Your reproductive system & its function is truly one of life's great wonders. A finely tuned sequence of events must take place for reproduction to occur.
Essentials
Proper secretion of estrogen & progesterone hormones from the ovaries which in turn would lead to proper development of at least one follicle each month - in other words ovulation (release of an egg from either ovary) must occur on time.
The fallopian tubes must pick up the released egg & in turn push it towards the uterus. Hence, it is essential that the tubes are patent & not blocked.
The sperm count should be within normal limits. The sperms deposited in the vagina swim upward & meet the egg in the fallopian tube.
Fertilization occurs in the tube & the embryo then is transported to the uterine cavity where it gets implanted. Hence, the cavity must be normal to facilitate accommodation of the growing embryo.
When you can't Conceive
Though we see couples increasingly approaching us even after a few months of marital life, subfertility by definition is either a woman's inability to conceive & bear a live child or a man's inability to impregnate a woman over a 12 months period of unprotected, regular & normal sexual intercourse.
Chances of pregnancy in a normal couple: 20 – 25% per month.
Hence from this, we can see that more than 90% of couples conceive in the first 2 years of married life.
When do we begin investigations?
After 1 year of unprotected, regular sexual intercourse.
EXCEPTIONS:
Women with ovulation disorders
Women aged 35 years or over
Reversal of sterilization in either partner
Traveling job with long periods of absence
Diagnosis of endometriosis
CAUSES:
BASIC INVESTIGATIONS:
Blood Investigations for the Couple
Transvaginal Ultrasound
Tests to document Ovulation
Urine LH Kits
Follicular Study
Serum Progesterone in mid Luteal Phase
Tests for Tubal Patency
HSG
SSG
Diagnostic Laparoscopy
Semen Analysis is a must before starting treatment