Couples often don’t know what to expect when they meet with their fertility specialist for the initial consult. Your doctor will recommend a diagnostic plan or infertility work-up to you. Infertility workup involves a counselling session, followed by a series of comprehensive & detailed tests which are essential to determine causes of infertility. This helps to decide which treatment option would be the most suitable for a particular couple. Mohali IVF centres pay special attention on the initial workup for an infertile couple and help them to select right kind of fertility treatment.
Male work up-
A man can expect to be queried about his family history. He will be asked whether he has ever undergone genital or prostate surgery, if he finds it difficult to achieve an erection, the nature of job he is doing, whether his job involves exposure to dangerous chemicals and if he is suffering from any chronic health problem.
Physical exam of the genitals and prostate is then done to check for any abnormalities that are affecting the sperm production or release.
Your doctor will recommend a series of blood tests to screen for conditions that might be affecting your fertility. These tests may include hormonal levels, sugar levels, viral markers, etc.
To determine the quality & quantity of sperm, semen analysis is done. It also helps to detect any morphological abnormalities in the semen sample.
Female work up-
A woman can expect to be questioned about her medical and menstrual history. This may include questions about regularity of menstrual cycle, abdominal surgeries, prior conceptions/miscarriages, any kind of gynaecological ailment such as endometriosis/ pelvic inflammatory disease, etc.
Physical Examination & Ultrasound-
The doctor will perform a physical exam during which he or she will do a pelvic exam and look for certain characteristics such as excess hair growth. The physician may also examine your breasts to see whether they leak any fluid or not.
Fertility assessment also involves a series of tests which include thyroid gland function, prolactin levels, sugar levels, etc
Day three assessment-
Between the second and fourth day of your period, a hormone assessment test is done. This cluster of tests is done to check hormone levels such as FSH, LH and E2 hormones.
Mid-luteal progesterone level-
If the results of day three assessment are normal, and your doctor is still in doubt whether you are ovulating or not, then he will recommend an additional blood test to measure progesterone levels as well.
If neither egg nor sperm production appears to be the problem, then it is possible that your partner’s sperms are running into a roadblock in the fallopian tube. If this is the case, then there are three different types of tests which can be used to determine absence/blockage of tubes. These tests include hysterosalpingogram (HSG), Sono histogram (SHSG) and diagnostic laparoscopy.
What happens after a work-up?
Fertility specialist will help you zero down on the most suitable infertility treatment according to your work-up. Many patients achieve a pregnancy just by taking medication which boosts egg and sperm production in both the partners. However, others may need to undergo more invasive and expensive procedures like IUI, IVF and ICSI as they are commonly used for unexplained infertility. There are some fertility centres in India where you can get low-cost IVF treatment.
This is a study on ‘Neglected symptoms of heart failure presented as peripartum cardiomyopathy: a case of maternal near-miss’. https://goo.gl/7b4E5H