Diagnosis/Tests

➣ Identifying the problem is the foremost important step.
➣ But all patients cannot be offered the same set of investigations. It is categorized according to the patients previous history and previous investigations done. If previous investigation is reliable, it is not repeated.
➣ Investigations are done for both male partner and female partner.

PRIMARY LEVEL:

Blood investigations:

➣ To assure the general health- CBC, RFT, GTT, HBA1C, LFT
➣ To rule out infective conditions which can compromise the health of developing baby- HIV, HBsAg, HCV- Ab, Rubella IgG.
➣ Hormonal evaluation of ovarian function- AMH , thyroid, prolactin levels which can influence the success rate and brain growth of fetus.
➣ Genetic evaluation (if needed).
➣ Immunological investigations ( if needed).

Ultrasound :

➣ To evaluate uterus , endometrium and ovaries.

SECONDARY LEVEL: (When OI and Natural cycle fail for 3 to 4 cycles)

➣ Tube testing - Saline Sonography, HSG
➣ Diagnostic laparoscopy
➣ Diagnostic hysteroscopy
➣ Trial cannulation

Operative Hysteroscopy (if needed)- Septal Resection, Myoma Resection, Polypectomy, Adhesion Removal.
Operative Laparoscopy (If needed)- Cystectomy, Myomectomy, Adhesiolysis, Tubal Canalization, Endometriotic cystectomy.

Tertiary level ( when IVF Fails or Longterm infertility)

➣ ERA- ENDOMETRIAL RECEPTIVITY ARRAY (in patients with ivf /ICSI failure, even after ytransferring a healthy embyo)
➣ PGS – PRE GENETIC SCREENING OF EMBRYOS(in patients with IVF/ICSI failure, a previous anomalous child, repeated abortions)"