Need Expert Advice?Our Gurus Can Help

Ans: A gynecological examination, while a part of routine cancer screening, is not highly accurate on its own for detecting most cancers, particularly in early stages; a pelvic exam is particularly poor at detecting ovarian cancer, and a Pap smear is primarily used for cervical cancer screening, meaning further tests like biopsies are usually needed for definitive diagnosis of most gynecological cancers.
Certain screening test are available to rule out cancers:
For women, the most common screening tests to rule out cancer include mammograms for breast cancer, Pap smears (along with HPV tests) for cervical cancer, and regular pelvic exams.
Mammograms:
An X-ray of the breast that can detect cancerous lumps early when they are easier to treat.
Pap smear:
A test that examines cells collected from the cervix to identify abnormal cell changes that could develop into cervical cancer. Me
HPV test:
Detects the human papillomavirus (HPV) which is a major risk factor for cervical cancer.
Co-Test: HPV WITH DNA
Endometrial cancer
Endometrial cancer often presents early with vaginal bleeding after menopause. Routine transvaginal ultrasound can be done.
IF NEEDED endometrial biopsy done and sent for testing for grading the endometrial cancer.
Ovarian cancer
A CA-125 blood test can indicate high levels of a biomarker that may be a sign of ovarian cancer along with other tumor markers CEA, LDH, AFP, ca19.9 Roma index
If needed MRI can be done to detect the extent of spread.
Self-breast examination
Once a month post menses can help patient to detect sny lump in breast or axilla or any nipple changes.
These screening methods help in early diagnoses n treatment of cancers in early stage.

Ans: About 5% to 10% of breast cancers and 10% to 15% of ovarian cancers are hereditary.
Women with a mother or sister diagnosed with ovarian cancer have around 3 times the risk of ovarian cancer.
If your mother has a history of ovarian cancer, the most effective preventive measure for your daughter is to consult a genetic counselor and consider genetic testing to determine if she carries BRCA mutations, which significantly increase the risk of ovarian cancer; if positive, she may choose to undergo a preventive surgery called a risk-reducing salpingo-oophorectomy (removal of the ovaries and fallopian tubes), and could also benefit from regular monitoring and discussing other preventive options like long-term oral contraceptive use with advise of your doctor.
To rule out other gynae cancers
1) routine gynae examination
2) routine blood test
3) Ultrasound of pelvis to detect any uterine or ovarian pathology
4) PAP WITH HPV DNA TEST to rule out cervical cancers
5) tumor markers like ca125 to rule out ovarian cancers
6) mammography to rule out breast lumps
And self-breast examination.

Ans: Early signs of ovarian, cervical and breast cancer
1). OVARIAN CANCER:
Bloating
Abdominal pain cramps and discomfort
Pelvic pain
Change in bowel habits
Increase frequency of urination or dysuria
Fatigue
Irregular bleeding
Weight loss
CERVICAL CANCER:
Abnormal continuos vaginal discharge
vaginal bleeding after sex.
vaginal bleeding after menopause.
vaginal bleeding between periods or periods that are heavier or longer than normal.
vaginal discharge that is watery and has a strong odor or that contains blood.
pelvic pain or pain during sex.
BREAST CANCER
Lump in breast
Lump in axilla
Redness on lump if breast
Abnormal venous dilation on breast
Orange peel appearance of breast skin
Abnormal or bloody discharge of nipples
Pap smears, mammograms and colonoscopies all offer a way to detect cancer early —
The 2 tests used most often (in addition to a complete pelvic exam) to screen for ovarian cancer are transvaginal ultrasound (TVUS) and the CA-125 blood test.
Regular gynecological exams, including Pap smears and HPV tests, are used to help screen for cervical cancer.
Mammograms
Self-breast examination helps in early detection of breast cancer.
Yes, early detection of ovarian, cervical, and breast cancers significantly improves survival rates, as cancers caught in their early stages are more treatable and have a much higher chance of successful treatment compared to when diagnosed at later stages; this is why regular screening for these cancers is strongly recommended.

