Pregnancy & Fertility

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IVF is more than just a medical procedure—it’s an emotional journey filled with hope and challenges. While uncertainties may arise, the right support system, emotional resilience, and expert guidance can make a significant difference. Advances in science have made parenthood possible for many, and no matter where you are in the process, hope remains within reach. This journey is yours to navigate, on your own terms and in your own time.

 When Should You Consider A Test Tube Baby  

Fertility

<h3>What is Anti-mullerian hormone (AMH) and what does the test tell you?</h3> If you're on a journey to parenthood and have come across the AMH test, you might be wondering—what does this really mean for you? Well, let’s break it down without the scary medical jargon. Think of your Anti-Müllerian Hormone (AMH) levels as a little sneak peek into how many eggs your ovaries still have in reserve. It’s not a verdict on your fertility—just a way to help you and your doctor make informed choices. But before you start stressing, remember: this is just one piece of the puzzle, not the whole story.&nbsp;<h3> What is the purpose of the AMH test?</h3><ul><li>Your Egg Reserve:&nbsp;Imagine your ovarian reserve like a box of chocolates (because everything is better with chocolate, right?). Over time, the number of chocolates slowly decreases. An AMH test helps estimate how many chocolates (eggs) are still in the box, but it doesn’t say anything about their quality—so don’t stress too much!</li><li>How You Might Respond to Fertility Treatments: If you're considering IVF or other fertility treatments, knowing your AMH levels can help your doctor customize the right dose of fertility meds for you. It’s all about giving your body the best chance to produce multiple eggs and increasing the odds of success.</li><li>Beyond Fertility—What Else Can AMH Tell You? PCOS &amp; Other Ovarian Conditions:&nbsp;If your AMH levels are higher than expected, it could be a sign of Polycystic Ovary Syndrome (PCOS) or other ovarian conditions. But here’s the good news: early awareness means better management! Whether it's lifestyle changes, medication, or fertility guidance, knowing your AMH levels helps you take control.</li></ul><h3>When should you do an AMH test?</h3>Whether you're planning for the future, exploring fertility treatments, or simply curious about your ovarian reserve, this test provides valuable insights without any extra stress. Let's break it down!&nbsp;Age &amp; AMH: What’s the Connection?<ul><li>In Your 20s? If you're not yet thinking about starting a family, you might not need an AMH test. But, if you have&nbsp;irregular cycles, a history of fertility challenges, or want to explore options like egg freezing, it's a great way to give yourself more clarity for the future.</li><li>Between 30-35? This is a great time to check your AMH levels—even if you're not ready for kids right now.&nbsp;Knowing your ovarian reserve can help you make informed decisions about your fertility timeline and plans. It's about having more control and understanding of what's going on inside.</li><li>Over 35? As fertility begins to naturally decline after 35, testing your AMH levels can be an essential part of understanding where you stand. Whether you're ready to try for a baby, considering egg freezing, or exploring IVF, knowing your AMH gives you the information you need to make confident decisions.</li></ul>Life Situations<ul><li>&nbsp;Exploring IVF, egg freezing, or egg donation? If you’re thinking about these options, an AMH test can help guide your path by giving your doctor an idea of the best treatment approach.</li><li>Dealing with irregular periods or reproductive health issues?&nbsp;Conditions like PCOS, endometriosis, or other reproductive concerns might impact your fertility. An AMH test can give important insights into your ovarian reserve and fertility potential. Not ready for children yet, but want to plan for the future? Even if you're not ready now, knowing your AMH levels can help you understand your fertility window and give you the space to plan your next steps.</li></ul><h3>When Should You Test?</h3>Worried about the timing? Don’t be! AMH levels are fairly stable throughout your menstrual cycle, so you can take the test at any point during the month—making it easy to fit into your schedule. Fertility is a deeply personal journey, and it’s totally okay to take it one step at a time. Whether you’re planning for the future or just want more clarity, an AMH test can provide you with the knowledge you need to move forward with confidence.&nbsp;<h2> What is the purpose of the AMH test?</h2><ul><li>In the Womb: Before you're even born, AMH plays a role in shaping reproductive organs. In males, it helps form male structures, while in females, it steps back, allowing the uterus, fallopian tubes, and ovaries to develop.</li><li>Through Childhood &amp; Puberty: If you’re female, AMH levels are naturally low until puberty, when your ovaries start producing more of it. The follicles inside your ovaries (the tiny sacs that hold immature eggs) make AMH, which means higher levels = more eggs in reserve.</li><li>As You Age:&nbsp;Over time, your ovarian reserve naturally declines—because, well, biology! But that doesn’t mean your dreams of motherhood are out of reach. Science is on your side, and knowing your AMH levels can help you make informed decisions, whether you’re thinking about conception now or planning for the future.&nbsp;&nbsp;</li></ul>&nbsp;<h3> What can't an AMH test tell you? &nbsp;</h3>You might be feeling curious and maybe a little bit anxious about what AMH testing means for your fertility journey, so let's take a moment to chat about what&nbsp;AMH can&nbsp;and can’t tell you. It’s important to keep in mind that this test is just one part of the bigger picture. Here's what AMH can’t fully predict—so you can go into your test feeling more at ease and informed!&nbsp;1. Egg QualityWhile AMH levels are a great indicator of your egg reserve (how many eggs you have left), they don’t tell you about the quality of those eggs. And yes, egg quality naturally declines as you age, but remember: every woman’s journey is unique, and having a lower AMH doesn’t mean you won’t have successful treatments. You can still have healthy eggs, even if your numbers are a little lower!&nbsp;2. Fertility PotentialAn AMH test is a valuable tool, but it’s just one piece of the puzzle. It doesn’t give you a full picture of your chances of pregnancy, because there are other key players—like sperm quality, fallopian tube health, and the health of your uterus—that also contribute. Don’t stress! The combination of all these factors gives your doctor a better sense of what might work best for you.&nbsp;3. Exact Timing of MenopauseIt’s true that low AMH levels can give you a hint that menopause may be approaching, but it won’t give you the exact date. Think of it like a guide that helps you understand your timeline more, but it can’t provide a precise prediction. And remember, everyone’s timeline is different, so don’t let that number define you.4. Ovulation StatusAMH levels don’t directly tell you whether you're currently ovulating or not. Ovulation is a whole different process that involves more than just your AMH levels. If you’re unsure whether you're ovulating or having irregular cycles, it’s a good idea to check in with your doctor about other tests that could give you a clearer answer.<h3> What is a good AMH level for your age?</h3>It’s totally normal for your AMH levels to decrease as you get older. So, if you're in your 30s, 40s, or even 50s, you might notice your ovarian reserve is a bit lower. Here's a general idea of what the numbers might look like as you age, just to give you an idea:<ul><li>At 25, you might have around 3.0 ng/mL.