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In Vitro Fertilization (IVF) at Chawla Nursing Home IVF: Your Path to Parenthood

In Vitro Fertilization (IVF) has revolutionized the realm of reproductive medicine, offering hope and possibilities to couples struggling with infertility. As a leading IVF center in Jalandhar, Chawla Nursing Home IVF specializes in providing advanced fertility treatments tailored to individual needs. Let's delve into the intricate process of IVF, the success rates, and the associated costs at this premier fertility clinic.

Understanding IVF: Step-by-Step Guide

1. Ovarian Stimulation: The IVF process typically begins with the administration of fertility medications to stimulate the ovaries, encouraging the production of multiple eggs.
2. Monitoring and Follicle Growth: Regular monitoring through ultrasound and blood tests helps track the growth of follicles within the ovaries.
3. Egg Retrieval: Once the follicles reach optimal maturity, a minor surgical procedure is performed to retrieve the eggs from the ovaries.
4. Sperm Collection and Preparation: Meanwhile, the male partner provides a sperm sample, which undergoes preparation in the laboratory to isolate the healthiest and most active sperm.
5. Fertilization: In the laboratory, the retrieved eggs are combined with sperm in a controlled environment, facilitating fertilization. This process can occur through conventional IVF or Intracytoplasmic Sperm Injection (ICSI), depending on the specific circumstances.
6. Embryo Cultivation: Fertilized eggs develop into embryos over several days, during which they are carefully monitored for optimal growth and quality.
7. Embryo Transfer: One or more viable embryos are selected for transfer into the woman's uterus, typically performed 3-5 days after egg retrieval.
8. Implantation and Pregnancy: Following embryo transfer, the hopeful wait begins as the embryo implants into the uterine lining. Pregnancy tests are conducted to confirm successful implantation and the onset of pregnancy.

Success Rates and Realistic Expectations

Chawla Nursing Home IVF boasts a remarkable track record of success, backed by cutting-edge technology and a team of experienced fertility experts. While individual success rates may vary depending on factors such as age, reproductive health, AMH levels, endometrial status, and underlying conditions, the clinic consistently achieves high success rates, with cumulative success rate of 80%, offering renewed hope to countless couples yearning for parenthood.

Cost Considerations

The cost of IVF treatment at Chawla Nursing Home IVF is competitively priced, ensuring accessibility without compromising on quality or personalized care. The clinic offers transparent pricing structures and may provide financing options or insurance coverage to alleviate financial burdens for patients.

Embarking on the journey of IVF at Chawla Nursing Home IVF represents a beacon of hope for couples navigating the challenges of infertility. With a comprehensive range of fertility treatments, state-of-the-art facilities, and a compassionate team of fertility experts, the clinic stands as a beacon of hope for couples in Jalandhar and beyond. Discover the transformative power of IVF at Chawla Nursing Home IVF, where dreams of parenthood become a reality. Call 0181 2224374, 5072323, 7307103001, 9023703001 to fix an appointment.

When a woman undergoes in vitro fertilization (IVF), she is usually given medicines to stimulate her ovaries to develop more than one egg at a time. Typically, all the eggs that are collected are fertilized with sperm. The fertilized eggs are monitored to see if any develop into embryos. One or more embryos are then transferred back to her uterus.

What is elective single-embryo transfer or eSET?

Elective single-embryo transfer (eSET) is when a woman undergoing IVF chooses to have a single embryo transferred when multiple embryos are available.

Why only a single embryo?

The primary goal of eSET is to decrease the multiple pregnancy rate associated with IVF. In the United States, approximately 30% of IVF pregnancies are twin pregnancy, and another 3% to 4% result in a triplet or higher order (4 or more implanted embryos) pregnancy. Transferring more than one embryo increases the chance of having a multiple pregnancy (twins, triplets, etc.).

Why would I want to avoid having a multiple pregnancy?

Multiple pregnancy is more dangerous for the mother and the fetuses. It often leads to premature delivery. Babies born prematurely are at risk for serious shortterm and long-term health problems such as cerebral palsy, long-term lung and gastrointestinal problems, and even death in the first few months of life. For more information about the risks to mother and babies, please see the ASRM booklet titled Multiple pregnancy and birth: twins, triplets, and high-order multiples. 

Are there other ways to prevent a multiple pregnancy with IVF?

Early in pregnancy, the number of fetuses can be decreased in order to increase the chances of having a baby or babies delivered as close to full-term as possible. The procedure is called multifetal pregnancy reduction. This procedure may not be an acceptable alternative for many couples and there are risks, including the possibility of losing the entire pregnancy. eSET reduces the chance you will have a multiple pregnancy and need to consider this procedure.

Am I a good candidate for eSET?

Only women with the best prognosis for a pregnancy should be considered for eSET. Many factors contribute to a successful outcome, and eSET is usually recommended for women who:

• are younger than 35 years 
• are undergoing their first assisted reproductive technology (ART) cycle
• have had a successful pregnancy in a previous ART cycle
• have a relatively large number of high-quality embryos
• have embryos available for cryopreservation (freezing to use in a later cycle)

How is the best embryo chosen?

To pick the highest-quality embryo to transfer, the laboratory grades each embryo based on its appearance. This assessment includes looking at the number and size of the cells, the rate of development, and other factors. Different grading systems are used and may vary from clinic to clinic. Systems also differ depending on whether the embryo is being evaluated in the cleavage or the blastocyst stage. No method can reliably predict which embryo will produce live offspring. 

Some programs are investigating new techniques for finding the best embryo, such as testing to see if an embryo is genetically normal. It is not yet known if these methods will help increase pregnancy rates.

How successful is eSET?

In women who are considered good candidates, eSET has shown excellent pregnancy rates. There is a small decrease in overall pregnancy rates after eSET because it is sometimes offered to women who are not good candidates for eSET (for instance, patients who have not succeeded in getting pregnant with IVF in the past and/or patients who are older than 35 years). However, freezing extra embryos and transferring in later cycles can give a comparable pregnancy rate without the risks associated with twinning. The benefit in choosing eSET is a dramatic drop in multiple pregnancy rates—overall, twin rates after eSET are around 1%-2%.

Whether to use eSET is a decision each patient should make after talking with her reproductive health professional. The patient should discuss her concerns and ask for clinic-specific success rates with eSET to assist in the final decision making.

The prospect of giving birth to multiple children at one time can feel overwhelming. This option provides you with a manageable alternative.

CHOOSING THE BEST EMBRYO

Many factors are involved in choosing the best embryo for implantation. Our lab performs an assessment on the embryos in order to determine the one with the highest quality. Among the characteristics considered are the number and size of the cells, the rate of development and other factors that identify embryos strong enough to survive.

After assessing the embryos, the lab director determines which embryo is the highest quality. Keep in mind there is no reliable way to determine which embryo will produce a fetus; however, eSET does allow us to determine which one has the best chance of growing.

WHY AVOID MULTIPLES?

There are health risks involved with the development of multiple fetuses in one pregnancy. These risks can affect the mother and the fetuses. Such a pregnancy often results in premature delivery. Babies who are born prematurely have an increased risk of serious long and short-term health problems. These may include:

- low birth weight

- cerebral palsy

- long-term lung problems

- long-term gastrointestinal problems

- other difficulties

Mothers giving birth to several babies at one time may experience high blood pressure, high blood sugar and gastrointestinal difficulties.

Get more information about eSet and the other fertility options available at Chawla Nursing Home and Maternity Hospital when you Schedule an appointment with one of our fertility doctors.

Recurrent miscarriage, defined as three or more consecutive pregnancy losses before 20 weeks of gestation, can be a challenging and emotionally distressing experience. The treatment of recurrent miscarriage involves identifying and addressing underlying causes, providing supportive care, and sometimes considering assisted reproductive technologies. It's important to note that the specific approach to treatment may vary based on individual circumstances, and consulting with a healthcare professional is essential for personalized advice.

Here are some common aspects of recurrent miscarriage treatment:

1. Investigation and Diagnosis:

   • Comprehensive medical and genetic testing is often conducted to identify potential causes. This may include tests for hormonal imbalances, autoimmune disorders, blood clotting disorders, chromosomal abnormalities, and structural abnormalities of the uterus.

2. Supportive Care:

   • Emotional support is crucial during this challenging time. Counseling, support groups, and therapy can help individuals and couples cope with the emotional toll of recurrent miscarriage.

3. Lifestyle and Environmental Factors:

   • Modifying lifestyle factors such as smoking, alcohol consumption, and drug use can be important. Avoiding exposure to environmental toxins and maintaining a healthy lifestyle can contribute to overall reproductive health.

4. Hormonal Support:

   • Hormonal imbalances, such as thyroid disorders or polycystic ovary syndrome (PCOS), may be addressed through medication to regulate hormone levels and improve fertility.

5. Anticoagulant Therapy:

   • If blood clotting disorders are identified, anticoagulant medications may be prescribed to improve blood flow to the uterus and reduce the risk of miscarriage.

6. Immune System Modulation:

   • In cases where autoimmune factors are suspected, immune system modulation may be considered to prevent the immune system from attacking the developing embryo.

7. Surgical Interventions:

   • Surgical procedures may be recommended to address structural abnormalities of the uterus, such as fibroids, polyps, or a septum.

8. Genetic Counseling:

   • Genetic counseling may be recommended to assess the risk of chromosomal abnormalities and provide guidance on family planning.

9. Assisted Reproductive Technologies (ART):

   • In some cases, couples may consider assisted reproductive technologies such as in vitro fertilization (IVF) with pre-implantation genetic testing to improve the chances of a successful pregnancy.

It's crucial for individuals and couples experiencing recurrent miscarriage to work closely with a reproductive endocrinologist or a healthcare team specializing in fertility and recurrent pregnancy loss. They can provide a thorough evaluation, personalized treatment plan, and ongoing support throughout the process.

Egg freezing, also known as mature oocyte cryopreservation, is a method used to save women's ability to get pregnant in the future.

Eggs harvested from your ovaries are frozen unfertilized and stored for later use. A frozen egg can be thawed, combined with sperm in a lab and implanted in your uterus (in vitro fertilization)IVF.

Your doctor can help you understand how egg freezing works, the potential risks and whether this method of fertility preservation is right for you based on your needs and reproductive history.

Why it's done

Egg freezing might be an option if you're not ready to become pregnant now but want to try to make sure you can get pregnant later.

Unlike with fertilized egg freezing (embryo cryopreservation), egg freezing doesn't require sperm because the eggs aren't fertilized before they're frozen. Just as with embryo freezing, however, you'll need to use fertility drugs to make you ovulate so that you'll produce multiple eggs for retrieval.

You might consider egg freezing if:

- You have a condition or circumstance that can affect your fertility. These might include sickle cell anemia, autoimmune diseases such as lupus, and gender diversity, such as being transgender.

- You need treatment for cancer or another illness that can affect your ability to get pregnant. Certain medical treatments — such as radiation or chemotherapy — can harm your fertility. Egg freezing before treatment might enable you to have biological children later.

- You're undergoing in vitro fertilization. When undergoing in vitro fertilization, some people prefer egg freezing to embryo freezing for religious or ethical reasons.

- You wish to preserve younger eggs now for future use. Freezing eggs at a younger age might help you get pregnant when you're ready.

You can use your frozen eggs to try to conceive a child with sperm from a partner or a sperm donor. A donor can be known or anonymous. The embryo can also be implanted in the uterus of another person to carry the pregnancy (gestational carrier).

There are several reasons why delaying pregnancy may be the best option for you. You may want to freeze your eggs if you are a woman who:

- would like to preserve your eggs when they are at their highest quality

- is single or married, with or without a partner and not ready to have children at this time

- will be receiving cancer treatment with radiation or chemotherapy

- needs to have her ovaries removed

- has a genetic history of early menopause, endometriosis or premature ovarian failure

Egg preservation is a good option for the woman who wants to be in charge of her fertility and determine for herself when it is a good time to start a family.

HOW IT WORKS

The egg preservation procedure requires the patient to take daily injections for 8-10 days. You will be monitored in our center every 2-3 days. When your eggs are ready for retrieval, they are collected and prepared for freezing. We use the most advanced vitrification technique, and the eggs are flash-frozen and stored right here at Chawla Fertility. When you are ready, you may return to our office to use your eggs when and how you choose.

EGG FREEZING WITH IN VITRO MATURATION (IVM)

Chawla Nursing Home and Maternity Hospital is the only fertility center in the Jalandhar, Punjab to use our unique IVM technologies as part of the egg freezing process. Patients who choose to use less medication and have fewer monitoring visits choose this procedure. In contrast to the 8-10 days of high dose hormonal medications, with IVM a lower dose is used for 2-3 days, after which the eggs are retrieved. The immature eggs go through the maturation process in the laboratory. Those eggs that achieve maturity are frozen in a similar manner as those retrieved in a traditional egg freezing cycle.

IVM is for the woman who does not want to take large amounts of hormones or who has been diagnosed with hormone-sensitive cancer, such as breast cancer. It is also a good option for women who have been diagnosed with polycystic ovarian syndrome(PCOS) or have a high risk of ovarian hyperstimulation syndrome.

You can take control of your fertility options with Chawla Nursing Home’s egg freezing or egg freezing with IVM. Learn more about the process by schedule a consultation appointment with us.

If you have localized breast cancer, your healthcare team will almost always recommend surgery to remove it. Surgery is considered the primary treatment for breast cancer when it's technically possible to remove the affected tissue. (It's not an effective treatment for metastatic breast cancer — when the cancer has already spread to other parts of your body.)

Sometimes breast cancer surgery removes an individual tumor from your breast (lumpectomy), and other times it may be necessary to remove your entire breast (mastectomy) to remove the cancer. Breast surgery for cancer is primarily a treatment, but it can also be diagnostic and even cosmetic. Sometimes surgery is exploratory to look for signs of cancer spreading. Sometimes it involves reconstructing your breast after a mastectomy.

The type of surgery that your healthcare team recommends for you will depend on many individual factors, including the type of cancer you have, how advanced it is, your general health and your personal preferences. Depending on your condition, surgery may be only a piece of your overall treatment plan, or it may be the only treatment you need.

What are the different types of surgeries for breast cancer?

The two types of surgery used to treat breast cancer are mastectomy and lumpectomy. Additional surgeries for breast cancer may include lymph node dissection (lymphadenectomy) and breast reconstruction surgery.

Mastectomy

Mastectomy, or breast removal surgery, is the most common surgery for breast cancer. That’s because mastectomy treats both late-stage and early-stage breast cancers. In addition, some people with a high risk of developing breast cancer in the future choose prophylactic mastectomy as a preventative measure.

Types of mastectomy procedures include:

- Total mastectomy: Removal of your entire breast, sparing your chest muscle beneath.

- Double mastectomy: Removal of both breasts. This may be necessary if the cancer has already spread to both breasts, or it may be a preventative measure.

- Skin-sparing or nipple-sparing mastectomy: Removal of all your breast tissue, but sparing your skin and, if possible, your nipple, to use to reconstruct your breast.

- Modified radical mastectomy: Removal of your breast tissue and your underarm lymph nodes. Lymph nodes are often the first place that breast cancer spreads to.

- Radical mastectomy: Removal of your breasts, underarm lymph nodes and chest muscles. This is a rare surgery, only necessary when breast cancer has infiltrated your chest muscles.

Lumpectomy

Lumpectomy, also called breast-conserving surgery, removes only part of your breast tissue. This is an alternative option for treating earlier-stage breast cancer. When the tumour is relatively small and hasn’t spread yet, you can have surgery just to remove the “lump” — the tumour itself. A lumpectomy also removes a margin of the surrounding tissue, just to make sure there aren’t any stray cancer cells left in your breast.

The benefit of lumpectomy is that it allows you to keep most of your breasts. But to prevent breast cancer from returning, your healthcare provider will most likely recommend radiation therapy after the surgery. Having a total mastectomy instead is often a way of avoiding radiation therapy. But for people who have the option, lumpectomy with radiation therapy is equally effective as total mastectomy in treating early-stage breast cancer.

Types of lumpectomy procedures include:

- Excisional biopsy: This is a procedure to remove a tumor for biopsy. Analyzing the tumor in a lab can help determine if the tumor is cancerous (malignant).

- Wide local excision: Surgery to remove a cancerous tumour and a margin of tissue around it. The marginal tissue will be tested afterwards to make sure it’s cancer-free.

- Quadrantectomy: A segmental mastectomy that removes about a quarter of your breast, including your duct-lobular system. Recommended when the tumour shows ductal spread.

- Re-excision lumpectomy: A procedure that follows the original excision of the tumour and the margin of tissue around it. When the marginal tissue tests positive for cancer cells, your surgeon will reopen the surgical site to remove an additional margin of tissue until the tissue comes back cancer-free.

Lymph node dissection

Your lymph system is often the first place cancer spreads, and cancer in your lymph nodes is a warning sign that it may be spreading beyond your breast. To find out, your surgeon may remove and analyze one or several of the lymph nodes under your arm next to your affected breast. This is where breast cancer cells would be most likely to drain.

Lymph node procedures include:

- Sentinel lymph node biopsy: This is an investigative procedure to find out if cancer has spread to your lymph system. The sentinel lymph node is a good indicator because it's the first node that filters fluid draining away from the affected breast. Your surgeon will often perform a sentinel node biopsy during the operation to remove the original tumour from your breast — and sometimes before. They'll remove the sentinel node and analyze it for cancer cells.

- Axillary lymph node dissection: If the sentinel node biopsy tests positive for cancer, or if your surgeon has other reason to believe you have pervasive cancer in your lymph nodes, they may want to remove a larger portion of lymph nodes to analyze. In an axillary lymph node dissection, your surgeon removes a pad of fatty tissue containing a group of axillary lymph nodes (the lymph nodes under your arm). They'll carefully search through the tissue for signs of cancer.

Reconstructive breast surgery

If you're having some or all of your breast or breasts removed to treat breast cancer, you may be interested in reconstructive surgery to restore your breast shape. Surgeons can often rebuild the breast with plastic surgery techniques immediately following your lumpectomy or mastectomy. They can also perform a separate surgery at a later time, such as after you've finished radiation therapy or chemotherapy treatment and your tissues have had time to recover.

Regardless of whether you have immediate or delayed reconstruction surgery, you may need an additional follow-up surgery to perfect your results. Follow-up surgeries may adjust the size balance between your breasts, for example, or add a reconstructed nipple. Breast reconstruction can use a mix of different methods and can happen in stages. You and your surgeon will determine the right methods and timing based on your condition and preferences.

Breast reconstruction methods include:

- Implant reconstruction: A breast implant replaces the tissue that was removed from your breast to restore its shape and volume. The implant is a silicone shell that’s filled with either saline or silicone gel. The surgeon places it over or under your muscle and covers it with your skin — either your original breast skin or a skin graft from another part of your body.

