Welcome to Dr. Rama Sofat Hospital and Dr. Ruchika's Fertility and Test Tube baby Centre where our motto is "Commitment" For Excellence". It offers the very best in the speciality of Obstetrics, Gynecology and Infertility Management. The hospital is headed by Dr. (Mrs.) Rama Sofat who had been Prof. & Head of Department of Obstetirics & Gynaecology at Dayanand Medical College & Hospital, Ludhiana. She has vast experience of over 35 years in the speciality and has trained many specialists who are settled all over the world. Her main associates in the hospital are Dr. Amit Sofat and Dr. (Mrs.) Ruchika Sofat. Dr. Amit has done his MD in Ob/ Gynae from PGI, Chandigarh and has specialised in Endoscopy, Hysteroscopy, Sexual Medicine and Ultrasonography. Dr. Ruchika has done her M.S. in Gynaecology from Gwalior and has specialized in IVF and Ultrasonography. They are assisted in their venture by an embryologist, neonatologist, lab specialist, general surgeon, anaesthetist and a psychiatrist. The administration is looked after by retired Principal, Dr. J.R. Sofat, who also heads the dental department & all types of modern dental treatment is carried out here.

This hospital is a leading institution where every possible treatment in the specialty of Obstetrics, Gynaecology and Infertility management is carried out under one roof. The hospital is very well staffed with experienced and highly qualified medical and paramedical personnel and is very well equipped with latest machinery so that the very best can be achieved. Besides an all out sympathetic, personalised and homely environment is available all the time.

It is a modern building, situated on main College Road with sufficient parking space There are two operation theatres, two labour rooms, IVF Block, OPD block and AC rooms. Our hospital is recognised for traetment of employees of PAU and SBI and also approved by most insurance companies to offer cashless facility.

Our Team

Dr. (Mrs.) Rama Sofat
MBBS.(Gold Medalist), MD (P.G.I., Chd.) FRSH (Eng.) MNANS, FICOG, Former Professor & Head (Ob/ Gynae) DMC, Ludhiana	Chief Gynaecologist & Obstetrician, Gynae Endocrinologist Intertility Specialist

Dr. (Mrs.) Ruhika Sofat
MBBS, (Gold Medalist), MS Diploma Ultrasound, Cert. Infertility	Gynaecologist & Obstetrician. Ultrasonologist Infertility IVF Specialist.

Dr. Amit Sofat
MBBS, (Medalist), MD (P.G.I. Chd.) Cert. Fetal Medicine Cert Endoscopy (AIIMS) Cert. Sexual Medicine	Gynaecologist & Obstetrician, Gynae Endoscopic & Hysteroscopic Surgeon, Ultrasonologist, Sexual Medicine Specialist. Infertility Specialist

Dr. Nirmal Bhasin
MD	Embryologist, Genetist

Dr Jagrup Kaur
MBBS, DCH	Paediatrician

Dr. Gaurav
MBBS, MD	Anaesthetist

Dr. Atima Gupta
MBBS, MD	Pathologist

Dr. J.R. Sofat
MDS, FRSH (Eng.), COM (U.S.A)	Dental Surgeon

Dr. Ravinder Singh
MBBS, MS.	General Surgeon

Our Services

1. High risk pregnancy management. Painless delivery and sitchless caesarian.

2. All types of Gynaecological Surgery.

3. Gynaecology Plastic Surgery operations such as Metroplasty Vaginoplasty.

4. Gynae Cancer Surgery.

5. Laparoscopic removal of uterus/ ovaries. Morcellator (Gyne Care USA)- a device to remove uterine fibroids through key hole surgery. This machine is first one installed at our hospital in Ludhiana.

6. Hysteroscopy of uterus - Diagnostics& therapeutic.

7. Balloon Therapy-USA for curing heavy periods. Ten minutes therapy without removal of uterus. No scar, no stitches, no anesthesia, no admission

8. Treatment for no menstruation or scanty menstruation.

9. Recanalisation of blocked tubes and reunion of cut/ tied tubes for infertile couples.

10. Removal of uterus (without opening the abdomen) from below - non-descent vaginal hysterectomy. (N.D.V.H)

11. Treatment of repeated abortions with medicines.

12. Abortion with medicines only.

13. Cryosurgery for precancerous lesions of uterus.

14. Excellent well equipped Nursery for new born babies.

15. Vaccination and treatment of children.

16. Diagnostic/ Investigation services.

a) Modern Lab tests including hormonal assays.

b) Routine X-Ray and Specialized X-Rays Like HSG, Barium Meal. etc.

c) ECG

d)Two ultrasound machines with linear, sector and vaginal probes for ovulation monitoring.

e) Video Colposcopy for early detection of female genital cancer.

f) Genetic Counseling Centre - For diagnosis of defects of baby before birth (approved by Punjab. Government)

g) Laparoscopy and Hysteroscopy.

h) Bone densitometry.

