What should one do if not able to conceive for years? - Dr. Sangeeta Gomes

If one is not able to conceive for a year or more, they need to meet the infertility specialist. The infertility specialist will do the following workup for you. First coming to the male factor like the fasting blood sugar, thyroid, follicle stimulating hormone, serum testosterone, semen analysis and semen culture sensitivity. If the count is low, the treatment is given for a period of 3 to 6 months and over this period, if the count increases naturally, the woman can get pregnant. If the count is low, then intrauterine insemination can be offered to the woman. If it is a case of azoospermia, where there are no sperms, then artificial insemination with donor sperms will be offered to the woman. coming to the female factor, we need to look at the female hormones like follicle stimulating hormones, luteinizing hormones , thyroid, prolactin and anti mullerian hormone, which gives us the clue if what is the ovarian reserve for the women. Next we need to look at the tubes to know if they are patent, allowing the eggs to travel from the ovary towards the uterus. Serial follicular scan has to be done to check whether eggs are forming normally first ovary and where they are rupturing naturally additional diagnostic tests like hysteroscopy, laparoscopy can be done if the need arises. If the follicles are not forming properly, then additional medications in the form of tablets and gonadotropins can be given. If the eggs are not okay and if the tubes are not patent then IVF can be advised with her own egg or with the donor egg. If the uterus is not okay, the surrogacy can be offered to the women, wherein the women’s egg is fertilized with the husband’s sperm or with the donor sperm and implanted in another woman’s uterus so that she can carry the pregnancy.