Fertility Evaluation

If a couple has been trying to have a baby without success, they should seek medical help. A medical evaluation may determine the reasons for a couple's infertility. Usually this process begins with physical exams and medical and sexual histories of both partners. If there is no obvious problem, like improperly timed intercourse or absence of ovulation, tests may be needed.

The goal in infertility diagnosis is to examine each component of the steps in becoming pregnant, from adequate sexual contact and frequency of intercourse to proper ovarian function and poor sperm penetration. Each link in the pregnancy chain is tested. More than one link can be weak. There is always a possibility of having one or more link weak. The diagnostic process can take months because of the sequencing of test; it may also be expensive. The bottom line is you're having trouble getting pregnant. The answer as to why is usually found in one or more of five major categories: Behavioural/chemical factors, ovulatory problems/hormone imbalance, anatomical problems, male factor problems, and local/cervical problems. Your doctor will attempt to address the relevance of each category to your particular situation and with input from you and your medical history, may quickly begin to focus on one area where he/she has some suspicions, and dwell less on others. Since there is a tremendous amount of information that your doctor sorts through to narrow down his diagnosis, it would take hours to explain the assimilation process. All of this can take a psychological toll. So we have our team of dedicated skilled doctors who also take special care in handling the patients. We approach each fertility problem as a unique challenge. After a complete history has been obtained, we outline a detailed, intense diagnostic program to allow us to arrive at a rapid diagnosis of the underlying fertility problem.

That translates into more than 6 million people who have trouble conceiving and bearing a child. And the chances of conceiving in any month are only 25 percent without fertility issues.

For Males

Sperm analysis

For a man, testing usually begins with tests of his semen to look at the number, shape, and movement of his sperm. This is called sperm evaluation. Sometimes other kinds of tests, such as hormone tests, are done. The semen analysis may need to be repeated. Together with a Fructose test, cases of obstructive and non-obstructive male factors can be diagnosed. While obstructive factors can be corrected by surgical procedures, other severe factors may require direct aspiration of sperm from the testes, epididymus, vas or sperm retrieval from a testicular biopsy together with an ICSI program. Sperm penetration and sperm function studies (Hamster, etc.) are also conducted.

Physical examination

A complete physical examination is done to rule out any abnormality of the reproductive system. The condition, size and look of testis and penis are also noted. All the other systems of the body are also inspected.

Blood test

A blood sample may be taken to check the level of those hormones that affect fertility. Blood is also test for any other infections like diabetes etc.

For Females

Most tests used to detect infertility in a woman check if and when ovulation has occurred. These tests may be performed before, during, or after ovulation. Others check for any structural abnormalities in her reproductive system.

Hormone Assays and Blood tests

A hormone study of the patient is crucial to diagnose the cause as well as to the treatment of infertility. The reason behind these tests is to know where the problems lie i.e. whether the cause lies within female reproductive system or in the endocrine system. The levels of Luteinizing hormone, Follicle-stimulating hormone, Prolactin, Oestrogen and Progesterone hormones are checked. Cases such as polycystic ovarian disease (PCOD),prolactinomas and other diseases due to hormonal imbalance can be detected easily. During an IVF or ICSI program, regular hormonal assays are done to see the body's response and to decide on further treatment. Blood tests will include routine hematological examination as well as tests to rule out diseases such as HIV, Hepatitis B and C, VDRL, immunological disease screening tests and other tests.

Basal body temperature test

After a woman ovulates, there is a rise in body temperature - as much as 1 degree F - that can happen suddenly in one day or slowly over several days. To record her basal body temperature, a woman has to take her oral temperature every morning before she gets out of bed and records it on a sheet of graph paper. This record usually has to be kept for 2-3 months. This test may suggest whether ovulation has occurred and whether it occurs on a regular basis.

Ultrasound scanning (USS) and Doppler scan

An Ultrasound scan can give basic diagnostic information of the female anatomical problems and with a transvaginal scan we can know whether apart from anatomical remarkability there is ovulation,size of ovulation and also the time of ovulation. A color Doppler scan can give much more detailed and indepth information than the regular USS. The resolution and quality of a doppler scan machine can prove crucial in follicular studies and the treatment schedule for an Assisted Reproduction program.

Postcoital Test (PCT)

The postcoital (after sex) test examines the ability of sperm to enter and move into the cervical mucus just before time of ovulation. A PCT can also show if there is a reaction between the sperm and cervical mucus that could be causing infertility.

Endometrial Biopsy

A long, hollow tube is passed into the patient's uterus late in her menstrual cycle, and a little of the lining is scraped off and examined with a microscope. The examination helps the physician tell whether the development of the egg and the lining of the uterus are in proper phase with each other. A biopsy is also done to rule out the presence of cancer, infection, or abnormal tissue growth (polyps).

Hysterosalpingogram

This is an x-ray study of the uterus and fallopian tubes. It is done just after a woman's menstrual period so there is no danger of her being pregnant and thereby exposing the fertilized egg or embryo to radiation. A dye containing iodine-technically called a contrast medium-is injected through the cervix. It spreads into the uterus and the fallopian tubes, allowing them to be visualized on x-ray. Among other things, this study often enables the physician to determine if the fallopian tubes are open.

Hysteroscopy

The patient's uterus is filled with a liquid or gas, instilled through the cervix. A small lighted telescope called a hysteroscope is then inserted into the uterus through the cervix, enabling the surgeon or physician to look directly inside. Many hysteroscopes have a separate channel through which instruments can be passed, often making it possible to immediately correct any abnormalities.

Laparoscopy

A laparoscope, like a hysteroscope, is a small-lighted telescope. It is slipped into the abdominal cavity through a small incision in or near the navel. For a dearer view of the woman's reproductive tract, the cavity is filled with gas during the procedure, and a colour solution-usually blue-is injected into the uterus and fallopian tubes advanced operative techniques may allow the repair of defects in the reproductive tract to be made at the same time as the examination.