Special Message:
Dr Sujoy Dasgupta is one of the leading doctors in Kolkata, who believes in patient's autonomy and patient-centred care, that means he strongly encourages patients to take their own decision, rather than imposing his own decision on his patients. He provides all the information related to the patient's particular diseases and provides all treatment options (like doing no treatment, medicine or surgery) and explains merits and demerits of all options, so that patients can take their own decision after judging all the aspects.
He is available at Garia, Narendrapur, Tollygunge, Behala, College Street, Salt Lake, Shakespeare Sarani and Sodpur.
Dr keeps himself updated regularly on the latest developments occurring in the field throughout the world and also keeps his patients updated by various means. He is possessing very bright academic career having number of Gold Medals, Honours, Awards and certifications. He has, to his credit two post graduate qualifications from India (MS, DNB) and number of certifications. He obtained MRCOG degree from the prestigious Royal College of Obstetricians and Gynaecologists, London, United Kingdom.
He has delivered invited lectures in various conferences at Regional, National and International Levels. He is actively involved in various organizations regarding social, academic and scientific acitivities- like Bengal Obstetric and Gynaecological Society (BOGS), Federation of Obstetric and Gynaecological Societies of India (FOGSI), Indian Association of Gynaecological Endoscopists (IAGE), Medical college Ex Students Association (MCESA) and Indian Medical Association (IMA) etc. He is managing the patients in line of "Evidence based Medicine"- that is according to the most recent scientific information obtained from Medical Literature.
Dr. is skilled to perform Infertility Work up, Infertility Counseling and Infertility Management in couples having all types of Infertility (Male, female and Unexplained). Many of his patients have experienced the joy of parenthood after long periods of Infertility. After his treatment, many couples with infertility problems like PCOS (Polycyctic Ovaries), Fibroids, Endometriosis conceived naturally after drug treatment, ovulation induction, surgery (laparoscopy, hysteroscopy in some cases) and in some advanced cases conception was possible by IUI (Intrauterine Insemination) and IVF (In vitro Fertilization- "test tube baby"). Many of his patients with low sperm counts are enjoying parethood after successful drug treatment, IUI and IVF. He continued his care to these couples throughout the pregnancy till delivery and afterwards. To give few examples- one patient with severe endometriosis, who refused surgery, conceived naturally after 3 months of injection therapy. Another patients with very low sperm counts was found to have hormonal imbalance, which was managed by medicines and sperm counts improved a lot to permit IUI and they conceived after 1st cycle.
Dr. has the expertise to treat successfully men and women with sexual problems. After his counseling, support and treatment, many patients with problems like ED (Erectile Dysfunction), PE (Premature Ejaculation), Painful Intercourse (Dysparaenia), Vaginal Dryness, Low libido etc are enjoying their conjugal life. To site an example, there was a couple where male partner had ejaculation problems. They were concerned about fertility problems. Doctor advised them to feel relaxed and performed IUI. The couple conceived and later on the ejaculatory problems subsided on its own. In another patient with severe premature ejaculation, he performed IUI and the couple had successful pregnancy.
Dr has made many couples with repeated miscarriage smile after successful treatment by giving them baby at or near term. He performs few investigations judiciously and finds out the cause to treat the cause. Even if no cause is found, he treats them with supportive care and many of them continued pregnancy with support and treatments. A Case report was published by him showing his successful management of a case of woman who conceived Triplet pregnancy after prolonged period of Secondary Infertility following Repeated Miscarriage (previous 3 loss) due to congenital abnormality in the uterus (Bicornuate Uterus) and delivered the babies in preterm condition. Another women with 3 previous miscarriage without any apparent cause conceived spontaneously and had successful live birth at term.
Dr is competent in counseling, diagnosing and managing woman before conception (Preconceptional Care), during pregnancy (Antenatal Care), Delivery (Normal Delivery and Cesarean Section) and after delivery (Postnatal care). He is especially interested in managing Medical Disorders in Pregnancy (e.g., women with Diabetes, Thyroid disorders, Hypertension, Epilepsy, Renal disease, Bleeding disorders, Clotting disorders etc in pregnancy). He managed many of his patients with High Risk Pregnancy successfully. To exemplify, recently one patient aged 38 years, conceived after IVF with twin pregnancy developed uncontrolled hypertension (high blood pressure), and for this reason he performed Cesarean Section on her at 30 weeks of pregnancy (just after 7 months). Fortunately mother's condition improved after delivery and the babies are doing well. Thus all the three lives have been saved. Another mother with IVF pregnancy had no movement of the baby. A prompt CTG was advised, following which the baby's life was saved by emergency C-section at midnight.
