What is to be done next in infertility ?

When there are difficulties in conceiving, there are various ways to solve them

• If ovulation is a problem – oral and injectable medications are available.
• When tubes are blocked they can be repaired using laparoscopy and hysteroscopy. If the repair is not possible, IVF is advised
• Intrauterine insemination allows the sperm and egg to come close to each other if the conditions are not conducive naturally
• When sperm quality or quantity is an issue various techniques ranging from IUI (Intrauterine Insemination) to IVF (Invitro Fertilisation) to ICSI (Intracytoplasmic Sperm Injections) are available or doner sperms from semen bank could be used.
• In case of fibroids, polyps, adhesions, endometriosis etc., reproductive gynaecological surgeries are available for correction of the problems.
• If all the procedures have failed, IVF is a good alternative.
• For elderly women who do not produce good quality eggs or have exhausted their ovarian reserves and are postmenopausal, egg donation or embryo donation provides a good alternative.

With appropriate treatment about 50-60% infertile couples conceive. An additional 40-50% would conceive by adopting an IVF/ICSI procedure.

Though infertility itself is not a disease it has a physiological condition itself doesn't cause physical unhealthiness, it will have a significant emotional impact on the couple and people it affects. Feelings like anger, sadness, guild and anxiety are usually experienced by the patients and may affect their self confidence and self esteem. Although highly advanced treatments are nowadays available for the couple yet they should decide in their own capacity, how far they are willing to go to achieve a pregnancy.

Tests that are recommended to evaluate your fertility

Female Partner:

Advice concerning fertility evaluation depends on your current physical, mental and fertility condition. In common, the tests that are recommended for the female partner are as follows:

• Serum hormone tests
• Follicle stimulating hormone (FSH)
• Leutinising Hormone (LH)
• Estradiol (E2)
• Thyroid stimulating hormone (TSH)
• Prolactin
• Fasting glucose
• Screening / Virology Testing
• Hepatitis B
• Hepatitis C antibody
• VDRL for Syphilis (RPR)
• HIV Antibody 1 and 2
• Torch Panel
• Cervical smear
• Type and Rh factor
• Clomiphene Citrate Challenge Test (CCCT) is an indicative test used to provide information about the ovarian reserve.
• Hysterosalpinogram (HSG) is a radiological procedure which uses a particular dye or fluid that is injected into the uterus and fallopian tubes to check for tubal patency and uterine contour.
• Hysteroscopy is a diagnostic procedure performed utilizing a hysteroscope to check if there are any fibroids and/or polyps present in the uterine cavity, and to remove them if they are found. This procedure is normally scheduled between days 6-11 of menstrual cycle.
• Diagnostic/ Operative Laparoscopy: All factors can be accessed in one shot. It is a gold standard test for female fertility. Any factors like PCOD, adhesions, subserous fibroids can be corrected simultaneously.

Male Partner:

• Semen Analysis and Culture
• Virology/ Screening Tests
• Hepatitis B
• Hepatitis C antibody
• VDRL for Syphilis (RPR)
• HIV Antibody 1 and 2
• Torch Panel