According to the latest statistics, the rate of infertility is on
the rise. It is a phenomenon that is not confined to just Kerala
or India. It is a global phenomenon, and the alarming factor is
that it is on the rise everyday.
Infertility is not something that can be blamed
on the male or the female. It can happen to either of the partners,
(40%) or in some cases, it can happen to both. One cannot restrict
it to either of the sexes.
The important thing however, is to have an
awareness of it. This booklet is designed specifically with this
in mind. It gives a broad outline of the causes of infertility,
and also looks into the different treatments available.
FEMALE REPRODUCTIVE SYSTEM
HOW DOES CONCEPTION TAKE PLACE ?
Normally a healthy woman's' menstrual cycle lasts a period of 28-30
days. Ovulation (that is when an ovum is released from the ovary
) occurs within 10-15 days in the cycle.(day 1 is the first day
of the mens.bleed) The released ovum is picked up by the fimbria.
a finger-like part located at the end of the Fallopian tube and
it is .placed in the ampullary portion of the tube(2nd part of the
tube)and stays there for about 12 to 24 hours , waiting for the
sperms. When the husband ejaculates the semen in the vagina , within
minutes actively motile sperms find their way to the cervix(mouth
of the uterus).The sperms are then stored safely for about 24 to
48 hours in the crypts of the cervical canal. From there the sperms
periodically move towards the fallopian tube through the uterine
cavity to meet with egg. Thus the male and the female gamates fuse
together to form zygote.(fertilized egg).This zygote then takes
about 4 to 5 days to reach back into the uterine cavity and then
implants near the fundus of the uterus and then grows as embryo
and then to foetus and further it completes it's growth over a period
of 260 days to become a mature baby, which is then delivered through
the vagina. 
WHY DOES CONCEPTION NOT TAKE PLACE ?
Unfortunately, this process doesn't happen in the case of everyone.
The reasons are many, and 80% of the time they are specific. The
other 20%, is classified as unexplained infertility happens due
to any of the many reasons. Most of these are female related, and
can be diagnosed only by very sophisticated medical examination.
Infertility in males is much easier to detect. The male
genital organs are well exposed unlike the female organs which needs
scanning & It can be ascertained by simple tests like to check
sperms for motility, morphology and survival. Tests can also be
conducted to check the final number of sperms that reach uterus
after copulation (P.C.T) These are reasons good enough to indicate
that infertility tests should always be conducted on the male partner
first.
REASONS FOR FEMALE INFERTILITY
- When ovulation (monthly ovum production) does not occur at all.
(25 % - 30% of causes for infertility)
- The fallopian tube can have a full or partial block (10 % -15%
of causes for infertility) *
- The cervical canal can have an infection, in which case sperms
are killed at the very entrance of the canal.
- Peritoneal factor: This is an illness called Endometriosis
- a condition where tissues inside the uterus invades and damages
the neighbouring reproductive organs like tube, ovary, and peritoneium
this accounts for 40% of female infertility.(40 % of causes for
infertility)
- Fibroids and adenomyosis these are benign tumours developing
in the body of the uterus.(5 % -10% of causes for infertility)
- Pelvic adhesions mainly following previous surgery, may impaire
tubo ovarian relations.
REASONS FOR MALE INFERTILITY
- Disorder in the production of sperm
- Inadequate number of sperms
- Poor motility
- Variations in shapes of sperm (presence of large number of abnormal
shaped sperms)
- Infection in prostrate gland or a block in the urinary tract
- Infection or blocks in testis & epididymis
- Presence of abnormal veins over the testicles known as varicocele
- Inability of the man to ejaculate into the vagina
There are other reasons for male infertility too. Some
of them are excessive smoking, excessive intake of intoxicants,
mumps, injury to testis, urinary disorders, pain during ejaculation,
use of tight underwear's, bathing in very hot water, sexually transmitted
diseases, and stress related professions.
VARICOCELE
It is seen in about 5% of general population and in about 25% infertile
males.
Blood vessel that carry impure blood from testis may
get blocked resulting in impure blood accumulation This causes increase
in testicular temperature and consequently sperm production decreases.
This is called varicocele. By a very simple micro surgery this can
be corrected and it improves the semen profile provided varicocele
is of significant grade (grade 2). Varicocele detected by the help
of a scan and which is not evident clinically doesn't require any
surgery.
MODERN TREATMENTS FOR MALE INFERTILITY
MICROSURGERY
With the advent of ART procedures micro surgical correction of male
tubal block has become absolute.
