IVF (Test Tube Baby) is not necessary for all couples with Infertility
One sunny day in 2018, this couple, let me call Mrs MT and Mr HT walk into my consultation room. They live pretty far away, and have come with a big pile of treatment papers.
As I spent some time discussing I found quite a few points that made me think. This lady has never been pregnant. The couple has been trying for 9 years and have been married for 11 years, which simply means we have an issue. I jotted down the following points to help me organize my thoughts.
1. She weighed 60 kilos and her BMI < 25. So she not obese which anyway was obvious for me just looking at her. Obesity can be a cause for infertility.
2. She has regular periods. Good it means her ovaries are doing their job well.
3. Her HSG (X-ray test for tubal patency) shows tubes as patent. Ok. That is further good news. The egg from her ovaries have a clear path to the uterus.
4. Her hysteroscopy ( insides of the uterus) and Laparoscopy (helps us see the outer surface of the uterus, tubes and ovaries) reports. Both the tests were normal. Another step to happiness.
5. She told me that she had ovulation induction more than 15 times and also intrauterine insemination once (injecting processed semen directly into the womb), but didn’t conceive. Which means we have a reason to investigate.
Meanwhile, I checked with Mr HT and he does not smoke nor drink and his BMI is < 25. Semen analysis reports showed that counts were normal, but the speed of sperm was not adequate. A quick Thyroid hormone study showed deficiency. I started my treatment for his probable causes.
It is part of our practice to test both. Problem can be either.
Incidentally, Mrs MT, had thyroid hormone deficiency, anaemia (low haemoglobin) and a 3-D scan showed a partial septum in the womb. Now this septum is excess tissue in the womb and can be a source of trouble for the woman getting pregnant. Yeah, it is true septum may not always prevent pregnancy, but I prefer to take no chance.
3D SCAN – Showing a good cavity
I still vividly remember the disbelief in their face when I listed all the probable issues both of them have and which need correction. There is absolute no way I can point a finger at one of these. Hence, you’ll never know, unless we try. Right?!
Medication was commenced on both, and with a simple hysteroscopy procedure, the offending septum was removed. We repeated the 3-D scan, 6 weeks after, to confirm what we achieved. Yes the shape of the uterus cavity is nice and ready to receive the baby.
Since uterus became normal after surgery, blood tests normalized, I encouraged natural attempts and in no time, the lady conceived.
I strongly believe discretion is a forte and this patient reinforced my beliefs. Great results can be achieved with minimal intervention. The capability of nature is much stronger than we are willing to accept.