Best Obstetrician & Gynaecologist in Kochi

Gynaecology, Obstetrics and Infertility

Doctors
Treatment and Facilities
Medical Treatment
Reproduction Centre
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Gynaecology, Obstetrics and Infertility

A woman’s life is marked by unique changes that occur with time: from attaining menarche, conception, pregnancy, childbirth and menopause. These changes do bring about problems, directly or indirectly associated with the reproductive system and hence requires a separate branch of medicine that focuses on these areas. The three specialties viz., Gynaecology, Obstetrics and Infertility are concerned with a woman’s healthful life overall.

Doctors

Dr. Hafeez Rahman PA

Chief Gynecologist & Laparoscopic Surgeon

Dr. Aby K. Koshy

Consultant Gynaecologist & Infertility Specialist

Best Gynecologist & Infertility Specialist in Kochi

Dr Sonia Farhan PH

Consultant Obstetrics & Gynaecology

Best Gynecologist and Obstetrician in Kochi

Our Service

Gynaecology involves medical and surgical therapies, for the complete spectrum of disorders involving the female reproductive system, whereas Obstetrics is the surgical specialty that deals with the care of mother and child, before, during and after childbirth. Assisted Reproduction is the special branch of medicine that is concerned with infertility issues in both men and women and involves diagnosis of infertility, therapeutic techniques to improve fertility and embryology services such as in vitro fertilization (IVF).

Treatment and Facilities

Sunrise Hospital is focused on "Laparoscopic and Endoscopic Surgeries’, and we are the apex centre for ‘Minimally Invasive Surgery’ in Asia. Catering to patients worldwide, our department is equipped with the most modern equipment and infrastructure to provide world-class treatment and surgical procedures for a wide spectrum of disorders and diseases. Equipped with the advanced MGM German laparoscopic system and operation theatres of international standard, we hold the cutting edge in minimally invasive surgery and other surgical procedures.

Pap smear: A Pap smear or a Pap test, is a procedure to test for cervical cancer in women. A Pap smear involves collecting cells from cervix — the lower, narrow end of your uterus that's at the top of the vagina. Detecting cervical cancer early with a Pap smear gives you a greater chance at a cure. A Pap smear can also detect changes in cervical cells for detecting and diagnosing cancer. Pap smear is the first step in halting the possible development of cervical cancer.

Liquid Based Cytology (LBC) is a new technique for collecting cytological samples in order to detect cervical cancer. With conventional cytology a smear taker takes a sample that is applied directly to a slide for microscopic investigation. With LBC, samples are collected in liquid vials and the slide is prepared semi-automatically at the laboratory. Potentially the advantages of LBC include a reduction in the number of inadequate slides, increased sensitivity of the test and increased productivity of smear readers.

: Gynecologist helps you listen to your body more carefully. Establishing a relationship with your gynecologist is an important priority for your health. With regular gynecological appointments, you can ensure your physical, sexual, and reproductive well-being.

Understand what’s normal and recognize when there’s a problem. Get answers to your questions about menstruation. Be advised about menopause and hormone replacement therapy. Schedule your annual appointments with your gynecologist, starting at age 13 to 15 or when you’re first sexually active.

Breast scan is an imaging test to look at your breasts. It is used when a mammogram has not given your healthcare provider enough information.

A breast scan is a type of nuclear imaging test. This means that a tiny amount of a radioactive matter is used during the scan. The radioactive matter called tracer sends out gamma rays. These are picked up by the scanner to make a picture of your breasts.

The areas of the breast where the radioactive tracer collects in greater amounts are called “hot spots.” The areas that do not absorb the tracer and appear less bright on the scan image are referred to as “cold spots.” Cancer cells are usually the hot spots in a breast scan.

A breast scan can be helpful in diagnosing breast cancer in younger women. Younger women usually have denser breasts than older women. Denser breast tissue can also happen because of Fibrocystic disease, Fatty breast tissue, Past breast surgery, Radiation therapy, Chemotherapy, Biopsy and Breast implants.

Mammography is specialized medical imaging that uses a low-dose x-ray system to see inside the breasts. A mammography exam, called a mammogram, aids in the early detection and diagnosis of breast diseases in women. An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.

Medical Treatment

Menorrhagia is the medical term for menstrual periods with abnormally heavy or prolonged bleeding. Although heavy menstrual bleeding is a common concern, most women don't experience blood loss severe enough to be defined as menorrhagia. With menorrhagia, you can't maintain your usual activities when you have your period because you have so much blood loss and cramping. If you dread your period because you have such heavy menstrual bleeding, talk with your doctor. There are many effective treatments for menorrhagia.

