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 Q.
What is the first stage of the treatment?
Ans.
The first Consultation. This involves a detailed case history of
both partners, and a clinical examination. Depending on the findings,
previous investigations and treatment done, we advise on the kind
of further investigation and treatment required.
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The
basic investigations needed for an infertile couple are:
- Semen
Analysis with Sperm Function Tests Hormone Assay’s
-
Wife (Day 2 FSH,LH, Prolactin, TSH, E2, ASA) (Day 21 Progestrone)
- Husband
FSH, ASA (on any day)
- Antisperm
Antibodies
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Presence of antisperm antibodies in the seminal plasma and/or
in cervical fluid prevents motility of sperms. Levels of ASA in female and male partners determine the procedure
in the treatment of infertility.
-
If ASA is high in the wife, then the treatment is IVF or
condom’s/oral steroids.
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If ASA is high in the husband then the treatment is IVF-ICSI
with oral steroids.
- Screening
for HIV, Hepatitis B, STD’s (husband and wife)
- Torch
(past history of spontaneous abortion)
-
Mucus Hostility Test- To check the receptivity of the cervical
mucus to sperm at the time of ovulation.
- Post
Coital Test-After 6 hours of intercourse, samples of cervical
mucus are examined to look for alive/ dead sperms.
- Tubal
Potency Test- To check the potency of the tubes.
- Hysterosalpingography
(H.S.G.)
- Sonosalpingogaphy
- Testicular
Biopsy - In case of Azoospermia.
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Q.
What other diagnostic tests can be carried out?
 Ans.
Vaginal Sonography is a base line scan. An ultra sound scan is carried
out to check Ovaries and the endometrial lining. In addition, fibroids
in the uterus and cysts in the ovaries can be diagnosed. Laparoscopy
is performed to inspect the uterus, tube and ovaries for the presence
of adhesions. Other pelvic problems such as Hydrosalpinx, pelvic
TB, Endometriosis and Fibroids can also be detected. Hysteroscopy
is used to inspect the cavity of the uterus via cervix using a fine
telescope called a hysteroscope. Hysteroscopy is in investigation
to assess the condition of the endometrium before IVF.
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