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GEMS for "Gynaecology Endoscopy Maternity Menopause Surgery"


In a country like India with a population over 1.3 billion, it is difficult to comprehend that infertility could be a problem. But indeed it is a big problem and the incidence of infertility is on the rise.

Infertility refers to an inability to conceive after having regular unprotected sex. Infertility can also refer to the biological inability of an individual to contribute to conception, or to a female who cannot carry a pregnancy to full term. In many countries infertility refers to a couple that has failed to conceive after 12 months of regular sexual intercourse without the use of contraception.

Studies indicate that slightly over half of all cases of infertility are a result of female conditions, while the rest are caused by either sperm disorders or unidentified factors.
Many cases of apparent infertility are treatable. Infertility may have a single cause in one of the partners, or it could be the result of a combination of factors.

Depending upon what your doctor suspects to be the problem for you, you will be subjected to some hormonal tests like FSH, LH, Prolactine,Ultra TSH, DHEAS,Testosterone levels & Estradiol levels.

General physical exam - the doctor will ask the woman about her medical history, medications, menstruation cycle, and sexual habits. She will also undergo a gynecological examination.
Blood test - several things will be checked, for example, whether hormone levels are correct and whether the woman is ovulating (progesterone test).
Hysterosalpingography - dye is injected into the woman's uterus which shows up in X-ray pictures. X-rays are taken to determine whether the dye travels properly out of the uterus and into the fallopian tubes. If the doctor identifies any problems, such as a blockage, surgery may need to be performed.
Laparoscopy - a thin, flexible tube with a camera at the end (laparoscope) is inserted into the abdomen and pelvis to look at the fallopian tubes, uterus and ovaries.
A small incision is made below the belly button and a needle is inserted into the abdominal cavity; carbon dioxide is injected to create a space for the laparoscope. The doctor will be able to detect endometriosis, scarring, blockages, and some irregularities of the uterus and fallopian tubes.
Ovarian reserve testing - this is done to find out how effective the eggs are after ovulation.
Genetic testing - this is to find out whether a genetic abnormality is interfering with the woman's fertility.
Pelvic ultrasound - high frequency sound waves create an image of an organ in the body, which in this case is the woman's uterus, fallopian tubes, and ovaries.
Chlamydia test - if the woman is found to have Chlamydia, which can affect fertility, she will be prescribed antibiotics to treat it.
Thyroid function test - according to the National Health Service (UK) between 1.3% and 5.1% of infertile women have an abnormal thyroid.
What Causes Female Infertility? Female infertility can be also be caused by a number of factors, including the following:
Damage to fallopian tubes. Damage to the fallopian tubes (which carry the eggs from the ovaries to the uterus) can prevent contact between the egg and sperm. Pelvic infections, endometriosis, and pelvic surgeries may lead to scar formation and fallopian tube damage.
Hormonal causes. Some women have problems with ovulation. Synchronized hormonal changes leading to the release of an egg from the ovary and the thickening of the endometrium (lining of the uterus) in preparation for the fertilized egg do not occur. These problems may be detected using basal body temperature charts, ovulation predictor kits, and blood tests to detect hormone levels.
Cervical causes. A small group of women may have a cervical condition in which the sperm cannot pass through the cervical canal. Whether due to abnormal mucus production or a prior cervical surgical procedure, this problem may be treated with intrauterine inseminations.
Uterine causes. Abnormal anatomy of the uterus; the presence of polyps and fibroids.
Unexplained infertility. The cause of infertility in approximately 20% of couples will not be determined using the currently available methods of investigation.
"Medical Causes:
1) Varicocele. A varicocele is a swelling of the veins that drain the testicle. It's the most common reversible cause of male infertility .
2) Infection. Some infections can interfere with sperm production or sperm health or can cause scarring that blocks the passage of sperm. These include inflammation of the epididymis (epididymitis) or testicles (orchitis) and some sexually transmitted infections, including gonorrhoea or HIV.
3)Ejaculation issues. Retrograde ejaculation occurs when semen enters the bladder during orgasm instead of emerging out the tip of the penis. Various health conditions can cause retrograde ejaculation, including diabetes, spinal injuries, medications, and surgery of the bladder, prostate or urethra.