Menstruation, or period, is normal vaginal bleeding that happens as part of a woman's monthly cycle. Many women have painful periods, also called dysmenorrhea. The pain is most often menstrual cramps, which are a throbbing, cramping pain in your lower abdomen. You may also have other symptoms, such as lower back pain, nausea, diarrhea, and headaches.

Period pain is not the same as premenstrual syndrome. PMS causes many different symptoms, including weight gain, bloating, irritability, and fatigue. PMS often starts one to two weeks before your period starts.

Vaginal infections can be caused by bacteria, fungi, parasites or viruses growing in and around your vulva and vagina. Infections of your vagina and vulva can cause symptoms such as soreness and itchiness around your vulva and vagina, and an unusual vaginal discharge. Most vaginal infections can be treated quickly. Getting medical advice as soon as you notice a problem can help to get rid of your infection quickly and prevent complications.

Symptoms of common vaginal infections

Depending on the type of infection, you might have:

A white discharge from your vagina that looks like cottage cheese; alternatively you might have, or a thinner, white, green or yellow fishy-smelling discharge
Itchiness or soreness in or around your vagina
Pain when you have sex
Pain when you pass urine
Pain in your lower abdomen (tummy) or pelvis
Bleeding between your periods or after you have sex
Warts or ulcers around your vulva (the skin around the outside of your vagina)

It's normal and healthy for women to have some discharge from their vagina. The amount and colour of this discharge can change during your menstrual cycle, as you get older, when you take the contraceptive pill and when you’re pregnant.

Some infections are best to get checked out at a sexual health clinic.

Long-term or chronic health problems during the teen years can often make physical and emotional development more complicated.

Illness, injury, medical treatments, hospitalization, and surgeries linked to chronic illness can cause a teen to worry even more about how they look. They can also interfere with a teen's desire to be independent. Chronic illness also affects a teen's relationships with parents and friends. A teen with a chronic health issue may struggle to cope with illness and response to treatment.

Adolescent medicine focuses on the health needs of the teen's illness, condition, or injury. Healthcare providers in this field expect and assess developmental complications linked to the specific health problem. These providers also help teens and their families come up with strategies to deal with chronic health issues.

Menopause is the time that marks the end of your menstrual cycles. It's diagnosed after you've gone 12 months without a menstrual period. Menopause can happen in your 40s or 50s, but the average age is 46 in India.

Menopause is a natural biological process. But the physical symptoms, such as hot flashes, and emotional symptoms of menopause may disrupt your sleep, lower your energy or affect emotional health. There are many effective treatments available, from lifestyle adjustments to hormone therapy.

In the months or years leading up to menopause (perimenopause), you might experience these signs and symptoms like Irregular periods, Vaginal dryness, Hot flashes, Chills, Night sweats , Sleep problems, Mood changes, Weight gain and slowed metabolism, Thinning hair and dry skin, Loss of breast fullness, including changes in menstruation, are different for every woman. Most likely, you'll experience some irregularity in your periods before they end.

Keep up with regular visits with your doctor for preventive health care and any medical concerns. Preventive health care as you age may include recommended health screening tests, such as colonoscopy, mammography and triglyceride screening. Your doctor might recommend other tests and exams, too, including thyroid testing if suggested by your history, and breast and pelvic exams. Always seek medical advice if you have bleeding from your vagina after menopause.

Chronic pelvic pain is pain in the area below your bellybutton and between your hips that lasts six months or longer.

Chronic pelvic pain can have multiple causes. It can be a symptom of another disease, or it can be a condition in its own right.

If your chronic pelvic pain appears to be caused by another medical problem, treating that problem may be enough to eliminate your pain.

and improve your quality of life.

The pain might sweep your hand over your entire pelvic area rather than point to a single spot. A chronic pelvic pain patient tend to be experiences severe and steady pain, Pain that comes and goes (intermittent), Dull aching, Crampin, Pressure or heaviness deep within your pelvis.

In addition, you may experience Pain during intercourse, Pain while having a bowel movement or urinating, Pain when you sit for long periods of time

In general, make an appointment with your doctor if your pelvic pain disrupts your daily life or if your symptoms seem to be getting worse.

The urogynecology specialists have experience treating all conditions of the female urinary and reproductive tract.

