Evaluation of the couple before proceeding to IVF / ICSI : -
1. Assessment of Uterine Cavity :-
Uterine size and shape is evaluated through hysterosalpingogram. Intracavity environment is assessed by hysteroscopy, bio physical profile of uterus is done with ultrasound, colour, doppler study. Endometrial biopsy is done to know the endometrial pattern and presents of infection. Ultrasound scanning is done to identify fibroids, adenomyosis, ovarian cysts, chocolate cysts, ovarian reserve (third day of periods) etc.
2. Assessment of ovarian reserve :-
Level of FSH & LH should be checked on 3 rd day of the menstrual cycle. This helps to estimate woman's ability to produce eggs in response to fertility drugs.
3. Cervical cultures:-
for urea plasma, Chlamydia and gonorrhea to check for any infection.
4. Endometriosis : -
The dark brown chocolate fluid is thought to be embryo toxic and kept separate form follicular aspirates that contain eggs.
5. Trial Embryo transfer :-
Measuring the depth of the endometrium cavity and mapping the route required to negotiate the cervical canal is useful prior to the actual embryo transfer procedure.
6. Frozen “back up” sperm sample :-
Frozen sperm sample is very useful when husband is not available at ovum pick up time or has difficulty providing the specimen on ovum pick up day.
7. Evaluation of sperm : -
Semen analysis is a routine test prior to IVF cycle. Sperm function test can also be done to check the quality of sperm.
And above all the most important is couples contemplating ART have to see a counselor. This professional is familiar with the emotional impact of infertility and infertility treatments and can help the couple to deal with this important aspect.