</li><li>By 30, it could be around 2.5 ng/mL.</li><li>At 35, it might drop to about 1.5 ng/mL.</li><li>By 40, you might be looking at 1 ng/mL.</li><li>Around 45, it could go as low as 0.5 ng/mL.</li></ul>But hey, remember higher AMH levels don’t always mean everything’s perfect! Some people with PCOS can have higher AMH, and that’s a condition that needs its own care and attention. So, always keep in mind that numbers are just one part of the picture when it comes to your fertility journey!<h3>Do at-home AMH tests work ?&nbsp;</h3>You might have seen that AMH tests are available in stores or online, and yes, at-home versions are out there too! They’re super convenient, and all it takes is a quick finger prick to get started.&nbsp; But here's the thing: while it's tempting to go the DIY route, the best thing you can do is connect with a fertility specialist to go over your results.&nbsp; Why? Fertility is a lot more than just a number, and having an expert in your corner can help you truly understand your unique situation and make sure you’re on the right track. Your fertility journey is so personal, and having that professional guidance can help make the whole process feel a lot more empowering!&nbsp; &nbsp;<h3>Process of AMH test</h3>The AMH test is pretty straightforward and, honestly, it’s not that bad! You might feel a quick pinch when the blood is drawn, but most people describe it as a brief, bearable moment of discomfort. Afterward, there’s minimal risk, and you could feel a tiny bit of soreness or even some light bruising where the needle went in but don’t worry – these sensations usually go away pretty quickly. &nbsp;<h3>The ideal time to schedule AMH test</h3>Your AMH levels stay pretty stable throughout your cycle, which means you're in control of when you want to take this step. Whether it's a busy Monday morning or a quiet weekend, the timing is completely up to you. Think of it as your body's way of making things a little easier during what can be an emotional journey. &nbsp;<h3>How do you prepare for the AMH test?</h3>To prepare for an AMH (Anti-Müllerian Hormone) test, you do not need to do anything special; no fasting is required, and you can take the test at any point during your menstrual cycle as AMH levels remain relatively stable throughout the month.&nbsp; Benefits of getting your AMH tested<ul><li>It’s a Fertility Check-In, Not a Deadline! If you’re trying to conceive (or thinking about it for the future), an AMH test can give you valuable insights—but it’s not a pass-or-fail test for pregnancy. Many people with lower AMH levels still go on to have healthy pregnancies.</li><li>&nbsp;Your Ovarian Reserve, Your Timeline! Every woman’s reproductive journey is unique. With career goals, lifestyle choices, and different priorities, there’s no single “right time” for motherhood. If you’re exploring options like egg freezing or IVF, knowing your AMH levels can help you plan ahead.</li><li>Menopause Insights: Wondering where you stand on your hormonal journey? AMH levels can offer clues about when menopause might be approaching—but don’t worry, they won’t give you an exact expiration date!</li></ul>Your fertility is as unique as you are. An AMH test isn’t here to define you—it’s here to empower you with information so you can make the best choices for your body and future. No matter where you are on this journey, you are not alone, and there is always hope.<h3>Conclusion</h3>The AMH test can offer you some really important insights, whether you’re trying to understand your fertility better or thinking ahead for the future. It’s a helpful step in your journey, especially if you’re facing challenges along the way. But here’s the thing—your AMH level is just one piece of the puzzle! By chatting with a healthcare professional, you’ll get the full picture and a deeper understanding of what the results mean for YOU. This way, you can take a thoughtful, personalized approach to your fertility and your reproductive health. Remember, it’s about embracing both the science and your own unique story—one step at a time.&nbsp;<h3> FAQs</h3> Q. Why is the AMH test important for fertility? A. An AMH (Anti-Müllerian Hormone) test plays a key role in fertility by offering valuable information about a woman's ovarian reserve, which shows how many eggs remain in her ovaries. This helps doctors evaluate her fertility potential and design the best treatment plans, especially for those looking into IVF, by predicting how her ovaries will respond to stimulation medications. &nbsp;Q. How is the AMH test performed? A. An AMH test is done by taking a small blood sample from a vein in your arm using a needle. The sample is then sent to a lab where the level of Anti-Müllerian Hormone (AMH) is measured. This test can be performed at any time during your menstrual cycle, as AMH levels stay fairly consistent throughout, and no special preparation is needed. Q. What are considered normal amh levels? A.&nbsp;A typical AMH (Anti-Müllerian Hormone) level for women of reproductive age is usually between 1.0 and 4.0 ng/mL, with the ideal range for IVF stimulation being between 1.0 and 3.5 ng/mL. However, it's crucial to understand that normal AMH levels can vary by age, and a healthcare provider should interpret your results in the context of your unique situation.&nbsp;Q. Can amh levels predict menopause onset? A. AMH (Anti-Müllerian Hormone) levels can provide an overview of ovarian reserve and may suggest an increased risk of early menopause. However, they are not able to accurately predict the exact timing of menopause due to variations between individuals and limitations in precision. While a low AMH level may indicate a higher chance of earlier menopause, it cannot determine the specific moment it will begin. &nbsp;Q. Do amh levels fluctuate during the menstrual cycle? A. AMH (Anti-Müllerian Hormone) levels typically remain stable throughout the menstrual cycle, so you can have an AMH test done at any time during your cycle to accurately evaluate your ovarian reserve. Research indicates that there is little to no fluctuation in AMH levels during the month. &nbsp;Q. Can lifestyle factors affect amh levels? A. Lifestyle factors such as smoking, heavy alcohol use, poor nutrition, chronic stress, and some medications can influence AMH (Anti-Müllerian Hormone) levels, which reflect ovarian reserve, potentially leading to a decrease. However, the extent to which these factors affect AMH levels can vary from person to person and may not always be enough to fully counteract the natural decline in ovarian reserve due to aging. &nbsp;Q. Is the amh test covered by insurance? A.&nbsp;Whether an insurance plan covers an AMH test depends on the plan and the reason for the test. You can check with your insurance provider to see if your plan covers the test Q. How do amh levels influence ivf treatment plans? A.&nbsp;AMH (Anti-Müllerian Hormone) levels significantly influence IVF treatment plans by indicating the number of eggs a woman has in her ovarian reserve, which helps doctors determine the optimal dosage of fertility drugs needed for ovarian stimulation, with higher AMH levels suggesting a larger pool of eggs requiring potentially lower medication doses and vice versa for low AMH levels, allowing for tailored treatment plans to maximize success rates &nbsp;Q. Are there ways to improve low amh levels? A.&nbsp;While directly increasing AMH levels is not possible, you can potentially improve your overall reproductive health and potentially optimize AMH levels by adopting a healthy lifestyle including a balanced diet rich in antioxidants, vitamins, and minerals, regular moderate exercise, stress management, maintaining a healthy weight, and limiting exposure to toxins; however, it's important to consult a fertility specialist to understand your specific situation and potential treatment options &nbsp;

