Dr. Ashish kale received the prestigious felicitation at Mumbai by The Economic time of India for being amongst the Most inspiring gynecologists of West India.

He’s the founder director of Ashakiran group of hospitals and ASHA IVF CENTRE AST Pune.

Pregnancy symptoms differ from woman to woman and pregnancy to pregnancy; however, one of the most significant pregnancy symptoms is a delayed or missed period.

Understanding the signs of pregnancy is important because each symptom may have causes other than pregnancy. You may experience pregnancy signs within a week of conception.

Most Common First Signs Of Pregnancy

What are the most common first signs of pregnancy? The most commonly reported first symptoms of pregnancy include:

• 29% of women surveyed reported a missed period as their first pregnancy symptom
• 25% indicated that nausea was the first sign of pregnancy
• 17% reported that a change in their breasts was the initial symptom of pregnancy

While implantation bleeding is often considered the first pregnancy symptom, the survey revealed that only 3% of women identified implantation bleeding as their first sign of pregnancy.

Symptoms Of Pregnancy Explained

Each of your symptoms of pregnancy below could be explained by other causes. What else could they be?

Spotting or light bleeding: If pregnant, this symptom is usually associated with implantation bleeding and is considered one of the earliest signs of pregnancy. The embryo usually implants to the uterine between 6 to 12 days after conception. Some women will experience spotting as well as cramping. Other women do not even notice implantation bleeding or cramping, so don’t worry if you are trying to get pregnant and don’t experience these symptoms; you could still be pregnant.

When this implantation occurs, light bleeding or spotting is perfectly normal. This symptom is sometimes accompanied by light cramping. Many women will conceive and not notice any implantation bleeding, so do not worry if you are trying to get pregnant and do not see this symptom, you could still be pregnant.

 Missed period: A delayed or missed period is the most common pregnancy symptom leading a woman to test for pregnancy. When you become pregnant, your next period should be missed.

Is it possible to be pregnant and still have a period? Some women can bleed while they are pregnant, but typically this bleeding will be shorter or lighter than a normal period. A missed period can be a symptom of pregnancy caused by something else.

Nausea or morning sickness: Nausea or morning sickness is the second most commonly reported first sign of pregnancy. Experienced to some degree by most expecting women, nausea typically shows up between 2 to 8 weeks after conception.

Nausea can be experienced with or without vomiting. It is important to know that nausea, frequently called morning sickness, can actually be experienced at any time of the day. Similarly, it usually occurs during the first trimester and subsides after that for most women, but some will experience nausea all throughout their pregnancies.

Swollen or tender breasts: The third most frequently cited symptom of pregnancy changes in the breasts.  These changes are usually indicated by swelling or tenderness. Changes to the breasts can start as early as 1 to 2 weeks after conception.

Fatigue or Tiredness: Following conception, as early as the first week after, many women cite feeling tired as a sign of pregnancy. This fatigue is commonly experienced by those who are expecting and is recognized as a typical symptom of pregnancy.

Frequent Pregnancy Symptoms

The previous symptoms are usually the first signs you experience when pregnant. There are other signs also commonly experienced by those who are expecting as well:

Backaches: Lower backaches are commonly reported by women who discover that they are pregnant. This symptom can occur with the onset of pregnancy, but it is often experienced later as the pregnancy progresses. This makes it an easy pregnancy symptom at week 27 to week 34.

Headaches: Experiencing headaches at the onset of pregnancy is another common early sign of pregnancy. Experts believe that the sudden rise of hormones in your body leads you to experience the headaches.

Headaches during pregnancy may also be caused by the increase of blood flow. There is an approximately 50% increase in the volume of blood flowing while you are expecting.

Frequent urination:  Don’t be surprised if you feel like you have to pee more often. Increase urination starts for most people between 6 to 8 weeks.

You will find that increased urination will pick back up or continue throughout your pregnancy as the expanding baby and uterus place pressure on your bladder.

Food cravings or food aversions:  The reason for certain food cravings or food aversions is not known. Don’t be surprised if you find yourself drawn to something you normally do not care for, or avoiding things that you normally like.