Conditions treated by urogynecology specialists includes, Congenital anomalies of the lower reproductive tract (for example, imperforate hymen, vaginal septum, uterine anomalies), Fecal incontinence, Overactive bladder syndrome, Pelvic organ prolapse, Post-hysterectomy prolapse, Stress urinary incontinence, Urethral diverticulum, Urgency urinary incontinence, Vesicovaginal and rectovaginal fistulas.

Our urogynecologists are expert in surgeries for stress urinary incontinence, uterovaginal prolapseda and pelvic floor disorders.

Surgical approaches to pelvic floor disorders includes, Sacral nerve stimulation, Anal sphincteroplasty, Artificial anal sphincter, Minimally invasive hysterectomy and Urethral reconstruction

Nonsurgical approaches to pelvic floor disorders includes Medications, Pessaries, Pelvic floor physical therapy, Biofeedback, Electrical stimulation ("e-stim"), Urge suppression, Pelvic floor re-education.

Hysteroscopy is a procedure that allows your doctor to look inside your uterus in order to diagnose and treat causes of abnormal bleeding. Hysteroscopy is done using a hysteroscope, a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus. An operative hysteroscopy can be used to remove polyps, fibroids and adhesions. Prior to the procedure, your doctor may prescribe a sedative to help you relax. You will then be prepared for anesthesia. The procedure itself takes place in the following order:

The doctor will dilate (widen) your cervix to allow the hysteroscope to be inserted.

The hysteroscope is inserted through your vagina and cervix into the uterus.

Carbon dioxide gas or a liquid solution is then inserted into the uterus, through the hysteroscope, to expand it and to clear away any blood or mucus.

Next, a light shone through the hysteroscope allows your doctor to see your uterus and the openings of the fallopian tubes into the uterine cavity.

Finally, if surgery needs to be performed, small instruments are inserted into the uterus through the hysteroscope.

The time it takes to perform hysteroscopy can range from less than five minutes to more than an hour. The length of the procedure depends on whether it is diagnostic or operative and whether an additional procedure, such as laparoscopy, is done at the same time. In general, however, diagnostic hysteroscopy takes less time than operative. Hysteroscopy is considered minor surgery and usually does not require an overnight stay in the hospital. However, in certain circumstances, such as if your doctor is concerned about your reaction to anesthesia, an overnight stay may be required.

Gynecologic laparoscopy is an alternative to open surgery. It uses a laparoscope to look inside your pelvic area. Open surgery often requires a large incision.

A laparoscope is a slender, lighted telescope. It allows your doctor to see inside your body. Diagnostic laparoscopy can determine whether you have conditions such as endometriosis or fibroids. It can also be a form of treatment. With miniaturized instruments, doctor can perform a variety of surgeries like ovarian cyst removal, surgical contraception, and hysterectomy. Laparoscopy generally has a shorter healing time than open surgery. It also leaves smaller scars. A gynecologist, general surgeon, or another type of specialist may perform this procedure.

Laparoscopy can be used for diagnosis, treatment, or both. A diagnostic procedure can sometimes turn into treatment for unexplained pelvic pain, unexplained infertility, history of pelvic infection.

Conditions that might be diagnosed using laparoscopy includes Endometriosis, uterine fibroids, ovarian cysts or tumors, ectopic pregnancy, pelvic abscess, pelvic adhesions or painful scar tissue, infertility, pelvic inflammatory disease, reproductive cancers

Treatment through laparoscopy includes hysterectomy, or removal of the uterus, removal of the ovaries, removal of ovarian cysts, removal of fibroids, blocking blood flow to fibroids, endometrial tissue ablation, which is a treatment for endometriosis, adhesion removal, reversal of a contraceptive surgery called tubal ligation, Burch procedure for incontinence and vault suspension to treat a prolapsed uterus.

Our dedicated team of obstetricians and labour room nursing staff endeavour to provide the best of care in the well equipped labour suite. Antenatal care includes antenatal classes, consultation with the physiotherapist and the nutritionist. Facilities for painless labour with epidural analgesia are available around the clock.

High Risk Obstetrics:

This involves the following-

*Evaluation for recurrent pregnancy loss (RPL)

Miscarriages can happen for many reasons. Having a miscarriage doesn’t mean a woman will have another miscarriage if she tries again. But some women suffer more than one miscarriage. This is called recurrent pregnancy loss (RPL). Women and families often grieve these losses deeply. Women may also worry that they are sick or did something to cause the losses. RPL, however, is often a natural process. Less than half of recurrent miscarriages have an obvious or treatable cause. Almost two-thirds of women with RPL will eventually have a healthy pregnancy — often without any extra treatment.

