Trouble Conceiving

Identifying the problem is the foremost important step. But all patients cannot be offered the same set of investigations. It is important to categorize according to the patient’s previous history, previous investigations done.

Investigations are done for both male partner and female partner

For MOM to be – Primary level

Blood investigations:

To assure the general health- CBC, RFT, GTT, HBA1C, LFT

To rule out infective conditions which can compromise the health of developing baby- HIV, HBsAg, HCV- Ab, Rubella IgG.

Hormonal evaluation of ovarian function- AMH, thyroid, prolactin levels which can influence the success rate and brain growth of fetus

Genetic evaluation- Karyotyping (if needed)

Immunological investigations – APLA screening (if needed)

Ultrasound:

To evaluate uterus, endometrium, and ovaries

Secondary Level:

When OI and Natural cycle fails for 3 to 4 cycles/ Married for more than 2 years and trying effectively then initially itself

Tube patency testing -Saline Sonography, HSG

Diagnostic laparoscopy

Diagnostic hysteroscopy

Trial cannulation

If Problem identified on an investigation

Operative Hysteroscopy (if needed)

Septal Resection

Myoma Resection

Polypectomy

Adhesion Removal

Operative Laparoscopy (If needed)

Cystectomy

Myomectomy

Adhesiolysis

Tubal Canalization

Endometriotic cystectomy

“For the Father to be”:

There is an equal contribution by male and female partners in fertility.

So evaluating the male partner should be done even if the female is having problems.