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Month: January 2024

how to get pregnant with adenomyosis naturally
9Jan

Fertility struggles can be a challenging and emotional journey for many couples. Adenomyosis, a condition where the tissue lining the uterus starts to grow into the muscular wall, can further complicate the path to conception.

Does adenomyosis affect fertility?

Adenomyosis initiates when the natural boundary between the internal and middle layers of the uterus is disrupted, leading to the growth of endometrial tissue within the uterine walls. Individuals with this condition often encounter symptoms such as heavy periods, pain, and lower abdominal fullness. These symptoms can disrupt the normal conception process, making the implantation of the zygote challenging and compromising adequate uterine support for the developing fetus. Consequently, this heightened difficulty increases the risk of miscarriage and premature birth.

Infertility in adenomyosis

Adenomyosis presents certain symptoms that serve as potential indicators of infertility. The foremost and most important of these is experiencing a painful period. Pain serves as a sign of inflammation, and where inflammation occurs, scar tissue formation follows. The inflamed uterus poses a challenge for the easy implantation of a fertilized egg.

Another notable symptom of adenomyosis is heavy bleeding, often indicative of hormonal imbalance that significantly impacts physiological processes crucial for pregnancy. Additionally, the globally enlarged uterus, a consequence of the presence of endometrial tissue within the uterine wall, adversely affects normal implantation.

Risk Factors for Adenomyosis-Related Fertility Issues

Several factors increase the likelihood of adenomyosis affecting fertility. These are:

  • having a history of pelvic infections
  • endometriosis
  •  previous uterine surgery raises the risk
  •  multiple miscarriages
  • age 35 years or more

Certain lifestyle factors can contribute too. Smoking and having a high body mass index (BMI) may make it harder for women with adenomyosis to get pregnant or sustain a pregnancy.

It’s essential to understand that not all women with adenomyosis will experience fertility problems. For those who do, there are various treatment options, including medication, surgery, and assisted reproductive technologies like in vitro fertilization (IVF).

How to get pregnant with adenomyosis naturally?

Lifestyle Modifications:

Adenomyosis diet: Adopting a nutrient-rich, balanced diet is crucial for overall health and fertility. Include a variety of fruits, vegetables, whole grains, and lean proteins in your daily meals. Antioxidant-rich foods such as berries, leafy greens, and nuts can help combat oxidative stress associated with adenomyosis.

Eating lots of fresh vegetables: Add more veggies in the diet, especially cruciferous ones like cauliflowers, radish, and turnips. These are rich in antioxidants, which fight inflammation caused by adenomyosis.

Don’t skip fruits: Despite concerns about sugar, fruits provide essential vitamins, minerals, fiber, and antioxidants. Berries, in particular, are excellent for their antioxidant properties. Include two servings of fruit daily for a healthy diet.

Include grains and carbs: Contrary to some advice, don’t cut out grains and carbs completely. They are essential for energy and meeting fiber needs. Opt for whole grains like brown rice, wholemeal pasta, and quinoa.

Incorporate healthy fat: Healthy fats, such as omega-3 fatty acids and vitamin E, can help manage pain. Include foods like avocados, nuts, seeds, oily fish, and extra virgin olive oil in your diet.

Cut down on saturated fats and excess sugars: Research suggests that foods high in saturated fats can trigger inflammation. Minimize foods like butter, coconut oil products, ghee, fried items, and sugary treats to manage inflammatory responses associated with adenomyosis.

Maintain a Healthy Weight:

Maintaining a healthy weight is essential for fertility. Both underweight and overweight conditions can negatively impact reproductive function. Achieving a healthy BMI through regular exercise and a balanced diet can improve hormonal balance and enhance fertility.

Regular Exercise:

Engaging in regular physical activity is beneficial for fertility and overall well-being. Exercise helps regulate hormones, improve blood flow to the reproductive organs, and reduce stress. Opt for activities you enjoy, such as walking, swimming, or yoga, and aim for at least 30 minutes of moderate exercise most days of the week.

Adenomyosis treatment for fertility

The treatment approach for adenomyosis-related fertility problems may involve a combination of medical and surgical interventions. It’s important to consult with a healthcare professional for personalized advice based on an individual’s specific situation. Here are some general treatment options:

Pain Management:

Over-the-counter pain relievers such as ibuprofen or naproxen may help manage pain associated with adenomyosis. Prescription medications, such as hormonal therapies, may be recommended by doctors to control pain and reduce inflammation.

