BEST FEMALE SEXOLOGIST AND SKIN TREATMENT FOR FEMALE ONLY

For Ladies Treatment Only :-

Dr.Mrs.Jully Pandey / Dr. Manoj Pandey, Dr.S.Kumar

B.A.M.S, Ayurvedachrya D.U.

email :- dr.jullypandey@gmail.com

Phone No. :- 0612 – 2721160

Mobile No. :-  09334200215 / 09279953889

Address :-

Kaya Kalp Clinic
Infront of Yamaha Moter Cycle Show Room 

In The Street of Bihar Namkeen Bhandar
Arya Kumar Road

Machhua Tolli

Patna - 800004

Bihar, India.

Healthy Lifestyle

Sexual health

www.kayakalpclinic.in

Sexual health basics

Sexuality is part of being human. Love, affection and intimacy all play a role in healthy relationships from childhood through old age.

You often hear about the importance of physical health, mental health and spiritual health, but feeling confident about your sexual health also is very important. Achieving sexual health allows for:

• Healthy relationships
• Planned pregnancies
• Disease prevention

That's why it's essential to be well-informed about all aspects of sexual health and what it takes to have a fulfilling sex life. Similarly, it's important to be aware of factors that can complicate your sexual health. Don't let embarrassment keep you from bringing up concerns or asking questions of your doctor or other health care providers.

STD prevention

Sexually transmitted diseases (STDs), or sexually transmitted infections (STIs), are infections generally acquired by sexual contact. You can get an STD by having unprotected sex with a partner who's infected. You can't always tell if someone is infected, however, because many STDs cause no symptoms, at least at first. In fact, a person might have an STD without knowing it.

That's why you have to be vigilant about STD prevention. If you're sexually active, your best bet for STD prevention is to have just one sex partner who doesn't have any STDs and who has sex only with you. If you're not in an exclusive relationship, you can still protect yourself by learning about and consistently practicing STD prevention, such as using condoms.

Women's sexual health

Women's sexual health is an important aspect of women's health, whether you're trying to prevent pregnancy and sexually transmitted infections or you're worried about low sex drive or other women's sexual health problems.

Learn how to achieve a fulfilling sexual relationship, and know how to protect yourself from sexually transmitted infections. As you get older, understand common changes in women's sexual health — and how to maintain a healthy and enjoyable sex life at any age.

Men's sexual health

Men's sexual health is an important aspect of men's health, whether you're trying to prevent pregnancy and sexually transmitted infections or you're worried about erectile dysfunction or other men's sexual health problems.

For some men, worries about penis size top the list of their sexual health concerns. However, you're probably more normal than you think — and penis-enlargement products and procedures aren't likely to be effective.

As you get older, understand common changes in men's sexual health — and how to maintain a healthy and enjoyable sex life at any age.

Sex and aging

Are sex and aging like oil and water? No! Many older adults desire and enjoy an active sex life. And an active interest in sex, as well as satisfaction with the frequency and quality of sexual activity, is positively associated with health in later life. So don't let anyone tell you that sex is only for the young.

Of course, there are some challenges when it comes to sex and aging. Physical changes, illness, disabilities and some medicines can make sex challenging or difficult to enjoy. Yet, many resources are available to older adults to help them achieve a satisfying sex life. Don't be afraid to bring up concerns with your doctor or other health care provider.

And remember, whatever your age, take precautions to protect yourself from sexually transmitted infections.

Talking to kids about sex

Kids and sexuality — those words strike fear into the hearts of many parents. But talking to kids about sex is an important part of parenting. Children and adolescents need your guidance to help them make healthy and appropriate decisions about their sexual behavior.

When it comes to talking to kids about sex, there's no set script. And sex education needn't be a single tell-all discussion. Instead, look for everyday opportunities and let your child set the pace with his or her questions. Provide just the information that your child is asking for and is able to understand. As your child matures and asks more-detailed questions, you can provide more-detailed responses.

It's normal to feel uncomfortable when talking to kids about sex. But remember that by providing accurate and open communication, you increase the odds that your child will understand your values and make appropriate choices about sex.

Healthy Lifestyle

Birth control

In-depth

Birth control options: Things to consider

Your birth control options may include oral contraceptives, barrier methods or natural family planning. Find out how to choose the method of contraception that's right for you.

If you're considering using birth control (contraception), you have various options. To help pick the right method of birth control for you and your partner, consider the following questions.

What birth control options are available?

Birth control options may include:

• Barrier methods. Examples include male and female condoms, as well as the diaphragm, cervical cap and contraceptive sponge.
• Hormonal methods. Examples include birth control pills, as well as the vaginal ring (NuvaRing), contraceptive implant (Implanon), contraceptive injection (Depo-Provera) and contraceptive patch (Ortho Evra).
• Intrauterine devices (IUDs). Examples include the copper IUD (ParaGard) and the hormonal IUD (Mirena).
• Sterilization. Examples include tubal ligation, Essure or Adiana for women, and vasectomy for men.
• Natural family planning. Examples include the rhythm, basal body temperature and cervical mucus methods.

