PATIENT INFORMATION

 

WHAT IS INFERTILITY?                                                                                            

Inability to conceive(pregnancy)after one year of unprotected intercourse is clinically defined as infertility,but if the age is more than 35 then after 6 months of trying for pregnancy  evaluation and treatment is warranted.

 

WHAT ARE THE REASONS FOR BEING INFERTILE?

Reasons for Infertility can be in Male(husband) or Female(wife) or both.But surprisingly it can be unexplained as well when no reason can be found,all tests reports being normal.Common reasons nowadays seen are age related and due to lifestyle changes.In females these reasons are delay in marriages and pregnancies, genital infections, obesity ,ovulatory dysfunction, tubal block etc.In males it is usually defect in sperms count and motility, or sometimes sexual dysfunction is there.

 

WHICH TESTS CAN TELL US ABOUT CAUSE FOR INFERTILITY?

A couple has to be subjected to various investigations and clinical workup to reach for the cause of infertility.This often requires patience and cooperation on behalf of patient as well as the concerned doctor.Workup is done in a stepwise manner depending on the clinical history and complaints of the couple.

 

Male Factor evaluation is relatively simpler and should be done first.Semen Analysis of the husbandprovides majority of information,rest supplemented by clinical examination and hormonal tests.

 

Female Factor evaluation is more detailed as it involves assesment of ovaries(egg release), tubes(egg &embryo transport) and uterus(implantation site) .A newer factor which is coming up as cause of female infertility is peritoneal,Endometriosis and pelvic adhesions being the diagnosis.

 

Ovulatory functions are tested by means of detailed menstrual history ,transvaginalsonography,Ovulation strips test, blood hormone levels( FSH, LH, Prolactin, TSH, Progestorone etc.)..

 

Tubal factor evaluation is done by a radiological procedure called HSG(Hysterosalphingography),this test gives an idea if the fallopian tubes are open or not

 

WHAT IS HSG(Hysterosalpingography)?.

Basically it is a X Ray of uterus and fallopian tubes .It is a simple OPD procedure where a radioopaque dye is injected with a cannula(access through vagina) into uterus and its course through both fallopian tubes followed by its spill into pelvis is visualised by X Ray films taken.The procedure does not require anaesthesia or admission, a few painkiller injections are given before the procedure. If findings of HSG are abnormal it warrants further evaluation,usually a workup for genital tuberculosis or confirmation of findings by Laparoscopy.

 

WHAT IS UTERINE DEFECTS INFERTILITY?

Uterine Abnormalities are relatively uncommon.Causes are congenital abnormalities(septum inside uterus, two horns of uterus etc.),adhesions inside uterus, genital tuberculosis, fibroids inside uterus.These are diagnosed with the help of HSG,Ultrasonography, Hysteroscopy,Laparoscopy.