- Autologous or “flap” reconstruction: This method takes tissue from another part of your body to reconstruct your breast. Skin, fat and sometimes muscle from areas such as your belly or buttocks tend to better resemble breast tissue in look and feel. Sometimes surgeons use a combination of flap and implant reconstruction for more realistic results.

- Nipple reconstruction: If you had a nipple-sparing mastectomy or lumpectomy, your surgeon preserved your nipple to use in the reconstruction of your breast. If they weren’t able to preserve your original nipple, they can construct a new one from a skin graft taken from another part of your body. This may be done in a follow-up surgery after breast reconstruction.

What happens before breast cancer surgery?

You'll consult with your healthcare team to decide the types of surgery best for you. Your health condition will determine your treatment options, and your personal preferences will help shape them. If you're interested in breast reconstruction during or after breast cancer surgery, you'll want to discuss these options in advance. Your overall cancer treatment plan may affect the timing and methods that'll work best for you.

What happens during breast cancer surgery?

Your breast cancer surgery will be tailored to your individual needs based on your discussions with your healthcare team. It may involve removing a portion of your breast, all of your breasts or both of them. It may include a sentinel lymph node biopsy (if you haven’t had one already) or the removal of several or all of your underarm (axillary) lymph nodes if cancer has already been found there.

If you’ve opted for breast reconstruction, your surgeon may begin or complete your reconstruction during the same surgery. This may involve additional wounds to your body — for example, if your surgeon needs to take tissue from another place on your body to reconstruct your breast. Alternatively, you may choose to delay breast reconstruction until after you’ve completed your cancer treatment.

How long is the surgery for breast cancer?

This will depend on how extensive it is. In general, a simple lumpectomy with or without sentinel node biopsy can usually be done in an hour. You can usually go home on the same day. On the other hand, a mastectomy with axillary lymph node dissection or a flap reconstruction at the same time may take up to three hours in surgery. You may have to stay in the hospital for one or more nights afterwards. Some people are candidates for having a mastectomy and going home the same day, depending on their general health and the extent of surgery.

How long is the recovery from breast cancer surgery?

You may be sore and have limited movement in your chest and arms for a few weeks afterwards. You’ll have painkillers to take home with you. You’ll also be given arm and shoulder exercises to practice daily. These are important to prevent stiffness. You may feel tired for a while. It can take several weeks to regain your former energy levels. You may need someone to help you around the house. Most people can resume their normal activities within about a month.

What happens after breast cancer surgery?

While you’re recovering from your surgery, your healthcare team will likely be working on lymph node biopsy results. They’ll want to make sure they’ve removed all of the cancer cells in your body. When they have their results, they’ll discuss these and your next steps with you. You might need additional follow-up surgery, radiation therapy or chemotherapy as part of your treatment plan. If you’ve completed your cancer treatment, you may now be ready to begin or complete your breast reconstruction.

When you come in for a consultation with one of Chawla Nursing Home’s doctors, you will be given information about all your options. Schedule your appointment today.

Recurrent miscarriage occurs in a small number of pregnancies and can be incredibly traumatic. So what are the causes, what treatments are available, and where can you go for support? We asked a fertility expert.

Miscarriage can be devastating, but sadly, it’s not uncommon — one in eight pregnancies will end this way. 

One lesser-known type of pregnancy loss is recurrent miscarriage. This is when a person experiences two or more miscarriages in a row, and although exact numbers aren’t known, it’s thought to affect between 1% and 2% of women who get pregnant. 

The effects of one miscarriage can be hard enough to deal with, but experiencing multiple pregnancy losses can be incredibly traumatic. Especially as we know that the causes of recurrent miscarriage are often not entirely clear (more on that below), which makes testing and identifying treatments tricky, too. Don’t lose hope, though, because studies show lots of people go on to have a family after recurrent miscarriages. 

We spoke to obstetricians, gynecologists, reproductive endocrinologists, and infertility specialists, to answer all of our questions about recurrent pregnancy loss. We also share how you can get support if you’ve experienced multiple miscarriages. 

What is recurrent miscarriage? How common is recurrent pregnancy loss?

Sometimes understanding more about what you’re experiencing can help you feel less alone. We now know that recurrent pregnancy loss affects between 1% and 2% of pregnant women. So while recurrent miscarriage is rare, it’s not unusual. But what exactly is it?

The American Society for Reproductive Medicine (ASRM) defines it as “the spontaneous loss of two or more pregnancies,” usually before the 20th week of pregnancy. 

The ASRM also notes that recurrent miscarriage is “distinct from infertility,” so it doesn’t necessarily mean you have fertility issues if you’ve experienced multiple miscarriages, and you’re highly likely to be able to try again, should you wish to. They also note that each pregnancy loss is different, which means further assessment of the couple or person experiencing the pregnancy could be necessary. That’s why it’s so important to reach out to your doctor or healthcare professional for tests, advice, and support.

Causes of recurrent miscarriage: What you should know

Understandably, many people look for answers after experiencing recurrent pregnancy loss, but unfortunately, the cause is unknown in around half of all cases. “Typically, 50% to 75% of the time, no clear cause is identified,” explains Dr Chawla.

Doctors believe there are potentially multiple factors that can affect your chances of having recurrent miscarriages, but — despite lots of studies and reviews — more research is needed to work out exactly what all of those causes are.

However, of those we do know, what’s the most common reason for recurrent miscarriage? According to Our Doctor, “The most common cause by far is embryos having too many or too few chromosomes [DNA molecules that are the building blocks of the human body]. This can happen randomly but is more common as we get older. Since 95% of miscarriages are from having too many or too few chromosomes, doctors need to determine if a loss was just ‘bad luck’ or if it was from something different.”

That means that if you’ve experienced two or more miscarriages in a row, you should book an appointment with your doctor or OB-GYN for a checkup. 

Some other potential recurrent miscarriage causes include:

• Translocation (where a segment from one chromosome sticks — or becomes “heritably linked” — to another chromosome)
• An unusually shaped uterus like a septate uterus (where the uterus is divided into two parts by a membrane or thin sheet of cells)
• Hormonal illnesses like diabetes or thyroid disease
• Antibodies created by the immune system that could attack the fetus
• Low hormone levels, sometimes caused by increased prolactin levels, which affect the function of the ovaries

Recurrent miscarriage testing: List of blood tests for recurrent miscarriage

If you’ve had multiple miscarriages, then you’ll probably want your doctor to run some tests or dig deeper into your medical history in the hope of finding some answers. So what should you ask for?

The ASRM recommends testing for karyotypes in both partners after recurrent miscarriages. This is where the parents (and sometimes the fetus’) chromosomes are screened for any genetic abnormalities that could be causing the problem.

You could also request an ultrasound to check the structure of your uterus or to find out if you have a weakened cervix. Unfortunately, this diagnosis is often only made retrospectively after a miscarriage in the second trimester.

Recurrent miscarriage treatment

Please know that there is treatment available for recurrent miscarriage, especially if a cause can be found, so your first step should be an appointment with your healthcare provider. They’ll talk you through the testing options above (plus any others they recommend), run through your medical history, and then pull together a plan of action.

Depending on what's happening for you, fertility treatment could be an option. “Often, if the cause is poor egg quality, in vitro fertilization (IVF) with preimplantation genetic testing is the only way to decrease loss from aneuploidy (extra or missing chromosomes),” Dr Chawla says.

within five years, so there is hope"

How to prevent recurrent miscarriage

Unfortunately, as Dr Chawla explains, recurrent miscarriage “can be very personalized, and there is the only treatment to reduce the risk but not prevent it completely.”

However, it can help to remember that lots of people go on to start a family after experiencing recurrent pregnancy loss. A 2006 trial on couples who had experienced three or more miscarriages found that over 60% had a baby within five years, so there are plenty of reasons to continue trying if that’s what you want.

“I would recommend that patients get evaluated by a doctor who specializes in recurrent pregnancy loss; most reproductive endocrinologists are trained in this,” Dr Chawla adds.

Those seeking support for recurrent miscarriage could also book an appointment with a clinical geneticist (gene expert). They’ll be able to explain your chances of a successful pregnancy in the future and whether there are any fertility treatments, such as IVF, that you could try. This type of advice is known as genetic counseling.

The Chawla IVF medical team at Chawla Nursing Home understands the risks and rewards that come with conventional IVF, and we will help you through every step of the way. Schedule a consultation appointment with one of our doctors at our Jalandhar location to find out if Recurrent Miscarriage Treatment is your best option for pregnancy.

Intracytoplasmic Sperm Injection (ICSI): BEST IVF ICSI CENTRE IN JALANDHAR 

Are you and your partner struggling with fertility issues? Have you heard about Intracytoplasmic Sperm Injection (ICSI) but aren't sure what it entails? Let's dive into what ICSI is all about and how it differs from traditional In Vitro Fertilization (IVF).Lets share the information from the best fertility clinic, best ivf and icsi centre at jalandhar

What is ICSI?

Intracytoplasmic Sperm Injection (ICSI) is an advanced assisted reproductive technology (ART) procedure used to treat infertility in couples where the male partner has low sperm count or poor sperm quality. During ICSI, a single sperm is directly injected into the cytoplasm of a mature egg to facilitate fertilization.

How is ICSI different from IVF?

While both ICSI and IVF are ART procedures used to address infertility, they differ in the way fertilization occurs. In traditional IVF, sperm and eggs are combined in a laboratory dish, allowing fertilization to occur naturally. However, in cases of severe male infertility or previous IVF failures, ICSI provides a more direct approach by manually injecting a sperm into the egg.

What happens prior to ICSI?

Before undergoing ICSI, both partners will undergo a series of tests to assess their fertility potential. For the male partner, a semen analysis will be performed to evaluate sperm count, motility, and morphology. Meanwhile, the female partner will undergo ovarian reserve testing and a pelvic ultrasound to assess her egg quality and reproductive health.

Steps of ICSI:

1. Ovarian Stimulation: The female partner will undergo ovarian stimulation using fertility medications to produce multiple mature eggs.
2. Egg Retrieval: Once the eggs are mature, they are retrieved from the ovaries using a minimally invasive procedure called transvaginal ultrasound-guided egg retrieval.
3. Sperm Collection: On the same day as egg retrieval, the male partner provides a semen sample, which is processed in the laboratory to isolate healthy sperm.
4. Sperm Injection: Using a specialized microscope and micromanipulation tools, a single sperm is carefully selected and injected into the center of each mature egg.
5. Fertilization Check: After injection, the eggs are monitored to ensure fertilization occurs. Successful fertilized eggs, now called embryos, are then cultured in the laboratory for several days.
6. Embryo Transfer: Once the embryos reach the appropriate stage of development, one or more are selected for transfer into the woman's uterus, with the goal of achieving pregnancy.

Fertilization Rate:

ICSI has been shown to have high success rates, especially in cases of severe male infertility. The fertilization rate with ICSI typically ranges from 50% to 80%, depending on various factors such as the quality of the sperm and eggs, the expertise of the laboratory staff, and the overall health of the couple.

ICSI offers hope to couples facing male infertility issues by providing a direct solution to fertilization problems. By understanding the process and its success rates, couples can make informed decisions about their fertility treatment options. If you're considering ICSI or have any questions, don't hesitate to reach out to our team at Chawla Nursing Home Jalandhar Punjab for personalized guidance and support you can Call 0181 5072323, 2224374 or 9023703001, 7307103001 for Appointment.

Laparoscopic surgery is a minimally invasive surgical technique used in the abdominal and pelvic areas. It uses the aid of a laparoscope — a thin, telescopic rod with a camera at the end — to see inside your body without opening it up. Instead of the 6- to 12-inch cut necessary for open abdominal surgery, laparoscopic surgery uses two to four small incisions of half an inch or less. One is for the camera, and the others are for the surgical instruments. Minimally invasive surgery may also be called “keyhole surgery,” referring to these small incisions.

A laparoscopy is a kind of exploratory surgery using a laparoscope. The surgeon explores your abdominal and pelvic cavities through one or two keyhole incisions. This is the less-invasive alternative to a laparotomy. It’s usually done for diagnostic purposes, to look for problems that imaging tests haven’t been able to identify. The surgeon may take tissue samples for biopsy during the exam. They may also be able to treat minor problems during the laparoscopy — for example, remove growths or blockages that they find during the exam.

What surgeries are performed laparoscopically?

Many common surgeries can be performed laparoscopically today. Whether you're a candidate for laparoscopic surgery will depend on how complicated your condition is. Some complicated conditions may require open surgery to manage. However, laparoscopic surgery is becoming the preferred default method for a growing list of common operations, due to its cost-saving benefits and improved patient outcomes. The list includes:

- Cyst, fibroid, stone, and polyp removals.

- Small tumour removals.

- Biopsies.

- Tubal ligation and reversal.

- Ectopic pregnancy removal.

- Endometriosis surgery.

- Urethral and vaginal reconstruction surgery.

- Orchiopexy (testicle correction surgery).

- Rectopexy (rectal prolapse repair).

- Hernia repair surgery.

- Esophageal anti-reflux surgery (fundoplication).

- Gastric bypass surgery.

- Cholecystectomy (gallbladder removal) for gallstones.

- Appendectomy (appendix removal) for appendicitis.

- Colectomy (bowel resection surgery).

- Abdominoperineal resection (rectum removal).

- Cystectomy (bladder removal).

- Prostatectomy (prostate removal).

- Adrenalectomy (adrenal gland removal).

- Nephrectomy (kidney removal).

- Splenectomy (spleen removal).

- Radical nephroureterectomy (for transitional cell cancer).

- Gastrectomy (stomach removal).

Is laparoscopic surgery major surgery?

The terms “major surgery” and “minor surgery” don’t have specific established definitions. Healthcare providers use them variably to describe how complicated and/or dangerous they feel one operation is compared to another and to set expectations for the recovery period. If you ask them about laparoscopic surgery, you may get different answers depending on what kind of operation you’re talking about and how extensive it is.

On one hand, laparoscopic surgery is considered minimally invasive because the incisions are small and the organs aren’t exposed. Also, the kinds of operations that can be done laparoscopically tend to be less complicated ones. Surgeries that turn out to be more complicated than expected may not be able to be safely completed using the laparoscopic method and may have to convert to open surgery, which is major surgery.

On the other hand, laparoscopic surgeries include organ removals, and if you feel like any removal of an organ must be major surgery, you’re not wrong. These kinds of operations carry certain inherent risks no matter how they're done such as risks of bleeding, damage to nearby organs, internal scarring and so on. But they are also common and have high success rates, and with the laparoscopic method, the recovery times will be shorter and easier.

How safe is laparoscopic surgery?

It's at least as safe as open surgery, and some risks are reduced. Smaller wounds reduce the risk of infection, blood loss and postoperative complications such as wound separation and incisional hernia. Laparoscopic surgery minimizes the direct contact between the surgeon and patient, which reduces the risk of any transmission of germs between the two. It also minimizes post-operative recovery time, which reduces the risks of prolonged bed rest, such as blood clots.

How should I prepare for my laparoscopic surgery?

Since most laparoscopic surgeries are performed under general anesthesia, you’ll need to prepare for this in a few ways. You’ll need to avoid eating or drinking for about eight hours before surgery. This is to prevent nausea from the anaesthesia. You should also arrange for someone to drive you home after the procedure. You’ll likely be able to go home the same day, but you may still be disoriented from the anesthesia. Your doctor may give you more specific instructions regarding your medications.

What are the advantages of this procedure?

- Less trauma to the abdominal wall.

- Less blood loss.

- Reduced risk of haemorrhage.

- Smaller scars.

- Reduced risk of wound infection.

- Shorter hospital stay.

- Less time in the hospital means less expense.

- Faster recovery time and return to activities.

- Less wound pain during healing.

- Less pain medication necessary.

When you come in for a consultation with one of Chawla Nursing Home’s doctors, you will be given information about all your options. Schedule your appointment today.

Hysteroscopy is a procedure that allows a surgeon to look inside of your uterus in order to diagnose and treat the causes of abnormal bleeding. Hysteroscopy is done using a hysteroscope, a thin, lighted tube that’s inserted into your vagina to examine your cervix and the inside of your uterus. An operative hysteroscopy can be used to remove polyps, fibroids and adhesions.

What is a hysteroscopy?

Hysteroscopy is primarily used to diagnose and treat the causes of abnormal uterine bleeding. The procedure allows your surgeon to look inside of your uterus with a tool called a hysteroscope. A hysteroscope is a thin, lighted tube that a surgeon inserts through your vagina to examine your cervix and the inside of your uterus.

Hysteroscopy can be a part of the diagnostic process, as well as the treatment process.

What is diagnostic hysteroscopy?

Diagnostic hysteroscopy identifies structural irregularities in your uterus that may be causing abnormal bleeding. Hysteroscopy may also be used to confirm the results of other tests, such as an ultrasound or hysterosalpingography (HSG). HSG is an X-ray dye test used to check whether your fallopian tubes are blocked. Blocked fallopian tubes may make it difficult to become pregnant.

What is operative hysteroscopy?

Operative hysteroscopy treats an abnormality detected during a diagnostic hysteroscopy. Your provider may perform a diagnostic and operative hysteroscopy at the same time, avoiding the need for a second surgery. During operative hysteroscopy, your surgeon uses a device to remove abnormalities that may be causing abnormal uterine bleeding.

Endometrial ablation is a procedure that treats abnormal uterine bleeding. Your surgeon uses the hysteroscope to look inside your uterus before using a device to destroy your uterine lining.

Why would I need a hysteroscopy?

Hysteroscopy is primarily used to identify and treat conditions that cause abnormal uterine bleeding, heavy menstrual bleeding, irregular spotting between periods and bleeding after menopause.

Your doctor may perform hysteroscopy to diagnose and correct the following uterine conditions:

• Polyps and fibroids: Hysteroscopy is used to find and remove these uterine structural abnormalities. Surgical removal of a polyp is called a hysteroscopy polypectomy. Surgical removal of a fibroid is called a hysteroscopy myomectomy.
• Adhesions: Also known as Asherman’s syndrome, uterine adhesions are bands of scar tissue that can form in your uterus and may lead to changes in menstrual flow and cause infertility. Hysteroscopy can help your doctor locate and remove the adhesions.
• Septums: Hysteroscopy can help determine whether you have a uterine septum, a malformation (defect) of the uterus that’s present from birth.

Hysteroscopy may also be used to:

• Diagnose the cause of repeated miscarriages or fertility problems.
• Locate an intrauterine device (IUD).
• Diagnose and remove placental tissue after birth.

Who is a candidate for hysteroscopy?