The AMH test can offer you some really important insights, whether you’re trying to understand your fertility better or thinking ahead for the future. It’s a helpful step in your journey, especially if you’re facing challenges along the way. But here’s the thing—your AMH level is just one piece of the puzzle! By chatting with a healthcare professional, you’ll get the full picture and a deeper understanding of what the results mean for YOU. This way, you can take a thoughtful, personalized approach to your fertility and your reproductive health. Remember, it’s about embracing both the science and your own unique story—one step at a time. 

What is AMH test?

By Dr. Annanyaa Reddy &nbsp;Endometriosis is a chronic inflammatory condition that brings challenges such as severe pelvic pain and difficulties getting pregnant. It is relatively common, affecting around 10% of adolescents and women of the reproductive age group (15-49 years) globally. Some women face this condition post-menopause as well. Nearly 26 million women in India have endometriosis. Around 25-50% of women with infertility and 50-80% of women with pelvic pain are diagnosed with endometriosis.&nbsp;Despite its high prevalence, many women are unaware of endometriosis and suffer for a long time without receiving the appropriate help. Today, let’s break this cycle and explore everything about endometriosis: symptoms, causes, risk factors, diagnosis, and treatment.&nbsp;<h3>Let’s Start with the Basics! What Is Endometriosis?</h3>Endometriosis is a uterine condition. During the first phase of the menstrual cycle, estrogen causes the endometrium (uterine lining) to grow and thicken inside the uterus in preparation for potential pregnancy. When conception does not happen, this lining sheds and exits the body through the vagina during a menstrual period.&nbsp; &nbsp;<figure class="image"><img style="aspect-ratio:602/385;" src="https://lh7-rt.googleusercontent.com/docsz/AD_4nXexB3Odpf2UAyU46EeUrD-BbnzFIX3j-__rKHVkGila6jM_96ViBVgwdwfXaRuVmqx5BCaIK-l3zx8c6ax1Onh9cAEit8P6U3-guCfgaRd9EsJVhEN9Q9hDG7OO7f-NqEhBbuIaEe2MvjEnIszCYyiZZUM?key=ojt4eWTs_Y31yc-YIY_USA" width="602" height="385"></figure>In endometriosis, tissue like the uterine lining grows outside the uterus, such as over the ovaries, fallopian tubes and other pelvic organs. Rarely, it can also develop in different body parts like the lungs, nose, brain, or over surgical scars.&nbsp;Endometrial tissue also responds to estrogen, undergoing growth, thickening, and shedding during menstruation. The only difference is that they cannot leave the body entirely since they are in abnormal places. As a result, the body experiences inflammation, scar tissue formation, ovarian cysts, and adhesions binding pelvic tissues and organs together.<h2>Signs and Symptoms of Endometriosis You Should Know</h2>The most common symptom of Endometriosis is chronic pelvic pain that lasts for over six months.&nbsp;<figure class="image"><img style="aspect-ratio:602/401;" src="https://lh7-rt.googleusercontent.com/docsz/AD_4nXeSbpuKLwm8OFIz7nS9U60QjfQKSsH1kUox8Wg4-dFd7gF13GUnghq-181cxj-jZAo_s-Jdr7a2Ljxc3KvrFYQdkPHABj2Xn6UpOWIMLVLGVY2B0qthYHK8Jct4s9tFuRePUB5H_ChRLs_gKff3zSIJvPUl?key=ojt4eWTs_Y31yc-YIY_USA" width="602" height="401"></figure>However, women with endometriosis may also have the following symptoms:<ul><li>Painful periods (pain may start before a period, continue during menstruation and remain for a few days afterwards)</li><li>Heavy menstrual flow</li><li>Spotting or bleeding in between periods</li><li>Pain during or after sex</li><li>Pain with bowel movements or urination</li><li>Rectal bleeding</li><li>Bleeding with urination</li><li>Difficulty getting pregnant&nbsp;</li><li>Fatigue&nbsp;</li></ul>More useful highlights around the signs and symptoms of endometriosis:&nbsp;<ul><li>Some women with endometriosis may also have less common symptoms such as chronic cough, chest pain, and shoulder tip pain.</li><li>Women with endometriosis-related ovarian cysts may experience abdominal pain along with pelvic discomfort.&nbsp;</li><li>Women having endometrial tissues growing in or around their surgical scar may experience recurring pain and swelling in that area, particularly during menstruation or intercourse.</li><li>In high-risk women, endometriosis can occur with a few other conditions, such as pelvic inflammatory disease and irritable bowel syndrome.&nbsp;</li><li>Many women will not have any symptoms of endometriosis and only find out about the condition when they face difficulties getting pregnant.</li></ul><h2>Common Known Causes of Endometriosis</h2>Researchers and doctors are yet to understand the causes of endometriosis. At present, there are various theories about why this condition develops. Let’s explore the popular ones:&nbsp;<ul><li>Genetics: Evidence suggests that women having a family history of first-degree relatives (mother or sister) with endometriosis are 7-10 times more likely to have the condition.&nbsp;</li><li>Direct transplantation:&nbsp;During surgeries such as c-sections, hysterectomies, or laparoscopic procedures, pieces of endometrial tissue can transfer and grow on various pelvic organs or structures outside the uterus.&nbsp;</li><li>Stem cell theory:&nbsp;Stem cells play a role in regenerating the endometrium (uterine lining) after it sheds during menstruation. Endometriosis occurs when these stem cells develop into endometrial cells and implant in areas beyond the uterus.</li><li>Retrograde menstruation theory: For a long time, experts believed endometriosis happened when the menstrual blood flowed backwards (retrograde) through the fallopian tubes, attached to the organs in the pelvis, and continued to grow there. However, this theory is unreliable, as endometrial implants sometimes occur in areas beyond the pelvis. Moreover, retrograde menstruation is relatively common and does not usually cause problems.</li></ul><h2>Risk Factors of Endometriosis</h2>Various factors that can increase the risk of endometriosis include:&nbsp;<ul><li>Low weight at birth</li><li>Never given birth</li><li>Being underweight&nbsp;</li><li>Early onset of menstruation (before 11 years of age)</li><li>Shorter menstrual cycles (27 days or less)</li><li>Heavy menstrual periods&nbsp;</li><li>Late menopause</li></ul><h2>Why Is It Challenging to Diagnose Endometriosis?</h2>Most women with endometriosis are not diagnosed until nearly 7-10 years after developing the condition. Despite medical advances, what is the reason behind delayed diagnosis?&nbsp;Multiple factors are at play in this situation. Firstly, our society normalises pain, which largely influences a woman’s decision to seek help when necessary. Secondly, the signs and symptoms of endometriosis often overlap with other health conditions, such as irritable bowel syndrome, interstitial cystitis, adenomyosis, and pelvic inflammatory disease.