Female diagnosis

Evaluation for infertility should be in systematic, expeditious and cost effective manner identifying all relevant factors. Generally the initial emphasis is on least invasive methods for detection of most common causes.

When to evaluate??

• No conception even after trying to conceive since one year

• Early evaluation (after 6 months of trying) is needed when

             - Age over 35 years

             - Menstrual abnormalities

             - Known/suspected uterine/tubal disease

             - Partner sub-fertile

Female Factors for Infertility

• Diminished egg reserve


• Uterine factor

• Tubal factor

• Endometriosis

Female factors of Infertility

Evaluation of Ovarian Reserve

It’s a measure of “reproductive potential” that is the number and quality of remaining oocytes(eggs).

   • Antral Follicle Count (AFC) : Follicles in both the ovaries are counted by trans-vaginal ultrasound.

Left Ovary
Right Ovary

   • AMH (Anti-Mullerian Hormone):

It is cycle independent "qualitative" & "quantitative" marker of predicting ovarian reserve and response.


   • Other Hormonal Tests:

             - FSH,LH (D2/3/4)

             - Estradiol (D2/3/4)

             - Thyroid function tests

             - Prolactin

Evaluation of Ovulatory Function

           • Menstrual history

           • Basal body temperature

           • Serum progesterone

           • Urinary LH

           • Serial Transvaginal Ultrasound

Evaluation of Uterus

           • Transvaginal Ultrasound (2D/3D)

           • Sonohysterography (SHG)

           • Hysteroscopy

           • Hysterosalpingography (HSG)

Evaluation of Fallopian Tube

           • Hysterosalpingography (HSG)

           • Sonosalpingography (SIS)

           • Laparoscopy


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