The food that expecting women crave or seek to avoid varies and are quite sporadic. It is alright to allow yourself the freedom to pursue those cravings and avoid the things you don’t want as long as you are getting the nutrition you need for a healthy pregnancy.

These cravings or aversions can occur early in pregnancy or anytime throughout your pregnancy.

Darkening of the Areolas: Some people lump darkening of the areolas into the symptom of pregnancy referred to as breast changes. That’s alright, it is important to note that if the areolas, area around your nipples, darkens, that is normal.  It is a common occurrence within those who are expecting.

Mood Swings: Expecting mothers frequently experience mood swings. This believed to be primarily caused by the hormonal changes that affect the neurotransmitters of the brain. The types of mood swings can vary from woman to woman.  Some may experience elevated highs and lows, whereas others alternate between states of happiness to states of depression or anxiety.

It is important to note that mood swings are normal; however, if you find yourself struggling with depression or extended periods of sadness, you should contact your healthcare provider. Some women prefer to go directly to a counsellor or mental health professional.

Pregnancy Symptom Alternatives

It is challenging already to determine if you are pregnant or not, but with symptoms of pregnancy varying from woman to woman and even pregnancy to pregnancy, it gets even more difficult. Additionally, most of the typical “pregnancy symptoms” can be explained by something else.

What else could it be?

A missed or delayed period, the most commonly reported first sign of pregnancy, could be caused by any of the following:

• Pending menstruation
• Excessive weight gain or loss
• Fatigue or exhaustion
• New workout regimen
• Hormonal imbalance
• Tension or stress
• Change in birth control usage
• Various illnesses
• Breastfeeding

Nausea or morning sickness, the second most frequently cited symptom of pregnancy, might be explained by one of the below:

• Food poisoning
• Tension or stress
• Anxiety
• Change in hormonal birth control
• Other stomach ailments

Tender or changing breasts, as the third most noted pregnancy symptom, might be triggered by any of the following:

• Hormonal imbalance
• Change in hormonal birth control
• Impending menstruation

Fatigue or tiredness can be brought on by any of the following:

• Tension or stress
• Exhaustion from working too hard
• Depression or other mental health struggles
• Common cold or flu
• New workout regimen
• Allergies or other ailments
• Lack of sleep
• Improper nutrition

If you’re having the trouble, Dr.Ashish Kale will help you figure out why, and work with you to find a treatment that can help. He is one of the best Gynaec Endoscopy Surgeon, IVF Specialist in Pune & currently practising at Ashakiran hospital which is one of the best Infertility Center in Pune.

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PCOS is a common hormonal abnormality seen mostly in reproductive Age groups Affects about 30% females.

Diagnosis is by Rotterdam criteria: 2/3 should be present.

• Oligo/anovulation
• Polycystic ovarian morphology
• Hyperandrogenism

It also affects other metabolisms like insulin resistance causing diabetes, impaired glucose tolerance and this ultimately exacerbates obesity

• It has a genetic predisposition.
• PCOS can either be lean PCOS or obese PCOS.
• This classification is important to categorize the causal effect and treatment also differs
• Insulin-mediated glucose disposal reflects the action of insulin on muscle cells and this is decreased by 30-40% in women with PCOS.
• This is further worsened with obesity.
• The endogenous glucose production is also affected and this causes glucose intolerance.
• They also have menstrual irregularities and infertility due to lack of mature egg (anovulation ) production.

Treatment

1. Change in lifestyle and diet
2. Exercise
3. Weight reduction
4. Drugs to regularise menses and antidiabetic drugs
5. Ovulation-inducing agents with or without IUI for subfertility

In case you have a concern or query you can always consult Dr.Ashish Kale & get answers to your questions!

If you’re having the trouble, Dr.Ashish Kale will help you figure out why, and work with you to find a treatment that can help. He is one of the best Gynaec Endoscopy Surgeon, IVF Specialist in Pune & currently practising at Ashakiran hospital which is one of the best Infertility Center in Pune.

