Dr Prerna Gupta MD AIIMS clinic

Fertility clinics are medical clinics that assist couples, and sometimes individuals, who want to become parents but for medical reasons have been unable to achieve this goal via the natural course. Clinics apply a number of diagnosis tests and sometimes very advanced medical treatments to achieve conceptions and pregnancies.

Hello,

Namaste, mera naam Dr. Prerna Gupta hai. Mein infertility aur IVF specialist hu. Meine apni padhai AIIMS se kari hai aur mein Delhi mein karyarat hu. Aaj hum PCOS(Polycystic Ovary Syndrome) aur infertility ke baare mein baat kareinge. Hum janege Polycystic Ovary Syndrome (PCOS) kya hai aur ye kaise infertility cause karta hai. Polycystic Ovary Syndrome bahut hi common decease hai. Ye almost 10 mein 2 patients ko hoti hai. Iska matlab meri OPD mein 10 patients aate hai toh unme se mein 2 Polycystic Ovary Syndrome disease ko dekhti hu. Polycystic Ovary Syndrome disease se infertility hona bahut common hai. Aur aaj hum kaise Polycystic Ovary Syndrome infertility cause karta hai aur iska treatment kya hai, iske baare mein baat kareinge.

Sabse pahle Polycystic Ovary Syndrome ki defination, hum Polycystic Ovary Syndrome ko diagnose kaise karte hai? Polycystic Ovary Syndrome ko janchane ke liye humare paas teen criteria hai. Agar apko irregular periods aate hai, agar aapko bahut der der se periods aate hai, mahine-dedh mahine mein periods aate hai, irregular periods hai. Secondly aapke symptoms hai jo dikhate hai ki apko male harmones jyada hai jaise ki apke shareer mein atyadhik baal hona ya apke paas acne jyada hona, apke hair fall hona ya fir thirdly apke ultra sound mein chote chote bahut saare 10mm se less follicles aaye huve hai ya cyst aaye huve hain. Toh inn teeno mein se irregular periods hona, male harmones jyada hona jaise ki atyadhik baal hona ya fir apke ultra sound mein PCOS oversize aana, inn teeno mein se do criteria apko hote hai tab apko hum Polycystic Ovary Syndrome disease mante hai ki haan aap Polycystic Ovary Syndrome se suffer karte hai aur Polycystic Ovary Syndrome kaaran ho sakta hai apko bachcha na thahrne ka. Polycystic Ovary Syndrome mein main problem ye hai ki apka egg bankar bada hokar release nahi hota. Polycystic Ovarian decease se unovelatry infertility hota hai matlab ovulation nahi ho pa raha hai, egg release nhi ho raha hai. Isliye bachcha nahi thahar raha hai. Agar egg hi release nahi hoga toh vo sperm se milega nahi aur bachcha nahi ho payega. Toh PCOS disease ka simple treatment hai ki humein apka jo ovulation mechanism hai vo wapas se start karna hai.

Jab bhi hum PCOS disease ka treatment shuru karte hai, most commonly ismein jo first line treatment hota hai vo hota hai weight loss. PCOS mein 70% women mein unka weight jo hota hai over weight hoti hai, unka normal BMI 25 ke upar hota hai. Toh first line of treatment hota hai ki aap apna wajan kam kariye, aap regular exercise kariye. Agar aap apna wajan even 10% kam kar lete hai, agar aap 75 ke hai aur aap 70 pe pahunch jaate hai, aap regular exercise karte hai, atleast 40 minutes a day, 5 days a week aap exercise karne lag jaate hai aur apna metabolism better kar lete hai toh humne dekha hai ki kai baar patients ko apne aap ovulation hone lag jaata hai, apne aap periods time se aane lag jaate hai, unko koi dawai ke bina hi bachcha thahar jaata hai. Agar apne ye weight loss kara hai, diet li hai uske baad bhi agar apko ovulation nahi ho raha hai, periods regularly nahi aa rahe hai toh second line of treatment hota hai drugs.