Ans: Yes, taking the i-pill can cause delayed periods or irregular bleeding. The I-pill is an emergency contraceptive pill that contains a high dose of hormones that can disrupt your menstrual cycle.
But it is advisable to do pregnancy test to rule out pregnancy

Ans: Yes, taking the i-pill can cause delayed periods or irregular bleeding. Sometimes after taking I pill spotting can occur within 7 days and cause irregular bleeding also. The I-pill is an emergency contraceptive pill that contains a high dose of hormones that can disrupt your menstrual cycle.
But it is advisable to do pregnancy test to rule out pregnancy.
Or visit your nearby gynae to rule out other causes if delayed menses

Ans: Yes, taking the i-pill can cause delayed periods or irregular bleeding. Sometimes after taking I pill spotting can occur within 7 days and cause irregular bleeding also. The I-pill is an emergency contraceptive pill that contains a high dose of hormones that can disrupt your menstrual cycle.
But it is advisable to do pregnancy test to rule out pregnancy.
Or visit your nearby gynae to rule out other causes if delayed menses

Ans: Yes, taking the i-pill can cause delayed periods or irregular bleeding. Sometimes after taking i pill spotting can occur within 7 days and cause irregular bleeding also. The i-pill is an emergency contraceptive pill that contains a high dose of hormones that can disrupt your menstrual cycle.
But it is advisable to do pregnancy test to rule out pregnancy.
Or visit your nearby gynae to rule out other causes if delayed menses

Ans: Hello
History noted
The above symptoms are of perimenopause
Perimenopause:
The transitional period before menopause, when the ovaries gradually produce less estrogen
Can begin in your 40s and last for several months or years
Symptoms include irregular periods, hot flashes, and mood swings
No menses for a period of one year is MENOPAUSE
Yes, you should visit your gynecologists. She will guide with lifestyle modifications, supplements to take care of mood swings, calcium supplements and multivitamins and dietary management for managing weight gain.

Ans: If you take the combined oral contraceptive pill, you can skip the hormone-free week and take two packs in a row.
If you take a progestin-only birth control pill, you can take it continuously to delay or prevent your period.
If you use the birth control patch or ring, you can start the next patch or ring immediately instead of taking a break.

Ans: Pill is used as an emergency contraceptive tablet in the event of unsafe intercourse or failure of contraception, to avoid unintended pregnancy. Within 24-72 hours after having unprotected sex, the emergency contraceptive pill must be taken. It is best to take the pill orally.
I pill can cause delayed periods or irregular periods
But it is advisable to do home pregnancy test to rule out pregnancy if you have delayed periods.

Ans: Delayed or missed after taking birth control pills. This can happen when you start or stop taking birth control, or when you change birth control methods.
Why might your period be delayed or missed after taking birth control pills?
Hormonal adjustment
When you start or stop taking birth control, your body needs time to adjust to the new hormone levels.
Birth control method change
Switching from one form of birth control to another can cause a delay or missed period.
Stress
Physical stress, like high-intensity exercise, can disrupt your menstrual cycle.
Diet changes
A sudden change in diet can cause a missed period.
Medical conditions
Certain medical conditions, like uterine polyps or fibroids, can cause irregular periods.
It's advisable to do home pregnancy test to rule out pregnancy.

Ans: ok

Ans: The time of life when a woman's ovaries stop producing hormones and menstrual periods stop. Natural menopause usually occurs around age 50. A woman is said to be in menopause when she hasn't had a period for 12 months in a row.
When to stop contraception non-hormonal contraception:
You can stop using contraception if you haven't had a period for 12 months.
Hormonal contraception:
You can stop using contraception if you haven't had a period for 12 months and a blood test confirms you're postmenopausal.
You can do serum FSH LEVEL can help to determine whether getting menopause

Ans: Since you have taken, I pill twice in a month,
There are chances if menstrual irregularities due to hormonal imbalance
But we can't ignore the chances of pregnancy. If the periods are delayed by a week, it is advisable to do pregnancy test also.
Taking an emergency contraceptive pill during the first three weeks of the menstrual cycle can cause the period to come early. If taken during the fourth week, the period may still arrive on schedule but with abnormal bleeding that is typically heavier than usual. However, when taken within a couple of days before or after ovulation, there is little to no change in the timing or amount of bleeding.
Additionally, it causes abdominal pain, which may also result in weakness, constipation, and body aches.

