Infertility

• Menstrual history of the woman is very important :-

     ·       Absent or irregular menstrual periods could mean an absence of ovulation, which can cause infertility.

·       Irregular menses can be seen in polycystic ovaries, a important cause of anovulation

·       Extreme pain during menstrual cycles can be a sign of infection / any myomas / endometriosis

• Physical examination including

·       A general examination like BMI, Pulse BP etc.

·       Any signs of hormone deficiencyor excess (such as facial hair)

·       A pelvic examination

• Blood tests

·       Hormonal tests like follicle-stimulating hormone (FSH),luteinizing hormone (LH) , oestradiol, and
anti-müllerian hormone (AMH) level to assess how well the ovaries are functioning,

·       T3 T4 TSH to test thyroid function

·       Prolactin to assess the presence of a benign pituitary tumor.

·     Blood sugar assessment

·       Urine routine

• Tests to confirm ovulation, or egg release. This can be done by

·       Blood tests like LH , progesterone

·       Basal body temperature monitoring (measured before getting out of bed in the morning) A woman’s
temperature usually rises by 0.5ºF to 1.0ºF after ovulation.

·       Ovulation kits to check LH levels in urine

·       Ultrasound Follicular monitoring for an accurate evaluation of follicle development and ovulation and
rupture

• Tests to evaluate the uterus

·       2D / 3D TAS AND TVS ultrasound to look for any uterine abnormalities like a uterine septum fibroids, polyps
and structural abnormalities like bicornuate or arcuate uterus