Balaji Action Hospital

Hello,

My name is Dr. Ruby Sehra. ART (Artificial Reproductive Techniques) are of 3 types. The commonly used techniques are IUI, IVF, ICSI. What is IUI? IUI is when husband's semen is washed and planted into the uterus and when sperm count is less or when the husband is having some problem in erection. Husband's semen can be preserved and can be utilized for IUI. Or in case sperm count is less or there is the thick mucus and it can reach the egg, in this case, IUI is helpful. Here normal ovulation is allowed to occur. Whenever you have normal follicular of 18 mm than an injection of rupturing the follicular is given to within 24-36 hours. It is an affordable treatment and absolutely painless procedure.

So, one should not get scared of this IUI procedure. Second is IVF and it is used when a woman is stimulated i.e. when multiple eggs are formed, they are taken out from a transvaginal procedure. This procedure is done under anesthesia. And it is a painless procedure. Once the eggs have been retrieved from your ovaries and placed with the washed semen. They both are fertilized together outside of the body. And when the embryo is formed, it is implanted in the uterus. This procedure is done mostly when it is unexplained fertility or when the cause is not known. Or you are trying it normally or with the IVF than IVF has been suggested. IVF is mostly done when the female tubes are blocked. Now the 3rd procedure is called ICSI.

This procedure is done in male infertility. When the count is low and the motility is low or when they are not able to come into the semen. Eggs are retrieved from the ovaries and the special instrument is there which is called micro-manipulator. With the help of this, a single sperm is injected into the good egg and then the baby is formed. When the embryo is formed, it is still in the uterus for 48 hours as in the procedure of IVF. If some problem is there in either of them then this procedure is used. You should go for it without any problem. The success rate of IUI is around 20%. The success rate is also varied from center to center. ICSI also has a good success rate. It is a good procedure in treating male infertility.

Thank you

Hi,

Me Dr. Ruby Sehra Director of Progeny AN IVF - ICSI Centre - A Unit of Sehra Medical Centre me apka swagat krti hun. Kuch questions logon ke maan me rehte hain kya IVF ya artificial techniques bhut mushkil hai? Kya bhut expensive hai ya hum uske layak hain? Kya hume krana chaiye ya nhi? Me in sab questions ke answer dungi. IVF bhut hi simple technique hai. Jab aap 2-3 saal normally try krne ke baad agar aap conceive nhi kar paye hain or apne kuch tests krayein hon or pta chale ki apke husband ke semen me kuch problem hai ya apke tubes me koi problem hai ya apko PCOS ki problem ki vjha se ovulation nhi hota.

In sab ka jawab aap lene ki koshish krte hain or naturally conceive krne ki koshish krte hain. Agar aap naturally conceive nhi kar pate hain to apko time waste krne ki jrurat nhi hai. Quki ek lady ke maximum eggs 35 years tak hi hote hain. Jaise hi apke 35 years complete hota hain, apke number of eggs sharply decline. Or apke eggs kam hone se apko or bhi problems ko face krna pdta hai. Agar aap wait krte rhenge to apko endometriosis, PID or infection ho skta hai tube me to ye sare complications arise ho skte hain.

IVF bhut hi simple technique hai and you must go for it. Neither it is time-consuming and it gives you a relief from your mental stress. Is se mental trauma ke chances badh jate hain. Ise face krna bhut mushkil hota hai. In sab se bachne ke lia agar aap IVF ke lia jate hain to apko kafi sukun milega. Shadi ke 2-3 saal bad ldkiyon ke weight badhne ke maximum chances hote hain or agar apka weight badh gya to apko PCOS ki problem ho jayegi. Apko fibroid jaisi bhi bimari bhi ho skti hai. Jis se apko normal pregnancy ke lia bhut jyada problem hone vaali hai. Apko jyada wait nhi krna chaiye. Within 3 years of marriage you should try for the conception.

I am Dr Ruby Sehra, consultant Sri Balaji Action Medical Hospital and Director of Progeny IVF Centre at Punjabi Bagh, New Delhi.

