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Diagnostic Services For Infertility

Tubal patency test

Hysterosalpingography: This could be done through a hysterosalpingography, (HSG) saline infusion sonography or a laparoscopy. This is done to check the patency of the tubes as well as get an idea of the uterine cavity. Around the 6th to 8th day postmenstrually a dye is inserted in the uterine cavity with the help of a cannula. Then X ray pictures are taken and spill of the dye through patent tubes is recorded on X ray.

hsg

Saline infusion sonography. Similar procedure can be done with introduction of saline into uterine cavity and visualization through ultrasound. The flow of saline is noted.

Laparoscopy and chromopertubation: This is done under general anesthesia and a laparoscope connected to a camera can visualize the tubes. A dye is passed through the uterus and its spill is noted from the tubal opening.

Transvaginal sonography

This is an ultrasound done through the vagina to assess the uterus tubes and adnexa. It is done after emptying the bladder. The ultrasound probe is introduced into the vagina. Uterus and ovaries are visualized for any pathology. Growth of the follicle is noted.

Transvaginal sonography

Advanced Semenalysis

It is an important part of assessment of the male. We do an advanced semenalysis where we measure the count, motility and morphology. The semen is given by the male partner and tested immediately. We have in house facilities of a separate semen collection room. Semen analysis is the first and basic test of the male. It not only tells us about the quantity of the sperm but also about the quality and fertilizing potential.

Evaluation of male patient

Male infertility is dealt with in a specialized way. All men have the facility of advanced semen analysis. The causes of male infertility could be testicular, pre testicular, or post testicular. A complete hormonal assessment is done where needed. A genetic analysis may be needed in patents with extremely low sperm counts. In cases of azospermia (absent sperms) testicular or epidydimal sperm extraction can be done and an ICSI performed. See section on TESA, PESA for azoospermia.

Hormonal tests

Various hormones tell us about the status of the ovaries. This includes follicle stimulating hormone, lutienizing hormone, thyroid, prolactin, AMH. All these hormones are done at a single place.

3D ultrasonography

Conventional sonography provides two-dimensional views of three-dimensional structures

The obvious advantages are that 3D ultrasound offers more rapid and reproducible image acquisition as well as enhanced visualization and post-processing capabilities. Its main applications include assessment of uterine congenital anomalies, intrauterine pathology, tubal patency, polycystic ovaries, ovarian follicular monitoring and endometrial receptivity.

It provides accurate measurement of organ dimensions and volumes, improved anatomic and blood flow information, improved assessment of complex anatomic anomalies, a better specificity in regard to the confirmation of normality and standardisation of the sonographic examination procedure

Ovulation induction and follicular monitoring

It is done transvaginally and involves series of ultrasounds to see growth of the follicles and endometrium. It helps in identifying the time when egg is mature in order to do IUI or egg retrieval in IVF. It involves process of serial ultrasonic monitoring of the ovarian follicles that helps in identifying egg maturation status as well as is used for determination of uterine lining thickness. For women under fertility medication, follicle monitoring assists in assessing response to treatment and in making adjustment to the fertility medication dosage during treatment in event of seeing inadequate response.

Counseling sessions

There is immense need for intensive and appropriate counseling in IVF patients seeing the intricacies and complex nature of the treatment. Time is taken out specially for these sessions. The whole treatment is explained. Number of visits are detailed and monitoring is discussed. Various options in Assisted reproductive technology is outlines. The successs rates and the cost is looked into. Counseling is essential to maintain transparency at each step between the patient and the doctorWe believe that the IVF patient needs immense support. We lay stress on this because we know that infertility is a condition which takes an enormous toll on the person suffering from it. Not many realize, that the most energetic, productive years get spent in getting oneself tested repeatedly and undergoing inappropriate treatment which leads to an emotional, financial and physical toll which translates into a negative impact on their marriage, profession, health, self esteem and relationships. Hence, these patients require all the support and counseling which can be given.