Only in cases of hormonal deficiency, hormone replacement
therapy is going to be effective and this is seen only in 5% of
the males. Apart from this there is no other indication for hormone
therapy. If the semen contains any bacteria this can be corrected
by appropriate antibiotics.
SPERM WASHING AND CAPACITATION (IUI)
When there is no varicocele or hormonal deficiency the couple has
a high chance of getting pregnancy after IUI where in a sample of
semen is prepared in the laboratory by washing in culture medium
and separating fast moving sperms by special techniques, is then
deposited high in the uterus by a fine catheter around the time
of ovulation is known as IUI . The success rate of IUI varies from
5 to 15% per cycle. After a maximum of five or six attempts there
is no point in repeating the procedure .In this case a couple has
to go for IVF or ICSI.
STEP BY STEP IN IUI
- Drug treatment, to encourage two or three eggs to mature. Usually
clomiphene and or gonadotropins are given to stimulate the growth
of follicles and cause ovulation.
- Monitoring of treatment, to measure the growth of follicles,
individualize drug doses and prevent serious side effects,By transvaginal
ultrasound scanning (three or four times during a treatment cycle)
Sometimes by measuring hormones in a blood sample.
- Sperm sample, provided on the morning of ovulation, is prepared
and inserted later that day
- Pregnancy testing and monitoring after 15 days.
MICROMANIPULATION (ICSI)
This is yet another sophisticated method .In this method
the selected sperm is made to enter the ovum with the help of a
special microscope and manipulator. This is the most modern method
in infertility treatments today. The techniques of intracytoplasmic
sperm injection ,or ICSI have been hailed as a revolution in the
past few years and have finally offered a viable treatment for even
the most difficult cases of male infertility. Where in the past
doctors could offer nothing but adoption or Dl (donor insemination)
to those couples whose infertility was a result of severe sperm
defects, now ICSI appears to offer a real treatment solution.
DIAGNOSIS OF FEMALE CAUSES
A wellconducted clinical exam and a transvaginal scan will give
a lot of information as to the condition of genital organs.
If they are in perfect order the first test to do is to check
for ovulation by serial scan, plus couple of hormones.
Next in order is to check the tubal patency, this is done in 3
ways;
If the pelvic anatomy is normal we can do either HSG (by X- ray)
or by SSG (by scan).
If there is any disease in the pelvis these may not be rewarding
so we have to do a laparoscopy.
The great advantage of it is at the same sitting we can correct
the problems as well.
The next in order is to check for the sperm survival known as P.C.T.
COMMON DISEASES LEADING TO FEMALE INFERTILITY AND THEIR MANAGEMENT
Endometriosis is a puzzling disease affecting girls
and women in their reproductive years. The name comes from the word
"endometrium", which is the tissue that lines the inside
of the uterus and builds up and shreds each month in the menstrual
cycle. In endometriosis, tissue like the endometrium is found outside
the uterus, in other areas of the body. In these locations outside
the uterus, the endometrial tissue develops into what are called
"nodules", "tumors", "lesions", "implants",
or "growths". These growths can cause pain, infertility,
and other problems.
The most common locations of endometrial growths are
in the abdomen - involving the ovaries, fallopian tubes, the ligaments
supporting the uterus, the area between the vagina and the rectum,
the outer surface of the uterus, and the lining of the pelvic cavity.
Sometimes the growths are also found in abdominal surgery scars,
on the intestines or in the rectum, on the bladder, vagina, cervix,
and vulva (external genitals). Endometrial growths have also been
found outside the abdomen, in the lung, arm, thigh, and other locations,
but these are uncommon.
Symptoms
The most common symptoms of endometriosis are pain before
and during periods (usually worse than "normal" men-strual
cramps), pain during or after sexual activity, infertility, and
heavy bleeding. Other symptoms may include fatigue; painful bowel
movements with periods; lower back pain with periods; diarrhea and
/or constipation and other intestinal upset with periods. Infertility
affects about 30-40% of women with endometriosis and is a common
result with progression of the disease.
The amount of pain is not necessarily related to the
extent or size of growths. Tiny growths (called "petechial")
have been found to be more active in producing prostaglandins, which
may explain the significant symptoms that often seem to occur with
small implants. Prostaglandins are substances produced throughout
the body, involved in numerous functions, and thought to cause many
of the symptoms of endometriosis.
