DIAGNOSTIC EVALUATION OF COUPLE FOR INFERTILITY TREATMENT
Diagnostic evaluation is the term that our establishment uses to describe our process of getting to know our clients better. This process includes a Detailed history of the client, different blood test, semen test, hormones, ultrasound, HSG, stress, work life balance etc. It also includes questions about the person’s mood and behaviour to better understand what symptoms might be most difficult for the person. Moreover, it can also include questions about the person’s past behaviour as well as life experiences. Furthermore, how exactly do we diagnose reasons of infertility in a couple, is also a part of diagnostic evaluation.
Before infertility testing, we work to understand your sexual habits and then we will make recommendations to improve your chances of getting pregnant. In some of the infertile couples, no particular cause is found (which is unexplained infertility).
Infertility evaluation can actually be expensive, and sometimes involves uncomfortable procedures. Some medical plans may not cover the price of fertility treatment.
TESTS FOR MEN
Fertility in male requires that the testicles produce enough healthy sperm, and also that the sperm is ejaculated really effectively into the vagina and then travels to the egg. Tests for male infertility try to determine whether any of these processes are impaired.
You may have to go through a general physical exam, which may include examination of your genitals. Specific fertility tests may include:
SEMEN ANALYSIS
Semen is usually obtained by masturbating or by interrupting intercourse as well as ejaculating your semen into a clean safe container. We analyse your semen specimen in our lab.We may sometimes ask for more than one semen specimens for the test to be as accurate as possible. In some cases, urine may also be tested for the presence of sperm.
HORMONE TEST
To check male fertility, male hormones including Testosterone are done from blood sample so as to determine any hormonal imbalance.
TESTICULAR BIOPSY
In some cases, where sperm count is nil, a testicular biopsy can be performed to check sperm production
GENETIC TESTING
Genetic testing may be required in few cases to see whether there is a genetic defect causing infertility.
IMAGING
In certain situations, imaging studies like a brain MRI, transrectal or scrotal ultrasound, or a test of the vas deferens (vasography) could also be performed.
OTHER SPECIALTY TESTING
In rare cases, other tests to evaluate the quality of the sperm may also be performed, like evaluating a semen specimen for DNA abnormalities.
TESTS FOR WOMEN
Fertility for females relies on the ovaries releasing healthy eggs. The reproductive tract must allow an egg to pass into the fallopian tubes and thus join with sperm for effective fertilization. The fertilized egg should be able to travel to the uterus as well as get implant in the lining. Tests for female infertility are designed to find out if any of these processes are impaired.
You may have to go through a general physical exam, including a regular gynaecological exam. Specific fertility tests may include:
OVULATION TESTING
A blood test measures fertility hormones to determine whether you’re ovulating.
OVARIAN RESERVE TESTING
To check ovarian reserve AMH testing is done along with other hormones early in the menstrual cycle.
OTHER HORMONE TESTING
Few other hormones like thyroid function test, insulin are also required
HYSTEROSALPINGOGRAPHY
Hysterosalpingography (HSG) is basically a contrast X-Ray test to check uterine cavity and fallopian tubes to find any kind of blockage, hydrosalpingitis, asherman syndrome etc.
IMAGING TESTS
Pelvic ultrasound looks for uterine or ovarian disease. Trans vaginal USG (TVS) is done to check and monitor growth of follicles and ovulation studies. Sometimes a sonohysterogram, also called a saline infusion sonogram, is also used to see details inside the uterus that aren’t seen on a regular ultrasound.
Some other test which are done in very rare cases include:
HYSTEROSCOPY
Depending on your symptoms, the doctor may request a hysteroscopy to look for uterine disease. During the procedure, the doctor may insert a thin, lighted device through your cervix into your uterus to view any potential abnormalities.
DIAGNOSTIC LAPAROSCOPY
This surgery which is minimally invasive involves making a small incision beneath your navel and then inserting a thin viewing device to examine your fallopian tubes, ovaries as well as uterus. By doing laproscopy we can rule out endometriosis, blockages, scarring and some other defects in ovaries, uterus and fallopian tubes which otherwise are difficult to find.
We together with you will decide which tests you will have and when. It’s not necessary that each and every infertile couple has to go through these entire tests.
Some other things we include in our Diagnostic Evaluation are:
MEDICAL HISTORY AND SYMPTOMS
We will discuss any medical conditions you have or had in the past, including sexually transmitted infections (STIs). Family history of certain diseases (Diabetes, Hypertension, Thalassemia etc) is also recorded to evaluate and rule out certain allied causes of infertility.
If you’re a woman, then we may ask if you have regular periods and whether you experience any bleeding between periods or after sex.
MEDICINE
Some medicines can affect your fertility. We will ask you about any medicine you’re taking and might discuss alternative treatments with you.
You should mention any non-prescription medicine you are taking, including herbal remedies and supplements.
LIFESTYLE
Several lifestyle factors can affect your fertility. What we really want to know is:
- if you smoke
- how much you weigh
- how much alcohol you drink?
- whether you take any illegal drugs
- if you’re stressed
Thus, we recommend making changes to your lifestyle to increase your chances of conceiving.
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