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Infertility Investigations

For Male Patients

  • Complete blood picture

    Random blood sugar

    Viral Screening

    Semen Analysis
    Sperm DNA Fragmentation Test

    A semen analysis is done as part of the initial consultation. We recommend two to three days' abstinence before producing the sample. Due to differing parameters between clinics we strongly recommend having an analysis performed here.

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For Female Patients

  • Complete blood picture

    Random blood sugar

    Viral Screening

    Screening for Tuberculosis

    Hormonal tests for S. Prolactin and Thyroid function tests

    Vaginal ultrasound (VOLUSON P8 3D/4D SCAN)

    Blood tests for FSH, E2, LH and AMH

    AMH (Anti-Mullerian Hormone) is a hormone that is produced by the ovaries and is strongly correlated with the egg follicle pool. This hormone does not fluctuate month to month like other hormones, and is a strong predictor of ovarian reserve.

    ENDOMETRIAL BIOPSY

    TB-PCR on the ENDOMETRIUM

    NATURAL KILLER CELLS

H.S.G (Hystero Salpingo Gram)

  • Usually performed between days 7-9 of the cycle. This is a dye test to check the patency of the fallopian tubes.

3D/4D Ultrasound (VOLUSON P8)

  • GE VOLUSON P8 3D/4D REALTIME- for complete workup of the female infertility Patients.

  • 3D ultrasound is an emerging technology with great promise to further this role. This overview describes and illustrates the applications of three-dimensional Transvaginal ultrasound in female infertility.

    The obvious advantages are that 3D ultrasound offers more rapid and reproducible image acquisition as well as enhanced visualization and post-processing capabilities. Ongoing research will likely continue to define the clinical role of 3D ultrasound and it is possible in the near future to regard to 3D ultrasound as the Golden Standard for pelvic imaging.

    Uterine cavity assessment

    The main advantage of pre cycle assessment using 3D is the coronal view of the uterine cavity to exclude Mullerian anomalies

    Uterine cavity lesions such as fibroids (submucous, Intramural and subserous) , endometrial polyps & IU Synechiae

    Ovarian volume calculation

    3D ultrasound is more accurate in determining ovarian volume using the Virtual Organ computer-aided Analysis (VOCAL, GE Kretz) technique.

    This technique employs a rotational method which involves the manual delineation of the ovarian volume throughout several planes as the data set is rotated through 180 degrees in a consecutive series of rotations

    Number of follicles at the early follicular phase has been reported to be a good test for prediction of ovarian response All follicles < 10mm are measured using 2D ultrasound in the longitudinal and transverse planes, however 3D techniques are now available for automatic calculation

    The uterine abnormality most commonly associated with miscarriages is a uterine septum

    Normal uterine lining does not grow over a septum, so if the embryo implants in the septum, it will not have an adequate blood supply for growth.

    The traditional way to correct a septum was performing an abdominal surgery called a "metroplasty", where the septum was removed, and the uterine walls sewn together.

    This surgery was not very successful, and nowadays we can remove a septum by hysteroscopy (``HYSTEROSCOPY GUIDED RESECTION``), which provides a much more successful outcome.

    Understanding the type of uterine defect one has is critical, because this will determine if surgical intervention is needed to optimize one's chances of a successful pregnancy.

    A 2D ultrasound can suggest that an abnormality is present, but does not necessarily differentiate among subtle abnormalities. The advantage of 3D/4D ultrasound is that it will better define the specific defect present. Based on this improved image, the best recommendation can be made

    Using ultrasound imaging in implantation Optimal conditions of implantation could be:- Endometrium > 7 mm, Endometrial volume > 2 ml , Dominant follicle >18mm, Hypo-echogenic endometrium with 3 well delineated layers, Uterine PI < 3 and the Presence of sub-endometrial vascular flow.

    We use a LOGIQ C5 Premium Ultrasound machine for our Oocyte retrievals and Embryo transfers.

    LOGIQ C5 Professional Ultrasound – at our Banjara hills OPD

Post-CoitalTest

  • This is performed approximately 24-48 hours after ovulation and is done to assess the receptivity of the cervical mucus.

    The doctor will advise you to have intercourse then attend the Unit for the test the next morning or later the same day.

Progesterone blood test

  • Taken approximately one week after ovulation occurs and is checked to ensure that the progesterone level rises as it should after ovulation.

    Often done in conjunction with the Ultrasound Follicular Tracking.

Laparoscopy

  • A Laparoscopy is a keyhole procedure to look inside the woman's pelvic area and examine the ovaries and womb. The procedure is performed under general anaesthetic and involves passing a telescope into the abdomen (tummy) through a small cut.

    It helps us to visualize the uterus, fallopian tubes, check the patency but most importantly an FTC (Fallopian tube catheterization) can be attempted to open the tubes if they are blocked.

Hysteroscopy

  • A Hysteroscopy is a procedure performed under anaesthetic where a tiny telescope is passed into the vagina and through the cervix (entrance to the womb) to view the lining of the womb and the opening of the Fallopian tubes.

    A sample of the womb lining (Endometrial biopsy) is taken for examination. This procedure also allows for the removal of small polyps / adhesions present in the uterus.

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