrograde Menstruation- This is a problem with menstrual flow. The blood flow passes into the fallopian tubes and the pelvic area instead of leaving the body in a natural way.

Embryonic cell growth: Sometimes, times, embryonic cells present in the abdomen and pelvis begin to convert into endometrial tissue.

Transformation of peritoneal cells: These are cells that form the inner lining of the abdomen. Hormone and immune conditions transform them into endometrial tissue.

Surgical scar: Movement of endometrial cells may occur during surgical procedures such as a section or hysterectomy.

Endometrial cell transport: Endometrial cells get transported to other portions of the body via the lymphatic system.

Heredity: There may be genetic factors involved. A history of endometriosis in close blood relatives puts you at risk.

Immune system disorder: Immune system disorder can also prevent the descent of extrauterine endometrial tissue growth.

Treatment

Early detection and diagnosis of endometriosis by skillful experts, followed by treatment results in better management and control.

Eva Hospital’s specialist team first conducts a pelvic exam, Ultrasound, Magnetic resonance imaging (MRI), and Laparoscopic diagnosis to identify the disorder. Dr. Shivani Bhutani says the treatment is aimed at relieving the patient from symptoms and preventing further consequences and risks.

Advanced treatment is available for endometriosis including:

Hormone therapy
Medical procedures such as Cauterization, Electrocoagulation, and endometrial Ablation
Electrosurgery and Laparoscopic surgery

See Your Doctor

Endometriosis is invariably misunderstood for other disorders that cause pelvic pain.

If you notice any signs and symptoms such as those discussed above, see your specialist doctor for a proper diagnosis and treatment.

Eva Hospital

How many times is IVF Possible

July 20, 2020March 30, 2024
by Eva Hospital

Pregnancy and parenting a baby are a dream for many. It becomes a fond dream when you are unable to conceive and get pregnant.

Thanks to modern science and technology, there are many new ways in which you can target to get pregnant and raise a baby.

The infertility drugs and various procedures of ART- Assisted Reproductive Techniques are a scientific blessing to achieve the state of pregnancy.

The most common ART procedures are intrauterine insemination (IUI), In-vitro fertilization (IVF), sperm or egg donation, and Intra-cytoplasmic

Sperm Injection (ICSI). However, the most commonly used procedure with a high success rate is In-vitro fertilization (IVF). Over 200000 babies were conceived with IVF successfully in the US alone in a year and you are no exception.

“Don’t give up!” advocates Dr. Shivani Bhutani, the best gynecologist of Punjab, from EVA Hospital, “With calculated actions and appropriate treatments, pregnancy can be achieved.”

How successful is IVF Treatment?

IVF is the process where the woman’s eggs are extracted and fertilized under controlled laboratory conditions and then the resulting embryo is transferred into the women’s uterus through the cervix.

If you have been trying to get pregnant in natural ways and haven’t been successful, with further investigation, the doctor will examine the causes of infertility. The most likely infertility causes are as follows:

Premature ovarian failure
Ovulation disorders
Hormonal imbalances
Endometriosis
Blocked Fallopian Tube
PCOS
Male infertility (in case of low sperm count, poor motility, and poor quality sperm)
Failed IUI treatment cycle
Unexplained infertility

Patients with any of the above lacunas have known to benefit from the cycles of IVF. Usually, patients around the age of 40 are known to have recommended IVF at the earliest.

IVF has been successful in all countries in the world. The Centre for Disease Control and Prevention (CDC) reports about 4 million births per year in the US. This implies that nearly 1% to 2% of births in the US are IVF babies. This clearly signifies that IVF and other ART techniques are the new buzzwords in combating infertility.

What Are the Factors That Affect the Success of Ivf?

There are a couple of factors affecting the success of IVF. Dr. Shivani Bhutani says, “The age of the woman is a predominant factor in the success of IVF.

Patients between the age brackets of 35-41 are more likely to get a successful IVF. There is a 4% success rate of patients who are over 42 years of age. Chances of success of IVF are higher at a younger age than older women with fewer eggs or poor quality eggs.

