Investigations

When to investigate ?

 

When a couple has not achieved pregnancy after two years of trying it is the time to investigate. For a couple who has managed to achieve pregnancy before this time interval is of six months.

This is not a rigid criteria. The age of the female partner is the most important deciding factor. If it is advanced it is good to investigate early.

 

What Investigations ?

 

1: Ovulation study by sonography : Checks availability of the egg.

2: Semen Analysis : Checks availability of good quality sperms.

3 : Laparoscopy : Checks whether egg and sperm can meet.

4: Hormone check : To detect the cause of ovulation defects

 

These are the basic investigatios.

 

Ovulation Study

 

Growth of the egg and its release from the ovary is monitered and documented by ultra sonography. This is called follicular monitoring as well.

 

Semen Analysis

Minimum three days' abstinence is required.

Sample should be produced in a sterile, non-reactive container.

 

Parameters

 

Count : More than 20 million / ml

Motility : More than 50 % with forward progression at the end of one hour

Morphology : More than 30 % normal forms

 

Motility is the most important parameter.

 

Jargons explained

Oligospermia or oligozoospermia- low sperm count. Very few sperm are found in the ejaculate.

 

Asthenozoospermia : poor motility and/or forward progression.

 

Teratozoospermia - low percentage of morphologically normal sperm.

 

Necrozoospermia - no live sperm in semen.

 

Azoospermia - no sperm at all is found in the semen

 

 

 

Laparoscopy

 

 

Laparoscopy is a procedure that involves insertion of a narrow telescope-like instrument through a small incision below the belly button. This allows visualization of the abdominal and pelvic organs including the area of the uterus, fallopian tubes and ovaries. 

This procedure allows us to determine whether there are any defects such as scar tissue, endometriosis, fibroid tumors and other abnormalities of the uterus, fallopian tubes and ovaries. If any defects are found then they can often be corrected with operative laparoscopy which involves placing instruments through ports in the scope and through additional, narrow (5 mm) ports which are usually inserted at the top of the pubic hair line in the lower abdomen.

This is a day care procedure and does not usually require overnight stay.

 

Hormonal check

 

T3, T4, TSH : Thyroid status

FSH

LH

Prolactine

 

FSH needs to be checked on the second of the period counting first day of bleeding as day one.