Evaluation of Infertility

Semen analysis -
A specimen of the male partner's semen is obtained in a sterile collection cup, and brought to the laboratory. The best results are obtained when the husband abstains for 3 days, and the sample arrives at the lab within an hour of ejaculation. The sample is then evaluated for volume, sperm count, motility (the percent that are swimming) and morphology (the number that are normally shaped). Although normal values, vary between laboratories, a normal count is typically >20 million/ml and normal motility and morphology are >50%. This test is done rule-out male causes for infertility, and to see if the couple might benefit from treatment such as artificial insemination.

Hormonal assays -
Tests are done on the blood to detect the level of hormones. Hormones are chemical substances produced by various organs in the body. An interplay of those produced by the ovary/testis, thyroid, pituitary and the adrenal glands is responsible for fertility.

Hysterosalpingography (HSG) -

This procedure is used to assess the uterine cavity and to check the patency of the fallopian tubes. The test is performed as an outpatient. A radio opaque solution is injected into the uterine cavity through the cervix. The passage of the dye through the uterus into the fallopian tubes is observed on a video display unit. X-rays are taken at the right intervals.

Hysteroscopy -
If a uterine abnormality is suspected after the HSG, your doctor may opt for this procedure, performed with a thin telescope mounted with a fiber optic light, called a hysteroscope. The hysteroscope is inserted through the cervix into the uterus and enables the doctor to see any uterine abnormalities or growths. "Photos" are taken for future reference. This procedure usually is performed in the early half of a woman's cycle so that the build-up of the endometrium does not obscure the doctor's view. However, if the doctor is planning to do an endometrial biopsy at the same time, it is done near the end of the cycle.

 

 

 

Laparoscopy-
A narrow fiber optic telescope is inserted through a woman's abdomen to look at the uterus, fallopian tubes, and ovaries and to discern endometriosis or pelvic adhesions, and is the best diagnostic tool for evaluating the ovaries. This test us usually done two or three days before menstruation is expected, and only after an HCG beta blood test ensures the woman is not pregnant.

Sonosalpingography -
In this test, under ultrasound guidance one can observe the passage of fluid i. e. saline (injected into the cervix via a syringe attached to a catheter), through the uterus into the tubes and finally spilling around the ovaries into the pouch of Douglas. This is an outpatient procedure.

 

 

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REPRODUCTIVE MEDICINE
Synopsis
Infertility
Evaluation of Infertility
Fetal Medicine