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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PCOS-Infertility- When to do Laparposcopy
Posted by on Friday, 24th April 2020
The basic problem in PCOS (Polycystic Ovary Syndrome) is that there are numerous eggs in the ovaries but they do not grow and Ovulate (release of eggs).
The first line of treatment in PCOS is weight control. Medicines like Metformin or Inositol can be added, if needed.
The second step is OVULATION INDUCTION (OI)- giving MEDICINES, ORALLY (Clomiphene or Letrozole) so that the eggs grow and get released ("Ovulation"). But while taking medicines, its important to see if the medicines are able to induce ovulation, by TVS Follicular Study.
What to do if the oral medicines are not working (you are not ovulating with oral medicines?)
In that case, we have 2 options-
1) Injection Gonadotrophin
2) Laparoscopy
Laparoscopic Ovarian Drilling (LOD)-
By Laparoscopy ("Microsurgery", putting camera inside the abdomen by key-hole), some of the follicles ("Cysts") are burned using electric current.
The Advantages of Laparoscopy are-
a) Any other possible diseases and causes of infertility can be detected (diseases of the tubes, endometriosis etc).
b) If the woman is having pain/ endometriosis/ cyst etc, these can be treated at the same time.
c) After laparoscopy, the chance of spontaneous conception increases (without need of frequent visits to the doctors).
The Disadvantages of Laparoscopy are-
a) If LOD is done in over-enthusiastic manner (many cysts are burned), it will damage the ovaries and the woman can land up in PREMATURE MENOPAUSE.
b) There is risk of anaesthesia and surgery.
c) The "Adhesion" (abnormal attachment between the organs) caused by Laparoscopy may further increase the risk of INFERTILITY.
So, LOD is done ONLY IF-
i) If the weight of the woman is normal;
ii) LH and AMH both are very high; and
iii) There was no response (Ovulation) with oral medicines.
All these 3 factors MUST be present before LOD.
Otherwise, LOD will do more harm than benefits.
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PCOS-Infertility- If oral tablets fail
Posted by on Friday, 24th April 2020
The basic problem in PCOS (Polycystic Ovary Syndrome) is that there are numerous eggs in the ovaries but they do not grow and Ovulate (release of eggs).
The first line of treatment in PCOS, therefore, is Ovulation Induction (giving medicine to grow and release the eggs). This has to be done VERY CAREFULLY. If medicines are ineffective, eggs won't grow. On the other hand, slight increase in dose can cause many follicles to grow, leading to serious complications like OHSS (Ovarian Hyperstimulation Syndrome- ovaries enlarge, water can accumulate in various body parts) and Multiple Pregnancy (Twin, Triplet etc). That's why we must do TVS Follicular Scan to see if eggs are growing and whether there is chance of OHSS or not.
The first line of agents in Ovulation Induction (OI) are usually oral tablets like CC (Clomiphene Citrate) and Letrozole. Sometimes we add Metformin tablet to improve the response to the oral medicines.
What to do if the oral medicines are not working (you are not ovulating with oral medicines)?
If these do not work we have 2 options-
1) Injection Gonadotropin (that carries small risk of OHSS and Multiple pregnancy, therefore, needs intense Monitoring by TVS)
2) surgery called LOD (Laparoscopic Ovarian Drilling- the electric current is used to burn few follicles in PCO). However, LOD carries surgical, anesthetic risks and also the risk of ovarian damage, if not done in proper way.
What to do if you had ovulation with oral medicines but failed to conceive?
If OI is done with oral medicine, the success rate is 15% per cycle. That means, out of 100 women taking the tablet, having regular intercourse and undergoing TVS Follicular Study, 15 will conceive at the end of one month.
It is useless to take the medicines for OI years after years. Pregnancy should happen within 6-9 cycles of OI.
If oral tablets has been tried for 4-6 months, it's better to add injections for next 3-4 months.
How to take the injections?
Injections are usually started from day 2/ 3/ 4 of the period. The number of injection depends on your response. The injections are NOT painful and need to be taken under the skin. TVS Follicular Study is done from day 8/9, once in every 2-3 days (until day 14-16) to confirm that the injection is working. You should have regular physical relationship as well.
How long injections can be taken?
How long you can take injections, depends on your age and the duration of infertility.
It is useless to take the injections for OI years after years. Pregnancy should happen within 3-4 cycles of OI.
If still pregnancy cannot happen, it's better to consider IUI or IVF.
