Dr. Sujoy Dasgupta Obstetrician and Gynecologist in Kolkata

Dr. Sujoy Dasgupta
Obstetrician and Gynecologist, Kolkata

MBBS (Gold Medalist, Hons), MS (Gold Medalist- OBGY), DNB (New Delhi), FIAOG, Fellow- Reproductive Endocrinology & Infertility- American College of Obstetricians & Gynecologists (USA)

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.

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 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. 

Site- https://drsujoydasgupta.continuouscare.io

Experience

Ex-Obstetrician, Gynaecologist, Laparoscopic Surgeon, KPC Medical College, Kolkata July, 2015 -  January, 2016

Consultant Gynaecologist, Obsterician, Infertility Specialist, Laparoscopy Surgeon, Sexologist, Upkar Nursing Home, College Street, Kolkata January, 2015 -  Present

Visiting Consultant Infertility, Sexology, Care IVF Central Avenue (Avenue X-Ray Clinic), Kokata - Currently working here

Consultant Gynaecologist, Obsterician, Infertility Specialist, Laparoscopy Surgeon, Sexologist, Hindusthan Health Point Garia, Kolkata January, 2014 -  Present

Visiting Consultant Gynaecologist, Obsterician, Infertility Specialist, Laparoscopy Surgeon, Remedy Hospital Garia, Kolkata July, 2013 -  Present

Visiting Consultant Gynaecologist, Obsterician, Infertility Specialist, Laparoscopy Surgeon, RSV Hospital Tollygunj November, 2014 -  Present

Visiting Consultant Gynaecologist, Obsterician, Infertility Specialist, Laparoscopy Surgeon, Iris Hospital Gangulybagan, Kolkata November, 2013 -  Present

Gynaecologist, Oncosurgery, Colposcopy, Hysteroscopy, Gynaecological Oncology, Chittaranjan National Cancer Institute (CNCI)

Incharge, Infertility and IUI, Infertility and IUI Clinic, Medical College, Kolkata

Visiting Consultant , Indian Air Force, West Bengal September, 2015 -  Present

Consultant Gynaecologist, Obsterician, Infertility Specialist, Laparoscopy Surgeon, Sexologist, Behala Balananda Brahmachary Hospital and Research Centre, Kolkata November, 2015 -  Present

Visiting Consultant Gynaecologist, Obsterician, Infertility Specialist, Laparoscopy Surgeon, Zenith Superspecialist Hospital Belgharia, Kolkata - Currently working here

Visiting Consultant, Infertility, Calcutta Cure Line Infertility and IVF Centre, Kolkata

Specialities

  • Obstetrics and Gynecology

  • Obstetric Ultrasound

  • Obstetric Emergency

  • Gynecology

  • Andrology

  • Sexology

  • Reproductive Medicine

  • IVF & Infertility

  • Gynaecological Endoscopy

  • Sexual Medicine

Procedures

  • Abdominal Hysterectomy

  • Abdominal Surgery

  • Ablation

  • Abortion

  • Abscess Incision and Drainage

Conditions

  • Abnormal Female Sexual Function

  • Abnormal Menstruation

  • Abnormal Uterine Bleeding

  • Acute (or Transient) Urinary Incontinence

  • Acute Urinary Retention

Expertise

Dr. Sujoy Gupta lends his expertise in the following areas of Gynecology, Infertility, Obstetrics, Sexual Dysfunction: https://drsujoydasgupta.continuouscare.io

  1. Gynaecological Care- Menstrual disorders, PCOS, Fibroid, White discharge, Menopause, Hormone Therapy
  2. 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
  3. Ultrasonography
  4. Laparoscopy, Hysteroscopy- Diagnostic, Adhesiolysis, PCOS Drilling, Cystectomy, Ectopic Pregnancy, Hysterectomy, Polypectomy, Biopsy, Tubal Recannulation, Salpingectomy, Myomectomy, Endometriosis
  5. Sexual Disorders- Male and Female- Low libido, Erectile Dysfunction, Premature Ejaculation, Female Sexual Dysfunction, Painful Intercourse
  6. Colposcopy, Cancer Screening, HPV Vaccination
  7. Gynaecological operations- Hysterectomy, Cystectomy, Cancer Surgery
  8. Pregnancy care- Pre-conceptional Care, Antenatal care, Postpartum Care
  9. High Risk Pregnancy- Diabetes, Hypertension, Thalassaemia, Epilepsy, Thyroid Diseases, Babies with abnormalities
  10. Delivery Service- Normal Delivery, Caesarean Delivery
  11. Miscarriage- Repeated Miscarriage
  12. Contraception Services- Family Planning, Abortion Services
  13. Abortion Services- Medical, Surgical

Education

MBBS (Gold Medalist, Hons), 2004, Medical College, Kolkata, Kolkata, India

MS (Obstetrics and Gynaecology- Gold Medalist), 2010, Medical College Kolkata, Kolkata, India