Surgery - Surgery can fix some problems in the uterus (womb), like extra tissue that divides the uterus, some fibroids, or scar tissue. Correcting the shape of the inside of the uterus can often lower the chance for miscarriage. The surgeon uses a tool with a camera (hysteroscope) passed through the vagina to repair the inside of the uterus. This is usually a 1-day procedure and recovery time is a few days to a week.

Correcting other medical problems - Recurrent pregnancy loss may be related to some medical problems. These include abnormal blood sugar levels, an over- or underactive thyroid gland, or high levels of the hormone prolactin. Treating medical conditions such as diabetes, thyroid dysfunction, or high prolactin levels can improve the chances of having a healthy, full-term pregnancy.

Genetic screening - In about 5% of couples with recurrent pregnancy loss, one of the parents has a rearrangement (translocation) of their chromosomes. If one parent has a translocation, this can cause fetuses with chromosome imbalances that are more likely to miscarry. The parents’ blood can be studied (karyotyped) to see if they have a translocation. If a chromosomal problem is found, the doctor might recommend genetic counseling. While many couples with translocations eventually conceive a healthy pregnancy naturally, your doctor might suggest fertility treatments, such as in vitro fertilization (IVF). During IVF, eggs and sperm are mixed outside of the body in a laboratory. After IVF, before the embryos are returned to the uterus, they can be tested (preimplantation genetic screening). This allows embryos without translocations to be chosen to increase the chance of a healthy pregnancy.

Lifestyle Choices - In general, whatever is healthy for a woman improves the chance of a healthy pregnancy. Limiting alcohol and caffeine intake may also help. Being overweight has been linked with increased risk of miscarriage, so healthy weight loss might also help pregnancy outcomes. There is no proof that stress, anxiety, or mild depression causes recurrent pregnancy loss. However, these are important problems that go along with recurrent pregnancy loss. Psychological support and counseling can help couples cope with the emotional pain of miscarriage and create a healthy environment for a pregnancy.

If you have suffered two or more miscarriages, you should talk with your health-care provider. Often, women decide to continue trying to get pregnant naturally. However, in certain situations, your doctor might suggest treatments to help reduce your risk for miscarriage.

*Antenatal, Intra and Postnatal management of medical & surgical illnesses in pregnancy in consultation with medical and surgical specialists

Antenatal Management: Antenatal care is the care you get from healthcare professionals to ensure you have a healthy pregnancy. It includes information on services and support to make choices right for you. Antenatal care will include regular appointments with a gynecologist, ultrasound scans and screening tests for you and your baby. If you’re healthy, and it’s your first pregnancy, you’ll usually have 10 antenatal appointments. If you’ve already had a healthy pregnancy, you might have fewer.

If you’re fit and healthy and you’re expected to have a pregnancy without any major problems, a small team of people will look after you. This will include a gynecologist and the nursing staff. If your pregnancy is more complicated, then an obstetrician (a doctor who specialises in pregnancy and childbirth) might be involved in your care too.

Intranatal care refers to care given to the mother and baby at the time of delivery. The main objectives Intranatal Management is Cleanliness, Smooth delivery without injuring mother or baby, Preventing complications, Delivery resuscitation for the baby

There are a number of ways to deliver a baby and whatever you choose, you must ensure the presence of a doctor at your side, while delivering a baby. Your doctor will determine the position of the fetus and help you through your delivery.

Postnatal care is essential for 6-8 weeks after the baby is born. During this period, the mother goes through a number of physical and emotional changes and thus requires rest, nutrition, and vaginal care. The main objectives of Postnatal Management are Prevent postpartum complications, Restore the mother to optimal health, Ensure problem-free breastfeeding and Sharing responsibility is essential for the health of the mother, after delivery. Get as much sleep as possible and pay attention to what you eat. Do not try and lose your pregnancy weight instantly. Schedule a checkup with your doctor six weeks after delivery to ensure your vagina has healed properly. Additionally, abstain from intercourse at this time. With proper care, every stage of your pregnancy can be a beautiful experience.

Fetal Medicine: Fetal Medicine deals with the evaluation and management of problems with the baby inside the womb (uterus). We have facilities for amniocentesis, chorionic villous sampling, fetal reduction, cordocentesis, fetoscopy, vesico- amniotic shunt, amnio patch and amnio infusion.