It's also important to be aware of emergency contraception — such as the morning-after pill (Plan B One-Step, Next Choice or Ella) — which can be used to prevent pregnancy after unprotected sex.

How do the different birth control options work?

Various types of birth control work in different ways. Birth control methods may:

• Prevent sperm from reaching the egg
• Inactivate or damage sperm
• Prevent an egg from being released each month
• Alter the lining of the uterus so a fertilized egg doesn't attach to it
• Thicken cervical mucus so sperm can't easily pass through it

What is the method's effectiveness?

To be effective, any method of contraception must be used consistently and correctly. Contraceptives that require little effort on your part, such as IUDs, contraceptive implants and sterilization, are associated with lower pregnancy rates. In contrast, methods that require monitoring fertility or periodic abstinence are associated with higher pregnancy rates. The bottom line is that the right method is the one that you are comfortable with and willing and able to use.

Is it reversible?

The method of contraception you choose depends on your reproductive goals. If you're planning pregnancy in the near future, you may want a method that's easily stopped or quickly reversible, such as an oral contraceptive or a barrier method. If you'd like to become pregnant — but not in the near future — you may want to consider an IUD. An IUD has a quick return to fertility, but it is expensive if you are going to use it only for a short time period. If you're certain that you don't ever want to have children, you may prefer a permanent method, such as sterilization. You may find that different contraceptive options work for you at different stages of your life.

Is it compatible with your religious beliefs or cultural practices?

Some forms of birth control are considered a violation of certain religious laws or cultural traditions. Weigh the risks and benefits of a birth control method against your personal convictions.

Is it convenient and affordable?

For some people, convenience suggests ease of use, no bothersome side effects or no disruption of the sexual experience. For others, convenience means no prescription is required. When choosing a method of contraception, consider how willing you are to plan ahead or, if necessary, adhere to a rigid schedule. It's important to choose a type of birth control that suits your lifestyle.

Some methods of contraception are inexpensive, while others are more costly. Ask your insurance provider about coverage, and then consider the expense as you make a decision.

What are the side effects?

Consider your tolerance for the possible side effects associated with a particular birth control method. Some methods, particularly those that contain estrogen or progesterone, pose more side effects — some potentially serious — than do others, such as barrier methods and natural family planning methods. Talk to your health care provider about your medical history and how it might affect your choice of birth control.

Does it protect against sexually transmitted infections?

Male and female condoms are the only methods of birth control that offer reliable protection from sexually transmitted infections. Unless you're in a mutually monogamous relationship and have been tested for sexually transmitted infections, use a new condom every time you have sex in addition to any other method of birth control you use.

Does it offer other benefits?

In addition to preventing pregnancy, some contraceptives provide benefits such as more predictable, lighter menstrual cycles, a decreased risk of sexually transmitted infections or a reduction in the risk of some cancers. If these benefits are important to you, they may influence your choice of birth control option.

Is it acceptable to your sexual partner?

Your partner may have birth control preferences that are similar to or different from your own. Discuss birth control options with your partner to help determine which method is acceptable to both of you.

What's the bottom line?

When you choose a birth control method, many factors come into play, including your age, health, emotional maturity, marital status and religious convictions. Knowing your options is part of the decision process — but an honest assessment of yourself, your partner and your relationship is just as important. Ideally, you and your partner will discuss the options and reach a mutually beneficial decision.

Birth control pill FAQ: Benefits, risks and choices

Get the facts about common concerns and questions about birth control pills.

If you use the birth control pill — that is, an oral contraceptive — you're probably happy with its convenience and reliability. Still, you may have many questions about the potential effects of the birth control pill on your overall health.

Can you use birth control pills to delay or eliminate your period?

Yes, birth control pills can be used to reduce or eliminate monthly bleeding. When birth control pills were first available, they were packaged as 21 days of active hormonal pills and seven days of placebo pills. During the week women took the placebo pills, they would have bleeding similar to a regular menstrual period.

Today women have many more options — from regimens with 24 days of active pills and four days of placebo pills to regimens that are all active pills. The first extended-cycle pill regimens introduced provide active hormone pills every day for three months, then one week of placebo pills or low-dose estrogen pills. Newer extended-cycle regimens are designed to be taken continuously for one year and suppress all menstrual bleeding.

Continuous or extended-cycle regimens have several potential benefits. They prevent hormonal fluctuations that are responsible for bleeding, cramping, headaches and other discomforts associated with getting your period. You also may find that you like the convenience of not having a period during important events or trips.

However, unscheduled bleeding and spotting often occur during the first few months on this type of regimen. It typically goes away with continued use, but some women continue to have unscheduled bleeding with continuous use of pills.

Do you need special pills or can you use ordinary birth control pills to prevent having a period?

There are birth control pill regimens designed to prevent bleeding for three months at a time or for as long as a year. But it's possible to prevent your period with continuous use of any birth control pill. This means skipping the placebo pills and starting right away on a new pack. Continuous use of your birth control pills works best if you're taking a monophasic pill — with the same hormone dose in the three weeks of active pills.

If you plan to have a baby, how soon after stopping the birth control pill can you conceive?