Ans: History noted
You are being 36 years with one delivered child and 1 miscarriage one at 12 weeks and another at early pregnancy:
It is advisable to Diagnostic evaluation should include maternal and paternal karyotypes, assessment of the uterine anatomy, and evaluation for thyroid dysfunction and immunological causes, APS, and selected thrombophilia's. In some women, evaluation for insulin resistance, ovarian reserve, antithyroid antibodies, and prolactin disorders may be indicated.
To do semen analysis also
To check for DNA FRAGMENTATION
TO DO hysteroscopy to evaluate the uterine cavity and rule out chronic endometritis.

Ans: History noted
The I-pill, also known as the morning-after pill, can cause menstrual irregularities, including delayed or early periods, spotting, or heavier or lighter bleeding.
If your periods are delayed for more than a week, you should take a pregnancy test.
You should also visit your nearest doctor if you are experiencing any changes.

Ans: History noted,
Since 19th of last month was your last period and you had unprotected sex on 10th of this month, pregnancy test is negative,
It's advisable to wait for a week, repeat home pregnancy test or blood test call serum beta hcg which is confirmatory.
Sometimes it can be hormonal imbalance or delayed ovulation. So sometimes we need to wait for a week to know the test report.
If still pregnancy test is negative, then you can visit your doctor, to get pills for withdrawal bleeding and to get hormonal test and sonography done to find the cause of delayed periods.
POSTINOR is an "emergency contraceptive pill” or "morning after pill”, that contains one common female hormone, levonorgestrel, a progestin. This hormone prevents pregnancy mainly by delaying or preventing ovulation (the release of an egg from the ovary), thus preventing fertilization.
Postino can only prevent you becoming pregnant if you take it within 72 hours of unprotected sex. It does not work if you are already pregnant. If you have unprotected sex after taking Postino, it will not stop you from becoming pregnant.

Ans: History noted
I pil is an emergency contraception.
If i pill taken within the first 24 hours, it is claimed to be highly effective at more than 95%. The effectiveness drops to 85% if taken between 25 and 48 hours. However, if taken between 49 and 72 hours, the effectiveness reduces significantly to 58% or less.

Ans: History noted
You are being 35 years
It is advisable to
Diagnostic evaluation should include maternal and paternal karyotypes, assessment of the uterine anatomy, and evaluation for thyroid dysfunction and immunological causes, APS, and selected thrombophilia's. In some women, evaluation for insulin resistance, ovarian reserve, antithyroid antibodies, and prolactin disorders may be indicated.
To do semen analysis also
To check for DNA FRAGMENTATION
TO DO hysteroscopy to evaluate the uterine cavity and rule out chronic endometritis

Ans: Explain the situation: Let them know that infertility is a life crisis that can affect many aspects of a person's life.
Ask for support: Let them know what you need from them, such as phone calls or questions.
Be respectful: Respect their need for privacy and don't ask leading questions.
Acknowledge their feelings: Don't minimize their feelings or compare their experience to others.
Be present: Meet them where they are at and be available to talk or hug.
Be patient: Infertility can be a life-long journey, so don't expect them to share everything right away.
Educate them: You can teach them about the medical aspects of infertility and how to deal with the emotional side.