Fetal Medicine and Perinatology

Maternal–fetal medicine or perinatology is a branch of medicine that focuses on managing health concerns of the mother and fetus prior to, during, and shortly after pregnancy. A growing number of technological advancements in obtaining and viewing images through noninvasive techniques have brought major breakthroughs in medicine, especially in the diagnosis of fetal anomalies In general, two types of examinations are used in order to obtain images of the uterine cavity during pregnancy ultrasound and magnetic resonance imaging (MRI). Computed tomography (CT) also provides detailed images of the fetus, especially of its skeleton, from the 30th week of pregnancy, although its utility is restricted because it involves the use of ionizing radiation.

Three-dimensional (3D) virtual modeling has gained great momentum in recent years, due to the high performance of software applied in the fields of engineering, architecture, and design. It has been taking an increasingly user friendly form, facilitating the visualization of 3D images.

Amniocentesis- It is diagnostic and therapeutic procedure, used in the prenatal diagnosis of chromosomal abnormalities and fetal infections. It is done under ultrasound guidance between 14-16 weeks of gestation. Four Dimensional (4D) Ultrasound- 4 D scans show moving images of your baby with time being the fourth dimension. With 4 D scans you can see skin of your baby ,or the baby yawning or sticking his/her tongue out.

Reproduction Centre

a type of artificial insemination — is a procedure for treating infertility. Sperm that have been washed and concentrated are placed directly in your uterus around the time your ovary releases one or more eggs to be fertilized. The hoped-for outcome of intrauterine insemination is for the sperm to swim into the fallopian tube and fertilize a waiting egg, resulting in a normal pregnancy. Depending on the reasons for infertility, IUI can be coordinated with your normal cycle or with fertility medications.

Why it's done:

A couple's ability to become pregnant depends on many different factors. Intrauterine insemination is used most often in couples who have:

- Donor sperm. For women who need to use donor sperm to get pregnant, IUI is most commonly used to achieve pregnancy. Frozen donor sperm specimens are obtained from certified labs and thawed before the IUI procedure.

- Unexplained infertility. IUI is often performed as a first treatment for unexplained infertility along with ovulation-inducing medications.

- Endometriosis-related infertility. For infertility related to endometriosis, using medications to obtain a good-quality egg along with performing IUI is often the first treatment approach.

- Mild male factor infertility (subfertility). Your partner's semen analysis, one of the first steps in the medical assessment of infertility, may show below-average sperm concentration, weak movement (motility) of sperm, or abnormalities in sperm size and shape (morphology). IUI can overcome some of these problems because preparing sperm for the procedure helps separate highly motile, normal sperm from those of lower quality.

- Cervical factor infertility. Your cervix, at the lower end of the uterus, provides the opening between your vagina and uterus. Mucus produced by the cervix around the time of ovulation provides an ideal environment for sperm to travel from your vagina to the fallopian tubes. But, if your cervical mucus is too thick, it may impede the sperm's journey. The cervix itself may also prevent sperm from reaching the egg. Scarring, such as that caused by a biopsy or other procedures, can cause the cervix to thicken. IUI bypasses your cervix, depositing sperm directly into your uterus and increasing the number of sperm available to meet the awaiting egg.

- Ovulatory factor infertility. IUI may also be performed for women who have infertility caused by problems with ovulation, including an absence of ovulation or a reduced number of eggs.

- Semen allergy. Rarely, a woman could have an allergy to proteins in her partner's semen. Ejaculation into the vagina causes redness, burning and swelling where the semen contacts the skin. A condom can protect you from the symptoms, but it also prevents pregnancy. If your sensitivity is severe, IUI can be effective, since many of the proteins in semen are removed before the sperm is inserted.

In vitro fertilization (IVF) is a complex series of procedures used to help with fertility or prevent genetic problems and assist with the conception of a child.

During IVF, mature eggs are collected (retrieved) from ovaries and fertilized by sperm in a lab. Then the fertilized egg (embryo) or eggs (embryos) are transferred to a uterus. One full cycle of IVF takes about three weeks. Sometimes these steps are split into different parts and the process can take longer.

IVF is the most effective form of assisted reproductive technology. The procedure can be done using your own eggs and your partner's sperm. Or IVF may involve eggs, sperm or embryos from a known or anonymous donor. In some cases, a gestational carrier — a woman who has an embryo implanted in her uterus — might be used.

Your chances of having a healthy baby using IVF depend on many factors, such as your age and the cause of infertility. In addition, IVF can be time-consuming, expensive and invasive. If more than one embryo is transferred to your uterus, IVF can result in a pregnancy with more than one fetus (multiple pregnancy).

