Latest Trends In Infertility Management
Vardaan Medical Center always a front runner to take an initiative in making people aware as a prime responsibility. Vardaan is going to start a monthly update on infertility Where to start and management practices for all colleagues and aspiring medical practioners whether in this field or sewing the society With their expertise. Our first initiative BEGINS ..
Where to start and…..Final DIAGNOSE!!
lt has always been a dilemma that Infertility IS a medical challenge with various indications resulting into this challenging problem to be solved. As per the latest trends a practroner should focus on the following factors both for male and female, Now how to BEGIN with...
1 - Complete history taking of the couple as per WHO format
2 - Physical examination of both the partners as per clinical requirement.
3 - Medical history and family background Viral Mariners of the couple.
4 - Hormonal profile of wife l.e. Prolactln. thyroid. FSH & LH(Days2) AMH or as per clinical assessment.
5 - Tubal evaluation by HSG/SSG on day 7.8,9 of the cycle.
6 - Uterine factors can be evaluated by Diagnostic Nysteroscopy/taparoscopy for ruling out pelvlc adhesions. Tuberculosis. endometriosis, hydrosalpinx . PCOD, Bioernuate uterus. Unlcomuate uterus. Septate uterus; and in case any anomaly. rectification and management should be done accordingly.
7 - Male semen analysis and inase of phvtical lnabiiity check for testicular volume and assessment of undescended testicles. In case of aaoospermla - FNAC/ Diagnostic TESA/ liormonal profile- FSH, LH, Prolactin,Thyroid, Testosterone levels to be evaluated.
8 - Ovulation Monitoring from Day 11 till follicle rupture.
A-R-T procedures to be decided after the above evaluations.
FIRST LINE OF TREATMENT
1 - Ovulation induction
2 - Antibiotic Management
3 - Supported drugs to male partner to increase sperm count, in case of low sperm count.
4 - hCG administration for rupture of follicle >=18mm
5 - An lUl after 36 hours of hCG trigger or natural intercourse to be advrsedhn case of Normal Sperm Count)
6 - Luteal Support With micronized Progesterone or injectables for 12-14 days.
UPI or BhCG in case of missed regular cycle to confirm a biochemical pregnancy