After you stop taking the pill, you may have only a two-week delay before you ovulate again. Your period would follow about four to six weeks after you take the last pill. Once ovulation resumes, you can become pregnant. If this happens during your first cycle off the pill, you may not have a period at all.

Is there an advantage to waiting a few months after stopping the pill before trying to conceive?

In the past, doctors had concerns that if you conceived immediately after stopping the pill, you had a higher risk of miscarriage. However, these concerns have proved to be largely unfounded. The hormones in birth control pills don't linger in your system.

Most women have no more than a four-week delay in menses after they stop using the pill. However, if your periods were infrequent before you started taking the pill, they will likely be that way again after you stop the pill. Some women find that it takes a couple of months before they return to regular ovulatory cycles. If you plan to wait a few months, you may want to use a backup form of birth control while your menstrual cycles get back to normal.

What happens if you stop taking the birth control pill but your period doesn't resume?

If you don't get a period for several months, you may have what's known as post-pill amenorrhea. The pill prevents your body from making hormones involved in ovulation and menstruation. When you stop taking the pill, it can take some time for your body to return to normal production of these hormones.

Typically, your period should start again within three months after you stop taking the pill. But some women, especially those who took the pill to regulate their menstrual cycles, may not have a period for many months.

If you don't have a period within three months, take a pregnancy test to make sure you're not pregnant and then see your doctor.

Will a pregnancy test be accurate if you're taking the birth control pill?

You can get accurate results from a pregnancy test while you're on the pill. Pregnancy tests work by measuring a specific pregnancy-related hormone — human chorionic gonadotropin (HCG) — in your blood or urine. The active ingredients in birth control pills don't affect how a pregnancy test measures the level of HCG in your system.

What happens if you take birth control pills while you're pregnant?

If you continued taking your birth control pill because you didn't realize you were pregnant, don't be alarmed. Despite years of this accident happening, there's very little evidence that exposure to the hormones in birth control pills causes birth defects. Once you learn that you're pregnant, stop taking the birth control pill.

Can you use several birth control pills at once for emergency contraception?

It's possible to use standard estrogen-progestin birth control pills for emergency contraception, but check with your doctor for the proper dose and timing of the pills.

There are two types of pills specifically designed to keep you from becoming pregnant if you've had unprotected vaginal intercourse. These medications are sometimes referred to as the "morning-after pill." Levonorgestrel (Plan B One-Step, Next Choice) is available over-the-counter. It's available at drugstores, as well as health clinics and Planned Parenthood. Ulipristal acetate (Ella) also is approved for emergency contraception. It's available only by prescription.

If you've been taking birth control pills for many years and decide to stop, can you stop at any time or should you finish your current pill packet?

In terms of your overall health, it makes little difference when you stop taking the pill. When you finally do stop the pill, you can expect some bleeding, which may change the rhythm of your menstrual cycle. But you can stop at any time.

Can you get pregnant during the week that you take the nonactive (placebo) pills?

Taking the nonactive pills doesn't put you at higher risk of unintended pregnancy. If you're taking your birth control pills exactly as directed, they're 98 to 99 percent effective at preventing pregnancy.

If, however, you've missed a pill — or several pills — during a cycle, you might be at higher risk of unintended pregnancy during that cycle. To be safe, use a backup form of contraception, such as a condom.

Do birth control pills cause weight gain?

Many women think so. But studies have shown that the effect of the birth control pill on weight is small — if it exists at all. Instead, you may be retaining more fluid, which can make you feel as if you've put on weight, particularly in your breasts, hips and thighs. The estrogen in birth control pills does affect fat (adipose) cells, making them larger but not more numerous.

How do birth control pills affect your risk of cancer?

Scientific evidence suggests using birth control pills for longer periods of time increases your risk of some cancers, such as cervical cancer and liver cancer, but it also decreases your risk of other types of cancer, including ovarian cancer and endometrial cancer.

The effect of birth control pills on breast cancer risk isn't quite clear. While some studies have shown a link between pill use and breast cancer, more-recent studies do not show an increased risk of breast cancer with the pill. If you're concerned about your risk of breast cancer, talk with your health care provider about whether the pill is the right contraceptive for you.

Do birth control pills affect cholesterol levels?

Birth control pills can affect cholesterol levels. How much of an effect depends on the type of pill you're taking and what concentration of estrogen or progestin it contains. Birth control pills with more estrogen can have a slightly beneficial overall effect on your blood lipid levels. In general, though, the changes aren't significant and don't affect your overall health.

Do birth control pills affect blood pressure?

Birth control pills may slightly increase blood pressure. If you take birth control pills, have your blood pressure checked regularly. If you already have high blood pressure, talk with your doctor about whether you should consider an alternative form of birth control.

Can women over age 35 continue taking birth control pills?

Although women older than age 35 used to be told to stop taking birth control pills, these limits no longer apply to healthy, nonsmoking women. However, birth control pills aren't recommended for women older than age 35 who smoke because of the risk of cardiovascular disease. If you're 35 or older and you smoke, you need to quit smoking before you can safely continue using birth control pills.

Can antibiotics decrease the effectiveness of birth control pills?

