International Fertility Centre Delhi

I am Dr Rita Bakshi, chairperson of international fertility centre situated in Green Park, New Delhi. I have been in this field of fertility of for last 18 years and I have look at couples from all over the world. Let me tell you couples from Africa, Ethiopia ,Nigeria, Afghanistan, Iraq, America, UK, Canada, Brazil name it and I seen it all. The important part is that today I am going to talk on Donor services, yes if somebody decides to have a baby there is no way one cannot have because there are only 3 big players in the field of fertility. The sperms from a man, egg from a woman and a uterus of where the pregnancy will thrive. In case a man does not have sperm at all, even after doing a PISA or a TISA then donors sperm is available. A frozen sperm which has been frozen for at least minimum 3 months tested for HIV, VDRL, HCV, hbs antigen, his height, weight, colour, physical characteristics educational statics all known sperm is available. In case the egg of a women, a women of 43, 44, 45 and has finished her egg cycle, that means there are no viable eggs left or in cases of premature ovarian failure or in cases of ovarian cyst removal or you know, whichever way even in a defective egg, egg donors are available. When they are young girls who from 21 years onwards who donate eggs again there educational status, the physical characteristics are known and the eggs can be matched to the woman who is going to receive the egg. So in case the man sperm is good but its wife eggs are not good they can take help of a donor egg, fertilized make the embryo the baby of outside and then put it inside his wife, for the pregnancy to thrive in the women's belly. In case the uterus has been destroyed because of multiple fibroids, tuberculosis, asherman's syndrome or she born without a uterus as in Mayer-Rokitansky-Kuster-Hauser syndrome. Then her answer is to have a uterus replacement, a uterus replacement means a surrogate woman who can harbour the pregnancy. Now the men and women egg and sperms are good then it is there genetic baby created outside and put inside the surrogate woman, surrogate women who are ready to do this process either because of altruistic reason or because of commercial reason but they are willing to harbour the pregnancy for 9,10 months and then give them the baby. The advantage in cases of surrogacy in their lower at the moment is that the birth certificate is in the name of the parents of the commissioning parents, of the intending parents and do not have the name of the surrogate anywhere. Therefore there is birth certificate which is in the name of parents and the baby is given as soon as it is born to the parents, so they get a zero day baby in their arms. These are the services the donor egg, the donor sperm or the donor uterus of surrogate as it is called which are freely available. Therefore I believe anybody who like to get pregnant or would like to have a baby, there are so many options available who would like everybody to make good use of it. Thank you so much.

I am Dr Rita Bakshi chairperson of international fertility centre situated in Green Park Delhi. I have been in this field of fertility for last 18 years, I have to deal with men women who want to conceive. Let me talk of Semen analysis today, yes whether couple wants to conceive I have always asked both the men and the women to come to the OPD and I always tell that for men it is very easy because they have only one single test to do and which is Semen analysis, come to the think of it, it's not surprising for many men not to want to get the test done. They think that they are producing semen and it is put in the predictor of fertility, but to tell you the truth there are many many men who have semen but they may not have any sperms or in other words what we call is azoospermia, no sperms in the ejaculate. So I will request all men to have this test, their role in the field of fertility for example how the test should can be done is that they have abstenin or they do not consummate or masturbate for 3 to 5 days, minimum 3 and maximum 5 days. when they do not masturbate, do not have sex then they should take a clean container with a wide mouth in which they can ejaculate the masturbation. It is important that the semen should reach the lab within the 1 hour of ejaculation. When the ejaculation happens it is mandatory that it has done your baby possibly by masturbation in the lab itself goes to the lab or if it is direct home it would not to be kept in the refrigerator or heated it should be close to the body, at body temperature and it should reach the lab in the one hour, once it is there the semen is left for coagulation and the coaglatim to liquify within an hour to 45 minutes it liquefied and then it is tested for three parameters concentration, motility and morphology. Now the concentration the WHO parameter has now changed and now anything more than 15 million is Good enough found and the motility more than 30% is good enough and morphology of 4% is good enough. So but it is very important that these parameters are meant, in case they are not then one does suspect either infection which one treated with antibiotics and then retest. It is about 3 months for another sperm cycle to start, so give a gap of 3 months repeat sperm semen analysis and check for this sperm or the semen quality. for that man who has used azoospermia and no sperm at all in those cases, we have to find out whether it is because of some obstruction that there is no sperm or it is non-obstructive azoospermia.In case there is an obstruction then one can work out all the obstructions or one can put legally in the testis or the epidemic and take out the sperms from there. In case it is non-obstructive azoospermia one has to see whether the test is atrophy, however, the testosterone amount and look at they just one last word on testosterone injection which many people in the gym and gym trainers give the testosterone injection and steroids injections cause a severe depression in the sperm count and there are many many very good looking study boys who have no sperms just because they have them on the injectables for a long time. So only advice is that stay away from these injections look at the semen analysis and work on it. Thank you so much.