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Pcos-Infertility- Treatment With Medicines Only
Posted by on Friday, 24th April 2020
How PCOS is related to the infertility?
Women with PCOS have good number of eggs inside the follicles but they cannot be released (Ovulation). As a result, sperms cannot meet the eggs, leading to infertility. Additionally, obesity, diabetes, high testosterone and insulin level all can be risk factors for infertility.
How PCOS is treated?
Unfortunately, there is no cure for PCOS. However, it can be kept under control. You should aim to keep your weight to a level that is normal. Losing only a small portion of weight will improve regularity of your periods, ovulation and also the chance of pregnancy.
Some women are prescribed “Insulin sensitizers” like inositol and metformin.
Treatment of fertility depends on your age, duration of infertility and other fertility factors. Usually the first line of treatment is OI (Ovulation Induction).
What is "Ovulation Induction" (OI)?
OI means taking medicines to help the follicles (fluid filled sacs in the ovaries, containing the eggs) grow and ovulate (rupture, releasing the eggs), to improve the chance of pregnancy. The medicines may be in the form of tablets or injections.
What tests should be done before OI?
The condition of your tubes (HSG), Ovaries (AMH, TVS) and husband's sperms (Semen Analysis) should be checked. In addition, blood group, Thalassemia screening and Rubella testing should be done to ensure that your baby should not have any problem during and after pregnancy. Do not conceal from your doctor, if you received any OI before.
How OI is done?
Oral tablets are usually started from day 2/ 3/ 4 of the period for 5 days. TVS Follicular Study is done from day 8/9, once in every 2-3 days (until day 14-16) to confirm that the medicine is working.
Is it necessary to undergo TVS Follicular Study while doing OI?
It is important to know whether the medicine given for OI is acting for you (ovaries are responding and ovulation is happening). If medicine is not working, then taking the same for several months, is the waste of time, money and energy. If the medicine is working in the first month, as confirmed by TVS, you can take the medicine for next few months without need of further TVS.
What's the success rate of OI?
If OI is done with oral medicine, the success rate is 15% per cycle. That means, out of 100 women taking the tablet, having regular intercourse and undergoing TVS Follicular Study, 15 will conceive at the end of one month.
When OI should NOT be done?
1. If you already tried OI for more than 6-9 months. Here OI in unlikely to succeed.
2. If both of your Fallopian Tubes are blocked. Here OI will not help.
3. If the husband has very low or absent sperm count / motility/ morphology. Here OI will not help.
How long OI can be done?
How long you can take OI, depends on your age and the duration of infertility.It is useless to take the medicines for OI years after years. Pregnancy should happen within 6-9 cycles of OI.
If oral tablets has been tried for 4-6 months, it's better to add injections for next 3-4 months.
If still pregnancy cannot happen, it's better to consider IUI or IVF.
Conclusion-
Most of the women with PCOS can conceive with simple OI only.
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Pcos- Infertility- How to Treat?
Posted by on Friday, 24th April 2020
How PCOS is related to the infertility?
Women with PCOS have good number of eggs inside the follicles but they cannot be released (Ovulation). As a result, sperms cannot meet the eggs, leading to infertility. Additionally, obesity, diabetes, high testosterone and insulin level all can be risk factors for infertility.
How PCOS is treated?
Unfortunately, there is no cure for PCOS. However, it can be kept under control. Majority of the women can keep the disease under control with lifestyle changes (diet and exercise), rather than medicines. These can also help to prevent the long-term consequences.
You should aim to keep your weight to a level that is normal. Losing only a small portion of weight will improve regularity of your periods, ovulation and also the chance of pregnancy.
Some women are prescribed “Insulin sensitizers” like inositol and metformin to reduce the level of insulin.
Treatment of fertility depends on your age, duration of infertility and other fertility factors. Usually the first line of treatment is OI (Ovulation Induction). The next lines are IUI (Intrauterine Insemination) and IVF (In Vitro fertilization) respectively.
What is Ovulation Induction?
Medicines (tablets, injection) are given to help your eggs grow and rupture. In the first cycle, it is important to see (by ultrasound) whether eggs are growing or not. If the eggs rupture, the chance of pregnancy per cycle is 15% and after 4-6 cycles of OI, it is nearly 50-60%. That means, out of 100 women who had ovulation, 15 can conceive after one month.
How IUI is done?
IUI is one step ahead of OI. Here along with medicines given for OI, husband’s sperm is collected, processed (“preparation”) and then inserted inside the uterus. The success rate is 15-20% per cycle.