Drugs hoti hai vo oral bhi hoti hai aur injectable bhi hoti hai. Initially aapko oral drugs shuru kari jaati hai. Jo most commonly drugs use kari jaati hai PCOS treatment mein, vo hoti hai clomiphene citrate ya fir letrozole tablets. Inn dono drugs ka ek hi kaam hai ki vo apke eggs banana aur unko time se release karna. Ye periods ke 2nd day to 6th day di jaati hai aur fir apka ultra sound hoti hai 10th ya 12th day, ye dekhne ke liye ki haan apke eggs ban rahe hai ya nahi ban rahe hai. Agar apko initial doses se eggs nahi badte hai toh apke doses badaye jate hai. Jaise ki clomiphene ko 50 se 100, 150 ya 200 bhi kara jaata hai. Agar apke inn dawaiyo se egg ban rahe hai toh inn dawaiyo per apko 3 se 6 mahine rakha jata hai aur hum kahte hai aapke ovalution ho raha hai ya eggs ban rahe hai toh 60 to 70% patients PCOS ke sirf simple ovalution drugs se hi conceive kar jaate hai. Fir aapne ye dawaiya li, 3 se 6 mahine li toh do cheeje ho sakti hai, ek hua ki humare ande ban hi nahi rahe hai isko hum kahte hai clomiphene resistance ki aapke eggs inn dawaiyo se nahi ban rahe hai. Dusra, ki apne li ye dawaiya, eggs bane, ovalution bhi hua, lekin conception nahi hua toh hum isko clomiphene failure kahte hai. Agar apko resistance ya failure hai toh hum second line of treatment pe ja sakte hai jo ya toh laparoscopic ovarian drilling ho sakta hai jisme hum ek operation karke apke ovaries mein chhed kar diye jaaye taaki vo apne aap ovalute kar jaaye ya fir hum second line of drugs, like injections, use kar sakte hai. Inn injections ke madhyam se bhi hum try kar sakte hai ki aapke eggs bane aur release karein.

Agar injectables se apke eggs bante hai toh ye bhi aap 3 se 6 mahine try kar sakte hai. Aapko ye baat jan na jaroori hai ki PCOS mein, kyuki aapke eggs nahi ban rahe the isliye apko bachcha nahi thahar raha tha, toh ismein duration of treatment se mat dariye ki 3 mahine, 6 mahine kyu wait karna padega? Agar mera anda ban raha hai toh mujhe pregnancy honi chaiye. Jaise marraige ke baad 6 mahine wait karte hai ki har mahine anda ban raha hai, release ho raha hai, hum try kar rahe hai par bachcha nahi thahar raha hai. Waise hi PCOS mein jaise hi ovalution shuru ho jaaye, iss treatment ko 5-6 mahine dijiye. Within 5 to 6 cycles hum kahte hai 80-90% patients inhi treatment se conceive kar jaate hai. Higher treatments like IVF and IUI bahut hi kam patients, sirf 10-15% patients ko jaroorat padti hai. PCOS mein success rate bahut high hoti hai. PCOS mein treatment easy hota hai agar aap sahi doctor ke paas pahunche. PCOS mein kaafi drugs bhi use kari jaati hai jaise metformin use kari jaati hai. Jaise ovaries ke number of eggs ko achche karne ke liye kai type ke adjuvins use kare jaate hai. Jitna evidence batata hai, metphomin jaisi dawaiya tabhi use kari jaati hai agar aap over weight hai aur apke sugar ke tests mein problem aayi hai. Iske alawa agar aap lean hai, apki sugar ki test normal hai toh metformin apki pregnancy rate nahi batata. Bahut saare drugs market mein available hai jo kahte hai ki agar aap ye drugs lenge toh apke quality of eggs hai PCOS mein vo improve kar jaati hai. Aisa koi bhi studies mein nahi dekha gaya hai. Jaroori hai ki aap apni lifestyle pe, apni diet pe dhyan dijiye. Saare vitamins, minerals, saari sabjiya khayein vo jyada jaroori hai rather than ye ye mehangi dawaiya khayein. Agar hum PCOS mein ovalution kar paate hai toh 90% patients waise hi conceive kar jaate hai. Vo ovulation chahe weight reduction se ho ya balanced diet se ho ya dawaiyo se ho. Sirf 10% patients jinme nahi conception ho pata unmein IVF treatment ki jarurat hoti hai. IVF treatment PCOS patients mein bahut successful hota hai, kyunki ismein bahut saare ande milte hai, toh freezing milti hai. Hum day 5 andro transfer tak pahunch jaate hai. Toh isme chances of conceptions achche hi rahte hai. Aisa nahi hai ki PCOS mein quality of eggs poor hoti hai, usme quality of eggs achchi hi milti hai. Toh agar apko PCOS hai toh ghabaraiye nah. Apke paas bahut saare options hai jisse aap apni fertility ko achieve kar sakti hai, conception achieve sakti hai. Hopefully, apko ye information informative mili hogi, apne koi nayi information gain kari hogi. Dhanyawad.

Thank You!

