Bikram Bhardwaj*, Gunjan Rai and Sampath S
Department of Obstetrics and Gynecology, Command Hospital, IndiaFulltext PDF
Objectives: High infertility levels are of great concern in the Indian society and there has been a recent surge in the use of ART and other fertility procedures like IUI. Around 10% of young couples during their reproductive career seek fertility treatment. The etiology can be multi-fold-male factor, female factor, combined and unexplained. Ovulation induction with IUI/Timed intercourse is a therapeutic modality in these patients with varied causes of infertility. IVF is not a necessary and only modality of treating these patients. The main thrust of this study was to highlight that by doing basic procedures like treating RTIs, diagnostic & operative hystero-laparoscopy and ovulation induction with IUI/Timed Intercourse can achieve fertility in 50% of clientele. IVF is not mandatory in all cases of infertility. Materials and Methods: This is a prospective study of 257 patients who visited the fertility clinic of a tertiary care hospital from Jan 2018 till June 2019. In all cases of Infertility, a detailed history taking followed by clinical examination was done. Investigations including USG for follicular study & HSG for tubal patency for female & Semen analysis for male partner were done. All women were subjected to Ovulation studies with timed intercourse for 3 to 6 cycles if basic male and female investigations were normal. However all cases of bilateral tubal blocks/endometriomas/structural abnormalities of uterus was straightaway subjected to hystero-laparoscopy. Dilatation and curettage were done to rule out tuberculosis in case of bilateral blocks and long standing infertility cases. Depending upon the cause, patients were subjected to further 3 cycles of ovulation induction and IUI. Patients with Male factor in the form of azoospermia/severe OATS and couples who didn’t respond to 6 cycles of ovulation induction with IUI were referred to ART centres for further management. Results: Total patients visiting fertility clinic were 257. Total patients conceived till June 2019 is 120 (48.6%). 74 (61.6%) patients conceived had primary infertility. 46 (38.4%) had secondary infertility. 116 patients had uterine pregnancies and 4 patients had ectopic pregnancies. Forty two patients conceived after OI+IUI & 62 patients conceived after OI+TI. Conclusion: Basic infertility procedures like HSG, Diagnostic & operative Hystero-Laparoscopy, treating RTIs and ovulation induction with IUI/Timed intercourse can achieve fertility in 50% of the clientele.
Infertility; Ovulation induction; Intra-uterine insemination
Bhardwaj B, Rai G, Sampath S. Successful Fertility Treatment by a Non-IVF Centre. J Clin Obstet Gynecol Infertil. 2019; 3(2): 1042.