I am Dr. Jayanti Kamat. I am an IVF consultant, obstetrician and gynaecologist practising for the last 20 years, I am practicing at Shrishti Fertility Care Centre and women's clinic. So today I will be talking about what to do if you are planning to have a baby, but have a difficulty in conceiving. If you're married for more than 1 year you are being tried for a baby for more than 1 year having regular sexual intercourse and not using any contraceptive then it is defined as infertility, at that time you should seek the help of infertility specialist or if the women’s age is more than 35 years and if she is married for 6 months she should seek the services of an infertility specialist. So why do we say the age of 34 years or 35 years is important that is because after the age of 30 a woman's reproductive capacity keeps on declining, so when the woman who is over 35 years it will affect her quality of oocytes, the quantity of oocytes and even if she gets pregnant there are more chances of genetic abnormalities in the baby like down syndrome, besides this she can have complications in pregnancy like pregnancy-induced hypertension, gestational diabetes, preterm delivery, premature rupture of membranes and difficult labour. So age is very important as far as infertility management is concerned. Now, why is infertility increasing has of today that is because of increasing age of marriage, postponement of childbearing, increased incidence of sexually transmitted diseases? Women today are very much into the workforce and they want to settle their career before they are planning to marry or even have a baby. Now there are two types of infertility that is one is primary infertility when the couple has never conceived and secondary infertility when the couple has conceived a child maybe it could be an abortion, it could be a miscarriage but they cannot conceive again. So when you go to an infertility specialist what do you expect firstly the doctor will take a detailed history, history of your age, your lifestyle habits and the number of times you have relations in a week, any previous treatment, any previous illnesses etc for the women a detailed menstrual history will be taken. So menstrual history like the date when you had the last menses whether your periods are regular. What is the interval between the periods, what is the blood flow during the periods is it less, scanty or excessive or is it painful or do you have pain before menses, all these things will be asked. It’s very important for a woman who is planning to conceive to keep a detailed menstrual calendar. So today we have a lot of apps on your mobile so it's very easy to keep track of your menstrual cycle. Then the doctor will ask you about the number of times you have relations in a week then about your lifestyle habits, diet etc. The next will be a physical examination, now in this physical examination we have a general examination and your specific examination so general examination will be the doctor will examine your blood pressure, pulse, whether you have anaemic or whether you are in a best of health, then a specific examination will be a per vaginal examination. So after finishing this she may advise you ultrasonography, ultrasonography is to know the structural defect in the uterus and as we all know the tubes, the reproductive system in a woman consists of a uterus, the tubes and the ovaries at the sides. Now all of us know that these tubes play a role in reproduction because they are the ones who which transport the oocytes and a fertilization takes place inside the tubes the tubes are very important so we cannot take out whether there is a block in the tubes or not just by doing a play ultrasonography. So there a specific test for that and those test are one is hysterosalpingography, where a die is injected inside the uterus and then an x-ray is taken to know whether the tubes are blocked, whether they are patent or not. In some certain cases when the doctor feels that they need more information about this, he may advise you a history of hysterolaparoscopy. Hysteroscopy is when we put an endoscope inside the uterus through the mouth of the uterus and see the inside part of the uterus, so what do we see when we first see the opening of the tubes, whether the uterus is normal, whether it has a symptom, whether it has a polyp, whether it has a fibroid so all these things can be seen. Laparoscopy is we put in another endoscope through the umbilicus of the women to see whether the tubes are patent, whether the shape of the uterus is normal, whether the surrounding organs are normal. Now this procedure of hystrolaparoscopy is preferably done under general anesthesia, at the most a woman will have to stay for few hours in the hospital or she can stay for the one whole day based on a comfort level. Then the doctor will also advise certain blood, certain blood test one are the general blood test that is the haemoglobin, the urine routine micro examination and the few other test and the specific blood test such as FSH, LH, serum prolactin, your thyroid relating hormone then AMH, so all these tests tell us the capacity of the women to produce eggs and the hormonal status in our body.
If you need any help in trying to conceive, you’re planning to conceive, you're trying to conceive for more than one year but you have not gained any success please contact me at lybrate.com.