Your doctor can help you understand how IVF works, the potential risks and whether this method of treating infertility is right for you.

Why it's done:

In vitro fertilization (IVF) is a treatment for infertility or genetic problems. If IVF is performed to treat infertility, you and your partner might be able to try less-invasive treatment options before attempting IVF, including fertility drugs to increase production of eggs or intrauterine insemination — a procedure in which sperm are placed directly in your uterus near the time of ovulation.

Sometimes, IVF is offered as a primary treatment for infertility in women over age 40. IVF can also be done if you have certain health conditions. For example, IVF may be an option if you or your partner has:

- Fallopian tube damage or blockage. Fallopian tube damage or blockage makes it difficult for an egg to be fertilized or for an embryo to travel to the uterus.

- Ovulation disorders. If ovulation is infrequent or absent, fewer eggs are available for fertilization.

- Endometriosis. Endometriosis occurs when the uterine tissue implants and grows outside of the uterus — often affecting the function of the ovaries, uterus and fallopian tubes.

- Uterine fibroids. Fibroids are benign tumors in the wall of the uterus and are common in women in their 30s and 40s. Fibroids can interfere with implantation of the fertilized egg.

- Previous tubal sterilization or removal. If you've had tubal ligation — a type of sterilization in which your fallopian tubes are cut or blocked to permanently prevent pregnancy — and want to conceive, IVF may be an alternative to tubal ligation reversal.

- Impaired sperm production or function. Below-average sperm concentration, weak movement of sperm (poor mobility), or abnormalities in sperm size and shape can make it difficult for sperm to fertilize an egg. If semen abnormalities are found, your partner might need to see a specialist to determine if there are correctable problems or underlying health concerns.

- Unexplained infertility. Unexplained infertility means no cause of infertility has been found despite evaluation for common causes.

- A genetic disorder. If you or your partner is at risk of passing on a genetic disorder to your child, you may be candidates for preimplantation genetic testing — a procedure that involves IVF. After the eggs are harvested and fertilized, they're screened for certain genetic problems, although not all genetic problems can be found. Embryos that don't contain identified problems can be transferred to the uterus.

- Fertility preservation for cancer or other health conditions. If you're about to start cancer treatment — such as radiation or chemotherapy — that could harm your fertility, IVF for fertility preservation may be an option. Women can have eggs harvested from their ovaries and frozen in an unfertilized state for later use. Or the eggs can be fertilized and frozen as embryos for future use.

Women who don't have a functional uterus or for whom pregnancy poses a serious health risk might choose IVF using another person to carry the pregnancy (gestational carrier). In this case, the woman's eggs are fertilized with sperm, but the resulting embryos are placed in the gestational carrier's uterus.

Intra cytoplasmic sperm injection (ICSI) is an assisted reproductive technology (ART) used to treat sperm-related infertility problems. ICSI is used to enhance the fertilization phase of in vitro fertilization (IVF) by injecting a single sperm into a mature egg. The fertilized egg is then placed in a woman's uterus or fallopian tube.

Why It Is Done:

ICSI is a laboratory procedure and a form of micromanipulation. It involves the injection of a single sperm directly into a mature egg using a glass needle called a micropipette.

ICSI is used to treat severe male infertility, as when little or no sperm are ejaculated in the semen. Immature sperm collected from the testicles usually can't move about and are more likely to fertilize an egg through ICSI.

ICSI can be used even if a couple's infertility is not related to a problem with sperm. Some couples choose to try ICSI after repeat in vitro fertilization has not worked.

ICSI is also used for couples who are planning to test the embryo for certain genetic problems. ICSI uses only one sperm for each egg. So there is no chance the genetic test can be contaminated by other sperm.

In cases with no sperm in the ejaculate due to a blockage, sperm aspiration or testicular biopsy may be performed to retrieve the sperm for ICSI.

Sperm donation:

Donated sperm (sperm not from your partner) can be used in many types of fertility treatment. The donated sperm is used to fertilise an egg either inside the woman's body (IUI) or outside the body (IVF).

Sperm donation can be considered in the following circumstances:

- single women who wish to conceive without a partner

- female same-sex couples

- in cases of azoospermia (lack of sperm in the ejaculate)

- for avoidance of genetic diseases which may be passed on from the male partner

- after recurrent ICSI treatment failures with poor quality sperm

Egg Donation:

Egg Donation is used in IVF/ICSI treatment. It involves stimulating the donor's ovaries to produce a number of eggs which are retrieved and then fertilised by your partner's or donor's sperm. The embryos that are created this way can be transferred into your womb so you can carry and deliver the baby.