DNB (Obstetrics and Gynaecology), 2014, National Board of Examinations, New Delhi, New Delhi, India

Fellow- Reproductive Endocrinology and Infertility, 2015, American College of Obstetricians and Gynecologists (ACOG, USA), USA

FIAOG, 2016, Indian Academy of Obstetrics and Gynaecology

Practice Information

Upkar Nursing Home, Kolkata

Upkar Nursing Home, Kolkata

Gate No.3, Opp. Medical College, 30D, College Street, Kolkata, West Bengal - 700073

WED, FRI

04:00 PM - 06:00 PM

Friends Diagnostic, Kolkata

Friends Diagnostic, Kolkata

128, Friends Diagnostic Building, Garia Main Road, Patuli Main Road, Baroda Avenue, Garia, Kolkata, West Bengal - 700084

THU, SAT

06:30 PM - 09:30 PM

Saha Polyclinic, Kolkata

Saha Polyclinic, Kolkata

Barasat Road, Kachkol More, End of Sodepur Flyover East, Near Sodepur Rail Station Platform Number 4, Sodepur, Kolkata, West Bengal - 700110

SAT

11:00 AM - 01:00 PM

Behala Balananda Hospital and Research Centre, Kolkata

Behala Balananda Hospital and Research Centre, Kolkata

Plot No. 151 & 153, Diamond Harbour Road, Behala, Kolkata, West Bengal - 700034

THU

11:00 AM - 01:00 PM

Care IVF Central Avenue, Kolkata

Care IVF Central Avenue, Kolkata

Adjacent to Beadon Street and Centra Avenue Junction, Beside Cafe Coffee Day, 8B Jatindra Mohan Avenue, Kolkata, West Bengal - 700006

Hindusthan Health Point, Kolkata

Hindusthan Health Point, Kolkata

Hindusthan More, Near WBSEB, 2406, Garia Main Road, Kolkata, West Bengal - 700084

MON

07:00 PM - 08:00 PM

Private Practice Information

Doctors' Point, Tolygunj, Phone 91630405537, 8100621444

Doctors' Point, Tolygunj, Phone 91630405537, 8100621444

71/1E Netaji Subhash Chandra Bose Road, Near Malancha Cinema Hall Tollygunj, Kolkata, West Bengal - 700040, Tollygunj, Kolkata - 700153

TUE

06:00 PM - 08:00 PM

FRI

07:00 PM - 09:00 PM

  • 8100621444, 91630405537, 9831483585
Friends Diagnostic Private Limited Garia Phone 9088482135, 03324309035

Friends Diagnostic Private Limited Garia Phone 9088482135, 03324309035

128 Baroda Avenue, Garia, Near 45 Bus Stand, Beside Palki Restaurant, Kolkata, Kolkata, West Bengal - 700084

THU

06:30 PM - 09:30 PM

SAT

06:30 PM - 09:30 PM

  • 9088482135, 9831483585
Saha Polyclinic Sodepur, Phone 9432316865

Saha Polyclinic Sodepur, Phone 9432316865

Barasat Road, Kachkol More, End of Sodepur Flyover East, Near Sodepur Rail Station Platform Number 4, Sodepur , Kolkata, West Bengal - 700110

SAT

11:00 AM - 01:00 PM

  • 9432316865, 9831483585
Upkar Nursing Home College Street, Phone 03322570166, 03322570165

Upkar Nursing Home College Street, Phone 03322570166, 03322570165

30D College Street, Opposit to gate Number 3 of Medical College Kolkata, Kolkata, West Bengal

WED

04:00 PM - 06:00 PM

FRI

04:00 PM - 06:00 PM

  • 03322570166, 03322570165, 9831483585
Behala Balananda Bramhachary Hospital and Research Centre

Behala Balananda Bramhachary Hospital and Research Centre

Plot No. 151 & 153, Diamond Harbour Road, Behala, Behala, Kolkata, West Bengal - 700034

THU

11:00 AM - 01:00 PM

  • (033) 23961687, (+91) 9433716111
Hindusthan Health Point Pvt Ltd, Garia, Phone 9831483585

Hindusthan Health Point Pvt Ltd, Garia, Phone 9831483585

2406 Garia Main Road, Hindusthan More, Garia, Kolkata 700084 , Kolkata, West Bengal - 700084

MON

07:00 PM - 08:00 PM

  • 9831483585, 9831483585
Techno India Hospital (DAMA) Salt Lake, Phone 03323576163, 03323350237

Techno India Hospital (DAMA) Salt Lake, Phone 03323576163, 03323350237

Jal Vayu Vihar, LB Block, Sector III, Kolkata, West Bengal 700098, Salt Lake, Kolkata, West Bengal - 700098

TUE

12:00 PM - 02:00 PM

  • 03323576163, 03323350237, 9831483585
Apollo Clinic Narendrapur, Phone 033-24770553, 033-24770554

Apollo Clinic Narendrapur, Phone 033-24770553, 033-24770554

Adyashakti Complex, 507 NSC Bose Road, Narendrapur , Opposite Mandir Gate , Kolkata , West Bengal , Kolkata, West Bengal - 700103

WED

07:00 PM - 09:00 PM

  • 033-24770553, 033-24770554 , 9831483585

Patient Experience

Your participation in the survey will help other patients make informed decisions. You will also be helping Dr. Sujoy Dasgupta and his staff know how they are doing and how they can improve their services.

