Gynaecology

Gynaecology Services at JIVA Fertility

At JIVA Fertility, we offer specialist gynecological care for women experiencing menstrual disorders, pelvic pain, endometriosis, fibroids, ovarian cysts, endometrial polyps, polycystic ovary syndrome (PCOS), and other conditions affecting your reproductive health. 

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Investigation and Management of Common Gynaecological Conditions

Endometriosis: Endometriosis is a common condition where tissue similar to the lining of the womb (endometrium) grows outside the womb, causing various symptoms including potentially affecting fertility.

• Assessment: We use advanced imaging techniques like transvaginal ultrasound and MRI scan to diagnose moderate to severe forms of endometriosis. A laparoscopic evaluation of the abdomen and pelvis under general anaesthesia will be required for some individuals. 
• Treatment Options: Managing endometriosis involves a combination of medical, surgical, and lifestyle approaches to reduce your symptoms and to improve quality of life which will depend on various factors including your wishes to conceive.

Uterine Fibroids: Uterine fibroids are non-cancerous growths in the womb that can cause heavy menstrual bleeding, pelvic pain, and pressure symptoms.

• Assessment: Diagnosis typically involves abdominal and pelvic exam and imaging tests like ultrasound and/or MRI for fibroids mapping (determine the size, number, and location of fibroids)
• Treatment Options: Symptoms due to fibroids can be managed by various hormonal medications, minimally invasive procedures and surgical interventions, which depends on various factor including your wishes to conceive.

Endometrial Polyps: Endometrial polyps are the growths in the lining of the womb (similar to skin tags) that can cause abnormal bleeding and may affect fertility, both natural and following assisted conception.

• Assessment: Diagnosis can be made on transvaginal ultrasound scan or saline infusion sonohysterography (SIS). A diagnostic hysteroscopy is considered to be the gold standard for diagnosis and removal of polyps.
• Treatment Options: Small, asymptomatic polyps can be monitored as some resolve without any intervention. Hormonal treatments can help manage symptoms, if you have, but they are not a permanent solution and are not suitable for individuals trying to conceive. Hysteroscopic polypectomy is a minimally invasive procedure which provide further information about the nature of the polyp and minimise your symptoms. 

Ovarian Cysts: Ovarian cysts are common in women before menopause. They are generally large fluid filled sacs (three cm in diameter or more) on or in the ovary, that can cause pelvic pain and other symptoms including difficulty becoming pregnant, depending on the nature and size of the cysts. The vast majority of these identified cysts are benign. 

• Assessment: Diagnosis is made sometimes by examination and mostly with the use of imaging techniques such as pelvic ultrasound scan or a CT/MRI scan. You will need blood tests if the ovarian cysts appear complex on scan
• Treatment Options: Many ovarian cysts resolve on their own and can be monitored with regular follow-up ultrasound scans. Hormonal contraceptives can help prevent the formation of new cysts and some may help shrink some of the existing ones. Laparoscopic ovarian cystectomy (removal of the cyst) or oophorectomy (removal of the ovary) may be necessary for larger or symptomatic cysts depending on the nature of the cyst. 

Pelvic Pain: Chronic pelvic pain can be due to various causes, including endometriosis, fibroids, ovarian cysts, and pelvic inflammatory disease.

• Assessment: Diagnosis involves a thorough medical history, physical exam, and with the use of imaging techniques such as pelvic ultrasound scan or a CT/MRI scan.
• Treatment Options: Pain killers, hormonal treatments, and antibiotics (if an infection is present) can help manage symptoms. Pelvic floor physical therapy can help alleviate pain related to muscle tension or spasm. Diagnostic laparoscopy can be used to diagnose and treat conditions like endometriosis and pelvic adhesions (scarring) that cause pelvic pain.

Menstrual Irregularities: We diagnose and treat various menstrual disorders, including heavy, irregular, or painful periods. Treatment options may include lifestyle changes, medications, or hormonal therapies to regulate menstrual cycles and alleviate symptoms.

Recurrent Miscarriage: About 1 or 2 out of 100 couple experience repeated early pregnancy losses. Our consultants will help you understand the possible reasons for recurrent miscarriage and more importantly, provide you with appropriate guidance and reassurance in taking the brave step towards your next pregnancy with confidence. Link to Recurrent Miscarriage profile

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What happens at your first appointment?

After making an appointment to be seen in the JIVA Fertility Gynaecology clinic, one of the members of the team will contact you to check the possible reasons for your appointment and you will be sent a patient introduction pack including information about various charges

You will have 40-minutes appointment with Mr Harish Bhandari which will include the following:

• A detailed and comprehensive review of your medical history including the details of previous miscarriages
• A detailed ultrasound scan of the pelvis (as appropriate) including:
  
  • 3D assessment of the uterus 
  • Endometrium (lining of the womb)
  • Presence of congenital or acquired uterine pathologies such as fibroids, adenomyosis, uterine septum etc. 
  • Evidence of damaged tubes (hydrosalpinx)
  • Assess ovaries for ovarian cysts, polycystic ovaries
  • Identify any scar tissue in the pelvis
• You will be advised on further investigations and/or treatment based on your clinical history, investigations undertaken so far and the ultrasound scan findings. In some instances, we would then suggest you return for a follow up appointment to review the results before agreeing a final treatment plan.