Welcome to part 2 of our conversation withDr. Tanuj Lawania (Medbound Handle: @Dr. Tanuj Lawania)
Dr. Darshit Patel: What are the main factors contributing to the increased rate of infertility and the growing reliance on Assisted Reproductive Technologies (ARTs) and artificial techniques in addressing fertility issues?
Dr. Tanuj Lawania: In past, many women used to get married at a young age, around 16 or 17, and start having children by the age of 20. This trend still exists in some sections of society, but infertility rates are more prominent in higher socioeconomic groups. Late marriages and the desire to focus on careers contribute to delayed childbearing, which is one of the factors leading to increasing infertility.
Another significant factor is people's lack of patience. Stress at work and the desire for a quicker solution to achieve their goal of having a child often lead individuals to seek assisted reproductive technologies (ART) rather than trying to conceive naturally. This includes options beyond IVF.
The third reason is prevalent in lower socioeconomic status, where many women suffer from pelvic inflammatory disease (PID). PID can damage the fallopian tubes, contributing to infertility. Lifestyle changes, such as diet and stress, also play a role. Hormones govern the female body, including menstrual cycles, and even slight stress can disrupt these hormones, affecting overall health.
Furthermore, there has been a significant increase in the glorification and advertisement of fertility treatments like IVF and ART due to advancements in medical techniques and information availability. This has led to increased stress and anxiety among individuals, as they become more aware of these options.
Addressing these issues requires multiple approaches. First, providing accurate and refined information to the public is essential. Secondly, regulating reproductive centers and establishing guidelines for their practices, especially in the emerging field of reproductive medicine, can help improve patient outcomes and reduce infertility rates.
Lastly, considering limitations on the use of social media for medical publicity may be beneficial. While social media can enhance knowledge and awareness, it should be used cautiously in the medical field, given the gravity of the issues involved. Stricter standards for medical advertising on social media could help maintain the integrity of the profession.
Dr. Darshit Patel: What advice do you recommend for pregnant patients in the wake of recent events such as flooding and the monsoon season to ensure their safety and well-being?
Dr. Tanuj Lawania: In monsoon season, there is a belief that preterm births are more common, it's not confirmed. I've read this in a few articles. I would suggest that during the monsoon seasons avoid consuming outside food. Eating such food can increase the diseases.
Additionally, it's important to ensure there are no stagnant water reservoirs in the vicinity as they can be breeding grounds for mosquitoes, which could lead to diseases like malaria and dengue. Developing any illness during pregnancy can complicate the situation, so extra caution is necessary.
When walking on rainy roads, wear proper shoes or suitable footwear to prevent slipping and falling, as accidents are common during this season.
I want to emphasize that pregnancy is not an illness but a natural phenomenon. It's a physiological process.
Dr. Darshit Patel: What motivated your choice of researching and writing about acute pancreatitis in your recent article?
Dr. Tanuj Lawania: When I was in my residency, I encountered two cases of acute pancreatitis, and unfortunately, one of the patients didn't survive despite excellent medical management. This experience led me to realize the importance of this condition. My friend, Dr. Maitreyi, and I decided to write a retrospective article. We gathered data from several past cases because acute pancreatitis during pregnancy is quite rare and not well-documented, even on the internet.
During our research we realized that this information could be valuable because it's not commonly found in textbooks. Many of the patients we studied had one thing in common, either gallstones or gallbladder sludge. Pregnant women are more susceptible to developing gallstones than gallbladder sludge.
If a pregnant woman presents with gallbladder stones or a large gallbladder cyst and experiences pain, it shouldn't be ignored, consider this the possibility of acute pancreatitis, as it can significantly impact both the mother and baby's health and increase mortality and morbidity risks. Managing such pregnancies as high-risk is crucial.
Dr. Darshit Patel: What skills and mindset do you believe are essential for someone aspiring to become a gynecologist or obstetrician?
Dr. Tanuj Lawania: For becoming an obstetrician and gynecologist, you should be somebody who can handle the stress because we have a lot of night duties, and the night duties are you know, they're very heavy, where we have to deliver a lot of babies and we have to do a lot of various sections. So you always have to be on your toes.
You cannot just sit calmly. So this branch is not for somebody who wants to relax and have a good life where the person is relaxing and having like eight or nine hours of sleep and all. This branch is not for that person. This branch is for the person who can take on all the stress and work under pressure because in the obstetric way, and you can actually divide the branch. So now this is obstetrics and gynecology.