The fertility problem or the reason for infertility also determines how quickly the patient can get pregnant. Sometimes a large dosage of ovarian stimulation drugs is needed to be administered to patients with ovarian dysfunction. Male infertility problems and unexplained infertility may, however, take longer than anticipated.

Previous pregnancy, miscarriages, age of the donor in case of donor eggs and the duration of time over which the couple has been infertile have been a few other factors affecting the success of IVF.

Dr. Bhutani strongly says apart from medical abnormalities, the lifestyle of the patient plays an important role in determining the success of IVF.

Overweight or underweight women, women who smoke, women who do not exercise or eat healthy have higher chances of prolonged infertility.

How Many Cycles of Ivf Are Recommended?

Depending on the factors mentioned above and the expertise of the doctor, the numbers of cycles of IVF vary from individual to individual.

The cost of IVF hovers between Rs.90000 to Rs.3,00,000 depending on the city and the facilities at the clinic. Research has shown that about 70% of the patients are usually successful after 6 or more cycles of IVF if the woman is about 40 years in age.

Dr. Bhutani recommends patients stop using their own eggs after 3-4 failed IVF cycles. The woman may not be producing sufficient eggs or eggs of good quality, so the doctor usually advises them to go for the donor eggs.

Dr. Shivani is known among her patients to endorse optimism and positivity and not to lose hope in such despairing times. She understands that the patient spends a fortune in each cycle and also adds to the mental agony with each failed IVF cycle. So she always advises her patients with empathy and positivity.

“There is no guarantee with each cycle and the process and the results vary from person to person,” says the best gynecologist in Punjab, dr. Bhutani.

You may be lucky to get pregnant in the first IVF cycle, but it may not hold true for any other couple. Dr. Bhutani says an average couple may need tentatively six IVF cycles before entering the threshold of parenthood.

Final Words

Pregnancy is a dream for many couples and lets the best team on board turn your dream into reality. Analyze the facilities the clinic provides and study the expertise of the gynecologist you plan to approach.

With finesse in skills and expertise and the best modern facilities at EVA hospital, Dr. Shivani Bhutani is the most trusted name for IVF in Punjab. Seek the help of the best team at EVA and get your queries solved and let the aim of parenthood achieve a real shape.

IVF

Unexplained Fertility

November 20, 2019March 30, 2024
by Eva Hospital

[wbc_heading title=”Unexplained Fertility
“]

It is startling that globally about 10% of infertile couples have unexplained fertility. Approximately one in four fertility challenged couples are usually told that there is no explanation as to why they haven’t been able to conceive. This is an alarming proportion and the unexplained or idiopathic infertility, as it is usually called, can be a reason of frustration to the childless couples.

Good news is that Dr. Shivani Bhutani, Eva Hospital has made an indelible mark in treating patients with unexplained infertility. She often says to her patients that this is not the end of the world and shows them the magic doors to treating unexplained infertility.

Unexplained fertility or UI is an oft-repeated term where the doctors are unable to diagnose the type or reason for infertility. The couple has got all possible tests and even after negating the prominent causes of infertility, the reason or the cause for infertility in their case is yet unknown.

The couple has consistently been failing to get pregnant despite unprotected sexual intercourse or any visible symptoms of anomalies. Even the experts in the field are also clueless about idiopathic infertility.

Unexplained infertility is justified if it is proven that:

The female is ovulating regularly
The female ovarian reserves are good
The female fallopian tubes are open and healthy
The sperm count, sperm shape and sperm movement is normal
Hysteroscopy reveals there are no uterine fertility issues.

When the normal infertility causes are ruled out, the following symptoms may be checked to detect the possible causes of unexplained infertility:

Some unrelated health ailments have come to light in cases of infertility. It could be celiac disease, diabetes, undiagnosed thyroid disorder or autoimmune illness that could affect fertility.

There may be improper functioning of cilia or the way in which fimbria picks up the egg during ovulation.

While the eggs may be mature, follicle inside which the eggs mature doesn’t burst to release the eggs. As a result the egg remains trapped inside the unopened corpus luteum. This anomaly is called Luteinized Unruptured follicle (LUF).

