In Indian context, infertility poses a complex social issue and requires more of counseling than actual management. Couples often seek advice at an early age and too immediately after marriage.
It is our policy at RAJ IVF CENTRE to counsel the couples to wait for reasonable amount of time before actual treatment. By definition, couple needs to be together without using any contraceptives for 2 years (of course woman’s age is taken into consideration) before embarking on investigations.
To make it simpler, at Level I, we need following tests.
Semen analysis
| Parameter | WHO 1999 | WHO 2010 |
|---|---|---|
| Volume | 2 ml | 5 ml |
| Concentration | 20 million/ml | 15 million/ml |
| Progressive Motility | 50 % | 32 % |
| Normal Forms | 14 % | 4 % |
Routine Blood Tests
By the time couple seeks the opinion at the Tertiary level clinic, most of the tests would have been done. To mention a few, we at RAJ IVF CENTRE ask for CBC (to rule out anemia), Blood group, viral markers, blood sugar, and serum creatinie.
USG of pelvis
From Infertility angle we need to know any uterine abnormality, fibroids, Endometrial Thickness, Ovarian volume, rule out Hydrosalphinx (fluid in fallopian tubes—if big enough to be seen) Endometrioma(Incidence of Endometriosis in infertile woman is higher ) or simple follicular cysts.
Hormone tests at level I (in case of Irregular menstrual cycles or advanced age)
Management options at Level- I
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- 1. Cycle evaluation
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- 2. Planned relation
- Level II
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- 1. Tubal patency test by HSG(by X-Ray) or Sono salphingography
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- 2. AMH (blood test))
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- 3. D3 Panel (Hormone blood test to be done on third day of menses)
- Management option at Level II
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- 1 Ovulation Induction with hormones—Anovulation is the condition where woman fail to produce the eggs, we put them on treatment to make them ovulate either with oral tablets or if necessary Hormone injections (we need to use Hormone injections with care as some times ovaries over respond creating complications. This condition is known as Ovarian Hyper stimulation syndrome).
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- 2 IUI (Details in Treatment section)
- Level III
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- 1 Hysteroscopy and laparoscopy (we prefer operative rather than diagnostic depending on the provisional Diagnosis we have in hand) for some video demonstrations refer to treatment page
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- 2 IVF or ICSI (TEST TUBE BABY) option is discussed at this stage (barring straight forward indications for the same) Details on Treatment page
- *Disclaimer; This is a General awareness information and not a treatment in itself. The tailor-made treatment depends on the individual clinical and laboratory findings.