Frequently asked questions

Here you can read frequently asked questions and replies from our staff. Or you can send as a new question your self, just fill out a form on the right hand side and we will answer as soon as possible! Your question and our answer will show up on our web site if we think it will help others too.

Ultrasound

What week of pregnancy is best to see your baby by 4D ultrasound?

4D ultrasound could be done during whole pregnancy, but it is advisable to make it after 16th week, because that is a period when baby shows completely and whole body could be seen clearly.

What are common causes of unusual vaginal discharge?

Increased vaginal discharge appears as result of presence of bacteria or yeast. Mostly unusual vaginal discharge is caused by Chlamidia, Mucoplasma, Ureaplasma etc. Their presence is best confirmed by testing samples from cervix or vagina. Most frequent infection by yeast is caused by Candida sp. Prescribed therapy depends on individual case and is specific for every patient, so it should be taken only with consultation with your doctor.

Condyloma – way of transmission and treatment?

HPV infection is mostly sexually transmitted infection, but there are many other ways to gain infection. Human papiloma virus could be transmitted from sheets during labour from mother to baby, from panty liners (that is way of gaining infection for young women whom even have had not sexual intercourses). Man also could have infection, but they are most often virus carriers. Genital varts or condyloma should be treated in time to avoid spreading. Removal could be done by evaporation (using thermocauter, or lasser). Intervention is with less pain (anaesthetics should be applied) and is best to perform it after your period. Once removed condyloma do not necessary prevent another appearance, because maybe some of them were invisible during evaporation and are going to proliferate later. (Common opinion is that virus could be activated again with lower immune state). Please, contact us, our doctor if you have any other questions.

What week of pregnancy is best to perform amniocentesis?

Amniocentesis is performed for mothers over age of 35 and with suspected family history. It is also provided if there is abnormal dabl and triple test results. Best time to done test is between 16th and 18th week of pregnancy. It should be done by doctor specialist who monitors pregnancy and finds reasons to make test. For further information, please contact our clinic.

HSG

Are you providing HSG?

HSG is routine test in our facilities. That is advanced technique guided by ultrasound. Test is unpain and patient could return to their own activity either day. HSG should be done after period most often prior ovulation as your doctor estimates. Microbiological tests should have normal results.

What is the purpose of having an HSG?

A hysterosalpingogram is done mainly for women who are having a hard time becoming pregnant.A hysterosalpingogram is test of the uterus and fallopian tubes which allows visualization of the inside of the uterus and tubes. Although the purpose of the hysterosalpingogram is not therapeutic, sometimes forcing dye through the tube will dislodge any material which blocks it. A number of women have become pregnant following a hysterosalpingogram without further treatment.

What should I do before my HSG?

Generally there is no special preparation needed for this test. However, depending upon your diagnosis, you may need to take antibiotics to guard against possible infection. To ensure that you are not pregnant, the study is done between Day 7 and 10 of your cycle.

What happens during an HSG?

If the tubes are not blocked by scars and tissue adhesions, the dye will flow into the abdominal cavity. This is a good sign but it does not guarantee that the tubes will function normally. It does give a rough estimate of the quality of the tubal structure and the tubal status of tubal lining.

What can I expect after my HSG?

Expect a sticky vaginal discharge for a few days as the dye is expelled from the uterus. Use a pad or panty liner during this time to allow fluid to escape. Any dye that remains will be absorbed without any ill effect.

Is it true I may be more likely to get pregnant after an HSG?

Although the purpose of the hysterosalpingogram is not therapeutic, sometimes forcing dye through the tube will dislodge any material which blocks it. A number of women have become pregnant following a hysterosalpingogram without further treatment.

What are the risks of having an HSG?

There is a small chance (less than 1 in 100) of a pelvic infection, endometritis, or salpingitis after the test. The chance may be higher for women who have had pelvic infections before. Your doctor may give you antibiotics if he or she thinks you might develop a pelvic infection.

Where can I get an HSG done?

HSG could be done in our facilities, just make appointment and consultation before to make precise estimation with your doctor about correct term and procedure.

Amniocentesis

Does amniocentesis hurt?

Most women will feel slight pain during amniocentesis. For the first day or so afterward, some women may feel cramps like those during their menstrual period, but that is the most discomfort a woman undergoing the procedure is likely to experience. Bleeding, fever, or leaking of amniotic fluid after amniocentesis may occur and should signal a call to your doctor.

Why does it take so long to get results back from the lab with genetic amniocentesis?

There are only a few stray cells in the amniotic fluid. The cells must grow and divide before enough are available for genetic tests, and cell growth rates vary so result times can differ from patient to patient.