&nbsp;Moreover, the severity of symptoms often doesn’t correlate with the extent of the disease. It means if you have unbearable pain, it does not necessarily mean your endometriosis has spread aggressively. Neither does little to no pain indicate lesser endometriosis growth. All of this combined leads to diagnostic challenges.&nbsp;That being said, if you think you may have endometriosis based on the symptoms discussed earlier, consult your gynecologist without further delay! If left untreated, endometriosis can mean more sick days, constant tiredness, and mental health challenges. In short, it will significantly affect your quality of life.&nbsp;&nbsp;<h2>What to Expect During Your First Endometriosis Evaluation? How Should You Prepare for the Consultation</h2>Coming to the question: how will your gynecologist diagnose endometriosis? Here’s a step-by-step guide to help you understand what to expect during your consultation and how to prepare for it:&nbsp;<ul><li>Medical history review:&nbsp;The gynecologist will begin the appointment by briefly discussing your symptoms. Tell them when you first noticed your pain, where you feel it, how severe it is, when it occurs, and whether it worsens during your periods. You can expect them to discuss more about your menstrual cycle and infertility issues. They will also likely discuss your family history and other related details to rule out risk factors.&nbsp;</li><li>Pelvic exam: During the pelvic exam, the gynecologist will carefully insert one or two gloved fingers in your vagina to examine the areas of your pelvis. They will check for any abnormal signs such as pain, tenderness, ovarian cysts, and growths behind the uterus.</li><li>Diagnostic tests: Lastly, the gynecologist will order imaging tests like ultrasound and magnetic resonance imaging (MRI) to understand the spread, location, and size of endometriosis growths.</li></ul>After the diagnosis, the provider will discuss the findings with you and suggest a relevant treatment plan. More on this ahead!&nbsp;<h2>How to Treat Endometriosis? Explore Non-Surgical and Surgical Strategies</h2>Is there a permanent cure for endometriosis? The answer is no. But is it possible to manage endometriosis? Yes, absolutely! Using the right treatment plan, people with endometriosis can reduce pain, improve fertility, and enjoy a good quality of life.&nbsp;There’s no one-size-fits-all approach when it comes to endometriosis treatment. Gynecologists prepare individualised treatment plans depending on the severity of the symptoms and whether the woman hopes to become pregnant in the future.&nbsp;<h3>Pain Management</h3>The first-line of treatment is usually pain management This can be done through a combination of painkillers and exercise, specifically pelvic floor physiotherapy.Painkillers: NSAIDs (non-steroidal anti-inflammatory drugs) are often recommended to relieve painPelvic Floor Physiotherapy: Studies have shown that pelvic floor physiotherapy can relieve much of the pain caused by endometriosis. This is because when a person experiences pain at or around the uterus, the muscles surrounding create a guarding response (contracting or tensing up). This creates more tension in the pelvic floor and abdomen. Pelvic floor physiotherapy can stretch and strengthen the pelvic floor decreasing&nbsp;pain and improve overall mobility <a href="https://proactiveforher.com/blogs/pregnancy/how-physiotherapy-can-help-during-pregnancy/">here</a>. Medical ManagementThe gynecologist may recommend further medication if symptoms persists.&nbsp;&nbsp;<ul><li>Oral contraceptive pills and gonadotropin-releasing hormone (GnRH) to slow down the progression of endometriosis</li><li>Levonorgestrel-releasing intrauterine system to reduce menstrual flow, hormonal fluctuations, and endometriosis symptoms</li></ul>Non-medical treatment options: &nbsp;<figure class="image"><img style="aspect-ratio:602/401;" src="https://lh7-rt.googleusercontent.com/docsz/AD_4nXfwpt2tFlU0SFQExIVRRMu5W7yTlMQvAFqaLksqFaRJrcDNKwn_4Bu43iEY9w0PK6Yy6or2PNH4xY4UTIcNj2uKc8LcXkVlpEUNvyOJlqt0l-M7XSoUH1uIrGM9OncOsK53DfuugQ_kiJEYG9LRzooMvayT?key=ojt4eWTs_Y31yc-YIY_USA" width="602" height="401"></figure><ul><li>Start a pelvic floor physiotherapy exercise routine</li><li>Consume a balanced diet</li><li>Avoid alcohol and smoking</li><li>Join therapy and support groups</li><li>Take Pelvic floor physiotherapy</li></ul>Surgeries:&nbsp;<ul><li>Laparoscopic surgery to remove endometriosis tissue</li><li>Hysterectomy to remove the uterus</li></ul><h3>How Does Endometriosis Affect Fertility? What Are the Treatment Options?</h3>Endometriosis affects fertility in many ways. If the endometrial tissue is present in the ovaries, they can cause fluid-filled cysts and decrease the number of eggs, reducing the chances of pregnancy every month. In 30% of endometriosis cases, the condition affects the fallopian tubes. It prevents the egg released from the ovary from travelling through the fallopian tube into the uterus for fertilisation. In other cases, even if an egg gets fertilised, it may be hard to attach and grow in the uterus.&nbsp;Once the gynecologist understands your unique reason behind infertility, they can decide on the effective treatment options for you, such as:&nbsp;<ul><li>Medication management to reduce endometrial growth</li><li>Surgical removal or destruction of the endometrial implants</li><li>Egg freezing before surgery to preserve healthy eggs&nbsp;</li><li>Intrauterine insemination (IUI) or In vitro fertilisation (IVF)</li></ul><h3>Conclusion</h3>There are options for treating endometriosis! Many women with endometriosis mistake the condition for bad period cramps and heavy flow, suffering silently all their lives. They end up at a gynecologist's office only when they are not able to get pregnant.&nbsp;The takeaway here? If you or a loved one has any degree of pelvic or period pain, do not normalise it. It could mean many things, and endometriosis is one of them. Additionally, as the condition can occur without symptoms, routine gynecologist consultations should be a part of your healthcare plan. This way, your provider can keep a check on your sexual and reproductive health and detect any abnormalities early.&nbsp;At Proactive For Her, we are committed to helping women with tailored solutions for endometriosis.&nbsp;<a href="https://proactiveforher.com/experts/regular-gynaecology/?tag=regular-gynaecology&amp;specialization=all&amp;page=1&amp;sort=availability&amp;mode=offline&amp;clinic=78b9e873-ce70-4f06-b39a-8c4ae448a37d">Book a consultation</a> with any of our trustworthy and non-judgmental gynecologists today and receive the help you deserve.

