Tuesday, 16 October 2012

Evaluating Infertility in Women


Evaluating Infertility


Before discussing anything about infertility is very much important to understand what is infertility? In medical terminology, a women that is not able to conceive after 6 to 12 months of having sex without any contraceptives is said to be infertile. However, this is very generic statement and many factors like age of the couple, frequency of intercourse, genetic factors are also important. The couple is said to undergo infertility evaluation so that exact cause can be determined and specific treatment can be suggested.


Methods of evaluating infertility in women:


There are various tests available that help in evaluating infertility, but doctors do not suggest that unless preliminary evaluation is done to understand probable cause of it. We at International Fertility Centre normally look some basic factors like:


  • Medical history: Our experts try to get clues from past health history of woman, her physical and sexual development during childhood, family history, illness, infections, exposure to radiations or toxins, consumption of drugs, tobacco or alcohol, etc.
  • Physical examination: It is also an important factor of infertility evaluation. Physical built, obesity, deficiency of vitamins or hormones, underweight, etc. will provide indications of physical factors behind infertility.
  • Menstrual history: Dr. Reeta Bakshi has a deep study of menstrual cycle to determine absence of menstruation, cycle irregularity etc. These conditions will have to be cured to eliminate infertility. Doctors perform ovulation test to determine abnormalities and measure hormone levels. Blood samples are collected to measure the hormone levels that control pregnancy.
  • Evaluation of uterus and fallopian tubes: These tests indicate the structural flaws of important organs responsible for infertility. Small uterine cavity, fibroids and other structural abnormalities, scarring of fallopian tube can make the pregnancy impossible. There are various methods of performing these tests:
    1. Hysterosalpingogram: It is X-ray imaging of the uterus performed under medical supervision by inserting a small catheter in the uterus. A special liquid is filled inside and X-ray image is taken and analysed to identify structural abnormalities.
    2. Hysteroscopy: It is a method of inserting a small tube with a source of light inside the uterus and to visualise the linings and inner portion of the uterus on the computer screen. 
    3. Pelvic ultrasound: Ultrasound images are used to identify structural abnormalities.  Sometimes, sterile solution is injected in the uterus cavity to enhance the visualization. It is called Sonohyseogram.
    4. Laparoscopy: A thin tube is inserted in the uterus using a small incision in the lower abdomen. A source of light at the end of this tube makes the view of entire uterus clear to the doctor looking at the computer screen.

  • Genetic tests: In the case where doctors suspect genetic or chromosome related causes behind Infertility, this test is suggested. Blood sample is collected to perform these tests.

  • Methods of evaluating infertility in men:


    • A thorough physical examination of the genital area is done to identify structural abnormalities.
    • Blood and urine tests to rule out the possibility of deceases, hormonal problems, STD or infections.
    • Semen analysis to check the sperm quantity, quality and other factors.
    • In case there is a suspicion of varicose veins in testicles, doctors may go for Doppler ultrasound.

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