So now, obstetrics is something that deals with the baby. So in obstetrics, you always have to be on your toes. But if you go more towards gynecology, it is more surgically chill, but surgically it is going to be more challenging. But it is more relaxed. You can have your elective cases and a more chill life if you are working towards gynecology or if you're going towards infertility because everything is going to be planned. It is not going to be elective. It is not going to be off.
But during your residency, if you're doing, you have to do both. You have to do the off practice also, gynecology practice also. So that is when you have to be, you know, always on your toes because the senior can tell you anything. And even if the senior is saying something, you have to forget that and move ahead and keep working. You also have to be very smart about when to operate and when not to operate. These are key things that you learn in your residency and then apply in your practice when you're in your office.
If you're looking for a chill life where you can sleep for six to seven hours, maybe eight hours a day, gynecology, obstetrics, and gynecology obstetrics are not for somebody who can take all the stress and work under pressure. For becoming an obstetrician and gynecologist, you should be somebody who can handle the stress because we have a lot of night duties, and the night duties are you know, they're very heavy, where we have to deliver a lot of babies and we have to do a lot of various sections. So you always have to be on your toes.
You cannot just sit calmly. So this branch is not for somebody who wants to relax and have a good life where the person is relaxing and having like eight or nine hours of sleep and all. This branch is not for that person. This branch is for the person who can take on all the stress and work under pressure because in the obstetric way, and you can actually divide the branch. So now this is obstetrics and gynecology.
So now, obstetrics is something that deals with the baby. So in obstetrics, you always have to be on your toes. But if you go more towards gynecology, it is more surgically chill, but surgically it is going to be more challenging. But it is more relaxed. You can have your elective cases and a more chill life if you are working towards gynecology or if you're going towards infertility because everything is going to be planned. It is not going to be elective. It is not going to be off.
But during your residency, if you're doing, you have to do both. You have to do the off practice also, gynecology practice also. So that is when you have to be, you know, always on your toes because the senior can tell you anything. And even if the senior is saying something, you have to forget that and move ahead and keep working. You also have to be very smart about when to operate and when not to operate. These are key things that you learn in your residency and then apply in your practice when you're in your office.
If you're looking for a chill life where you can sleep for six to seven hours, maybe eight hours a day, gynecology, obstetrics, and gynecology obstetrics are not for somebody who can take all the stress and work under pressure.
Stress at work and the desire for a quicker solution to achieve their goal of having a child often lead individuals to seek assisted reproductive technologies (ART) rather than trying to conceive naturally.
Dr. Tanuj Lawania
Priya Bairagi: Is it advisable to use pills to suppress menstruation for ritual purposes, considering the potential hormone-related disturbances in the body? Additionally, regarding the product V wash heavily promoted on social media, is it recommended for use, given its visibility on these platforms?
Dr. Tanuj Lawania: Like you mentioned, if somebody is taking medication to delay their period because they have a medical reason, that is not a problem. If you have consulted a gynecologist and you're taking it under supervision, it will not cause any issues because you're taking it only once. What it will do is, if you've taken it for that duration of time, the period will get delayed by maybe a week or 10 days. So, your next cycle will come later. For example, if your cycle was supposed to come on the 24th, and you took the medication, it might come around the 31stt or the 1st and 2nd , as your cycle length gets shifted.
There are certain occasions where people can take hormonal pills, but it has to be directed by a gynecologist because only a gynecologist knows what history needs to be extracted from the patient before prescribing hormonal pills.
I'd like to emphasize that people should avoid buying any kind of hormonal pills or medical abortion pills from pharmacies without a prescription. In India, it is quite common for people to purchase unprescribed abortion pills from pharmacies. Government guidelines also support the need for these hormonal pills to be dispensed only on prescription.
Regarding your second question, your vagina is a self-cleaning organ, and you don't need special washes to clean it. Using plain water is sufficient. When you use extra products, it can alter the pH of your vagina and make you more susceptible to bacterial and fungal infections. Vaginal wash products like V wash are specifically designed for cleaning the vulva, the outer genital area, not the inside of the vagina. Using washes or soaps inside the vagina can disrupt its natural pH balance and potentially lead to issues.
Stay tuned for the third part of this interview!