The effects of antibiotics on birth control pills may be overstated — except in the case of one antibiotic, rifampin. Studies clearly show that rifampin decreases the effectiveness of birth control pills in preventing ovulation. However, rifampin isn't used widely today.


Healthy Lifestyle


Infant and toddler health

Breast-feeding and medications: What's safe?

Wondering about breast-feeding and medications? Know how medications can affect your breast milk and which drugs are safe to take.

If you're breast-feeding, you know you're giving your baby a healthy start. However, if you need to take medication while you're breast-feeding, you might have questions about the possible impact on your breast milk.

Here's what you need to know about medications and breast-feeding.

Do all medications pass into breast milk?

Almost any drug that's present in your blood will transfer into your breast milk to some extent, although the level of medication in your breast milk is likely to be low. There are exceptions, though, in which drugs can become concentrated in breast milk. As a result, every medication must be considered separately.

Does my baby's health and age influence how he or she might be affected by exposure to medication in my breast milk?

Yes.

Exposure to medication in breast milk poses the greatest risk to premature babies, newborns, and babies who are medically unstable or have poorly functioning kidneys. The risk is lowest for healthy babies 6 months and older.

Should I stop breast-feeding while taking medication?

Most medications are safe to take while breast-feeding. Also, the benefit of continuing to take a medication for a chronic condition while breast-feeding often outweighs any potential risks.

Still, some medications aren't safe to take while breast-feeding.

If you currently take a medication that could be harmful to your baby, your health care provider might be able to recommend a safe alternative medication. If not, he or she might recommend that you stop breast-feeding temporarily or permanently — depending on how long you need to take the medication.

If you need to stop breast-feeding only temporarily, use a breast pump to keep up your milk supply until you're able to breast-feed again. Simply discard the milk you pump while you're taking the medication.

If you need to stop breast-feeding permanently — which is unusual — ask your health care provider to help you choose an infant formula that will meet your baby's needs.

What medications are safe to take while breast-feeding?

With your health care provider's input, consider this list of medications found to be safe during breast-feeding. Keep in mind that this isn't a comprehensive list of safe medications.

Pain relievers

• Acetaminophen (Tylenol, others)
• Ibuprofen (Advil, Motrin IB, others)
• Naproxen (Aleve, Naprosyn, others) — short-term use only

Antimicrobial medications

• Fluconazole (Diflucan)
• Miconazole (Monistat 3, Micaderm, others)
• Clotrimazole (Mycelex, Lotrimin, others)
• Penicillins (amoxicillin, ampicillin, others)
• Cephalosporins (Keflex, Duricef, others)

Antihistamines

• Loratadine (Claritin, Alavert, others)
• Fexofenadine (Allegra)

Decongestants

• Saline nasal drops
• Medications containing pseudoephedrine (Sudafed, Zyrtec D, others) — use with caution because pseudoephedrine can decrease milk supply

Birth control pills

• Progestin-only contraceptives, such as the minipill

New research suggests that combination birth control pills, oral contraceptives that contain estrogen and a progestin, don't affect milk production. Still, consider waiting until breast-feeding is firmly established — about six to eight weeks — before using this type of birth control pill.

Gastrointestinal medications

• Famotidine (Pepcid)
• Omeprazole (Prilosec)
• Cimetidine (Tagamet)

Antidepressants

• Paroxetine (Paxil)
• Sertraline (Zoloft)
• Fluvoxamine (Luvox)

Constipation medications

• Docusate sodium (Colace)

Do I need my health care provider's OK ahead of time?

If you plan to take medication while breast-feeding, it's always best to check with your health care provider first.

Avoid taking medications that aren't necessary, such as herbal medications, high-dose vitamins and unusual supplements.

Also ask about the timing. For example, taking medication immediately after breast-feeding might help minimize your baby's exposure. However, different drugs peak in breast milk at different times.

What if my baby has a reaction?

When you're taking medication, be sure to watch your baby for any unusual signs or symptoms — such as a change in eating or sleeping habits, fussiness or a rash. If you notice any change in your baby's behavior, contact his or her doctor.


Healthy Lifestyle

Birth control

Delaying your period with birth control pills

If you take birth control pills, you may not need to have a monthly period. Find out how to use the pill to have more control over your cycle.By Kaya Kalp Clinic Patna 

Are you interested in having fewer periods? It's possible with birth control pills. Find out how and get answers to common questions about using birth control pills to delay or prevent periods.

How does it work?

Traditional birth control pills are designed to mimic a natural menstrual cycle. A traditional pill pack contains 28 pills, but only 21 are active — containing hormones to suppress your fertility. The other seven pills are inactive. The bleeding that occurs during the week you take the inactive pills is withdrawal bleeding, which looks like a period. This is your body's response to stopping the hormones. If you skip the inactive pills and start a new pack of active pills right away, you won't have this withdrawal bleeding.

The bleeding that occurs while you take the inactive pills isn't the same as a regular period. Nor is the bleeding necessary for health. This is good news if you take birth control pills and want more control over your menstrual cycle, either for personal or medical reasons.

What are the benefits of delaying your period?