4)Antibodies that attack sperm. Anti-sperm antibodies are immune system cells that mistakenly identify sperm as harmful invaders and attempt to eliminate them.
5)Tumours. Cancers and non-malignant tumours can affect the male reproductive organs directly, through the glands that release hormones related to reproduction, such as the pituitary gland, or through unknown causes. In some cases, surgery, radiation or chemotherapy to treat tumours can affect male fertility.
6)Undescended testicles. In some males, during fetal development one or both testicles fail to descend from the abdomen into the sac that normally contains the testicles (scrotum). Decreased fertility is more likely in men who have had this condition.
7)Hormone imbalances. Infertility can result from disorders of the testicles themselves or an abnormality affecting other hormonal systems including the hypothalamus, pituitary, thyroid and adrenal glands. Low testosterone (male hypogonadism) and other hormonal problems have a number of possible underlying causes .
8)Defects of tubules that transport sperm. Many different tubes carry sperm. They can be blocked due to various causes, including inadvertent injury from surgery, prior infections, trauma or abnormal development, such as with cystic fibrosis or similar inherited conditions.
9)Chromosome defects. Inherited disorders such as Klinefelter's syndrome — in which a male is born with two X chromosomes and one Y chromosome (instead of one X and one Y) — cause abnormal development of the male reproductive organs.
10)Problems with sexual intercourse. These can include trouble keeping or maintaining an erection sufficient for sex (erectile dysfunction), premature ejaculation, painful intercourse, anatomical abnormalities such as having a urethral opening beneath the penis (hypospadias), or psychological or relationship problems that interfere with sex.
11)Celiac disease. A digestive disorder caused by sensitivity to gluten, celiac disease can cause male infertility. Fertility may improve after adopting a gluten-free diet.
12)Prior surgeries. Certain surgeries may prevent you from having sperm in your ejaculate, including vasectomy, inguinal hernia repairs, scrotal or testicular surgeries, prostate surgeries, and large abdominal surgeries performed for testicular and rectal cancers, among others.
13)environmental causes Overexposure to certain environmental elements such as heat, toxins and chemicals can reduce sperm production or sperm function.ndustrial chemicals. Extended exposure to benzenes, toluene, xylene, pesticides, herbicides, organic solvents, painting materials and lead may contribute to low sperm counts. Heavy metal exposure. Exposure to lead or other heavy metals also may cause infertility. Radiation or X-rays. Exposure to radiation can reduce sperm production, though it will often eventually return to normal. With high doses of radiation, sperm production can be permanently reduced. Overheating the testicles. Elevated temperatures impair sperm production and function. Although studies are limited and are inconclusive, frequent use of saunas or hot tubs may temporarily impair your sperm count. Sitting for long periods, wearing tight clothing or working on a laptop computer for long stretches of time also may increase the temperature in your scrotum and may slightly reduce sperm production. "
General physical exam - the doctor will ask the man about his medical history, medications, and sexual habits. The physician will also carry out an examination of his genitals. The testicles will be checked for lumps or deformities, while the shape and structure of the penis will be examined for any abnormalities.
Semen analysis - the doctor may ask for some specimens of semen. They will be analyzed in a laboratory for sperm concentration, motility, colour, quality, infections and whether any blood is present. As sperm counts can fluctuate, the man may have to produce more samples.
Blood test - the lab will test for several things, including the man's level of testosterone and other male hormones.
Ultrasound test - the doctor will determine whether there is any ejaculatory duct obstruction, retrograde ejaculation, or other abnormality.
Chlamydia test - if the man is found to have Chlamydia, which can affect fertility, he will be prescribed antibiotics to treat it.
IUI is a way to help an infertile couple to conceive. The commonest indications of IUI are, incase of : 1)male sub fertility where there is oligo asthenojuse spermia. 2)Cervical factors causing infertility 3) Unexplained infertility

A fine catheter is inserted through the cervix into the uterus to place a sperm sample directly into the uterus. The sperm is washed in a fluid and the best specimens are selected. This procedure must be done when ovulation occurs. The woman may be given a low dose of ovary stimulating hormones.

