Hysteroscopy is a procedure where a narrow telescope like instrument is introduced through the vagina and cervix into the uterine cavity.
The cavity is then distended with fluid and visualized.

Hysteroscopy is used for:

For any uterine cavity problems like
1) Fibroids

2) Endometrial polyps

3) Partition in the uterus (Septum)

What is Laproscopy?

Laproscopy is a surgical procedure done under anaesthesia where two or three small cuts are made in the abdomen through which the surgeon inserts a laproscope and other special instruments.
A laproscope is a thin, fiber optic tube fitted with a light and camera.

When is Laproscopy done.

Laproscopy is done to find out the cause of infertility along with other tests.

It helps to diagnose the following conditions.
1) Fibroids and treatment
2) Endometriosis
3) Blocked tubes
4) Pelvic adhesions ( Due to previous other surgeries)
5) Ovarian cysts
6) Polycystic ovaries for ovarian drilling
7) Ectopic pregnancy
8) Total pathology like hydrosalphinx before IVF-ET.

What is IVF?( Test Tube Baby)

In vitro fertilization is a process by which egg cells are fertilized by sperm outside the womb (In the laboratory) that in vitro.

When is IVF done?

1) Blocked/damaged or absent fallopian tubes
2) Endometriosis
3) Unexplained Infertility
4) Recurrent failures of IOI
5) Male factor infertility
6) Age related infertility
7) Menopause
8) Low ovarian reserve
9) Pre-implantation Genetic diagnosis

IVF program involves full steps:

1) Initial consultation and counseling
2) Investigation
3) Ovarian stimulation with injections
4) Egg Retrieval
5) Sperm collection
6) Embryo culture
7) Embryo transfer

1) Counseling:

Patient workup is taken into consideration like HSG, semen report, laproscopy, hysteroscopy and ultrasonography.

2) Investigation:

For wife:
1. USG
2. HSG
3. Hormonal Profile
4. Routine blood tests

For Husband:
1. Semen analysis
2. Culture
3. Sperm Function test
4. Routine blood tests

3) Ovarian stimulation:

Ovarian stimulation is done with fertility drugs to produce multiple eggs to increase the potential for producing multiple embryos. During stimulation, ultrasonography examination and lab tests are performed. Stimulation is done either by long protocol or antagonist cycle.

4) Egg Retrieval:

When eggs are ready for retrieval, egg pick up is done at the clinic under short anesthesia by inserting a needle through the vagina into the ovaries using ultrasound guidance. Fluid from the follicles is drawn into a test tube to retrieve the eggs. Patients generally are able to go home after a few hours of egg retrieval.

5) Sperm collection:

The male partner typically collects a semen sample through mastarbation. This is usually done while egg retrieval is being performed. The semen is examined under microscope and best sperms are selected for ICSI. Men who have difficulty in producing semen sample on the day of egg retrieval can have their sperms collected ahead of time and cryopreserved for use in this situation.

6) Embryo culture:

The best quality sperms are mixed with eggs after retrieving the eggs. If the sperm quality or quantity is low we do ICSI ( Intracytoplasmic sperm infection) , a process where a single sperm is injected directly into the egg to achieve fertilization. Eggs are examined the next day for fertilization.

7) Embryo transfer:

Two + Five days after fertilization we transfer the embryos into the uterus through a thin embryo transfer catheter after negotiating the cervix under sonographic guidance. The extra embryos obtained can be cryo preserved and stored in liquid nitrogen for future use if necessary. Blood test for pregnancy is done usually after two weeks of transfer

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