Delaying your period can treat or prevent various menstrual symptoms. It might be worth considering if you have:

• A physical or mental disability that makes it difficult to use sanitary napkins or tampons
• A condition worsened by menstruation, such as endometriosis, anemia, asthma, migraines or epilepsy
• Breast tenderness, bloating or mood swings in the seven to 10 days before your period
• Headaches or other menstrual symptoms during the week you take inactive birth control pills
• Heavy, prolonged, frequent or painful periods

In addition, menstrual bleeding is sometimes simply inconvenient. You may want to postpone your period until after an important exam, athletic event, vacation or special occasion, such as your wedding or honeymoon. Delaying your period may also help you save money, since you may use fewer hygiene products or pain relievers.

Is it safe for all women to delay menstruation?

If your doctor says it's OK for you to take birth control pills, it's probably safe to use them to delay your period. Not all doctors think it's a good idea to delay menstruation, however. Even those who support the option may not mention it unless you bring up the topic. If you want to try delaying your period, you may have to take the lead. Ask your doctor which option might work for you.

What are the drawbacks to delaying your period?

Breakthrough bleeding — bleeding or spotting between periods — is common when you use birth control pills to delay or prevent periods, especially during the first few months. Breakthrough bleeding typically decreases over time, however, as your body adjusts to the new regimen.

Another drawback of routinely delaying your period is that it may be more difficult to tell if you're pregnant. If you have morning sickness, breast tenderness or unusual fatigue, take a home pregnancy test or consult your doctor.



Low sperm count


Is there a home sperm test that can tell me whether I'm fertile or not?

Answers from Doctor Kaya Kalp Clinic Patna.

A new home sperm test is now available that measures your sperm count — the number of sperm in the fluid (semen) ejaculated during an orgasm. The test requires a man to ejaculate into a collection cup. The semen is transferred into a bottle of solution and mixed. Then six drops are placed onto a testing device. Results are read after seven minutes. The test detects a protein found only in sperm. A positive result indicates that your sperm count is above 20 million sperm per milliliter of semen, near the low threshold of "normal."

Fertility experts express caution about using a home sperm test to assess your fertility. A semen analysis is an important tool in assessing male fertility. But it is by no means a direct measure of a man's fertility. The typical semen analysis performed by an infertility specialist assesses the following characteristics:

• Semen volume
• Total sperm number (sperm count)
• Sperm concentration
• Vitality (percent alive)
• Movement (motility)
• Shape (morphology)

No one of these characteristics alone can predict the fertility potential of a man. In fact, only half the infertile men have recognizable causes of infertility detectable by semen analysis. Many men with low sperm counts have fathered children, and many men with high sperm counts have been unsuccessful in fathering children. The only true measure of fertility is the ability to cause a pregnancy.

Instructions with the home sperm test say that if your sperm count is below 20 million sperm per milliliter (negative), you should consult a doctor about a complete fertility evaluation. However, a positive result does not mean you don't have fertility issues. Male fertility is complicated, with many contributing factors.

One situation where the test might have some value: If a woman is late in the fertility life span (older than age 38), her partner might do a quick home sperm test at the outset of trying to get pregnant, to see if there's cause for further testing. Better to identify an issue early when the fertility clock is ticking.


Tests and Procedures

In vitro fertilization (IVF)




Definition

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  Egg retrieval technique

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  ICSI

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  Blastocyst

In vitro fertilization (IVF) is a complex series of procedures used to treat fertility or genetic problems and assist with the conception of a child. During IVF, mature eggs are collected (retrieved) from your ovaries and fertilized by sperm in a lab. Then the fertilized egg (embryo) or eggs are implanted in your uterus. One cycle of IVF takes about two weeks.

IVF is the most effective form of assisted reproductive technology. The procedure can be done using your own eggs and your partner's sperm. Or IVF may involve eggs, sperm or embryos from a known or anonymous donor. In some cases, a gestational carrier — a woman who has an embryo implanted in her uterus — might be used.

Your chances of having a healthy baby using IVF depend on many factors, such as your age and the cause of infertility. In addition, IVF can be time-consuming, expensive and invasive. If more than one embryo is implanted in your uterus, IVF can result in a pregnancy with more than one fetus (multiple pregnancy).

Your doctor can help you understand how IVF works, the potential risks and whether this method of treating infertility is right for you.

Tests and Procedures

In vitro fertilization (IVF)




Why it's done

In vitro fertilization (IVF) is a treatment for infertility or genetic problems. If IVF is performed to treat infertility, you and your partner might be able to try less invasive treatment options before attempting IVF, including fertility drugs to increase production of eggs or intrauterine insemination — a procedure in which sperm are placed directly in your uterus near the time of ovulation.