Complications from fertility treatments are rare; nevertheless, some people do experience side effects. Anyone undergoing ovarian stimulation is at risk of developing ovarian hyperstimulation syndrome (OHSS), one of the most serious side effects of fertility treatments. Because if this, It’s to your advantage to be informed and on the lookout for symptoms to bring to your doctor’s attention.

What is OHSS?

OHSS is irritation of the ovaries that can happen when they are stimulated to produce a lot of eggs at once. OHSS is caused by high levels of estrogen in the bloodstream, which causes the ovarian blood vessels to become leaky to fluids. This means fluids leave the bloodstream and collect in the abdominal cavity.

Even though a woman with OHSS drinks plenty of fluids, she can become severely dehydrated. As a result, the blood becomes thickened leaving her at risk for blood clots in the legs and lungs.

What are the Symptoms of OHSS?

The symptoms of OHSS may be mild, moderate, or severe and usually begin four to five days following egg collection. The accumulation of fluid in the abdominal cavity can be very uncomfortable and cause bloating, sometimes breathlessness. In severe cases, the fluid enters the lungs and causes respiratory distress.

Mild OHSS

• Mild abdominal pain
• Abdominal bloating and weight gain
• Mild nausea
• Vomiting
• Diarrhea
• Tenderness around the ovaries

Moderate to Severe OHSS

• Rapid weight gain
• Severe abdominal pain
• Persistent nausea and vomiting
• Decreased urinary frequency
• Dark urine
• Shortness of breath
• Tight and enlarged abdomen
• Dizziness

Who is at risk?

Some women are more at risk than others of developing this complication. Women with polycystic ovaries are most at risk because they have many tiny follicles present that Respond to the stimulation medicine. Other women at risk are those who have a high number of antral follicles, high anti-mullerian hormone (AMH) levels, high luteinizing hormone (LH) blood level and high LH to follicle-stimulating hormone (FSH)ratio.

An individual’s risk should be assessed by a doctor ahead of starting an IVF cycle to adjust the starting dose of stimulation medication accordingly. Additionally, the doctor will do regular ultrasound scans of the ovaries during the stimulation phase and monitor the circulating estrogen levels as they rise.

If the blood estrogen level is rising too high or too quickly, the doctor can reduce the dose of FSH medication or “coast” the treatment by stopping the FSH injections for a few days. This will give the ovaries a break from being over-stimulated and help to reduce the chance of OHSS.

How common is OHSS?

Mild OHSS occurs in around 30% of all treatment cycles and is considered a normal side effect of ovarian stimulation for IVF. The symptoms are easily managed with over-the-counter painkillers, dietary changes, and increased fluid intake.

Severe OHSS affects around 3 to 8% of cycles and is managed well with medical help.

Clinical Treatment of OHSS

For more severe cases, the following may be required:

• Cancellation of embryo transfer until a later date
• Prescription anti-nausea medication
• Drain excess fluid from the abdomen with a needle puncture, similar to an egg retrieval
• Administer intravenous fluids

How can OHSS be prevented?

Prevention is better than cure, and your doctor should monitor the stimulation phase of the IVF cycle carefully. Ultrasounds and blood tests measure the ovaries’ response to the stimulation drugs.

The dose will be lowered if the estrogen levels become too high or you may take a break from injections for a day or two. It is better to start with a lower dose and add extra FSH during ovarian stimulation than start too high and be at risk for complications. If the ovarian response is extremely high the doctor might choose to cancel the cycle altogether and start again with a lower dose next time.

If you’re having the trouble, Dr. Ashish Kale will help you figure out why, and work with you to find a treatment that can help. He is one of the best Gynaec Endoscopy Surgeon, IVF Specialist in Pune & currently practicing at Ashakiran hospital which is one of the best Infertility Center in Pune.

Dr. Ashish Kale should be able to choose the best treatment regimen for you that minimizes the chance of complications while maximizing the treatment outcome.

Feeling very privileged and humbled to receive the “Dr. C.S. Munagekar Award” for Original research work by National IMA HQ New Delhi 2018-2019 at Eagleton Resort Bangalore by National IMA President Dr. Ravi Wankhedkar.