Infertility is defined as the inability to conceive after one year of unprotected coitus and affects about 10 – 15 % of couples
Primary infertility denotes those patients who have never conceived.
Secondary infertility indicates previous pregnancy but failure to conceive subsequently
What are the causes of infertility?
The normal process of fertilization can be interrupted at various levels resulting in infertility. The causes include
1) Male factor
2) Ovulatory dysfunction
3) Tuboperitoneal factor (including endometriosis)
4) Uterine factor
5) Cervical and immunological factor
6) Unexplained infertility
What is an infertility evaluation?
An infertility evaluation includes exams and tests to try to find the reason why you and your partner have not become pregnant. If a cause is found, treatment may be possible. In many cases, infertility can be successfully treated even if no cause is found
What are the basic investigations?
The basic investigations that must be done to before starting treatment are semen analysis, confirmation of ovulation, baseline ultrasound and documentation of tubal patency.
What are imaging tests and procedures done?
Different imaging tests and procedure are used to look at the uterus, ovaries, and Fallopian tubes to find problems. Some procedures also are used to treat certain problems if they are found. The procedures that you may have depend on your symptoms as well as the results of other tests. Common imaging tests for female infertility include the following:
Ultrasound exam- This test can predict when ovulation will occur by viewing changes in the follicles.
Sonohysterography- This special ultrasound exam looks for scarring or other problem inside the uterus.
Hysterosalpingography- This X –ray procedure shows the inside of the uterus and whether the fallopian tubes are blocked.
Hysteroscopy- The procedure uses a camera with a thin light source that is inserted through the cervix and into the uterus. This can show problems inside the uterus and help guide minor surgery.
Laparoscopy- this procedure uses a camera with a thin light source that is inserted through the abdomen. This can show the fallopian tubes, ovaries, and the outside of the uterus.
When is laparoscopy indicated?
When any abnormal findings suggestive of endometriosis or PID are detected in the clinical or sonological work up, or when tubal occlusion or per- adnexal adhesions are suspected on the HSG. In the former category, laparoscopy would be the first line diagnostic method by passing a HSG.