Your surgeon will review your medical history and evaluate your current health to determine whether a hysteroscopy is appropriate. Although there are many benefits associated with hysteroscopy, it’s not right for everyone. For example, you shouldn’t have a hysteroscopy if:

• You’re pregnant.
• You have a pelvic infection.

When should hysteroscopy be performed?

If your periods are regular, your surgeon will likely recommend scheduling your hysteroscopy for the first week after you stop bleeding. This timing will allow the best view of the inside of your uterus. If you have irregular menstrual cycles, you may need to work with your surgeon to find the best time for your hysteroscopy. The procedure can take place at any time if you’ve gone through menopause.

What happens before a hysteroscopy?

Your surgeon will ensure you’re a good candidate for a hysteroscopy, talk you through the procedure and answer any questions you may have. You’ll receive instructions so you’re prepared for your procedure.

Your provider may:

• Take a medical history and ask what medicines you’re taking, including vitamins and supplements. Before the procedure, you may need to stop taking medications that prevent blood clotting (anticoagulants), including aspirin.
• Perform a physical exam, pelvic exam and pregnancy test. You may need to take a blood test or complete other diagnostic tests depending on the specifics of your procedure.
• Explain how to prepare, including the clothes you should wear for the procedure, whether you’ll need to fast beforehand and whether you’ll need someone to drive you home after your hysteroscopy.

What happens during a hysteroscopy?

On the day of the procedure, you’ll be asked to empty your bladder and change into a hospital gown. You may receive anesthesia or a sedative to help you relax. The type of anesthesia you receive depends on whether the hysteroscopy will take place in a hospital or your surgeon’s office and whether other procedures will occur simultaneously.

You’ll be positioned on the exam table with your legs in stirrups. Once you’re in position, your surgeon will:

1. Perform a pelvic exam.
2. Dilate (open) your cervix so the hysteroscope can be inserted.
3. Insert the hysteroscope through your vagina and cervix into your uterus.
4. Send a liquid solution through the hysteroscope and into your uterus, gently expanding it and clearing any blood or mucus. This step allows your surgeon to view your uterus, uterine lining and fallopian tubes.
5. Inspect your uterine cavity and the openings of your fallopian tubes. The light from the hysteroscope makes it easier for your surgeon to get a clear view.
6. Insert surgical instruments through the hysteroscope that can be used to remove any irregular abnormalities (if surgery is needed).

A hysteroscopy can last anywhere from five minutes to more than an hour. The length of the procedure depends on whether it’s diagnostic or operative and whether an additional procedure, such as laparoscopy, is done simultaneously. Diagnostic hysteroscopy usually takes less time than operative.

What can I expect after a hysteroscopy?

If you received anesthesia during your hysteroscopy, you might be observed for several hours in the recovery room. You may have some cramping or light bleeding that lasts for a few days. It’s also not unusual to feel somewhat faint or sick immediately following your procedure.

Will I have to stay in the hospital overnight after a hysteroscopy?

Hysteroscopy is considered minor surgery and usually doesn’t require an overnight hospital stay. If your provider is concerned about your reaction to anesthesia, you may need to stay overnight.

What are the benefits of hysteroscopy?

Hysteroscopy can allow your surgeon to diagnose and treat conditions with a single surgery. In addition, a hysteroscopy enables surgery that’s both minimally invasive and precise. Hysteroscopy can allow your surgeon to locate abnormalities and remove them without damaging surrounding tissue.

How safe is hysteroscopy?

Hysteroscopy is considered a safe procedure. As with any surgery, complications can occur. With hysteroscopy, complications occur in less than 1% of cases and can include:

• Infection.
• Heavy bleeding.
• Intrauterine scarring.
• Reaction to the anesthesia.
• Injury to your cervix, uterus, bowel or bladder.
• Reaction to the substance used to expand your uterus.

How long does it take to recover from hysteroscopy?

Your recovery time depends on how extensive your procedure was — for instance, if your hysteroscopy was both diagnostic and operative. People recovering from a hysterectomy are often advised to avoid douching, intercourse or inserting anything into their vagina (like tampons) for two weeks following the procedure. You may be advised to avoid baths, swimming and hot tubs during your recovery.

Follow your surgeon’s guidance based on your unique situation.

When should I see my healthcare provider?

Contact your provider if you experience any of the following symptoms:

• Fever.
• Severe abdominal pain.
• Heavy vaginal bleeding.

How painful is a hysteroscopy?

Everyone’s experience is different. Studies have shown that factors like how long the procedure is, whether or not a person has given birth before and how anxious a person is prior to surgery may affect their pain perception during hysteroscopy.

Speak with your surgeon about your concerns. Ask about what you can expect to feel during your hysteroscopy. Ask about what type of anesthesia you’ll receive in order to remain comfortable throughout the procedure.

Are you awake for a hysteroscopy?

It depends. Anesthesia for hysteroscopy may be local, regional or general. General anesthesia will put you to sleep.

• Local anesthesia: A small part of your body will be numb for a short time.
• Regional anesthesia: A larger portion of your body will be numb for a few hours.
• General anesthesia: Your entire body will be numb for the whole surgery.

If you're having general anesthesia, you may not be able to eat or drink for a certain amount of time before the hysteroscopy.

Is hysteroscopy major surgery?

An operative hysteroscopy is considered minor surgery. It doesn’t usually require a hospital overnight stay. Unlike more invasive procedures that open your abdomen to access organs, a hysteroscopy can be performed through your vagina.

Is a D&C the same as a hysteroscopy?

No. Both a D&C (dilation and curettage) and an operative hysteroscopy allow your surgeon to remove tissue from your uterus. While a hysteroscopy enables your provider to find growths and remove them with precise surgical instruments, a D&C allows your surgeon to sample greater amounts of tissue from your uterine lining by performing a gentle scraping.

Should I be worried about hysteroscopy?

You shouldn’t be. Hysteroscopy is widely considered a safe procedure, with minimal risks involved.

Contact Chawla Fertility to schedule a consultation appointment, and discover if you are a good candidate for Hysteroscopy Treatment.

All pregnancies carry risks. The definition of a “high-risk” pregnancy is any pregnancy that carries increased health risks for the pregnant person, fetus or both. People with high-risk pregnancies may need extra care before, during and after they give birth. This helps to reduce the possibility of complications.

However, having a pregnancy that’s considered high-risk doesn’t mean you or your fetus will have problems. Many people experience healthy pregnancies and normal labour and delivery despite having special health needs.

What causes high-risk pregnancy?

Factors that make a pregnancy high risk include:

- Preexisting health conditions.

- Pregnancy-related health conditions.

- Lifestyle factors (including smoking, drug addiction, alcohol abuse and exposure to certain toxins).

- Age (being over 35 or under 17 when pregnant).

What are common medical risk factors for a high-risk pregnancy?

People with many preexisting conditions have increased health risks during pregnancy. Some of these conditions include:

- Autoimmune diseases, such as lupus or multiple sclerosis (MS).

- COVID-19.

- Diabetes.

- Fibroids.

- High blood pressure.

- HIV/AIDS.

- Kidney disease.

- Low body weight (BMI of less than 18.5).

- Mental health disorders, such as depression.

- Obesity.

- Polycystic ovary syndrome (PCOS).

- Thyroid disease.

- Blood clotting disorders.

Pregnancy-related health conditions that can pose risks to the pregnant person and fetus include:

- Birth defects or genetic conditions in the fetus.

- Poor growth in the fetus.

- Gestational diabetes.

- Multiple gestation (pregnancy with more than one fetus, such as twins or triplets).

- Preeclampsia and eclampsia.

- Previous preterm labor or birth, or other complications with previous pregnancies.

What are the signs and symptoms of a high-risk pregnancy?

Talk to your doctor right away if you experience any of the following symptoms during pregnancy, whether or not your pregnancy is considered high-risk:

- Abdominal pain that doesn’t go away.

- Chest pain.

- Dizziness or fainting.

- Extreme fatigue.

- The fetus's movement stops or slows.

- Fever over 100.4°F.

- Heart palpitations.

- Nausea and vomiting that’s worse than normal morning sickness.

- Severe headache that won’t go away or gets worse.

- Swelling, redness or pain in your face or limbs.

- Thoughts about harming yourself or the fetus.

- Trouble breathing.

- Vaginal bleeding or discharge.

At what age is pregnancy considered high-risk?

People who get pregnant for the first time after age 35 have high-risk pregnancies. Research suggests they’re more likely to have complications than younger people. These may include early pregnancy loss and pregnancy-related health conditions such as gestational diabetes.

Young people under 17 also have high-risk pregnancies because they may be:

- Anemic.

- Less likely to get thorough prenatal care.

- More likely to have premature labour or birth.

- Unaware they have sexually transmitted infections (STIs).

How is high-risk pregnancy diagnosed and monitored?

Getting early and thorough prenatal care is critical. It’s the best way to detect and diagnose a high-risk pregnancy. Be sure to tell your healthcare provider about your health history and any past pregnancies. If you do have a high-risk pregnancy, you may need special monitoring throughout your pregnancy.

Tests to monitor your health and the health of the fetus may include:

- Blood and urine testing to check for genetic conditions or certain congenital conditions (birth defects).

- Ultrasonography, which uses sound waves to create images of the fetus to screen for congenital conditions.

- Monitoring to ensure the fetus is getting enough oxygen, such as a biophysical profile, which monitors their breathing, movements and amniotic fluid using ultrasound, and a non-stress test, which monitors their heart rate.

Learn more about our procedures and your options by scheduling a consultation appointment with one of our doctors.

IUI (intrauterine insemination) is a type of artificial insemination. Sperm that have been washed and concentrated are placed directly inside of your uterus during ovulation. This helps healthy sperm get closer to the egg when it’s released by your ovaries. It’s a common fertility treatment for couples or individuals wishing to conceive.

What is IUI (intrauterine insemination)?

Intrauterine insemination (IUI), a type of artificial insemination, is a fertility treatment where sperm is placed directly into a person’s uterus.

During a natural conception, sperm has to travel from your vagina through your cervix, into your uterus and to your fallopian tubes. Only 5% of the sperm are able to travel from your vagina to your uterus. Once your ovary releases an egg, it travels to your fallopian tube. This is where the sperm and egg meet and fertilization occurs. With IUI, the sperm is collected, washed and concentrated so that only high-quality sperm remain. This sperm is placed directly into your uterus with a catheter (thin tube), putting it closer to your fallopian tubes. IUI makes it easier for the sperm to reach an egg because it cuts down on the time and distance it has to travel. This increases your chance of becoming pregnant.

Healthcare providers often try IUI before other more invasive and expensive fertility treatments. IUIs can be performed with your partner’s sperm or with donor sperm. A person may take fertility drugs to ensure eggs are released during ovulation.

Why is IUI performed?

People choose IUI for many reasons, such as infertility issues, or as a reproductive option for same-sex female couples or females who wish to have a baby without a partner, using a sperm donor.

Intrauterine insemination (IUI) may be used when these conditions are present:

• Cervical mucus problems or other problems with your cervix. Your cervix separates your vagina and uterus from each other. Mucus produced by your cervix helps sperm travel from your vagina, through your uterus and to your fallopian tubes. Thick mucus can make it hard for sperm to swim. With IUI, sperm bypasses your cervix and goes directly to your uterus.
• Low sperm count or other sperm impairments. Semen analysis is part of infertility treatment. It may show that your partner’s sperm is small, weak, slow or oddly shaped, or that your partner doesn’t have much sperm. IUI can help these problems because only high-quality sperm is selected and used in your treatment.
• You’re using donor sperm. IUI is used when people use sperm from a person who isn’t the birth parent’s partner. This is called donor insemination (DI). DI is done when one partner has no sperm or when the sperm quality is so low that the sperm can’t be used. Single women or same-sex female couples who wish to conceive can also use donor sperm.
• Ejaculation or erection dysfunction. IUI can be used when one partner can’t get or sustain an erection or isn’t able to ejaculate.
• Semen allergy. In rare cases, people have an allergy to their partner’s semen. It can cause burning, swelling and redness in their vagina. IUI can be effective because the proteins causing the allergy are removed during sperm washing.
• Unexplained infertility. This is when healthcare providers can't find the cause for infertility.

How long is the IUI process from beginning to end?

The timeline for the IUI procedure is approximately four weeks (around 28 days) from beginning to end. It’s about the same length as a regular menstrual cycle.

• Before starting the IUI process, you (and your partner) will have a thorough examination that could include bloodwork, semen analysis, ultrasound and other diagnostics.
• Some people are given oral fertility medicine for five days or injectable medication for up to two weeks. This increases your chances of ovulation and releasing multiple eggs. Not all people require these medications.
• Insemination is a quick process. It takes a few minutes to insert the sperm. Your healthcare provider may ask you to lie down for around 15 minutes afterward.
• You can take a pregnancy test two weeks after insemination.

Does IUI work?

The success varies depending on the underlying cause of infertility. IUI works best in people with unexplained infertility, and people with cervical mucus issues or issues with ejaculation. There are certain conditions like fallopian tube disorders, endometriosis or severe sperm impairment where IUI won’t work well. Treatments like IVF (in vitro fertilization) may work better for these issues.

What is the difference between IVF and IUI (intrauterine insemination)?

Intrauterine insemination (IUI) is different from in vitro fertilization (IVF) because fertilization occurs inside of your fallopian tube in an IUI procedure. A sperm sample is collected and washed so that only high-quality sperm are left. This sample is inserted into your uterus with a catheter during ovulation. This method helps the sperm get to the egg more easily in hopes fertilization will happen. With IVF, the sperm and egg are fertilized outside of your body (in a lab) and then placed in your uterus as an embryo. IUI is less expensive and less invasive than IVF. IUI has a lower success rate per cycle.

What are the steps of IUI treatment?

Every treatment plan and healthcare provider may have a slightly different process. IUI treatment typically includes the following:

Ovulation

• Your healthcare provider will need to know exactly when you’re ovulating. The timing of ovulation is critical to make sure sperm is injected at the right time.
• Determining the time of ovulation can be done using an at-home ovulation prediction kit that detects luteinizing hormone (LH). Your healthcare provider can also detect LH in blood tests. They may also use transvaginal ultrasound to look for signs mature eggs. Sometimes, you’re given an injection of human chorionic gonadotropin (hCG) or other fertility medications to make you ovulate one or more eggs. Ovulation typically occurs around 10 to 16 days after the first day of your period.
• Insemination (inserting the sperm into your uterus) usually occurs within 24 to 36 hours after LH is detected (either in your blood or urine), or after the hCG injection.

Semen sample preparation

• Your partner provides a fresh sperm sample on the day of the IUI procedure. In some cases, your partner can provide the sample before and your healthcare provider can freeze it until it is time to be used. If you’re using a sperm donor, the sample will be thawed and prepared.
• Sperm is prepared for insemination through a process called “sperm washing” that pulls out a concentrated amount of healthy sperm. If you’re using donor sperm, the sperm bank usually sends sperm that’s already washed.

Insemination

• The insemination procedure is simple and takes just a few minutes. You’ll lie down on the exam table. Your healthcare provider will insert a speculum into your vagina — similar to what happens during a Pap test. Next, a catheter is inserted through your cervix into your uterus. Finally, your healthcare provider injects the washed sperm sample into your uterus.
• You may be asked to lie down for 10 to 30 minutes after insemination. Pregnancy happens if sperm fertilizes an egg and the fertilized egg implants in the lining of your uterus.
• You may be given progesterone after IUI. Progesterone helps maintain the lining of your uterus and can improve the chances of implantation.
• You can take a pregnancy test approximately two weeks after IUI.

Please consult with your healthcare provider to get the best understanding of the IUI process and what to expect.

What do you do to prepare for IUI treatment?

Before starting IUI treatment, you’ll need a thorough medical exam and fertility tests. Your partner will be examined and tested as well. This could include:

• A uterine exam.
• Ultrasounds of your uterus.
• A semen analysis.
• Screening for sexually transmitted infections (STIs) and other infectious diseases.
• Blood tests.

Your healthcare provider may recommend taking folic acid (included in most prenatal vitamins) at least three months before conception (or IUI treatment).

What can you expect after IUI treatment?

There are some mild symptoms that you can experience after IUI:

• Mild cramping.
• Spotting for one or two days.

Most people will return to normal activities right away. You should avoid anything that makes you feel uncomfortable after IUI, but there usually aren’t any restrictions. A pregnancy test can be taken around two weeks after IUI.

How painful is IUI treatment?

Anesthesia isn’t required for IUI and the procedure shouldn’t be painful. However, you may have mild cramping and discomfort during and right after insemination.

What medications are used during IUI?

IUI is often combined with fertility medications that stimulate your ovaries to produce and release as many eggs as possible. However, it’s not always needed. Some common medications are:

• Clomiphene citrate (Clomid® or Serophene®).
• Letrozole (Femara®).
• hCG (human Chorionic Gonadotropin).
• FSH (follicle-stimulating hormone).
• Prenatal vitamins (recommended for all pregnancies).

Your healthcare provider will determine if fertility drugs will be used as part of your IUI treatment.

How much does IUI cost?

The cost of IUI varies depending on the fertility clinic you use, your health history, use of medications and diagnostic testing. It’s less expensive than other infertility treatments like IVF. You can expect to pay between Rs.30,000 and Rs.360,000 per cycle without insurance. Some states have laws that require insurance companies to cover part of the costs of infertility treatment.

What are the risks of IUI?

IUI is low risk compared to other more invasive fertility treatments like IVF. Some of the risks of IUI are:

• Multiple births: You might release more than one egg if you take fertility medication. This increases your chances of becoming pregnant with twins, triplets or more. A pregnancy with multiple babies carries a higher risk of premature labor and low birth weight.
• Infection: This is rare.
• Spotting: The procedure can cause a small amount of vaginal bleeding.
• Ovarian hyperstimulation syndrome (OHSS): A rare side effect caused by taking too much fertility medication. OHSS causes your ovaries to become painful and swollen.

How effective is IUI in getting pregnant?

IUI can be highly effective, especially when fertility drugs are used. The pregnancy rate for IUI when fertility drugs are used can be as high as 20%. The effectiveness of IUI is mostly dependent on the underlying cause of infertility and the age of the birth parent. The IUI fertility rate is about the same as a normal conception (around 20%), which means IUI helps bring people’s chances up to a more typical success rate.

How long does it take to know you are pregnant after IUI?

You’ll know if you’re pregnant approximately two weeks after IUI. It takes about that long for human chorionic gonadotropin (hCG) to be detected in blood or urine. Your healthcare provider will let you know if you should return for a blood test to detect pregnancy or if you can use an at-home urine test.

How many cycles of IUI do you try before IVF?

