Infertility

The basic evaluation of an infertile couple by Dr. Sepehr KatiraieM.D.

 

INTRODUCTION: Having a baby needs both parent dedication, time and financial security to raise this baby.

 

• First Visit: The basic requirement of infertility work up is:
• WORK-UP OF THE INFERTILE COUPLE
  1. History and Physical
  2. Ovulation assessment: basal body temperature chart( BBTs), midluteal progesterone,
  3. Hysterosalpingogram
  4. Semen analysis
  5. Age>35: FSH (cycle day 3)

1. Ovulation assessment on female party (blood test), The methods used to assess ovulation include: basal body temperature charts, midluteal progesterone levels, a luteal phase endometrial biopsy, home testing of luteinizing hormone (LH) levels and serial ultra-sonogram to evaluate follicular growth.
2. Semen evaluation: tell your partner to come for evaluation. Its not count if your husband have baby from you or another women before, today is important your doctor wants to know if he is producing sperm today or not?
3. anatomical genital part assessment:including:

• pap smear: May show Infection or anatomical abnormality. Some times a couple may have only simple vaginal infection and this infection preventing them from having baby that’s reason for your doctor to prescribe you antibiotic and vaginal cream to clean your vaginal area
•  ultrasound of uterus: to make sure you have normal uterus and ovaries
•  Hysterosalpingogram = injection of contrast material or dye to uterus to see if tubes are open or not

 

• Second Visit: your Doctor will evaluate all the result and let you know what option and treatment is good for you

 

• Hormone Therapy:   To evaluate hormone therapy response ultrasound and post coital test needed.

1. Clomiphen 50 mg will be given from 5^th day of menstruation till day 10^th for 5 days. This hormone therapy need to followed by ultrasound exam on day 12^th to see if follicles are in the ovary or not . Will continue 3 month with 50 mg dosage if pregnancy didn’t happen then¿
2.  Clomiphen 100 mg will be given from 5^th day of menstruation till day 10^th for 5 days. This hormone therapy need to followed by ultrasound exam on day 12^th + LH surge test + intra cervical or intrauterine husband sperm injection into women. Will continue 3 month with 100 mg dosage if pregnancy didn’t happen then¿
3.  Clomiphen 150 mg will be given from 5^th day of menstruation till day 10^th for 5 days. This hormone therapy need to followed by ultrasound exam on day 12^th. Will continue 3 month with 150 mg dosage if pregnancy didn’t happen then¿
4.  IVF or invitro fertilization or other hormone therapy may be considered.