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PROCESS OF FERTILISATION
To conceive, an egg (ovum) from the woman has to combine with a sperm from the man. An ovum is released from an ovary when a woman ovulates. This usually occurs once a month between 12 and 16 days from the start of her last period if she has a regular monthly cycle of 28-30 days. The ovum travels down a Fallopian tube to the middle of the womb (uterus) over 12-24 hours.
WHEN TO SEE A DOCTOR
It's a myth that infertility is always a "woman's problem". Half of all cases of infertility result from problems with the man's reproductive system. Of couples that seek medical treatment for infertility, 20% conceive before the treatment actually begins. One reason may be that anxiety about infertility may have contributed to the fertility problem, so contacting a doctor and counseling helps. 50% conceive within two years from starting treatment. Most infertility results from physical problems in a man or woman's reproductive system.
It is usually worth seeing a GP if you have not conceived after one year of trying. A GP can check for some common causes, talk things over, and discuss possible options. You may want to see your GP earlier, if the woman in the couple is over the age of 36 or if either partner has a history of fertility problems.
Investigations for the male
Apart from necessary basic blood and urine examination, semen analysis will be done.
Investigations for the female
Routine investigations such as CBC, FBS, urine routine, TSH,/ FSH / LH / Prolactin (Day 2 of the cycle) VDRL, Hepatitis B, HIV and Blood grouping and Rubella IgG levels will be done. The following tests could be done as per the doctor's requisition:
The above tests are to be done on day 2 or 3 of the menstrual cycle (First day of the period is counted as Day 1).
Assisted Reproductive Technology (ART) is the term used for infertility treatments. These treatments are designed to increase the number of eggs or sperms and to bring them together, thus improving the likelihood of pregnancy.
Infertility treatment can range from practical lifestyle changes to extended medical procedures - depending on the nature of the problem. As a first step, it may just be a few simple measures, like awareness of fertile period and psycho social interventions (Quit Smoking / Alcohol, Relaxation Therapy).
Fallopian tube problems - surgery may help some women with infertility caused by Fallopian tube problems. Some women who have had a tubal tie (sterilisation) in the past for contraception may be able to have their fertility restored by tubal surgery.
Endometriosis - laparascopic surgery may help to improve fertility in women with endometriosis.
Polycystic ovary syndrome - an operation on the ovaries may be suitable for some women with PCOS. The procedure is sometimes called ovarian drilling or ovarian diathermy. Using keyhole surgery, a heat source (diathermy) is usually used to destroy some of the tiny cysts (follicles) that develop in the ovaries. It is usually done if other treatments for PCOS haven't worked.
Fibroids - for women with fibroids, surgery (to remove the fibroid) may be considered if there is no other explanation for the infertility.
Male infertility - when sperm are blocked by an abnormality in the epididymis (a coiled tube inside the scrotum that is used to store sperm) in the testis, surgery may help. Varicoceles (like varicose veins of the testes) that occur in men who have an abnormal sperm count may be repaired.
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