SIRM - for the joys of PARENTHOOD

The Management Protocol

When to seek advice:

A couple should seriously think about seeking medical advice if they still remain childless after one whole year of trying. If the wife is more than 30 years of age, they should approach a doctor after six months of trying since increasing female age has profound effects on the success rate of the treatment cycles.

Initial Consultation and Counseling:

A couple should go together as there are many things that have to be discussed. The couple is interviewed in detail about their reproductive and medical history to identify possible reasons for the causes of their infertility. The details of any previous tests or investigations and prior treatment are reviewed in detail as these aid in planning future management. A full general physical examination is performed.

The normal process of reproduction is explained to the patients so that they can understand the purpose of the various steps taken.

Relevant initial tests are ordered which are usually semen analysis, ultrasound scan and a few blood tests. These tests tell us if the problem lies in ovulation (egg formation), sperm production or any other issue in the ovary or the uterus (womb).

Follow up Consultations:

The results of the previous tests are discussed. A few more advanced tests may be required such as laparoscopy, to look inside the abdomen (tummy) of the female by camera, under general anaesthesia. This will provide us with the complete information about the Fallopian tubes (oviducts) which are crucial organs for pregnancy to occur. If the husband’s semen shows no sperms then he will need a few more tests to confirm if he is producing sperms inside the testicles.

If a certain cause of sub-fertility is identified, the treatment is directed accordingly. It is proven fact that in 30% of the cases, the problem lies with the male, whereas in 30% of the cases, a female factor is responsible. In 30% of the cases, both male and female factors lead to sub-fertility and in the remaining 10% of cases, the cause is unknown (unexplained infertility). After determining the source of the problem, different treatment options are discussed with the patient. Treatment is always individualized as this gives the best results.


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