Ans: If you had periods in 7 days with history of i pill taken,
There are chances if menstrual irregularities, spotting or having irregular periods due to hormonal imbalance

Ans: Hello, sorry to hear about your breast cancer, but the best part is breast cancer is curable
Since you are 32 years of age, and you might undergo chemo, radiotherapy which might affect your fertility. So best option is to undergo egg freezing.
Before we start the procedure, we need to know your AMH level (to know your ovarian reserve) and basic blood work up to get your fitness fir the procedure
The procedure normally needs first 15 days of your cycle where you will need to undergo 3 to 4 scans to monitor the egg growth (follicle growth) and injections from day 2 of your periods till the eggs grow and mature
These injections are safe in form of LH OR FSH hormone. It can sometimes cause
Nausea vomit, constipation, mood swings, low abdominal heaviness, breast tenderness.
These are experienced by some.
Once you are ready then you will be admitted as day care procedure and egg retrieval done under short anesthesia. You will be able to go home in 6 to 7 hours.
During this period of stimulation, you can do regular routine work.
Zumba, jumping and heavy activities avoided during stim.
So, freezing your eggs now is a better. Option
If you delay further the quality and quantity of eggs gets hampered.

Ans: Sorry not able to understand. Can you please elaborate or be specific.

Ans: Hello
History noted
Since you had taken i pill for emergency contraception, there are chances if you are getting early periods after last i pill dose
If you have spotting it can because of i pill
Yes, you can rule out pregnancy by home pregnancy test or beta hcg level a blood test by 9th of next month.
Generally, after i pill there is possibility of irregular periods for couple of months.
You might get your periods after one month or it can get delayed.

Ans: Hello! If you have taken emergency contraception
4 days prior to periods,
There are high chances your periods can get delayed.
The morning-after pill, also known as the I-pill, can delay your period by up to one week. However, in rare cases, your period may be delayed for several weeks. If your period is more than a week late, or if it is lighter than usual, you should take a pregnancy test and speak to a doctor.
The I-pill is an emergency contraceptive tablet that contains a synthetic hormone that mimics progesterone. It's not intended to be used as a regular method of birth control.

Ans: History noted.
Considering your age 35 years, trying to conceive since, one year and few test done, one of which suggest possibility of tubal blockage, there are various modalities of treatment.
Firstly, you can do laparoscopy to note the severity if blockage and do tubal cannulation.
Tubal cannulation is often the first line of treatment for patients with blocked fallopian tubes because it's a non-invasive procedure that's widely available.
Tubal cannulation is a procedure that can unblock fallopian tubes and is highly successful for proximal tubal blockages, with a success rate of over 80%. However, it may not be successful for all patients and is not recommended for distal tubal occlusions.
This procedure if successful can avoid IVF procedure. Laparoscopy has…
Yes, before ivf get all your blood test, ecg, 2 D echo, xray chest to rule out any illness
Same with your husband to get semen analysis and viral markers with blood sugars to be done.

Ans: Firstly, period was on 1st October
Taken Ipil on 13 November with intercourse prior 2 days
Kindly get urine pregnancy test done first and foremost
Secondly
Ipills can cause irregular or delayed menses also.
If still no periods in one week with negative urine pregnancy test, visit your gynec and get good usg pelvis and few hormonal tests done.

Ans: Hello, noted your concerns
You are in late 20’s with irregular periods, acne, weight gain,
You are undergoing hormonal imbalance
We need to do certain blood test like
CBC, tsh prolactin fasting insulin level
Hba1c, testosterone level
DHEA, LH FSH ESTRADIOL LEVEL
Amd AMH level to check for fertility level
Usg pelvis to rule out
Pcos
The mainstay treatment. For pcos is lifestyle changes
1) Daily exercise, walks. Zumba, running
2) Good nutritious food with proteins, vitamins, minerals, low carbs and fats
3) good adequate sleep 7 to 8 hours
4) stress management: yoga meditation, breathing exercise
5) supplements to controls effects of pcos
6) low dose OC PILLS TO regularize the cycles

Ans: Hello
Since your daughter is 13 years old and just started getting periods that is menarche, she is in her puberty. She is undergoing lots of hormonal changes which is very common in this age group from 10 to 12 to 14 to 16 years of age group.
She will be having physical, cognitive and psychosocial changes. She is bound to have mood swings, irritation, change in behavior. During this phase they are in establishment of own identity, autonomy, sexuality. Not going to school can happen cause if awkwardness in periods, scare of staining clothes, not able to perform activities as routine due to pain or bleeding.
All these are common behavioral changes in most teenagers.
1) We as a parent we need to make ourselves available for open communication. With our children without hesitation.
2) We should be more like friends to them than parents.
3) Openly speak to them regarding periods, all emotional and behavioral changes to them and reassure them that these are normal changes to happen and accept them with grace and understanding.
4) Engage the kids in other activities likes their hobbies and physical exercises to control adverse behavior.
5) Talk openly about sex to your children so that they know about self-care.

