Fertility and general Investigation
History wall

Infertility is defined as inability of a couple to conceive naturally after one year of regular unprotected sexual intercourse. It remains a major clinical and social problem, affecting perhaps one couple in six. It affects 13% to 15% of couples worldwide. In addition, infertility is considered also a public problem. It does not affect the couple's life only, but it also affects the health-care services and social environment. The feelings experienced by the infertile couples include depression, grief, guilt, shame, and inadequacy with social isolation. Infertility strikes diverse groups-affecting people from all socioeconomic levels and cutting across all racial, ethnic and religious lines.

For healthy young couples, the probability of getting pregnancy per a reproductive cycle is about 20% to 25%. Their cumulative probabilities of conception are 60% within the first 6 months, 84% within the first year, and 92% within the second year of regular fertility-focused sexual activity.

Types of Infertility

1) Primary Infertility:

Couple has never produced a pregnancy

2) Secondary Infertility:

Woman has previously been pregnant, regardless of the outcome, and now is unable to conceive (History of prior pregnancy including miscarriage or ectopic)

The causes of infertility can be divided into four major categories:

1) The female factor;

2) The male factor;

3) combined factors;

4) Unexplained infertility

It is difficult to assign exact percentage to each of these categories; however, it is generally reported that in approximately 35% of cases, infertility is mainly due to a female factor, in 30% to a male factor, in 15% to abnormalities detected in both partners, and in 25% of cases no diagnosis can be made after a complete investigation.

“A careful history and physical examination can identify symptoms or signs suggesting a specific cause for infertility and thereby help to focus subsequent diagnostic evaluation on the factor(s) most likely responsible”

1) Female Partner Evaluation :

1) Hormonal assessment: AMH, FSH,LH,E2,TSH, Prolactin

2) Routine blood tests

3) Transvaginal Ultrasound, Saline infusion sonography (SIS), Hysterosalpingography (HSG)

Laparoscopy and Hysteroscopy

2) Male Partner Evaluation :

Semen Analysis & Semen Culture

1) Hormonal assessment: FSH, LH, Testosterone, TSH, Prolactin

2) Genetic assessment : Karyotyping, Y chromosome microdeletion

3) Surgical Sperm Retrieval: PESA, TESA, TESE

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