There are options for treating endometriosis! Many women with endometriosis mistake the condition for bad period cramps and heavy flow, suffering silently all their lives. They end up at a gynecologist's office only when they are not able to get pregnant. 

The takeaway here? If you or a loved one has any degree of pelvic or period pain, do not normalise it. It could mean many things, and endometriosis is one of them. Additionally, as the condition can occur without symptoms, routine gynecologist consultations should be a part of your healthcare plan. This way, your provider can keep a check on your sexual and reproductive health and detect any abnormalities early. At Proactive For Her, we are committed to helping women with tailored solutions for endometriosis. 

All You Need to Know about Endometriosis

Does the word 'ovulation' ring a bell? Yes, it is a concept you probably learned during your sex-ed class in school. Plus, if you use a period tracking app, you may receive predictions about your ovulation day every month.&nbsp;A quick little revision: Ovulation is a part of your monthly cycle when one of your ovaries releases a mature egg. If the sperm meets the egg and fertilises it during this period, you can conceive. If not, you will get your period. Knowing when you are ovulating is helpful in both situations: when you are trying to get pregnant and when you are trying&nbsp;not&nbsp;to get pregnant.&nbsp;Okay, but how on earth do you know your ovary has released an egg and your body is preparing for a possible pregnancy? Well, just like menstruation announces its arrival a week in advance with PMS symptoms, ovulation does the same with various physical and emotional changes. So, without further ado, let's get straight into understanding ovulation!&nbsp;&nbsp;&nbsp;&nbsp;<h3>First Up, What Is Ovulation?</h3>Girls are born with millions of immature eggs stored in their two ovaries. The ovaries remain dormant for long and become active during the preteen or teen phase, causing ovulation followed by the first menstrual period. From that stage on until menopause, the process of ovulation and menstruation typically occurs once every month.&nbsp;Ovulation is preceded by the follicular phase when the follicle-stimulating hormone (FSH) causes the ovaries to produce follicles or sacs containing several immature eggs. At this stage, there is a surge of luteinizing hormone (LH) which triggers ovulation.&nbsp;Only one mature egg is released and moves to the fallopian tube to be fertilised. Ovulation usually occurs in the middle of the cycle (day 10-18 of a 21-35 days menstrual cycle) and lasts for about a day. If a sperm fertilises the egg during the 24-hour window, pregnancy can occur.&nbsp;&nbsp;<figure class="image"><img style="aspect-ratio:602/401;" src="https://lh7-rt.googleusercontent.com/docsz/AD_4nXeMKraZa0FEKkqokj4dF5DOcZssWf9CmpvPTKiUhXIrhGVMQQG3jJo8Kcr2uFOQeuTgP2GAmVXjxZVtzhKP_gQc3kRGOlWf4UMj1Lae_woxtnFIGeYiUWvHdgwzBCpe1hzG2UYcZOvwwoRHenpkaIFAee7r?key=oQcLFYc3xDDvHKaIr8D4kKEr" width="602" height="401"></figure> After ovulation, the body enters the luteal phase. The progesterone hormone surges to help thicken the uterine lining in preparation for pregnancy. However, if pregnancy does not happen, estrogen and progesterone drop considerably, causing the lining and egg to shed during menstruation. That marks the beginning of the four-stage menstrual cycle all over again.&nbsp;&nbsp;<h3>Identifying Your Fertile Window: What Are the Signs of Ovulation?</h3>Now that the concept of ovulation is clearer, let's move on to the main bit: How do you know you are ovulating? Unlike PMS symptoms, ovulation signs are generally subtle. You may experience them up to a week, including before, during, and after ovulation.&nbsp;However, it varies significantly from person to person and cycle to cycle. You may notice all, some, or none of these symptoms. Remember that the absence of these symptoms does not mean you are not ovulating. That said, let's explore ten clues to help you predict your most fertile days.&nbsp;Cervical mucus changes&nbsp;As you approach ovulation, your cervical mucus appears different, thanks to the increase in estrogen. From the usual watery consistency, it becomes clear, stretchy, thick, and slippery, resembling an egg white! Additionally, the body produces more than usual cervical mucus. Why do these changes happen? Well, it has two purposes: to provide enough lubrication for comfortable sex and to help the sperm easily swim up its way to the egg.&nbsp;&nbsp;<figure class="image"><img style="aspect-ratio:602/401;" src="https://lh7-rt.googleusercontent.com/docsz/AD_4nXdUINanYk18O6HkzBUNWe5PxhCtN21vR-b-4NsxGtxFaAeZ-fPWOMKvswmktU1wLRxB3XbvT1Le7bIrzkbHOvRK1wyW7EOz_bJz2P0dN9XiaN8r179cFU3n0fvC7SMAdmQPgGGFgqfveWXaNzIjaiah09gq?key=oQcLFYc3xDDvHKaIr8D4kKEr" width="602" height="401"></figure>Tender breasts and sore nipplesIf you notice a mild, lingering pain in your breasts and nipples around the middle of your monthly cycle, ovulatory phase hormones are to blame! You may experience discomfort during high-impact activities or intimate breast play.&nbsp;Pelvic or lower abdominal pain&nbsp;Ovulation can cause minor cramping and discomfort in the pelvic or lower abdominal region. The pain usually occurs on either the right or left side, but it may shift sides from cycle to cycle. Ovulation pain, also called ‘mittelschmerz pain’, can last from a few minutes to a few hours and is known to be an effect of the follicle rupturing to release the egg.&nbsp;&nbsp;Mild spottingWhen the follicle bursts open, along with pain, it can also cause a small amount of bleeding. While it's not a common symptom, it is also not a cause of concern. You may notice some pink, red or brown discharge in your underpants for a day or two. However, if the spotting continues longer, it could indicate an underlying issue, and you must&nbsp;<a href="https://proactiveforher.com/experts/regular-gynaecology/?tag=regular-gynaecology&amp;specialization=all&amp;page=1&amp;sort=availability&amp;mode=offline&amp;clinic=78b9e873-ce70-4f06-b39a-8c4ae448a37d">see a gynecologist</a>.&nbsp;Good mood and high sex drive&nbsp;Have you noticed a particular time every month when you feel happy, energetic, attractive and have a greater desire to have sex? Well, experts say the feel-good emotions and high libido are simply the result of hormones such as estrogen and testosterone at work to encourage sexual activity for procreation.