Too much stress, incompatibility, relationship issues are inexplicable reasons which may affect fertility in couples. Dr. Bhutani recommends some fertility yoga exercises and a diet to alleviate stress and help patients get pregnant.

The doctor may take time in guessing that with normal sperm count, the male sperm is unable to fertilize the eggs. During the transition period, the semen may reach cervix from the cervical mucus. The condition is called hostile cervical mucus and technically difficult to comprehend.

Endometrium lining or uterine lining can be a major barrier for implanting the embryo. Endometrial cysts may cause fallopian tube blockage or disrupt ovulation. A series of ultrasound scans have to be carried out to detect this cause of infertility.

A series of tests may be conducted if you are under 35 years and have been trying for one year or if you are over 35 and have been trying for more than 6 months. Various tests like laparoscopy (to detect endometriosis), semen analysis, blood tests (to check hormone levels), ovulation tests, Hysterosalpingogram (HSG) for detailed fallopian tube analysis, FSH/AMH tests (to check for egg quality) and analysis of basic medical history may be conducted to detect any unexplained cause of infertility.

Dr. Shivani is very optimistic for her patients and thoroughly conducts all the tests to determine the root cause of the problem. The treatment for unexplained fertility is empiric as the cause is not restricted to a particular impairment.

Following are the possible treatments that can help in unexplained infertility:

Gonadotropins are the hormones which help in stimulating the reproductive organs of the body. Treatments such as IVF and IUI use gonadotropins as a part of treatment to stimulate the ovaries.

In this process sperms are placed directly inside the uterus and moved to the fallopian tubes so that fertilization takes place.

FSG and LH are the natural hormones which are used to make medicine. These help to stimulate the ovaries and produce more eggs. This increases the chances of getting pregnant.

Eva Hospital offers the best diagnosis of infertility and Dr. Shivani insists that unexplained infertility is the result of incessant stress or ‘trying too hard’. She counsels her patients in the best way and offers logical and result derived conclusions. For any difficulty in getting pregnant get in touch with Dr. Shivani for best results.

Knee Surgery

Endometriosis and IVF

October 24, 2019March 30, 2024
by Eva Hospital

Infertility has been a major cause of depression among women. The causes of infertility may be many but one of the most debatable and discussed cause is endometriosis.

Endometriosis has been one of the most challenging diseases for gynecologists in helping women conceive. This is typically a condition where endometrial tissue which lines the womb, starts to grow outside the womb. Not only does it cause immense pain, it is one of the leading causes of infertility. The causes of endometriosis remain oblivious yet sometimes endometriosis may be caused due to genetic predisposition, immune dysfunction or may be environmental changes.

The process of endometriosis means chronic inflammation, scar tissue, and adhesions. Women with endometriosis usually complain of pelvic pain, dysmenorrhea, dyspareunia, and the whole baggage of infertility. Endometrial deposits can cause disruption or obstruction in the fallopian tubes and can prevent fertilization. The endometrial deposits can lead to cysts and interfere with the process of ovulation.

Endometriosis has been reported to affect 6%-10% of the female population and nearly 25%-50% of infertile women suffer from this debilitating disease. What’s even more startling is that nearly 35%-50% of the women with endometriosis are infertile.

Endometriosis at all stages has been reported to affect female fertility potential. With inflammation and subsequent formation of adhesions in the pelvis, the anatomy of the pelvis is distorted and this directly affects the anatomical connection between ovaries and fallopian tubes.

Advanced stages of endometriosis may lead to tubal blockages and also the formation of hydrosalpinges. In fact even mild or minimal endometriosis adversely affects spontaneous conception.

With all said and done it can be noted that some laparoscopic surgery may be a good option for younger patients. However for patients beyond 37 years the situation is alarming.

IVF comes as a blessing to patients suffering from endometriosis and are relatively not so young in age. Various researches show that after 1-4 IVF treatments nearly 56.7% women even in stage 3 or 4 endometriosis were pregnant and a whopping 40.3% were successfully able to give birth.