- Egg Donation can be considered in women with ovarian failure or in cases of repeated IVF/ICSI failure due to poor quality eggs.

- Egg donation involves stimulating the donor's ovaries to produce a number of eggs which are retrieved and then fertilised by your partner's sperm. The embryos that are created can be transferred into your womb so you can conceive and deliver the baby.

- Egg Donation may be considered for women with ovarian failure or in cases of repeated IVF/ICSIfailure due to poor quality eggs.

Cryopreservation—the ability to freeze and thaw with retention of viability—provides flexibility in human infertility therapy when gametes or embryos are handled in vitro because frozen tissue can be stored indefinitely in liquid nitrogen at -196°C.

TESA is a procedure performed for men who are having sperm retrieved for IVF/ICSI. It is done with local anesthesia in the operating room or office and is coordinated with their female partner’s egg retrieval. A needle is inserted in the testicle and tissue/sperm are aspirated. TESA is performed for men with obstructive azoospermia (s/p vasectomy). Occasionally, TESA doesn’t provide enough tissue/sperm and an open testis biopsy is needed.

TESE involves making a small incision in the testis and examining the tubules for the presence of sperm. It is either done as a scheduled procedure or is coordinated with their female partner’s egg retrieval. TESE is usually performed in the operating room with sedation, but can be performed in the office with local anesthesia alone. Patients usually cryopreserve sperm during this procedure for future IVF/ICSI. MicroTESE has replaced this as the optimal form of retrieval for men with no sperm in their ejaculate (azoospermia) from a problem with production.

PESA is a procedure performed for men who are having sperm retrieved for IVF/ICSI who have obstructive azoospermia from either a prior vasectomy or infection. It is done with local anesthesia in the operating room or office and is coordinated with their female partner’s egg retrieval.

For women, some common situations where surgery is required include the removal of uterine fibroids, polyps, pelvic adhesions, and endometriosis tissue.

For men, surgical treatments include vasectomy reversal and varicocele repair, a procedure treating varicose veins in the scrotum.

In any case, SCRC’s fertility specialists offer a variety of innovative, advanced fertility surgeries to address your unique situation.

Among the surgical options available to women are:

Hysteroscopy
Laparoscopy

What Is A Hysteroscopy?

A doctor performs a hysteroscopy to look at the lining of your uterus with a viewing tool called a hysteroscope. The procedure is performed to find the cause of abnormal bleeding, to remove uterine growths like polyps and small fibroids, and to examine the uterus to see if there’s a problem with its shape or size that’s preventing you from becoming pregnant or causing repeated miscarriages. A hysteroscopy is both diagnostic and therapeutic.

What Are Polyps?

A polyp is an overgrowth of the glandular surface of the endometrium. Polyps are often removed by hysteroscopic surgery to remove any impediments to implantation. Uterine polyps are found in up to 10% of women. Polyps can take up space within the uterine cavity, cause a zone of inflammation and can decrease pregnancy rates. Polyps may be single or multiple and measure between a few millimeters to several centimeters. The cause of uterine polyps is unknown but they seem to develop in response to the hormone estrogen. Most of the time they are asymptomatic, but some women who experience heavy menstrual bleeds, spotting in between menstrual periods or irregular menstrual bleeding may have polyps.

What is Laparoscopy?

Laparoscopic surgery is a minimally invasive diagnostic and therapeutic procedure that uses a telescopic camera system to visualize abdominal and reproductive organs. The surgeon makes tiny incisions (approximately 0.5 to 1 cm) in the abdomen through which a thin, fiber-optic tube fitted with a light and camera is inserted. Suspicious growths can be biopsied and repairs can be made during a laparoscopy, making more invasive surgery unnecessary.

What are Uterine Fibroids?

Fibroids are growths in or on the uterus which are almost always benign. They vary in size and grow inside the uterine cavity (where pregnancies develop), in the uterine muscle wall itself, or on the uterine surface.

Between 30 and 40 percent of women have fibroids. Most uterine fibroids are asymptomatic and women do not even know they have them; they do not require treatment. In some women they can cause abnormal uterine bleeding, abdominal pain, pressure and sub-fertility. These cases are treated surgically with a myomectomy. There are several surgical options, including an abdominal myomectomy, hysteroscopic myomectomy, and laparoscopic myomectomy.

Symptoms of Fibroids includes Pain in the abdomen and back, Difficulty with bowel movements and increased urination, Sub-fertility and miscarriage, Heavy bleeding with periods, Increased pain with periods, Spotting throughout the month and Anemia or low blood counts.

