Gynecology and Obstetrics Online Doctors Consultation — page 17

Though we don’t regularly advise medications for helping lactation but I believe breastfeeding is the first thing which connects mother to her infant. Now for non medical management part 1. Correct position and breastfeeding techniques https://www.researchgate.net/figure/Breastfeeding-techniques-and-Burping-Positions_fig1_364305561 2. It is advised to take no stress which means you should be calm everytime. 3. Keep trying even if no milk is being poured out from any breast 4. Trying emptying breast manually As far medication is involved Take 1. Tablet Domstal 10mg three times a day until optimal breast milk comes out from each breast 2. Lactogranules- put it in milk PS- Tablet Domstal can have a side effect- causing your neck to turn at one side. It is quite common side effect. In case you experience such side effect stop the medication and don’t panic it will become normal after sometime. Hope it solves your query Thank you

Do you have discharge?

Patient Name: Varshini Age: 24 years Date: 13/04/25 Chief Complaints: Diagnosis of PCOS (ovarian enlargement, irregular periods) Subclinical hypothyroidism No medication prescribed by previous doctor for PCOS Diagnosis Considerations: Polycystic Ovary Syndrome (PCOS) Subclinical Hypothyroidism Irregular menstrual cycles due to hormonal imbalance Blood Tests: Repeat Thyroid Function Tests (TSH, T3, T4) to monitor thyroid status and ensure proper management. Hormonal Profile: LH, FSH, estrogen, progesterone levels to check hormonal imbalance. Glucose and Insulin Levels: To check for insulin resistance, which is common in PCOS. *Follow with the reports for your treatment plan* Thank you Dr Shayeque Reza MD 9800280276

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