Occasionally, IVF is offered as a primary treatment for infertility in women over age 40. IVF can also be done if you have certain health conditions. For example, IVF may be an option if you or your partner has:

• Fallopian tube damage or blockage. Fallopian tube damage or blockage makes it difficult for an egg to be fertilized or for an embryo to travel to the uterus.
• Ovulation disorders. If ovulation is infrequent or absent, fewer eggs are available for fertilization.
• Premature ovarian failure. Premature ovarian failure is the loss of normal ovarian function before age 40. If your ovaries fail, they don't produce normal amounts of the hormone estrogen or have eggs to release regularly.
• Endometriosis. Endometriosis occurs when the uterine tissue implants and grows outside of the uterus — often affecting the function of the ovaries, uterus and fallopian tubes.
• Uterine fibroids. Fibroids are benign tumors in the wall of the uterus and are common in women in their 30s and 40s. Fibroids can interfere with implantation of the fertilized egg.
• Previous tubal sterilization or removal. If you've had tubal ligation — a type of sterilization in which your fallopian tubes are cut or blocked to permanently prevent pregnancy — and want to conceive, IVF may be an alternative to tubal ligation reversal.
• Impaired sperm production or function. Below-average sperm concentration, weak movement of sperm (poor mobility), or abnormalities in sperm size and shape can make it difficult for sperm to fertilize an egg. If semen abnormalities are found, your partner might need to see a specialist to determine if there are correctable problems or underlying health concerns.
• Unexplained infertility. Unexplained infertility means no cause of infertility has been found despite evaluation for common causes.
• A genetic disorder. If you or your partner is at risk of passing on a genetic disorder to your child, you may be candidates for preimplantation genetic diagnosis — a procedure that involves IVF. After the eggs are harvested and fertilized, they're screened for certain genetic problems, although not all genetic problems can be found. Embryos that don't contain identified problems can be transferred to the uterus.
• Fertility preservation for cancer or other health conditions. If you're about to start cancer treatment — such as radiation or chemotherapy — that could harm your fertility, IVF for fertility preservation may be an option. Women can have eggs harvested from their ovaries and frozen in an unfertilized state for later use. Or the eggs can be fertilized and frozen as embryos for future use. Women who don't have a functional uterus or for whom pregnancy poses a serious health risk might choose IVF using another person to carry the pregnancy (gestational carrier). In this case, the woman's eggs are fertilized with sperm, but the resulting embryos are placed in the gestational carrier's uterus.















Risks
By Kaya Kalp Clinic Patna
Specific steps of an in vitro fertilization (IVF) cycle carry risks, including:
• Multiple births. IVF increases the risk of multiple births if more than one embryo is implanted in your uterus. A pregnancy with multiple fetuses carries a higher risk of early labor and low birth weight than pregnancy with a single fetus does.
• Premature delivery and low birth weight. Research suggests that use of IVF slightly increases the risk that a baby will be born early or with a low birth weight.
• Ovarian hyperstimulation syndrome. Use of injectable fertility drugs, such as human chorionic gonadotropin (HCG), to induce ovulation can cause ovarian hyperstimulation syndrome, in which your ovaries become swollen and painful. Signs and symptoms typically last a week and include mild abdominal pain, bloating, nausea, vomiting and diarrhea. If you become pregnant, however, your symptoms might last several weeks. Rarely, it's possible to develop a more severe form of ovarian hyperstimulation syndrome that can also cause rapid weight gain and shortness of breath.
• Miscarriage. The rate of miscarriage for women who conceive using IVF with fresh embryos is similar to that of women who conceive naturally — about 15 to 20 percent — but the rate increases with maternal age. Use of frozen embryos during IVF, however, may slightly increase the risk of miscarriage.
• Egg-retrieval procedure complications. Use of an aspirating needle to collect eggs could possibly cause bleeding, infection, or damage to the bowel, bladder or a blood vessel. Risks are also associated with general anesthesia, if used.
• Ectopic pregnancy. About 2 to 5 percent of women who use IVF will have an ectopic pregnancy — when the fertilized egg implants outside the uterus, usually in a fallopian tube. The fertilized egg can't survive outside the uterus, and there's no way to continue the pregnancy.
• Birth defects. The age of the mother is the primary risk factor in the development of birth defects, no matter how the child is conceived. More research is needed to determine whether babies conceived using IVF might be at increased risk of certain birth defects. Some experts believe that the use of IVF does not increase the risk of having a baby with birth defects.
• Ovarian cancer. Although some early studies suggested there may be a link between certain medications used to stimulate egg growth and the development of a specific type of ovarian tumor, more recent studies do not support these findings.
Stress. Use of IVF can be financially, physically and emotionally draining. Support from counselors, family and friends can help you and your partner through the ups and downs of infertility treatment.












