Treatment options available for Infertility: Dr Sabherwal

crop_4_240x240may27Dr Sheetal Sabharwal, MD,DGO, Obstetrician and Gynaecologist is a pioneer in Hydro Birth (water birth). She is the Director and partner at Tulip women’s health care centre. She is also a Consultant at Hinduja healthcare surgical Khar, Mumbai.

She also specializes in Obstetrics – labour and delivery, especially high risk deliveries, Infertility, Puberty (adolescent gynaecology) and Menopause.

Dr Sabharwal answered Sify readers’ queries related to the above in an exclusive chat.

Are there any risks involved for the baby in water birth?The risks are the same as those of a normal vaginal delivery outside of water

Is hydro birth usually suggested by the Obstetrician or one can decide to go for it?
Unfortunately since most obstetricians do not practice hydro birth they will not offer it so most often patients have to opt for it and enquire accordingly . In our practice we offer it to all patients who are fit for it

How does hydro birth work?
Hydro birth is the use of warm water for birthing which acts as a muscle relaxant thereby relieving pain and speeding up labour ,it is also a smooth transit medium for the baby who is born from water into water thus reducing the shock effect

do you get a lot of complaints for back pain/ weakness in pregnancy ? is this normal ? how should one avoid/treat this condition ?
Yes and they are best avoided by good back strengthening exercises , stretching of muscles . Appropriate posture maintains cd and adequate supplementation of vitamins and calcium help prevent this

Hello Ma’am, Could you please tell me if menstrual irregularities could cause pains in bone/muscles
Menstrual irregularities are often a result of other imbalances and can be associated with bone and muscle pains for eg thyroid illnesses and vit d 3. Deficiency assoc with PCOS

What are the benefits of hydro labor over conventional techniques
Hydro labour is helpful to relieve pain and shorten labour WITHOuT the use of medication and drugs . While conventional techniques may take longer and often require medical intervention to expedite and relieve pain

Dear doctor please giv some expert basic suggestion for good health of mother and baby after delivery.
A relaxed and healthy mother will raise a healthy happy baby so the mother s diet should be nutritious and wholesome coupled with adequate sleep and rest . Breast feeding at least for 6. Months will help the baby to be healthy

Is some kind of counselling required for children reaching early puberty like my daughter?
Yes it is advisable so that they get clear and correct information rather than hearsay regarding the reproductive health issues

I have 9yrs 7months daughter who has started menstruating. Will her overall growth get affected ?
Well her growth will definitely slow down but involve her in a good fitness regime with exercise sports etc esp cycling swimming etc which help better muscle and bone and hence overall body development

Does a normal delivery indicate better lifetime health for mother?
It cannot be generalised . A high risk traumatic normal delivery can sometimes be worse than a surgical one but yes a normal delivery is always more natural and hence quicker in terms of recovery

After how many months of delivery should I start exercising?
If it’s a normal delivery 6 to 8 weeks and if it’s a c section 3 months ! Regular brisk walking can be started as early as 4. Weeks after

I am under medical guidance but I needed your advice M’am on how to gain only the necessary weight during pregnancy. I don’t want to gaib excess weight which becomesdifficult to lose post pregnancy.
The right way to gain healthy but not excess weight is by having adequate quantities of protein … At least 40 to 60 gm s of protein which may not come from diet alone so sometimes additional supplementation is helpful . Also excessive carbohydrate ( sugars ) cause unnecessary weight gain

From what age does a woman’s pregnancy increase the chances of being high risk?
High risk pregnancies can occur at any age but increased risk to the pregnancy due to age happens after 40

Being 2 months pregnant I will be travelling to my native place by train soon. What should I keep in mind?
Train journeys are safe but avoid eating food on the train so carry food from home . Drink plenty of fluids and wash hands frequently . Avoid people with coughs and colds and request for a seat change if so

I am 28 yrs and 2 months pregnant woman Which foods should I completely avoid?
All foods are safe in pregnancy but you must avoid eating raw and uncooked food outside of ur home . This includes all roadside food , banquets and buffets at hotels ,. Also avoid fruit juices outside Reduce processed food and food high in sugar