IUI is more commonly done when the man has a low sperm count, decreased sperm motility, or when infertility does not have an identifiable cause. The procedure is also helpful for males suffering from severe erectile dysfunction.
Thanks to the advancement of technology, many couples are given hope for a baby.
#FUN Fact
Louise Joy Brown, born in England in 1978, was the world's first IVF baby. Before IVF is done the female takes fertility drugs to encourage the ovaries to produce more eggs than normal.
Introducing IVF
In Vitro Fertilization (IVF) involves a sequence of highly coordinated steps beginning when a woman is given hormones to stimulate her ovaries to produce large amounts of mature eggs. These eggs are then retrieved under transvaginal ultrasound guidance. Unlike in spontaneous conception, where the eggs are fertilized within the female’s fallopian tubes, in IVF, fertilization happens in a container hence the term “in-vitro”. After 3 to 5 days of incubation in a special solution, the developing embryos are then “returned” by way of the cervix into the uterus where they are expected to grow into full-term infants in 9 months time.
IVF maybe widely used as a treatment option for most cases of infertility but unfortunately the financial cost made it beyond the reach of most couples particularly those in developing countries like India. That is changing now. It has come within the reach of common people and the facility is easily available.
If you're older than 40 or unable to become pregnant with your own eggs, donor eggs can help you conceive and deliver a baby. If you and your partner both have fertility problems, or if you've had repeated miscarriages because of embryo issues, donor embryos may be an option.
Single women with fertility problems can also conceive using donor eggs or embryos, and men without a female partner can become fathers by using donor eggs or embryos and a gestational carrier.
If you're at risk for passing a genetic disease to your child, donor eggs or embryos may be an option, though many couples prefer to try IVF using their own embryos that have been genetically tested to screen for inherited disorders.
Coping mentally
As it is impossible to know how long treatment will go on for and how successful it will be, coping and persevering can be stressful. The emotional toll on both partners might be considerable and can have an impact on their relationship. Some people find that joining a support group helps - being able to talk to others who share similar problems, aspirations and anxieties can be uplifting. It is important to tell your doctor if you are suffering mentally and/or emotionally. Most fertility doctors have access to counsellors, as well as other people and professionals who can offer helpful support.
What is PCOS?
Polycystic ovary (ovarian) syndrome (PCOS) is a common hormonal disorder affecting an increasing number of women between puberty and menopause. It is a multisystemic disorder affecting a number of systems chiefly the reproductive system.
The condition is usually diagnosed based on the following factors:
·         Infrequent or absent menses
·         Increased androgens (Male hormones)
·         Appearance of multiple small cysts of the ovary on ultra sonography.
Why does it occur?
PCOS is believed to be linked to both lifestyle factors and genetics- in other words it may run in the family.
The majority of women who have PCOS also have what is known as insulin resistance, which occurs when the body struggles to carry out the normal actions of insulin such as regulating the blood glucose levels. High levels of insulin can also increase the production of the male hormones including testosterone from the ovary, which contributes to such symptoms as excessive hair and acne. Diagnosing PCOS Your doctor will consider your symptoms and usually complete a physical examination, blood tests and an ultrasound. Physical examination Your doctor will ask you numerous questions about your menstrual cycle, symptoms, weight and examine you for physical signs of PCOS, e.g. acne, excessive hair growth and darkened skin. Blood test Your blood may be tested for high cholesterol, blood sugar levels (i.e. insulin resistance) and for changes in LH (luteinising hormone) and FSH (follicle stimulating hormone). Ultra sonography will be performed. Long term effects:
·         Infertility
·         Diabetes
·         Complications in pregnancy
·         Cardio-vascular disease
·         Metabolic syndrome
·         Endometrial cancer
PCOS is believed to be linked to both lifestyle factors and genetics- in other words it may run in the family. If you are experiencing any of the above symptoms, visit GEMS Hospital today! Here at GEMS Hospital We have launched the very first of its kind PCOS Club. Visit GEMS Hospital find out about the special packages designed to tackle this complex multi systemic disease. Join the fight against PCOS Now!!!

Antenatal Classes

At GEMS Specialty Clinic for Women , antenatal classes have been designed to prepare expectant parents for what is to come during pregnancy, birth and the weeks that come after the baby is born.

At these sessions, parents-to-be get to talk to an expert on a weekly basis about any queries they may have. Besides covering parent's questions, at our antenatal classes, we cover range of topics such as diet, fitness, posture, hygiene, exercises , fetal development, piles, constipation and sexual intercourse during pregnancy.
The sessions also explain labor, the types of birthing (caesarian, induction etc.), breathing exercises and birthing positions, how to recognize whether you're in labor, what happens step by step, options for pain relief and complications such as breech births.

There are also various antenatal classes that are dedicated to fathers about how to help during pregnancy and how to feel involved.