Diagnosing Uterine Fibroids

Most fibroids are diagnosed with transvaginal ultrasound. If your uterine fibroid is close to or protruding into your uterine cavity, your physician may have you obtain a hysterosalpingogram or a saline sonogram to better map out the relationship of your fibroids to the uterine cavity.

Achievements

Consistently high IVF success rates

Largest size of fibroid in the world (5.4 Kg weight) removed laparoscopically
1st documented successful amniopatch for premature pre-labour rupture of membranes in India
Largest series of laparoscopic surgeries by any one single laparoscopic surgeon (120,000)
Largest series of total laparoscopic hysterectomies by any one single laparoscopic surgeon (30,000)
New innovative laparoscopic sling surgery for conservative management of uterine prolapse without any recurrence till date
Laparoscopic encerclage (antenatal and interval) procedure for cervical incompetence )
Successful emergency cervical encerclage for prolapsed amniotic membranes
Laparoscopic unification surgery for bicornuate uterus
Laparoscopic management of acute postpartum uterine inversion

Our centre is globally known for training doctors in minimally invasive surgery. Till date more than 2800 doctors from India and abroad have undergone training here. We have following training programs.

Gynaec laparoscopy - 15 days training
Advanced training for total laparoscopic hysterectomy (TLH) – 4 days
Training for basic diagnostic hysteroscopy- 1 day

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Sunrise Hospital, Cochin (www.sunrisehospitalcochin.com)

A Unit of Sunrise Institute of Medical Sciences Pvt Ltd, Kerala, India.

GST No 32AAICS4341K2ZB

Gynaecology, Obstetrics and Infertility

Gynaecology, Obstetrics and Infertility

Gynaecology, Obstetrics and Infertility

Doctors

Dr. Hafeez Rahman PA

Dr. Aby K. Koshy

Dr Sonia Farhan PH

Our Service

Treatment and Facilities

Medical Treatment

Reproduction Centre

Achievements

Support Services

Links

Sunrise Videos

Contact us

Sunrise Links

Sunrise Videos

Support Services

Other

Gynaecology, Obstetrics and Infertility

Gynaecology, Obstetrics and Infertility

Gynaecology, Obstetrics and Infertility

Doctors

Dr. Hafeez Rahman PA

Dr. Aby K. Koshy

Dr Sonia Farhan PH

Our Service

Treatment and Facilities

Gynaecology and Laparoscopic Surgery

Preventive Gynaecology

Liquid based cytology

Gynaecological checkups

Breast scans

Mammography

Medical Treatment

Menorrhagia or Heavy bleeding

Breast implants

Premenstural Syndrome (PMS)

Genital infections

Adolescent health clinic: A dedicated team of Gynaecologist, Paediatrician and Psychologist to take care of special needs of adolescent patients

Menopausal Clinic: Special team of Gynaecologist, Orthopaedician and Endocrinologist to take care of geriatric problems. Estimation of Bone mineral density.

Pain Clinic: Evaluation of chronic pelvic pain, vulval pain, pain during intercourse and cancer related pain

Symptoms of Pelvic Pain

Urogynaecology : Urodynamic Studies, Surgeries for stress urinary incontinence and uterovaginal prolapsed, pelvic exercise training for urge incontinence

Hysteroscopic surgeries for – infertility, bleeding problems, missing contraceptive devices, removals of polyps, fibroids and septum & endometrial ablation.

Laparoscopic surgeries for fibroids, endometriosis, prolapse, incontinence, reversal of sterilisation, cervical incompetence, gynaecological cancers and infertility

Obstetrics

Intranatal Management

Postnatal Management

Antenatal counselling by team of Gynaecologist, Neonatologist, and Paediatric Surgeon for congenital defects

Reproduction Centre

We provide comprehensive evaluation of the infertility couple and have a fully equipped lab with hormonal assays. The following procedures are done - Intra uterine insemination - (IUI)

In vitro fertilisation - (IVF)

Intra cytoplasmic sperm injection - (ICSI)

Sperm and egg donation

Cryopreservation of gametes and embryos

Testicular sperm aspiration - (TESA)

Percutaneous Epididymal Sperm Aspiration - (PESA)

Fertility enhancing surgeries

Achievements

OUR SPECIAL ACHIEVEMENTS

TRAINING IN MINIMALLY INVASIVE SURGERY

Support Services

Links

Sunrise Videos

Contact us