What should be the right intake of calcium for woman above 40yrs?
The right dosage of calcium is between 1000 to 1500 mg of calcium

Which are the best forms of contraceptives for women today?
The ideal contraceptive for women varies from age groups and maternity status , the most widely used and recommended are the oral contraceptive pills and the IUD or the intrauterine device

Please give some guidance on birth control pills?
Birth control pills are hormonal pills most commonly a combination of estrogen and progesterone ,they are one of the most effective methods of contraception with more than 99% efficacy . There are various types of progesterone in combination with estrogen . O c pills should be used only after detailed clinical history and evaluation by a gyn or family planning expert

What makes a pregnancy high risk?
Factors like high blood pressure ,diabetes in preg low fetal birth weight ,previous surgery including a c section and multiple pregnancy ,elderly mother thyroid or any other medical illness in preg all contribute to high risk to name a few !

What are the best foods to have during periods?
Lots of liquids ,fruits and foods rich in iron and calcium Avoid chocolates and cheese and excess sugar

Does eating papaya result in heavy flow during periods?
No it does not

Why is it that the blood flow is very slow and scanty for the first 4-5hrs on the first day of my periods?
This is not always the case but it is normal for a few women to have a slow and scanty start to their menses . It usuall y does not need investigation

Hi doctor i get frequent urination on the first day of periods. Is this normal?
Yes this is quite a common and normal symptom

Is there any special criteria for parents if they want to go for surrogacy?
There are strict guidelines for surrogacy which need to be clearly understood prior to opting for the procedure and it is best that a couple go and see the doctor concerned together to understand these thoroughly

Can infertility be treated naturally without medications or surgery?
Infertility should be tested based on the cause . In cases of unexplained infertility since there is no cause there may not be any definitive treatment

My brother’s wife has some health issues. She is overweight also. She hasn’t been able to conceive a child since 6yrs. It has been affecting her psychologically. Any advice?
Obesity and weight gain are important factors in reducing fertility and must be addressed suitably . She should consult a gynaecologist to rule out PCOS and other hormonal imbalances

Because giving birth to a baby after 40-42yrs increases the chances of his/her retarded growth especially the brain even after birth. Does this happen in all cases?
No it does. Not happen in all cases and many tests are now available for genetic testing for the same in pregnancy

I am 45 yrs female. My husband is younger to me. I still have normal menstrual cycle. Due to some problems I could not become a mother at the right age. I want a baby now. Is it possible?
Yes you can have a baby but with medical assistance so pl see a infertility expert soon

Is there an age criteria for a mother for the IUI treatment?
Earlier the better . As age advannces conception usually gets iffy hot and success of iui is lower

I am 36yr female desiring to conceive. All reports normal but have been unsuccessful. Till what age should I try conceiving naturally?
After 35 medical intervention Is definitely recommended

Do you suggest some multivitamin supplements for growing girls?
Usually if the diet is well balanced no supplementation is needed but if not or you see signs of weakness the. A iron with multivitamin syrup can be given daily for 3. Months

As my 12yrs daughter has started mensturating what should I do to ensure her a healthy growth?
Nutritious diet rich in iron and calcium . Maintain fluids and electrolyte s during menses and regular exercise through sports or dance , Cycling etc

How to guide my 12 yr daughter about her bodily changes?
It is best to take her to a doctor who can explain to her or now some good books are available on the same so read them with her

What reasons lead a cesarean delivery?
Low lying placenta , breech baby . Prev c sec , medical complications like high bp diabetes or fetal growth disorders and labour complications

What all should be done from her side for a normal delivery?
Regular exercises like yoga , Pilates and walks ,! A good nutritious diet which is high in protein

Can we expect a normal delivery because she has a family history of caesareans?
A family history of caesareans is not relevant but the reasons for the c sections maybe ! But if this pregnancy is absolutely healthy and normal the chances of a normal delivery are more than 70 %

My wife is due with her first child sometime next month. She is quite healthy but has anxiety problem. There are no elder ladies to guide. Medical guidance is there. But still I get worried for her. What is your suggestion for her?
The best solution for anxiety of the unknown is to gather more knowledge and correct information from reliable sources . There are good books ,websites so get your doctor to recommend the same

