Aniruddha Malpani
Articles
DIY - Insemination
DIY (do-it-yourself) or self-insemination, is a method in which the woman (or her partner) inserts semen into the vagina herself, without medical intervention. This is a useful technique for couples... [more]
Ask the Doctor
Dr Malpani would be happy to provide a second opinion on your problem. Please fill in the following form, and email it to malpani@vsnl.com , or courier it (with a self-addressed stamped envelope... [more]
Do you have an infertility problem? When to start worrying!
"So, when are you planning to have a baby?" This is the most common question most newly married couples in India are asked - sometimes even as soon as they have returned from the honeymoon!... [more]
Finding Out What's Wrong -- The Basic Medical Tests
In order to understand why pregnancy doesn't occur, we need to examine the four critical areas which are needed to make a baby - eggs, sperm, fallopian tubes and the uterus. The tests, which often... [more]
Testing the Man - Semen Analysis
In the past, infertility was blamed wholly and solely on the woman. This may have been to protect the fragile male ego, because the male psyche equates fertility with virility, and views failure to... [more]
Beyond the Semen Analysis
For the man with an abnormal semen analysis, additional tests which may be recommended include specialized sperm tests, blood tests; and testis biopsy. Antisperm Antibodies Test The role of [more]
Diagnosis and Treatment of Male Infertility -- More Confusion!
The commonest reason for male infertility is a low sperm count, and the commonest reason for this is what doctors call "idiopathic" which simply means, we do not know! This is one of the reasons why... [more]
The Case of the Man with a Low Sperm Count
Many infertile men are obsessed about their sperm count - and this seems to become the central concern in their lives. Remember that the real question the man with a fertility problem is asking is... [more]
Microinjection: The Latest Advance in Treating the Infertile Man
The introduction of Microinjection Technology into the in vitro fertilization laboratory has revolutionized our treatment of the infertile man. Intracytoplasmic sperm injection, or ICSI, is a new... [more]
Ultrasound - Seeing with Sound
Ultrasound or sonography has helped revolutionize our approach to the infertile patient. Ultrasound gynecologist's helps the doctor to "image" or see structures in the female pelvis.... [more]
Laparoscopy -- The Kinder Cut
Laparoscopy is a surgical procedure in which a telescope is inserted inside the abdomen through a small cut below the navel, so that the doctor can have a look at the pelvic organs in the infertile... [more]
Hysteroscopy
Hysteroscopy, as the name suggests (hystero = uterus; scopy = to see), is a surgical procedure in which a telescope is inserted inside the uterus to examine the uterine lining. This procedure can... [more]
The Tubal Connection
The fallopian tubes project out from each side of the body of the uterus and form the passages through which the egg is conducted from the ovary into the uterus. The fallopian tubes are about 10cm... [more]
Ovulation -- Normal and Abnormal
Normal ovulation Normally, one of the ovaries releases a single mature egg every month, and this is called ovulation. Women may notice pain or abdominal discomfort at the time of ovulation and... [more]
The Older Woman
Most infertility specialists define an older woman as one who is more than 35 years, but this is an arbitrary number. A woman's fertility does not fall off at a particular age, but starts declining... [more]
Polycystic Ovarian Disease (PCOD)
Patients suffering from polycystic ovarian disease (PCOD) have multiple small cysts in their ovaries (the word poly means many). These cysts occur when the regular changes of a normal menstrual cycle... [more]
The Cervical Factor
Normal cervical mucus Cervical mucus is a jelly-like substance produced by tiny glands in the cervix called cervical crypts. It has a protective function and may prevent bacteria from getting into the [more]
Endometriosis -- The Silent Invader
Endometriosis is a common disorder that affects women of reproductive age. It occurs when normal endometrial tissue (the lining of the uterus) grows outside the uterus. This misplaced tissue may... [more]
Ectopic Pregnancy - The Time Bomb in the Tube
An ectopic pregnancy is one that develops outside the uterus. Most ectopics are found in the fallopian tube and these are called tubal pregnancies. However, they can also occur at other pelvic sites... [more]
Unexplained Infertility
Unexplained infertility means that doctors cannot determine why the couple is infertile - it is a confession of medical ignorance. Patients with unexplained infertility fall into two groups. The... [more]
Secondary Infertility -- Caught Between Fertile and Infertile Worlds
For most people, infertility conjures up the image of a couple without a child. But what about a couple who have borne a child, and now want to extend their family but find they are unable to do so?... [more]
Empty Arms - The Lonely Trauma of Miscarriage
An extended definition of infertility includes women who conceive but cannot carry a pregnancy to the full term that is women who have repeated miscarriages or pregnancy failures. The medical term... [more]
Understanding Your Medicines
You must be aware of what medicines you are taking and why. It's easy for doctors to prescribe medicines, but it's your responsibility to be well-informed about them, so that you know exactly what to... [more]
Intrauterine Insemination (IUI)
Sometimes Nature needs help to start a pregnancy, and the doctor can do this by giving the sperm a piggyback ride through a fine tube into the body. This procedure is called intrauterine insemination... [more]
Test Tube Babies - IVF and GIFT
The birth of Louise Brown through in vitro fertilization (IVF) in 1978 was a major milestone in infertility treatment. It dramatically changed the treatment options for infertile couples, and... [more]
Preimplantation Genetic Diagnosis - The Newest ART
PGD or pre-implantation genetic diagnosis is a new technique, which marries the recent spectacular advances in molecular genetics and assisted reproductive technology. Pre-implantation genetic... [more]