Achievements & Contributions

  • Dasgupta S, Chaudhury K, Mukherjee K. Usefulness of chorionic villus sampling for prenatal diagnosis of thalassaemia: a clinical study in eastern India. Int J Reprod Contracept Obstet Gynecol 2015 Jun; 4(3):790-794.
  • Dam P, Chakravorty PS, Mukherjee P, Dasgupta S. An Atypical Successful Outcome of Multifetal Pregnancy in Bicornuate Uterus: A Case Report. J Int Med Sci Academ Oct-Dec 2014; 27 (4) : 211-212.
  • Ghosh I, Mittal S, Banerjee D, Singh P, Dasgupta S, Chatterjee S, Biswas J, Panda C, Basu P. Study of accuracy of colposcopy in VIA and HPV detection-based cervical cancer screening program. Aus N Z J Obstet Gynaecol 2014; 54: 570–575  DOI: 10.1111/ajo.12282 PMID: 25476810.
  • Dasgupta S, Mukherjee K, Chaudhury K. Risk of miscarriage following chorionic villus sampling on 315 cases for prenatal diagnosis of Thalassemia. BJOG. EP3.07. DOI: 10.1111/1471-0528.12778: 29-30.
  • Dam P, Dasgupta S, Das N, Chakravorty PS.  Evaluation of Role of Intrauterine Insemination in Infertility in a Tertiary Care Hospital. J of Evolution of Med and Dent Sci 2014 Apr 21; 3 (16):  4337-4348. 
  • Dasgupta S. Incisional Hernia in Pregnancy: A Review. Int Med J of Students' Research 2012 Jan; 2 (1): 18-23.
  • Dasgupta S. An Unusual Association of Lung and Ovarian Malignancy in a Young Nonsmoker Female. Int J of User-Driven Healthcare 2012 Oct-Dec; 2(4): 20-28.
  • Biswas T, Sen P, Dasgupta S, Guha Niyogi S, Ghosh GC, Bera K, Biswas R. Creating Secondary Learning Resources from BMJ Case Reports through Medical Student Conversational Learning in a Web Based Forum: A Young Man with Fever and Lymph Node Enlargement. Int J of User-Driven Healthcare 2011 Jul-Sept; 1(3): 7-19.
  • Dasgupta S. Unexplained Infertility- An Enigma of reproductive Medicine. Asian Students' Med J 2011 May; 6(6).
  • Basu P, Dasgupta S, Singh P. "Screening of Cervical Cancer" in Screening in Obstetrics and Gynaecology: Management of Abnormality. Pandey A, Magon N Eds. FOGSI Publication: Jaypee 2015 p135-146.
  • Dasgupta S, Banerjee Ray P. Association between ophthalmoscopic changes and obstetric outcomes in preeclampsia and eclampsia. Int J Reprod Contracept Obstet Gynecol 2015 Dec; 4(6): 1944-1949.
  • Dasgupta S, Sarkhel A, Jain A.   Single Loading Dose of Magnesium Sulphate in Severe Preeclampsia and Eclampsia-Is it Effective? A Randomized Prospective Study. Obstet Gynecol Int J 2015 Sept, 2(6)
  • Dasgupta S. Salpingectomy should be done routinely during hysterectomy. BOGS Times 2015 July: 7 (1); 6-7. 
  • Banerjee, D, Singh, P, Dasgupta, S, Mandal, R, Basu, P, Biswas, A phase II randomised trial evaluating concomitant immunotherapy and radiation therapy for stage-III cervical cancer. BJOG 2014 Mar; 121 (S2): 197
  • Gold Medal in Biochemistry, 1st Professional MBBS
  • Gold Medal in Pharmacology, 2nd Professional MBBS
  • Gold Medal in Otorhinolaryngology (ENT), 3rd Professional MBBS Part I
  • Gold Medal in Obstetrics and Gynaecology, 3rd Professional MBBS Part II
  • Gold Medal in Obstetrics and Gynaecology for being selected as "Best PG Student" in MS, Obstetrics and Gynaecology
  • Mcnamar Silver Medal in Biochemistry in 1st Professional MBBS
  • Sutherland Silver Medal in Forensic Medicine and Toxicology in 2nd Professional MBBS
  • Senior Class Assistant (The "Best Student")  in Biochemistry
  • Senior Class Assistant (The "Best Student") in Pharmacology
  • Senior Class Assistant (The "Best Student") in ENT
  • Senior Class Assistant (The "Best Student") in Paediatric Medicine
  • 1st Certificate of Honours in Physiology in 1st Professional MBBS
  • Honours (80.1% marks) in Biochemistry
  • Honours (80% marks) in Pharmacology
  • Honours (77% marks) in ENT
  • Kunj-Kusum Scholarship for securing the FIRST position in 2nd Professional MBBS Examination among the students of the college
  • Highest Marks in the University in Biochemistry
  • Highest Marks in the College in Pharmacology
  • Highest Marks in the College in ENT
  • Dr Saroj Bhattacharya Memorial Award in Obstetrics and Gynaecology in 3rd Professional MBBS Part II
  • 1st Prize in Case Presentation in BOGSCON - "An Atypical Outcome of Multifetal Pregnancy in Bicornuate Uterus"
  • 2nd Prize in AICC-RCOG Quiz in Pune, on "Medical Disorders in pregnancy"
  • Champion, Late Smt Birangana Devi Oration Competetion, Conference on Recent Trends in Cancer Research, Early Diagnosis, Prevention & Therapy "The Accuracy of Diagnostic Colposcopy using IFCPC 2011 Classification in Women Screened by VIA and HPV DNA Test"
  • 1st Prize, Oral Paper Presentation, 9th Annual Conference of ISCCP "The Accuracy of IFCPC 2011 Classification to Detect Cervical Neoplasia"
  • Invited Panelist at Panel Discussion, Plexus, Annual Fest of KPC Medical College, 2011 "Occupational Hazard among Health Care Providers"
  • Invited Faculty at Scientific Programme of MCESA, 2014 "Obstetric Critical Care"