IVF provides a ray of hope for patients suffering from endometriosis. Women diagnosed with endometriosis have shown favorable results for conception when treated with IVF or FET (Frozen Embryo Transfer). In IVF, women’s eggs are retrieved and fertilized with partner’s sperms under controlled conditions in a laboratory. The resulting embryos are transferred in the uterus and pregnancy is ensured. Since endometriosis does not interfere with the fetus development, the pregnancy is healthy and so are the babies after IVF.

Endometriosis is a hindrance to conception and pregnancy. However under the aegis of an experienced doctor/gynecologist, the stumbling block can be removed and pregnancy can be accomplished. Dr. Shivani Bhutani, Eva Hospital, Ludhiana is a renowned doctor specialist in infertility and has handled umpteen cases of couples suffering from endometriosis successfully. She says, “Endometriosis has a detrimental effect on pregnancy. However with proper diagnosis and IVF/FET treatment, the infertility clause can be ruled out.”

Let there be million memories with your baby as you get rid of the infertility due to endometriosis. For any query or diagnosis, seek an appointment with the best infertility expert of Punjab, Dr. Bhutani.

Eva Hospital

क्या 40+ वर्ष की महिलाएँ माँ बन सकती हैं?

October 2, 2019March 22, 2024
by Eva Hospital

एक महिला का प्राकृतिक मूल है-माँ बनना। कोख में बच्चा आने से लेकर बच्चे के पालन पोषण में ही एक औरत को तृप्ति मिलती है।

लेकिन आज के बदलते युग में महिलाएँ अपने व्यवसाय, काम एवं आर्थिक स्थिति को पूर्णतया एहमियत दे रहीं हैं।

इसके रहते 40 की उम्र तक गर्भवती न होना बहुत सामान्य हो गया है। पर 40 की उम्र तक पहुँचकर क्या माँ बनना आसान या मुमकिन है?

[wbc_heading title=”गर्भपात विलंब के कारण”]

आज के आधुनिक युग में आदमी और औरत दोनो ही पारिवारिक एवं वित्तीय स्थिति का संतुलन कंधे-से-कंधा मिलाकर कर रहें हैं। इसके चलते परिवार नियोजन का फैसला कुछ देर के एिल विलंबित कर दिया जाता है। निम्न कुछ कारण है जिनके रहते औरतों को गर्भपात को स्थगित करना पड़ता है-

आज महिला भी अपने केरियर या व्यवसाय को पूरी तरह आगे बढ़ाना चाहती है। केरियर में वृद्धि ही मुख्य कारण है कि वह छोटी उम्र में बच्चा नहीं कर रहीं।

यदि किसी की एकलौती संतान अथवा एकलौते पुत्र की आकस्मिक मृत्यु हो जाए और पति यदि 50 वर्ष के करीब और माँ यदि 40 वर्ष की हो तो दूसरा बच्चा प्लैन करना असंभव लगता है।

आज मीडिया में प्रजनन की सहुलयित, यानि ART (Assisted Reproductive Technologies) की प्रचार इतनी ज़्यादा है कि कुछ दंपति छोटी उम्र में बच्चा पैदा करने को एहमियत ही नहीं देते।

अगर किसी का तलाक हो और पुनः जीवन व्यतीत करने के लिए पुनर्विवाह के बारे में सोचे, 40 की उम्र तक पहुँचना बहुत आम बात है। ऐसे में बच्चे पैदा करना विलंबित होना मामूली बात है।
इन कारणों अथवा अन्य किसी भी कारणों के चलते विलंबित गर्भपात बांझपन की ओर चलता है। 40 की उम्र तक बांझपन एवं नपुनसकता की संभावना बढ़ जाती है।

औरतों में 40 वर्ष की उम्र तक प्रजनन झूमता में गिराव आने लगती है। इसके निम्नलिखित में से कोई भी कारण हो सकते हैं
1. कम मात्रा में या अच्छे फर्टटाइल अंडे न बनना।
2. ओव्यूलेशन न होना
3. कुछ अदंरूनी बीमारियाँ जैसे फाईब्राइड, एंडोमिट्रीओसिस अथवा
4. ओव्यूलेशन ठीक से न होना
5. पुरुषों में करीब 40 की उम्र के पश्चात शारीरिक बदलाव आते है जिससे उनका पिता बनना मुश्किल हो जाता है। यह न केवल शारीरिक यद्यपि मानसिक तनाव एवं डिप्रेशन का मुख्य कारण है।