17. General Surgery operations.

18. Assisted reproductive Treatment (ART) for treatment of infertility such as IUI, IVF, ICSI

19. Semen Bank for infertile couple in case of male with No/ Less Sperms

20. Sexual Disfunction Clinic,

21. Family Planning and Contraceptive Services.

22. Clinic for post menopausal woman.

23. All kinds of modern dental treatment available here.

Ruchika's Fertility and Test Tube Baby Centre .

This is a part of Dr. Rama Sofat Hospital and caters to the infertile patients. This centre provides the most scientific, latest and personalized services. The centre is furnished with latest state of the art machines so that world class treatment may be carried out here. To accomplish the high level of results the centre has got three highly experienced M.D. Gynae doctors in the team who are trained in the different areas of management of infertility aspect.

Dentistry

All types of Dental Treatment is camed out by Dr. J.R. Sofat who has been the head of dental department at DMC Ludhiana for 35 yrs & has been formerly the Principal of dental College Sunam Presently is the Director cum Professor at B.J.S Dental College Ludhiana. All types of dental treatment such as periodontal treatment , smile designing, orthodontic treatment, dentures, crown & bridge work are carried out here.

Surgery

All kinds of general surgery are carried out at this hospital. We remove of Gall Bladder Stones/ Ureteric Stones/ Kidney Stones/ Appendix/ Hernia, Pile/ Prostate etc. These surgerie are carried out by Dr. Ravinder Singh M.B.B.S, M.S. (General Surgen) All the surgery are done routinely through key hole surgery

Infertility

What is Infertility

Infertility implies apparent failure of a couple to conceive. To be issueless is a serious social problem which is a cause of a great mental stress. A couple is labelled as infertile when the female fails to conceive even after one year of unprotected intercourse with her male partner. The causes of infertility are :-

40 % in male

40 % in the Female

10 % in both male and female

10 % unknown

The number of infertile females in the world is approximately 100 millions with an incidence of 10-15 %.

Causes Of Infertility

There are innumerable causes which need meticulous and systematic investigation.

Causes In Male

1.	Semen : The number, morphology and motility of sperms is not adequate. This can be due to stress, addiction to tobacco, alcohol and other drugs, mumps, hormonal disturbances, hypothyroidism, diabetes, obesity, advancing age etc.

2. Inability to deposit the semen into vagina due to defects in penis, premature ejaculation etc. 1 to 2 % couples are found to have unconsummated marriage.

3. Infrequent coitus or no coitus during fertile phase.

4. Use of lubricants during coitus.

Causes In Female

1. Congenital absence of vagina or uterus and/ or hypo plastic uterus.

2. Ovarian insufficiency which means eggs do not form properly. It is responsible for 30-40 % of female infertility . This happens due to disturbance of hormones. This is manifested as disturbed or no menstruation, growth of hair on face, milk like secretions from breasts etc.

3. Blocked fallopian tubes. This represents 15-20 % cases. This can result from T.B., venereal diseases and inflammation of uterine lining following infection.

4. Defects in Uterus : Small size, divided uterus with septa, presence of fibroids in uterus etc.

5. Defects In Vagina:- Vaginal inflammation, presence of septa, imperforated hymen and presence of tumors.

6. Defects in cervix or mouth of uterus : Its position, presence of growth, hostile mucus etc.

7. Immunological factors :- Presence of anti sperm antibodies in semen or in cervical mucus.

8. Peritoneal Factors.

9. Genetic and unknown causes.

10. Other related factors :- Anxiety, Obesity, Addiction to drugs etc.

EVALUATION OF INFERTILITY :

It includes history, examination and certain tests. It is very important to find the cause of infertility so that a successful treatment is carried out. Hence both male and female partners have to be investigated. The husband and wife should be questioned separately so as to give any confidential secrets and then together. They should be asked regarding age, active married life, previous marriages, frequency and timing of coitus, sexual dysfunction, menstruation, use of drugs and any addiction.

Both partners should be thoroughly examined. In the female, after general physical and abdominal examination, vaginal examination should be done to assess vagina, cervix, uterus and any enlargement or fixation of appendages. Many times only a minor defect is there which can be easily corrected . Investigation is done on following lines :-

Tests for the Male

1. Semen analysis : it should be done after 2-3 days of abstinence of sex. It includes sperm count, morphology, motility, presence of infection etc.