I am Dr Rita Bakshi, chairperson of international fertility centre situated in the Green Park, Delhi. I have been in the field of fertility for last nearly 18 years and I have found people very anxious for fertility, let me just tell then there is no way one cannot get pregnant nowadays if one decides to get pregnant because, so many donor services are available. So you can have donor sperm, you can have donor egg and you can have surrogacy and the replacement of sperm, egg or uterus. Let me talk of my topic and that my topic is AMH yes Anti Mullerian Hormone as a test of fertility for females the only important test that I look at in a couple is first and foremost is serum AMH that been serum Anti Mullerian Hormone. Now this test can be done on any day of the cycle, it is not important that one should be on day 2 or day 3 it can be done on any day of the cycle. Secondly, it is a blood test now this test tell us the number, the quantity of eggs a women has for example all females are born with a finite number of eggs unlike men who have sperms been produced all throughout their life. Women are born with a certain number of eggs which are fixed, so some are born with less eggs some are born with more eggs but why is it important, it is important to know because if you decide not to get married at 30 or 31 and you decide that ok I have children do I have how many years do I have before I can plan a marriage or the pregnancy. Then by doing this test I can say that yes your AMH is good you can wait or it is not that good please don't wait at all. It also indicate that of people who wants to postpone their pregnancy they are married, they are working, career are important, so they don't know how many years they can postpone. So by doing this test I can say that yes you can wait for may be a year, 2 years or no not do not wait at all. I can also say when people come for fertility whether they would require donor eggs or is there own fertile potential, the eggs good enough them or not by just looking at AMH. AMH normally is between 3 to 5 nanogram per ml. So if it is say very less .5, .4, .3 then you know it is very low she does not have a good quantity of eggs at all. She may require the help of a donor egg and if the AMH is just very high safe if it is 6, 7, 8, 9, 10 that means she probably is suffering from PCOS polycystic ovary. In these cases, it will be very important when I do IVF that she could hyper stimulate and therefore AMH is a very good indicator letting me know how much drug to use and how much not to use. So in a way, especially if ovarian cancers are there, there fertility preservation is there, the women who do not want to you know want to freeze their eggs. So we can make out that the eggs can be frozen for a limited number of time by looking at AMH. So in all to submit all AMH is very- very important fertility predictor of a woman of the number egg, quantity of an eggs a woman possesses and she can plan her fertility according to the AMH level. Thank you.

I am Dr Rita Bakshi, the consultant physician in Gynaecologist and IVF specialist at International Fertility Centre. Today, let us talk about Polycystic Ovarian Syndrome (PCOS) which is commonly heard by every single person. Every young girl now has a diagnosis of PCOS.

Now, what is PCOS?

This is a syndrome in which the girls have abnormal cycles. Abnormal cycles mean prolonged cycles, they bleed frequently and also they have symptoms of excessive androgens i.e, an excessive male hormone. So may see these girls have lot of hormones on their chin, neck, on their breast, on their arms. And also they have Acanthosis nigricans that mean they have darkness in their neck and they have small cysts in the ovary. This is just due to the hormonal pattern disturbance in girls and instead of having one egg every month, they have a number of eggs start developing but not even one good egg. So these girls not only have abnormal cycles, hair growth, loss of hair from the head, but also they may have some difficulty in getting pregnant.

Now, if I speak about the long term problems of PCOS is that there are most chances of Diabetes. And not only in them, but the chances of Diabetes in their siblings are also higher. Also, if you go in even longer term then the chances of endometrial cancer is also higher. So it is important to recognize this when it exists and how to treat it. 

Now these girls are taking a lot of stress. So you have to teach them to stay stress-free by doing yoga, change their lifestyle, getting rid of junk food and do some exercises every day. 45 minutes of exercise every single day is going to work a long way to help them normalise the hormonal patterns. Besides that, these girls sometimes put on over contraceptive pills to regularise their cycles. There are some drugs like metformin and myo inositol which have come in a big way, which are changing the pattern. So there are some girls which are in slim PCOS and there are some under obese PCOS. So in obese PCOS, we have alfacalcidol and comunicacion which help these girls to lose weight and also develop the normal hormonal pattern. So we have to treat two patterns differently, a lean PCOS and an obese PCOS. 

The girls should understand that this is not something for which they should be worried about. Yet it is a known entity so they should keep it under control and take help whenever required. It is important when we are trying to become fertile or trying to become pregnant that they can go to a specialist who is dealing with this problem and take some help. Because some help may be required to develop their eggs and help try to conceive.

One should know that their sister or mother or anyone is suffering from the same pattern. It is not something to worry much. My only emphasize is please do not get tensed, just change your lifestyle, do some exercise, take some help from doctors. And that is all you require to get overcome from PCOS.

Thank you.

If you require any help, you can consult me through Lybrate or can directly visit International Fertility Centre.

Symptoms of Menopause and its adverse effects and preventions

I am Dr Rita Bakshi. Chairman of National Infertility Centre, Gynecologist and obstetrician. Today I will talk about menopause.

