High Time- See An Infertility Expert Now!!

These days, more and more younger women are losing on their potency abilities in India which has given a steep rise to the assisted reproductive technology especially in all the metro cities like Delhi, Mumbai and Hyderabad.

It is believed that the changed and stressful lifestyles has contributed to the rise in infertility in not only in women, but men and young girls too. Late marriages, is yet another reason for the rising problem. According to the recent studies, the chances of becoming pregnant drops ominously after the age of 35. So, if you have been trying for a baby since a few years, are above 35 years of age and still not conceiving, then it is the time for you to see the best infertility specialist for guidance.

It is believed that a couple should wait for 2 years before they see an infertility expert. However, if you feel some problem with your cycle or any other issue, then an expert intervention is a must. Delhi is considered to have some of best IVF specialist in Delhi, however it is essential that you pick the best infertility specialist so that you get best of treatments and support too.

Seeing an infertility specialist can be a very stressful thing (if not picked the right one) and so, it is recommended that you do your part of homework well in advance. The internet is a great way to know about the Assisted Reproductive Technology as doing this will make you mentally prepared for what can be in store for you. So, get the best infertility specialist in Delhi and sink in to the feeling of motherhood soon!!

Gynaecologists - Some Great Tips to Choose a Good One

When it is about selecting a new gynaecologist, due to change in insurance or a move, a woman must take the time to pick one that will work fine for her. Certain considerations should be kept in mind such as location, philosophical harmony, specialties and doctor’s availability before the final choice is made. Let’s discuss these factors in details and find out how to choose gynaecologist in west Delhi or IVF doctor.

Specialties

Gynaecologists are often marked as best IVF doctor in Delhi and they are also specialist in infertility, obstetrics, or oncology. If you are facing problems in getting pregnant, you'll need a physician who has great experience in infertility. If you or any of your relative has had gynaecological or uterus cancer, it's a great idea to be hauled up with a specialist who has expertise in oncology. Thus, it is important that a doctor as per your requirement is chosen such that appropriate medical treatment can be taken and best result is achieved out of the same. On the other side, if you clearly don't plan to have further children, you might also need to select a doctor whose practice is restricted to gynaecology so that you won't have to struggle for appointments with timeslots that are used up otherwise.

Insurance

You must make certain that your insurance is admitted by a considered medical provider. You don't want to be startled by a big bill for care that you imagined was to be included in your health plan. Hence this should be considered and ensured well in advance before the choice of gynaecologists is made.

Philosophy

If you are curious about alternative health cures and natural care, you must be assured that doctor is willing to hear out your views.  It is good that you have an initial meeting with the doctor, wherein you can address your concerns with him, and ask if he can do something for you.

Gender

Some females prefer a female doctor while another feel more relaxed with a male. Think about your own likings and pick a new gynaecologist respectively.

Location

According to your medical condition, you should make choice of the doctor and his location. If in case you are choosing a doctor away from your home, be prepared for travelling a long distance whenever you witness any such problem.

Compatibility

Let's face it; you will be giving some of your most private health details to the doctor. Hence it is important that you choose a gynaecologist with whom you feel relaxed discussing your most private body parts and functions.

Office Hours

What are the appointment hours and do they adjust their timings as per your comfort and availability? How long is the normal wait for an appointment? If they are too occupied, it may be hard to get in touch with them. In that case of an impasse, who recounts for them? It is good to inquire about the working hours and then make a wise decision with respect to choice of doctor.

IVF Treatment & Its Success

IVF or In Vitro Fertilization is very much the buzzword in the medical community as well as among the married couples who are looking to have a child. However, it was not much long ago that IVF was considered to be a mysterious procedure used with couples facing issues of infertility. The babies produced from such procedures were known as the test tube babies. Unlike the traditionally simpler method of artificial insemination where the sperm is put into the woman’s uterus and the conception takes place normally, in the process of IVF the sperm and the eggs are combined outside the woman’s body in the laboratory. Once the embryo or embryos are formed, they are placed inside the uterus. In Vitro Fertilization is typically an expensive and complex procedure. Only around 5% of couples having infertility issues try it out. However, since 1981 when it was first introduced in U.S., it has led to the birth of more than 200000 babies.

