A guide to those seeking treatment of infertility at Infertility Centre, Bijulibazar, Kathmandu, Nepal
Investigations of your infertility for proper diagnosis
1. Both the couple needs to see a Consultant Reproductive Endocrinologist (RE) at the Infertility Centre in addition to other doctors for counseling infertility. You need to bring reports of any treatment you had before. You can come any day of your menstrual cycle. The Centre is open 24 hrs. 7 days a week but you can see doctors strictly with appointments. Appointments are made at 10am-7pm except Saturdays. The clinic is open on Govt. Holidays
2. Counseling is a longer session when you will be told about the whole process & treatment pattern you may need.
3. On D2/D3 of your menstrual cycle you need to test your hormone levels.
4. Husband's semen will be tested after 3 days of abstinence within 1/2 hr. of ejaculation. Sperm Count >50million with >50% motility is accepted as normal test.
5. Hormones will be assayed if the sperm count is abnormal.
6. USG of pelvis is done on D2/D5 of period by trans-vaginal route to see any cyst or tumors around your uterus & ovaries. There may be multiple small cysts as black pearl necklace which is a case of Polycystic Ovarian syndrome.
7. A Radiological or Sonographic Hysterosalpingography (HSG) is done after the bleeding stops on D6/9 of your period to assess the patency of your fallopian tubes. Normally both are patent.
8. Those couples who had recurrent abortions are tested for TORCH test, Blood glucose & genetic testing.
Treatment of the problem you may be having
1. Fertility is possible only when all the above tests result are normal.
2. Treatment may take several months till fertility recovery.
3. In case of abnormal hormone profile RE will adjust hormone levels. RE will take care of this condition & also regularize your period if they are irregular. This may take several months.
RE will also guide you about your weight if you are overweight or underweight. If your ovaries are inactive RE will provide some ovarian stimulants to induce proper egg development in the ovaries. This will be followed -up by USG usually after a week of stimulation & hormone therapy may continue for sometimes till recovery.
4. Poor sperm count will be taken care by hormone therapy, sperm tonics as well as Intrauterine Insemination (IUI) of husband' sperm.
5. In case of nil sperm in semen analysis, IUI of donor's sperm is done with a written consent of the couple.
6. Recurrent abortions are treated according to their test results.
7. Blocked fallopian tubes are offered a very effective non-invasive technique of Clear Passage Therapy using pelvic maneuver followed by hydrotubation. This is non-surgical treatment, may take 1-3 cycles for recovery.
8. Unsuccessful treatment cases whom tubes could not be open, if they can afford, In Vitro Fertilization (IVF-test-tube treatment) is the treatment of choice for these couples.
9. Couples who cannot afford IVF are advised for adoption.