  • Quiz Master of Scientific Programme, MCESA, 2014
  • Workshop Coordinator, ISCCP ANnual Conference, 2014
  • Invited Faculty at Live Workshop on Colposcopy and Manegement of Cervical Precancers, CNCI, April 2014; August 2014; December 2014; July 2015
  • Invited Faculty at Scientific Programme in BOGSCON, 2015 "Thromboprophylaxis in Obstetrics"
  • Invited Faculty at Scientific Programme in MCESA, 2015 "Thromboprophylaxis in Pregnancy"
  • Quiz Master in Scientific Programme of MCESA, 2015
  • Examiner, Vivavoce Table, FORCE 2015
  • Quiz Master, Retrocon, 2015
  • CME of Medical Education and research Committee, BOGS, 2015
  • Chairperson in a session, Endogyn, 2015
  • Chairperson in a session, Annual Conference of South Kolkata Medical Association, IMA, 2015
  • An Atypical Outcome Of Multifoetal Gestation In Bicornuate Uterus 1st prize in BOGSCON, 2012  January, 2012 ECOHUB Conclave, Kolkata
  • Prevalence And Significance Of Anti-Phospholipid Antibodies In Selected At-Risk Obstetric Cases: A Comparative Prospective Study East Zone Yuva FOGSI May, 2012 Hotel Hindusthan International, Kolkata
  • Management Of Overt Diabetes Before, During And After Pregnancy   June, 2012 Eden Hospital Seminar Room
  • Perineal Injury In Obstetrics- Prevention And Management.   August, 2012 Eden Hospital Seminar Room
  • Operative Vaginal Delivery- Is It A Lost Art?   October, 2012 Eden Hospital Seminar Room.
  • Evaluation of Role of Intrauterine Insemination (IUI) in Infertility ART-AIM Update October, 2013 Hyatt Regency, HKolkata
  • The Accuracy of Diagnostic Colposcopy using IFCPC 2011 Terminology   BOGSCON, 2014. January, 2014 ITC Sonar, Kolkata
  • The Accuracy of Diagnostic Colposcopy using IFCPC 2011 Classification in Women Screened by VIA and HPV DNA Test Champion in Late Smt Birangana Devi Oration Competition February, 2014 CNCI., Kolkata
  • The Accuracy of IFCPC 2011 Classification to Detect Cervical. Neoplasias   1st prize in 9th Annual Conference of ISCCP, 2014  February, 2014 Hotel Hindusthan International, Kolkata
  • Growing Teratoma Syndrome- More Questions Than Answers BOGS Clinical Meeting June, 2014 Medical College, Kolkata
  • Rate of Miscarriage Following Chorionic Villus Sampling on 315 for Prenatal Diagnosis of Thalassaemia http://epostersonline.com/rcog2014/?q=node/3040   RCOG World Congress, 2014 HICC, Hyderabad March, 2014
  • Invited Panelist in a Panel Discussion on "Saving Mothers" in a CME by BOGS Committee of Safe Motherhood, at Medical College Kolkata, 2015
  • Invited Faculty at East Zone Yuva FOGSI 2015 held at Puri- "Prophylactic Salpingectomy"
  • Invited Speaker, "Prophylactic Salpingectomy"- East Zone Yuva FOGSI, Puri, 2015
  • Invited Expert Panelist, "High Risk Pregnancy", "Why Mothers Die" International Conference, Kolkata 2015
  • Invited Speaker- "Management of Sexually Transmitted Diseases", BOGSCON 2016
  • Invited Quiz Master, Mediquiz, Scientific Programme of 82nd Reunion of Medical College Kolkata- 2016
  • Peer Reviwer of BMJ Case Reports
  • Active member of BOGS (The Bengal Obstetric & Gynaecological Society)
  • Live member of FOGSI (Federation of Obstetric & Gynaecological Societies of India)
  • Member of IAGE (Indian Association of Gynaecological Endoscopists)
  • Live Member of IMA (Indian Medical Association)
  • Active Member of MCESA (Medical College Ex-Students’ Association)
  • Active Member of JVAA (Jadavpur Vidyapith Alumni Association)
  • Secretary, Publication, Website and Buletin Committee, BOGS, 2015-16
  • Secretary, Medical Education and Research Committee, BOGS, 2014-15
  • Coordinator, Website Committee, MCESA, 2014-15
  • Cultural Secretary, JVAA, 2013-2014, 2014-2015
  • Member, Registration Committee, Endogyn, 2015
  • Member, Scientific Committee, 81st Scientific Annual Conference of MCESA
  • Member, Publication Committee, Retrocon 2015 (Annual Reunion and Scientific programme of CSS)
  • Member, Scientific Committee, FORCE (FOGSI Revision Course for Examinations), 2015
  • Member, Workshop Committee, BOGSCON 40, 2015
  • Member, Publication Committee, 9th Annual Conference of ISCCP (Indian Scioety of Colposcopy and Cervical Pathology, 2014
  • Executive Committee Member, Medical College Ex-Students' Association (MCESA) 2016-17, 2017-18
  • Member, Scientific Committee, "Why Mothers Die" International Conference, 2015
  • Member, Workshop Committee, BOGSCON 2016
  • Member, Workshop Committee, International Conference on High Risk Pregnancy and Labour, 2016
  • Member, Scientific Committee, BOGSCON 2017
  • Member, Scientific Committee, Endogyn 2017
  • Member, managing Committee, BOGS, 2016-17, 2017-18
  • Member, Scientific Committee, FORCE 2016
  • Secretary, Perinatology Committee, BOGS, 2016-17
  • Secretary, Website Committee, BOGS 2017-18
  • Member, Scientific Committee, BEST, 2017