Hormonal Therapies:

Hormonal treatments like birth control pills, hormonal IUDs (intrauterine devices), or progestin therapy may help regulate menstrual bleeding and reduce symptoms. Gonadotropin-releasing hormone (GnRH) agonists may be prescribed to induce a temporary menopause-like state, suppressing estrogen production and reducing adenomyosis symptoms.

Fertility Treatments:

If adenomyosis is affecting fertility, fertility treatments such as in vitro fertilization (IVF) may be considered. IVF involves retrieving eggs, fertilizing them outside the body, and then transferring the embryos into the uterus.

Surgery:

In some cases, surgery may be recommended to remove adenomyosis-affected tissue. This can be done through a procedure called adenomyomectomy. In severe cases or when fertility is not a concern, a hysterectomy (removal of the uterus) may be considered.

3-D Precision Guided Uterine Artery Embolization (UAE):

3-D Precision Guided UAE is a minimally invasive procedure where tiny particles are injected into the blood vessels supplying the uterus, cutting off the blood flow to the adenomyosis-affected tissue.

Dr. Imtiaz Ahmad, an expert endovascular surgeon and interventional radiologist, is the pioneer of this procedure in Pakistan. With extensive experience in treating fertility issues in both males and females, he has played a crucial role in helping numerous couples realize their dream of starting a family. Dr. Ahmad is committed to the principle of utilizing minimally invasive technology in his practice, emphasizing a patient-centric approach to provide effective and compassionate care.

For further assistance email us at at info@drimtiazahmad.com. Follow us on Instagram @Profdr_imtiaz_ahmad for daily updates.

varicocele treatment without surgery
8Jan

A torturous mass above the testicles is a common finding in men. Many people, with little to no knowledge about genitalia, mistakenly believe this is a normal finding until the disease begins to manifest consequences.
Varicocele is a condition characterized by the enlargement of the veins within the scrotum, which is the pouch of skin containing the testicles. These veins are called the pampiniform plexus. Varicoceles are similar to varicose veins that occur in the legs. This pathology results from the malfunction of the valves within the veins that regulate blood flow to the testes. It affects about 10-15% of men.

Causes:

The exact cause of varicocele remains unclear but many factors can contribute:

Faulty Valves:

The veins in the spermatic cord, which carry blood to and from the testicles, have one-way valves that help regulate blood flow. If these valves become weak or fail to function properly, blood can pool in the veins, leading to their enlargement and the formation of a varicocele.

Anatomy:

The anatomy of the blood vessels in the spermatic cord may contribute to its development. The left testicular vein is longer and connects to the left renal vein at a right angle, making it more prone to increased pressure and backflow of blood.

Genetic Factors:

There may be a genetic component to the development of varicoceles.

Increased Intra-Abdominal Pressure:

Conditions that lead to increased pressure within the abdomen, such as chronic constipation, heavy lifting, or prolonged standing, may contribute to the development or worsening of varicoceles.

Unknown Causes:

In some cases, the exact cause of varicoceles remains unknown.

Symptoms:

Varicoceles often develop without causing noticeable symptoms, and some individuals may be unaware that they have this condition. When symptoms do occur, they can vary in intensity.

Pain or Discomfort:

A dull, aching pain or discomfort in the scrotum is a common symptom of varicoceles, more pronounced after standing for long periods.

Visible Enlargement:

The veins within the scrotum may become visibly enlarged or swollen, giving the appearance of a “bag of worms.” This is often more noticeable when standing.

Testicular Atrophy (Rare):

In some cases, particularly if the varicocele develops during adolescence, there may be a discrepancy in the size of the testicles. The affected testicle may be smaller than the other due to reduced blood flow and potential impact on testicular growth.

Infertility:

Varicoceles are a common cause of male infertility, and they may impact sperm production, motility, and quality. In cases where fertility is a concern, a healthcare professional may recommend further evaluation and, if necessary, treatment.

