We consider a couple to have infertility if they have not conceived despite regular intercourse without using any birth control for at least a year. 15 to 20 % of couples will not conceive despite a year of trying. However, this does not mean they are infertile. The couple must be investigated and treated accordingly.

We can divide female factors for infertility as

• - Ovarian factor
• - Tubal factor
• - Uterine factor
• - Endometrial factor
• - Unexplained factors

The most common ovulatory factor is PCOS and Chocolate Cyst. The other being Premature Ovarian Failure.

The tubal factors include hydrosalpinx and tubal block.

Uterine factors include the unicornuate uterus, bicornuate uterus, fibroid uterus and adenomyosis.

Endometrial factors include Asherman Syndrome, Endometrial Polyp, thin endometrium and endometriosis.

Pelvic factors like vaginal septum, other factors such as Hormone Imbalance like hypothyroid, hyperprolactinemia, Diabetes Mellitus etc also can cause infertility.

Malefactors include Oligospermia, OATS and Azoospermia.

Every Couple needs proper counselling and support in their first visit followed by investigations done for both the partners. For Women, the basic hormone profile including AMH and other necessary blood investigations. For men, Semen Analysis and blood Investigations are done.

• - Transvaginal Ultrasound
• - Follicular Study
• - SSG- Saline Infusion Sonography
• - HSG- Hysterosalpingography
• - IUI – IntraUterine Insemination
• - ICSI – IntraCytoplasmic Sperm Injection
• - IMSI – Intra Morphologically Selected Sperm Injection
• - PICSI – Physiological IntraCytoplasmic Sperm Injection
• - Surgical Sperm Extraction – TESA, PESA/ Micro TESE
• - CryoPreservation
• - LAH ‐ Laser Assisted Hatching
• - ERA – Endometrial Receptivity Array
• - PGD – Preimplantation Genetic Diagnosis
• - Donor Programme ( Gametes & Embryos)
• - 3D Laparoscopic Surgeries Adenomyomectomy Chocolate Cystectomy Adhesiolysis Abdominal cerclage
• - Hysteroscopic Septal resection
• - Tubal Cannulation
• - Tubal Recanalization

It is a syndrome when a woman has any two of the following three:‐

• - Oligo/ Anovulation – Irregular Periods, either getting periods once in 2 to 3 months or at times frequent menstruation
• - Hyperandrogenism ‐ Excessive Hair growth, acne, high androgen level in the blood
• - Polycystic Ovaries detected by ultrasound.

Obesity in PCOS patients can decrease the infertility treatment outcomes. So weight reduction is the basic treatment followed by hormone correction and drugs for ovulation induction. Drug-Resistant ovaries can be benefited from laparoscopic ovarian drilling.

Since insulin resistance and hyperinsulinemia are thought to play a central role, insulin sensitizers like metformin will help correct the hormone imbalance.

Fibroids are benign tumours made of smooth muscle cells and fibrous connective tissue that develop in the Uterus. The cause of fibroids isn't well understood. Risk factors include a family history of fibroids, obesity or early onset of puberty.

Symptoms:‐

• - Heavy Menstrual Bleeding
• - Prolonged Periods