Articles
Female Infertility Treatment in India
by Ajit Yadav Interventional Radiology IndiaFemale Infertility Treatment in India
Hydrosalpinx
Hydrosalpinx is the name for a condition in which a woman’s fallopian tube becomes blocked with fluid.
There are different causes for this condition and symptoms can vary depending on the individual. Some women do not experience any symptoms, but hydrosalpinx can have a severe impact on fertility.
Symptoms of hydrosalpinx include:
- abdominal and pelvic pain
- unusual vaginal discharge
Diagnosis
Hydrosalpinx is characterized by one or both fallopian tubes being filled with water.
A doctor can diagnose hydrosalpinx using several methods. These include:
- An ultrasound: This is one way of looking for hydrosalpinx, but is not as effective.
- Hysterosalpingogram (HSG ): This is a type of X-ray that can display tubal blockages. A special dye visible to the X-ray is introduced through the vagina and cervix.
- Laparoscopy: Also known as keyhole surgery, a laparoscopy is a surgical procedure where small incisions are made in the abdomen, and a camera is inserted. This allows a surgeon to see the organs and remove fluid or other issues.
A diagnostic laparoscopy can also determine whether there is another issue that may be causing infertility, such as endometriosis.
Hydrosalpinx and infertility
Anyone with hydrosalpinx should seek professional advice for planning a pregnancy.
During conception, the egg travels from an ovary along the fallopian tube to the uterus. Hydrosalpinx causes the fallopian tube to become blocked with fluid, so the egg cannot pass down the tube, Also, the fimbria that help to draw the egg from the ovary into the tubes can become stuck together.
If only one fallopian tube is blocked, it is still possible to conceive without intervention, as eggs from the other ovary will still be able to make it to the uterus.
There is also a chance that the fluid build up could leak into the uterus and interfere with the embryo implanting itself properly.
Treatment and management
The most common treatment for a woman with hydrosalpinx is to have surgery to remove the affected tube. This type of surgery is known as salpingectomy. Surgery may also be offered to remove scar tissue or other adhesions that could be affecting fertility. If endometriosis is found to be the cause, doctors can also remove the endometrial growths.
Another possible treatment is sclerotherapy. Sclerotherapy is where an ultrasound-guided needle is used to draw fluid out of the affected tube. A special chemical, called a sclerosing agent, is then injected, which should prevent the fluid from building back up again.
Interventional ultrasound sclerotherapy before IVF is a very effective and acceptable prophylactic intervention alternative to salpingectomy for patients with hydrosalpinx, with no adverse effect on ovarian reserve and responsiveness during the IVF procedure.
Interventional ultrasound sclerotherapy before the IVF cycle can improve the endometrial receptivity and pregnancy rate.
What you are to do before procedure (Preparation)?
- Book prior appointment
- Visit us in OPD (9am-5pm) after breakfast, take prescribed medicine and with empty bladder(*No need to hold urine)
- Referring Doctor prescription, previous lab results (*PT/INR), imaging etc.
- If you are on blood thinner like Aspirin or warfarin inform during appointment.
- One accompanying person
- Need to sign a consent form for procedure
Approx. Stay in hospital?
We have very fast and competent working team (Consultant, fellow, clinical assistant, technician and ward assistant) which provide you comfortable atmosphere and ease your nerves. Usual time of stay is around 6 hours.
Complications:
These are very safe procedures with minor (<1%) complication. Mild pain can occur for which medicines will be given. There should be no lingering pain or other unpleasant sensation.
Resume to work?
You can resume your work after 1 day if existing disease allows.
Fallopian Tube Recanalization
Fallopian tube recanalization (FTR) is a nonsurgical procedure to clear blockages in the fallopian tubes, part of a woman’s reproductive system.
What are fallopian tubes/uterine tubes?
The fallopian tubes are important for female fertility. They are the passageways for the eggs to travel from the ovaries to the uterus. During conception:
- The ovary releases an egg, which travels into the fallopian tube.
- Sperm travels into the fallopian tubes to fertilize the egg.
- The resulting embryo is nourished and transported to the uterus where the pregnancy continues.
A common cause of female infertility is a blockage of the fallopian tubes, usually as the result of debris that has built up. Occasionally, scarring from surgery or serious infection can lead to a blockage as well.
What happens during a fallopian tube recanalization?
Fallopian tube recanalization (FTR) is a nonsurgical procedure our interventional radiologists use to treat these blockages. Recanalization is the medical term for “reopening.”
During the procedure, which does not require any needles or incisions, we will:
- Place a speculum into the vagina and pass a small plastic tube (catheter) through the cervix into the uterus.
- Inject a liquid contrast agent (sometimes called a dye, although nothing is stained) through the catheter.
- Examine the uterine cavity on a nearby monitor using an X-ray camera.
- Obtain a hystero-salpingogram or HSG. Literally, that means a "uterus-and-fallopian-tube-picture.”
- Determine if there is a blockage and if it is located on one or both fallopian tubes.
