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Overview

Parenthood is one of the major transitions in an adult’s life. It has been seen that about 20% of couples face some kind of problem in conceiving and need help. In recent times infertility is on rise due to lifestyle problems and changing environment conditions. Infertility, though not a life threatening condition, is very stressful condition in a couple’s life. We at Jaypee hospital understand this and try to make your journey from treatment to success as comfortable as possible.

Not all cases of childlessness arise due to problems with the woman. In many cases the reason for infertility is due to male infertility issues. Jaypee Hospital offers comprehensive andrology services through its consultant andrologists and state-of-the-art andrology laboratory. This begins with evaluation of factors causing male infertility and male sexual problems.

Andrology Services

  • Semen analysis
  • Doppler ultrasound evaluation for varicocele
  • Treatment of an ejaculation by vibrator or electro-ejaculator
  • Sperm function tests – DNA fragmentation, HOS test
  • Sperm viability testing—MACS (Magnetic Activated Cell Sorting)
  • Surgical sperm retrieval by PESA/TESA/TESE/microdissection TESE
  • Assessment and medical treatment for male sexual problems

When you see us for the first time, you will be registered with Jaypee hospital. We will note your history in detail including Menstrual history, Coital history, Medical & Surgical History. We will review your previous reports and past treatments. We therefore recommend that you carry your previous reports and treatment details with you when you visit us. We will then do a basic evaluation to mainly check for 3 parameters:

  • Ovulation: this is done via transvaginal sonography, generally starting from day 11 of the menstrual cycle. This checks for growth and rupture of the follicle (egg). The patient will be advised timed intercourse depending on the day of her ovulation. If required, medication will be advised to induce ovulation.
  • Tubal status: this is done either via HSG (hysterosalpingography) or Laparoscopy + Hysteroscopy or sonosalpingography.
  • Uterine cavity: the uterus is evaluated via transvaginal ultrasound to check the growth of the endometrial lining and to rule out abnormalities like fibroids or polyps. If required a hysteroscopy can be done to further examine and rectify a problem.

Unexplained Infertility: 10% – 15 % of infertile couples will have a completely normal workup, where no known cause of infertility can be detected.

Endoscopy

Endoscopy is a procedure where a thin, lighted tube (Endoscope) is inserted into the uterus to examine it for infections, diseases or any abnormalities. The two frequently carried out endoscopy procedures are Hysteroscopy and Laparoscopy

Hysteroscopy

Hysteroscopy is the inspection of the uterine cavity by passing the endoscope through the cervix. It allows for the diagnosis of problems in the cavity of the uterus and also serves as a method for correction of most problems (operative hysteroscopy). Common conditions that can be treated through Hysteroscopy are tumours like polyps, fibroids, abnormalities like septum, etc.

Laparoscopy

Laparoscopy involves placement of the endoscope in to the abdominal cavity, generally through the umbilicus to visualize the uterus, tubes, ovaries and the pelvis. The patency of the tubes is also checked at the same time by injecting a blue dye. Certain abnormalities like fibroids, endometriosis, adhesions etc can also be treated at the same time [operative laparoscopy].

The Concept

It is the process of placing processed semen sample containing motile sperms through the cervix into the uterine cavity around the time of ovulation.

Whom does it help?

IUI is generally the first line of treatment when medication and timed intercourse does not succeed. It is recommended for patients with mild to moderate decrease in sperm count and /or motility, or if there is mild endometriosis. For women who do not ovulate regularly, ovulation induction maybe combined with IUI. Also, in some couples in whom there is no apparent cause for infertility (unexplained infertility), IUI may be advised.

What are the requirements before IUI?
  • Confirmation that you are ovulating, either with or without medications
  • Patent tubes
  • A normal or mild to moderately decreased sperm count
Treatment

You will generally be advised medications from Day 2 or 3 of your menses for 5 – 10 days. Your response will be monitored by sonography every 3-4 days.

When the follicle/s are of appropriate size, the final process of ovulation will be triggered with an injection of hcg and the IUI procedure will be planned approximately 36 hours later.

Your partner needs to provide his semen sample on the day of an IUI. If a problem is anticipated, previously preserved sample can also be used. The semen sample is processed in the laboratory and then injected into the uterus.

You may then be given medications for support for the next 14 days at the end of which a serum Beta-hCG test is done to confirm pregnancy.

Precautions

Since this is a relatively simple and safe procedure, it does not require any special precautions. Only a few minutes rest after the procedure and then you can resume your routine.

Possible Complications

Apart from mild pain and spotting on the day of an IUI, there are no major complications. Around five to ten percent of the patients have multiple [generally twin] pregnancies. Sometimes, a patient may respond excessively to medications and produce more eggs, putting her at risk for multiple pregnancies and a condition called Ovarian Hyper Stimulation Syndrome (OHSS). If there is a risk of this occurring, your doctor will advise you accordingly and the cycle may be cancelled or converted to an IVF cycle. Infection is a very rare complication.

What are the chances of success?

Worldwide, the success rates for IUI average about 15%. Most of the pregnancies occur within the first three IUI cycles. We generally recommend a maximum of three IUI cycles

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