Ans: 20 years old
Taken ipill
Not got periods for 1.5 months and pregnancy test negative.
We need to understand i pill is an emergency contraception which contains lenonorgestrel which acts by blocking LH AND FSH hormones, prevent ovary by releasing egg or prevent egg sperm fertilization.
It does not regularize periods. Infact ipill can cause delayed or irregular periods or at times periods can happen as spotting.
Since pregnancy test is negative, I would advise repeat pregnancy test after one week if you dent get periods and then consult your doctor. She will advise you tablets to get periods.

Ans: Fertility test for males is
Semen analysis with 3 days of abstinence which gives information of sperm count and motility.
If any issues with it then we do hormonal test like
Tsh, Lh, Fsh, testosterone level, prolactin level
If needed, we do
Usg scrotum with doppler
These test help to find out
Less sperm count or no sperm count
Defect in sperms morphology ,
Low motility of sperms or any infections .
DNA FRAGMENTATION TEST help to detect
the degree of DNA damage present in a semen sample.

Ans: History noted, you are being 45 years and wife being 41 years, married since 6 years, staying separately since 4 years, now together since 5 months and with all the challenges.
Every woman has a right to plan for family and have a baby.
Considering financial challenges, future expense can be taken care of with mutual discussion Between you both.
Age factor: can be explained to your wife that fertility level might be compromised with age than if needed can undergo ivf treatment and chances if getting blood pressure and diabetes.
Sarcastic behavior can be tackled with couple counselling, family support psychological therapy and eliminating the root cause.
The above said things are manageable
Being a gynaec and obstetrician, i can take away the right of a woman from being mother and motherhood.

Ans: Hello
Your period was on 25th October
And taken i pill on 3rd December
If taken within the first 24 hours, it is claimed to be highly effective at more than 95%.
Since pco and irregular periods and taken i pill, withdrawal bleed can take5 to 10 days
But if you don't get periods in 3 week's time
Please check pregnancy test
Since you have pcod with irregular periods and taken i pil there can be change in period cycle also.

Ans: Hello Priya, since you are 36 years, married since 4 years, primary infertility, yes, ivf is a better option.
Many patients have lots of myths regarding ivf treatment. But with modern injections and process of egg retrieval it's not that difficult as it seems to be.
The injections which have to be given for 10 to 12 days are either intramuscular in the muscle) or subcutaneous (just below the skin). Easy to be taken. We get injections in PEN form too like insulin injection which is easy to operate and can be self-injected. The effects of the injections are till the process. It doesn't have long lasting side effects.
The main side effects:
1) nausea vomit
2) breast tenderness
3) bloating
4) headache
5) mood swings and hot flushes
6) fatigue
7) pain after egg retrieval
8) cramping
9) constipation due to progesterone therapy
10) ovarian hyperstimulation
Ovarian hyperstimulation syndrome (OHSS) occurs when fertility drugs overstimulate the ovaries, causing them to swell and release chemicals into the bloodstream.
Symptoms:
Severe abdominal pain.
Severe, persistent nausea and vomiting.
Blood clots.
Decreased urination.
Shortness of breath.
Tight or enlarged abdomen.
To consult the doctor if above symptoms to decide if need of hospitalization
So, tat investigations and necessary treatment can be done
But with regular ultrasound and modern injections, ohss is become very rare and treatable

Ans: Hello
Since you are 37 years, married since, 5 years, primary infertility with weight gain with irregular periods and stressor
I would first advise you series of hormonal test to be done like TSH, prolactin, HBA1C, fasting insulin level, fasting and post lunch sugars, cortisol level, testosterone level, vit D and vit B12 and CBC and most importantly AMH LEVEL to know about fertility level
To do usg pelvis to rule out ovarian cyst or pcos or any other gyneac pathology.
Lifestyle modification
Daily walks, yoga, meditation, stress management or any other form of exercises which help to release endorphins, dopamine and good hormones which help to regulate the cycle
Diet: nutritious diet, green veggies, fruits, nuts, proteins, chicken, eggs (if you are non veg).
Please visit your doctor, because considering your age it's better to understand to concentrate on fertility then regularizing your cycles.