Dr is trained to perform all types of Obstetric and Gynaecological Operations including Hysteroscopy and Laparosopy, Hysterectomy, Cystectomy etc. He performs all types of life saving surgeries, like Ectopic Pregnancy, management of abortion and miscarriage in pregnancy. He is specially trained to perform cancer Surgeries for women with Gynaecological Cancers. Not only for cancers, he is also expert in proving "Cancer Prevention Care" to women in form of Counseling, Screening, vaccination and also Colposcopy.
Dr has been actively involved in many Clinical Research projects like- projects on use of Magnesium Sulphate single dose in Hypertensive disorders, Managing women with Myasthania Gravis in pregnancy, IUI in various forms of Infertility, Pregnancy outcomes after Infertility Treatment, cervical cancer Screening based on HPV detection techniques etc.
Dr. Sujoy Dasgupta lends his expertise in the following areas of Gynecology, Infertility, Obstetrics, Sexual Dysfunction
Gynaecological Care- Menstrual disorders, PCOS, Fibroid, White discharge, Menopause, Hormone Therapy
Infertility- Drug treatment, Male and Female Infertility, Unexplained Infertility, Endometriosis, PCOS, Fibroid, Low Sperm Count, Ovulation Induction, TVS, HyCoSy, SIS, IUI, IVF, TESA, PESA, ICSI, Hysteroscopy, Laparoscopy
Ultrasonography
Laparoscopy, Hysteroscopy- Diagnostic, Adhesiolysis, PCOS Drilling, Cystectomy, Ectopic Pregnancy, Hysterectomy, Polypectomy, Biopsy, Tubal Recannulation, Salpingectomy, Myomectomy, Endometriosis
Sexual Disorders- Male and Female- Low libido, Erectile Dysfunction, Premature Ejaculation, Female Sexual Dysfunction, Painful Intercourse
Colposcopy, Cancer Screening, HPV Vaccination
Gynaecological operations- Hysterectomy, Cystectomy, Cancer Surgery
Pregnancy care- Pre-conceptional Care, Antenatal care, Postpartum Care
High Risk Pregnancy- Diabetes, Hypertension, Thalassaemia, Epilepsy, Thyroid Diseases, Babies with abnormalities
Delivery Service- Normal Delivery, Caesarean Delivery
Miscarriage- Repeated Miscarriage
Contraception Services- Family Planning, Abortion Services
Abortion Services- Medical, Surgical
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Opening Blocked Fallopian Tube- Hysteroscopic Tubal Cannulation (Under Laparoscopy)
Posted by on Friday, 24th April 2020
What are the options if tubes are found blocked in HSG?
You still can consider SSG (Sonosalpingography) or SIS (Saline Infusion Sonography) as a second test to check tubal patency. SSG is an option before you take the final decision. However, if SSG also shows the “block”, then there are simply two options. You can consider laparoscopy or go for IVF straightforward. It depends on your age, other fertility factors (condition of the sperms and ovaries), duration of infertility and your wish.
Why and how Laparoscopy is done?
If HSG or SSG show both the tubes are blocked, then the only way to confirm the blockage is by laparoscopy. This is, because, sometimes, the spasm of the muscles of the tube during HSG or SSG can lead to“false positive” result; that means if tubes are found to be blocked by those tests, the tubes may actually be found open actually during laparoscopy. Laparoscopy is also advised to check the tubal patency, if there are other reasons (like removal of cyst or severe pain) or when HSG or SSG could not be done for technical difficulties. Laparoscopy is done under general anaesthesia with two or three small opening (key-hole surgery) in the abdomen and a coloured material (“dye”) is introduced through the uterus.
What is "Hysteroscopic Tubal Cannulation"?
During laparoscopy, we can make attempt to remove the block by simultaneous use of Hysteroscopy. Hysteroscopy is done by inserting a small telescope with camera inside your womb (uterus) through the vagina) under the anaesthesia. During Cannulation, a small wire is passed through the hysteroscope through the womb into the tube. Laparoscope is used to see the passage of the wire through the tube. This can open the blocked tubes in many cases.Please remember, you need laparoscopy and hysteroscopy at the same sitting. So,there is no need of two operations separately.