Most healthcare providers recommend three cycles of IUI before pursuing another reproductive treatment, like IVF. If you’re over the age of 40, some healthcare providers recommend just one cycle of IUI before moving on to IVF. This is because the success rates for IVF are higher for that age group and timely treatment is important.

In some cases, going straight to IVF treatment and skipping IUI may be better for you. This is the case if you have a condition like endometriosis, fallopian tube damage or advanced maternal age.

If you haven’t gotten pregnant after three cycles of IUI, your healthcare provider will discuss the next steps with you.

When should I contact my healthcare provider?

If you’re taking fertility medications for IUI, you should contact your healthcare provider if any of the following happens:

• Severe pelvic or abdominal pain.
• Nausea and vomiting.
• Shortness of breath.
• Sudden weight gain.
• Dizziness or lightheadedness.

Is there anything I can do to increase my chances of pregnancy with IUI?

Several factors can determine the success of IUI. These factors include:

• Age.
• If you use fertility drugs.
• Health conditions.
• Your cause of infertility.

Your healthcare provider will work with you to determine how to increase your chances of becoming pregnant using IUI.

What is the success rate of IUI?

Other than the reason for infertility, age is the most important factor in determining the success of IUI. Most healthcare providers will recommend IUI before turning 40 to increase your chance of becoming pregnant.

As a person ages, they have fewer eggs and the quality of those eggs decreases. The pregnancy rate for IUI by age is:

• Age 20 to 30: 17.6%
• Age 31 to 35: 13.3%
• Age 36 to 38: 13.4%
• Age 39 to 40: 10.6%
• Over 40: 5.4%

Is IUI better than IVF?

Most people will try IUI before IVF because it’s more affordable and less invasive. In some cases, your healthcare provider will decide IUI will not work for you and recommend IVF. This can be due to age or the underlying reason for infertility. One treatment isn’t better than the other, but one may give you a higher chance of conceiving.

Can I have sex after IUI?

Yes, you can have sex before and after IUI. You’re increasing your chances of becoming pregnant by having sex the day of IUI or the day after.

Contact Chawla Fertility to schedule a consultation appointment, and discover if you are a good candidate for IUI (Intrauterine Insemination).

Uterine fibroids are a common type of noncancerous tumor that can grow in and on your uterus. Not all fibroids cause symptoms, but when they do, symptoms can include heavy menstrual bleeding, back pain, frequent urination and pain during sex. Small fibroids often don’t need treatment, but larger fibroids can be treated with medications or surgery.

What are uterine fibroids?

Uterine fibroids (also called leiomyomas) are growths made up of the muscle and connective tissue from the wall of the uterus. These growths are usually not cancerous (benign). Your uterus is an upside down pear-shaped organ in your pelvis. The normal size of your uterus is similar to a lemon. It’s the place where a baby grows and develops during pregnancy.

Fibroids can grow as a single nodule (one growth) or in a cluster. Fibroid clusters can range in size from 1 mm to more than 20 cm (8 inches) in diameter or even larger. For comparison, they can get as large as the size of a watermelon. These growths can develop within the wall of the uterus, inside the main cavity of the organ or even on the outer surface. Fibroids can vary in size, number and location within and on your uterus.

You may experience a variety of symptoms with uterine fibroids and these may not be the same symptoms that another woman with fibroids will experience. Because of how unique fibroids can be, your treatment plan will depend on your individual case.

Are fibroids common?

Fibroids are actually a very common type of growth in your pelvis. Approximately 40 to 80% of people have fibroids. However, many people don’t experience any symptoms from their fibroids, so they don’t realize they have fibroids. This can happen when you have small fibroids — called asymptomatic because they don’t cause you to feel anything unusual.

Who is at risk for uterine fibroids?

There are several risk factors that can play a role in your chances of developing fibroids. These can include:

• Obesity and a higher body weight (more than 20% over the weight that's considered healthy for you).
• Family history of fibroids.
• Not having children.
• Early onset of menstruation (getting your period at a young age).
• Late age for menopause.

Where do fibroids grow?

There are several places both inside and outside of your uterus where fibroids can grow. The location and size of your fibroids is important for your treatment. Where your fibroids are growing, how big they are and how many of them you have will determine which type of treatment will work best for you or if treatment is even necessary.

There are different names given for the places your fibroids are located in and on the uterus. These names describe not only where the fibroid is, but how it’s attached. Specific locations where you can have uterine fibroids include:

• Submucosal fibroids: In this case, the fibroids are growing inside the uterine space (cavity) where a baby grows during pregnancy. Think of the growths extending down into the empty space in the middle of the uterus.
• Intramural fibroids: These fibroids are embedded into the wall of the uterus itself. Picture the sides of the uterus like walls of a house. The fibroids are growing inside this muscular wall.
• Subserosal fibroids: Located on the outside of the uterus this time, these fibroids are connected closely to the outside wall of the uterus.
• Pedunculated fibroids: The least common type, these fibroids are also located on the outside of the uterus. However, pedunculated fibroids are connected to the uterus with a thin stem. They’re often described as mushroom-like because they have a stalk and then a much wider top.

What do fibroids look like?

Fibroids are typically rounded growths that can look like nodules of smooth muscle tissue. In some cases, they can be attached with a thin stem, giving them a mushroom-like appearance.

Are fibroids cancer?

It’s extremely rare for a fibroid to go through changes that transform it into a cancerous or a malignant tumor. In fact, one out of 350 people with fibroids will develop malignancy. There’s no test that’s 100% predictive in detecting rare fibroid-related cancers. However, people who have rapid growth of uterine fibroids, or fibroids that grow during menopause, should be evaluated immediately.

What causes uterine fibroids?

The causes of fibroids are not known. Most fibroids happen in people of reproductive age. They typically aren’t seen in young people who haven’t had their first period yet.

What are the symptoms of uterine fibroids?

Most fibroids do not cause any symptoms and don’t require treatment other than regular observation by your healthcare provider. These are typically small fibroids. When you don’t experience symptoms, it’s called an asymptomatic fibroid. Larger fibroids can cause you to experience a variety of symptoms, including:

• Excessive or painful bleeding during your period (menstruation).
• Bleeding between your periods.
• A feeling of fullness in your lower abdomen/bloating.
• Frequent urination (this can happen when a fibroid puts pressure on your bladder).
• Pain during sex.
• Low back pain.
• Constipation.
• Chronic vaginal discharge.
• Inability to urinate or completely empty your bladder.
• Increased abdominal distention (enlargement), causing your abdomen to look pregnant.

The symptoms of uterine fibroids usually stabilize or go away after you’ve gone through menopause because hormone levels decline within your body.

What does uterine fibroid pain feel like?

There are a variety of feelings you might experience if you have fibroids. If you have small fibroids, you may feel nothing at all and not even notice they’re there. For larger fibroids, however, you can experience discomforts and even pains related to the condition. Fibroids can cause you to feel back pain, severe menstrual cramps, sharp stabbing pains in your abdomen and even pain during sex.

Can fibroids change over time?

Fibroids can actually shrink or grow over time. They can change size suddenly or steadily over a long period of time. This can happen for a variety of reasons, but in most cases this change in fibroid size is linked to the amount of hormones in your body. When you have high levels of hormones in your body, fibroids can get bigger. This can happen at specific times in your life, like during pregnancy. Your body releases high levels of hormones during pregnancy to support the growth of your baby. This surge of hormones also causes the fibroid to grow. If you know you have fibroids before a pregnancy, talk to your healthcare provider. You may need to be monitored to see how the fibroid grows throughout the pregnancy. Fibroids can also shrink when your hormone levels drop. This is common after menopause. Once a woman has passed through menopause, the amount of hormones in her body is much lower. This can cause the fibroids to shrink in size. Often, your symptoms can also get better after menopause.

Can fibroids cause anemia?

Anemia is a condition that happens when your body doesn’t have enough healthy red blood cells to carry oxygen to your organs. It can make you feel tired and weak. Some people may develop intense cravings for ice, starch or dirt. This is called pica and is associated with anemia. Anemia can happen to people who have frequent or extremely heavy periods. Fibroids can cause your periods to be very heavy or for you to even bleed between periods. Some treatments like oral iron pills — or if you're significantly anemic, an iron infusion (by IV) — can improve your anemia. Talk to your healthcare provider if you are experiencing symptoms of anemia while you have fibroids.

How are uterine fibroids diagnosed?

In many cases, fibroids are first discovered during a regular exam with your health provider. They can be felt during a pelvic exam and can be found during a gynecologic exam or during prenatal care. Quite often your description of heavy bleeding and other related symptoms may alert your healthcare provider to consider fibroids as a part of the diagnosis. There are several tests that can be done to confirm fibroids and determine their size and location. These tests can include:

• Ultrasonography: This non-invasive imaging test creates a picture of your internal organs with sound waves. Depending on the size of the uterus, the ultrasound may be performed by the transvaginal or transabdominal route.
• Magnetic resonance imaging (MRI): This test creates detailed images of your internal organs by using magnets and radio waves.
• Computed tomography (CT): A CT scan uses X-ray images to make a detailed image of your internal organs from several angles.
• Hysteroscopy: During a hysteroscopy, your provider will use a device called a scope (a thin, flexible tube with a camera on the end) to look at fibroids inside your uterus. The scope is passed through your vagina and cervix and then moved into your uterus.
• Hysterosalpingography (HSG): This a detailed X-ray where a contrast material is injected first and then X-rays of the uterus are taken. This is more often used in people who are also undergoing infertility evaluation.
• Sonohysterography: In this imaging test, a small catheter is placed transvaginally and saline is injected via the catheter into the uterine cavity. This extra fluid helps to create a clearer image of your uterus than you would see during a standard ultrasound.
• Laparoscopy: During this test, your provider will make a small cut (incision) in your lower abdomen. A thin and flexible tube with a camera on the end will be inserted to look closely at your internal organs.

How are uterine fibroids treated?

Treatment for uterine fibroids can vary depending on the size, number and location of the fibroids, as well as what symptoms they’re causing. If you aren’t experiencing any symptoms from your fibroids, you may not need treatment. Small fibroids can often be left alone. Some people never experience any symptoms or have any problems associated with fibroids. Your fibroids will be monitored closely over time, but there’s no need to take immediate action. Periodic pelvic exams and ultrasound may be recommend by your healthcare provider depending on the size or symptoms of your fibroid.If you are experiencing symptoms from your fibroids — including anemia from the excess bleeding, moderate to severe pain, infertility issues or urinary tract and bowel problems — treatment is usually needed to help. Your treatment plan will depend on a few factors, including:

• How many fibroids you have.
• The size of your fibroids.
• Where your fibroids are located.
• What symptoms you are experiencing related to the fibroids.
• Your desire for pregnancy.
• Your desire for uterine preservation.

The best treatment option for you will also depend on your future fertility goals. If you want to have children in the future, some treatment options may not be an option for you. Talk to your healthcare provider about your thoughts on fertility and your goals for the future when discussing treatment options. Treatment options for uterine fibroids can include:

Medications

• Over-the-counter (OTC) pain medications: These medications can be used to manage discomforts and pain caused by the fibroids. OTC medications include acetaminophen and ibuprofen.
• Iron supplements: If you have anemia from the excess bleeding, your provider may also suggest you take an iron supplement.
• Birth control: Birth control can also be used to help with symptoms of fibroids — specifically heavy bleeding during and between periods and menstrual cramps. Birth control can be used to help control heavy menstrual bleeding. There are a variety of birth control options you can use, including oral contraceptive pills, intravaginal contraception, injections and intrauterine devices (IUDs).
• Gonadotropin-releasing hormone (GnRH) agonists: These medications can be taken via a nasal spray or injection and they work by shrinking your fibroids. They’re sometimes used to shrink a fibroid before surgery, making it easier to remove the fibroid. However, these medications are temporary and if you stop taking them, the fibroids can grow back.
• Oral therapies: Elagolix is a new oral therapy indicated for the management of heavy uterine bleeding in people who haven't experienced menopause with symptomatic uterine fibroids. It can be used up to 24 months. Talk to your doctor for pros and cons of this therapy. Another oral therapy, Tranexamic acid, is an antifibrinolytic oral drug that’s indicated for the treatment of cyclic heavy menstrual bleeding in people with uterine fibroids. Your doctor will monitor you during this therapy.

It’s important to talk to your healthcare provider about any medication you take. Always consult your provider before starting a new medication to discuss any possible complications.

Fibroid surgery

There are several factors to consider when talking about the different types of surgery for fibroid removal. Not only can the size, location and number of fibroids influence the type of surgery, but your wishes for future pregnancies can also be an important factor when developing a treatment plan. Some surgical options preserve the uterus and allow you to become pregnant in the future, while other options can either damage or remove the uterus.

Myomectomy is a procedure that allows your provider to remove the fibroids without damaging the uterus. There are several types of myomectomy. The type of procedure that may work best for you will depend on where your fibroids are located, how big they are and the number of fibroids. The types of myomectomy procedure to remove fibroids can include:

• Hysteroscopy: This procedure is done by inserting a scope (a thin, flexible tube-like tool) through the vagina and cervix and into the uterus. No incisions are made during this procedure. During the procedure, you provider will use the scope to cut away the fibroids. Your provider will then remove the fibroids.
• Laparoscopy: In this procedure, your provider will use a scope to remove the fibroids. Unlike the hysteroscopy, this procedure involves placing a few small incisions in your abdomen. This is how the scope will enter and exist your body. This procedure can also be accomplished with the assistance of a robot.
• Laparotomy: During this procedure, an incision is made in your abdomen and the fibroids are removed through this one larger cut.

If you aren’t planning future pregnancies, there are additional surgical options your healthcare provider may recommend. These options are not recommended if pregnancy is desired and there are surgical approaches that remove the uterus. These surgeries can be very effective, but they typically prevent future pregnancies. Surgeries to remove fibroids can include:

• Hysterectomy: During this surgery, your uterus is removed. A hysterectomy is the only way to cure fibroids. By removing your uterus completely, the fibroids can’t come back and your symptoms should go away. If your uterus alone is removed — the ovaries are left in place — you will not go into menopause after a hysterectomy. This procedure might be recommended if you’re experiencing very heavy bleeding from your fibroids or if you have large fibroids. When recommended, the most minimally invasive procedure to perform hysteroscopy is advisable. Minimally invasive procedures include vaginal, laparoscopic or robotic approaches.
• Uterine fibroid embolization: This procedure is performed by an interventional radiologist who works with your gynecologist. A small catheter is placed in the uterine artery or radial artery and small particles are used to block the flow of blood from the uterine artery to the fibroids. Loss of blood flow shrinks the fibroids — improving your symptoms.
• Radiofrequency ablation (RFA): This is a safe and effective treatment for people with symptomatic uterine fibroids and can be delivered by laparoscopic, transvaginal or transcervical approaches.

There’s also a newer procedure called magnetic resonance imaging (MRI)-guided focused ultrasound that can be used to treat fibroids. This technique is actually done while you’re inside a MRI machine. You are placed inside the machine — which allows your provider to have a clear view of the fibroids — and then an ultrasound is used to send targeted sound waves at the fibroids. This damages the fibroids.

Are there any risks related to fibroid treatments?

There can be risks to any treatment. Medications can have side effects and some may not be a good fit for you. Talk to your healthcare provider about all medications you may be taking for other medical conditions and your complete medical history before starting a new medication. If you experience side effects after starting a new medication, call your provider to discuss your options.

There are also always risks involved in surgical treatment of fibroids. Any surgery places you at risk of infection, bleeding, and any inherent risks associated with surgery and anesthesia. An additional risk of fibroid removal surgery can involve future pregnancies. Some surgical options can prevent future pregnancies. Myomectomy is a procedure that only removes the fibroids, allowing for future pregnancies. However, people who have had a myomectomy may need to deliver future babies via Caesarean section (C-section).

How large do uterine fibroids need to be before being surgically removed?

The normal uterine size is the size of a lemon or 8 cm. There isn’t a definitive size of a fibroid that would automatically mandate removal. Your healthcare provider will determine the symptoms that are causing the problem. Fibroids the size of a marble for instance, if located within the uterine cavity, may be associated with profound bleeding. Fibroids the size of a grapefruit or larger may cause you to experience pelvic pressure, as well as make you look pregnant and see increased abdominal growth that can make the abdomen enlarged. It’s important for the healthcare provider and patient to discuss symptoms which might require surgical intervention.

Can fibroids be prevented?

In general, you can’t prevent fibroids. You can reduce your risk by maintaining a healthy body weight and getting regular pelvic exams. If you have small fibroids, develop a plan with your healthcare provider to monitor them.

Can I get pregnant if I have uterine fibroids?

Yes, you can get pregnant if you have uterine fibroids. If you already know you have fibroids when you get pregnant, your healthcare provider will work with you to develop a monitoring plan for the fibroids. During pregnancy, your body releases elevated levels of hormones. These hormones support the growth of your baby. However, they can also cause your fibroids to get bigger. Large fibroids can prevent your baby from being able to flip into the correct fetal position, increasing your risk of a breech birth or malpresentation of the fetal head. In very rare cases, you may be at higher risk of a pre-term delivery or a C-section delivery. In some cases, fibroids can contribute to infertility. It can be difficult to pinpoint an exact cause of infertility, but some people are able to become pregnant after receiving treatment for fibroids.

Will fibroids go away on their own?

Fibroids can shrink in some people after menopause. This happens because of a decrease in hormones. When the fibroids shrink, your symptoms may go away. Small fibroids may not need treatment if they aren’t causing any symptoms.

The Chawla IVF medical team at Chawla Nursing Home understands the risks and rewards that come with Uterine Fibroids, and we will help you through every step of the way. Schedule a consultation appointment with one of our doctors at ourJalandhar location to find out if Uterine Fibroids is your best option for pregnancy.

Boost your chances of conceiving with Laser Assisted Hatching Treatment In Jalandhar, Punjab.

What is Laser Assisted Hatching (LAH)?

Laser Assisted Hatching is a procedure that thins out the protective shell covering the embryo called the Zona Pellucida. The thinning of the zona by laser beam shots from the Diode Laser allows the embryo to hatch out of the shell and promotes implantation. This improves the chances of conception.

Once the egg is fertilised with sperm in the lab, the resulting embryo is placed into the uterus. If everything goes well, it will implant and develop into a growing fetus. But sometimes things may not go as planned—the embryo may not implant or it may implant but fail to develop properly. This may be due to the shell of the embryo being thick, or not able to thin out spontaneously resulting in failure to implant or to implant incompletely.

A  study published by the National Library of Medicine showed that patients above 35 years had better implantation rates following LAH with higher clinical pregnancy success rates.

Why do doctors recommend Laser Assisted Hatching (LAH)?