Ans: Hello Neha considering you are 34 years, and trying to conceive since 3 years
First of all, you both need to undergo blood test
1) Neha:
CBC, Blood Sugars, Vit B12, Vit D, Liver and Kidney screening, hormonal (TSH AND PROLACTIN), viral markers test and most important AMH LEVEL to know ovarian reserve.
Usg pelvis tp rule out fibroids, ovarian cyst
2) Husband:
Blood Sugars
Semen analysis to know about sperm count, motility.
These tests can give an idea about both. Fertility level and any particular supplements needed and chances of successful pregnancy.
Considering hectic lifestyle certain measures to be taken
1) stress management: yoga, walks, exercise, meditation
2) adequate sleep at least 6 to 7 hours
3) Adequate exercise and walks which releases endorphins , dopamine and good hormones needed for hormone circulation.
4) Good nutrition:
Contains antioxidants
Vit B6, Vit B12, Omega 3 fatty acids, iron, zinc, magnesium, calcium, Vit D, green veggies, fruits, eggs, chicken for protein
5) your gynec will advise certain supplements to be taken for additional supplements.

Ans: Hello
If you have pain and cramps in your periods, it's called dysmenorrhea
You can take anti spasmodic medicines or pain killers like paracetamol
Use heat. Soaking in a hot bath or using a heating pad, hot water bottle or heat patch on your lower abdomen might ease menstrual cramps.
Try dietary supplements. A number of studies have indicated that Vitamin E, Omega-3 fatty acids, Vitamin B-1 (Thiamin), Vitamin B-6 and Magnesium supplements might reduce menstrual cramps
Reduce stress. Psychological stress might increase your risk of menstrual cramps and their severity.

Ans: Hello
You are 51 with fibroids, with menorrhagia
Firstly,
1) We Need to get usg 3 D pelvis done with fibroid mapping.
2) Blood test to see for CBC, tsh , prolactin, tsh level
Since you are 51 and if your hemoglobin is maintained and bleeding controlled, we can wait and observe with regular usg monitoring for fibroids
Since you are 51, there are chances of you being in perimenopause and menopause, so there are chances fibroids reduce in size, and you become asymptomatic because post menopause estrogen level drops and fibroids are estrogen dependent.
If wish to go for conservative management:
a) Cyclic Oc pills or continuous Oc pills to create pseudoamennorhoea which will control dysmenorrhea and bleeding
B) Lupron Depot is a synthetic hormone that reduces the body's production of estrogen and progesterone, causing a temporary menopause-like state. This can shrink fibroids, stop menstrual periods, and improve anemia.
Uterine fibroid embolization:
This minimally invasive procedure involves injecting small particles into the uterine artery to block blood flow to the fibroids.
Radiofrequency ablation (RFA):
This treatment uses microwave energy to treat smaller fibroids in people who haven't reached menopause.
Progestin-releasing intrauterine device (IUD)
This option is for women with fibroids that don't distort the uterus. It can reduce heavy bleeding but doesn't treat the fibroids.
But if symptoms like
Heavy periods
Pain
Frequent periods
Drop in hemoglobin
Disturbed quality of life
Then best option will be removal of uterus keeping ovaries intact if ovaries are healthy to maintain hormones.