When Hysteroscopic Tubal Cannulation is done?
If you are at younger age, other fertility factors normal and the infertility is of shorter duration, laparoscopy may be the suitable approach for you. That means, if there is good chance that you can conceive without IVF, this operation is suitable for you.
What is the next step if this operation is "Successful"?
The operation is "SUCCESSFUL" when the "blocked" tube(s) are opened by this operation. In that case, you can try for pregnancy naturally, by ovulation induction or by IUI (Intrauterine Insemination), depending on your circumstances. If you fail to conceive within 6-12 months’ time after laparoscopy, even when the tubes were found open, you may need to consider IVF.
What to do if the operation FAILS to open the blocked tube?
Unfortunately in that case, you will require IVF.
When Hysteroscopic Tubal Cannulation is NOT advisable?
If the conditions of your ovaries or partner’s sperms are not satisfactory, your age is on the higher side, or infertility is of long duration, directly going for IVF would be the better option for you. Because, in these cases, even if tubes can be opened, there is fair chance that you will require IVF. By opting for IVF directly in such cases,, you can avoid the risks and costs related to laparoscopy.
What are the RISKS involved in this operation?
This is a very safe operation. But like any other surgeries, there is small risk of complications. Majority of the women undergoing this surgery, will not face any problems. However, out of 1000 women having the surgery, 1-2 can face problems like infection, excessive bleeding, damage to the organs (ovaries, tubes, uterus, bowel, urinary tract). There is small risk that the patient may need open operation and rarely second operation. Out of the 12000 women undergoing this operation, one can have life-threatening complications.
Conclusion-
If there is good chance that you can conceive naturally, after seeing blocked Fallopian tubes in HSG and SSG, Hysteroscopic Tubal Cannulation can be a good option for you.
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Ejaculation Problem- Fatherhood is Possible
Posted by on Friday, 24th April 2020
What are the causes of Ejaculation problems?
The problem may be due to some previous surgery (in the prostate gland, hernia, in the abdomen for cancer), diabetes neurological problems, spinal cord injury, diseases of prostate, some obstruction in the sperm conducting ducts etc
What is the next step?
Please do not hesitate to inform your doctor. He/ she will ask some questions and examine you to find out the cause. Some blood tests (like sugar) may be advised. Urine test is commonly advised. In few men, the problem may be retrograde ejaculation (Semen going into bladder instead of moving forward). In that case, sperms can be found in the urine immediately after masturbation. Scrotal ultrasound examines the details of your scrotum (testes and the organs surrounding them). TRUS (Transrectal ultrasound) is advised to see the problems in the prostate gland and around, here the ultrasound probe is inserted inside the anus.
What are the treatment options?
In very few cases, some medicines can help to improve ejaculation. These can help, particularly in retrograde ejaculation. However, in most cases, medicines are not helpful. Nevertheless, pregnancy is possible and you can become the biological father of your kids.
Vibro-ejaculator can sometimes be helpful. It is a small device applied on the front part of the penis ("Glans Penis") to discharge the semen. You can collect the semen in this way and use it at home.
How sperms can be collected?
Non-toxic condom- If you have nocturnal emission (“Night fall”) you can use this condom over penis while sleeping and collect the semen and carry it to the laboratory. The sperms can be frozen for furture use by IUI/ ICSI.
Vibro-ejaculator- can help to collect the sperms, which can be frozen for future IUI/ ICSI.
Testing urine- The sperms can be retrieved from urine and can be used for IUI/ ICSI. However, you need special preparation to reduce the normal acidity of the urine.
Prostatic message- If urine test shows no sperms, inserting lubricated gloved fingers inside your anus to message your prostate gland can sometimes help.
Electroejaculation- If prostatic message fails, your prostate gland can be stimulated using a small probe inserted through the anus under general anaesthesia. However, it is not widely available.
Testicular biopsy- If all of the above method fails, sperms can be collected from the epididymis (small gland above the testis) by small needle (PESA- Percutaneous Epididymal Sperm Aspiration) or and or sometimes, by a small cut (MESE Microsurgical Epididymal Sperm Extraction). All these are done under anaesthesia. If these fail, TESA (Testicular Sperm Aspiration- a small needle is inserted inside the testes) or TESE (Testicular Sperm Extraction- a small cut is made) can be done. Sperms collected by this way, can only be used for ICSI.
In all cases, sperms can be frozen for future use.