DIAGNOSIS
Diagnosis of endometriosis is generally considered uncertain until
proven by laparoscopy.
TREATMENT
Treatment for endometriosis has varied over the years but no sure
cure has yet been found.
About 40 % of the female infertility cases are attributed
to Endometriosis. The most effective treatment in such a case is
operative laparoscopy, in which endometrial growth is destroyed
through laser treatment. This procedure can be conducted through
an endoscopy, which does not require the abdomen to be opened.
In a span of just 6 years, the centre has conducted
4000 such surgeries. Of these, 63 % of them have been certified
successful - with the patients going on to full-term pregnancies
and subsequent deliveries.
The success of this procedure won the faculty the coveted
"International Young Scientist Award" at the Endometriosis
conference organised at Yokohama, Japan, in November 1996.
ANOVULATION
This is a disorder in the hormone production that facilitates ovulation
.Among them the commonest variety is known as polycystic ovarian
syndrome (PCOS).
Effective medicines are available to cure this problem,
but the most effective treatment to PCOD is Endoscopic surgery (also
known as Endoscopic Ovarian Drilling).
Around one in five women have polycystic ovaries. This
term describes the appearance of the ovaries when they are seen
on an ultrasound scan the polycystic ovary syndrome (PCOS) is the
name given to a condition in which women with polycystic ovaries
have polycystic ovary syndrome, but all women with PCOS do have
polycystic ovaries.
The diagnosis of PCOS has been made much easier in recent
years by the availability of ultrasound scanning .before this, only
women with the most severe symptoms could be diagnosed with accuracy
today ,the condition can be detected even when the problems are
only mild.
SYMPTOMS OF PCOS
1. MENSTRUAL IRREGULARITIES
The imbalance of hormone production from both the ovaries and pituitary
may result in either irregular ovulation or no ovulation at all
(known as 'anovulation'). Menstrual periods may therefore become
irregular -perhaps heavier than usual,perhaps occurring after long
gaps (oligomenorrhoea) or perhaps not at all (amenorrhoea). Some
women notice pelvic pain .which may be related to the effect of
hormones on the flow of blood through the pelvic veins.
2. FERTILITY
Irregular ovulation usually means that pregnancy is more difficult
to achieve. Similarly ,if ovulation is not taking place ,it is just
not possible to conceive without treatment. So women with irregular
cycles hoping to get pregnant will have a better chance once their
monthly cycles have returned to normal.
3. MISCARRIAGE
While miscarriage seems an unfortunate chance event for most couples,
it is now known that women with PCOS who have high circulating levels
of LH may be at greater risk. The explanation is probably that too
high a level of LH in the blood stream makes it more difficult for
the egg to develop within the follicle, and for an embryo to implant
within the uterus.
4. SKIN PROBLEMS
One of the hormones which may be released from in unusually high
amounts from the ovary is testosterone ,the male sex hormone which
circulates in both men and women. Excessive 'testosterone levels
in women may be a cause of acne on the face and back, or unwanted
hair on the face .chest arms and legs. The levels of testosterone
in women with PCOS are still much lower than those found in men.
The every day problems of PCOS are often only amenable
to medical treatment, but there are also some lifestyle changes
which can improve symptoms. For example doctors know that the body's
hormone balance can be upset by the excessive body weight, and certainly
PCOS is more common in obese women than in those with a correct
weight to height ratio.
Equally some women with polycystic ovaries only develop symptoms
when they put on weight .so a correct weight to height ratio will
help, and this can be measured by an equation called 'the body mass
index' (BMI). Your BMI is your weight in kilograms divided by your
height in metres and then squared -or as doctors would write kilogram
/metre square. A normal BMI is between 20 and 25.
MANAGEMENT OF PCOS
It thus goes without saying that all women with polycystic ovaries
should try to maintain a normal weight and to have regular periods.
Medical treatment is usually confined to those with the troublesome
symptoms of PCOS.
DRUGS TO INDUCE OVULATION
In case where ovulation is irregular or non-existant, drugs can
be used. The most common is clomiphene citrate, which is taken as
a tablet for five days from the second day of menstruation. Results
show that four out of five women given clomiphene do ovulate ,but
only about one in three actually become pregnant. The starting dose
is usually 50 milligrams, which may be increased to 100 milligrams.
Clomiphene can cause thickening of mucus in the cervix, so a post
-coital test can tell doctors how well the sperms are surviving
in a genital tract.