Blog

Introduction

When couples get married, they often view parenthood as the next stage in their family life. They want to have a child, they want to be “mom” and “dad”, they cannot imagine that this may be hard to achieve or may not be a natural process. When several trials to conceive fail, they are shocked. Their basic expectation about family life gets shattered. Most of the couples are desperately looking for medical therapy that will end into a misery. Clearly this is not a struggle to survive; it is a struggle to fulfill a dream, to achieve what they view as a “full life”.

What is needed for pregnancy?

In the male partner, sperms are normally produced in the testes after puberty (after attainment of characters like growth of beard, moustache etc). From the testes, they are carried through the sperm conducting ducts (epididymis, vas, seminal vesicle and prostate gland). Then during sexual stimulation, after proper erection and ejaculation, they come out through penis. During sexual intercourse, these sperms, present in semen, are deposited inside the vagina.

 In female partner, the deposited sperms must travel from vagina through the cervix (the mouth of the uterus). The cervix acts as gate-keeper, a it prevents entry of dead and abnormal sperms as well as bacteria present in semen, in the uterus. From uterus, sperms reach the Fallopian tubes (the tubes that are attached to the both sides of the uterus) where the sperms must meet the egg (ovum). The eggs are produced only before birth and so, there are fixed number of eggs inside the ovary. The ovum released from the ovary, into the abdomen at the time of ovulation (rupture of the surface of ovary to release the ovum). That ovum must be taken by the tube and thus inside the tube an embryo (earliest form of the baby) is formed, by meeting of the egg and the sperm.

It should be mentioned that out of nearly 200-300 million sperms, in average, deposited in vagina, hardly 500- 800 sperms can reach near the eggs and only one will succeed to form the embryo. The embryo then travels through the tube into the uterus and the uterus attaches the embryo firmly with it and thus the pregnancy starts. So, if there is defect in any one of them there will be difficulty in achieving pregnancy.