&nbsp;<figure class="image"><img style="aspect-ratio:602/401;" src="https://lh7-rt.googleusercontent.com/docsz/AD_4nXcowywnhGBjQiWaDNthpapfF1m5XOPilZkRGIuq36G6coYznOxG-fjjy-yXXybio-Eyg6MWaEND9nGiVjvOEEJqdlZM7t6AgtAf1hR6M0562GbRiGwAyga7l_ADBEajdphQhe7SDmdFhoEkJ7SxqZLJGgw?key=oQcLFYc3xDDvHKaIr8D4kKEr" width="602" height="401"></figure>Appetite shifts&nbsp;If you pay close attention to your appetite throughout the month, you will realise it decreases slightly right before ovulation, when estrogen is the dominant hormone in the body. In contrast, after ovulation, as progesterone takes over, you crave more food than usual.&nbsp;Basal body temperature changesBasal body temperature is the temperature of the body at rest. You can measure it right after waking up before you get out of bed and engage in any activity. At the beginning of the menstrual cycle, it will be around 96 to 98°F. As you approach ovulation, it will reduce slightly and right after ovulation, it will increase by about 1°F, reaching 97 to 99°F. Tracking the basal body temperature for a few months can help you predict your most fertile days.HeadachesCan ovulation make you uncomfortable? Yes, the hormonal changes during the process can cause headaches and interrupt your daily routine. You may experience symptoms like throbbing pain in one or both sides of the head, sensitivity to bright lights or sound, blurred vision, nausea, and vomiting. Ovulation headaches may last anywhere between a few hours to a few days.&nbsp;Heightened sensesHormonal fluctuations during ovulation may make you more sensitive to smell and taste than on other days of the menstrual cycle. While research has found evidence of this phenomenon, it is not always a foolproof indicator of ovulation.&nbsp;<h3>Factors That Affect Ovulation: Is It Possible to Not Ovulate Every Month?</h3>While ovulation is designed to be a monthly process, it may not always be that way. Various situations can interrupt the natural process of egg maturation and release for fertilisation every month. The most common signs of improper ovulation include irregular menstrual cycles, heavy or light periods, painful periods, mood swings, unexplained weight changes, and infertility. You may face ovulation difficulties if:&nbsp;<ul><li>You have conditions such as PCOS, thyroid disorders, or endometriosis.&nbsp;</li><li>You are taking certain medications such as antidepressants, antipsychotic medications, antihypertensives, thyroid medication, and chemotherapy drugs.&nbsp;</li></ul>&nbsp;<figure class="image"><img style="aspect-ratio:602/401;" src="https://lh7-rt.googleusercontent.com/docsz/AD_4nXd00V9MaLXuOgFnRMeeSRn51DnfW_xu_P6r5BqVeUqX8Z_jSc2ynN-YVP3n9ycF_i2DSdDLKBn85S9hFLHMkKdHIEbTgTA3JHd3npMpoqF9rG12BaOn2bgRYKFXExLyQiKAFoeE5JjBFrozHTPLu6tGOfU?key=oQcLFYc3xDDvHKaIr8D4kKEr" width="602" height="401"></figure><ul><li>Your BMI is less than 18 or higher than 25&nbsp;</li><li>You have fluctuations in weight&nbsp;</li><li>You are engaging in excessive high-impact exercise.&nbsp;</li><li>You are facing chronic stress.&nbsp;</li></ul>Ovulation may also temporarily be disrupted in your body if:&nbsp;<ul><li>You are using hormonal contraceptive methods such as birth control pills or intrauterine devices (IUDs).&nbsp;</li><li>You recently gave birth.&nbsp;</li><li>You are breastfeeding.&nbsp;</li></ul><h3>A Game of Calculations: How Can You Track Ovulation?</h3>As discussed, tracking ovulation is helpful when trying to conceive. Having sex in the days leading up to ovulation and during your 24-hour fertile window increases your chances of pregnancy. At the same time, knowing your fertile days is essential to avoid pregnancy. You can be extra cautious with intimacy during that time.&nbsp;Predicting your ovulation involves paying attention to your body's subtle signs and mastering calculations. It can take a few monthly cycles to become in tune with your body, recognise patterns, and perfect your predictions.&nbsp;Here are some popular ways to track ovulation:&nbsp;<ul><li>Ovulation symptoms journal:&nbsp;Maintain an ovulation journal and track the following details throughout the month: the appearance of your cervical mucus, BBT readings, and physical and emotional changes (cramps, breast tenderness, mood, energy levels, sex drive).&nbsp;</li><li>Calendar method: Mark your menstruation dates on a calendar every month. Since ovulation occurs in the middle of the menstrual cycle, you can determine the average length of your cycle and accordingly predict ovulation. If manual calendar tracking seems complicated, you can use a period-tracking app for automated predictions.&nbsp;</li><li>Ovulation home test: If tracking ovulation signs and using the calendar method are not working, you can explore ovulation home tests. The kit contains strips similar to pregnancy tests. You need to pee on the strip, which will measure your luteinising hormone (LH) levels. If they are high, you will test positive, suggesting you are fertile. You should then have sex for the next few days to increase your chances of pregnancy.&nbsp;</li></ul><figure class="image"><img style="aspect-ratio:602/401;" src="https://lh7-rt.googleusercontent.com/docsz/AD_4nXevoqdiy_hy3JKy3x8aVmIQVHE0yAixGyVJu-5lQaG4TdsDE4SviNhHpOP22DjCcj5Zts3jy3b71IvY4UMi3iL_hoSElLrblgBz0QLUh1QpcEX7B-l84fqfjlvOkWyUFNuovfB5N7iW-gMNPsXZsK5qgq3o?key=oQcLFYc3xDDvHKaIr8D4kKEr" width="602" height="401"></figure> Remember that no ovulation prediction methods are reliable if you have irregular periods. Neither can they detect fertility issues (it is possible to have them with regular menstrual cycles too). Book an appointment with a<a href="https://proactiveforher.com/what-we-treat/fertility/">&nbsp;fertility specialist</a> if:&nbsp;<ul><li>You are under 35 years old and have been trying to get pregnant for around a year with no success</li><li>You are over 35 years old and have been trying to get pregnant for around six months with no success</li></ul><h3>Takeaway</h3>Whether you are attempting to conceive or avoid pregnancy, understanding your ovulation symptoms and predicting your fertile days is essential once you become sexually active. At the same time, addressing symptoms of ovulation disorders such as irregular periods is vital for receiving timely treatment and preventing complications such as infertility.&nbsp;Do you have more ovulation-related queries?<a href="https://proactiveforher.com/experts/?specialization=fertility&amp;page=1&amp;sort=availability&amp;mode=offline&amp;clinic=78b9e873-ce70-4f06-b39a-8c4ae448a37d">&nbsp;Talk to our fertility specialists</a> at Proactive For Her today.