If you’ve been trying to get pregnant for a while and haven’t succeeded, your doctor may suggest the Laser Assisted Hatching procedure. A tiny breach of about 30 microns is made in the shell of the embryo, thereby thinning down the Zona or breaching it. This procedure is particularly useful

• If  2 or 3  IVF cycles have resulted in failed implantation.
• For women over the age of 36.
• In the presence of poor-quality embryos.
• Thick zona pellucida
• Before the PGT procedure.
• Before transferring frozen embryos.

Advantages of Laser Assisted Hatching (LAH)

LAH creates a breach in or thinning of the zona, thus facilitating the opening of the zona more quickly.

Advantages of laser-assisted hatching include:

• Higher success rates for hatching.
• Better survival rates of the embryos.
• Less invasive than other techniques like mechanical hatching or hatching using acid tyrode.

Risks associated with Laser Assisted Hatching (LAH)

While many studies have shown that the technique is useful, it does have some risks associated with it. Risks include:

• The twinning of the embryo.  
• Trapping of the embryo in the shell
• Incomplete hatching.

We are here to help you get pregnant.

We understand your desire to be a parent and we want to help you in your journey to parenthood. We know that IVF can be stressful, so we are here to ease your stress. Our team of highly trained doctors and nurses will guide you through every step of the process, from beginning to end.

Our IVF centre has been chosen by couples from all over the world as their first choice for Laser-Assisted Hatching. For couples who are experiencing difficulties conceiving, we suggest laser-assisted hatching if conditions are favourable.

We also provide support after your treatment has been completed, so that you can feel confident that any problems that may arise will be dealt with quickly and efficiently. Our goal is to help you achieve your dream of starting a family.

Success rate of Laser Assisted Hatching in Chawla Nursing Home & Maternity Hospital, Jalandhar

The success rate of Laser Assisted Hatching treatment in Chawla Nursing Home & Maternity Hospital, Jalandhar depends on many factors including the quality of the embryo, the skill of the technologist, and the quality of the equipment being used. We use the diode laser which is the safest laser available.

The Chawla IVF medical team at Chawla Nursing Home understands the risks and rewards that come with Laser Assisted Hatching (LAH) Treatment, and we will help you through every step of the way. Schedule a consultation appointment with one of our doctors at our Jalandhar location to find out if Laser Assisted Hatching (LAH) Treatment is your best option for pregnancy.

Menopause is a point in time when a person has gone 12 consecutive months without a menstrual period. Menopause is a natural part of aging and marks the end of your reproductive years. On average, menopause happens at age 51.

What is menopause?

Menopause is a point in time when you’ve gone 12 consecutive months without a menstrual cycle. The time leading up to menopause is called perimenopause. This is when a lot of women or people assigned female at birth (AFAB) start to transition to menopause. They may notice changes in their menstrual cycles or have symptoms like hot flashes.

What are the three stages of menopause?

Natural menopause is the permanent ending of menstruation that doesn’t happen because of any type of medical treatment. The process is gradual and happens in three stages:

• Perimenopause or “menopause transition”: Perimenopause can begin eight to 10 years before menopause when your ovaries gradually produce less estrogen. It usually starts when you’re in your 40s. Perimenopause lasts up until menopause, the point when your ovaries stop releasing eggs. In the last one to two years of perimenopause, the drop in estrogen accelerates. At this stage, many people may experience menopause symptoms. But, you’re still having menstrual cycles during this time and can get pregnant.
• Menopause: Menopause is the point when you no longer have menstrual periods. At this stage, your ovaries have stopped releasing eggs and stopped producing most of their estrogen. A healthcare provider diagnoses menopause when you’ve gone without a menstrual period for 12 consecutive months.
• Postmenopause: This is the name given to the time after you haven’t had a period for an entire year (or the rest of your life after menopause). During this stage, menopausal symptoms, such as hot flashes, may get better. However, some people continue to experience menopausal symptoms for a decade or longer after the menopause transition. As a result of a lower estrogen level, people in the postmenopausal phase are at an increased risk for several health conditions, such as osteoporosis and heart disease.

What is the normal age for menopause?

The average age of menopause in the United States is approximately 51 years old. However, the transition to menopause usually begins in your mid-40s.

What are the signs of menopause?

You may be transitioning into menopause if you begin experiencing some or all of the following symptoms:

• Hot flashes, also known as vasomotor symptoms (a sudden feeling of warmth that spreads over your body).
• Night sweats and/or cold flashes.
• Vaginal dryness that causes discomfort during sex.
• Urinary urgency (a pressing need to pee more frequently).
• Difficulty sleeping (insomnia).
• Emotional changes (irritability, mood swings or mild depression).
• Dry skin, dry eyes or dry mouth.
• Breast tenderness.
• Worsening of premenstrual syndrome (PMS).
• Irregular periods or periods that are heavier or lighter than usual.

Some people might also experience:

• Racing heart.
• Headaches.
• Joint and muscle aches and pains.
• Changes in libido (sex drive).
• Difficulty concentrating or memory lapses (often temporary).
• Weight gain.
• Hair loss or thinning.

Changes in your hormone levels cause these symptoms. Some people may have intense symptoms of menopause, while others have mild symptoms. Not everyone will have the same symptoms as they transition to menopause.

Contact a healthcare provider if you’re unsure if your symptoms are related to menopause or another health condition.

How long do you have symptoms of menopause?

You can have symptoms of menopause for up to 10 years. However, most people experience symptoms of menopause for less than five years.

What are hot flashes and how long will I have them?

Hot flashes are one of the most frequent symptoms of menopause. It’s a brief sensation of heat. Aside from the heat, hot flashes can also come with:

• A red, flushed face.
• Sweating.
• A chilled feeling after the heat.

The intensity, frequency and duration of hot flashes differ for each individual. Typically, hot flashes are less severe as time goes on.

Why does menopause happen?

When menopause happens on its own (natural menopause), it’s a normal part of aging. Menopause is defined as a complete year without menstrual bleeding, in the absence of any surgery or medical condition that may cause bleeding to stop such as hormonal birth control, radiation therapy or surgical removal of your ovaries.

As you age, your reproductive cycle begins to slow down and prepares to stop. This cycle has been continuously functioning since puberty. As menopause nears, your ovaries make less of a hormone called estrogen. When this decrease occurs, your menstrual cycle (period) starts to change. It can become irregular and then stop.

Physical changes can also happen as your body adapts to different levels of hormones. The symptoms you experience during each stage of menopause (perimenopause, menopause and postmenopause) are all part of your body’s adjustment to these changes.

What hormonal changes happen during menopause?

The traditional changes we think of as “menopause” happen when your ovaries no longer produce high levels of hormones. Your ovaries are the reproductive glands that store and release eggs. They also produce the hormones estrogen and progesterone. Together, estrogen and progesterone control menstruation. Estrogen also influences how your body uses calcium and maintains cholesterol levels in your blood.

As menopause nears, your ovaries no longer release eggs, and you’ll have your last menstrual cycle.

How do I know if I'm in menopause?

You’ll know you’ve reached menopause when you’ve gone 12 consecutive months without a menstrual period. Contact your healthcare provider if you have any type of vaginal bleeding after menopause. Vaginal bleeding after menopause could be a sign of a more serious health issue.

How is menopause diagnosed?

There are several ways your healthcare provider can diagnose menopause. The first is discussing your menstrual cycle over the last year. Menopause is unique in that your provider diagnoses it after it occurs. If you’ve gone a full year (12 straight months) without a period, you’ve entered menopause and may be postmenopausal.

Can menopause be treated?

Menopause is a natural process that your body goes through. In some cases, you may not need any treatment for menopause. When discussing treatment for menopause with your provider, it’s about treating the symptoms of menopause that disrupt your life. There are many different types of treatments for the symptoms of menopause. The main types of treatment for menopause are:

• Hormone therapy.
• Nonhormonal treatments.

It’s important to talk to your healthcare provider while you’re going through menopause to craft a treatment plan that works for you. Every person is different and has unique needs.

What is hormone therapy for menopause like?

During menopause, your body goes through major hormonal changes — decreasing the amount of hormones it makes. Your ovaries produce estrogen and progesterone. When your ovaries no longer make enough estrogen and progesterone, hormone therapy can make up for lost hormones. Hormone therapy boosts your hormone levels and can help symptoms like hot flashes and vaginal dryness. It can also help prevent osteoporosis.

There are two main types of hormone therapy:

• Estrogen therapy (ET): In this treatment, you take estrogen alone. Your provider prescribes it in a low dose. Estrogen comes in many forms, such as a patch, pill, cream, vaginal ring, gel or spray. Estrogen therapy isn’t a good treatment for you if you still have a uterus.
• Estrogen Progesterone/Progestin Hormone Therapy (EPT): This treatment is also called combination therapy because it uses doses of estrogen and progesterone. Progesterone is available in its natural form, or also as a progestin (a synthetic form of progesterone). This type of hormone therapy is for people who still have their uterus.

Are there any risks to hormone therapy?

The health risks of hormone therapy include:

• Endometrial cancer (only increased if you use estrogen therapy and still have your uterus).
• Gallstones and gallbladder issues.
• Blood clots.
• Deep vein thrombosis.
• Pulmonary embolism.
• Stroke.

These risks are lower if you start hormone therapy within 10 years of menopause. After that point, your risk for cardiovascular diseases is higher.

A correlation exists between severe hot flashes and night sweats and your risk for cardiovascular disease. Healthcare providers may suggest starting hormone therapy if you have these severe symptoms since it’s an indicator for future cardiovascular risk.

Going on hormone therapy is an individualized decision. Discuss all past medical conditions and your family history with your healthcare provider to understand the risks versus benefits of hormone therapy.

What are nonhormonal therapies for menopause?

Though hormone therapy is a very effective method for relieving menopause symptoms, it’s not the perfect treatment for everyone. Nonhormonal treatments include changes to your diet and lifestyle. These treatments are often good options for people who have other medical conditions or have recently been treated for breast cancer. The main nonhormonal treatments that your provider may recommend include:

• Changing your diet.
• Avoiding triggers to hot flashes.
• Exercising.
• Joining support groups.
• Prescription medications.

Diet

Sometimes changing your diet can help relieve menopause symptoms. Limiting the amount of caffeine you consume every day and cutting back on spicy foods can make your hot flashes less severe. You can also add foods that contain plant estrogen into your diet. Plant estrogen (isoflavones) isn’t a replacement for the estrogen your body makes before menopause. Foods to try include:

• Soybeans.
• Chickpeas.
• Lentils.
• Flaxseed.
• Grains.
• Beans.
• Fruits.
• Vegetables.

Avoiding triggers to hot flashes

Certain things in your daily life could be triggers for hot flashes. To help relieve your symptoms, try and identify these triggers and work around them. This could include keeping your bedroom cool at night, wearing layers of clothing or quitting smoking. Weight loss can also help with hot flashes.

Exercising

Working out can be difficult if you’re dealing with hot flashes, but exercising can help relieve several other symptoms of menopause. Exercise can help you sleep through the night and is recommended if you have insomnia. Calm, tranquil types of exercise like yoga can also help with your mood and relieve any fears or anxiety you may be feeling.

Joining support groups

Talking to other people who are also going through menopause can be a great relief for many. Joining a support group can not only give you an outlet for the many emotions running through your head, but also help you answer questions you may not even know you have.

Prescription medications

Prescription medications such as estrogen therapy (estrogen in a cream, gel or pill), birth control pills and antidepressants (SSRIs and SNRIs) can help manage symptoms of menopause like mood swings and hot flashes. Prescription vaginal creams can help relieve vaginal dryness. A seizure medication called gabapentin has been shown to relieve hot flashes. Speak with your healthcare provider to see if nonhormonal medications could work for managing your symptoms.

Can I get pregnant during menopause?

The possibility of pregnancy disappears once you’re postmenopausal. However, you can get pregnant during the menopause transition (perimenopause). If you don’t want to become pregnant, you should continue to use some form of birth control until you’re sure you’ve gone through menopause. Ask your healthcare provider before you stop using contraception.

What are the long-term health risks associated with menopause?

There are several conditions that you could be at a higher risk of after menopause. Your risk for any condition depends on many things like your family history, your health before menopause and lifestyle factors. Two conditions that affect your health after menopause are osteoporosis and coronary artery disease.

Osteoporosis

Osteoporosis, a “brittle-bone” disease, occurs when the insides of bones become less dense, making them more fragile and likely to fracture. Estrogen plays an important role in preserving bone mass. Estrogen signals cells in the bones to stop breaking down.

People lose an average of 25% of their bone mass from the time of menopause to age 60. This is largely because of the loss of estrogen. Over time, this loss of bone can lead to bone fractures. Your healthcare provider may want to test the strength of your bones over time. Bone mineral density testing, also called bone densitometry, is a quick way to see how much calcium you have in certain parts of your bones. The test is used to detect osteoporosis and osteopenia. Osteopenia is a disease where bone density is decreased and this can be a precursor to later osteoporosis.

If you have osteoporosis or osteopenia, your treatment options could include estrogen therapy.

Coronary artery disease

Coronary artery disease is the narrowing or blockage of arteries that supply your heart muscle with blood. This happens when fatty plaque builds up in the artery walls (known as atherosclerosis). This buildup is associated with high levels of cholesterol in your blood. After menopause, your risk for coronary artery disease increases because of several things, including:

• The loss of estrogen.
• Increased blood pressure.
• A decrease in physical activity.
• Certain lifestyle habits from your past catching up with you (like smoking or excessive alcohol consumption).

Will hormone therapy help prevent long-term health risks?

The benefits and risks of hormone therapy vary depending on your age and health history. In general, younger people in their 50s tend to get more benefits from hormone therapy compared to those who are postmenopausal in their 60s. People who undergo premature menopause often receive hormone therapy until age 50 to make up for the extra years of estrogen loss.

Can menopause affect sleep?

Some people may experience trouble sleeping through the night and insomnia during menopause. This can be a normal side effect of menopause itself, or it could be due to another symptom of menopause. Hot flashes are a common culprit of sleepless nights during menopause.

Can menopause affect my sex life?

After menopause, your body has less estrogen. This major change in your hormonal balance can affect your sex life. Many people experiencing menopause may notice that they’re not as easily aroused as before. Sometimes, people also may be less sensitive to touch and other physical contact than before menopause.

These feelings, coupled with the other emotional changes you may be experiencing, can all lead to a decreased interest in sex. Keep in mind that your body is going through a lot of change during menopause. Some of the other factors that can play a role in a decreased sex drive can include:

• Having bladder control problems.
• Having trouble sleeping through the night.
• Experiencing stress, anxiety or depression.
• Coping with other medical conditions and medications.

All of these factors can disrupt your life and even cause tension in your relationship(s). In addition to these changes, the lower levels of estrogen in your body can cause a decrease in the blood supply to your vagina. This can cause dryness. When you don’t have the right amount of lubrication in your vagina, it can lead to painful intercourse.

Don’t be afraid to talk to your healthcare provider about any decreases you’re experiencing in your sex drive. Your provider will discuss options to help you feel better. For example, you can treat vaginal dryness with over-the-counter (OTC), water-soluble or silicone lubricants. Your healthcare provider can also prescribe estrogen or non-estrogen hormones to treat the vaginal tissue. They can prescribe this in a low-dose cream, pill or vaginal ring.

Do all menopausal people experience a decrease in sexual desire?

Not all people experience a decreased sexual desire. In some cases, it’s just the opposite. This could be because there’s no longer any fear of getting pregnant. For many, this allows them to enjoy sex without worrying about family planning.

However, it’s still important to use protection (condoms) during sex if you’re not in a monogamous relationship. You still need to protect yourself from sexually transmitted infections (STIs). You can get an STI at any time in your life, even after menopause.

Can I get pregnant if I’ve gone through menopause?

No, you can’t get pregnant after menopause because ovulation is no longer occurring.

Does menopause cause weight gain?

It may. Hormone changes can impact your weight. For example, you may start to lose muscle as you get older, which can affect how your body gains weight.

Does menopause affect your teeth or mouth?

Yes. Your teeth and gums are susceptible to the hormonal changes that occur during menopause. This can lead to noticeable symptoms like a dry mouth or sensitive teeth and gums. This could increase your risk of developing cavities or gingivitis.

Does menopause affect your eyes?

Yes. One of the symptoms of the transition to menopause is dry eyes.

Can menopause cause facial hair growth?

Yes, facial hair growth can be a change related to menopause. This is because testosterone is relatively higher than estrogen. If facial hair becomes a problem for you, waxing or using other hair removers may be options.

Is having a hard time concentrating and being forgetful a normal part of menopause?

Unfortunately, concentration and minor memory problems can be a normal part of menopause. Though this doesn’t happen to everyone, it can happen. If you’re having memory problems during menopause, call your healthcare provider. Several activities have been shown to stimulate the brain and help rejuvenate your memory. These activities can include:

• Doing crossword puzzles and other mentally stimulating activities like reading and doing math problems.
• Cutting back on passive activities like watching TV.
• Getting plenty of exercise.

What is premature menopause?

Menopause, when it occurs between the ages of 45 and 55, is considered “natural” and is a normal part of aging. Menopause that occurs before the age of 45 is called early menopause. Menopause that occurs at 40 or younger is considered premature menopause. When there’s no medical or surgical cause for premature menopause, it’s called primary ovarian insufficiency.

Can menopause cause depression?

Yes, several factors related to menopause can lead to depression. Your body goes through a lot of changes during menopause. There are extreme shifts in your hormone levels, you may not sleep well because of hot flashes and you may experience mood swings. Anxiety and fear could also be at play during this time.

If you experience any of the symptoms of depression, talk to your healthcare provider. During your conversation, your provider will tell you about different types of treatment and check to make sure there isn’t another medical condition causing your depression.

Are there any other emotional changes that can happen during menopause?

Menopause can cause a variety of emotional changes, including:

• A lack of motivation and difficulty concentrating.
• Anxiety, depression, mood changes and tension.
• Aggressiveness and irritability.

All of these emotional changes can happen outside of menopause, too. You’ve probably experienced some of them throughout your life.

Your healthcare provider may be able to prescribe a medication to help you (hormone therapy or an antidepressant). It may also help to just know that there’s a name for the feelings you’re experiencing. Support groups and counseling are useful tools when dealing with emotional changes during menopause.

How does menopause affect my bladder control?

Unfortunately, bladder control issues (also called urinary incontinence) are common for people going through menopause. There are several reasons why this happens, including:

• Estrogen. Estrogen plays many roles in your body, including keeping the lining of your bladder and urethra healthy.
• Pelvic floor muscles. They support the organs in your pelvis — your bladder and uterus. Throughout your life, these muscles can weaken. This can happen during pregnancy, childbirth and from weight gain. When the muscles weaken, you can experience urinary incontinence (leakage).

Will I start menopause if I have a hysterectomy?

