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How To Find What Is Wrong - For Her ?

Initial Consultation

Female infertility treatment Male infertility treatment This is the first time that we get to know more about you and your specific problems. We take detailed noted about your medical and surgical history and any tests that you might have undergone in the past. This helps us to avoid putting you though unnecessary investigations.


Blood Tests

Blood tests like FSH and LH (to check the egg producing ability of your ovaries), Prolactin (to check for any hyperprolactinaemia) and TSH (to rule out thyroid problems).

Ultrasonography Scan

Ultrasonography Scan to look at your womb(uterus) and ovaries. Ultrasonography helps in diagnosing any obvious tumours and also polycystic ovaries. The scan is always done via the trans vaginal route as it gives the most accurate information.

Follicle Tracking

Follicle Tracking may be done to follow the development of the follicle and to check if the egg is coming out.

Hysterosalpingography

Treatment of Blocked Fallopian tubes This test evaluates the condition of your uterus and fallopian tubes. Fluid is injected into your uterus, and an X-ray is taken to determine whether the fluid progresses out of the uterus and into your fallopian tubes and general peritoneal cavity. Blockage or problems often can be located and may be corrected with surgery. However it has its limitations that it cannot comment on the health of the tubes. Sometimes the tubes may be open but may be wrongly analyzed by HSG as blocked due to spasm of the mouth of the tubes.

Laparoscopy

Laparoscopy It is the best possible method to evaluate the patency of the fallopian tubes as well as find out if there are any other problems involved. Performed under general anesthesia, this procedure involves inserting a thin viewing device into your abdomen and pelvis to examine your fallopian tubes, ovaries and uterus. A small incision (8 to 10 millimeters) is made beneath your navel, and a needle is inserted into your abdominal cavity. A small amount of gas (usually carbon dioxide) is inserted into the abdomen to create space for entry of the laparoscope - an illuminated, fiber-optic telescope.

The most common problems identified by laparoscopy are endometriosis and scarring. We can also detect blockages or irregularities of the fallopian tubes and uterus.

A blue dye is injected into the cervical canal and through the uterus and fallopian tubes to determine whether they are open. At the end of the procedure, the gas and laparoscope are drawn out and the incision is closed. Laparoscopy offers far more information than a hysterosalpingogram and it also helps in making a clear separation between patients who can benefit from IUI and those who can benefit from IVF. Laparoscopy generally is done as a "Day Care" procedure, that is you can go back home the same day and resume normal work and acitivities.

Hysteroscopy

Hysterocopy Similar to Laparoscopy, this procedure is done to see the insides of your womb to diagnose conditions like polyps, etc. which are usually missed by Ultrasonography. It gives information about the health of the inside of the womb (uterus). In case of isolated blockage of just the inner ends of the tubes, fine cannula can be passed via a hysteroscope to remove the blockage. Laparoscopy should ALWAYS be accompanied by Hysterescopy as it can be done in the same sitting and reduces the overall cost of the procedure while providing a host of information which is vital.

Basal Body Temperature

Although this test was once a standard, basal body temperature charting is used less often today. Charting a woman's body temperature doesn't give as precise time of ovulation as earlier believed.

Urinary Luteinizing Hormone (LH) Detector Kits

A number of at-home kits are available to test your LH level. Although these kits may be helpful, they also can be inaccurate and misleading. They are usually used along with Ultrasonography Follicular studies to try and predict the time of ovulation more accurately.

Sono Salpingography

This involves inserting a catheter inside the uterine cavity and injecting saline or a special dye . Ultrasonography and Doppler studies are used to track the flow of saline through the uterine cavity and fallopian tubes and can provide vital information. It is intermediate in information between hysterosalpingogram and laparoscopy. It does not require anaesthesia.

D&C and endometrial Biopsy

Once a favourite form of investigation to detect ovulation, it has now been abandoned as non invasive and simple tests like Ultrasonography can detect ovulation avoiding complications of anaesthesia and infection which do more harm than good. Endometrial biopsy has a role only as a accompaniment with Hystero laparoscopic procedure especially when Tuberculosis is suspect.

Not everyone needs to undergo all, or even many, of these tests before the cause of infertility is found. Which tests are used and their sequence depend on discussion and agreement between you and our consultants.

How To Find What Is Wrong - For Her ?

While for the female there are a battery of investigations, the list of which never seems to end, for the male, the semen analysis is the simplest and best test available. A specimen of ejaculated semen obtained after a period of abstinence ranging between 3-7 days is required. The sample is examined as per WHO protocols for quantity, colour, sperm count, motility, shape and structure, presence of any infection or blood. Sometimes an extended analysis may be required to see how the sperms survive in culture media for 24hrs at 37 degrees. A culture of the semen sample may also be required.

Further specialized tests, hormone analysis and examination by an Andrologist (male infertility specialist) may be required depending on the initial test reports.

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