However, while clomiphene is a useful drug for many
women with infertility problems, it is not always suitable for those
with PCOS because it can cause an exaggerated rise in blood levels
of LH which could impede fertilization or increase the chance of
10 miscarriage .so if clomiphene has not been successful in women
with PCOS within six months, more investigations and alternative
treatments are usually called for.
Side effects with clomiphene have been reported, notably
stomach and bowel upsets, hot flushes, bloating, headache, dizziness,
depression and breast discomfort. Multiple pregnancy is a risk whenever
ovulation is induced with fertility dugs-in natural conception the
risk is about one in eighty, in induced ovulation about one in twenty.
There is no increased risk of birth defects from fertility drugs.
LAPAROSCOPIC OVARIAN DIATHERMY
A new, minimally -invasive operation which is performed
through a laparoscope looks set to replace the more traumatic 'wedge
resection' in which a part of the ovary was removed surgically.
The new procedure -known as laparoscopic ovarian diathermy-actually
burns parts of the ovary to correct any hormonal abnormalities and
thus make ovulation possible.
IN VITRO FERTILIZATION
IVF, The test tube baby technique in which a woman's
egg are fertilized with the partner's sperm in the laboratory, is
usually recommended to women who have blocked fallopian tubes, or
men with poor sperm. IVF is sometimes offered to women with PCOS
who want to conceive when other treatments have failed. However
PCOS on it's own is not an indication for IVF. Women with PCOS who
do undertake IVF are greater risk of the ovarian hyperstimulation
syndrome and must be carefully monitored.
TUBAL BLOCK (BLOCK IN FALLOPIAN TUBE)
Almost 10 % of reported female infertility is due to a common problem
called tubal block.
If the tubal block is at the tip of the fallopian tube, it can be
removed either through endoscopic surgery or microsurgery . If the
block is at the beginning, either utero tubal implantation after
laparotomy or it could be tackled by tubal cannulation through hysteroscopy.
Nowadays Tubal cannulation through endoscopyis widely recognized
as the ideal solution. A special X-ray technique hystero salpingo
graphy( HSG ) or diagnostic laparoscopy can be used to detect this.
Another method of detecting tubal block is by sono salpingography
which is done with the help of scan.
CERVICAL FACTOR
As mentioned earlier, the solution for this is to deposit a prepared
sperm directly into the uterus or the fallopian tube. The medical
terminology for this is known as Intra Uterine Insemination ( IUI
) . Other treatments available are IVF-ET, Micromanipulation, In
Vitro Fertilization(IVF), (TET) Intra Cytoplasmic sperm Injection
(ICSI)
INVITRO FERTILIZATION
IVF is the original test tube baby technique and probably the most
widely practiced assisted-conception procedure in the world. In
simple terms IVF removes several eggs from the ovary fertilizes
them in the laboratory with sperm from the male partner, and transfers
a small selection of the resulting embryos to the womb for implantation
and pregnancy. Although IVF was developed to treat couples whose
principal cause of infertility is tubal damage, the technique has
also been found useful in those with endometriosis, sperm disorders
(poor sperm counts or morphology) and even unexplained infertility.
Studies indicate that the expectation of pregnancy from one cycle
of treatment is around 25 percent, and the chance of delivery slightly
less. Overall the average take-home baby rate from IVF is about
15 percent for each cycle of treatment. These rates are not much
different from those of normal fertile couples. Most studies have
shown pregnancy rates falling in women after the age of 35, which
is why many infertility specialists encourage couples to act quickly
when the female partner is already in early 30's.
ICSI
The ICSI technique makes use of the most powerful microscopes and
'micromanipulators': embryologists ,for example .holding a single
human egg at the end of a fine suction pipette, can penetrate the
egg with a needle which is seven or more times finer than the diameter
of the human hair. In normal, conception a single ejaculation of
semen might contain more than 200 million viable sperms-but from
this vast number only a few hundred will actually reach the released
egg in the fallopian tube and be able to fertilize it. Men with
total sperm counts below 20 million or so (or 5 million per millimeter)
were always thought impossible to treat; now ICSI can achieve fertilization
with just one sperm cell injected into an egg.
In males with no sperms known as azoospermia some times
we can aspirate 5 or 10 mature sperms from the testes and these
sperms can be utilized for ICSI thus these unfortunate males can
also become fathers.