- Thread a smaller catheter through the first catheter and then into the fallopian tube to clear the blockage.
More than 90 percent of the time, we can reopen at least one blocked fallopian tube and restore normal function.
What you are to do before procedure (Preparation)?
- Book prior appointment
- Visit us in OPD (9am-5pm) after breakfast, take prescribed medicine and with empty bladder(*No need to hold urine)
- Referring Doctor prescription, previous lab results (*PT/INR), imaging etc.
- If you are on blood thinner like Aspirin or warfarin inform during appointment.
- One accompanying person
- Need to sign a consent form for procedure
Approx. Stay in hospital?
We have very fast and competent working team (Consultant, fellow, clinical assistant, technician and ward assistant) which provide you comfortable atmosphere and ease your nerves. Usual time of stay is around 6 hours.
Complications:
These are very safe procedures with minor (<1%) complication. Most women will have a little spotting for a day or two afterward. There should be no lingering pain or other unpleasant sensation.
Resume to work?
You can resume your work after 1 day if existing disease allows.
Outcomes for fallopian tube recanalization
Usually, both fallopian tubes can be unblocked. On average, about a quarter of couples will conceive, most within a cycle or two. The FTR procedure is timed so that there was no risk of being fertile at the time of your procedure. You may begin trying to get pregnant again once the spotting has stopped, and don't have to wait an extra cycle in between.
Successful FTR and pregnancy are lower when severe scarring is present from prior surgery or bad infections, such as PID (Pelvic Inflammatory Disease). FTR unclogs the tubes, but does not reverse the process at work that caused them to become blocked in the first place.
For that reason, about 1/3 of patients will reocclude their tubes by about 6 months. You may wish to consult your doctor if you have not gotten pregnant after 6 months and he or she is thinking about enhancing your fertility, such as giving you injections to stimulate your ovaries. It is advisable in that case to make sure that your tubes are still open. An interventional radiologist can perform an HSG and safely repeat the FTR if blockage is again found.
Pelvic Congestion Syndrome
You may feel a dull, ongoing pain that may worsen around intercourse or when you have been standing or sitting for long periods of time.
The pain caused by this syndrome can be traced to varicose veins that develop in the pelvis and ovaries. Veins become “varicose” when their walls or valves are stretched or weakened by the pressure of blood flowing through them, and blood collects in them. Interventional radiologists use a treatment called embolization to close off these weakened veins and to re-route the blood circulation around them.
For women who have been diagnosed with pelvic congestion—or when pelvic congestion is suspected—a consultation with one of our interventional radiologists can help with both diagnosis and treatment.
Pelvic congestion is difficult to diagnose. A pelvic exam and routine imaging will not show enlarged veins, so it's important to get appropriate imaging tests, such as USG, CT or MRI. It's also important to rule out other potentially serious conditions.
The most accurate diagnosis for pelvic congestion is called a venogram and is performed by an interventional radiologist, who inserts a long, thin tube called a catheter into a vein in the neck or groin and uses X-ray imaging to guide it to the ovarian and pelvic veins. Contrast dye is injected to make the veins more visible. If enlarged, leaky veins are discovered, we can treat them during the same procedure.
Our physicians will review treatment options and help you determine whether a venogram and embolization is the best approach for your pelvic pain.
Treatment for pelvic congestion by embolization is minimally-invasive and very effective when performed by an experienced interventional radiologist. Using X-ray imaging guidance, our interventional radiologists block blood flow to the veins by closing them off with a tiny metallic coils or other blocking ("embolic") agents. Once the flow of blood through the veins is stopped, the vein shrinks and most women experience a significant reduction of their pain.
What you are to do before procedure (Preparation)?
- Book prior appointment
- Visit us in OPD (9am-5pm) after breakfast, take prescribed medicine and with empty bladder(*No need to hold urine)
- Referring Doctor prescription, previous lab results (*PT/INR), imaging etc.
- If you are on blood thinner like Aspirin or warfarin inform during appointment.
- One accompanying person
- Need to sign a consent form for procedure
Approx. Stay in hospital?
We have very fast and competent working team (Consultant, fellow, clinical assistant, technician and ward assistant) which provide you comfortable atmosphere and ease your nerves. Usual time of stay is around 6 hours.
Complications:
Extremely rare potential complications of embolization include allergy, a blood clot in a vein, and migration of the embolic agent from its original site.
Resume to work?
You can resume your work after 1 day if existing disease allows.
To schedule an appointment with Dr. Ajit Yadav, please contact:
Name: Interventional Radiology India
Address: Sir Ganga Ram Hospital, Old Rajendra Nagar, Delhi - 110060, India
Phone: 011 42251897, +91 - 9958474870
Website: www.interventionalradiologyindia.com
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About Ajit Yadav 
Interventional Radiology India
7 connections, 0 recommendations, 56 honor points.Joined APSense since, April 10th, 2023, From Delhi city, India.
Created on Aug 17th 2023 04:09. Viewed 88 times.