IVF can be an option for couples if one or either partner has any of the following problems:

Endometriosis

·         Problems with ovulation

·         Low sperm counts

·         Any unexplained fertility problems

·         Antibody problems that can harm the eggs or sperm

·         Problems associated with the fallopian tubes or uterus

The inability of a sperm to penetrate the egg or survive in cervical mucus 

A woman who chooses to undergo an IVF process will need to visit the IVF clinic on a regular basis and go through hormonal therapy to produce greater number of eggs on a monthly basis. This will help the medical expert to enhance chances of ovulation within the woman. The doctor may carry out blood tests and ultrasound to find out whether the eggs are at the best stage for extraction.  

Success Rates of IVF Procedure 

The success rates associated with an IVF procedure depends on several factors, such as reasons for infertility, the age of the patient and the center from where the procedure is being done. Among the various ART (assisted reproductive technology) procedures carried out in U.S., such as IVF, ZIFT and GIFT, IVF is the most common and accounts for about 99% of all procedures. According to some recent reports, it was found out that

·         The percentage of the cycles that led to live births was around 22.4% on an average (can be higher or lower according to the age of a woman).

·      Pregnancy was successfully achieved in about 29.4% cases on an average (can be higher or lower according to the age of a woman).

The age of the woman is a critical factor when it came to the success of an IVF procedure. For example, a woman aged less than 35 years had about 39.6% chance of successfully having a baby through IVF, whereas a woman aged 40 years or more has a typical chance of success of about 11.5%. Nevertheless, recent findings have suggested that the overall success rate with IVF is increasing for every age group.   

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          How to prevent C Section

                              Or

     Avoiding Unnecessary C Section

                             Or 

    Protecting the new Moms ( 1st time)          from C section

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The science is advancing,we are moving away from conventional open surgery to laparoscopic surgery  to robotic surgery.We want smaller cuts for uterus removal ovarian cysts,,fibroid removal  but what are we doing for delivery? We are going away from vaginal deliveries towards big scars of cesarean deliveries. Once a cesarean,there are 80% chances of having a 2^nd cesarean also & if 3^rd pregnancy occurs- 3^rd is inevitably an indication for elective cesarean section.The chances of having laparoscopic or robotic hysterectomies are minimized case if required  at later age.

When the girl is young ,about to be a mom, needs to have less trauma to body & maintain her figure,  we give her big scars of cesarean section & when she is old of 45 & needs hysterectomy, we try to manipulate her by giving smalls scars of laproscopic surgery or robotic surgery ( through small holes)

The uses of robotic surgery is undoubtedly good  as it leads to faster recovery but why  the C- section rates are going so high.

 C section is a major surgery and carries risk for infection ,bladder and bowel injuries,serious complications for future pregnancy like aldherent placenta ,bleeding per vaginum during pregnancy & more chances of 2^nd cesarean & hysterectomies.

Justified Indication of C - section are -

1) breech presentation or oblique lie.

2) low lying placenta or placenta previa

 3)pre eclampsia/eaclampsia

4) multiple pregnancy with first breech or transverse lie

5)big sized babies leading to shoulder dystocia.

6) Cpd

Unjustified indication of C section are

a)  Fear of labor pains thus avoiding vaginal deleiveries.

b) wanting to have baby at auspicious moments e.g janmashtami and guru purab. Or at specific date & time as guided by astrologers.

c)  patient on continuous fetal heart monitoring showed single reading of dropping fetal heart rate during labor pain.

d) if having insurance coverage are more likely to undergo C-section.

f) for convenience of doctor as C-section is less time consuming and more profitable.

g) lack of availiblity of obstetrician and anaesthetist  round the clock.

h) fear of medicolegal litigations.

