- Pre Treatment Evaluation And Counseling
During your initial visit our Specialist will take detail history and do a clinical examination.
Initial assessment includes age, duration of infertility, menstrual pattern, any significant medical or surgical history, body weight/BMI, BP, and history of substance abuse. At the same time the previous fertility treatment record is also checked if done.
Our counselor make you opt for balanced diet and daily physical exercise for 20-30 min along with useful fertility tips to cope up with stress of infertility in the form of meditation or yoga. Following a healthy daily routine with adequate sleep is as important as leaving harmful habits like junk food, caffeine, tobacco or alcohol. Lifestyle change alone can boost chances of conception.
- Pelvic Ultrasound And Follicular Monitoring
A simple trans-vaginal scan is scheduled as per the menstrual cycle to check the ovaries and uterus of the female. It serves few important purposes:
- Gives an idea about antral follicle count which means number of eggs present in both ovaries.
- Endometrial thickness and pattern as per the day of menstrual cycle can be assessed.
- Rules out any pathology like ovarian cyst, endometriosis, polyp, fibroid or any malformation of the uterus.
- Hormonal Assays
For a woman’s menstrual cycle to allow ovulation, egg fertilization and embryo implantation into the womb, it is crucial that the female hormone system is well regulated. The important hormones are Anti-Mullerian Hormone (AMH), Follicle Stimulating Hormone (FSH), Leutinizing Hormone (LH), Estradiol (E2) & Progesterone (P4). It should be noted that the blood test should be done between the second and fifth day of the menstrual cycle, since your hormones are in basal levels and can be compared with the reference values. Female sex hormones also give a reflection of the ovarian reserve which means the number of eggs present in both the ovaries of female at one point of time.
There are certain other hormones which help in regulation of menstrual cycle & ovulation like thyroid, prolactin and few others.
- Tubal Patency Tests
Fallopian tubes play very important role in egg pickup after ovulation, fertilization with sperm and transporting the embryo to uterus for implantation. Any blockage in the tubes can lead to infertility. To check the patency of tubes Hysterosalpingography (HSG), Sonosalpingography (SSG), Hysterosalpingo-contrast-sonography (HyCoSy) or Diagnostic Laparoscopy is advised.
- Ovulation Induction
The use of drugs to stimulate development of eggs in female is called ovulation induction. It is mainly done for patients with PCOS or patients undergoing IUI. In ovulation induction we aim at producing 1-2 eggs only and the cycle monitoring is done with TVS.
- Diagnostic Laparoscopy and Hysteroscopy
This is a day care procedure done under anesthesia. A thin 5mm gynecological endoscope is introduced via a tiny incision in the abdomen to check uterus, ovaries and fallopian tubes. It is mainly done in cases where fallopian tubes are blocked on HSG or there is fibroid or endometriosis or if there is any history of pelvic infection. This procedure is diagnostic as well as therapeutic at the same sitting.
Now a day Hysteroscopy is also performed along with Laparoscopy where the 3-5 mm hysteroscope is introduced through vagina in the uterus to check for any abnormality like polyp, fibroid or intrauterine adhesions. Diagnostic Hysteroscopy is also used to collect biopsy sample to check for pelvic infections and TB.
- Endometrial Receptivity Array (ERA)
ERA test is done in recurrent IVF failure cases. ERA evaluates the endometrial receptivity to determine the optimal time for embryo transfer. In this test the window of implantation is calculated in exact hours by doing genetic analysis of the sample of endometrial lining in a natural or stimulated cycle. It is an OPD procedure and painless.