Bapat Urology Centre

Intrauterine insemination (IUI) and in vitro fertilization (IVF) are two commonly used methods of fertility treatment, which increase a couple’s chance of becoming pregnant. IVF is the most successful method of fertility treatment utilized today to help couples to conceive.

Hello!

I am Dr. Sonali Tawde. I am a practicing gynecologist and fertility specialist. Today we will discuss about PCOS. What is PCOS? It is polycystic ovarian syndrome which is a complex endocrine disorder mainly seen in the reproductive age group in up to 30% of the females. It is the single most common cause of female infertility. When we want to diagnose PCOS we have to have 2-3 key features which include the absence of ovulation, the rise in the male hormone level called testosterone or DHS and sonographic appearance of polycystic ovaries.

They usually present to us with irregular cycles or infertility mainly because of the ovulatory disturbances. Sometimes especially the young females or college going girls present to us with acne and excessive hair growth on the face and chest. 80 to 90% of these females are either overweight or obese. The severity of the symptoms is directly proportional to the degree of weight gain. In later life, they are more likely to develop type 2 diabetes, an increase in the cholesterol level and hence the metabolic syndrome.

The treatment mainly depends upon the symptoms and duration of the patient. The mainstay of the management will remain lifestyle modification which includes diet, nutrition, exercise and weight loss. If they coming to us for fertility issues then the treatment depends upon the husband's semen parameters, the tubal potency reports and other associated pathological reports. It usually starts from simple ovulation induction with follicular scans to IUI which is Intrauterine Insemination.

If it fails to achieve pregnancy then they may have to go for IVF or ICSI. If they are coming to us for irregular cycles then the medication does help them to get regular menses. One has to remember that PCOS is the condition which cannot be cured but can be definitely controlled. Your participation in the management of PCOS plays an equally important role as that of us. So if any of you is suffering from PCOS, please consult your specialist or gynecologist.

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Hello!

I am Dr. Sonali Tawde. I am a practicing gynecologist and fertility specialist. Today we will discuss the role of Hysterolaparoscopy in the management of infertility. Hysterolaparoscopy is endoscopy procedure where we put a small telescope in the abdominal cavity to check the female reproductive organs like uterus, the fallopian tube, the ovaries and the surrounding tissues. This is usually indicated in cases of fibroids, endometriosis, pelvic inflammatory diseases, tubal pathologies like tubal blocks, ovarian cyst, complex cyst, tubo-ovarian masses.

Some cases of unexplained infertility where the simple treatment measures do not help to achieve the pregnancy they may also go for Hysterolaparoscopy. Hysterolaparoscopy alone usually deals with the legions in the endometrial cavity like septum, adhesions, submucous fibroids or polyps. Some cases of severe adhesions like Asherman's syndrome or weak submucous fibroid may need a secondary or a relook hysteroscopy.

Those patients who are going for IVF may or may not need a laparoscopy but usually, hysteroscopy is indicated in such cases. Especially if they have a history of recurrent implantation failure or repetitive miscarriages. This procedure usually requires modern equipment, skin surgeon with expertise and a very good OT setup. So if you are going for this procedure, please check if you are doing it at the right place and in the right hands.

Hysterolaparoscopy definitely plays a crucial role in the management of infertility. But before that, it is always better to discuss with your fertility specialist or gynecologist that what are benefits and risks involved in this procedure in particularly your case.

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