Today we have just going to talk about 10 things which you should keep in your mind before undergoing any medical abortion. As everybody knows that tablets for medical abortion are available on the chemist counter, but they are really been misused, a chemist is not doctors and your pregnancy is a human pregnancy respect it and carefully abort it, under the supervision of a doctor. I would like to mention that there are certain things which you should always keep in your mind before undergoing a medical abortion, number one that never takes the tablets on your own, always consult your gynaecologist or doctor. Secondly, try it to recollect, when did you have your normal periods, when was a normal flow of the period. Sometimes the flow is scanty next two periods and you start counting and you have scanty periods, the pregnancy started when you had normal periods. That means you had last month scanty periods but normal periods but 2 months back, so the pregnancy will not be of the 4 weeks it will be 8 weeks. So, bigger pregnancies cannot be dealt with a tablet. So make sure that you remember correctly when you had normal periods. Thirdly, never hide from the doctor that you ever had pills in between suppose you had scanty pills or the pregnancy test was positive, you took the pills but you never abort it. So this should be also told to the doctor that you had the pills but you never aborted, you tried to hide it is going to create complications. Then you should never hide from your doctor that you have undergone any surgery you had any complications during pregnancy or during medical termination of pregnancy like you had severe bleeding, you had a perforation of the uterus or there was some problem during getting an abortion done. This has an impact on your abortion during this time if it was perforated the uterus is weak this time again the complication can arise, so the doctor will choose whether you have to undergo a medical abortion or you have to go a surgical abortion. So never hide that you had this complication during your delivery, during any surgery, or during last medical termination of pregnancy. As I told you, you should always consult your gynaecologist before you undergo any medical abortion so that she can properly guide you that how the tablets are to be taken and what should be timing and how many tablets are to be taken. In market only one kit is available you just you don't know what time to take whether its just food related or not and you just take the tablets and you never take antibiotics after that and you just keep on bleeding-bleeding-bleeding and once after 2 months you realise that next period has also not gone now you will go to the hospital or a doctor but then you already landed up in complication. So, always consult before taking tablets on your own consult your doctor or qualified a gynaecologist. Then seven-point is that if the doctor has prescribed you medicine you please take it as prescribed further the doctor and do not try to take haphazardly because food and other things have an impact on the medical termination of pregnancy. Remember it is a painful procedure, it should never be taken when you are alone at home you need somebodies help, if you have pain you should have somebody else also who can help you out to take to the doctor. Secondly, then once you have taken your tablet and you are completely awarded or not that has to ascertain with the help of a fresh ultrasound, that means after abortion you must get an ultrasound done, after a week or 5 days because so as to rule out that there are no retained products of conception and you don't require any further treatment. That means if she doesn't get it then if the product keeps lying you will keep bleeding, you will have septicemia and it is going to be a big problem for you. Then never hesitate the last but not the least never hesitate to get a DNC done, that is a cleaning of the uterus, if the products are remaining inside the uterus it needs to be cleaned otherwise you will not have normal periods, it will cause septicemia and it will further the periods will be regulated.

If you have any further queries about this problem or any other gynaecological problems or IVF related problem you can consult doctor Ruby Sehra.

Hi Guys!

I’m Dr.Ruby Sehra consultant gynecologist of Sehra medical center and head of department of balaji section behalf.

Today I’m just going to talk about post-menopausal bleeding. Post-menopausal bleeding means any abnormal bleeding once you finish your periods that means you have stopped having your periods but after six months you are again having bleeding, this is an abnormal bleeding. This can be cancerous or non-cancerous. It can be because of the just endometrium hypoplasia i.e. thickening of uterine lining or it can be because of the polyps i.e. the extra growth which could be cancerous or non-cancerous. I don’t think that you should take it lightly. The incidence you must be knowing that it is around every four to five women after fifty years of age. In one lac women are suffering from this cancerous abnormal uterine cancer. This cancer has become little less in incidence because of the early diagnosis. So, I suggest you to not ignore this symptoms of abnormal bleeding after 50 years or after your menopause and get yourself investigated the earliest possible. Immediately consult your doctor, get investigations done, get all the procedures small procedures done and get your surgery done. Because this is the only cancer which gives us an indications at an earliest age. If we don’t listen to it or if we don’t pay attention to it than we are going to land up in big complication. Endometrial cancer is thickening of the inner lining of the uterus that u can see here that this is the uterus this is the growth in the inside the cavity of uterus this can be here in the cavity or in the lower down.so, once you have abnormal bleeding the other symptoms can be that you are having a foul smelling discharge. Then the chances of having a cancer is high. If u have in your past have had high bleeding, PCOS or you had any estrogen dependent medicine taken and you have diabetes and you have a hypotension then you are all more at risk of a endometrial cancer. Once you had this cancer the myths are that it will go away, don’t worry about it…NO! This is the indication, god is giving you. Take an appropriate action at appropriate time so that you don’t land up in big complications. How?? You should go to the doctor that’s why the screening is done to know it earlier. Once you know it earlier that you have good chances of that you will not have any other problem. Once you had this problem then you should go to the doctor get your ultrasonography done to know how much thicken is your endometrium and you should get your pap smear done. If advice you may have to go your MRI undergo. If your endometrial thickening is more than 4 mm then it is definitely an indication to undergo a surgery. Surgery is quite easy and it’s just consist of total abdominal hysterectomy or laparoscopic hysterectomy with bilateral salpingectomy. But the total recovery period after laparoscopic hysterectomy is just a week or ten days and you go walking on the third day of surgery and you are self-sufficient and you can take care of yourself and you don’t need anybody’s help. But the only thing is that you have to be in time. In case, the cell, growth has spread in various adjacent organs then we have to for a bigger surgery. Once you gone to the doctor, got your DNC done, your hysteroscopy done and the ultrasound done. If the biopsy says that it is a cancer then you should get hysterectomy done immediately and without any delay. So as to get a good success rate of survival. Chemotherapy and other things are really painful so in case it is detected earlier then you will not have to undergo this chemotherapy and radiation and you will be taken completely care off.