Ans: A girl's body may not follow an exact schedule. It's common, especially in the first 2 years after a girl starts getting her period, to skip periods or to have irregular periods.
Irregular periods happen because of hormonal changes, weight gain, or rapid weight loss, illness, stress, sedentary life or gynecological issues.
But if periods become very frequently irregular
Please visit your gynecologist
And will advise
1) hormonal test
2) usg pelvis to rule out any ovarian cyst or pco
And will treat accordingly
1) lifestyle modification: regular walk, exercises are needed for hormonal circulation and for release of good hormones
2) avoid junk and have good nutritious food.
3) stress management, yoga, walks meditation

Ans: When pregnant, you should eat a variety of foods to ensure you, and your baby get the nutrients they need:
Fruits and vegetables:
Eat a variety of fruits and vegetables, including dark leafy greens, to get vitamins and minerals.
Whole grains: Eat whole grains like brown rice, barley, quinoa, and whole-wheat bread.
Protein: Eat a variety of proteins, including lean meats, poultry, fish, eggs, beans, peas, nuts, and seeds.
Dairy: Choose pasteurized dairy products like milk, cheese, and yogurt.
Folate and folic acid: Eat foods that are high in folate and folic acid, such as cereal, spinach, beans.
Omega-3 fatty acids: Eat foods that are high in omega-3 fatty acids, such as fish liver oil, salmon, shrimp
Flax seeds
Iron: Eat foods that are high in iron to make up for the increased amount of blood in your body, green veggies, dates, jaggery, beet root carrots, prepare food in iron pan.
Fiber: Eat enough fiber to prevent constipation, which is common during pregnancy.
Food that can be eaten during acute morning sickness is
1) Ginger
2) Lemon
3) Mint
4) Curd
5) Coconut Water
6) Rice Water
7) Khichdi
8) Bananas
9) Watermelon
10) Toast
11) Jeera Water
12) Ajwain
13) Cardamom
14) Pomegranate Juice
15) Bland Biscuits and Crackers

Ans: Considering your age 37 and husband 39 and planning to have a baby
The chance of having a child with Down syndrome increases with the mother's age:
Age 25: The chance is about 1 in 1,200
Age 35: The chance is about 1 in 400
Age 40: The chance is about 1 in 100
Age 45: The chance is about 1 in 30
If you're over 35 and thinking about getting pregnant, you can:
Get genetic counseling to learn more about your risk
Get regular checkups
Eat a variety of healthy foods
Get regular exercise and plenty of rest
Avoid smoking, vaping, drinking alcohol, and using cannabis or other drugs
To start folic acid (vit B6 and B 12) and DHA 3 months prior to conception.
Learn about prenatal testing for chromosomal conditions like your gynae will perform serial ultrasound at different trimesters like NT SCAN, anomaly scan, fetal 2 D echo and blood markers like dual marker and NIPT to rule out any form of congenital anomalies.

Ans: While stories about women giving birth in their 50s, 60s, and even 70s make for good headlines, these pregnancies are usually accomplished with donor eggs and in vitro fertilization (IVF). There is no set oldest age when you can get pregnant naturally, but fertility starts to decline as you age.
Due to advances in technology surrounding fertility, pregnancy, and delivery, it's possible to safely have a baby at age 40. However, any pregnancy after age 40 is considered high risk.
Pregnant people over age 35 are more at risk for complications like miscarriage, congenital disorders and high blood pressure.
Firstly, we like to investigate an completely
Baseline blood test
Hormonal test
Amh level (to know fertility potential)
Usg pelvis to rule out any fibroids, cysts
Xray ecg
Then can plan pregnancy
We can screen for babies well-being during pregnancy by serial ultrasound and blood markers and nipt to rule out any abnormalities.

Ans: According to Mayo Clinic, during pregnancy, the ligaments that support a woman’s breast might stretch as it gets fuller and heavier. This stretching is often one of the common causes of breast sagging post-pregnancy.
Foods that are rich in estrogen include:
Soy products: Tofu, edamame, tempeh, soy yogurt, and soymilk are rich in isoflavones, which are phytoestrogens.
Nuts and seeds: Almonds, flaxseeds, peanuts, sesame seeds, and sunflower seeds are rich in estrogen.
Fruits: Apples, berries, grapes, peaches, pears, and plums are rich in estrogen.
Vegetables: Broccoli, Brussels sprouts, kale, onions, spinach, and sprouts are rich in estrogen.
Grains: Barley, oats, and wheat germ are rich in estrogen.
Plant-based liquids: Beer, coffee, olive oil, red wine, and tea are rich in estrogen.
Eggs and milk: These animal products contain high levels of estrogen.