Varicocele grade:

Varicoceles are often graded based on their size and severity. The most commonly used is the clinical grading system, which classifies varicoceles into three grades:

Grade I (Subclinical or Small):

Grade I varicoceles are typically not visible or palpable (felt) without the Valsalva maneuver, which involves bearing down or taking a deep breath to increase abdominal pressure. They may only be detected using techniques like ultrasound. These are considered mild or subclinical and may not cause noticeable symptoms.

Grade II (Palpable):

Grade II varicoceles are palpable (can be felt) without the need for the Valsalva maneuver. The veins are easily felt when the person is standing. This grade indicates a moderate-sized varicocele.

Grade III (Visible):

Grade III varicoceles are not only palpable but also visible. The enlarged veins are easily seen when the person is standing. These are considered large and may be associated with more significant symptoms.

Sarteschi/Liguori is another classification that depends on swollen veins, where they are, and their behavior when standing or lying down.

  • Grade 1: Swollen veins in the groin when standing.
  • Grade 2: Swollen veins reach the upper part of the testis when standing.
  • Grade 3: Swollen veins around the testis when standing.
  • Grade 4: Swollen veins when lying down and standing, getting bigger when a person strains. Varicocele grade 4 symptoms include dull aching pain, visible veins and testicular shrinkage may happen.
  • Grade 5: Enlarged veins when lying down and standing. Testicular shrinkage is common. Reflux doesn’t increase when you strain.

Diagnosis:

The diagnosis of a varicocele typically involves a combination of a physical examination, medical history review, and sometimes imaging studies like ultrasound.

A common test used by physicians to check for varicoceles is valsalva maneuver. This involves taking a deep breath and bearing down, which increases abdominal pressure. The doctor will then check for changes in the size of the veins in the scrotum during this maneuver.

How Are Varicoceles Treated?

The treatment of varicocele depends on the staging of the disease. For some watchful waiting is best while others having severe issue medical intervention is needed.

Observation:

Not all varicoceles cause symptoms or fertility issues. In some cases, the condition may be asymptomatic and not require treatment. Regular monitoring may be recommended to assess any changes in symptoms or the varicocele itself.

Supportive Measures:

Scrotal Support: Wearing supportive underwear or a scrotal support (like a jockstrap) can help relieve discomfort associated with varicoceles by reducing pressure on the veins.

Lifestyle Changes:

Diet and Exercise: Maintaining a healthy lifestyle, including regular exercise and a balanced diet, can contribute to overall vascular health.

Medication:

There is no specific medication approved for the treatment of varicoceles, but some medications may be prescribed to manage symptoms such as pain or discomfort. Non-steroidal anti-inflammatory drugs (NSAIDs) may be recommended for pain relief.

3-D Precision Guided Varicocele Embolization:

This is varicocele treatment without surgery. Transcatheter embolization is a minimally invasive procedure in which a catheter is threaded through the blood vessels to the varicocele. A substance is then injected to block the blood flow in the affected veins, causing them to shrink. This procedure is typically performed by an interventional radiologist.

Dr. Imtiaz Ahmed is an expert endovascular surgeon and interventional radiologist with extensive experience in embolization techniques. He is the founder of 3-D precision guided varicocele embolization of varicocele.He has successfully treated all grades of varicocele without surgery. His areas of expertise include non-surgical treatment for varicocele, male infertility, and venous leak. Additionally, he addresses female infertility issues.

For further assistance email now at info@drimtiazahmad.com. Follow us on Instagram @Profdr_imtiaz_ahmad for daily updates.

varicocele vs hydrocele
5Jan

Scrotal swelling is a common symptom of various scrotal pathologies. At times, the similarity of other symptoms can make it challenging for doctors to establish a clinical diagnosis without conducting tests. Two common conditions that can share similar presentations are varicocele and hydrocele. Both involve the scrotum, but they differ in their causes, symptoms, and treatments.

Varicocele vs Hydrocele

Varicocele:

Varicocele is a condition characterized by the enlargement of the veins within the scrotum (the pampiniform plexus).

Causes:

It occurs when the valves within the veins that regulate blood flow back to the heart do not function properly, leading to blood pooling and the enlargement of the veins.

Symptoms:

Apart from varicocele testicle lump other symptoms are:

Pain or Discomfort: Aching or dragging pain in the scrotum is a common symptom. This pain may vary from mild to moderate and can be more pronounced after standing or physical exertion.

