GYNECOLOGY
Artificial Insemination | Colposcopy | .
Artificial Insemination
Artificial Insemination is the procedure to tackle infertility issues, wherein the sperm is introduced either into the vagina, identified to be as intracervical insemination or directly into the uterus for further implantation, identified to be as intrauterine insemination. The procedure is being commonly opted by many single women and lesbians.
Preparation for Intrauterine insemination (IUI) procedure
- On the basis of pelvic examination and ultrasound, the childbearing capacity of a woman and any structural abnormality in the ovaries and fallopian tube is determined.
- With the help of an ovulation predictor kit, the ovulation time is predicted by when the woman secretes maximum level of luteinizing hormone (LH); and at the same time serum sample with enriched sperm count is kept ready for further insemination.
- In case the woman has a problem with ovulation, she will be given hormonal injections.
- Ideally, IUI should be suggested within 6 hours, either side of the ovulation.
During the Procedure
- The intrauterine insemination (IUI) is a simple process lasting for 45 mins to 1 hour and can be performed in the fertility clinic.
- The patient is asked to lie down in a hospital gown on an examination table. The cervix is observed with a speculum and further cleaned with a little culture medium.
- The sperms are injected into the cervix using a fine plastic catheter. The patient is asked to stay immobile in a similar position for approximately 15 to 45 mins.
Risk & Complications
- The IUI is a relatively safe procedure with a rare indication of any complications; however, it has a relatively low success rate, demanding for multiple attempts.
- In some rare cases, the procedure may be associated with infection-causing abdominal pain.
- The fertility drugs prescribed may have various side effects like depression, hot flushes, pain etc.
- The drugs can also cause ‘ovarian hyperstimulation syndrome’ associated with the formation of multiple ovarian cysts, swelling in the ovaries, multiple egg production; thus, increasing the risk of multiple pregnancies.
- leading to the formation of ovarian cysts, swelling of the ovaries and production of multiple eggs at a time that can result in multiple pregnancies
Uses of intrauterine insemination
- It is a less expensive procedure, providing a more natural way of fertility.
- IUI is useful when the female partner suffers from a sperm allergy, has mild endometritis, cervical mucus resentment or when the male partner suffers from poor sperm motility or a low sperm count, unable to ejaculate into the vagina.
- In case of the unavailability of a semen sample of a partner, even stored semen can be applied.
- Since the procedure is non-invasive recovery is faster.
Travelers guide
For medical tourists, advanced planning, proper diet, moderate exercise and a healthy lifestyle is suggested to increase the success rate.
Colposcopy
Colposcopy is a gynecological procedure helpful for obtaining an illustrative, magnified view of the cervix, vagina, and vulva; in order to determine the structural abnormality and associated diseased condition.
Additional information about the procedure
The procedure is usually painless can be performed in the clinic itself.
Preparation before procedure
- Test to be scheduled when not menstruating.
- Sexual intercourse, vaginal medications, application of tampons should be avoided 24 hours prior to the procedure.
The abnormalities associated with cervix and vagina can be detected, such as:
- Inflammatory due to infection
- Benign or malignant tumors
- Injuries
An accurate diagnosis can be achieved through the application of specific tests like an acetic acid wash, color filters, and tissue biopsies.
Cervical abnormalities can be eliminated using certain treatments, such as:
- Cryocautery and carbon dioxide laser,
- Loop electrosurgical excision procedure (LEEP)
These treatment procedures are associated with some discomfort or pain.
Precautions after the Procedure
- Post-procedure, slight bleeding, or discharge of green-coffee colored fluid can be reported for a few days.
- The patient is advised to avoid douching, sexual intercourse, vaginal medications, or the application of tampons.
.
Definition: The procedure is associated with removal of the uterus through laparoscopic or conventional open surgery; with vaginal as well as abdominal incisions. If required, ovaries can also be removed, depending upon the patient’s health.
Why did it need?
. is advised in conditions that include
- Uterine/ovarian cancer
- Uterine fibroids
- Endometriosis
- Pelvic Adhesions
- Uterine bleeding not controlled by medicine
- Uterine prolepses
- Adenomyosis
- Complications during childbirth
Facts and figures
- . is the second most common surgeries performed on 5,56,000 women annually; confirming to be 1 in 3 women over 60 years of age.
- 55% of the total hysterectomies are performed on women between 35-40; however, the number of women in their 30s-40s undergoing the surgery is increasing.
- The United States is ranked first with the highest rate of hysterectomies.
- It is estimated that 30% of hysterectomies are unnecessary.
Risk and complications associated with . surgery includes
- Hemorrhage in the pelvic region
- Infection
- Damage to adjacent organs- bladder or bowel injuries
- Anaesthesia reaction
- Unwanted scarring on the abdomen
Advantages
- . can cure multiple indications like uterine cancer, uterine fibroids, and endometriosis.
- Significant improvement has been reported in health, post-. in women suffering from uterine bleeding.
- The operation improves a woman’s quality of life. According to a study 71% of women who had hysterectomies, reported feeling better mentally, physically, and sexually after the operation.
Disadvantages
- Depression and loss of libido, post-.
- Hormone replacement therapy is advised in case of the removal of ovaries, due to an increased risk of osteoporosis and heart disease.
Preoperative Preparation
- Complete physical examination
- Blood and urinalysis
- X-rays and USG
- Consultation 7 days prior to the procedure for medicinal D0’s and Don’ts.
- Quit unhealthy habits, like smoking, drinking, etc.
- Post-operative rehabilitation can be arranged through family, friends,and caretaker.
- 7-8 hours of fasting is advised prior to surgery.
Post operative care
- Open surgery needs hospitalization for 4-5 days, whereas laparoscopic incision is a one-day procedure.
- The medications will be given to control pain and to prevent infection
- The patient who needs to remove ovary may need to start hormone replacement therapy
Dos, Don’ts and Precautions
- Do follow the medication schedule and diet suggested by the dietician.
- Don’t indulge in heavy physical activity for 1-2 weeks after the operation
- Avoid sexual activity, use of douche, tampons for 6 weeks post-surgery.