Ans: Hello noted
Since you are 36 years and gonna turn 37
Amh is 1.67
And weight 69
So, considering your age and amh being 1.67 one year back, we need to repeat your AMH. Amh is supposed to reduce with age, it means the egg forming capacity of the ovary diminishes with age.
So, you need to focus of conception. At the same time, you can do exercises and dietary changes to reduce your weight
Let both happen hand in hand
And yes, correction of vitamin D, tsh is needed
Have nutritious food, antioxidants, proteins in your diet
Have supplements which help in improving the quality of eggs.

Ans: Hey, since you are 44 years, you are in your peri menopausal phase which causes hormonal imbalance
But since have consumed IPILL, which is an emergency contraception, periods can be up to a week late and sometimes even later. If your period is more than a week late, we recommend taking a pregnancy test. You may have some irregular bleeding after you take the Ipill, and before your next period. This can range from spotting to heavy bleeding.
So please do home pregnancy test once to rule out pregnancy. If its negative, then await normal regular periods.

Ans: Noted
Wife 47 yrs and husband 50 years having son 16 yrs old, having a startup business
Can adopt a child but not of same gender which you have from the marriage
The minimum age difference between the child and the prospective adoptive parent must at least 25 years
Composite age of husband and wife is 97 years (if composite age between 90 to 100 years. Can adopt child above 2 years and upto 4 years)

Ans: Noted
Husband 42 yrs
Wants to marry a woman 46 yrs and concerned about conception
Firstly, ita important to understand that as age advances the egg forming capacity of women diminishes and same with males, the sperm quality, quantity, motility also gets affected.
We need to evaluate the AMH LEVEL in woman to detect the ovarian function and other hormonal test also.
We need to do semen analysis in males after 3 to 4 days of abstinence
Chances of conception above 40 is 3 to 5 percent
But it's not impossible and can happen with assisted reproductive techniques.
Ivf Icsi techniques

Ans: At age of 43, there is a hormonal imbalance which can result in weight gain, scanty menses, hair fall, discharge from nipple.
It can be due to stress, diet changes or lifestyle changes
Watery discharge from nipple can be due to impaired, raised prolactin level which can and treated with medicine under supervision of your doctor
To check for hormones
TSH, prolactin, LH, FSH, estradiol level, and correct accordingly
Weight gain can be taken care by correcting hormonal imbalance, dietary changes (including proteins less carbs, less oily and fatty food), exercises (Zumba, cardio, daily walks)
Hair fall can be taken care of by improving nutrition, including vitamin A, C, D, iron, biotin, zinc, protein, essential fatty acids and taking supplements under doctor supervision

Ans: History noted
Since she missed her periods, tsh higher side
Urine pregnancy test twice negative
I would advise
1) to get one usg pelvis done to rule out any cyst
2) hormonal test
Tsh , prolactin
Since TSH is high, advisable to start thyroid medications tab thyronorm to bring down the tsh level to within normal limits
If usg pelvis is normal
Can give withdrawal bleed in form of progesterone pills to get periods.
Keep a watch on further cycles
If still irregular, then to keep on cyclic oral contraceptive pills to regularize periods
To maintain menstrual diary
To control TSH LEVEL

Ans: Hey, since you are 44 years, you are in your peri menopausal phase which causes hormonal imbalance
But since have consumed IPILL, which is an emergency contraception, periods can be up to a week late and sometimes even later. If your period is more than a week late, we recommend taking a pregnancy test. You may have some irregular bleeding after you take the Ipill, and before your next period. This can range from spotting to heavy bleeding.
So please do home pregnancy test once to rule out pregnancy. If its negative, then await normal regular periods.