It depends on if your surgeon also removed your ovaries during the hysterectomy. If you kept your ovaries, you may not have symptoms of menopause right away. If your surgeon also removes your ovaries, you’ll have symptoms of menopause immediately.

Can I have an orgasm after menopause?

Yes, you can still have an orgasm after menopause. An orgasm may feel hard to achieve once you’ve reached menopause, but there’s no physical reason to prevent you from having an orgasm.

Do men go through menopause?

Andropause, or male menopause, is a term that describes decreasing testosterone levels in men or people assigned male at birth (AMAB). Testosterone production in men declines about 1% per year — much more gradually than estrogen production in women. Healthcare providers often debate calling this slow decline in testosterone “menopause” since it’s not as drastic of a hormone shift and doesn’t carry the same intensity of side effects as menopause in women. Some men won’t even notice the change because it happens over many years or decades. Other names for the male version of menopause are age-related low testosterone, male hypogonadism or androgen deficiency.

Schedule a consultation appointment with one of our doctors at ourJalandhar location to find out if Menopause Treatment is your best option for pregnancy.

Women with polycystic ovary syndrome (PCOS) have a hormonal imbalance that interferes with normal reproductive processes. PCOS usually starts at puberty and is associated with irregular periods and other hormone-related symptoms. The most concerning issues with PCOS are the increase of infertility, the risk of developing type 2 diabetes and cardiovascular disease, and the higher risk of developing endometrial (uterine) cancer at an early age.

What are the symptoms of PCOS?

• Irregular menstrual periods, or no menstrual periods at all.
• Decreased frequency or complete lack of ovulation, resulting in problems with infertility.
• Obesity, often specifically characterized by weight gain in the upper body and abdomen.
• Oily skin and hair and persistent acne into adulthood.
• Abnormal hair growth, in a masculine distribution (facial hair, heavy hair growth on arms, chest, and abdomen).
• Tendency to develop type 2 diabetes.

What causes PCOS syndrome?

Research is ongoing to uncover a cause for PCOS. There is evidence that shows a link between certain forms of PCOS and family history, suggesting a genetic basis for the condition.

How is PCOS diagnosed?

Most cases can be diagnosed with a thorough evaluation of your medical history and symptoms, as well as a physical exam. A blood test may be required to measure the levels of various hormones. In some cases, an ultrasound of the ovaries may help with diagnosis.

How is PCOS treated?

Although PCOS can be treated with medications, treatment is often highly dependent on your goals and your symptoms.

If you want to become pregnant, you may need the assistance of oral or injected fertility medications. If you do not want to become pregnant, you may consider birth control pills to prevent pregnancy and regulate periods. Periods can also be regulated using the hormone progesterone.

There is also a non-hormonal treatment option which is a medication usually used for diabetes. Even if you don't have diabetes, this medication may help restore fertility and assist with weight loss.

Other symptoms such as unwanted hair growth, acne, obesity, and diabetes should be managed by specialists in those areas. Birth control pills are often helpful in the treatment of hair growth and acne.

Specific treatment options should be discussed with your physician.

How can PCOS be prevented?

There is no known prevention for PCOS. However, through proper nutrition and weight management, many women with polycystic ovary syndrome can avoid developing diabetes and cardiovascular problems.

How can I improve my chances of conceiving if I have PCOS?

While specific fertility issues should be addressed with your physician, there are some general healthcare guidelines that may improve your chances of becoming pregnant:

• Folic acid (400 mcg. supplement a day, with a diet rich in folic acid, including leafy green vegetables, dried beans, liver, and citrus fruits)
• Limit caffeine (Fewer than two caffeinated beverages per day)
• Eat well (Healthy well-balanced diet)
• Exercise and maintain a healthy weight (maintain a normal exercise routine, 20 to 30 minutes per day, 4 to 5 times per week)

The Chawla IVF medical team at Chawla Nursing Home understands the risks and rewards that come with Polycystic Ovary Syndrome (PCOS) Treatment, and we will help you through every step of the way. Schedule a consultation appointment with one of our doctors at our Jalandhar location to find out if Polycystic Ovary Syndrome (PCOS) Treatment is your best option for pregnancy.

Premature ejaculation is a type of sexual dysfunction that occurs when a man has an orgasm and releases (ejaculates) semen sooner than he or his partner would like. It often happens before or shortly after penetration during intercourse. Premature ejaculation can be a frustrating experience for both you and your sexual partner and makes your sex lives less enjoyable. However, the good news is that it’s usually fixable!

How common is premature ejaculation?

Between 30% and 40% of men experience premature ejaculation at some point in their life. According to the American Urological Association, premature ejaculation is the most common type of sexual dysfunction in men. About one in five men between the ages of 18 and 59 report incidences of premature ejaculation.

Although the definition of premature ejaculation varies, the American Urological Association defines ejaculation as “premature” if it occurs sooner than desired, either before or shortly after penetration, causing distress to either one or both partners. The American Psychiatric Association defines three levels of severity (mild, moderate, and severe), based on time to ejaculation, with mild being under one minute. If pressed for a time frame, many doctors would define prematurity as ejaculation within a minute of beginning intercourse. Despite professional opinions, your feelings as to what is premature are also considered.

What causes premature ejaculation?

Physical, chemical and emotional/psychological factors cause premature ejaculation.

Physical and chemical problems include:

- An underlying erectile dysfunction diagnosis.

- A hormonal problem with oxytocin levels, which has a role in sexual function in men. Other hormone levels that play a role in sexual function include luteinizing hormone (LH), prolactin and thyroid-stimulating hormone (TSH)

- Low serotonin or dopamine levels, chemicals in the brain that are involved in sexual desire and excitement.

- A penis that is extra sensitive to stimulation.

Emotional or psychological causes include:

- Performance anxiety. This could be due to the nervousness of being with a new partner, the anxiousness of having sex again after a long period of abstinence, lack of confidence, guilt, being overly excited or stimulated or other reasons.

- Stress.

- Relationship problems.

- Depression.

How are the causes of premature ejaculation diagnosed?

If you have frequent premature ejaculations, or if premature ejaculation is causing you anxiety or depression and affecting your relationship, make an appointment to see a urologist.

Your urologist will begin an exam by asking about your sexual experiences. You will likely be asked:

- How long have you had this problem?

- Under what circumstances does it happen?

- How often does it happen?

- Does premature ejaculation happen at every sexual attempt?

- Does it happen with all partners?

- Does premature ejaculation occur when you masturbate?

- Do you have trouble maintaining an erection?

While the questions are personal, you must answer your urologist honestly so they can best diagnose the source of your problem.

Your urologist will also ask about any other medical conditions you may have and any medications including over-the-counter medications, supplements and herbal products you are taking. You will also be asked about any alcohol and illegal drug use.

RETROGRADE EJACULATION AND INFERTILITY

Unlike premature ejaculation, retrograde ejaculation does impact fertility. This is not a common condition and causes only about 0.3-2% of infertility problems. With retrograde ejaculation, the sperm are not making it to your partner even though they are viable.

Retrograde ejaculation is the result of the sphincter muscles of the bladder failing to respond correctly. Instead of semen travelling out through the head of the penis, it travels back into the bladder, where most of the sperm becomes trapped.

Certain health conditions such as diabetes or hypertension or mood-altering medications can cause retrograde ejaculation. Surgery to the prostate or urethra can also result in this condition. In some situations, it is reversible. Treatment for the condition depends on the cause. It may be as simple as stopping a certain medication.

Chawala Nursing Home can help you build your family, whether you are experiencing premature ejaculation or retrograde ejaculation. Contact our fertility office to schedule an appointment for an examination and consultation. We will help you explore your options.

A semen analysis looks at the volume and quality of a man’s sperm. It is one of the first steps to detect male fertility issues. The test also shows whether a vasectomy was successful. Semen analysis involves collecting a semen sample and evaluating it in a lab.

What is semen?

This substance is released from a man’s penis when he has an orgasm (ejaculates). It contains:

Sperm, male reproductive cells. The cells have a unique shape that contains:

• Head, which includes genetic material (DNA) to fertilize a woman’s egg.
• A tail that helps it travel (“swim”) through a woman’s reproductive system to reach the egg and fertilize it.

Fluids, which make it possible to deposit sperm toward the back of a woman’s vagina. This area is close to the cervix, which is the opening of the uterus, where a fetus develops.

Proteins, vitamins and minerals that fuel the sperm’s journey to the egg

What is a semen analysis?

A semen analysis is a lab test that examines a sample of semen under a microscope. It evaluates things such as sperm count, activity (motility) and shape (morphology).

Who needs a semen analysis?

Reasons you may need a semen analysis include:

Male infertility: If a couple has been having difficulty trying to conceive, there may be a semen abnormality. In some cases, it’s due to an issue with a man’s sperm. A semen analysis evaluates the likelihood that a man can cause a pregnancy.

Vasectomy follow-up: A semen analysis determines whether a vasectomy was successful. This procedure blocks the tubes that deposit sperm in semen. If there are no sperm in the semen, the vasectomy worked, and a man cannot get a woman pregnant.

How does a semen analysis work?

A man masturbates to produce a semen sample. This is the preferred method because it provides a clean sample. Since sperm counts vary from day to day, you may need to provide more than one sample spaced out a few weeks apart.

Healthcare providers use research-based methods to handle and test semen. Going to a lab that specializes in semen analysis ensures you receive accurate results.

This includes labs that:

• Are part of a fertility clinic.
• Perform a high volume of semen analyses.

What does the analysis look at?

A post-vasectomy semen analysis checks to see whether the semen contains sperm.

• Normal results would show no sperm or very few non-moving sperm.
• Abnormal results would contain moving sperm or high numbers of non-moving sperm.

When used as a fertility test in men, it looks at:

• pH level: Whether semen is too acidic, which can affect sperm health.
• Semen volume: Amount of semen in the sample (in millimetres).
• Sperm concentration: Number of sperm per millimetre of semen.
• Sperm morphology: Size and shape of the sperm.
• Sperm motility: Ability of the sperm to swim toward an egg.
• Time to liquefaction: How quickly semen changes from a sticky substance to a liquid.
• Vitality: Percent of live sperm in the sample.
• White blood cells: A sign of infection or inflammation.

How do I prepare for a semen analysis if it’s used for fertility testing?

You will need to abstain from sexual activity for two to seven days. This includes intercourse and masturbation. Doing so ensures sperm counts are at their highest level, so you receive a thorough analysis.

How do I prepare for post-vasectomy semen analysis?

This test is done after a vasectomy is performed, usually 8 to 12 weeks later. It’s helpful to masturbate several times after your vasectomy. This helps clear sperm from your system. You may be able to provide a semen sample at home and then bring it to the lab.

How do I provide a semen sample to check fertility?

Providing a sample by masturbating is the preferred method. This usually takes place in a lab in a private, comfortable room. You put the sample into a sterile, wide-mouthed container.

If you are not able to masturbate due to religious reasons, you still have options. Your healthcare provider may give you a nonlubricated condom to use during intercourse.

What do results look like for post-vasectomy semen analysis?

After a vasectomy, it can take several weeks for semen to become sperm-free (azoospermia) or have very few non-moving sperm. You should use backup birth control, like condoms until you have a test with the desired result.

What do results look like for male fertility testing?

The lab compares the characteristics of your semen to expected values. Your semen should contain:

• Active sperm, each with a single round head and tail.
• A certain number of sperm.
• Have a pH that’s not too acidic.
• The fluid turns into liquid in a short amount of time so it can travel through a woman’s reproductive system.

What do abnormal results mean for my ability to help a woman conceive?

Abnormal results mean that you have a below-average chance of getting a woman pregnant. But a semen analysis is not the only factor in evaluating male infertility.

Extra testing is often needed to learn more. These tests may confirm or rule out:

• Blockages that prevent the body from releasing sperm into semen.
• Infection.
• Low sperm count.
• Low testosterone or hormone abnormalities.
• Side effects of medications or other medical issues.

Contact Chawla Nursing Home to schedule an appointment for a consultation to learn more about our Semen Analysis.

Sperm banking collects, freezes and stores your sperm cells. Many people bank their sperm to increase their chances of having biological children in the future. Sperm banking is safe and helps you maintain your fertility for years.

What is sperm banking?

Sperm banking is a process that collects, freezes and stores your sperm cells in a special healthcare facility (sperm bank).

Sperm cells are reproductive cells in men and people assigned male at birth (AMAB). Your testes (testicles) produce sperm. When you ejaculate during orgasm, you release approximately 300 million sperm cells in your semen. Semen is the whitish-grey fluid that releases from your penis when you orgasm.

Why should I bank my sperm?

Deciding to bank your sperm is very personal. You may want to use your sperm to have children in the future. However, your current situation or circumstances may not allow you to have a baby through sex (intercourse). Situations or circumstances may include:

• Health conditions. Testicular cancer, Hodgkin’s lymphoma and leukaemia have high risks of causing male infertility.
• Certain treatments. Some treatments may prevent you from achieving pregnancy (infertility). These may include chemotherapy, orchiectomy or gender affirmation surgery. After these treatments, your sperm cell numbers may decrease significantly, or you may no longer be able to make sperm.
• Age. Most men and people AMAB make millions of new sperm cells each day. However, as you age, the quality of your sperm may decrease. This generally occurs in men aged 40 and older.
• Low sperm count. You may have a low sperm count if you’re younger than 40. Even banking a low number of quality sperm can help you have children through assisted reproductive procedures. One effective procedure is in vitro fertilization with intracytoplasmic sperm injection (ICSI).
• Frequent travelling. Many people travel a lot for work. The best time for women or people assigned female at birth (AFAB) to get pregnant is during their fertile window (five days before ovulation up to one day after ovulation). If your partner ovulates while one of you is travelling, they may use your frozen sperm to become pregnant.
• Military deployment. Dangerous military employment may result in injuries to your reproductive organs.
• Vasectomy. Many people choose to have a vasectomy as a form of birth control. However, they may change their minds as they get older and wish to have children.

If you’re married or in a committed relationship, it’s best if your partner is involved in your decision. If you’re younger than 18, you should discuss your thoughts with your parents, guardians or caregivers.

When should I start banking my sperm?

You may have to decide to bank your sperm quickly, especially if you have a serious illness. It’s a good idea to talk to your healthcare provider about banking your sperm before starting treatment.

It’s usually safe to collect sperm samples during your first week of chemotherapy or radiation treatments. Chemotherapy and radiation may damage the genetic material in your developing sperm, but your mature sperm are resistant to damage.

Will banking sperm delay my medical treatment?

No, banking your sperm won’t delay the start of your medical treatment.

Your testicles constantly produce sperm. However, it takes time to build up (replenish) your sperm cell levels after each ejaculation. It’s best to collect a sample at least 48 hours after your last sexual activity (masturbation or intercourse) to have the greatest sperm cell level.

You may have to collect several samples. Your healthcare provider will collect other samples after another 48 hours of abstinence. However, if your treatment schedule doesn’t allow that much time, waiting 24 hours between collections is often enough.

How common is sperm banking?

Sperm banking is common. Healthcare providers first preserved semen in dry ice in 1953 and later used it to conceive a human baby. They used liquid nitrogen to preserve semen samples starting in 1963.

What happens before sperm banking?

Before you bank your sperm, your healthcare provider will test you for sexually transmitted infections (STIs), including syphilis, hepatitis B, hepatitis C and HIV and AIDS. They’ll likely use a blood test.

During a blood test, your healthcare provider will use a thin needle (21 gauge, slightly smaller than a standard earring) to withdraw a small amount of blood from a vein in your arm. It’s not usually painful, but you’ll feel a slight pinch as the needle goes through your skin.

After your healthcare provider has taken your blood sample, they’ll send it to a laboratory (lab) for testing. Lab technicians will then examine your blood for the presence of any STIs.

What happens during sperm banking?

During sperm banking, you’ll go to a special healthcare facility called a fertility clinic. A healthcare provider will lead you to a private room and give you a special container.

The container is usually a small plastic jar with a screw-top lid. Some fertility clinics also offer collection condoms. Collection condoms are different from over-the-counter (OTC) condoms. OTC condoms can damage your sperm. Many also contain lubricants that kill sperm cells (spermicide).

In the privacy of the room, you’ll masturbate and use the special container to collect your semen.

Lubricants, including saliva, may damage or slow down your sperm. If you require a lubricant, your healthcare provider can provide an approved lubricant that’s safe for sperm.

Some people may require the use of a masturbation aid (sex toy). If you wish to use a sex toy, talk to your healthcare provider to ensure it won’t damage your sperm or limit your sample.

Masturbation is a private act. Some people have difficulty providing a semen sample outside of the comfort of their homes. If you’re not comfortable or can’t masturbate at a fertility clinic, you may be able to use a home sperm-banking kit. Your healthcare provider can discreetly mail a sperm-banking kit to your home along with detailed instructions for collecting and returning the sample for storage.

If you provide a semen sample at home, you may have to drop your semen off at the fertility clinic within a few hours. You may also have to keep it as close to your body temperature as possible to ensure your sperm’s health.

What happens after sperm banking?

After you’ve collected your semen sample and given it to your healthcare provider, they’ll carefully label and code your sample with:

• Your name.
• Your patient identification (ID) number.
• An internal control number (an additional unique number that ensures proper identification).
• The date.

The fertility clinic may copy your photo ID for your permanent file as an additional safety measure.

This information ensures accurate identification and confidentiality at the time of storage, during storage and at the time of release.

Your healthcare provider will collect a small amount of your semen sample for testing. They’ll divide the rest of your sample into small amounts, treat them with a special chemical that protects your sperm during the freezing process (cryopreservative) and store them in special containers called cryovials.

The freezing process starts right away. Your healthcare provider will place the samples in a freezer set to -20 degrees Fahrenheit (-29 degrees Celsius). This step prevents your sperm from dying due to an extreme drop in temperature.

Your healthcare provider then puts your samples in a liquid nitrogen vapour that’s -86 degrees Fahrenheit (-66 degrees Celsius) for approximately two hours.

Finally, your healthcare provider will permanently store your samples in a deep freeze storage tank that contains liquid nitrogen. The liquid nitrogen is -321 degrees Fahrenheit (-196 degrees Celsius).

What tests are done on my sperm?

Your healthcare provider will analyze a small amount of your semen sample before freezing it. They’ll examine:

• The total number of sperm cells.
• The total number of live sperm.
• The percentage of sperm that are moving (motility).

Between 24 and 48 hours after your healthcare provider freezes your semen sample, they’ll analyze a small amount to measure the percentage of sperm that survive the freezing process. In general, sperm from a high-quality semen sample has a better recovery rate after thawing.

