So many young couples today, plan for delayed parenthood. Many are of the opinion that they should enjoy their life for a few years before starting a family and getting bogged down with the responsibilities of children. After a few years, they get so focused on their careers and settling themselves up financially, which then becomes the priority before having children. Many couples in their early thirties are of the opinion that they need to be financially secure to provide a comfortable life for their children. By the time couples get around to family planning, they are in their late thirties and some even in their early 40’s.
Earlier the older generation and parents used to keep the pressure on, for children. Now couples turn around and tell their elders that medical science is so advanced that they do not need to worry about having children later in life. In essence, they are right. The belief that at least one or two children should be born before a woman becomes 30 is no longer viable. Today couples have the privilege and freedom to time their pregnancies. They can decide at what age and stage in their life they want to have a child.
Delayed parenthood has consequences, but couples are no longer concerned. They want to be able to afford to give their children luxuries and comfortable life, so career takes precedence before family planning.
Infertility is not just a condition that arises with as people as they age. It can be something that some women are even born with. Some people feel that only older couples need fertility treatment, but that is not so. Many young couples also find that they are not able to conceive. In fact, many young girls are diagnosed with polycystic ovary syndrome (PCOS) in their early twenties. This ovulation disorder leads to infertility. All young women who are detected with polycystic ovaries will have to have some kind of medical treatment to conceive. This condition affects the ovaries and ovulation, thus inhibiting the natural course of pregnancy.
The decision to have a child is a big thing for couples today. They take into consideration various factors and cost is just one small factor. What concerns most couples today is the time they have to devote to their child and the restrictions it will place on their life. This is the reality of family planning by couples living in nuclear homes in the metropolitans cities in India. The joy of parenthood takes a backseat and is something that develops over time as the child is born and starts to grow. This is due to the focus shift from enjoying the simple pleasures in life to trying to enjoy the things money can buy.
Once a couple decides to have a baby, and they are mentally prepared for it. Since every decision is time-bound, they do not want to wait any longer. Some couples feel that a medical check-up will help them to ensure that everything is in order before they start trying to get pregnant. Usually, the responsibility is left to the female partner. She is the one who needs to get a medical check-up since she is the one who has to get pregnant. Men rarely feel the need to have a fertility test unless specifically advised by a doctor. And even then it pricks the Indian male ego.
Couples who have been trying to have a baby for over a year or two years and have been unsuccessful in their attempt usually feel that they should have a gynaecological check-up to see if everything is alright.
Many doctors recommend fertility testing before couples decide to start a family. This helps them to assess their fertility condition. Most of the fertility tests are usually prescribed for the woman. Along with the tests, the doctors will also asses the female fertility with a series of questions regarding their history and past.
MEDICAL HISTORY
A doctor will start a fertility test by first enquiring about the medical history of a patient. A medical history includes a list of previous illness. Some illness may have long term consequences that could have an effect on fertility. Previous surgeries, especially in the pelvic region or the abdominal area, need to be assessed. Some surgeries could have a damaging effect on the reproductive organs. It would be wise for a patient to reveal a list of strong medication that she may have been prescribed in the past. Some medicines have side effects that could damage the quality of the eggs in the ovaries or affect the levels of the hormone in the body leading to ovulation problems and a problem with the normal function of the pituitary glands and the ovaries. Any accidents or physical injuries to the abdominal area or otherwise should also be disclosed to the doctor. Medical treatments such as chemotherapy have very adverse consequences on the quality and quantity of the female ovarian reserve.
OVULATION ASSESSMENT
It is advisable for a woman to keep a track record of her menstrual cycle for at least 3 to 6 months and give this information to the doctor. Studying the menstrual cycle dates and the number of days in between each menstrual cycle is important for fertility. Through studying the menstrual cycle, the doctor can calculate the ovulation date and advise the patient, which are the best days to have sex.
A regular menstrual cycle is one which takes place every 28 to 35 days. Occasionally there may be disruption to a menstrual cycle due to severe emotional distress, but in general, a woman should resume a regular cycle.
An irregular menstrual cycle is a symptom of an ovulation disorder and needs further medical tests and medication. A woman who has irregularities in her menstrual cycle will need medicines to facilitate being able to get pregnant. Polycystic Ovary Syndrome is a disease of the ovaries which disrupts ovulation. A woman suffering from this condition requires medication to help ovulation and to induce a normal functioning of the ovaries. Women who have ovulation disorders are not able to conceive easily.
PHYSICAL EXAMINATION
If you are planning a baby and just checking your fertility to assess if anything is wrong, then a doctor may perform a basic physical examination, including checking for visible signs of vaginal infections. A physical examination helps to assure a woman that her reproductive organs are in order to support pregnancy.
Patients who have been trying for a baby and are not able to conceive may have to undergo a more intrusive physical examination. This will entail a pelvic ultrasound which is conducted through the vaginal canal. A small ultrasound device is inserted to check the uterus, ovaries etc. This enables the doctor to check if there are any abnormalities in the uterus, ovaries or fallopian tubes. The ultrasound can help doctors ascertain if there is any evidence of pelvic scarring. Sometimes the ovaries are very close to the uterus and appear to be stuck to it. Or there could be other physical abnormalities which could hinder a normal pregnancy.
