Infirtility Evaluation

 

Investigation of infertile couple

 

 

Identifying the exact cause is essential for proper treatment .Investigations are done to detect the cause of infertility.
Causes of infertility – male factors -30%, female factors 30%, combined 30%,unexplained – 10%

Diagnosis is done after the couple is subjected to the following:

•  History – personal and family
•  Examination – of the male and female partner
• Tests and other procedures

Evaluation of Male partner:

      Not all the tests are needed for all patients.

      General health, HIV , HBS AG & HCV   are  to be tested .

 

Basic investigation of Male

Investigation	Purpose
Semen analysis	Know the total sperm count, motility, normality of sperms and other parameters.
Hormonal analysis by blood test: FSH, LH, Testosterone and Prolactin.	Know the cause of Azoospermia.
Scrotal Ultrasound	Distinguish varicocele from other testicular lesions
Semen C&S	To rule out infection.
Chromosomal analysis	In cases involving severely defective spermatogenesis genetic counseling and testing is offered.
Counseling	About investigation result and future treatment.
Note: Semen taken after 2-7 days of sexual abstinence. Semen ejaculated by masturbation in special container at home, hotel or hospital. . The above procedures are done with one sample of semen

 

 Evaluation of female partner:

   Age of the female partner is an important factor in fertility and as a woman becomes older her fertility diminishes.

   General health, HIV, HBS AG, HCV, HB estimation (should be >10 g before embarking upon IVF treatment.

 

Basic investigation of Female

Investigation	Purpose
Hormonal evaluation	Baseline levels of FSH, LH on day -2 or day 3- of the menstrual cycle is estimated which predicts the ovarian reserve .Other hormones like TSH and Prolactin are also estimated. Inhibin & Anti mullerian hormone gives additional information.
Baseline Ultra Sound Scanning	To assess the uterus and ovaries –to rule out fibroids, cysts, to assess the number of available follicles, and ovarian volume and accessibility of the ovaries during ovum pick up.
Hysterosalpingogram	Assess the uterine cavity and tubal patency
Hysterolaparoscopy	Indicated in some cases
Trial ET	Anticipate and rectify any difficulty during actual embryo transfer.
Counseling	To explain the procedure, complications, success rates and to clear any doubts of patients.
One menstrual cycle (one month): From Day2 (D2) of the menses for one month is needed for observing/ checking the varying structural, functional and hormonal changes in uterus and ovary. For IVF treatment, next / another menstrual cycle is selected.