Everything you need to know about Fertility Care & Evalution
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As per the historical data and the general population view, ART assisted reproductive technology procedures like IVF is usually seen as a last resort in any fertility treatment.

But, with the introduction of new medicines and excellent freezing protocols, pregnancy rates have increased and complications like OHSS and multiple pregnancies has decreased. Therefore, IVF is nowadays included early as a treatment strategy to maximize the chances for successful fertility outcome.

Fertility care and evaluation

Initial evaluation and counseling

At your initial visit, a detailed history will be taken to know about your menstrual cycle, previous obstetric history if any and previous fertility treatment details and outcome.

Based on the initial evaluation and history, the couple will be advised fertility wellness test which includes complete hormonal blood tests for the wife and a detailed semen test for the husband. If the couple has already performed the tests elsewhere the reports will be reviewed.

Fertility and Reproduction – basic concepts

  • Ovary: At the onset of menstruation, tiny follicles line the surface of the ovary which gradually grows under the influence of hormones released from the brain. Each of these follicles is destined to produce and mature an egg. The dominant and the strongest follicle is selected and released at mid-cycle called ovulation. Ideally, ovulation or release of the egg happens by day 14 or 15 for a 28-day cycle. This normal physiology of the egg maturation and release dictates the quality and the quantity of the egg to be released for fertilization.
  • Fallopian Tubes: “The road to travel”…..…..the fallopian tubes are fine tubular structures whose one end is in close proximity to the ovaries and the other end opening inside the uterine cavity. The sperms after ejaculation travel through the uterine cavity into the tubes. Likewise, the egg after ovulation enters the tube through the opposite side. Fertilization happens inside the fallopian tubes and the fertilized egg, called the embryo travels retrograde to enter the uterine cavity. The fallopian tubes need to be patent and healthy to carry out fertilization and transport the embryo to facilitate implantation inside the uterine cavity.
  • Endometrial cavity/ uterus: otherwise called the bed of the baby. It has to be of an adequate thickness such that the embryo finds itself a suitable place to implant and grows its roots ensuring strong healthy implantation.
  • Sperm: As per the World Health Organization, WHO criteria, a normal semen report is as follows:
    • Count of >15 million/ml, 45-50% motility, >4% normal morphology.
    • Semen count lower than the above needs retest and revaluation of treatment strategies.
  • Hormones: the blood hormonal parameters in the wife should be normal to support timely ovulation and sustain early pregnancy.

 

Healthy pregnancy outcome is the result of egg releasing on time with patent tubes and normal adequate endometrial lining supported by a normal healthy sperm function and hormonal support of the mother.

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Dr Partha Das

Dr Partha Das is a highly skilled fertility/IVF Physician specializing in Reproductive Endocrinology and Infertility. Dr Partha consults and manages patients presenting with complex gynecological, male and female infertility issues and management of recurrent miscarriage and IVF failures.

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