For infertility patients

Not getting pregnant, despite having carefully timed, unprotected sex for one year.

The cause of infertility may be difficult to determine but may include inadequate levels of certain hormones in both men and women, and trouble with ovulation in women.

The main symptom is an inability to get pregnant. In many cases, there are no additional symptoms.

Many treatments significantly improve the chances of getting pregnant. They include hormone treatments, fertility drugs and surgery. In addition, assisted reproduction uses various medical techniques to fertilise an egg.

Female sex organs

Fallopian tube, ovary, womb or uterus, bladder, cervix, vagina, vulva.

Functions

  • Pelvis The pelvis is the bony structure that the baby will pass through when it is born.
  • Uterus The uterus is about the size and shape of a small, upside down pear. It is made of muscle and increases in size as the baby grows.
  • Fallopian tubes: The fallopian tubes lead from the ovaries to the uterus. Eggs are released from the ovaries into the fallopian tubes each month. This is where fertilization takes place.
  • Ovaries There are two ovaries, each about the size of a walnut. They produce the eggs or ova.
  • Cervix The cervix is the neck of the uterus. It is normally almost closed, with just a small opening through which blood passes during monthly periods. During labour, the cervix will dilate to  let the baby move from the uterus into the vagina.
  • Vagina Most babies are born through the vagina, which is a tube about 8cm (3 inches) long. It leads from the cervix down to the vulva, where it opens between the legs. The vagina is very elastic, so it can easily stretch around a man’s penis during sex or around a baby during labour.

Understanding how pregnancy occurs

Ovulation occurs each month when an egg (ovum) is released from one of the ovaries around the 14th day of the period in a woman with regular periods. The ‘fingers’ at the end of the fallopian tubes help to direct the egg down into the tube. At the same time, the lining of the uterus begins to thicken and the mucus in the cervix becomes thinner so that sperm can swim through it more easily.

The egg begins to travel down the fallopian tube. If a man and woman have recently had sex, the egg might be fertilized here by the man’s sperm .The lining of the uterus is now thick enough for the fertilized egg to be implanted and the woman becomes pregnant.

If the egg is not fertilized, it will pass out of the body as the woman’s monthly period along with the lining of the uterus, which is also shed. The egg is so small that it cannot be seen.

Conception is the process that begins with the fertilization of an egg and ends with the implantation of an egg into a woman’s uterus.

Some facts:

  • Sperm is about 1/25th of a millimetre long and has a head, neck and tail. The tail moves from side to side so that the sperm can swim up the vagina into the      uterus and fallopian tubes.
  • One egg or ovum (occasionally two or more) is released from the woman’s ovaries every month. It moves down into the fallopian tube where it may be fertilized by a man’s sperm.

Infertility is defined as inability of a couple to conceive even 1 year after regular, unprotected intercourse.

Very common (4-18%)

It can be due to male factors (30%), female factors (40%), combined male and female factors or unexplained (5%).

The principle used is “SEE AND TREAT”

Laparoscopy and hysteroscopy will be done to see if everything is normal.

In laparoscopy,

  • Uterus, fallopian tubes, ovaries will be seen.
  • A blue coloured dye is pushed from the vaginal end into the cervix (mouth of the uterus) and seen if it comes out freely through the fallopian tubes, which will help us to diagnose if the fallopian tubes are blocked or open.
  • If there is a problem in any of the organs we will treat it at the same time.
  • So there is no need for any repeat surgery or procedure.