Do normal amniocentesis results guarantee a normal baby?

No test can guarantee a healthy baby. The results of amniocentesis are very likely to be accurate. (The accuracy of the chromosome test is estimated to be between 99.4% and 100%.) So a normal result can accurately exclude some problems and should be reassuring. Still, amniocentesis does not test for everything. Most of the approximately 4% of babies who are born with some abnormality do not have a chromosome defect or other disorder that amniocentesis detects.

Can amniocentesis determine the sex of the baby?

Yes, amniocentesis is used to observe chromosomal abnormalities and will also show if the baby has an X and a Y chromosome (in which case it's a boy) or two X chromosomes (in which case it's a girl).

Should I have CVS or wait and have amniocentesis?

It depends. If you know you're at risk for having a baby with a chromosomal abnormality and you want to know if there's a problem during the first trimester, you may want to consider CVS. But if you want to have a multiple marker screening (which is a blood test) before deciding to undergo a more invasive procedure, amniocentesis may be a better choice. A session with a genetic counselor can help you make an informed decision.

Aren't there risks involved in the procedure?

Amniocentesis increases the risk of miscarriage by less than 1% over the baseline risk for miscarriage. There is also a slight risk of uterine infection (less than one in 1,000) and bleeding. Generally, the more experience a clinician has in performing amniocentesis, the lower the risk of complications will be.

Infertility

What should I do if I think I am infertile?

If you've had more than a year of regular sex without birth control and you haven't achieved a pregnancy, it may be time to see a doctor. If a year hasn't passed yet, a good strategy is to plan to have sex during the days the woman is ovulating. To find the days when she ovulates, a woman can take her temperature by mouth or in the vagina with special thermometers available in drugstores. Her temperature will rise slightly on the days she ovulates.

My husband and I are having trouble conceiving a child. Should he try wearing loose underwear?

Tight fitting underwear as well as hot tubs and saunas decrease a man's sperm count because they raise the temperature of the testes. It might be wise to try loose underwear, and refrain from using hot tubs and saunas.

If I'm over 40, can I have children?

A woman's fertility declines markedly at age 40, but in many cases, she may still have children. Men's sperm begins to decrease after age 25, but they can stay fertile into their 60s and 70s.

Can marijuana cause infertility?

Marijuana, as well as nicotine and other legal and illegal drugs, can be a cause of infertility. If you smoke marijuana and you're trying to have a child, it's best to abstain.

I've heard that assisted reproductive techniques usually result in multiple births, such as twins, triplets or more. Is this true?

The great majority - about two thirds - of assisted reproductive births are single births. The rest are multiple births, with most being twins. Only six percent of these births are triplets or more.

Cervical cancer

What causes cervical cancer?

We don't always know what causes cervical cancer, just like we don't know what causes most cancers. Not uncommonly however, this disease occurs when a virus or other factor causes cells within the cervix to become abnormal, then cancerous. Cervical cancer becomes invasive when malignant cells spread to nearby tissues, organs, or other parts of the body.

Why do some women develop cervical cancer?

The primary risk factors associated with cervical cancer are age, awoman's sexual habits, and infection with a high-risk strain of human papillomavirus (HPV). Lifestyle, race, and other factors probably affect a woman's chances of developing cervical cancer.

Can cervical cancer be prevented?

Routine Pap tests can detect almost all instances of early cervical cancer and precancerous (tending to become cancerous) changes in cervical cells. Prompt treatment of these abnormalities can prevent cervical cancer.

How is cervical cancer diagnosed?

Routine screening for cervical abnormalities can detect early-stage cancer and precancerous conditions (that are not yet malignant).

Why are regular Pap tests so important?

Cervical cancer grows slowly, and regular Pap tests can detect the disease in its earliest, most curable stages.

Who should be screened for cervical cancer?

Every woman who has reached the age of 18 or who is or has been sexually active should have regular Pap tests.

Is cervical cancer curable?

If caught in the early stages, cervical cancer is almost 100% curable. The chances of detecting cervical cancer at an early stage are greatly increased by having regular Pap smears. Pap smears are probably the most successful of all screening procedures ever devised to detect early cancer.

4D Ultrasound

What is the number one thing that I can do to aid in receiving a successful ultrasound?

Water, water, water. The more water a mommy drinks, the more amniotic fluid you will have surrounding your baby and that will aid in a successful ultrasound.

What is an elective prenatal ultrasound?

We offer elective 2D, 3D & 4D prenatal ultrasounds to provide a positive bonding experience for the mother, father and family members with the unborn baby. We feel that realistic surface images provide a connection between the parents and baby that can be beneficial to the whole family.