STEP BY STEP IN ICSI
- Drug treatment, to stimulate several eggs to mature
- GnRH antagonist to suppress all other hormone activity (injections
/nasal spray for (usually) two weeks before gonodotropins and
then a further 10-14 days depending on response)
- gonodotropins to stimulate the growth of follicles and cause
ovulation
- Monitoring of treatment to measure the growth of follicles,
individualize drug doses and prevent serious side effects.
- Bytransvaginal ultrasound scanning (two or three times during
a treatment cycle)
-Sometimes by measuring hormones in a blood sample.
- Egg collection, usually under local anaesthetic, lasts between
10 and 20 minutes.
- Guided by transvaginal ultrasound
- Collected through the vagina (32-36 hours after final hormone
injection)
- Sperm sample provided on same day as egg collection
The sample can be obtained in natural way or following aspiration
from the epididymis (MESA) or extraction from the testis (TESE)
- FERTILIZATION
One single sperm cell is injected into a single egg cell Eggs
are examined the next day under the microscope to see whether
fertilization has occurred.
- EMBRYO TRANSFER (USUALLY TWO OR THREE DAYS AFTER FERTILIZATION)
- Transvaginal transfer of no more than three embryos
-embryos placed in the womb
- Spare embryos usually frozen.
- PREGNANCY TESTING / MONITORING
THE RISKS OF ASSISTED CONCEPTION
Because all assisted conception methods offer an overall chance
of a baby of around 15 to 20 % for each cycle of treatment, the
biggest hazard for those embarking on treatment is disappointment.
However as studies show the chances of pregnancy do increase with
additional cycles and are comparable to nature.
These are few risks associated with the actual treatments
themselves. GIFT requires general anaesthesia for laproscopy to
take place, and this can - on very rare occasions - cause complications.
Indeed, this is one reason why infertility specialists in some countries
have preferred IVF to GIFT - not because the results are better
but because a general anaesthetic is not required.
The most common side effects of treatment are multiple
pregnancies. These not only cause serious social complications (particularly
as the babies begin to grow) but are also associated with higher
rates of pregnancy loss and lower birth weight babies. The most
published 'danger' of assisted conception had been a condition called
'ovarian hyperstimulation syndrome' (OHSS) which can very rarely
occur as a result of the drug treatment given in the stages before
the egg collection. Too high a dose of drug can cause excessive
stimulation of the ovaries, which may be noticed as a pain in the
abdomen. It is to avoid the risk -as well as the risk of multiple
pregnancies - that doctors monitor drug treatment and it's effect
on the ovary.
BLASTOCYST CULTURE
This is yet another effective method of infertility treatment. It
improves the success rate of IVF and ICSI by 50%.
In the Blastocyst Culture, the 4 or 8 celled embryo
is not transferred to the uterus. Instead it is allowed to divide
again after which it becomes a multi celled complex entity called
a Morule. In the next stage of division it is called a Blastocyst.
It is at this stage it is transferred to the uterus.
The advantage here is that the Blastocyst sticks more lastingly
to the uterus, thus reducing chances of rejection. The only disadvantage
here is the difficulty involved to grow the embryo to the Blastocyst
stage. Also we must get lot of embryos to grow 1 or 2 blastocysts.
ASSISTED HATCHING
Assisted Hatching is advantageous to those who have a history of
failed IVF or ICSI.
If the female partner is above the age of 35, the ovum
is likely tohave a thick outer layer (thick zone). Inevitably the
covering layer of the embryo will also be thick. In such circumstances
a hole is made on the outer layer of the ovum using the precision
glass needle of a micromanipulator, after which the embryo will
be able to break open the outer layer.
This treatment can be conducted using a laser beam or even acid
tyroid.
GENETIC STUDY
Almost 15% of infertility cases can be attributed to chromosome
disorders. Studies have shown infertility to be caused by the loss
of the y chromosome. In fact, it is the same anomalous sex chromosome
that causes premature ovarian failure (the state of being incapable
to produce ovum) among females. Anomaly of xx or xy chromosome is
said to be the reason for 5 % of neonatal death and still born cases.
PRENATAL DIAGNOSES
Modern medical science now offers facilities to find out the variation
of chromosomes. This is called prenatal diagnosis.
When a woman becomes pregnant after the age of 35,
the likelihood of having a baby affected with Down's Syndrome increases.
This is because there is an excess number of 21st chromosomes are
formed in the foetus.
If the first born child is mentally or bodily handicapped
the second too is likely to become that way. Especially when either
the male or female partner suffers from chromosome disorders. By
conducting the pre-natal test we can get to know if the child in
the womb has any malformation.