OVARIAN RESERVE CHECK
The vaginal ultrasound can also be used to check the ovarian reserve. The ovarian reserve is assessed by the number of antral follicles which are visible. Antral follicles are resting follicles and are between 2 mm to 9 mm in diameter. The Antral follicles give us an idea of the number of primordial follicles. The primordial follicles are microscopic in size and contain an immature egg which has the capability to mature and ovulate. The lesser the quantity of the antral follicles, the lesser the number of primordial follicles we can expect. This means that the patient has a low ovarian reserve.
Case Study: Seema and Ankur decided to do a general health check-up and thought a fertility test would be good too. Both were in their early thirties and had been married for a little over two years. A vaginal ultrasound showed that Seema had smaller ovaries than normal, and she also had a very low antral follicle count. This is unusual at this early age, but one cannot totally eliminate the possibility. They were fortunate to get this test done while Seema still had some primordial follicles which could be extracted for IVF treatment. The ovarian stimulation was able to mature quite a good quantity of eggs. All the eggs were fertilised, and excess embryos were frozen for future use as they planned to have more than one child.
BLOOD TEST
A blood test, together with the ultrasound test is the best way to get a precise estimation of the ovarian reserve. The blood test is conducted on the 3rd day of the menstrual cycle. This gives an accurate idea of the different hormone levels in the body. The blood test determines the levels of the Follicle Stimulating Hormone(FSH), Luteinizing Hormone(LH), Anti-Mullerian Hormone and estradiol hormone levels.
SEMEN ANALYSIS TEST
The semen analysis test is a very important test that should be conducted even before a couple start trying to have a baby. This test helps to determine male fertility conditions. The most common male infertility problem that affects most males is low sperm count. Men with a low sperm count are not able to make their female partner pregnant. Sometimes couples who are trying to get pregnant are not able to conceive. They later find out that the male partner suffers from a low sperm count. A semen analysis test is conducted in the beginning helps to save time. The couple can seek alternate fertility options instead of getting their hopes up every ovulation cycle.
A semen analysis test gives a detailed report about the sperm count as well as the sperm quality. Sperm morphology and sperm motility are important factors of sperm quality. The size of the sperm makes a difference in its ability to swim and penetrate the egg. Usually, a sperm that is small in size is an underdeveloped sperm and may not be of the required quality. A male who has a large number of small sperm is characterised as having poor sperm quality. The shape of the sperm also matters. An abnormally shaped sperm may have swimming restrictions as well as a problem penetrating the outer covering of the female egg to fertilise it.
Other issues detected with a semen analysis test are the vitality of the sperm. Sperm that are very active are considered as good sperm. However, generally, only a small percentage of sperm are active. The active sperm are assessed for their swimming capabilities and their ability to move in a forward direction. Many sperm just move around in circles and are not able to go anywhere in particular. Sperm that move in a forward direction are known to have progressive motility. A male that has a sufficient percentage of sperm that are normally shaped of a good size and with progressive motility is considered to have a healthy sperm quality.
HYSTEROSALPINGOGRAM (HSG) TEST
The Hysterosalpingogram test is commonly referred to as HSG and is an important test. It checks the fertility potential of a woman. It checks if the fallopian tubes are blocked, the extent of the blockage and the location of the blockage. Almost 25% of the women who are diagnosed with fertility problems suffer from blocked fallopian tubes. A woman may have a partial blockage or a total tubal blockage. Any kind of blockage in the fallopian tube will hinder the movement of the female egg and the embryo. If the embryo is not able to move to the uterus due to an obstruction in the fallopian tubes, it could lead to an ectopic pregnancy. This will not only totally damage the fallopian tube but is very dangerous for the mother as well. It poses a huge health risk, which could be fatal if not treated in time.
Some women have only one blocked tube, which means they can have a successful normal pregnancy or IUI pregnancy. There are a number of treatments for infertility due to tubal factor. If a woman has a bilateral tubal blockage, IVF is the best fertility treatment option.
This HSG test is a radiology procedure and will normally be performed in the radiology department. The procedure involves the injecting of a dye into the uterine cavity. This dye travels through the uterus into the fallopian tubes.
A Senior Fertility Consultant at Medicover states, “We have many women who come to us seeking help to get pregnant. After an HSG test, we find that a large percentage of them suffer from tubal factor infertility. We are able to determine their fertility health through this test successfully, and it also helps with the success of the IVF treatment if they should choose to opt for it.”
The Hysterosalpingogram test is also used to check abnormalities in the uterus. The usual problems that women have with their uterus that hinder pregnancy are polyps, fibroid tumours, uterine scar tissue and congenital uterine anomalies. The presence of these problems may not always cause infertility but could lead to other problems such as miscarriage or preterm births.
Medicover has state of the art setup to perform a thorough fertility testing on both the male and female partner. With a well-equipped laboratory and modern technology methods, couples can get a complete fertility test. Well experienced and highly qualified lab technicians and doctors assess the test reports and determine if other tests are required, in case they find that some areas appear to have a potential problem. Medicover does not leave anything to chance and will also present the patient with solutions options in case a problem is detected.
Fertility testing should always be done in a fertility clinic that has the required infrastructure and up to date technology. Some couples in an attempt to save money may decide to get their tests done at cheaper labs and clinics which could later cause them other problems due to lack of proper diagnosis and Proper lab facilities.
Medicover is leading in the field of fertility solutions in India. Couples that have fertility problems can easily get advice regarding their fertility condition from Medicover’s expert in house fertility consultants’ who are internationally trained and certified.
The best and most advanced technology fertility treatment is available at Medicover Fertility Clinic. In Vitro Fertilisation is the most preferred fertility treatment, and Medicover has the best setup and highest success rate for IVF treatment.