Thus, to summarise, pregnancy requires

1.       Production of healthy (“Normal Morphology”) and movable (“Normal Motility”) sperms in adequate number (“Normal Count”) in the testes

2.       Transport of these sperms through the sperm conducting ducts from testes to penis

3.       Successful Erection and Ejaculation during Intercourse to deposit adequate number of these sperms in the vagina

4.       Transport of these sperms from vagina through cervix to the uterus and the tubes

5.       Presence of sufficient number of eggs inside the ovary and ability to release the eggs from the ovaries

6.       Pick up of the eggs by the tubes

7.       Approximation of eggs and the sperms to form the embryo

8.       Transport of embryo from the tubes into the uterus

9.       Acceptance of the embryo by the uterus and its growth

What is Infertility?

Literally, the word “Infertility” means inability to conceive. But in reality, there are very few couples, who have no chance of natural conception and are called “Absolutely Infertile”. In fact, in many couples who present to infertility clinics, pregnancy may be the matter of time, thus the chance factor.

It should be kept in mind that, if there is factors to question fertility of either male or female or the female is of age less than 35 years; after one cycle (one month) of regular frequent intercourse, the chance of conception in human being is only 15%. That means, out of 100 couples trying for conception, only 15 will be able to succeed after one month of trying. The word “Regular” and “Frequent” are important; because to achieve pregnancy, couples are advised to keep intimate relationships for at least 2-3 times a week and this should be increased particularly around the time of ovulation (Middle of the menstrual cycle). Thus chance of pregnancy after 6 months, 12 months and 24 months of regular trying are respectively 60%, 80% and 100%.

The word, “Subfertility” seems better and more scientific than “Infertility”, to describe the couples who have reduced chance of conception, due to any cause. However, the word “Infertility”, seems more popular, although it puts pressure on the couples. In most cases, usually we advise to investigate after one year of regular and frequent intercourse, when the couples fail to conceive. However, if there are factors to question fertility; for example female with age more than 35 years, or with previous surgery in tubes/ ovaries/ uterus or known diseases like PCOS or endometriosis; or male partner having surgery in scrotum or groin or any hormonal problems or sexual dysfunctions- the wait period is usually reduced and couples can be investigated, even soon after marriage.

What causes Infertility?

Please look at the point “Thus, to summarise, pregnancy requires” where 9 points have been mentioned.

Thus the common causes may be

1.       Problems in male- total absence of production of sperms, less than adequate number of sperms, problems in morphology and motility of sperms (most sperms not healthy or movable), blockage in transport of sperms and inability to deposit sperms in the vagina (sexual dysfunction- Erectile Dysfunction or less commonly, Ejaculatory Dysfunction). Examples include hormonal problems (Testosterone, thyroid, prolactin), diabetes, liver problems, causes present since birth, chromosomal abnormalities, surgery, infection, sexually transmitted diseases, smoking, exposure of scrotum to high temperature, some medicines or psychological causes.

2.       Problems in female- total absence of less than adequate number of eggs in the ovaries, problems in ovulation, problems in picking of eggs by the tubes, blockage of tubes, problems in conduction of sperms or embryo by the uterus, problems in accepting the embryos by the uterus. Examples include causes present since birth, chromosomal abnormalities, polycystic ovarian syndrome (PCOS), old age, increased weight, fibroid, endometriosis, pelvic inflammatory diseases (PID), tuberculosis (TB), infections, smoking, surgery, some medicines, hormonal problems (thyroid, prolactin) or excessive stress.

3.       Unknown causes- Despite thorough investigations, 25-30% causes of infertility remain unknown. This is called “Unexplained Infertility”. The reason may be mere chance factors or there may be some causes which, still medical science has yet to discover. But this should be kept in mind while treating infertility. That means, even with correction of the possible factors (like improving sperm counts or thyroid problems etc) or with proper treatment (IUI, IVF or ICSI), unfortunately the treatment can fail and the exact reason, why the treatment failed, is sometimes difficult to find out. 

In general, what are the treatment options for infertility?

To start with, please remember there is no hard and fast rules for infertility treatment. Often medical science fails to understand why couples with very severe form of infertility conceive sooner than those who are having all tests normal. That means, whatever treatment is offered, it’s very important to continue regular sexual intercourse, as the chance of natural pregnancy is usually there in almost all couples. Your doctor will present the facts to you, without pressurizing you on a particular option. After coming to know all pros and cons of different treatment options, you can take decision. Do not hurry. It’s quite natural that you might be in stress.

In general, after the initial tests, a few periods of natural trying is allowed. After that, ovulation induction (giving medicines to release eggs from the ovaries) is offered, failing which IUI and finally IVF is offered. What will be the preferred treatment for you, will depend on your age, duration of marriage, male and female factors and of course, your age. For example, a woman with both tubes blocked or a male with very low sperm count, IVF would be the first line of treatment.

What is Fallopian Tube(s)?