How much does hydro birth cost?
The cost of a hydro birth is nearly equal to the cost of a c section

Are all hydro births normal deliveries?
Hydro birth is a normal delivery in water

What are the benfits of hydro birth?
Of the many benefits of hydro births the main ones are Natural birth technique Pain relief ( bet 50. – 80% ) Shortening of labour

I have a 10yr old daughter who got her menses 5 months back. But she doesn’t show any signs o breast development. Has she reached any early puberty stage?
Pubert involves breast changes hair changes and onset of menses . The changes can happen in different sequences but usually starts with appearance of breasts and pubic and axilllary hair so consult a doctor for your daughter

What other risks are involved in water birth?
The risks of water birth are the same as that of a normal vaginal delivery in experienced hands

Are there chances of more infections for the mother and child in water birth?
There is no increased risk of infection to mother or baby with water birth In comparison to normal birth

Madam is it right that the labour time gets stretched during water birth?
On the contrary !!! Labour time has been shortened with water birth in more than 80% of our patients

Are there any side effects of IUI or IVF treatment?
The side effects of iui / ivf are those of hormonal stimulation which vary from patient to patient . The common ones are bloating headaches and gastritis

Are there 90 percent chance of getting twins by IUI or IVF? Why so..
There are definitely higher chances but surely not 90% . It is due to higher number of eggs produced during hypersration with these procedures

Which has better success rate IUI or IVF?
IVF has a better success rate

crop_2_240x240may27All tests of my wife and myself are normal. But we have still not become patents. We have still not tried IUI or IVF. What is your advice M’am?
Unexplained infertility is fairly common these days but medical intervention with it without iui and ivf can help . Pl consult a gynaecologist / infertility expert

Hello. My friend had suggested that doing innerthigh stretches every alternate day helps in reducing menstrual pain. Is this true?
Exercise is known to help reduce menstrual pain but isolated exercises of the thinner thigh … I’m not sure how helpful that would be

Why do I get vaginal pain during ovulution?
It’s called mittleschmerz pain indicative of ovulation …. It is normal

Hello. Is it normal to get a little thick white discharge during the ovulution period?
Yes as long as there is no foul smell or discolouration !

Should my 14yrs daughter avoid all physical activities in her school like outdoor sports and dance classes during her periods?
Not at all ! Pl do not encourage the age old regressive practice of restricting activities during menses !

Should I make some diet changes for my 14yrs daughter which can reduce her period pain?
Usually diet is not a direct contributor to pain but regular exercise and reduction of sugar in the diet will help

My 14 yrs daughter gets a lot of period pain. We give her half crocin on first day to get some relief. What os your advice for her?
Period pain is quite normal and common at that age . Half a Crocin is not a medically recommended dose so it would be better to start on a more specific pain killer like mefanamic acid or drotaverin after consulting a gynaecologist based on your daughters history and weight

Can all pregnant females opt for water birth?
No vidhita all patients cannot opt for hydro birth as certain high risk or medically complicated pregnancies are not suitable for it

My sis is pregnant. I want to know about water birth.
Water birth is a natural birthing method where the use of warm water ( body temp 37 degrees) causes pain relief in labour along with cutting short the duration of labour . However details can only be discussed after knowing the patients history

How long does the menopausal phase last in a woman? Thank you.
Menopause is the cessation of the period and hence lasts a lifetime once it sets in ,. I think What YOU mean is the perimenopausal state that leads ?o the menopause Which can last anywhere bet 1 ?o 5 years

What health risks usually accompany menopausal phase?
Menopause is associated with mood swings , osteoporosis , increased risk of hypertension and heart disease , decreased libido, weight gain and high cholesterol and sometime depression

Hi Doc, I am 43 yrs female. Yet to get to the menopausal stage but I have this psychological fear about menopause. Please guide.
Hi ! Menopause is a natural phenomenon that happens to all normal women ! So a start would be to stop thinking that u are about to enter in to a disease state . Anxiety related to menopause is often worse than that caused by it … Do not anticipate the menopausal changes as they differ from woman to woman . The key to a healthy menopause is a healthy lifestyle so work on that