How you prepare
By Kaya Kalp Clinic Patna
The Centers for Disease Control and Prevention and the Society for Assisted Reproductive Technology provide information online about U.S. clinics' individual pregnancy and live birth rates. When choosing an in vitro fertilization (IVF) clinic, keep in mind that a clinic's success rate depends on many factors, such as patients' ages and medical issues, as well as the clinic's treatment population and treatment approaches. Ask for detailed information about the costs associated with each step of the procedure.
Before beginning a cycle of IVF using your own eggs and sperm, you and your partner will likely need various screenings, including:
• Ovarian reserve testing. To determine the quantity and quality of your eggs, your doctor might test the concentration of follicle-stimulating hormone (FSH), estradiol (estrogen) and antimullerian hormone in your blood during the first few days of your menstrual cycle. Test results, often used together with an ultrasound of your ovaries, can help predict how your ovaries will respond to fertility medication.
• Semen analysis. If not done as part of your initial fertility evaluation, your doctor will conduct a semen analysis shortly before the start of an IVF treatment cycle.
• Infectious disease screening. You and your partner will both be screened for infectious diseases, including HIV.
• Practice (mock) embryo transfer. Your doctor might conduct a mock embryo transfer to determine the depth of your uterine cavity and the technique most likely to successfully place the embryos into your uterus.
• Uterine cavity exam. Your doctor will examine your uterine cavity before you start IVF. This might involve a sonohysterography — in which fluid is injected through the cervix into your uterus — and an ultrasound to create images of your uterine cavity. Or it might include a hysteroscopy — in which a thin, flexible, lighted telescope (hysteroscope) is inserted through your vagina and cervix into your uterus.
Before beginning a cycle of IVF, consider important questions, including:






• How many embryos will be implanted? The number of embryos implanted is typically based on the age and number of eggs retrieved. Since the rate of implantation is lower for older women, more embryos are usually implanted — except for women using donor eggs. However, most doctors follow specific guidelines to prevent a higher order multiple pregnancy — and in some countries, legislation limits the number of embryos that can be implanted at once. Make sure you and your doctor agree on the number of embryos that will be implanted before they're transferred.
• What will you do with any extra embryos? Extra embryos can be frozen and stored for future use for several years. Not all embryos will survive the freezing and thawing process, although most will. Cryopreservation can make future cycles of IVF less expensive and less invasive. However, the live birth rate from frozen embryos is slightly lower than the live birth rate from fresh embryos. Or you might be able to donate unused frozen embryos to another couple or a research facility. You might also choose to discard unused embryos.
• How will you handle a multiple pregnancy? If more than one embryo is implanted in your uterus, IVF can result in a multiple pregnancy — which poses health risks for you and your babies. In some cases, fetal reduction can be used to help a woman deliver fewer babies with lower health risks. Pursuing fetal reduction, however, is a major decision with ethical, emotional and psychological consequences.
• Have you considered the potential complications associated with using donor eggs, sperm or embryos or a gestational carrier? A trained counselor with expertise in donor issues can help you understand the concerns, such as the legal rights of the donor. You also may need an attorney to file court papers to help you become legal parents of an implanted embryo.