We make no claims that 3-D as used in this examination is performed to better assess the baby for abnormalities. A routine ultrasound examination must have already been performed to assess the gestational age of the fetus and to evaluate for fetal anomalies as well as the basic components of fetal anatomy recommended for screening.

Is it safe? Are there any risks to me, or my baby?

Extensive studies over 30 years have found that ultrasound has not been shown to cause any harm to mother or baby. Routine scanning of all pregnancies is now normal throughout the world. In 3D/4D scanning exactly the same type and intensity of ultrasound is used as with conventional 2D scanning. 3D and 4D Ultrasound both utilize sound waves to look inside the body. The technology is similar to radar. A probe placed on the body emits sound waves into the body, listens for the return echo and generates an image. 4D ultrasound will be similar to a conventional scan in terms of exposure.

Do I need an appointment?

Yes, appointments are necessary for all of our services.

How far along should I be before I have a 4D ultrasound?

Although 4D ultrasound images can be obtained at any stage, the best time for chubby cheeks and facial features is 27-34 weeks. If you are really excited about seeing your baby before 27 weeks, we highly encourage you to make appointment earlier. The best time for determining gender, seeing unfelt fetal movements and getting an overall look at the body is 18-23 weeks.

Will I always get a beautiful image of my baby?

Unfortunately there are no guarantees. There are things that are beyond our control. The babies position, the amount of amniotic fluid, and the mothers body type can sometimes affect the quality of the ultrasound session. If it does happen we encourage you to come back another day. We want everyone to be totally satisfied.

Can I bring my family and friends?

Absolutely, this is a family event. The more the merrier.

Are you able to tell the sex of the baby?

Yes, in most cases we can provide an indication of the sex of the baby. We can't however guarantee that the baby will cooperate during your session. Certain factors such as body tissue content, developmental stage and fetal position all affect the ability to determine sex.

Genital Warts

What are the symptoms of genital warts?

Only certain types of HPV cause genital warts. Other types of HPV, not related to genital warts, can cause abnormal cell changes on the genital skin, usually on a female's cervix.

What do warts look like?

Genital warts appear as growths or bumps. Warts may be raised or flat, single or multiple, small or large. They tend to be flesh-colored or whitish in appearance. Warts usually do not cause itching, burning, or pain.

Where can they appear?

Females

• Vulva (entire outer female genital area)
• In or around the vagina
• In or around the anus
• Groin (where the genital area meets the inner thigh)
• Cervix (less common than external warts)

Males

• Penis
• Scrotum (balls)
• In or around the anus
• Groin (where the genital area meets the inner thigh)

How often can episodes occur?

• Some people only have one episode, while others have recurrences
• When warts are present, the virus is considered active
• When warts are gone, the virus is latent (sleeping) in the skin cells - it may or may not be contagious at this time
• Genital warts may or may not return after the first episode
• A healthy immune system is usually able to clear the virus, or suppress it, over time.
• Warts may appear within several weeks after sex with someone who has the wart-types of HPV, or it may take several months or years to appear. Or, warts may never appear. This makes it hard to know exactly when or from whom someone got the virus.

How are they transmitted?

• Any person who is sexually active can get genital warts.
• The types of HPV that cause genital warts are usually spread by direct skin-to-skin contact during vaginal, anal, or possibly oral sex with someone who has this infection.
• Very little is known about passing subclinical HPV to sex partners. HPV may be more likely transmitted when warts are present, but the virus can be transmitted even when there are no visible symptoms.
• The types of HPV that cause genital warts are usually different from those causing warts on other body parts, such as the hands. People do not get genital warts by touching warts on their hands or feet.
• Warts on other parts of the body, such as the hands, are caused by different types of HPV.
• Warts are not commonly found in the mouth, so some experts believe that transmission through oral sex is not as likely as with genital-to-genital or genital-to-anal contact.

Testing/Diagnosis

Sometimes, warts can be very hard to see. Also, it can be hard to tell the difference between a wart and normal bumps on the genital area. If someone thinks he or she has warts or have been exposed to HPV, they should go to a doctor or clinic. A doctor will check more closely and may use a magnifying lens to find smaller warts.

A biopsy is not necessary for diagnosing genital warts. This is only done if the bump is unusual looking or discolored.

