Infertility Investigation

Infertility Investigation

Investigation in Female:

Hormonal Blood Tests:

• FSH and LH: This blood test should be done during day 2 to day 5 of your cycle. FSH, LH levels are important to know your ovarian function. Day 1 is first full day of your period. Blood levels after 5th day can give us wrong information.
• TSH: to know your thyroid hormonal levels. Thyroid hormone can sometimes disturb the menstrual cycle and thereby affect fertility.

Prolactin: High levels of prolactin are known to be associated with problems with ovulation

Infection screen:

• HIV I & II: For the benefit of patients, staff and other people these tests are compulsory if you are undergoing assisted reproductive treatment.
• HBsAg: This test is to know that you are not carrying hepatitis B virus.
• Anti HCV: This test is to know your status for hepatitis C virus.
• VDRL: Routine test for syphilis
• If you need further information about these viruses please speak to the nurse.
• Rubella IgG: This is an important test to perform before you conceive. If this test is negative, it means that you are susceptible to get rubella infection during pregnancy, which can harm your baby. In that case Rubella vaccine is advisable.

Sonography:

• Usually Gynae sonographies are performed through internal (vaginal) probe. It is best to keep your bladder empty during the procedure as it gives best pictures of organs. During vaginal sonography (TVS) we can normally see the shape and size of uterus, location, volume and appearance of ovaries.
• Follicular study to be performed from day 9 till repture of follical.

Please note that normal tubes are not seen during the sonography.

Saline Infused Sonography (SIS):

• This is a special form of sonography performed to see the cavity of the uterus and patency of the fallopian tubes. You are required to start the first day of antibiotic.
• SIS is advisable to perform after stopping your periods and before your day of ovulation (i.e. Day 5-14)
• Hysterosalpingography: In this test, doctors use x-rays to check for physical problems of the uterus and fallopian tubes. They start by injecting a special dye through the vagina into the uterus. This dye shows up on the x-ray. This allows the doctor to see if the dye moves normally through the uterus into the fallopian tubes. With these x-rays doctors can find blockages that may be causing infertility. Blockages can prevent the egg from moving from the fallopian tube to the uterus. Blockages can also keep the sperm from reaching the egg.
• Laparoscopy: During this surgery doctors use a tool called a laparoscope to see inside the abdomen. The doctor makes a small cut in the lower abdomen and inserts the laparoscope. Using the laparoscope, doctors check the ovaries, fallopian tubes, and uterus for disease and physical problems. Doctors can usually find scarring and endometriosis by laparoscopy.
• Hysteroscopy: With this the inside of the uterus and the openings of the fallopian tubes are checked for any potential problems. Usually hysteroscopy, laparoscopy and tube testing are combined and done at the same sitting.

Investigation in Male

Semen Analysis:

This is an important test in cases of sub fertility. We advise you to have 3 days of abstinence before producing the sample. Please do not use any spermicidal jelly or condoms for production. Please bring the sample to us within an hour of production by keeping it at close to the body temperature. Result of the test will be discussed with you in 1-2 days. Three important things we analyze in the semen sample are count, motility and morphology.

Infection screen:

• HIV I & II: For the benefit of patients, staff and other people these tests are compulsory if you are undergoing assisted reproductive treatment.
• HBsAg: This test is to know that you are not carrying hepatitis B virus.
• Anti HCV: This test is to know your status for hepatitis C virus.
• VDRL: Routine test for syphilis.

Hormonal tests on male and sonography of testis are performed for cases of azoospermia that is no sperm found in the sample.

How do doctors treat infertility?

Infertility can be treated with medicine, surgery, artificial insemination or assisted reproductive technology. Many times these treatments are combined. About two-thirds of couples who are treated for infertility are able to have a baby. In most cases infertility is treated with drugs or surgery. Doctors recommend specific treatments for infertility based on:

• test results
• how long the couple has been trying to get pregnant
• the age of both the man and woman
• the overall health of the partners
• preference of the partners