Hi,

I am Dr. Prerna Gupta, IVF Specialist, Dr Prerna Gupta MD AIIMS clinic, Delhi. Today I will talk about IVF consult ke baare mein. Aaj hum janenge ki jab hum IVF Dr ke pass jaate hain toh humein kya kya chizen le jaani chaiye. Kya kya reports humare pass honi chaiye aur humein kya kya discuss karna chaiye IVF Dr se? Aap ko humesha apne saare purane records carry karne hain. Bahut jaruri hai ki pehle jo bhi aap ke investigations hue hain, jo bhi laparoscopy, hyteroscopy surgeries hui hain, koi bhi aap ke treatments hue hain, ovulation induction hue hain, IUI hue hain, konsi medicines use ki gayi hain, kaise eggs banaye gaye hain, kaisa scan hua hai, ye sari informations bahut important hain and humein pata chal jata hai ki aap ke eggs kaise bante hain, aap ke treatment ke failure ka karan kya hai, aap ki lining kaise banti hai. Aap ki laparoscopy ki report humein dekha deti hain ki aap ka uterus kaisa hai, lining mein koi problem toh nahi hai and organc issue toh nahi hai. Aap ka treatment inhi se plan ho jata hai.

Aap ko aur tests ki jarurat nahi padti hai. Agar aap ka test pichle 2 years mein hua hai toh repeat karane ki jarurat nahi hai. Aapke latest treatment mein thyroid ka report chaiye hota hai, viral markers chaiye hote hain, aap ke husband ka recent analysis chaiye hota hai. Ye dynamic tests hote hain and ye change hote rehte hain. Toh ye within 6 months ke tests aap ke chaiye hote hain. Uske baad Dr aap ka TVS karte hain. Is se kafi information milti hain. Is se vo aap ke uterus ko dekhte hain, lining dekhi jaati hai, fibroid dekha jata hai, polyp dekha jata hai ki kahin hai toh nahi. Agar aisa kuch bhi hai toh ye pregnancy mein aap ko problem kar sakta hai. Dusra vo aap ke ovaries ko dekhte hain and check karte hain ki kitne number of eggs kaise hain. Aap ki ovaries ki accessibility dekhi jaati hai. Aap ki ovaries mein IVF karna easy hai ya difficult hai. Aap ki ovary mein koi cyst toh nahi hai, endometriosis toh nahi hai ya fir koi aur karan toh nahi hai jis se pregnancy rate kam ho sakta hai. Is investigation ke baad aap ka treatment plan ho sakta hai. IVF mein aap ka dekha jata hai ki koi pre-IVF test toh nahi hona, koi medicines toh nahi shuru honi. Pre-IVF mein injection mahavari ke 21 din se dia jaate hain. Aap ko medicines di ja sakti hai taki aap ki egg quality better ho.

Ye bahut hi kam proportion patients mei chaiye hota hai. Maan lijiye ki aap ka hysteroscopy nahi hai but aap ke ultrasound mein cavity mein issue dikh rahi hai toh vo hysteroscpy plan kar sakte hain. Ismein dekha jata hai ki koi drug ki koi jarurat toh nahi hai. Dekha jata hai ki ICSI ki jarurat hai ya nahi agar unexplained infertility hai ya fir husband ke sperm mein problem hai. Ek hai freeze all cycle jo PCOS ke patients mein kia jata hai. In sab ke baad chances of conception dekha jata hai. Ye baat karna bahut jruri hai because IVF 100% guaranteed treatment nahi hai. IVF ke failures hain, chances of conception depend karta hai patient ke upar like uski age. Agar aap ki umar 35 saal se kam hai toh aap ke chances of conception 50-60% hi hain. Aap ke chances of conception is pe bhi depend karta hai ki aap ko freezing milti hai ya nahi. Agar aap ko freezing milti hai and agar aap ka cycle fail kar jata hai toh dusri baar bina freezing kare aap ko frozen embryo dia jaa sakte hain. IVF success rate ke baad aata hai IVF cost. Ye aap apne Dr se clear jarur kar lein. Aap dekhein ki cost mein kya included hai and kya excluded hai.