Using Donor Sperm
THERAPEUTIC INSEMINATION BY DONOR [TID] means using the sperm from a donor to achieve a pregnancy, and is a treatment option if the man is infertile. While TID is a well-established method for... [more]
Surrogate Mothering
The word "surrogate" means substitute or replacement and a surrogate mother is one who lends her uterus to another couple so that they can have a baby. In the West where fewer and fewer babies are... [more]
When Enough Is Enough - The Decision to End Treatment
One of the most difficult aspects of infertility treatment may be examining the question of when to stop medical therapy. You may find yourselves asking, "When should we stop? When will we know that... [more]
Adoption - Yours by Choice
You don't have to be superhuman, superkind, superloving or perfect to be able to adopt a child, you just have to be ready. Being ready only happens when you've had time to get used to the idea; and... [more]
Stress and Infertility
Stress has become a buzzword today. It is one of the most over used words in our vocabulary - and one of the most poorly understood ones as well. Stress is defined as any event that a person... [more]
The Emotional Crisis of Infertility
Sir William Osler, a famous physician, once said that human beings have two basic desires - to get and to beget. To have your own family is a universal dream. This dream can become a nightmare for... [more]
How to Cope with Infertility
Even though the stress of infertility is often unavoidable, there are many steps that you can take to decrease the pain. First of all, both of you must recognize that you'll have different feelings... [more]
Infertility and Sexuality
Infertility brings about many changes in a couple's relationship. It may bond you closer together in unspoken sadness and hope - and allow mutual support and understanding which leads to a sharing... [more]
Support Groups -- Self - Help Is the Best Help
Infertility causes great personal suffering and distress. Most of this is hidden from the public gaze, and this is why it is still not talked about openly. The reasons for the lack of public support... [more]
Helping Hands - How Friends and Relatives Can Help
This chapter is to help friends and family members to understand the needs of an infertile couple better. Sometimes it's difficult to know what to say to a couple that are confronted by an... [more]
Rights of The Infertile Couple - And What Society Needs to Do About Them
The right to have a baby is something most of us take for granted, and we often lose sight of the fact that one in ten married couples will not be able to have the child they want. Infertility is a... [more]
Alternative Medicine: Exploring Your Treatment Options
There is no doubt that modern medicine inspires awe. IVF laboratories and sophisticated ultrasound scanning machines appear very impressive and reassuring when you are infertile. However,... [more]
Making Decisions about Treatment
Discovering that you have a fertility problem can be a difficult process. In addition to the emotional stress you now find yourselves faced with making endless decisions about treatment. The word... [more]
How to Find the Best Doctor
In a perfect world, you'd have the perfect doctor, who treats you as an intelligent couple, has plenty of time, infinite wisdom, low fees, is totally honest yet compassionate, has a conveniently... [more]
How to Make the Most of Your Doctor
Remember that just finding a good doctor is not enough. For an infertile couple, the doctor-patient relationship is the ultimate one-to-one relationship, in which you confide fully in your doctor and... [more]
The Infertile Patient's Guide to the Internet
Most infertile patients are hungry for information - and "Look it up on the Internet" is fast becoming the standard prescription for any infertile couple. Medical journals, textbooks, encyclopaedias,... [more]
The Ethical Issues - Right or Wrong?
The new reproductive technologies have spawned new ethical concerns. These are controversial subjects, which have attracted wide media attention and public debate. However, the law and public opinion... [more]
How Much Does Treatment Cost?
The Economics of Infertility Treatment Being infertile can be very expensive! Tests and treatment cost considerable money, and since there is no definite endpoint, budgeting for medical expenses can... [more]
Pregnant - At Last!
For most infertile patients, getting pregnant is the ultimate dream, which keeps them going through tests, treatments and surgery. What happens when the dream finally comes true? Making the Diagnosis... [more]
Preventing Infertility
Often preventing infertility is much easier and better than treating it! What can you do to reduce the risk of being infertile? The biggest preventable danger to fertility is due to uncontrolled... [more]
The Infertile Patient's Prayer and Infertility
Lord, Give me Strength... To keep my cool when another period starts. To keep my chin up when a co-worker announces her pregnancy. To have a good relationship with my friend in spite o [more]
Making IVF Affordable
IVF and related assisted reproductive technologies (ART) offer great hope to infertile couples the world over. Because these techniques are so expensive, however, they are out of the reach of the... [more]
Why are Women Scared of IVF?
Since everyone knows that IVF is the most effective way of treating infertility, why are so many infertile couples still so wary of going in for IVF? Some couples worry that a test tube baby is... [more]
Infertility Record Sheet
This form can be useful to summarise and record your infertility history; and is very useful when you need to seek a second opinion.Date __________________ Name of wife ___________________________ [more]
Appendix 1: Common Laboratory Tests
Parameter Results/Normal Values --------------------------------------------------------------------------------Colour Gray Coagulate? Yes Liquefy? Yes If yes,time in minu [more]
Glossary
Abortion: the medical term for miscarriage. The various types include:Complete abortion: A miscarriage in which all of the products of conception have been expelled and the cervix is closed. [more]