Visible Swelling: Swelling or enlargement of the veins in the scrotum may be noticeable, particularly when standing. This presentation can sometimes be mistaken for an inguinal hernia, as both conditions share similar symptoms. However, in the case of varicocele, the veins may feel like a bag of worms, helping differentiate whether it is hernia or varicocele.

Testicular Atrophy (Rare): In some cases, prolonged or severe varicoceles may lead to testicular atrophy (shrinkage), although this is rare.

Infertility (in some cases): Varicoceles can potentially affect fertility in some men. The increased blood flow and higher temperature in the scrotum caused by the varicocele may interfere with sperm production or function.

Diagnosis:

Diagnosis is usually made through physical examination, and additional tests such as ultrasound may be conducted to assess the severity.

Treatment:

Treatment may not be necessary if the varicocele is not causing symptoms or fertility issues. If treatment is needed, options include surgical procedures like varicocelectomy or non-surgical approaches such as embolization. However, we recommend minimally invasive 3-D Precision Guided Varicocele Embolization for all grades of varicoceles.

Hydrocele:

Definition:

Hydrocele is a condition characterized by the accumulation of fluid in the sac surrounding the testes (tunica vaginalis).

Causes and Types of hydrocele :

The hydrocele can be communicating or noncommunicating. The 4 types of hydrocele are:

Communicating Hydrocele: This type of hydrocele occurs when there is a communication or connection between the tunica vaginalis and the abdominal cavity, allowing fluid to flow into the scrotum. It is often caused by the incomplete closure of the processus vaginalis, a tube-like structure that connects the abdomen and the scrotum during fetal development. This incomplete closure creates a pathway for fluid to move into the scrotum.

Non-Communicating Hydrocele: In this type of hydrocele, there is no direct communication between the abdominal cavity and the tunica vaginalis. Instead, fluid accumulates within the tunica vaginalis itself. Non-communicating hydroceles are often the result of irritation, inflammation, or injury that leads to an increased production of fluid or a decreased absorption of fluid within the tunica vaginalis.

Congenital Hydrocele: Some hydroceles are present at birth and are referred to as congenital hydroceles. These may result from the persistence of the processus vaginalis or other factors during fetal development.

Acquired Hydrocele: Acquired hydroceles develop after birth and may be caused by conditions such as infections, trauma, or inflammation.

Symptoms:

Hydrocele symptoms are:

Swelling:The most noticeable symptom of a hydrocele is swelling in the scrotum. The size of the swelling can vary, and it may be more prominent after physical activity or at the end of the day.

Painless enlargement: Hydroceles are typically painless, and the swelling is often not associated with discomfort or tenderness. However, if there is sudden pain or tenderness, it may indicate another underlying issue, such as infection or injury.

Heaviness or dragging sensation: Some individuals with hydroceles may experience a feeling of heaviness or a dragging sensation in the affected side of the scrotum due to the increased size and weight of the fluid-filled sac.

Transillumination: In some cases, the doctor may use a light source to shine light through the scrotum to help distinguish a hydrocele from other conditions. A hydrocele will typically transmit light, whereas a solid mass (such as a tumor) will not.

Diagnosis:

Diagnosis is usually based on physical examination, and transillumination (shining a light through the scrotum) may be used to differentiate it from other conditions.

Treatment:

Small, asymptomatic hydroceles may not require treatment. If the hydrocele is large, causes discomfort, or if it persists, treatment options may include drainage through aspiration or surgical intervention.

This brief overview of hydrocele vs varicocele may help clarify the distinctions between these two conditions. It is always crucial to consult a doctor for the proper management of these diseases. Attempts at self-diagnosis can often delay treatment and, eventually, lead to complications such as infertility.

Dr. Imtiaz Ahmed, an expert endovascular surgeon and interventional radiologist, stands out as a leading doctor in the field. His specialization lies in the treatment of male infertility issues. Dr. Ahmed employs the principles of minimally invasive surgery, ensuring that his approach is not only swift but also pain-free and highly effective.

Contact now at info@drimtiazahmad.com for further assistance. Follow us on Instagram @Profdr_imtiaz_ahmad for daily updates.