Gynecology and Obstetrics Online Doctors Consultation — page 12

Hello Niti, This is a matter of concern . You need proper treatment and I am here to help you. Thank you for sharing your details, I understand this must be an emotionally and physically difficult journey. While I can’t give a definitive diagnosis without access to full clinical records, I can explain possible reasons for implantation failure in your case and suggest what might help next, in a format that mirrors a specialist’s note. Follow-Up Clinical Note – Recurrent Implantation Failure Evaluation Patient Name: [Niti Makkar] Age/Sex: 36/F Date: 12-04-2025 Chief Complaints: 2 failed IUI cycles at Rani Bagh clinic 2 failed IVF cycles at AIIMS No successful embryo implantation History of PCOD, low AMH, thyroid disorder, and endometriosis Probable Contributing Factors to Implantation Failure Low AMH (Anti-Mullerian Hormone): Indicates diminished ovarian reserve. Often leads to fewer eggs retrieved and lower-quality embryos. Endometriosis: Can cause inflammation and immune dysregulation in the uterus. Alters endometrial receptivity (uterus lining may not support implantation well). PCOD (Polycystic Ovarian Disease): Causes hormonal imbalance and poor egg quality. Associated with insulin resistance, which may affect implantation. Thyroid Disorders (especially hypothyroidism): Even mild imbalances in TSH can reduce chances of successful implantation. Target TSH before and during pregnancy: <2.5 mIU/L Uterine Environment: Endometriosis or prior surgeries may cause scarring or poor blood supply. Thin or non-receptive endometrial lining could be a cause. May need Doppler and hysteroscopy assessment. Immunological Factors / Genetic Compatibility: Abnormal NK cell activity or immune rejection. Embryo genetics (aneuploidy) or HLA compatibility issues. Recommended Next Steps Investigations: Endometrial Receptivity Assay (ERA Test) – to check the optimal implantation window. Hysteroscopy – to directly assess uterine cavity for adhesions, scarring, endometriotic lesions. Thrombophilia Profile – rule out clotting disorders affecting blood supply to embryo. Autoimmune panel – ANA, antiphospholipid antibodies, thyroid antibodies. Karyotyping (you and partner) – rule out chromosomal translocation. Treatment Considerations: Frozen Embryo Transfer (FET) – in a hormonally controlled cycle after correcting thyroid, lining, etc. Use of donor eggs – may be considered due to low AMH and repeated IVF failure (if egg quality is a concern). Endometrial scratch or PRP therapy – may improve implantation rates in some patients. Immunotherapy (under guidance) – low-dose steroids, intralipid infusions if immune factors suspected. Lifestyle optimization – insulin resistance control (Metformin), thyroid strict control, anti-inflammatory diet. * Please give me your valueable review. Dr Shayeque Reza MD 9800280276

provide more information and reports.

hello kanchan… please let me know any medication you are taking.

Patient Name: Ritika Age: 24 years Chronic Illnesses: None Primary Complaint: Blood in urine during periods, pain while urinating History: Sexual activity in December Missed periods in December and January Took emergency contraceptive pill in January Delayed period onset in December Currently experiencing hematuria (blood in urine) and dysuria (painful urination) Provisional Diagnosis: Urinary Tract Infection (UTI) – Most likely, especially with symptoms of painful urination and blood in urine. Hormonal Imbalance/Post-pill effects – Emergency contraceptive pills can disrupt your cycle and cause irregular bleeding. Other possibilities: Mild vaginal trauma or irritation from sexual activity Kidney stone (less common at this age but possible) Less likely but serious: bladder infection or reproductive tract infection Prescription Plan (Humanized Format): Urine Routine & Microscopy Test To check for infection, RBCs, or crystals Collect a midstream urine sample * follow up with reports for the treatment plan* Thank you Dr Shayeque Reza MD 9800280276

Hello Sujata, Hello, aapka sawal bahut hi important hai, especially jab aap conceive karne ki koshish kar rahi hain. Aapne bataya ki aapne doctor se conceive karne ke liye medicine li thi aur unhone aapko progesterone ki tablet bhi di thi. Progesterone tablet lene se periods delay ho sakte hain. Agar pregnancy nahi bhi hui ho, phir bhi jab tak aap progesterone le rahi hoti hain ya uske kuch din baad tak periods nahi aate. Jab progesterone band kiya jata hai tab hormone levels girte hain aur uske baad withdrawal bleeding hoti hai, jise period samjha ja sakta hai. Agar aap pregnant ho gayi hain to body naturally progesterone banati hai aur tablet bhi continue ki jati hai, jiske kaaran periods nahi aate. Pregnancy test karne ka sahi samay hai jab aapke expected period date ke baad kam se kam 7 se 10 din beet chuke hoon. Aap ghar par urine pregnancy test subah ke pehle urine se karein, kyunki tab urine zyada concentrated hota hai aur test accurate hota hai. Agar result negative aaye lekin periods abhi bhi na aaye, to 3 se 4 din baad test dobara karein ya blood test jise Beta-hCG kehte hain, wo karwayein. Blood test pregnancy confirm karne ka sabse reliable tareeka hai. Agar aap pregnant hui hain to pehle month me kuch common symptoms ho sakte hain jaise periods miss hona, breasts me heaviness ya tenderness, subah subah nausea ya vomiting, thakan zyada lagna, neend zyada aana, mood swings, bar bar peshab aana, aur kabhi kabhi halka spotting bhi ho sakta hai jo implantation bleeding ho sakta hai. Lekin har mahila ko ye symptoms nahi hote, isliye symptom na hone ka matlab ye nahi ki aap pregnant nahi hain. Abhi aapko kya karna chahiye, agar aapke periods 5 se 7 din se late hain to aap ghar par pregnancy test kar sakti hain. Agar result negative ho aur phir bhi period na aaye, to blood test karwana best rahega. Agar pregnancy confirm ho jati hai to aapko progesterone tablet continue rakhni chahiye jaise doctor ne bataya hai. Agar pregnancy nahi hui hai to doctor aapke cycle reset karne ke liye dusri medicine suggest karenge. Agar aap mujhe bata paayein ki aapki last period kis date ko aayi thi, aapne progesterone kaunsa liya tha aur kitne din tak liya tha, to main aapko aur exact guidance de sakti hoon. Dr Shayeque Reza MD 9800280276

do TVS