Ovulation is a monthly process where one of the ovaries releases a mature egg, which can be fertilized by a sperm. It occurs in the middle of the cycle, usually on days 10-18 of a 21-35-day menstrual cycle. The follicular phase is triggered by the follicle-stimulating hormone (FSH) and the surge of luteinizing hormone (LH). The luteal phase involves the progesterone hormone to thicken the uterine lining. It is possible to not ovulate every month due to various factors, such as conditions like PCOS, thyroid disorders, endometriosis, medications, BMI fluctuations, excessive high-impact exercise, chronic stress, hormonal contraceptives, recent births, or breastfeeding. Tracking ovulation is crucial for conceiving and avoiding pregnancy.

Exploring Ovulation: Signs and Methods of Tracking

Understanding your reproductive health is a crucial step in your journey, and the&nbsp;HSG test (hysterosalpingogram) plays a key role in diagnosing uterine or fallopian tube concerns. Whether you’re trying to conceive or addressing fertility issues, this test provides valuable insights.Yet, as important as the test is, it can also bring up a lot of questions. How much does the&nbsp;HSG test cost in India? What does the procedure involve? How should you prepare for it? Does insurance cover the cost of an HSG test in India? These are common, valid concerns—and the good news is that with the right information, you can feel informed and confident.&nbsp;This guide simplifies everything you need to know, so you can approach the test with clarity and confidence. We'll ensure you’re ready to take this step with clarity and ease. Because when it comes to your health, you deserve answers, support, and care tailored to you.<h3> What is a hysterosalpingogram (HSG)?</h3>An&nbsp;HSG test, or&nbsp;hysterosalpingogram, is a specialized X-ray procedure designed to assess the health of your uterus and fallopian tubes. Think of it as a diagnostic tool that helps doctors understand if there are any physical barriers or issues preventing pregnancy.&nbsp;Why take an HSG?An&nbsp;HSG test helps answer&nbsp;key questions about fertility, including:<ul><li>&nbsp;Are the fallopian tubes open?&nbsp;</li></ul>Blocked fallopian tubes prevent the egg and sperm from meeting, making pregnancy difficult.<ul><li>Is the uterus healthy?&nbsp;</li></ul>Conditions like fibroids, polyps, or scar tissue can impact implantation and pregnancy success.<ul><li>Is further fertility treatment needed?&nbsp;</li></ul>If the test reveals blockages or abnormalities, additional procedures or assisted reproductive techniques like IVF may be necessary.The HSG test is a critical tool for uncovering potential causes of infertility. By identifying issues like blockages or abnormalities, it empowers doctors with valuable insights to chart the next steps in your fertility journey and create a personalized treatment plan.Whether the test highlights an issue that needs attention or reassures you that everything is functioning as it should, it serves as a valuable guide for treatment.Though the idea of undergoing an HSG test may seem intimidating, understanding the process and its purpose can help you approach it with confidence and ease.<h3>Who should take an HSG test?</h3>The HSG test is recommended for women who:<ul><li>Have been trying to conceive for over a year without success.</li><li>Have experienced recurrent miscarriages or pregnancy losses.</li><li>Suspect blocked fallopian tubes due to past infections, endometriosis, or surgeries.</li><li>Are preparing for fertility treatments like IUI or IVF, where open tubes are crucial.</li><li>Have irregular periods or a history of uterine abnormalities such as fibroids or polyps.</li></ul><h3>Process of HSG test</h3>If you’re feeling a little nervous about the HSG test, you’re not alone. Many women worry about what to expect, but the procedure is generally straightforward and quick. Let’s walk you through it so you feel more confident and prepared.<ol><li>Before the Test</li></ol>Your doctor will usually schedule the test between day 7 and day 10 of your cycle, after your period but before ovulation. This timing helps make sure you’re not pregnant and reduces the risk of infection. You may be asked to take an over-the-counter pain reliever about an hour before the test to help with any possible discomfort.&nbsp; &nbsp; 2. During the Test<ul><li>Getting Ready: You’ll lie down on a table, and a small instrument will be gently placed in your vagina to help the doctor see your cervix clearly. This is similar to what happens during a routine gynecological exam (so chill out!).</li><li>Adding the Dye: The doctor will use a small, soft tube to gently pass a special liquid (contrast dye) into your uterus. You might feel some mild cramping at this point, similar to period pain- we know you can fight this :) .</li><li>Taking the X-rays: As the liquid flows through your uterus and fallopian tubes, the doctor will use an X-ray machine to capture images. These images show if the tubes are open or if there’s a blockage.</li><li>Finishing Up: Once the images are taken, the equipment is removed, and you’re done! The entire test usually takes about 15-30 minutes.</li></ul><h3>What is the next step after the HSG test?</h3>Once the HSG test is complete, your doctor will analyze the results. If no blockages or abnormalities are detected, you can proceed with your fertility plan. If issues are found, further treatment options, such as surgery or assisted reproductive techniques like IVF, may be recommended.You might have some mild cramping or light spotting for a day or two, which is completely normal. Most women feel fine to go back to their usual activities right after the test. Your doctor will review the results with you, often in a follow-up appointment, and guide you on the next steps.The HSG test may sound a bit daunting, but it’s a quick procedure that provides crucial insights about your reproductive health. Knowing what to expect can help make the experience much less stressful.<h3>What you should know before your HSG Test</h3>The thought of undergoing an HSG test can be nerve-wracking, but being well-prepared can ease your worries.