What should be the option- IUI or ICSI?
If your wife's results are satisfactory (At least one Fallopian Tube is open, adequate number of eggs in the ovaries), IUI (Intrauterine Insemination) can be a suitable option. In IUI, your sperms can be used, if your sperm count is satisfactory.
In IUI, the sperms are inserted through a small tube, inside the uterus. IUI is cheaper, but the success rate is 10-15% per cycle (out of 100 couples doing IUI, 10-15 can conceive in one month).
However, ICSI is to be done if your sperm count is very low and sperms are collected by TESA/ TESE/ MESA/ PESA. ICSI (Intracytoplasmic Sperm Injection) should also be considered if your wife's reports are not satisfactory (both the Fallopian Tubes blocked, ovaries have less number of eggs) and you have done 4-6 cycles of IUI.
ICSI is a special type of IVF (In Vitro Fertilization). In standard IVF, your wife will be given some injections to mature her eggs, which will be collected through the vagina. These eggs are then mixed with the sperms in the laboratory to produce the embryos.
In ICSI, the sperms collected from your body are directly injected, under the microscope, inside the eggs. The success rate of ICSI is 40% per cycle but it's expensive.
When Donor sperms should be used?
If a couple cannot afford ICSI but IUI using husband's sperm is not possible, Donor-Sperm-IUI is the option, if the wife's reports are satisfactory. Again if TESE sample fails to retrieve adequate amount of good quality sperms, IUI/ICSI should be done with donor sperms.
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Hydrosalpinx (Swelling of the Fallopian Tube)
Posted by on Friday, 24th April 2020
What is hydrosalpinx?
Sometimes, the Fallopian Tubes (the tubes remaining on both sides of the the uterus, where the sperms and the eggs meet to form the embryo) become swollen and contains fluid. This condition is called hydrosalpinx.
What are the reasons for hydrosalpinx?
The most common reason is PID (Pelvic Inflammatory Disease), where sexually transmitted infection (STI) can damage the tube and block it. As a result, the secretions accumulate inside the tube. Another reason is endometriosis (the lining of the uterus may lie outside the uterus and causes blockage of the tube). Previous surgery, infections like tuberculosis may also be responsible.
How hydrosalpinx is harmful?
In hydrosalpinx the inner lining of the tube is damaged. Usually hydrosalpinx is associated with blockage of the tube, so that the egg and the sperm cannot meet properly. Even if the tube is found open by HSG, because of the damage of the inner lining, the tube cannot function properly and as a result, the embryo is not formed inside the tube.
In case, a woman requires IVF, the fluid present in the hydrosalpinx, leaks inside the uterus and damages the embryo and thus leads to failure of IVF treatment.
How hydrosalpinx is diagnosed?
Sometimes HSG can show small hydrosalpinx. If it is not shown in the TVS, in most cases, nothing special is required. However, if the TVS shows hydrosalpinx, the damaged Fallopian tube must be REMOVED, because this tube IS DOING MORE HARM THAN BENEFIT.
How hydrosalpinx is removed?
The ideal procedure is laparoscopy, where by means of key-hole surgery, the diseased tube is removed (Salpingectomy). However, in some cases, it may not be possible, technically, to remove the tube. In that case, the tube is blocked by special clip.
What should be done if both the tube contains hydrosalpinx?
In that case, both the tube should be removed. But, unfortunately, in that case, the only option remaining for pregnancy, is IVF.
What should be done if hydrosalpinx is seen during or before IVF?
In that case, it's better to remove the tube after egg collection (and freezing the embryos), so that the effect of surgery on ovaries can be minimised (there is small chance of ovarian damage in few women during surgery).
However, if you had previous laparoscopy and it was not possible to remove or clip the tubes, there is an alternative option, called "Aspiration" by which the fluid inside the tube is taken out vaginally by inserting a needle under ultrasound guidance (just like egg collection) under anaesthesia. However, this is temporary measure and the fluid may accumulate later on. Therefore, it should ONLY be done in selective and difficult cases and should be done ONLY before the embryo transfer.
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When one fallopian tube is blocked
Posted by on Friday, 24th April 2020
In some cases, we find one Fallopian tube is Open in HSG and another tube is blocked in HSG. What to do in that case?
Please remember, one Fallopian tube can be sufficient for pregnancy. So, you DO NOT need any Laparoscopy or IVF if all other factors are normal.