This knowledge, along with the advice of a good medical
counsellor will help you to arrive at a right decision.
4D SCAN
The VOLUSON730 scanner helps to sort out complex structures quickly.
It offer much benefit in the evaluation of suspected fetal anomalies,
growth reduction etc.
"Having the voluson 730 in our office drives satisfaction
not only with our staff but also with the patients we care for patients
appreciate being able to visualize their babies moving three dimensions.
With other systems, 3D reconstructions were tedious and time consuming.
The voluson 730 gives us the highest quality 3D and real time 4Dinstantly.
The voluson 730 allows me to see and evaluate fetal movement unlike
any other ultrasound system on the market. Beyond this outstanding
3D the volusion 730 delivers competitive high-end 2Dimage resolution"
WHAT YOU SHOULD KNOW BEFORE AN INFERTILITY TREATMENT
Prior to an infertility treatment, it is essential one should know
the following facts:
- If you suspect infertility, consult a reliable doctor immediately.
- Infertility can be suspected only if regular sexual intercourse
without contraceptives does not yield any result at least after
one year. In cases where the woman is above 30 years of age ,
a check for infertility is advised if there is no pregnancy reported
within six months of unprotected intercourse.
- Infertility is not the fault of the woman alone. Either husband
or wife may be infertile. In such cases tests should be run to
find out for which of the partners the problem is.
- For the treatment process, take care in choosing the doctor
and the hospital. A good hospital with modern facilities would
be the ideal choice.
- Before the treatment get a correct assessment of the costing.
- Ask your doctor about the success rate of every treatment.
Just in case the treatment you choose has only a 10 % chance of
success, you could assess the financial situation and decide whether
to go in for the treatment or not. If the treatment get more complicated
ask the doctor the likely success rate of it. Sometimes you will
have to spend for treatment which does not even ensure 10% success.
- If the treatment within your financial status does not yield
positive results there is always the option of legal adoption.
But then again, if there is a hesitancy to adopting, the couple
can even think about a life without children or babies.
The myth that children will look after their parents during old
age is not quite true.
ESSENTIAL INFORMATION FOR THOSE WHO REGISTERED HERE FOR INFERTILITY
TREATMENT
FOR SCANNING
It has to be done in the morning of the 10th day of the menstrual
cycle, and has to be continued everyday for the next five days.
Along with scanning Post Coital Test ( PCT) can also be done. To
do this test, the couple should have had intercourse 12 hours prior
to it. Those who do not need a PCT but are doing Follicular Scanning
should make sure they have sexual intercourse from the 10th day
of the menstrual cycle to the 15th day.
- Before scanning, make sure the bladder is empty.
- If, during the treatment, at any point of time period starts
again, the doctor has to be informed immediately.
- If pregnancy is confirmed, the doctor has to be informed.
FOR ENDOSCOPIC SURGERY
Those patients who come for endoscopic surgery should get admitted
one days prior to it. Under normal circumstances, the patient is
discharged after 24 hours. 2-3 days rest at home is necessary, after
which normal life can ensue.
- For those who are travelling a long distance for the IUI treatment,
it is advisable to come prepared for a 2-3 days stay in the hospital.
- The endoscopic surgery is recordable. Those who want to record
the surgery should entrust a cassette with the duty nurse prior
to the surgery.
THE INFERTILITY CLINIC
- The clinic, CRAFT .attached to K J Hospital is one of the most
reputed infertility clinics in Kerala.
- It offers all modern medical facilities and has helped turn
many infertility cases into success stories
- The speciality of surgery at CRAFT is that the patient has
to spend only 1 or 2 days in the hospital, after which a few days
of bed rest are sufficient to bring back normalcy.
- Endoscopic Surgery done here is so specialised, it can be made
use of for a wide range of uterus related illnesses -excessive
bleeding, fibroids and ovarian cysts can all be corrected through
the same procedure.
- To rectify urinary tract disorder, CRAFT performs the Burch
Colpo Suspension Surgery. This is also done by Endoscopy.
- Endoscopy can also be used to set right the fallopian tube,
after sterilization
- BALOON THERAPY In cases of severe bleeding from the uterus
where conception is not a problem this is an ideal way to stop
the bleeding with out removing the uterus.
ALMOST ALL THESE FACILITIES ARE ALSO AVAILABLE IN DUBAI CLINIC
AS WELL
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