Treatment

• While there is no medical cure for HPV, there are several treatment options available for genital warts.
• The goal of any treatment should be to remove visible genital warts to get rid of annoying symptoms. No one treatment is best for all cases.
• Treating the warts may possibly help reduce the risk of transmission to a partner who may have never been exposed to the wart-types of HPV.
• When choosing what treatment to use, the health care provider will consider the size, location and number of warts, changes in the warts, patient preference, cost of treatment, convenience, adverse effects, and their own experience with the treatments.
• Some treatments are done in a clinic or doctor's office; others are prescription creams that can be used at home for many weeks.
• Treatments done in the doctor's office include:
• Cryotherapy (freezing off the wart with liquid nitrogen). This can be relatively inexpensive, but must be done by a trained doctor or nurse.
• Laser therapy (using an intense light to destroy warts).This is used for larger or extensive warts, especially those that have not responded well to other treatments.

Menopause

How long does it have to be after my last period before I know I have been through the menopause? I keep thinking my periods have finished, but I seem to have a period every four or five months.

The general consensus is that you consider you have passed your menopause when you have stopped menstruating for one year. The menopause is actually the last day of your last period, and can only be dated with hindsight.

How do I know if I am taking the correct dose of HRT?

If your hot flushes, night sweats and vaginal dryness are controlled adequately by HRT, then you are probably receiving an effective dose.

Symptoms such as breast tenderness, fluid retention and mood swings could signify that the dose is too high and your doctor may wish to reduce the strength of your medication. Younger women typically require higher doses of HRT to control their symptoms. Occasionally, blood tests may be necessary to determine dosage adjustment.

I take HRT, but I have read about the importance of including phytoestrogens into the diet at the time of the menopause. Is it wise to do both, or should I do only one or the other?

As far as we are aware, no research has been conducted to show that the two types of treatment conflict in any way. If you intend to stay on HRT and consume substantial amounts of phytoestrogen, consult your doctor with a view to adjusting the dose of your HRT.

How much phytoestrogen do I need each day to control my hot flushes?

The dosage used in isoflavone trials varies enormously from approximately 30mg up to 160mg per day. Our experience shows it takes approximately 100mg of isoflavones (phytoestrogens found in soya products) per day to control severe hot flushes. Research confirms it is best to consume these in small quantities throughout the day, rather than in one sitting.

As a rough guide, you will find approximately 20mg of isoflavones in a 250ml glass of soya milk, approximately 12mg in a soya yoghurt or dessert, 25mg in 100g of tofu, and 8mg of lignans, which are similar, in a tablespoon of organic golden linseeds.

If I don't take HRT, in the longterm I have heard that I will be more at risk of heart disease and osteoporosis. Is there anything I can do to protect myself?

HRT does help to protect against bone loss in the short term, and it is thought that it helps to improve the bone mass by 3 per cent while you are taking it. However, within five years of stopping HRT your bones will have returned to how they would have been without the HRT.

Although it was thought that HRT did protect against heart disease, more recent research has shown this is not the case and that, in fact, it can increase the risk of heart disease and stroke.

Incorporating phytoestrogen, the naturally occurring oestrogen-like substances, into your daily routine has been shown to protect your bones as well as your heart, and additionally it seems to protect against memory loss. Therefore, not taking HRT is not putting you at further risk.

Does everyone absorb isoflavones well, or is there anything I can do to improve their use in my body?

It appears that some people are better at absorbing isoflavones than others, and there are, indeed, ways of improving absorption. Both alcohol and cigarettes tend to impede the absorption of phytoestrogen, and it has been well documented that a course of antibiotics can disturb absorption for several months.

Reducing alcohol consumption to only small quantities, cutting smoking to a minimum or better still, stopping altogether, and taking a supplement of probiotics, especially after a course of antibiotics, is likely to help improve absorption.

Can I overdose on phytoestrogens?

Although in theory it is possible to overdose on many things, including water, if you stay within the range of phytoestrogens tested in clinical trials you should not suffer any adverse effects.

Contraception

 

My mates say that condoms are dangerous to use, because they break. Are they right?

No. Condoms do break occasionally, but this is unlikely if you handle them gently, and don’t snag them with your fingernails or jewellery. It’s recently become clear that a lot of females who ask for the morning after pill say the condom broke - because they don’t want to admit that they didn’t use one. This has helped to give condoms a false reputation for breaking. Even if one in a thousand condoms breaks, that’s still far, far better than the risks of not using one at all.

Is it true that you can’t get pregnant the first time you do it?

This is a dangerous myth that has been responsible for a lot of unwanted pregnancies. You can get pregnant the first time you have sex, and it has happened to many, many young women. You might get away with it, because the chance of getting pregnant from a single act of sex is around one in 20. But it really isn’t worth taking the risk. If you’re going to do it, use a reliable method of contraception.

A friend has told me that you can’t get pregnant if you do it standing up. Is there any truth in this?

