Late marriages causes infertility: Dr. Sahetya

Dr Raju Sahetya is the director of Pushpaa hospital, a practicing Obstetrician and Gynaecologist. He is a specialist in infertility, endoscopy and prenatal diagnosis.He is also the Vice President of Indian Society for Prenatal Diagnosis & Fetal Therapy.

He did his PG from Seth G. S. Medical College and was trained at The King Edward Hospital and The Nowrosjee Wadia Maternity Hospital, Mumbai.

Dr Raju Sahetya answered Sify readers’ queries related to the above in an exclusive chat. Read the transcript below.

Sir, Does IVF Produces baby girls only? often noticed baby girls from IVF pregnancies.

It not true!!

Hello doctor, I m 35 married female. my periods are regular but last 2 -3 they last upto 7 days. I feel low bp after periods. Bleeding is ok. Feels bodyache alot fater periods. I want to conceive for my second child. pls advice me……….

Get your yourself evaluated. Check on your haemoglobin and your pelvic ultrasound.

Hello, sir, after delivery of 6 month my wife body/Bones pain is not going her Bones pain is increase time to time . what i do tall me?

Give her calcium with D3 regularly and follow up with your Doctor.

I suffer digestion problem as well.Need to go 2-3 times a day.My stomach is bloated.Is it all due to fibroid?pls suggest remedy

Get in touch with your gynaec. There could be some associated colitis. It may not be due to fibroids alone.

I have a intramural fibroid in uterus of 5.5cm?can i conceive?What are precautions?Or shud i go for operation?

You should go a Myomectomy without wasting any further time.

What are the basic normal symptoms and changes during pregnancy?Thanks for the answers Doctor.

Early you have pregnancy sickness like nausea, tenderness on breasts, feeling fatigue, frequency of passing urine, pigmentation of pregnancy and cravings for certain types of foods. Also there are some taste and smell changes.

Should I opt for some exercises during the 1st or 2nd trimester of pregnancy or only walking daily is enough?

Initially walking daily is enough but 2nd trimester onwards some relaxation exercises. Later on yoga and prenatal exercises under supervision of an expert.

What is the best position to sleep in during pregnancy?

Most of the early time of pregnancy one can sleep in a position one is comfortable in. During the latter part i.e. after 24 weeks of pregnancy on should sleep side ways preferably on the left side.

What prenatal vitamin do you recommend?

As soon as pregnancy is confirmed one should start taking follic acid, from 12th week onwards iron and calcium have to be introduced upto child birth and lactation.

What should I avoid during pregnancy in terms to diet?

A balance diet is the rule. Its always safer for the healthy outcome to avoid foods which will lead to over weight gain. So eat healthy, relax and exercise regularly.

Good afternoon Doctor Raju, I am 32 yrs female. I am 3 weeks pregnant. How much weight should I gain during pregnancy and what rate?

Weight gain in pregnancy is between 9-15 kgs and an average of 12 kgs is healthy weight gain. In modern practice the doctor as well as the patient are both happy if there is not too much weight gain. And it all depends on your tendency.

My wife is in her 7the week of pregnency. U/S show twin one live and other empty sac. Is there any possibility that the empty sac develop in later stage ?? Looking forward for your valuable advise.

here is smaller possibilty that you may get to see a second embryo and if not there is possibilty of vanishing one of the twins. Repeat your ultrasound after 2 weeks and let me know.

Hello Dr!! I have been having my periods regularly since last 6 months. But this time I haven’t had my periods since last 10 days. So I got a beta hcg test done and the result was found to be 21.74. Is my pregnancy confirmed?

You are pregnant!! Congrats!

Can homeopathy medicine can effective in getting baby.?how long it will take to get a good result?

Its not a good idea because the treatment should be target oriented and not general.

Sir. We did laproscopy treatment to get a child after that they said us to make IUI test ,We took 3 IUI that too got failure.Now our question is how many times that we can make IUI ?If IUI is failed what is the next test to do?

If all tests are normal you fall into a category of unexplained fertility. Anxiety is responsible many times. So give a break for a month or so. Try a couple cycles again and then opt for IVF.

I have 26 yrs.have irregular periods but not overweight.advised to take clomid 100mg and follicular study.i took 3 times and ovulated but not many times can we take clomid?can i conceive? normal hormones.

If all is clear then try couple of cycles with clomid before venturing into higher treatment.

I have pcod. Advised to take clomid 100 mg and follicular study.have done for 3 times ,ovulated but not conceived.i am not overweight,just periods are many times can we take clomid.will i be able to conceive?

You require to evaluate further. It is very important to know your husband’s semen’s results. and in your case the patency of the tubes and the uterine cavity are to be evaluated. Along with a follicular study the endometrial studies are equally important.

I’m 39, unmarried, with PCOD. now my periods are even more irregular than before. usually scanty, sometimes very heavy. can it be menopause

When you know you have PCOD you should not equate the situation with menopause. What you require is see a gynaec and get treated for PCOD.

