Fertility




 

Fertility has four major aspects Physical, Sexual, functional (lmp, premenstrual and menstrual symptoms) and Psychosocial (self, couple, family and society).

 In physical aspect, we evaluate the female by testing the egg, tube, hormones (Thyroid, prolactin, progesterone, Fsh, Lh etc) and the male by semen analysis. Problems in these areas can be identified and progress for treatment can be assessed. These factors are evaluated individually and treated with medicines and procedures. Impact of Sexual factor on conception and doubts are cleared; sexual problems are addressed.

In functional aspect, all these factors work together and conception (Fertilization, Implantation & Maintanance of pregnancy) occurs. Immune and hormone factors are responsible for this. Conception depends on egg & sperm quality (immune function) and emotional state of mother (Hormone function).

There are no tests to detect these functions in normal course. (except in IVF). When it functions conception occurs or else she gets periods.

Fertility issue is like   iceberg. Physical factors are the tip. Sexual, functional and emotional aspects are the submerged part of iceberg.



Physical Factors:

TESTS DONE FOR MALE:

A semen analysis measures semen volume, sperm quantity, concentration, morphology and motility. The analysis also looks for white blood cells in the semen, which might indicate infection.

Hormone Analysis: Depending upon requirement.

Sonography of Scrotum: To diagnose Varicocele. and size of testes.

Sperm Function tests: Depending upon requirement.

 

TESTS DONE FOR FEMALE :

  • Routine blood investigations
  • Hormone Analysis
  • USG
  • Follicular study
  • HSG
  • Laparoscopy

Normal Semen Parameters:

Parameter Normal Range
Volume 2.0 ml
Sperm Concentration >15 millions/ml
Motility 30%
Morphology >4% normal forms
Vitality 75% live spermatozoa

pH

White Blood Cells

7.2-8.0
<01 million/ml

 

TESTS DONE FOR FEMALE :

Follicular study

It’s a sonography to know egg size , rate of growth,time of release  and uterus lining thickness).

 Post-coital test  (to see sperms in cervical mucus collected 3-6 hrs after intercourse) is also done during follicular study.

HSG

X-ray to know tubal patency and shape of uterus.

 

 

 

Hormone analysis

Measurements of thyroid  (TSH,T4), Prolactin, Androgens (Testosterone, DHEA-S), FSH and LH,AMH,  Estrogenand Progestrone may be helpful in certain situations to further elucidate the cause of ovulatory  and luteal problems.

Routine Blood Investigation

 

 

 

Laparoscopy

 

 

 

Hysteroscopy

Hysteroscopy is useful for diagnosing and treating some problems that cause infertility, Septil Resection, miscarriages (eg., intrauterine adhesions, sub mucosal fibroids, endometrial polyps) and abnormal menstrual bleeding.