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Planning for a baby. Given injection to rupture follicle. Should I go for laparoscopy?

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Infertility Specialist
Practicing since : 1982
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we are planning for a baby for last 1 year we ahve completed 3 1/2 years of our marriage. my gynaec is doing a follicular study and LAST WEEK she gave me a injection to rupture and today i went for check up and she said it has ruptured and the endometrium line is also good. My last period was on 7th feb so she told me to keep the fingers crossed and if i get my periods to come on 2nd day of periods or she will suggest for laprosopy diagnostics. Is this required.What is ur view on this.
Posted Sat, 23 Mar 2013 in Infertility Problem
 
 
Answered by Dr. Aniruddha Malpani 21 hours later
You need to be patient - Nature takes time to make a baby !

The chances of a pregnancy in the bedroom for a fertile couple in one month are about 25%. This called the fecundity rate.

Therefore I would not advise you to have a laparoscopy !

Do a complete workup before starting treatment haphazardly. You need the following simple medical tests
1. Semen analysis for your husband (to check his sperm count and motility);
2. Blood tests for you for the following reproductive hormones - FSH (follicle-stimulating hormone), LH (luteinising hormone), PRL (prolactin) and TSH (thyroid stimulating hormone) on Day 3 of your cycle (to check the quality of your eggs). Do this from a reliable lab such as Specialty Ranbaxy
and
3. A HSG (hysterosalpingogram, X-ray of the uterus and tubes) on Day 8 of your cycle (to confirm
your fallopian tubes are open);
4. The vaginal ultrasound scan on Day 10-11 should check for the following.
a. ovarian volume
b. antral follicle count
c. uterus morphology
d. endometrial thickness and texture

Please send me the detailed test results and medical reports . You can scan them in as a single pdf file and email them to my attention (Attn:Dr. Aniruddha Malpani) at YYYY@YYYY

With these test results, we can determine what medical problems are causing your infertility. If there is a problem, then we can treat it !

Your chances of conceiving with the right treatment are excellent because you are young. We look forward to helping you to have a baby !

Regards,

Dr Aniruddha Malpani, MD
Malpani Infertility Clinic, XXXXXXX XXXXXXX SBS Road, Colaba
Bombay 400 005. India
Tel: 91-22-0000, 0000, 2218 3270
FAX ( India) 91-22-0000.
Helping couples build families !
PS Read our book, How to Have a Baby - A Guide for the Infertile Couple,
online at WWW.WWWW.WW !
Above answer was peer-reviewed by
 
Follow-up: Planning for a baby. Given injection to rupture follicle. Should I go for laparoscopy? 3 hours later
We have done my husbands semen test

Physical Examination:-
1. Volume (ML):_2.2ml
2.Appearance:_Cream white
3.Self liquefaction:_20min
4.Viscosity:_Gelatinous

Chemical Examination:-
1.Reaction (PH):_8.0
2.Fructose:_Positive

Sperm Count:-
1.No of Sperms/ml:- 67 million/ml
2.No sperms/ejaculate:_147.4million

Motility
A) Rapid linear progressive:- 50%
B)Sluggish linear progressive:_25%
C)Total forward progressive(A+B):_75%
D)Non progressive motility:_05%
E)Immotile sperms:_20%

Sperm Morphology:-
1)Total Normal Forms:_60%
2)Abnormal Head Forms:_29%
3)Mid-portion abnormalities:_03%
4)Tail abnormalities:_08%

Microscopic Examination:_
1)Epithelial Cells/hpf:_3-4/hpf
2)Leukocytes(pus cells)hpf:_2-3/hpf

My thyroid test results

TSH:_1.62 uIU/mL
Total WBC Count:_6,000 Cells/Cumm
RBS:_93MG/DL
HAEMOGLOBIN:_14.0GM%

i HAVE DONE THE hsg TEST AND THE REPORTS ARE NORMAL.
Follicular Study:- all normall
In the intial stage my doctor did a sonography and she found that there is small blood clot in my left ovary and from last check she told the blood clot is not there now.

My gynaec said that the endometric line is good thick what does this mean could you please elaborate.

Doctor from yesterday i am having heaviness in my lower belly ,around my stomach and pain in nipples. Today my body temperature is changed.I am having feverish type feeling. What do they mean.

Please advise

 
 
Answered by Dr. Aniruddha Malpani 40 hours later
Thanks for providing the details but I would also like to know
- What's your AMH level?
- What's your antral follicle count?

AMH level and antral follicle count are important to help us treat infertility issues better.

Can you please do ALL the tests I asked for and upload them here? Also please note that the test needs to be done in a systematically as described in my previous reply (Day 3; Day 8 and Day 10-11 of menstrual cycle). Please discuss with your treating doctor and plan the test accordingly.

Endometrial thickness is a ultrasound based measurement which assess the chances of successful implantation.

Your current symptoms may or may not be related to your treatment. Without a detailed clinical examination, it would be difficult to predict the cause. Therefore I would suggest you to discuss with your treating doctor; get the test done as per your menstrual cycle and plan your treatment.

Dr Aniruddha Malpani, MD
Malpani Infertility Clinic, XXXXXXX XXXXXXX SBS Road, Coleaba
Bombay 400 005. India
Tel: 91-22-0000, 0000, 2218 3270
FAX ( India) 91-22-0000.

Helping you to build your family !

P.S: Watch our infertility cartoon film at WWW.WWWW.WW
Read our book, How to Have a Baby - A Guide for the Infertile Couple,
online at WWW.WWWW.WW !

Read my blog about improving the doctor-patient
relationship at WWW.WWWW.WW
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