Based on the test results before and after freezing, your healthcare provider can recommend the optimal number of semen samples to ensure the best chance of pregnancy. They can also advise whether intrauterine insemination (artificial insemination) or in vitro fertilization is your best treatment option.

How can I withdraw my semen sample?

Notify your fertility clinic at least four weeks before you’re ready to use it for fertility treatment. You or your legally appointed executor must then fill out a release form.

What are the advantages of sperm banking?

There are many advantages to banking your sperm, including:

• Fertility. Medical treatments and biological or environmental factors can cause male infertility. Banking your healthy sperm helps maintain your fertility or gives you the option to have biological children if circumstances in your life change.
• Health and safety. Using cryopreserved sperm don’t increase the risk of congenital conditions (conditions present at birth). Babies conceived with cryopreserved sperm are just as healthy as those conceived through sexual intercourse.
• Longevity. When stored correctly, semen samples don’t deteriorate even after many years of deep freezing.

What are the risks or complications of sperm banking?

Complications of sperm banking may include:

Ejaculation failure

Some conditions may cause erectile dysfunction (ED), delayed ejaculation, inability to ejaculate (anejaculation) or other symptoms that may make it difficult or impossible to collect a quality semen sample through masturbation.

If you can’t produce a semen sample through masturbation, your healthcare provider may suggest surgically retrieving your sperm cells. Sperm retrieval surgeries include:

• Microscopic testicular sperm extraction (microTESE).
• Needle aspiration biopsy (NAB).
• Percutaneous epididymal sperm aspiration (PESA).

Cost

The cost of cryopreserving one semen sample is usually around Rs.80,000. Each semen sample usually costs about Rs.30,000 to store each year.

It’s a good idea to check with your insurance provider to see if they cover the costs of banking sperm.

Inherited disorders

If you wish to bank your sperm because you have cancer, you may worry about the health of your biological children.

A few types of cancer can run in families. Your healthcare provider can tell you whether your cancer is one of those types.

If you have a type of cancer or hereditary condition that runs in families, it’s a good idea to talk to a genetic counselor. Genetic counsellors are healthcare providers with special training in educating people about the risks of an inherited disorder.

What happens to my stored sperm samples if I die?

When you bank your sperm, it’s a good idea to legally appoint a partner, family member or trusted friend as an executor (someone who can execute your will). They can withdraw your sperm samples from the sperm bank after your death. They can also order a sperm bank to destroy your samples if you wish.

Your significant other may wish to use your banked sperm to have children.

Contact Chawla Nursing Home to schedule an appointment for a consultation to learn more about our Sperm Banking.

Comprehensive Circumcision Services: Balancing Tradition and Health

Welcome to our in-depth guide on Circumcision, a procedure that intertwines cultural, medical, and personal facets. Also referred to as Male Circumcision, this practice entails the surgical removal of the foreskin, or Prepuce, revealing a complex interplay of tradition and health considerations. This article provides a holistic view of circumcision, its varied applications, and its implications for individuals and communities.

Indications: Circumcision serves a range of purposes, making it more than just a surgical procedure. From addressing medical conditions like Phomisis(a condition of the tight foreskin) and Paraphimosis (where the foreskin gets trapped behind the glans) to managing Balanitis (inflammation of the glans), the indications for circumcision encompass health, hygiene, and prevention.

Our Circumcision Surgery offerings encompass various techniques, including the advanced Stapler Circumcision and the innovative Zsr Circumcision Surgery. These methods not only ensure efficacy but also contribute to minimal discomfort and a quicker recovery.

Benefits and Considerations: The benefits of circumcision extend beyond medical management. Improved genital hygiene and reduced risk of certain infections are some of the health advantages. However, cultural and religious dimensions cannot be overlooked. For some, Religious Circumcision signifies a deeply rooted practice, while others opt for Medical Circumcision for personal or health reasons.

Affordable Solutions: Low cost circumcision Surgery: We understand that access to quality healthcare is crucial. Our commitment to providing comprehensive care extends to ensuring affordability. Our Low cost circumcision Surgery services enable individuals to make informed decisions without compromising on quality and safety.

Variety of Techniques: Stapler Circumcision (Zsr Circumcision): Our expertise encompasses a range of techniques to suit individual needs. Stapler Circumcision offers precision and reduced operative time, while Zsr Circumcision Surgery brings the benefits of quick recovery and minimal tissue trauma.

Circumcision Rates and Neonatal Circumcision: Circumcision rates vary worldwide, influenced by cultural norms, religious practices, and medical recommendations. Neonatal Circumcision —performed shortly after birth—is often a choice made by parents, considering health benefits and cultural factors. Decisions should be well-informed, taking medical advice and cultural preferences into account.

Conclusion: Circumcision is a multifaceted practice that necessitates a nuanced understanding. It involves more than the physical removal of the foreskin; it touches on health, identity, culture, and tradition. Our dedicated services aim to provide comprehensive support, ensuring you make an informed choice that aligns with your health needs and personal beliefs.

Contact Chawla Nursing Home and Maternity Hospital to schedule an appointment for a consultation to learn more about our Circumcision treatment.

Erectile Dysfunction (ED): Causes, Symptoms, and Treatment Options

Are you or someone you care about facing the challenges of Erectile Dysfunction (ED), also known as impotence or male sexual dysfunction? You're not alone. ED is a common issue that affects millions of men worldwide. We aim to provide comprehensive information about ED, including its causes, symptoms, diagnosis, and the various treatment options available, including ED medications like Viagra, Cialis, and Levitra.

Causes of Erectile Dysfunction (ED): ED can have both psychological and physical causes. Psychological factors like stress, anxiety, depression, and relationship problems can contribute to ED. On the other hand, physical causes may include diabetes, heart disease, obesity, high blood pressure, smoking, and hormonal imbalances. Understanding the underlying cause is crucial for effective treatment.

Symptoms and Diagnosis: The key symptom of ED is the consistent inability to achieve or maintain an erection sufficient for sexual activity. If you're experiencing these symptoms, it's essential to consult a specialist who can diagnose the issue. Accurate diagnosis often involves a physical exam, blood tests, and a discussion of your medical history and lifestyle factors.

Treatment Options: Fortunately, ED is a treatable condition, and there are various options available. PDE5 inhibitors like Viagra, Cialis, and Levitra are commonly prescribed medications that enhance blood flow to the penis, aiding in achieving and sustaining an erection. Lifestyle changes, including exercise, a healthy diet, and stress management, can also improve ED.

Natural Remedies and Exercises: For those seeking alternatives or complementary therapies, there are natural remedies and exercises that may help alleviate ED symptoms. These include kegel exercises, acupuncture, and herbal supplements. However, it's crucial to consult a healthcare professional before trying these approaches.

Support and Resources: Living with ED can be emotionally challenging, affecting not only individuals but also their partners and relationships. Support groups, counselling, and open communication can play a crucial role in addressing these concerns.

Prevention and Awareness: Understanding ED risk factors, such as the connection between ED and diabetes, high blood pressure, or prostate cancer, can help individuals take preventive measures. Regular check-ups and a healthy lifestyle are vital steps towards maintaining sexual health.

Your journey towards regaining sexual health and well-being begins with understanding and taking proactive steps. Contact our helpline 9023703001, 18009003001

You may not know you have a low sperm count (also called oligospermia) until you’re trying to have a baby and aren’t succeeding. Tests may show that you have fewer than the typical number of sperm. There are treatments for many causes of low sperm count.

What is oligospermia (low sperm count)?

Oligospermia is a term that means you have a low sperm count. One medical definition is that you have fewer than 15 million sperm in 1 millilitre of semen. A typical sperm count is more than 15 million sperm per 1 milliliter of semen.

Besides being known as low sperm count, oligospermia is also called oligozoospermia. A severely low sperm count (fewer than 5 million sperm in 1 millilitre of semen) is also known as severe oligospermia.

What is the difference between oligospermia and azoospermia?

Oligospermia means that you do have a measurable amount of sperm in your semen, but the numbers are lower than the typical numbers. If you have azoospermia, it means there no sperm seen in your semen.

Having a low sperm count is a significant factor in infertility. You may be infertile if you’ve been trying to get pregnant (or get someone pregnant) for a year and haven’t yet done so. This means that for at least a year you’ve been having regular sex without using birth control methods.

How common is oligospermia?

Researchers aren’t sure how many people have oligospermia. The condition isn’t usually diagnosed unless a couple is trying to conceive and can’t. There are an estimated 180 million couples throughout the world who are dealing with infertility.

Infertility among people who have been assigned male at birth contributes to about half of the infertility issues overall. (Healthcare providers may call this male infertility or male-factor infertility.) This figure of about 50% includes situations where male factor infertility is the only factor and those more common situations where there are fertility factors in both partners.

What are the signs and symptoms of oligospermia?

The main sign or symptom of a low sperm count is the inability to conceive a baby with a partner after one year of unprotected sexual intercourse.

What causes a low sperm count?

There are a variety of things that could cause you to experience oligospermia or other sperm disorders. The list of causes includes:

- Diseases, including those related to genetics, infection, hormones and obstructions (blockages).

- Environmental toxins.

- Heat.

- Drugs.

Diseases and conditions

Some of the diseases that can cause a low sperm count include:

- Genetic conditions such as Klinefelter syndrome and cystic fibrosis.

- Infections such as sexually transmitted infections, urinary tract infections, and viral illnesses including mumps.

- Issues like low testosterone and other hormonal abnormalities. Hypogonadism is a condition where the sex glands don’t produce enough sex hormones.

- Blockages that stop sperm from leaving your body.

Toxins

Toxins aren’t good for any part of your body, including sperm count. Some of the toxins that are present in the environment include heavy metals like arsenic, cadmium, lead and mercury.

Heat

Your testicles work best at a particular temperature, which is slightly lower than your body temperature. Heat-related situations that affect sperm production include:

- Having undescended testicles. If the testicles are still up near the groin, they’re too hot.

- Having varicocele. These twisted veins can be large and can increase the temperature of the testicles.

- Spending a long time in hot tubs. This cause may be reversed – your sperm count could increase once you stop spending time in hot water.

Medications and drugs

Both prescribed medications and non-prescription substances can make your sperm count low. Many categories of medications can be involved. Some of these medications include:

- Testosterone.

- Methadone.

- Nitrofurantoin.

- Lamotrigine.

- Clomipramine.

- Paroxetine.

- Prednisone.

- Methotrexate.

- Finasteride.

- Sirolimus

Many other medications may affect sperm counts. Check with your healthcare provider or pharmacist if you think your medication may be causing problems. Don’t stop taking prescribed medications on your own without discussing them with your healthcare provider.

How is oligospermia diagnosed?

Your healthcare provider will take a medical history and do a physical examination. They may order other tests, including:

- Semen analysis and sperm function tests.

- Urinalysis to test for retrograde ejaculation (sperm moving backwards inside you).

- Imaging tests of your reproductive organs, including transrectal and scrotal ultrasounds.

- Tests of your endocrine system to measure hormone levels.

- Testing for genetic disorders.

How is oligospermia treated?

Your provider’s treatment suggestions will depend on the cause of the oligospermia. You may increase your sperm count by stopping medications or behaviours that are contributing to low sperm levels.

Other causes may need other treatments. For instance:

- You may need surgery to treat a varicocele or blocked sperm ducts.

- Your provider may prescribe hormone supplements.

- Your provider may prescribe antibiotics for infections.

- Your provider may suggest counselling to deal with issues like erectile dysfunction or premature ejaculation.

There are cases when you won’t be able to increase your sperm count. If you’re trying to conceive, your provider might suggest other ways to assist in reproduction.

Learn more about our procedures and your options by scheduling a consultation appointment with one of our doctors.

Azoospermia: Understanding Male Infertility and Fertility Challenges.

Azoospermia: Unveiling the Challenge

Azoospermia, often referred to as "no sperm count," is a perplexing condition within the realm of male infertility. In this condition, the ejaculate contains zero sperm, posing a significant hurdle for couples aspiring to conceive. The absence of sperm can stem from various underlying factors, affecting the complex process of sperm production, maturation, and release.

About Male Infertility

Male infertility can be attributed to multiple factors, including issues related to sperm production, quality, and transportation. Among the contributing factors are hormonal imbalances, genetic anomalies, testicular failure, and obstructions in the reproductive system. These factors collectively can lead to conditions like azoospermia, where the sperm count is reduced to zero, or oligospermia, characterized by a low sperm count.

Understanding Azoospermia Types

Two primary categories of azoospermia exist: non-obstructive azoospermia and obstructive azoospermia. In non-obstructive azoospermia, a malfunction in the testicles hinders sperm production, often attributed to conditions like Sertoli cell-only syndrome or hormonal imbalances. On the other hand, obstructive azoospermia results from physical blockages that prevent the sperm from reaching the ejaculate despite being produced in the testicles.

Diagnostic Approaches

Diagnosing azoospermia involves a critical step called semen analysis. This process examines the ejaculate for the presence or absence of sperm. If no sperm are found, further investigations are conducted to discern whether the issue is non-obstructive or obstructive in nature. This distinction is crucial for determining appropriate treatment options.

Treatment Paths

The treatment journey for azoospermia varies based on the underlying cause. In cases of obstructive azoospermia, where sperm production is normal but blocked, surgical procedures can help retrieve sperm from the reproductive tract. Non-obstructive azoospermia treatments may include hormonal therapies, lifestyle adjustments, and assisted reproductive techniques such as in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI).

Genetic Aspects and Reproductive Health

Genetic causes of azoospermia shed light on how certain genetic mutations and abnormalities can disrupt the normal processes of sperm production and maturation. Understanding the genetic components of azoospermia can not only aid in diagnosis but also influence family planning decisions and reproductive health strategies.

Empowering Fertility Solutions

At Chawla Embryo IVF, Chawla nursing home and maternity hospital, Jalandhar Punjab, we understand the profound impact of azoospermia on couples' dreams of parenthood. Our expert team is dedicated to providing comprehensive diagnostic assessments, personalized treatment plans, and unwavering support throughout your journey. We believe in empowering our patients with knowledge, compassion, and the latest advancements in reproductive medicine to overcome fertility challenges.

Contact Us:

Contact us today on +919023703001,+917307103001 to schedule a consultation and embark on a path towards understanding, addressing, and conquering azoospermia. Your journey to parenthood begins here Chawla nursing home and Maternity Hospital, Jalandhar ,Punjab

Varicoceles (pronounced “VAIR-ick-oh-seals”) are a common disorder of the veins inside your scrotum, the protective sac that protects and holds your testicles (balls). If you have a varicocele, it means veins inside your scrotum are enlarged (wider than they should be).

Varicoceles are similar to varicose veins, a common condition that causes veins in your leg to swell and lose their shape.

Varicoceles are usually painless but can sometimes cause aching testicles or pain that may come and go. In some people, a varicocele can affect fertility. If a varicocele doesn’t bother you, you may not need treatment.

How common are varicoceles?

Varicoceles affect 15% to 20% of all men and people assigned male at birth (AMAB) in the U.S. — about 1 in 5. In most people who have a varicocele, it occurs on the left side. Less commonly, it can sometimes affect the right-sided scrotum or both sides.

Who gets varicoceles?

Varicoceles can happen to anyone with testicles, at any age. Healthcare providers believe many cases are congenital (present at birth). Often, people notice a varicocele during their teenage years. Medical experts suspect this timing has to do with puberty, when blood flow to the genitals increases. Sometimes, the varicocele can prevent your testicle from growing properly.

What are the symptoms of varicoceles?

A varicocele often causes no symptoms. You may notice:

- Dull testicular pain or scrotal aching, which often gets better when you lie down.

- Symptoms that get worse after certain activities, such as bike riding or being on your feet for hours.

- Swollen testicle or scrotum.

- Size changes or differences in your testicles.

- Male infertility (inability to conceive after one year of trying).

- Small lump above the affected testicle.

What does a varicocele feel like?

Varicoceles may cause mild discomfort, aches or pain, usually in your left testicle. Larger, swollen veins in your scrotal sac often feel or look like a bag of worms (or spaghetti). A small varicocele may be too small to see or feel.

How is a varicocele diagnosed?

A healthcare provider may diagnose a varicocele after examining your symptoms during a physical exam. To confirm a diagnosis, you might have an ultrasound test, which can provide more detail of your testicular veins.

Your provider may recommend semen tests or blood tests if you’re concerned that a varicocele may affect your fertility. Some insurance providers cover semen tests, but others might not.

If you are experiencing problems with fertility, contact the specialists at Chawla Fertility clinic. We provide options and solutions for a variety of fertility issues. Schedule your consultation appointment with us today.

A penile implant restores your ability to get an erection. There are two types of penile implants: inflatable and non-inflatable. Risks include erosion and mechanical failure. Most people can resume sexual activity six weeks after receiving a penile implant.

What is a penile implant?

A penile implant is a surgically implanted device that helps you get an erection, usually if you have erectile dysfunction (ED).

There are two types of penile implants:

• Inflatable penile implant: A pump in your scrotum (the pouch of skin behind your penis) allows you to get an erection whenever you choose.
• Non-inflatable penile implant: Bendable silicone rods in the erection chambers of your penis allowing you to extend the rods into an erect position.

Other names for a penile implant include penis implant and penile prosthesis.

How does a penile implant work?

An inflatable penile implant consists of two cylinders, a reservoir and a pump that a healthcare provider surgically places in your body.

The provider inserts the cylinders into your penis. Tubes connect the cylinders to a separate reservoir under your lower abdominal (stomach) muscles. The reservoir contains fluid. A pump also connects to this system. It sits under the loose skin of your scrotum, between your testicles.

To inflate the implant (prosthesis), you press the pump in your scrotum. Pressing the pump doesn’t put any pressure on your testicles. The pump transfers fluid from the reservoir to the cylinders in your penis, inflating them to the level of hardness that you want. Once erect, you can maintain your erection for as long as you wish, even after an orgasm. When you want to stop being erect, pressing a valve on the pump returns the fluid to the reservoir, which deflates your penis.

A non-inflatable penile implant consists of two firms, flexible silicone rods. This type of device doesn’t require pumping. To use the implant, you press on your penis to extend the rod into position. You can use the implant for as long as you wish — the hardness doesn’t change, even after an orgasm. After using the implant, you press on your penis again to push it back down.

Who is a good candidate for a penis implant?

Most people who are good candidates for a penis implant have ED or Peyronie’s disease. However, their condition can’t improve naturally or with other conservative medical treatments, such as medications or a vacuum constriction device (penis pump).

A healthcare provider may also recommend penile implants as a component of gender affirmation surgery. A penile implant occurs after surgery to construct a penis (metoidioplasty or phalloplasty).

How common are penile implants?

Penile implants are becoming more common. Worldwide, healthcare providers performed over 63,000 penile implants between 2005 and 2012. About 86% of those procedures occurred in the United States.