None whatsoever. You can get pregnant in any position.

My boyfriend says we don’t need contraception, because he will pull out at the last minute. Is this a good idea?

Not really. ‘Withdrawal', or coitus interruptus as it’s known, is not a good way to avoid pregnancy – partly because boys leak sperm before they come

I have heard that women can only get pregnant during a certain part of the menstrual cycle. Could my partner and I have unprotected sex if we avoid these ‘dangerous’ times of the month?

I really wouldn’t advise this, particularly if you don’t know much about what you’re doing.

It is true that women are usually at their most fertile during the middle part of their cycle.

This is about 12 to 14 days after the start of a period. Women are generally at their least fertile just before menstruation, during menstruation, and just after menstruation. But it's still possible to fall pregnant and your monthly cycle can change. Frankly, it’s a gamble.

I am thinking of trying the Pill, but my mother says it’s dangerous for younger women.

I’m afraid she has this the wrong way round. The risks of the Pill aren’t all that big, but they’re much greater in older women. In the age group 16 to 30, the danger of serious side-effects from the Pill is very small – unless you are a smoker or have other risk factors such as a history of thrombosis (clots), or a family history of relatives who had heart attacks or strokes at an early age.

You will be asked about these things when you first go to a doc to obtain the Pill. She will also check your blood pressure – because a raised BP does increase the risk of complications from the Pill.

Does the Pill turn women off sex?

No, this is largely a fantasy. Most women become more keen on sex because they know the Pill is giving them excellent protection against unwanted pregnancy. A very small number of women say the Pill reduces their libido. If you find this is the case, it’s always worth changing to another of the 23 brands that are available in the UK.

What methods of contraception are reliable?

There are 12 methods of contraception that you can regard as highly dependable.

1. The Pill.
2. The mini-Pill.
3. The patch (Evra).
4. The IUD (the coil).
5. The IUS (Mirena).
6. The injection.
7. The condom.
8. The diaphragm
9. Vasectomy (male sterilisation).
10. Female sterilisation.
11. Natural family planning if taught by a properly qualified professional.

All these methods do carry a small failure rate – nothing is 100 per cent effective. But each of these options is an awful lot better than just crossing your fingers and hoping for the best.

 

 

What about spermicides? Are they effective?

Spermicidal creams, foams, pessaries and sponges are no longer considered effective enough on their own.

What is the best method of contraception?

Quite a few couples come into my clinic asking this question, but there isn't a best method of family planning. What matters is what works for you. Different things suit different people. If it’s any help, the two most popular methods in the UK are the Pill and male condom.

Vasectomy and female sterilisation are popular with people who don’t want any more children.

What about new forms of contraception?

It is probable that new methods of contraception – such as the vaginal ring – will soon become available. However, the much hyped ‘male Pill’ is unlikely to be on the market within the next few years.

 

PCT

Why It Is Done?

The postcoital test may be done if you are not able to become pregnant and:

• You are ovulating, your fallopian tubes are not blocked, and your partner's sperm are normal. A problem with your cervical mucus may be causing infertility.
• Immune system problems, such as sperm antibodies, may be a cause of infertility.
• Your male partner does not want to be tested.

How To Prepare

The postcoital test must be done within 1 to 2 days of ovulation. Follow your doctor's instructions for checking your basal body temperature, cervical mucus, and the level of luteinizing hormone (LH) in your urine. If your test shows that you are ovulating, call for a doctor's visit for the next day.

Have sex about 1 hour before your visit. Do not use lubricants during sex. Do not douche or take a bath after sex, but you may take a shower.

Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean.

How It Is Done

A postcoital test is done in your doctor's office.

This is similar to having a pelvic examination or Pap test.

Risks

A pelvic examination to collect a cervical mucus sample does not cause problems.

Results

A postcoital test checks to see whether sperm are present and moving normally after sex.

Results of the postcoital test may be shared with you right after the test.

Postcoital test results

Normal:

• Normal amounts of sperm are seen in the sample.
• Sperm are moving forward through the cervical mucus.
• Mucus stretches at least 5 cm.
• Mucus dries in a fernlike pattern.

Abnormal

• Mucus does not stretch 5 cm.
• Mucus does not dry in a fernlike pattern.
• No sperm or a large number of dead sperm are seen in the sample.
• Sperm are clumped together and not moving normally.

What To Think About

• Clumped or dead sperm may mean that the cervical mucus has problems that affect the sperm or that you or your partner has developed antibodies against the sperm immunologic infertility.
• Many couples find it hard to have sex "on demand," especially when an examination must be done soon after having sex.

 

 

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