Infertility is a common problem, occurring in approximately 10-15% of couples worldwide. Infertility is defined as the inability to conceive a pregnancy after two years of unprotected intercourse. It can be either primary – when the female has never conceived or secondary – when there has been a previously documented pregnancy – either a live birth a even a failed pregnancy e.g. miscarriage or ectopic pregnancy.
Causes of infertility
|Female factor – Tubal problem||20%|
|Female factor – Ovulatory problem||20%|
- Semen analysis of husband.
- Basic blood investigation of female.
- Harmone analysis.
- Ultrasound – pelvis.
- Hysterosalpingography – to see tube patency.
- Laparoscopy: Diagnostic laparoscopy is the gold standard to detect tubal and peritoneal causes. Any abnormality including endometriosis and pelvic adhesions that are not detected by ultrasound and hysterosalpingography is readily seen and also rectified. The dye can also be injected inside the uterus and patency of fallopian tubes confirmed. Infertility treatment can be modified according to the problem present:
If ovulatory disorder – medicines are given.
If polycystic ovaries are present – ovarian drilling is done.
If fibroids are present – myomectomy is done.
If tubes are blocked – the site of blockage is determined and reanastomosis is done.
If tubo ovarian adhesions present – Adhesiolysis is done.
Tubal recanalisation can be done if there is a history of tubectomy.
If Hydrosalpinx is present – Neosalpingostomy is done.
- Hysteroscopy: In this procedure a telescope is introduced inside the uterus & the uterine cavity visualized.
If polyps are present – Polypectomy is done.
If septate uterus – septum is cut.
If ashermans syndrome present – Adhesiolysis is done.
Endometrical biopsy can be taken for sent for histopathological examination.