Fertility Assessment Assessment:
Generally, Infertility results from female factors about one-third of the time and male infertility factors about one-third of the time. In the rest, the cause is either unknown or a combination of male and female factors.
When to see a doctor ??
1. If you’re in your early 30 s or younger, most doctors recommend trying to get pregnant for at least a year before having any testing or treatment.
2. If you’re age 30 to 35, discuss your concerns with your doctor after six months of trying.
3. If you’re over 35 or have a history of irregular or painful periods, pelvic inflammatory disease (PID), repeated miscarriages, prior cancer treatment or endometriosis, your doctor may want to begin testing or treatment right away.
4. Ovulation disorders account for infertility in 25 percent of infertile couples
Abnormal FSH and LH secretion, Polycystic ovary syndrome (PCOS), Luteal phase defect, Premature ovarian failure, Premature ovarian failure.
2. Damage to fallopian tubes (tubal infertility)
4. Cervical narrowing or blockage
5. Uterine causes
6. Unexplained infertility
Treatments can either attempt to restore fertility — by means of medication or surgery — or assist in reproduction with sophisticated techniques.
Fertility restoration: Stimulating ovulation with fertility drugs
Fertility drugs, which regulate or induce ovulation, are the main treatment for women who are infertile due to ovulation disorders. In general, they work like the natural hormones — follicle-stimulating hormone (FSH) and luteinizing hormone (LH) — to trigger ovulation.
Reproductive assistance: In vitro fertilization
This effective technique involves retrieving mature eggs from a woman, fertilizing them with a man’s sperm in a dish in a laboratory and transferring the embryos in the uterus three to five days after fertilization. In vitro fertilization (IVF) often is recommended when both fallopian tubes are blocked. It’s also widely used for a number of other conditions, such as endometriosis, unexplained infertility, cervical factor infertility, male infertility and ovulation disorders.
SonoSalpingography : It is a diagnostic procedure to check Fallopian tube patency.
It is an Out-patient clinic procedure done under USG guidance, wherein normal saline is pushed through the cervical os opening, and Ultrasound is used to determine the flow from the Uterus and fallopian tube.
This is done to check for any blocks in the Fallopian tube.
Intra-Uterine Insemination: IUI is a procedure usually done for cases of Male Infertility, and in cases of female cervical factors leading to infertility.
In this procedure, the semen sample is centrifuged and the viable motile sperm containing solution is prepared. This solution is then deposited inside the uterine cavity using a small suction cannula.
It is an OPD procedure, and usually doesn’t require any anesthesia.
Hystero- Laparoscopy: It can both be a diagnostic or operative procedure in cases of Infertility. It is done to visualize the abdominal cavity and uterine cavity to determine any structural abnormality.
In case of dense adhesions or any polyp inside the uterine cavity, HysteroscopicAdhesionolysis and Polypectomy can be performed. Similarly, Laparoscopic Adhesionolysis, Laparoscopic Ovarian cystectomy , Myomectomy, Ovarian drilling, Endometriotic fulguration can be done in the same sitting.
This procedure is usually done under GA.