Fallopian tubes (commonly called “the tubes”) are the structures that are connected to the both sides of the uterus, as mentioned above. Each tube is of 10 cm length. The part attached to the uterus is called the “cornu” and the part remaining free is called the “fimbria”. It’s the fimbria, that is present near the ovary and picks up the ovum and transports it inside the tube. The cornu received the sperms from the uterus and passes it inside. Inside the tube, the sperms and the egg meet to form the embryo, which then travels down the tubes into the uterus and then the pregnancy starts.

What happens if tubes are blocked?

If both the tubes are blocked completely, anywhere along the length (cornu, fimbria or the middle), pregnancy is not possible. This is quite obvious, because either the sperm cannot enter or the egg is not picked up or they cannot meet.

However, if any of the tubes are partially blocked, then the sperms and egg can pass and meet but the embryo cannot come down into the uterus. As a result, the pregnancy continues inside the tube, which is called “Ectopic pregnancy” that is life-threatening for the mother. It’s important to remember that ectopic pregnancy can happen even if both the tubes are open.

What are the reasons for tubal blockage?

Often, the exact cause is not known. Infection is the commonest cause. The infections may be due to sexually transmitted infection (STI), particularly Chlamydia infection or infection from bowel or appendix. Tuberculosis is very common in our country and can affect the tubes, silently, without affecting any other parts (not even the lungs) of the body. Endometriosis is also a common reason for tubal blockage. Any pelvic surgery (surgery in ovaries, tubes, uterus, even appendix) can block the tubes by “adhesion”. This means the tube may be open but attached to the bowel or rotated on itself, so that the tube cannot pick up the eggs from the ovaries. Sometimes fibroid of uterus can compress the tube and cause blockage. Women, with previous history of ectopic pregnancy, are at risk. Uncommonly, some abnormalities, present since birth can block the tubes.

What are the types of tubal blockage?

Tubal block may be one sided or both sided. It may involve only a particular part of a tube or multiple parts of a tube. The site of the block may be the cornu, the fimbria or the middle portion.

Hydrosalpinx, is a thing that you must know. In this condition, the tube is blocked but the mid-portion is dilated and contains some fluid (often infected). This tube is not functional. And the problem is even if there is pregnancy by IVF inside the uterus, this fluid from the tube may trickle down, coming in contact with the embryo and can potentially kill the embryo!

How can I understand that the tubes are blocked?

Unfortunately, very few women have signs or symptoms indicating tubal block. However, if you had previous infections in pelvis, tuberculosis in any part of the body, appendicectomy or other gynaecological surgery, there is chance of tubal block. Patients with fibroid and endometriosis are also at risk of tubal block. If you feel severe pain during periods or during intercourse, there is a chance that the tubes may be blocked.

When the tubes should be tested?

As mentioned earlier, the routine investigation of infertility includes testing for the ‘open-ness’ of the tubes- “Tubal patency tests”. That means if pregnancy does not come within 12 months of regular intercourse, then we usually advise the tests. Sometimes, tests are needed, after 6 months of trying (see above). However, in some women, with low risk of tubal block (no risk factors as mentioned above), it may be appropriate to start treatment and continue it for few cycles and if no response, then tubes should be tested.

How the tubes are tested?

The method of tubal patency test depends on your risk of having blocked tubes and also your wishes, availability of resources, other fertility factors and of course the affordability.

Routine ultrasound (like TVS) cannot detect tubal patency. However, it can detect the hydrosalpinx in most of the cases.

If you do not have any risk factors (like pain during periods, endometriosis, previous infections or surgery), you can choose either HSG or SIS. These are done in out-door basis, without any need of anesthesia.

HSG (Hystero-salingogram) is a method by which, your tubes will be seen under Xray. After visualizing your cervix (mouth of the uterus) by a speculum (instrument inserted in the vagina) a small screw will be inserted inside the cervix and a contrast material (which can be seen by the X ray) will be given through it. If tubes are open, the Xray will show that the contrast material will be going through the tubes into the abdomen.

The advantage of HSG is that, a test showing open tube has good correlation with tubal patency (if HSG shows the tubes are open, it’s likely that tubes are open). It is widely available and also cheaper.

However, the problem is that most of the women feel it painful, although they are given pain-killers for it. In addition, there is small risk of infection, for which antibiotics are prescribed. The contrast material can rarely give rise to allergy in some sensitive women and it may be life-threatening in very rare cases. Another problem is the false positive result. That means if tubes are found to be blocked in HSG, in 50% cases, they will be found to be open subsequently in laparoscopy. This is mainly because of some spasm of the muscles of the tube during the test.

SIS (Saline infusion sonography) or HyCoSy (Hystero-Contrast-Sonography) is the method by which tubal patency is checked by ultrasound (TVS) along with water like material inserted inside the uterus through a small tube. If tubes are open, the passage of water can be seen going into the abdomen through the tubes, in the ultrasound.