IVF mein kafi hidden charges ho sakte hain jiske baarein mein aap ko pehle hi pata hona chaiye. IVF mehenga hota hai kyuki ismein medicines kafi mehengi hoti hain. Aap ko puchna hai ki IVF ke treatment ke cost mein ICSI ki cost included hai ya nahi. Kya treatment mein medicines ki charges included hain. Kya blastocyst transfer hai, kya koi extra charges hain and freezing ke charges kya hai. Agar aap ko ye sare charges pata honge toh aap financially uske according plan kar sakte hain. Kabhi bhi kisi type ki scheme mein na jaayein kyuki IVF koi kapde ka business hai hai. Aap ko quality treatment lena hai. Koi short-cuts aap ko nahi lene hain. Islia aap ko apne oral records dikhane hain. Humein apne recent 6 months ki investigation leke jaani hai. IVF ke chances pata karne hain and cost kya hai. Ye saari baatein humein pehle se hi Dr ke paas leke jana chaiye taki humare pass sufal consult ho sake. Humara pass sare questions ke answers hone chaiye. Jis se hum decision le payenge and treatment shuru kar payenge. Hopefully, ye information aap ke lia faydemand rahi hogi. Iske alwa agar aap ke koi questions hain toh aap Lybrate ke through mujhe contact kar sakte hain.

Thank You.

Hi,

I am Dr. Prerna Gupta, IVF Specialist, Dr Prerna Gupta MD AIIMS clinic, Delhi. Today I will talk about egg freezing which can help you in stopping your biological clog. Egg freezing aisa lagta hai ki jaise ek nayi science hai. Lekin ye bahut saalon se humare pass available thi. Aaj kal logon ki shaadi late ho rahi hai. Pehle 23-24 ki age mein jo shaadi hoti thi ab aisa kam hota hai and 30-32 saal ki age mein shaadi hoti hai. Aap ka career hote hai and aap ki age 35 tak ki ho jaati hai. AIsa farak aane se humare eggs mein bhi changes aa jate hain. Aisa kaha jata hai ki lady apne eggs leke paida hoti hai. Har mahine unmein se kayi hazaron eggs khatam hote rehte hain. Jaise jaise humari age hoti hai, humare eggs ki quality bhi kam hoti hai. Humara down syndrome bhi badhta rehta hai. Humara miscarriage 22-23 ki age mein bhi ho sakta hai. 40 ki age mein 40% women ko miscarriage ho sakta hai. Miscarriage ka karan ho sakta hai ki eggs ki shape kaisi hai. Jaise jaise humari age hoti hai, hum 3 chizon se lad rahe hoti hain. Humara ovarian reserve kam ho jata hai, eggs quality kam hoti hai and miscarriage rate kam hota hai. Healthy pregnancy k chances kam ho jaate hain.

Is problem ko solve karne ke lia egg freezing hai IVF department mein. Egg freezing 28-32 ki age mein kabhi bhi kara sakte hain. Jab bhi aap egg freezing karate hain, unki age utni hi rehti hai. Egg freezing young age ke lia hai, ye bahut jaruri hai kyuki ayi logon ko hota hai 38-39 ki age pe egg freezing ka socte hain. Ismein itna fayada nahi hota hai. Egg freezing ki jarurat un logon ko jyada hoti hai jinhein cancer hai ya fir aap 30-32 ke ho gaye hain and aap ka shaadi and bache ka koi plan nahi hai. Hum prefer karte hain ki jab aap egg freezing karayein toh aap 35 ki age se kam mein karayein. Taki hum aap ko healthy bacha de sakein. Egg freezing IVF jaisa hi hota hai. Ismein aap ko pehle infertility ke Dr se milna hota hai. Usmein aap ka ultrasound kia jata hai. Vo aap ko blood test bhi prescribe kar sakti hai. Iske baad aap ka IVF cycle shuru hota hai. Jismein aap ke mahine dusre din se injection chalte hain. Operation mein koi operation nahi hota hai eggs nikalne ke lia. Ye ek ultrasound ke through kia jata hai. Usmein ek patli si needle daal ke eggs nikal dia jaate hain. Fir in eggs ko freeze kia jata hai.

Dusri condition hai ki aaj kal humare pass married couple aa rahein hain. Vo bhi egg freeze karate hain. Toh aise case mein patient ko suggest kia jata hai ki embryo freeze karaya jaaye. Yahan pe egg freezing ka jaisa hi kaam hota hai but ismein bacha bana kar freeze kia jata hai. Embryos mein jyada capacity hoti hai. So, agar aap married hain to embryo freezing karayein. Agar patient kis surgery ke lia ja rahi hain like endometriosis toh unhein suggest kia jata hai ki egg freeze kara lein. Taki number of eggs mein kami na aaye. Iska success rate bahut acha hai and sahi age pe karan chaiye kyuki egg quality achi hoti hai and humein numbers ache milein. Lekin aap ko dhayan rakhna hai ki aap jahan bhi egg freezing ya fir embryo freeze karayein vo achi lab ho. Mujhe asha hai ki aap ko ye jankari aci lagi hogi.

Agar aap ko koi question hai toh aap mujhe contact karein.

Thank You.