The word itself means meno and pause means pause of menses. And that means stoppage of menstrual cycle of a woman. Now all of us women are in doubt with a certain quantity of eggs at beginning. At puberty we start our menses you know which is usually around 11-12 years. And this menses continues every month the cycle happens for three to five days every 28 to 35 days for everybody. It could be 28 days for some it could be 35 for the other. It could be 3 days for some and 5 days for other. So this is how the cycle happens every single month day in day out every month till we reach around age of 45 to 52 you know which is the usual age of menopause. That means the menses stop completely. Now the period before the menopause also called the perimenopause When your cycle start going a little long you know and there is a long period of gap with the cycles are about to stop. This is called the period of perimenopause.

Lot of changes one starts expecting at perimenopause. Now it is normal for women at this time to feel fatigued, to feel urinary symptoms. They do have you know pain during sex because of excessive dryness in vagina. You start losing your hair, losing your eyebrows and there are skin changes as the wrinkles and hot flushes. Hot flushes in something which many women have. Suddenly will get up at night. They are drenched in sweat. And even in winters their time to have the AC on. This what is hot flashes which happen? Some people have and some people don't have. You will have heard some of the people would just say that I just went into menopause I didn't even realize. There was not even a single change. While some women have very painful end to menses that means they have a huge heavy periods and they have all these symptoms and they have severe mood changes. One is so irritable one doesn't want to talk. And you are fighting you are frustrated. So all the things have to be taken in your stride. Because menopause is a very natural normal phenomena. And what do you do so, that your hormone estrogen is the one which is the problem. Because there are no eggs anymore so there is no estrogen that is why all these changes are happening.

One way is to have hormone replacement therapy. So if the symptoms are so strong that means hot flashing and this is really so disturbing then one can take hormones that is estrogen Progesterone replacement therapy or the HRT as it is called. Now if a person is on HRT one should keep getting investigated and see you know it doesn't cause cancer.

What are the things that should know in Menopause and after Menopause? In Menopause after Menopause male female nearly become equal. You know you are prone to heart disease Lipid profile changes So it is important when you are going into Menopause to get your lipid profile done to get your ECG done, to get your ultrasound done, to get your Pap smear done and get your mammo graphy done. All these tests should be done so that you know you are normal and there is nothing wrong in all that. Keep a good Lifestyle, must exercise. You know 40 minutes of exercise and especially weight bearing exercises are important. Be stress free, exercise, go out in the sun, enjoy your life, and if required take the help of hormones otherwise lot of tender loving care with lot of people around will just bite you through that period.

Dr. Rita Bakshi I am available either through lybrate or you can contact me at International Fertility Center H-6 Green Park, New Delhi-16. Thank you.

Here are some causes and treatments of infertility

Hello I am Dr. Rita Bakshi a fertility consultant. To make a baby it required a male and a female . A male sperm and female egg. Its very easy to blame a female for not having a baby but really speaking 50% of the cause lies with the male Or the sperm.

Today I would like to tell you that male that means the sperm produced in the factory called the testis they carry through the tubes and then they come out and ejaculate. Now the problem can be in factory itself that means there are no sperm being made it could be in the tubes that means obstructive where you know tubes are blocked and sperms are being produced but they are not coming out in ejaculate or the problem could be in the structure or the function of the sperm. That means the numbers and the motility its very common you know we have seen patients from Afghanistan, Iraq who are and if you see the number of sperm they have a very few or none it does not appear. Otherwise but single one sperm test done three days of abstinence when the male does not had any ejaculation for three days if he gives us sperm sample its very easy to see the number the motility the fallacy of the sperm weather to see its normally or not now people with obstructive so you know if you there is an obstruction and the sperm production is normal.

Then we either open the tube, the carrying tube or we can take out the sperm directly from testis by putting a needle and then doing an IVF procedure. I really like to give hope to all the males who are carrying this guilt of not having a baby because of the problem with them. But today it is possible, it is very much possible to have a baby of your own by the process of IVF, XE, IMC and carry your own genetic material forward. Of course lifestyle modifications like you know controlling alcohol controlling smoking drugs going for exercise you know keeping the diabetes under control not taking you know. People are taking a lot of strain so they have an ejaculation problem or they have impotence.

So all these causes can be easily dealt with in the process of IVF. it really doesn't matter because of you are able to give sperms or we are able to take out the sperm from testis sperm do. The process of IVF XE and give you your own baby now. That is so important so male do not lose hope their is so much hope in the proved of IVF XE. Keeping a good lifestyle is very important please maybe you don't realise that smoking has a huge territial effect on activity of the sperm. Taking lot if antioxidant is very important so keep a good lifestyle go to the Doctor there is enough health going for the procedure which can give you your own baby so. My motto in life is to have at least one child per couple. 

OCPC is what I really believe in and for that I would like all of you who would like to contact me I am available at Lybrate. I am also available on my consult me online.