Diagnosis / Tests for MOM to be
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.
For the Male partner the expected counts for normal conception is
Sperm Concentration 8 – 15 million/cc
If the results are between 8 to 15 million with at least 40 % motility Intrauterine insemination ( IUI ) can be done with good success rates and minimal costs
By doing IUI, the semen is concentrated from 2 to 3 ml to 0.5 ml with maximum active sperms and placed in the uterine cavity for better chances to meet the oocyte.
If Sperm Concentration less than 5 million
If counts are less than the above values, even after medications and lifestyle modifications the ICSI will be the best option. Though the costs are little more the success rates are very good, so having your own genetic baby will come true.
All male fertility treatments in one Roof
· Semen and testicular sperm freezing
· PESA/ Testicular extraction of sperms (TESA, TESE)
· Testicular mapping/ Micro TESE
· Vasectomy reversal
· Varicocele surgeries
· So even if there is no sperm in the semen sample, need not worry, the couple can still have their own genetic child in most of the instances.
The problem in having Sex
We do have sexual dysfunction clinics which help to resolve many fertility problems.
Sex counselors help in identifying the problems
If vaginismus / painful intercourse we offer best remedies
If Erection difficulty/ Premature Ejaculation- particular tests and medications will help.
Conclusion
Do the basic workup for both male and female partners as the first step, this can be useful during pregnancy even if you become pregnant in the next month
Making sure there are no major issues will by itself inculcate a positive feeling
Even if a problem is identified, early recognition is the best way to rectify problems
Health and time can never be got back once lost. Hence check yourself and stay healthy