  

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Things to be done by Mom to prevents C -section

a)    Avoid unnecessary weight gain. Averege weight gain of 11-13 kg during pregnancy will give you an average baby wt of 2.5 – 3.1 kg. A weight gain of more than 15 kg will give you macrosomic baby. An average indian women with average  height of  5feet 3 inches  cannot delivers a baby of more then 3.6-3.8 kg ,so avoid  unnecessary weight gain during pregnancy by modifying your dietery patterns i.e more of protiens and reduce carbohydrates intake.

b) Exercise – working women having sedentary job should exercise more or attend antenatal classes.

c) Shortning the period of rest & sleep to not more than 8 hrs. in a day.

d) Pregnancy is a physiological state & not a disease does not require bed-rest. Working actually throughout your pregnancy unless otherwise indicated in cases of  high blood pressure or low lying  placenta gives you more chance of having vaginal deleivery.

e) Avoiding  white flour and maida in,pitza,pasta & chowmein & pure starches like potato & rice.

f) Doing more of household works.

g) Attend antinatal classes to learn more about exercises ,diet & nutrition labor pains & delievery

h) Being patient & cooperative during  labor

i) Having a good support during labor like doula

THINGS TO BE DONE BY A DOCTOR TO AVOID C-SECTION

Choosing a Coregiver/ Doctor – ask your doctor about What is her rate of primary   cesarean sections—which should be  as low as  10%. Ask about the places where she takes  her clients  for birthing & inquire about hospital policies for labor birth care & find out the c section rates.

Before marrying a man,we survey all his particulars , his family & financial status but some patients do little research  about the doctor and go by the fact which doctor has a big name, does more publicity and more  by word of mouth references.Most of the popular doctor gives undesirable or very high cesarean rates. 

This is where the difference lies between an unskilled & well trained obstetrician.If the obstetrician is well trained in good premiere institution, where she has conducted a good number of delivery including forceps ,vaccum,rotation of occiput in occipitoposterior position,she is confidant enough to handle such complicated vaginal deleiveries and she is confident enough to do cesarean in of deep stuck head ( if trial fails) ,unnecessary c section  rate can be  significantly  diminished.

CHOOSING A BIRTHING PLACE ask about the fascilities like epidural anaesthesia, nursery & blood bank  in the hospital. Most of the hospitals do not collect the data for vaginal cesarean delivery ratio and moreover they are not transparent about the data for individual doctor’s vaginal to cesarean ratio. The data collection should be transparent as it attribute for the patient to choose their obstetrician.

INDUCTION OF LABOR Studies have shown that at less then 40 weeks of gestation women who underwant induction have lower rate of c section compare to those who received expectant management.Use of cerrvical ripening methods such as misopristol,dinoprostgel or pge 2 gel. foleys bulbsand laminaria tents lead to lower rate of c section.

b) If colourd doppler studies is normal ,the baby weight is within normal range & the mother is feeling good fetal movements  & the cervix is unfavourable,do not induce  the labor before 40 weeks unless medically indicated

c)wait for   24 Hours to call it as failed induction .

d) in case of ruptured membranes wait for 12 -14 hrs. of induction

 LABOR SUPPORT – it is the most effective tool to improve labor and delivery outcome as continuous presence of one to one personnel support such as doula improves patient satisfaction and co operation ,this resource is underutilized  .Doulas are schooled to give massage,positioning,relaxation,information and many more skills to make the patient comfortable during labor.

Cesarean section are  required If second stage is prolonged that is more than 3 hours or 4 hours in cases of epidural analgesia, operative vaginal delivery like foreceps or vacuum delivery should be used judiciously as they do not have serious morbidity like intracerebral haemrrhage. Hopefully the combine efforts of the doctor and patient would definitely reduce the Ceserean Section rate.

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