What you can expect
By Kaya Kalp Clinic Clinic Patna 










Multimedia
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  Egg retrieval technique
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  ICSI
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  Blastocyst
In vitro fertilization (IVF) involves several steps — ovulation induction, egg retrieval, sperm retrieval, fertilization and embryo transfer. One cycle of IVF can take about two weeks, and more than one cycle may be required.
Ovulation induction
If you're using your own eggs during IVF, at the start of a cycle you'll begin treatment with synthetic hormones to stimulate your ovaries to produce multiple eggs — rather than the single egg that normally develops each month. Multiple eggs are needed because some eggs won't fertilize or develop normally after fertilization.
You may need several different medications, such as:
• Medications for ovarian stimulation. To stimulate your ovaries, you might receive an injectable medication containing a follicle-stimulating hormone (FSH), a luteinizing hormone (LH) or a combination of both. These medications stimulate more than one egg to develop at a time.
• Medications for oocyte maturation. When the follicles are ready for egg retrieval — generally after eight to 14 days — you will take human chorionic gonadotropin (HCG) or other medications to help the eggs mature.
• Medications to prevent premature ovulation. These medications prevent your body from releasing the developing eggs too soon.
• Medications to prepare the lining of your uterus. On the day of egg retrieval or at the time of embryo transfer, your doctor might recommend that you begin taking progesterone supplements to make the lining of your uterus more receptive to implantation.
Your doctor will work with you to determine which medications to use and when to use them.
Typically, you'll need one to two weeks of ovarian stimulation before your eggs are ready for retrieval. To determine when the eggs are ready for collection, your doctor will likely perform:
• Vaginal ultrasound, a procedure that uses sound waves to create an image of your ovaries to monitor the development of fluid-filled ovarian sacs where eggs mature (follicles)
• Blood tests to measure your response to ovarian stimulation medications — estrogen levels typically increase as follicles develop and progesterone levels remain low until after ovulation
Sometimes IVF cycles need to be canceled before egg retrieval for one of these reasons:
• Inadequate number of follicles developing
• Premature ovulation
• Too many follicles developing, creating a risk of ovarian hyperstimulation syndrome
• Other medical issues
If your cycle is canceled, your doctor might recommend changing medications or their dose to promote a better response during future IVF cycles. Or you may be advised that you need an egg donor.
Egg retrieval
Egg retrieval can be done in your doctor's office or a clinic 34 to 36 hours after the final injection and before ovulation.
• During egg retrieval, you'll be sedated and given pain medication.
• Transvaginal ultrasound aspiration is the usual retrieval method. An ultrasound probe is inserted into your vagina to identify follicles. Then a thin needle is inserted into an ultrasound guide to go through the vagina and into the follicles to retrieve the eggs.
• If your ovaries aren't accessible through transvaginal ultrasound, an abdominal surgery or laparoscopy — a procedure in which a tiny incision is made near your navel and a slender viewing instrument (laparoscope) is inserted — may be used to guide the needle.
• The eggs are removed from the follicles through a needle connected to a suction device. Multiple eggs can be removed in about 20 minutes.
• After egg retrieval, you may experience cramping and feelings of fullness or pressure.
• Mature eggs are placed in a nutritive liquid (culture medium) and incubated. Eggs that appear healthy and mature will be mixed with sperm to attempt to create embryos. However, not all eggs may be successfully fertilized.
Sperm retrieval
If you're using your partner's sperm, he'll provide a semen sample at your doctor's office or a clinic through masturbation the morning of egg retrieval. Other methods, such as testicular aspiration — the use of a needle or surgical procedure to extract sperm directly from the testicle — are sometimes required. Donor sperm also can be used. Sperm are separated from the semen fluid in the lab.
Fertilization
Fertilization can be attempted using two common methods:
• Insemination. During insemination, healthy sperm and mature eggs are mixed and incubated overnight.
• Intracytoplasmic sperm injection (ICSI). In ICSI, a single healthy sperm is injected directly into each mature egg. ICSI is often used when semen quality or number is a problem or if fertilization attempts during prior IVF cycles failed.
In certain situations, your doctor may recommend other procedures before embryo implantation.
• Assisted hatching. About five to six days after fertilization, an embryo "hatches" from its surrounding membrane (zona pellucida), allowing it to implant into the lining of the uterus. If you're an older woman, or if you've have had multiple failed IVF attempts, your doctor might recommend assisted hatching — a technique in which a hole is made in the zona pellucida just before implantation to help the embryo hatch and implant.
• Preimplantation genetic testing. Embryos are allowed to develop in the incubator until they reach a stage where a small sample can be removed and tested for specific genetic diseases or the correct number of chromosomes, typically after five to six days of development. Embryos that don't contain affected genes or chromosomes can be implanted in your uterus. While preimplantation genetic testing can reduce the likelihood that a parent will pass on a genetic problem, it can't eliminate the risk. Prenatal testing may still be recommended.
Embryo transfer
Embryo transfer is done at your doctor's office or a clinic and usually takes place two to six days after egg retrieval.
• You might be given a mild sedative. The procedure is usually painless, although you might experience mild cramping.
• The doctor or nurse will insert a long, thin, flexible tube called a catheter into your vagina, through your cervix and into your uterus.
• A syringe containing one or more embryos suspended in a small amount of fluid is attached to the end of the catheter and then delivered through the tube into your uterus.
If successful, the embryo will implant in the lining of your uterus about six to 10 days after egg retrieval.
After the procedure
After the embryo transfer, you can resume your normal daily activities. However, your ovaries may still be enlarged. Consider avoiding vigorous activity, which could cause discomfort.
Typical side effects include:
• Passing a small amount of clear or bloody fluid shortly after the procedure — due to the swabbing of the cervix before the embryo transfer
• Breast tenderness due to high estrogen levels
• Mild bloating
• Mild cramping
• Constipation
If you develop moderate or severe pain after the embryo transfer, contact your doctor. He or she will evaluate you for factors such as infection, twisting of an ovary (ovarian torsion) and severe ovarian hyperstimulation syndrome.


Results
By Kaya Kalp Clinic Patna,
Your doctor will take a blood sample to detect whether you're pregnant about 10 days to two weeks after egg retrieval.
• If you're pregnant, your doctor will refer you to an obstetrician or other pregnancy specialist for prenatal care.
• If you're not pregnant, you'll stop taking progesterone and likely get your period within a week. If you don't get your period or you have unusual bleeding, contact your doctor. If you're interested in attempting another cycle of in vitro fertilization (IVF), your doctor might suggest steps you can take to improve your chances of getting pregnant through IVF.
The chances of giving birth to a healthy baby after using IVF depend on various factors, including:
• Maternal age. The younger you are, the more likely you are to get pregnant and give birth to a healthy baby using your own eggs during IVF. Women age 41 and older are often counseled to consider using donor eggs during IVF to increase the chances of success.
• Embryo status. Transfer of embryos which are more developed is associated with higher pregnancy rates compared with less developed embryos (day two or three). However, not all embryos survive the development process. Talk with your doctor or other care provider about your specific situation.
• Reproductive history. Women who've previously given birth are more likely to be able to get pregnant using IVF than are women who've never given birth. Success rates are lower for women who've previously used IVF multiple times but didn't get pregnant.
• Cause of infertility. Having a normal supply of eggs increases your chances of being able to get pregnant using IVF. Women who have endometriosis are less likely to be able to get pregnant using IVF than are women who have unexplained infertility.
• Lifestyle factors. Women who smoke typically have fewer eggs retrieved during IVF and may miscarry more often. Smoking can lower a woman's chance of success using IVF by 50 percent. Obesity can decrease your chances of getting pregnant and having a baby. Use of alcohol, recreational drugs, excessive caffeine and certain medications also can be harmful.
Talk with your doctor about any factors that apply to you and how they may affect your chances of a successful pregnancy.
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