Infertility

(source: Google image)

What is infertility?

About one in every seven married couples experiences difficulty in having children. Sub-fertility affects both men and women equally and therefore the problem should be regarded as a shared one.

When to consult the Doctor??

It is wise to seek advice from a fertility specialist if you do not become pregnant after trying to conceive for about six months to one year (depends on female partner's age)

(source: Google image)

The above protocol is applicable for women with no pelvic pathology such as fibroids, endometriosis and ovarian cysts 

We can categories Infertility problems as following:

i) Primary Infertility – where someone who has never conceived a child in the past and is facing difficulties to conceive

ii) Secondary Infertility – where a person has had one or more pregnancies, including miscarriages in the past, but is having difficulties to conceive again.

Infertility doesn't mean you can never have a child.
It just means you or your partner or the both of you need some “fine tuning” or some form of fertility treatment to help you to conceive.

What causes infertility?

Fertility problems in Women

a)    Ovulation Problems - Inability to produce mature eggs or inadequate number of eggs due to pre-mature menopause  and aging problem

b)    Blocked tubes - prevent sperms from reaching the eggs

c)    Endometriosis

d)    Polycystic ovaries

e)    Smoking

f)     Age, (>35 years fertility problems; after 45 years pregnant is rare)

Fertility problems in Men

a) Poor semen quality
  * Low sperm count
  * Low sperm motility
  *Abnormally formed sperm
  *Blocked sperm ducts

b) Alcohol consumption and smoking lowers sperm count

c) Drugs - affects sperm production

d) Exposure to radiation
e) Varicocele

Whom to test and when to test??

   i) Women who is >35 years old and have been trying to conceive for 6 months plus

  ii) Women who is < 35 years old and have been trying to conceive for one year

            

What kind of tests will be conducted??

a) For Men

   -SFA (Seminal Fluid Analysis) (refer to note 1 & 2)

b) For Women

     Ovulation tests

 1. Transvaginal Scan (TVS)

 2. Hormone tests

     Tubal patency

      1. HSG (Hysterosalphingogram)

      2. Laparoscopy

Seminal Fluid Analysis

Instructions before proceeding to seminal fluid analysis

(Note 1 & 2 respectively)

Image illustrates alive and dead sperms.

Trans vaginal Scan (TVS)

Picture 1: Scanning room

(source: Google image)
Picture 2: Intra-transvaginal ultrasound probe

(source: Google image)

Picture 3

(source: Google image)

Picture 4: Scan image shows development of follicles 

(source: Google image)

What is HSG??

HSG is carried out in women who are <35 years old and in women with no gross pelvic pathology noted on ultrasound . 

HSG is an office procedure which takes no longer than a half an hour. It is done in radiology department and carried out by placing an iodine-based dye through the cervix and taking x-rays to help to determine the shape of the uterus and to check whether the fallopian tubes are blocked or open.The pain is bearable and there is no need for anesthesia.  Occasionally the dye used during a hysterosalpingogram will push through and clears the blocked tube. This test also helps to discover problems in uterus, such as an injury, polyps and fibroid's. 

Fasting before procedure is not required. This test is usually carried out after your period that is from Day 6 to Day 10. We don’t do the procedure during the Day 10 to Day 14 as it will be your ovulating period, which we don’t want to interfere with the possible pregnancy.

Picture 5: HSG procedure room

(source: Google image)

Picture 6 :  The injected dye shows the blockage at the both side of fallopian tube (arrow)

(source: Google image)

Picture 7: Injected dye illustrates the patent fallopian tubes

(source: Google image)
Picture 8: Brief explanation of HSG procedure

Pre-pregnancy Counseling

 It is vital to go for a consultation before you plan to get pregnant especially if either or both partners have medical related issues. During consultation with the doctor, they can investigate whether there are any problems that could affect their pregnancy and other problems that should be treated to improve fertility and increase the chances of getting pregnant and having a healthy baby.

Contact us for further information regarding your fertility issues;

Contact Number:

Hospital D/L   : 05 - 540 5555 EXT. 5665/5666

Tel / Fax        : 05 - 540 5665

Email             : drvjbalan@gmail.com

p/s:  Stay tune for our next topic " Laparoscopy"!!! 

It's hard to wait around for something you know might never happen; but it's even harder to give up when you know it's everything you want. Don't give up. Seek help!

-Admin K