The advantage of HyCoSy is that it’s much less painful than HSG, although mild discomfort may be there. Pain-killers and antibiotics are prescribed usually. Additionally, problems inside the uterus can be better visualized, even better than normal TVS. In addition, the false positive result is much lower, only 7%. That means if HyCoSy suggests that the tubes are blocked, in most cases, the tubes will be found to be blocked at laparoscopy.

The problem with HyCoSy is mainly the cost and it’s not available everywhere.

An important merit of doing the tubal test is that, sometimes the water or the contrast material used in these tests can open the “mild” block. That’s why we often find patients who conceive spontaneously with pregnancy inside the uterus, after apparently “blocked” tubes in HSG or HyCoSy.

Now, laparoscopy is reserved for those, who are at high risk of tubal block. This includes women with risk factors (pain, surgery, infection etc) o women having “blocked” tube in HSG or HyCoSy. Clearly, it’s done after hospitalization under general anaesthesia inside the OT. Two or three small opening (key-hole surgery) will be put inside the abdomen and through vagina a coloured material (“dye”) will be given inside the uterus. If the tubes are open, the laparoscopic camera will show that dyes coming out of the tubes inside the abdomen.

The advantage is that it’s a definitive test, can help you to make final decision. It also provides the options of treatment. If there is corneal block in HSG, we can make attempt to open the tubes using laparoscopy (see below). In addition, if there is hydrosalpinx, where the tube serves no function, the tubes can be removed (salpingectomy) or clipped (we put clips to block the tubes) to improve the chance of pregnancy if IVF is the only option left for you. In addition, laparoscopy helps us to see whether there is any other diseases that have been missed by routine tests and that may account for infertility. We can treat the cysts of PCOS (by applying current to destroy some cysts), remove any large cysts, remove any adhesion, treat endometriosis etc.

The disadvantage of laparoscopy is of course, the need of anaesthesia and associated surgical and anaesthetic risks, although in modern era, the serious complications are uncommon.

What are my options if tubes are found to be blocked in HSG?

There are simply two options. It depends on your age, fertility factors and affordability. Number one is directly, you can go for IVF. In that case, you can save time and cost. It may be a preferred option, if you are aged or have some other fertility factors (low sperm count, endometriosis etc). The chance of pregnancy per cycle of IVF is usually 40%.

Another option is that you can confirm the block by other tests, keeping in mind that you may need IVF if the tubes are found blocked ultimately. We usually advise to have laparoscopy. However, some women want to give a trial with HyCoSy, because if HyCoSy shows the tubes are open, then you can avoid laparoscopy and you can try different fertility treatment options.

In laparoscopy, first we see if tubes are open or not. If open, there is no need of further treatment in laparoscopy. However, if tubes are found blocked, especially if the block is in cornu, we can try “hysteroscopic tubal cannulation”, where we put a small catheter through hysteroscope (a telescope, like endoscope, put inside the uterus through vagina so that we can see inside the uterus using a camera) to open the tubes. If tubes can be opened, you have all options for fertility treatment open.  However, if we fail to open the tubes, the only option left is IVF. In addition, if there is fimbrial block, it can be released and new opening in the fimbria can be made. The treatment of hydrosalpinx by laparoscopy has already been discussed (see above).

Having said that, there are some group of women, who conceive while waiting for IVF or laparoscopy after a blocked tube found in HSG.

What can I do if tubes are blocked in HyCoSy?

In this case also, there is choice between the two- laparoscopy first and IVF directly.

What can I do if laparoscopy suggests tubal block?

Unfortunately, in that case, the only option left is IVF. As mentioned before, if hydrosalpinx is found it must be treated before IVF. However, sometimes we find hydrosalpinx in laparoscopy but cannot cut the tube of clip it, simply because you did not give consent to us for doing so. In that case, we can suck out (“aspirate”) the fluid from the hydrosalpinx under ultrasound guidance (no need of further laparoscopy) using the needle.

How tubal block is dealt in your particular centre by Dr Sujoy Dasgupta?

We believe in patient’s autonomy. So we want to give time on discussion and presentation of facts and figures to the couples. We encourage questions from the couples and take utmost care so that no question remains unanswered.

We do not take decisions and impose it on the couples. We advise the couples to take time before taking decision on a particular treatment. If the couple decides, we respect and support their decision.

We prefer to have SIS or HyCoSy, rather than HSG, to reduce the pain to the women. We discuss all the options if tubes are found blocked.

Conclusion

Tubal factor can account for 20-25% cases of female infertility. It’s more common in secondary infertility (women who conceived earlier- whatever be the fate of the pregnancy). Tubal test is a part of infertility investigation. The choice between HSG and HyCoCy is open to you. If tubes are found blocked, the options are IVF directly or confirming the block by laparoscopy.