When IVF is advised?
If a woman fails to conceive after 4-6 cycles of IUI, if the age is on higher side, there is long duration of infertility or additional problems like sperm defects or tubal blocks, IVF is advised. The success rate is 40-50% per cycle. But caution should be taken as these women are at risk of developing OHSS (Ovarian hyperstimulation syndrome- excessive response by ovaries) and twin pregnancy. Frozen embryo transfer reduces the risk.
Is there any role of laparoscopy?
Only very few women who fail to ovulate with any medicines, sometimes laparoscopy is done where some cysts are punctured using electric current (laparoscopic ovarian drilling- LOD). Additionally, LOD can be done for women requiring laparoscopy for other purposes (like pain, testing the tubes). However, LOD carries risk of ovarian damage and therefore, should be done in selective patients.
Conclusion-
PCOS is common but majority of the women can do well with life style changes. The chance of pregnancy after treatment is higher for women with PCOS than for other women.
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PCOS is not disease of CYSTS
Posted by on Friday, 24th April 2020
What is polycystic ovary syndrome (PCOS)?
PCOS is hormonal disorder where there are irregular periods, excessive hair growth on face or body (“hirsutism”), loss of hair on head, oily skin, acne and weight gain along with polycystic ovaries found in ultrasound.
The symptoms vary from woman to woman. Some women have very few mild symptoms, while others are affected more severely by a wider range of symptoms.
Polycystic ovaries have more number of follicles (fluid-filled spaces containing the eggs), which appear like cysts. However, the “cysts” in PCOS are not tumours. The main problem in PCOS is not the “cysts”, rather cysts are arising because of hormonal problems.
Presence of polycystic ovaries does not always mean PCOS.
A diagnosis is made when you have any two of the following:
1.irregular, infrequent periods or no periods at all
2.an increase in facial or body hair and/or blood tests that show higher testosterone levels
3.an ultrasound scan that shows polycystic ovaries.
It is a quite common condition, affecting 2 to 26 in every 100 women.
What causes PCOS?
The exact cause of PCOS is not yet known but it often runs in families.
The symptoms are related to abnormal hormone levels:
1.Testosterone is a hormone that is produced in small amounts by the ovaries in all women. Women with PCOS have slightly higher than normal levels of testosterone
2. Insulin is a hormone that controls the level of glucose (a type of sugar) in the blood. If you have PCOS, your body may not respond to insulin (“insulin resistance”), so the level of glucose is higher. To try to prevent the glucose levels becoming higher, your body produces even more insulin. High levels of insulin can lead to weight gain, irregular periods, fertility problems and higher levels of testosterone.
Is PCOS related to other diseases?
Effect of PCOS is not limited to the ovaries. Women with PCOS are more prone to develop diabetes, high blood pressure, heart disease, stroke, depression and mood swings, snoring and daytime drowsiness and sometimes, cancer in the lining of the uterus (endometrium). The risks are higher for obese women.
How PCOS is related to the infertility?
Women with PCOS have good number of eggs inside the follicles but they cannot be released (Ovulation). As a result, sperms cannot meet the eggs, leading to infertility. Additionally, obesity, diabetes, high testosterone and insulin level all can be risk factors for infertility.
How PCOS can be cured?
Unfortunately, there is no cure for PCOS. However, it can be kept under control. Majority of the women can keep the disease under control with lifestyle changes (diet and exercise), rather than medicines. These can also help to prevent the long-term consequences.
You should aim to keep your weight to a level that is normal. Losing only a small portion of weight will improve regularity of your periods, ovulation and also the chance of pregnancy.
Some women are prescribed “Insulin sensitizers” like inositol and metformin, which help to keep insulin level normal.
Treatment of fertility depends on your age, duration of infertility and other fertility factors. Usually the first line of treatment is OI (Ovulation Induction). The next lines are IUI (Intrauterine Insemination) and IVF (In Vitro fertilization) respectively.
Is any special precaution required in pregnancy?
Women with PCOS are at higher risk of developing miscarriage, diabetes (gestational diabetes mellitus- GDM), high blood pressure (preeclampsia), growth problems, premature delivery during pregnancy. Therefore, screening for GDM should be done along with regular scan under specialist supervision throughout pregnancy.
Conclusion
PCOS is common but majority of the women can do well with life style changes. The chance of pregnancy after treatment is higher for women with PCOS than for other women. Proper care should be taken before and during pregnancy.
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