If one tube is blocked and other is open, do I need Laparoscopy?
In this case, laparoscopy is needed ONLY in the following circumstances-
1) If any tube is swollen (Hydrosalpinx), because the fluid inside the Hydrosalpinx can damage the embryo. In that case, even if you need IVF, the hydrosalpinx MUST be removed by laparoscopy.
2) If you need laparoscopy for other reasons like Severe pain during periods, Ovarian Cyst, Endometriosis, Fibroid. In these cases, laparoscopy is needed to remove these diseases and improve your chance of pregnancy.
If only oneFallopian tube is open and other is closed, can I try naturally?
Of course, you can try. Even you can have Ovulation Induction (OI), by which medicine is given to improve your chance of pregnancy. However, for how long you will continue this type of treatment, depends on your age, duration of trying for pregnancy, condition of your husband's sperms and your ovaries. If any of these are not satisfactory, you should not rely on trying "naturally" for long periods.
If one tube is blocked and another tube is open, can I try IUI?
In most of cases, if your ovaries and your husband's sperms are good and your age is relatively young, you can try IUI. In most cases, the results of IUI is good. However, in some specific tube block, IUI result is not satisfactory.
Do I need IVF if one Fallopian tube is open?
You need IVF only if your husband's sperm condition is not good, your ovaries are not functioning well, you have been trying for pregnancy for long time or your age is on the higher side. If IUI fails, in that case, also you need to think about IVF.
Conclusion
In majority of the cases of one Fallopian tube block (and other tube remaining open), you don't need to worry. There is no need for laparoscopy or IVF if all other factors remain satisfactory.
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when both fallopian tubes are blocked in HSG
Posted by on Friday, 24th April 2020
What are the options if tubes are found blocked in HSG?
You still can consider SSG (Sonosalpingography) or SIS (Saline Infusion Sonography) as a second test to check tubal patency. SSG is an option before you take the final decision. If tubes are open on SSG, you can avoid both Laparoscopy and IVF. If the SSG shows tubes are open, depending on the reports of you and your husband, we can advise medicines (Ovulation Induction) or IUI. At the same time, during SSG, we can evaluate the condition of your uterus and the ovaries. Finally, it's very cheap (even cheaper than HSG).
However, if SSG also shows the “block”, then there are simply two options. You can consider laparoscopy or go for IVF straightforward. It depends on your age, other fertility factors (condition of the sperms and ovaries), duration of infertility and your wish.
When and how Laparoscopy is done?
If HSG or SSG show both the tubes are blocked, then the only way to confirm the blockage is by laparoscopy. This is, because, sometimes, the spasm of the muscles of the tube during HSG or SSG can lead to“false positive” result; that means if tubes are found to be blocked by those tests, the tubes may actually be found open actually during laparoscopy.
Laparoscopy is also advised to check the tubal patency, if there are other reasons (like removal of cyst or severe pain) or when HSG or SSG could not be done for technical difficulties.
Laparoscopy is done under general anaesthesia with two or three small opening (key-hole surgery) in the abdomen and a coloured material (“dye”) is introduced through the uterus.
What are the merits and demerits of laparoscopy?
If you are at younger age, other fertility factors normal and the infertility is of shorter duration, laparoscopy may be the suitable approach for you. If laparoscopy confirms the potency of the tube(s), you can try for pregnancy naturally, by ovulation induction or by IUI (Intrauterine Insemination), depending on your circumstances. Sometimes, attempt can be made to remove the block by laparoscopy ("Hysteroscopic tubal Cannulation"). At the same time, the condition of your ovaries, uterus and the surrounding areas can be assessed in better way and treated, if necessary.
However, if laparoscopy confirms the blockage of both the tubes, you will require IVF. Moreover, although it’s a safe procedure in most cases, there some anaesthesia and surgery-related risks.
When should one go for IVF?
If the conditions of your ovaries or partner’s sperms are not satisfactory, your age is on the higher side, or infertility is of long duration, directly going for IVF would be the better option for you. In that case, you can avoid the risks and costs related to laparoscopy.
Of course, if laparoscopy confirms tubal block, the only fertility-treatment option remaining for you is IVF.
Again, if you fail to conceive within 6-12 months’ time after laparoscopy, even when the tubes were found open, you may need to consider IVF.
Conclusion
If tubes are found blocked, the options are IVF directly or confirming the block by laparoscopy. Many factors are to be taken into account before final decision.
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