Thank you.

Hello friends!

Today I’m going to tell you about how natural conceptions take place and what the pre requisites for the conception are. 50% of the part is played by the male and 50% of the part is played by female. What we require in the female is you can understand the uterus the tubes and the ovaries and the male in male what we require is sperm count of at least 60 to 1 million per ml and motility of 40%. In female these are the female reproductive organs, you can see uterus and the right and the left tubes and ovaries.

Every month when you ovulate when you start having your period’s one of the egg is selected out of the millions of eggs in your ovaries. One of the egg which is normally 0.005ml increases to size to up to 24mm within 10 to 14 days of your periods. Once it reaches a 24mm size this follicle has a pressure trigger pressure due to which this follicle ruptures, It releases its eggs. The egg which is picked up by the tube and the part which is left behind is the corpus luteum.

This eggs forms a baby, corpus luteum forms hormones to support the pregnancy. Once it has been thrown into the peritoneal cavity, the tubes picks it up or sucks it up and goes into the fimbrial end of the tube. Once it is reached to the tube then if you have intercourse then the sperms are deposited here. Millions of sperms in the semen they have the veg’ing tails they also travel to the uterine cavity and you can see it travels through the tube and they also reached the fimbral part of the tube.

One of the sperm out of millions of sperms enters into the egg and this fertilization take place. This fertilization induces a rapid division in the cell and from one cell to 2 to 4 as well as it forms a ball of cells and side by side it is transported from the tube to the uterus. What happens in the once it reaches a uterus the endometrial cavity which is already formed a carpet further the embryo, embryo buries into the endometrium and then it starts developing further like this from the various shape and finally the baby reaches into your lap.

So what we require from the female is that she should have normal ovary which is ovulating every month and she should have tubes which is patent so as it can transfer the sperms it can pick up the egg and then it can fertilize the egg and side by side which should be able to transferred because of its cilia. It should be able to transferred the embryo from the tube to the uterus and you can understand that this endometrial lining should also be thicker enough that is around 10mm thicker enough so that the baby can implant inside a endometrial cavity nicely.

With the help of the video I will just demonstrate how the egg is ruptured? How the tubes picks up the eggs? How the sperms travel through the tube? And how this baby is formed? And then finally transported to the uterine cavity. You can see the sperms are entering in the uterine cavity and finally they are travelling towards the tube to meet the egg which is already lined in the fimbral part of the tube. Millions of eggs they are touching the eggs but only one of them is successful to penetrate this egg.

Once the sperm has entered into the egg this embryo forms is travelling. You can see this travelling through the tube to reached the endometrial cavity where it implants itself and will finally forms a baby in the uterine cavity. This is the division of the cells. This embryo being transported from the tube to the uterine cavity. The endometrium has already laid a carpet where it burry itself and finally grow. You can see the egg has buried inside the carpet which is being laid by the tick endometrium. So I have explain you about the conception. In case you have any queries related to your conceptions please contact Progeny AN IVF-ICSI center at Punjabi Bagh, New Delhi.