2. Hormonal assays.

Tests For Female

1. Blood tests for hormones.

2. Testing the lining of uterus prior to/ during menstruation.

3. Uterus examination by Ultrasonography/ Hysteroscopy.

4. Examination of ovaries, fallopian tubes and peritoneum by laparoscopy.

5. T.V.S Sonography for ovulation monitoring.

6. Testing the fallopian tubes - Hystero Salpingography

7. Evaluation of cervical mucus.

Advice To Couple

Personal life of the couple should be full of love and free from stress and worry. If any one is suffering from high B.P., diabetes and V.D. etc., it should be treated The couple should avoid use of all addiction. The weight should be under control. Aim should be to produce the baby soon after marriage. The fertility reduces with advancing age. Couple is explained about fertile period and advised to achieve pregnancy during that period. For a pregnancy to occur, the following conditions are needed :-

1. Ovulation - Egg formation.

2. Sperm count must be adequate.

3. Intercourse during fertile phase.

4. Cervical mucus must not be hostile to sperms.

5. There must not be any obstruction to fertilization.

Rationale Of Treatment for Female :-

1. Hormones and drugs to improve ovulation.

2. Treatment for blocked fallopian tubes.

3. Treatment for Polycystic ovaries.

4. Treatment for uterine fibroids and uterine/ cervical polyps.

5. Diagnostic and operative laparoscopy and hysteroscopy.

Treatment Of Infertility

A. Surgical Treatment :- After evaluation, the doctor may pin point the effect. Quite often, surgical treatment alone is enough to remove the cause of infertility and thus eliminating the need for ART. Operative Laparoscopy and Hysteroscopy can correct some major causes of infertility such as endometriosis, polyps, fibroids, congenital abnormalities, pelvic adhesions and diseases of ovaries. Blocked fallopian tubes are also opened surgically.

B. Induction of Ovulation :Ovaries are stimulated with drugs to produce multiple eggs thereby improving chances of fertilization. Thereafter one can resort to natural means or artificial insemination.

C. Assisted Reproductive Technologies (ART) : When other treatments fail, only then we recommend ART whereby a very meticulous care and highly standardized procedure is followed.

1. Intra Uterine Insemination (I.U.I) :- It is an effective and first line of treatment in cases of subnormal semen quality, hostile Cervical mucus, sexual dysfunction, retrograde ejaculation and unexplained infertility. In this procedure female partner is given fertility drugs to stimulate ovaries to produce more eggs so that chances of pregnancy improve. The IUI is usually performed between day 12 and 15 after the onset of periods depending on the ovulation which is determined with the help of vaginal ultrasound. The male partner provides semen sample two hours prior to insemination. Active sperms are then separated by advanced semen preparation and thereafter suspended in a special culture medium. About half ml. of this preparation is deposited high in uterus near the openings of fallopian tubes which completes the process of IUI. The procedure is painless. The patient lies down for 30 minutes before going home. There are no physical restriction after IUI. The IUI-D also called donor Insemination may be resorted to where male partner has less or no sperms.

2. IVF-ET. This is common type of Artificial Reproductive Technique (ART). The eggs are aspirated out of the ovaries under Ultrasonographic guidance. Sperms and eggs are then placed together in a test tube or a petridish under a special body like environment. After fertilization the embryo is placed in the uterus where it grows naturally.

With the help of hormones and injections, we produce many eggs which on maturity are taken out with a special needle under the guidance of a Trans Vaginal Sonography (TVS) and placed in Co² incubator. Then good quality sperms from male's semen are separated and placed in Co2 incubator. After 3-4 hours a specific quantity of sperms are placed along each egg and again placed in Co² incubator. After 2 or 3 days the fertilized eggs are deposited in uterus with the help of a special catheter. Not more than 3 embryos are transferred . If implanted, the pregnancy will grow like in a normal woman. The success rate, the world over about 30-35 %

Other Option Like IVF-ET

a) Gamete Intra fallopian transfer (GIFT). Here eggs and sperms are directly placed in the fallopian tubes.

b) Tubal Embryo Transfer : (ZIFT) Here fertilized eggs are placed in the fallopian tubes.

c) Donor Oocyte (eggs) and Donor Sperm :- Some women and some men are not able to produce healthy eggs and sperms respectively. In such case IVF-ET can be donation of Oocyte and sperms from known or unknown donors. Donor Insemination is also possible.

d) Intra Cytoplasmic Sperm Injection. (ICSI) This method is used where sperm count is very less. In this procedure a single sperm is injected into the egg with the help of a sophisticated machine called micro manipulator which aids in fertilization.

e) Assisted Hatching :- In some cases the Zona pellucida i.e. the shell surrounding the eggs is hard and sperms are not able to penetrate it. A hole is drilled with laser into the shell of the egg thereby helping the sperm to fertilize the egg.

f) Micro Epididymis Sperm Aspiration (MESA) and Testicular sperm Aspiration (TESA) are resorted to where sperms are formed but do not find their way out in the ejaculate

Dr. Rama Sofat Hospital & Dr. Ruchika's Fertility (IVF)
And
Test Tube Baby Centre
Address: 435, College Road, Near Malwa Girls School,
Ludhiana-141 001. (Pb.)
Telefax +91-161-2410400, 2410500
Mobile +91-98147-04712-98147-04714
E-mail info@ramasofathospital.com
Website : www.RamaSofatHospital.com

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