At GEMS, Antenatal classes don't just stop at birth either, they go as far as the weeks and months following child birth and how to care for yourself and your baby. Topics include ways of feeding and problems you can encounter (mastitis for example), maternity pads and bras etc., nappy changing, classes on how fathers can help, clothing, bathing, massage and sleeping routines, postnatal depression and also contraception after the birth.

Antenatal Classes timings :

Contact us to book a seat :

40 Plus Clinic

Life isn't about finding yourself. Life is about creating yourself. - George Bernard Shaw

The modern Indian urban mother might be worried about the health of her child and the well being of her family, but most of the times her own health takes a backseat. She often neglects her regular health checkups and delays visiting a doctor.

At Gems Specialty Clinic for Women, we aim at providing women with complete gynecological care at every stage of their life. Especially after the age of forty, an annual check up is a must.

Once enrolled in our 40 Plus Clinic, we make sure to remind you about your annual or half yearly complete health check up (as the case may be) and schedule an appointment for it to suit your convenience.

Our 40 Plus Clinic offers following services:
1. Blood tests: CBC, Lipid profile, Blood sugar, Urine routine,
2. Clinical examination
3. Ultrasonography
4. PAP smear
5. Nutrition and Diet counseling
6. Psychological counseling
7. Consultation with a physician
8. Mammography*
9. Colposcopy*
10. Bone densitometry*

*if advised by the physician
Just one hour at GEMS in a year could go a long way in maintaining good health!
40 Plus Clinic timings: Monday: 7.30 am – 10 am
Please call us on + 91 20 -----------------between 9.30 am and 6.30 pm to schedule an appointment.

Ultrasound Sonography

An ultrasound exam is a non invasive procedure that uses high-frequency sound waves to scan a woman’s abdomen and pelvic cavity. The sound waves create a picture or a sonogram of the abdomen.

At Gems Specialty Clinic for Women, all our patients are offered a superb service in all areas of pregnancy and gynecological scanning.

The recently renovated ultrasound suite features the latest state-of-the-art equipment with three- and four-dimensional capabilities. In addition to general ultrasound, Gems offers specialized ultrasound services, including high-risk obstetrical sonogram.

For appointments, contact our customer care desk at :

Contraception Advice and Management

Our doctors are specialists in birth control and can help you choose the most suitable method of contraception for your lifestyle, as well as provide contraception itself.

Various methods of contraception advised and administered are:

1. Hormonal : IUS(Mirena), pill, injection, emergency contraception.

2. Barrier: IUD, diaphragm or cervical cap, female and male condoms.

3. Permanent: Vasectomy, Female sterilisation.

Nutrition & Diet Counseling

Take care of your body. It’s the only place you have to live in.

Nutrition is a critical component of all phases of a woman’s life. Starting as a young girl through adulthood, the child-bearing years, menopause and as an elder adult; food, eating habits and weight play important roles in a woman’s overall health and well being.

Women have unique nutritional concerns in different phases of their life requiring specialized nutritional guidance. Lifestyle modification through diet forms an effective and important part of the treatments for conditions such as PCOS, gestational diabetes, infertility and obesity.

Our nutrition and dietitics experts help you to manage various health challenges by providing customized meal plans. They assist you to :

1. Lose weight
2. Improve your fertility
3. Decrease risk in gestational diabetes
4. Understand PCOS and insulin resistance
5. Manage diabetes and increased cholesterol levels
6. Weight management in thyroid related problems

Visit our Nutrition Counseling Clinic on any ---------------- between ---- and -----.

For appointments, contact us on ------------.

Psychological Counseling

" A good laugh and a long sleep are the best cures in the doctor's book" . - Irish Proverb

Cervical Cancer Vaccination

Cervical cancer is the no.1 cancer amongst Indian women, yet very few are aware of it. Most cervical cancers are caused by the sexually transmitted Human Papilloma Virus or HPV.

Cervical cancer usually has no symptoms in its early stages and hence prevention and early detection is very important. To detect cervical cancer in the early stages, regular PAP smear tests should be done. Vaginal bleeding after sex, between periods or after menopause, pelvic pain or pain during sex are some of the symptoms of cervical cancer.

Fortunately cervical cancer can be prevented by vaccination and regular screening. However vaccine should be given before a girl or a woman is exposed to the virus.

Dr Charulata Bapaye is personally committed to spread awareness about cervical cancer and has been active in the crusade against cervical cancer.

Under her leadership, GEMS Specialty Clinic for Women has been appointed as an ambassador for vaccination against cervical cancer.