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Dr Neelu Koura

Dr Neelu Thapar Koura M.S.(Obstetrics & Gynae) Laproendoscopic Surgeon Infertility Specialist

Diagnosis And Test

At our center to diagnose the reasons of infertility certain Investigations and Tests are done and accordingly we group the couples under following categories. If the reason of infertility is –

Tubal Factors :-

 If Hysterosalpingography is showing blocked tubes, then patient has 2 options :- 1-  If it is a long standing infertility, we recommend IVF. 2– Or else we do Laparoscopy to confirm tubal block because HSG sometimes gives false +ve results and also by Laparoscopy we can get additional information about condition of tubes and other pelvic pathologies which can affect the course of treatment. If we find that the reason is – –      Patent Tubes :- then we recommend three cycles of IUI. And if still no conception then we direct the patient towards IVF. –      Blocked Tubes :-  then we recommend IVF Advise :- If age of patient is more than 35 and also if  infertility has been more than 5 yrs, then the person should go for IVF straight away.

Endometriosis :-

Laparoscopy is the gold standard for confirming diagnoses of Endometriosis, which is very much a common cause of infertility. Cases of mild Endometriosis can undergo laparoscopic surgery for the removal of chocolate cysts. Thereafter, they can try ovulation Induction + IUI, and if this fails then patients must resort to IVF early as endometriosis is bound to increase with time and delay will only decrease the chances of conception.

Polycystic ovaries :-

Diagnoses of Polycystic ovaries is confirmed by clinical history, examination, hormone profile and ultrasound. In patients with Polycystic ovaries ovulation is induced by Clomiphene Citrate, or Gonadotropins, and then they are supplemented with IUI (Referto treatments for detail). If after 4-5 months patient does not ovulate or does not conceive inspite of ovulation then IVF will be a more better and successful procedure for this group of patients.

Male Factor :-

If the factor of infertility is Patients with low sperm counts, poor motility of sperms, poor Morphology need Andrological evaluation by a urologist (Available on floor at our centre). Medicines are prescribed as treatment but one need to remember that these medicines benefit small segment of patients only. If after 3 months there is no improvement and you have already tried medical management and waited enough then IVF/ICSI can be a boon for you. Please don’t refrain yourself from this treatment only because of some Myths. IVF/ICSI is the treatment of choice.

Premature Ovarian Failure/Menopause :-

Patients whose Ovaries have stopped functioning and have lost the ability to form egg or have attained natural Menopause can also conceive using option of donor egg.(For procedure please read the Treatments Section)