Dr as i have fibroids shd i go for periodic checkups?i am 43 with 2 children i have no gynaec problems.

If you have no problem frequent check ups are not required. Once a year or so a routine check up can be considered.

Why do IUI or IVF result in twins, triplets or so on?

All ART require stimulation of the ovary, to give more no. of eggs. Due to these reasons the patient is at a risk of multiple pregnancies in adequate and controlled stimulated cycles. But in adequate and controlled stimulated cycles the higher grades of multilple pregnancies can be prevented.

If found successful, can IUI or IVF be tried again for the second child? Or is it advised only once, till successful?

If the reason for requiring ART in the first place still exist goes without saying you require it again.

Which is the best treatment according to you for childless couples?

The best treatment is actually the natural way of going about it but if there is a problem it has to be established after a thorough investigation to know what you really deserve.

What can young women do to prevent infertility?

Marry at the right time, eat healthy, exercise regularly, avoid junk eating and have the knowledge of fertility in your cycle…

Hi Doctor Sahetya, Why is infertility so common today?

Late marriages, ambitious women , pollution, junk eating, addiction to alcohol and smoking, infections(STD) are the prime reasons.

Will I be able to conceive someday with a day and a half to two day menstrual cycle. I have past 40yrs now.

If you are already 40yrs you need to examine your hormones and your ovarian reserve to evaluate your fertility.

My menstrual period lasts only for one and a half to two days. I started my menses at an early age of 9 yrs.They have always been regular at a 28 day cycle. Is this normal?

If your periods are regular then a little less flow is not a cause for concern.Just check your Haemoglobin.

When is the menstrual pain not considered normal?

When along with the pain there is heavy flow and passage of clots. And the pain when does not respond to usual pain killers.

What is the main reason behind painful periods?

Painful periods called as dysmenorrhea could be premenstrual or could be with the onset of menses. Premenstrual are the congestive type which is usually hormone related. The one which at the onset of periods is spasmodic and could be due to stenosed cervix, tumours like fibroids in the uterus or infection.

Any lifestyle changes to improve menopause symptoms?

Regular exercises like yoga, healthy eating habits and accepting the fact as natural.

Do menopause treatments have side effects? If yes, then what are they like?

Taken under expert supervision menopause treatment could be safe.If taken as self medication without follow up it could be of small risk.The follow up of HRT is to check that there is no problem arising related to breast and the body of uterus. There is a low risk of developing to those who are at risk of breast cancer and endometrial cancer.

How will I know it is over?

When you feel that you longer are restless, irritable, sleep well and sleep well and also when you don’t have hot flashes, it means its over and gone.

How long does menopause typically last?

Its a variable entity. It depends upon your own self and the surroundings those are supportive. It may last from a few months to a couple of years.

I am 48 yrs. Are hot flashes only linked to menopause?Or can it be linked to something else also?

If you are 48yrs and you have hot flashes the most likely reason could be peri menopause or menopause. Simple test like FSH and E2 levels would establish the fact.

My semen quality is very low spream ,what to do sir

You have to be thoroughly investigated and be treated accordingly. Medical therapy may help. You have to try it out.

My wife’s right side Fallopian Tube is blocked and left side Fallopian not work very well what to do ,please suggest me

The biological function of the fallopian tube is to transport the male & female gamates at the ampulla of the fallopian tube. Blocked tube will not serve the purpose and inefficient tube will also make this difficult. If the fallopian tubes are not in order attempt should be made to treat and correct them. In modern era such patients should resort to assisted reproductive techniques like IVF and so on.

Old leucorrohea is pemanently cured or not ?

With proper cytology and diagnosis and targeted treatment old leucorrohea can be treated permanently.

Dr is a pap smear compulsory????

Pap smear is a screening test.All those who are above 30 yrs their main concern would be whether they are at risk of pre-cancer, cancer of the cervix. Just a routine speculum examination may not ensure the patient against the above mentioned conditions. Therefore a pap smear taken would conclude that the patient is not at risk of pre-cancer or cancer condition. If the report is all normal pap smear could be repeated once in 2 or 3 yrs. In situations where pap smear shows cellular changes like anaplasia or dusplasia, these patients would require closer watch and sometimes even cervical biopasy for hystopathology studies to rule out the pre-cancer or cancer.In the western world and most of the good clinics in our country, pap smear as a screening test is becoming mandatory, in the attempt to prevent cervical cancer.

Dr. I am 42 with 2 kids a scan showed that i have fibroids. i have flash pain on and off .everything is ok other than that shd igo for a checkup.

Fibroids per say are not of great concern unless they are associated with menstrual problems or with pain which is more often or severe. Flash pain once in a way requires a good anti-spasmotice pain killer. But if the pain is too often it is better to review your condition with your Gynaec. And what is required is routine pelvic examination. If unconclusive then you may require a pelvic sonography.

Dr.Raju Sahetya
M.D., D.G.O., D.F.P., F.C.P.S., F.I.C.O.G.,
Obsterician & Gyanecologist
Infertility & Laparoscopic Surgeon.

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