<ul><li>Schedule Smartly: The test is typically done in the first half of your menstrual cycle (days 7–10), after your period and before ovulation. This timing ensures the uterus is clear of tissue, and there's no risk of disrupting a potential pregnancy.</li><li>Pain Management: Some women prefer taking a mild pain reliever about an hour before the procedure to ease cramping or discomfort. Always check with your doctor before taking medication.</li><li>Emotional Readiness: It’s normal to feel anxious, especially if you’re worried about results. Bring a trusted friend or partner for emotional support if possible.</li></ul><h3>Do's and Don'ts before the test</h3><figure class="table"><table><tbody><tr><td>Do's</td><td>Don'ts</td></tr><tr><td><ul><li>Wear loose, comfortable clothing for easy movement and relaxation.</li><li>Eat a light meal before your appointment unless instructed otherwise.</li><li>Bring any relevant medical records or prescriptions.</li></ul></td><td><ul><li>Avoid using tampons, douches, or vaginal medications a day or two before the test.</li><li>Skip the test if there’s any chance you might be pregnant.</li><li>Refrain from scheduling the test if you’re experiencing an active pelvic infection.</li></ul></td></tr></tbody></table></figure>By following these guidelines, you can ensure a smoother experience with fewer complications!<h3>Are there any side effects of HSG?</h3>The HSG test is generally safe, but mild side effects are possible:<ul><li>Cramping: Some women report cramping similar to menstrual pain during or after the test.</li><li>Spotting: Light bleeding is common for a day or two.</li><li>Dizziness: Rarely, the discomfort might cause lightheadedness.</li><li>Serious complications, like infections, are extremely rare but possible. Be sure to contact your doctor if you experience severe pain, fever, or heavy bleeding afterward.</li></ul><h3>Is an HSG painful?</h3><ul><li>The&nbsp;HSG test (hysterosalpingogram) may cause mild to moderate cramping, similar to menstrual pain, but it typically lasts only a few minutes. Discomfort occurs when the&nbsp;contrast dye is injected to check for blockages in the fallopian tubes. Women with&nbsp;blocked tubes may experience slightly more pain. To ease discomfort, doctors recommend taking a&nbsp;painkiller before the test. Most women resume normal activities the same day. If you’re worried, discuss pain management options with your doctor beforehand.</li><li>The good news? The procedure is brief, and many women find the clarity it provides worth the temporary discomfort.</li><li>The test helps identify blockages or structural issues that may affect fertility, guiding further treatment options. Your doctor will evaluate your specific situation to determine whether the test is necessary.</li></ul><h3>Does insurance cover HSG?</h3><ul><li>Are you wondering,&nbsp;“Does&nbsp; my insurance cover the cost of an HSG test in India?”&nbsp;Well this is a common question for many women navigating the financial aspects of healthcare. The answer depends on your insurance policy. Some plans cover diagnostic tests, while others might not. We recommend contacting your provider for clarification. Be sure to ask about additional charges like doctor consultations, pre-test medications, or follow-up visits.</li></ul>Are There Any Additional Charges Associated with the HSG Test?<ul><li>Yes, there may be extra costs beyond the test itself. For example:</li><li>Doctor consultation fees: These can range from ₹500 to ₹1,500 depending on the clinic.</li><li>Pre- or post-test medications: Pain relievers or antibiotics may be prescribed.</li><li>Follow-up appointments: After the test, you’ll likely need a review of the results with your doctor.</li><li>Discussing these potential expenses ahead of time can help you plan your budget more effectively!</li></ul><h3>HSG CPT Codes</h3>When discussing medical tests, you may hear about&nbsp;CPT codes. If the term sounds technical, don’t worry—it’s simpler than it seems. Understanding these codes can help you navigate billing, insurance, and medical records more confidently. CPT stands for&nbsp;Current Procedural Terminology, a system of five-digit codes used to identify medical procedures. For an HSG test, two CPT codes are commonly used:<ul><li>58340: This represents the catheterization portion of the procedure, where a thin tube is inserted into the cervix to introduce contrast dye.</li><li>74740: This covers the radiological imaging part of the test, where X-rays are taken to track the dye’s flow through the uterus and fallopian tubes.</li><li>CPT codes might seem technical, but they’re just&nbsp;tools for organization. If you have questions, ask your doctor or clinic for clarity.&nbsp;</li></ul><h3>How can Proactive For Her help?</h3>At&nbsp;Proactive for Her, we prioritize creating a supportive and safe space for women seeking answers about their reproductive health. While we don’t provide HSG tests or related services directly, our team of experienced doctors and gynecologists is always approachable and ready to guide you. We ensure speedy responses to your queries, offer convenient teleconsultations, and guarantee a judgment-free environment where you can discuss your concerns openly. At Proactive for Her, your comfort, privacy, and health are our top priorities.<h3>The Seal of Her Approval</h3>“The experience was super smooth. I had come across Proactive on Instagram and was extremely eager to get a consultation. Indeed, they are non-judgmental, just as they claim. I didn't feel even an inch of discomfort during the entire process. The doctor was very kind throughout and answered the gazillion biology questions I kept asking her

The HSG test is an X-ray procedure that checks the uterus and fallopian tubes for blockages or abnormalities affecting fertility. It costs ₹2,500–₹7,000 in India, with insurance coverage varying by provider. The test takes 15-30 minutes, may cause mild cramping, and is done between days 7-10 of the menstrual cycle. Proper preparation and pain management can ease discomfort. While Proactive For Her doesn’t offer HSG tests, their experts provide guidance on reproductive health.

HSG Test: Price, Results, Process, Insurance

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