यौन इच्छाओं में प्रवृत्ति टेस्टिकल में दर्द या सूजना, शुक्राणु उपजाऊ न होना इनफटिलिटी के लक्षण है। महिलाओं में मुख्यतः अनियमित मासिक धर्म, पीड़ायुक्त मासिक धर्म, मासिक धर्म न आना या हार्मोन असंतुलन 40 वर्ष के बाद आपत्तिजनक है एवं इनफर्टिलिटी के लक्षण हैं। आज के इस युग में उम्र एक ऐसा कारक है जो महिला एवं पुरुष दोनों में इंफर्टिलिटि का मुख्य कारण है।

आज के दौर में 40+ वर्ष की महिलाओं का इनफर्टिलिटी से जुड़े विषयों पर इलाज की मांग बढ़ रही है। यह न सिर्फ भारत में, यद्यपि पूरे विश्व में इनफर्टिलिटी से झूझती महिलाओं की संख्या बढ़ रही है।
डा. शिवानी भुटानी, ईवा अस्पताल, की मुख्य फर्टिलिटी डाक्टर है। इनका कहना है कि केवल 2008 से 2016 इनफर्टिलिटी के मरीज़ों में 3.23 प्रतिशत की बढ़ौतरी रही है। डा. शिवानी, पंजाब की श्रेष्ठ इनफर्टिलिटी जाँच डाक्अर कहती है कि इन 5 कारकों पर निर्धारित है इनफटिलिटी के इलाजः-

1. ओवरियन सिसर्व
2. सिमेन (वीर्य) प्रोफाइल
3. टयूबल धैर्य एवं पैल्विक पैैथोलाॅजी
4. लोगों की स्वीकार्यता एवं सामथ्र्य

(1) अंडोत्सर्ग अधिष्ठापन – ओवयुलेशन इंडक्शन
(2) अनुक्रमिक अस्थिमृदुता एवं प्रोजेस्टेरोन, यानि अनुक्रमिक एस्टेजेरोन एवं प्रोजेस्टेरोन
(3) आई यु आई (IUI)
(4) दत्तक ग्रहण अथवा अंडोपशन
(5) ART असिसटिड रिपरोडक्त्टिब टकनीक

1. (IUI) (पति अथवा दाता शुक्राणु से)
2. IVF/ICSI (आॅटोलागस अंडे या दाता अंडेे)
3. IVF (दाता भू्रप के साथ)
4. IVF (सरोगेसी)

एक जाँच के दौरान (2008 से सितंबर 2016 तक) यह नतीजे निर्धारित किए गए जिनसे यह पता चलता है कि 40+उम्र के लोगों में इनफर्टिलिटी मैेनेजमेंट से कितना फायदा हुआ। ओवयुलेशन इडंक्शन से लगभग 2.99 प्रतिशत वृद्धि, अनुक्रमिक एस्टेजेरोन एवं प्रोजेस्टेरोन (3.95%), IUI (1.57%), IVF (महिला के अपने अंडे से 7.25%, IVF दाता के अंडों से 20.65% दाता एम्बे्रयो से 12.77% और सरोगेसी से 14.28% इंफर्टिलिटी मैनेजमेंट में वृद्धि हुई है।

डा. शिवानी IVF तकनीक को सर्वोत्तम मानती हैं।
IVF(इन विट्रो फटिलाइजेशन) से गर्भधारण की संभावना 30%-45% होती है। सेहतमंद भू्रण का पता लगाने के लिए नई स्क्रीनिंग विधि का प्रयोग किया जा रहा है जिससे 60 फीसदी ज़्यादा सफलता प्राप्त हो रही है। आज उम्र की बाधा को तोड़ते हुई 40+वर्ष की महिलाएँ अब गर्भपात एवं माँ बनने का सपना पूरा कर रहीं हैं।