How long does a penile implant last?

On average, penile implants last 20 years. When the implant wears out, it stops working. Your surgeon can revise it, usually by replacing it with a new implant.

Do penile implants make you bigger?

Penile implants can’t make your penis bigger than it is before surgery. Your erection may even seem shorter than what you remember when you were getting natural erections.

It’s important to know that the head of your penis (glans) doesn’t get hard (engorged) after inflation because the implant isn’t in the head of your penis. This can make it seem like your penis isn’t as large as it was before your implant. Your healthcare provider may prescribe you medication to help increase the blood flow to the head of your penis.

Modern penile implant models have cylinders that may slightly increase your penis length, thickness and stiffness. This can occur gradually over time as you use the device.

How big can a penile implant be?

In most cases, the look and size of your erection after a penile implant are comparable to the size of your stretched-out penis before surgery. Your surgeon always measures the inside of your penis and places the biggest implant that’s safe to put in your body. The implant is a custom fit according to your inner measurements.

Can you get hard with a penile implant?

Yes, a penile implant allows you to get an erection whenever you’d like. It can take a couple of minutes to pump the inflatable penile implant to its full rigidity. The non-inflatable implant is always the same hardness.

Once you have a penile implant, you’ll always need the implant to get hard. Medications will no longer work. You won’t be able to get a natural erection without the implant, especially if a surgeon removes the implant and doesn’t replace it with another.

Does a penile implant feel the same?

When you inflate your penis, the prosthesis makes your penis stiff and thick, like a natural erection. Most people with a penile implant report that sex feels the same or better than before the procedure. It won’t change the sensation on the skin of your penis. A penile implant also doesn’t affect your ability to ejaculate and orgasm. It may take you a few weeks or even a couple of months to adjust to the sensation of having an implant. However, many people who get penile implants report high satisfaction once they fully heal.

If you feel the implant with your hand, you’ll be able to feel the difference, especially if it isn’t erect. However, during intercourse, your partner won’t be able to tell the difference between a penile implant and a natural erection.

Once you heal after surgery, the implant isn’t obvious to anyone else who might see you naked, such as in a locker room or public bathroom.

What happens before a penis implant?

Before a penis implant, you’ll meet with a healthcare provider. They’ll check your general health and take your vitals (temperature, pulse and blood pressure). They’ll also make sure that you can empty your bladder and don’t have any severe urinary issues. Once you meet with a surgeon, they’ll talk to you about which type of penile implant is right for you according to your body and your needs.

Tell your healthcare provider about any prescription or over-the-counter (OTC) medications you’re taking. These include herbal supplements. Aspirin, anti-inflammatory drugs, certain herbal supplements and blood thinners can increase your risk of bleeding. Be sure to check with your healthcare provider before stopping any medications.

Tell the healthcare provider about any allergies you have as well. Include all known allergies. These include medications (especially antibiotics), skin cleaners like iodine or isopropyl alcohol, latex and foods.

The healthcare provider will also give you specific instructions on eating and drinking before your penis implant. You shouldn’t eat or drink anything after midnight the night before your surgery. If you must take medications, you should take them with a small sip of water.

It’s a good idea to wash your abdomen and groin the day before thoroughly and the morning of your procedure to reduce the risk of infection. You don’t need to shave your abdomen or pubic hair around your penis and scrotum before your procedure. Your surgeon will do this immediately before your surgery.

If you have an active skin or urinary infection before surgery, notify your surgeon. Skin and urinary infections increase the risk of infecting your implant. Always make sure that you have no active infections in your body before having implant surgery.

What happens during a penis implant?

A special team of healthcare providers will perform a penis implant. The team typically includes:

• Urologist (surgeon).
• Anesthesiologist.
• Nurses.

The anesthesiologist will sedate you (put you under) with general anesthesia. You won’t be awake, won’t move and won’t feel any pain during the procedure.

The urologist may insert a catheter into your bladder through your penis. A catheter is a soft, hollow tube that allows urine (pee) to flow out of your body. Your urologist will usually remove a catheter after the surgery.

The urologist will inject pain medication to keep you numb even after the procedure ends. The urologist will then make an incision on your genital area and insert the implant into your corpora cavernosa. Your corpora cavernosa (singular: corpus cavernosum) are two columns or tubes of spongy tissue that fill with blood and make your penis hard. Your healthcare team will customize the size of your implant according to the size of your penis.

If you get an inflatable implant, your urologist will then insert the reservoir in your abdomen and the pump inside your scrotum. They may or may not need to make additional incisions to place these components, but the incisions are quite small.

After inserting the implant, your surgeon will close the incisions with dissolvable stitches. They may stitch small silicone tubes (surgical drains) in your incision sites. These surgical drains remove blood or fluid from inside your body. They’ll then place a bandage over the incision.

How long does a penis implant take?

A penis implant usually takes one to two hours to complete.

What happens after a penis implant is placed?

The anesthesiologist will stop putting anesthesia into your body. You’ll be conscious (awake) within a few minutes, but you’ll likely feel very groggy.

You’ll then move to a recovery room. Healthcare providers will wait for you to wake up more fully and track your overall health. Once you fully wake up, your groin and abdominal area may feel sore. Providers will treat your pain and teach you pain management techniques. They may also prescribe antibiotics.

In most cases, you can go home a few hours after a penile implant. However, you must have a family member or friend drive you home. It’s also a good idea to have a family member or friend help take care of you the first day or two after a penile implant.

What are the advantages of a penile implant?

The main advantage of a penile implant is that it allows you to get and maintain an erection firm enough for sex, whenever you wish and for as long as you want. It won’t change the sensation on the skin of your penis or your ability to orgasm and ejaculate.

Other advantages of a penile implant include:

• The procedure is relatively safe. There’s a low risk of complications or side effects.
• Satisfying results. Over 90% of people with a penile implant are happy with the results.
• Penile implants are durable. New penile implants are typically last 20 years.
• It’s an outpatient procedure. The procedure usually takes one to two hours to complete, and most people can go home the same day.
• Increased self-esteem.

Is a penile implant noticeable?

An inflatable penile implant isn’t noticeable. You may have small scars from your incisions, but the scars usually aren’t noticeable.

Non-inflatable penile implants are always semi-erect, so they may be more difficult to obscure with clothes.

What are the risks or complications of a penile implant?

Penile implant surgery is overall very safe. However, it’s important to know about some of the uncommon risks, including:

• Uncontrolled bleeding after the procedure, which may require additional surgery.
• Damage to your urethra, which requires surgical repair and delays placement of your implant.
• Infection, which requires removal of your implant.
• Excessive scar tissue.
• The implant wears away layers of skin (erosion).
• Pump or reservoir displacement.
• Mechanical failure.
• Perception of the shorter penis length.
• Decreased blood flow to the head of the penis, which requires removal of your implant.

What is the recovery time after a penile implant?

It’s important to remember that your body is unique, so healing times vary among people. In general, pain, swelling and discomfort should decrease after a week. You may have tenderness for up to six weeks.

Your healthcare provider may prescribe antibiotics, pain relievers or other medications. Take them as directed.

To manage pain, some people take over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin (Bayer®), ibuprofen (Advil®) or naproxen (Aleve®). Not everyone can take NSAIDs, so be sure to ask your healthcare provider for other medications if needed.

To help your body heal as you recover, gently clean and dry your affected areas regularly to prevent infection. Wash your hands with soap and water before changing your bandages. It’s also a good idea to wash your hands before using the restroom.

To help reduce pain and swelling, apply an ice pack to your affected areas for up to 10 minutes. You may do this repeatedly throughout the day.

As you recover, it’s important to avoid heavy lifting or strenuous exercises that can put pressure on your incisions.

When can I have sex or masturbate after a penile implant?

Your surgeon will let you know when it’s safe to resume masturbation or intercourse depending on your specific surgery. In general, avoid sexual activity for at least four weeks after a penile implant.

When can I go back to work?

If you work at a desk, you should take at least a week off work.

If you have a more physically demanding job, you should schedule at least two to four weeks to recover before returning to work.

When should I see my healthcare provider?

Schedule regular follow-up appointments with your healthcare provider.

If you have a surgical drain, your provider will typically remove it one to three days after the procedure.

You should see a provider about four to six weeks after your procedure to learn how to use your penile implant.

Call a healthcare provider right away if you have any complications after a penile implant. These may include:

• Heavy bleeding at your incision sites.
• A fever of 100 degrees Fahrenheit (38 degrees Celsius) or higher.
• Infection of the surgical incision.
• Increased pain.

How much does a penile implant cost?

The cost of a penile implant is usually between Rs. 10 lakh and Rs.15 lakh. However, the price varies between surgeons and medical facilities. Talk to a healthcare provider to better understand their exact pricing.

Will insurance cover the cost of a penile implant?

Yes, insurance coverage for a penile implant is often applicable if a healthcare provider diagnoses you with erectile dysfunction. Many major insurance companies, Medicare and Medicaid cover the cost of surgery for eligible people.

Contact Chawla Nursing Home to schedule an appointment for a consultation to learn more about our Penile Implants Treatment.

Laparoscopic surgery is a minimally invasive surgical technique used in the abdominal and pelvic areas. It uses the aid of a laparoscope — a thin, telescopic rod with a camera at the end — to see inside your body without opening it up. Instead of the 6- to 12-inch cut necessary for open abdominal surgery, laparoscopic surgery uses two to four small incisions of half an inch or less. One is for the camera, and the others are for the surgical instruments. Minimally invasive surgery may also be called “keyhole surgery,” referring to these small incisions.

A laparoscopy is a kind of exploratory surgery using a laparoscope. The surgeon explores your abdominal and pelvic cavities through one or two keyhole incisions. This is the less-invasive alternative to a laparotomy. It’s usually done for diagnostic purposes, to look for problems that imaging tests haven’t been able to identify. The surgeon may take tissue samples for biopsy during the exam. They may also be able to treat minor problems during the laparoscopy — for example, remove growths or blockages that they find during the exam.

What surgeries are performed laparoscopically?

Many common surgeries can be performed laparoscopically today. Whether you're a candidate for laparoscopic surgery will depend on how complicated your condition is. Some complicated conditions may require open surgery to manage. However, laparoscopic surgery is becoming the preferred default method for a growing list of common operations, due to its cost-saving benefits and improved patient outcomes. The list includes:

- Cyst, fibroid, stone, and polyp removals.

- Small tumour removals.

- Biopsies.

- Tubal ligation and reversal.

- Ectopic pregnancy removal.

- Endometriosis surgery.

- Urethral and vaginal reconstruction surgery.

- Orchiopexy (testicle correction surgery).

- Rectopexy (rectal prolapse repair).

- Hernia repair surgery.

- Esophageal anti-reflux surgery (fundoplication).

- Gastric bypass surgery.

- Cholecystectomy (gallbladder removal) for gallstones.

- Appendectomy (appendix removal) for appendicitis.

- Colectomy (bowel resection surgery).

- Abdominoperineal resection (rectum removal).

- Cystectomy (bladder removal).

- Prostatectomy (prostate removal).

- Adrenalectomy (adrenal gland removal).

- Nephrectomy (kidney removal).

- Splenectomy (spleen removal).

- Radical nephroureterectomy (for transitional cell cancer).

- Whipple procedure (pancreaticoduodenectomy) for pancreatic cancer.

- Gastrectomy (stomach removal).

- Liver resection.

Is laparoscopic surgery major surgery?

The terms “major surgery” and “minor surgery” don’t have specific established definitions. Healthcare providers use them variably to describe how complicated and/or dangerous they feel one operation is compared to another and to set expectations for the recovery period. If you ask them about laparoscopic surgery, you may get different answers depending on what kind of operation you’re talking about and how extensive it is.

On one hand, laparoscopic surgery is considered minimally invasive because the incisions are small and the organs aren’t exposed. Also, the kinds of operations that can be done laparoscopically tend to be less complicated ones. Surgeries that turn out to be more complicated than expected may not be able to be safely completed using the laparoscopic method and may have to convert to open surgery, which is major surgery.

On the other hand, laparoscopic surgeries include organ removals, and if you feel like any removal of an organ must be major surgery, you’re not wrong. These kinds of operations carry certain inherent risks no matter how they're done such as risks of bleeding, damage to nearby organs, internal scarring and so on. But they are also common and have high success rates, and with the laparoscopic method, the recovery times will be shorter and easier.

How safe is laparoscopic surgery?

It's at least as safe as open surgery, and some risks are reduced. Smaller wounds reduce the risk of infection, blood loss and postoperative complications such as wound separation and incisional hernia. Laparoscopic surgery minimizes the direct contact between the surgeon and patient, which reduces the risk of any transmission of germs between the two. It also minimizes post-operative recovery time, which reduces the risks of prolonged bed rest, such as blood clots.

How should I prepare for my laparoscopic surgery?

Since most laparoscopic surgeries are performed under general anesthesia, you’ll need to prepare for this in a few ways. You’ll need to avoid eating or drinking for about eight hours before surgery. This is to prevent nausea from the anaesthesia. You should also arrange for someone to drive you home after the procedure. You’ll likely be able to go home the same day, but you may still be disoriented from the anesthesia. Your doctor may give you more specific instructions regarding your medications.

What are the advantages of this procedure?

- Less trauma to the abdominal wall.

- Less blood loss.

- Reduced risk of haemorrhage.

- Smaller scars.

- Reduced risk of wound infection.

- Shorter hospital stay.

- Less time in the hospital means less expense.

- Faster recovery time and return to activities.

- Less wound pain during healing.

- Less pain medication necessary.

When you come in for a consultation with one of Chawla Nursing Home’s doctors, you will be given information about all your options. Schedule your appointment today.

3D laparoscopy has made a landmark achievement in the field of surgery for Gynaecology. It helps to provide in-depth perception along with correct measurement of the dimensions related to the anatomical spaces. Thus, it contributes towards increasing the skills of the laparoscopic surgeon in his attempt towards dissecting tissues and in designing strategies related to the surgery. 3D Laparoscopy helps a surgeon to perform the intracorporeal suture in an absolutely perfect manner. This is regarded as the World’s Best 3D Laparoscopy System.

3D laparoscopy helps to reduce the time frame of a gynaecologist and along with it, it increases the accuracy level of the surgeon. Even the complications involved with carrying out this surgery are reduced.

Surgeries Performed With The Help of 3D Laparoscopy

There are a number of surgeries, which surgeons can perform with the help of 3D Laparoscopy.

They include:

1. Radical Hysterectomy - This is an operation mainly performed to treat cancer that affects the uterine cervix.
2. Parametrectomy - This is an extremely viable technique for women suffering from invasive cervical cancer or a recurrent endometrial cancer of vagina after having undergone hysterectomy previously.
3. Difficult TLH (Frozen Pelvis and Endometriosis) - Difficult TLH aims to solve a case for all patients, who suffer from the problem of containing Double Uterus, Double Cervix and Double Vagina with Severe Pelvic Endometriosis along with Diffuse Pelvic Adhesion after having undergone Hemi-Subtotal Hysterectomy previously.
4. Completion - This surgery gets conducted for all those who are suffering from Endometrium and Ovarian cancers.
5. TLH - This surgery involves a laparoscopic ligation of the arteries and veins present in the ovaries, with the removal of the uterus either through the vagina or abdomen. Finally, it involves the laparoscopic closure of the vaginal cuff.
6. Adenomyomectomy - The surgery is performed in order to conserve the uterus for future pregnancy in patients, who are suffering from massive adenomyosis.
7. Myomectomy - It involves the surgical removal of uterine fibroids. This is an extremely effective procedure.
8. Adnexal and Retroperitoneal Masses - This 3D Laparoscopic Surgery even helps to get rid of these masses and avoid complications.
9. Prolapse of Uterus and Bladder - This condition is caused due to the weakening of the muscles and tissues that provide support to the organs in the pelvis. The surgery helps to attach the vaginal vault to the sacrum with surgical mesh.
10. Tuboplasty - This surgery mainly attempts to restore patency along with the functioning of the Fallopian Tubes, which can help women to achieve pregnancy.
11. Sling Surgeries - Those who suffer from urinary stress incontinence, sling surgery can help ease out the symptoms of incontinence.
12. Fertility Enhancing Surgeries - 3D Laparoscopic surgeries can help to perform even all those surgeries to enhance the rate of fertility like Endoscopic Reproductive Surgery.
13. Ectopic Pregnancy - There are times when ectopic pregnancy can lead to heavy bleeding. Under those circumstances, 3D Laparoscopic Surgery helps in conducting an emergency surgery through an abdominal incision.

Advantages of 3D Laparoscopy

There are quite a number of advantages related to the use of 3D Laparoscopy towards carrying out surgeries for different organs.

The advantages include:

• As this requires a minimum incision, hence there are almost no complications involved. So, there is a faster recovery period for the patients.
• Shorter stay in the hospital
• The improved manner of performing cosmesis or correction of a body part through surgeries.
• This method of surgery ensures lot lesser amount of blood loss.
• There is a very less amount of pain, which patients have to suffer after the surgery gets conducted.

In case you have a concern or query you can always consult a specialist & get answers to your questions!

Becoming a single mom is now an option many women choose for various reasons. Independent parenthood presents unique challenges for many women seeking to start a family on their own. Chawla Nursing Home & Maternity Hospital offers different options to help you achieve your goal, and we guide you through the entire process from beginning to completion.

STARTING THE PROCESS

There are many things to take into account when you are considering independent parenthood. You will need a sperm donor. Chawla Nursing Home works very closely with the highest quality sperm banks nationwide. We can help guide you in the selection process.

Regardless of whether you choose a donor yourself or select one from the sperm bank, each donor is screened extensively for infectious diseases according to FDA guidelines. Genetic screenings are also part of the process. A brief medical and family history must also be obtained from the sperm donor. When you select sperm from a qualified sperm bank, the sample has already gone through the required quarantine and screening process.

INTRAUTERINE INSEMINATION OR IN VITRO FERTILIZATION

Chawla Nursing Home offers IUI and IVF treatments. The IUI procedure involves inserting donor sperm directly inside the uterus by the physician. IVF requires your eggs to be removed from your body. They are then fertilized by donor sperm in the laboratory where they are cultured and returned to the uterus.

Your initial consultation and fertility evaluation will be used as a guide in determining the best options for your treatment. After deciding which option is best, the next step is to select a sperm source. Some women choose to ask a family friend to be the donor while others prefer the anonymity of the sperm bank.

Independent parenthood is not for everyone. For those who pursue this route, Chawla Nursing Home & Maternity Hospital can make the journey getting there easier. In addition to a variety of treatment options, we also offer financial options to help make this journey affordable. If you are ready to take the plunge, contact our office today, and schedule an appointment for a consultation with one of our fertility specialists.