First experience at an infertility clinic - Gunasheela

So... we walked in Gunasheela one weekend.  It was quite a drive from where we live, but the clinic itself is located in Basavangudi in a really nice part of the city.  The first thing that struck me when going in was the crowd!  Half of Bangalore's infertile population seemed to be sitting there and it was a lot of people.

As soon as we got in, the process started with a fairly thorough medical history being collected by an assistant type person (not sure of their qualification). They collect name, occupation, height, weight, blood group, blood pressure and so on. We also had some older medical reports with us (basically, one time a pelvic exam and hormone assay was done in the past as well as some reports from a routine annual medical check.  Values from these reports were also noted.

Before reading further, it may be a good idea to familiarize yourself with the female reproductive system - see a WebMD link here.

They started off with an ultrasound of the uterus and ovaries (called a transvaginal scan).  The ultrasound gives an idea of the size and shape of the uterus and the endometrium (uterus lining, which gets shed with each menstrual period).  Some cases are due to abnormalities in the uterus and many such cases can be diagnosed from the ultrasound itself. Further, the ovaries can be visualized as well as the follicles (think of them as eggs growing inside the ovary.  In one cycle, normally, one follicle matures and releases an egg into the uterus through what are called fallopian tubes while the others die out in the ovary itself).

This is followed by a request to come for a Day 2 or Day 3 visit.  Day 2/3 is the 2nd or 3rd day after the menstrual cycle starts (which is counted as Day 1).  They measured hormone levels (FSH - Follicle Stimulating Hormone), LH (Leutenizing Hormone) and Prolactin) as well as TSH - Thyroid Stimulating Hormone.  We had a recent TSH results from our annual medical check and so that was not repeated.

One thing they look for in the Day2/3 scan is what is called the Antral Follicle Count (AFC) in the ovaries.  This is the count of "seed" follicles which can develop into follicles during the cycle.  Normally, the AFC goes down as a woman ages. In  If IVF type of treatment is opted for, it is these antral follicles which are stimulated, so the AFC is also a measure of the ovarian reserve of a woman and one measure of the chances of success in IVF.

In our case, all results to this point were good.  So they prescribed a semen analysis for me which also came our normal. Then, the next test was to do a more detailed evaluation of the uterus which is using a method called the HSG.