| Case #1
A 33-year-old female patient with a seven-year history
of primary infertility.
Her gynecologist did a laparoscopy that showed mild endometriosis.
All other fertility test results were normal. After six
months of unsuccessful Clomid treatments, she was referred
to an IVF centre. There, she underwent treatment with
fertility injections and inseminations for four months,
and proceeded to go through two IVF treatments that were
unsuccessful.
When this patient was referred to Astra Fertility Clinic,
we reviewed her previous investigations and a uterine
septum was noticed. This factor has not been considered
significant by her previous treatment specialists.
The patient underwent surgery (uterine septum incision),
and she had a spontaneous pregnancy within 6 months of
the procedure.
Comment:
Precise diagnosis is the key to treatment success.
It is not always easy to pinpoint the cause of the infertility
problem. At Astra Fertility Clinic, we are fortunate to
have capable staff who can detect and correct uterine
abnormalities using hysteroscopy in a simple day surgery
procedure.
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Case #2
A 29-year-old female patient with three years history
of secondary infertility.
Her previous infertility specialist recommended IVF after
the failure of several ovulation induction and insemination
cycles. She was referred to Astra Fertility Clinic for
a second opinion. At Astra, after reviewing the charts
and going through her investigative cycle, persistent
elevation of her LH was noticed, in spite of having regular
menstrual cycles. The patient became pregnant after one
cycle of down regulation with lupron combined with super-ovulation
and intercourse.
Comment: Always get a second opinion
if no clear diagnosis is given for your fertility problem.
“Unexplained fertility”, while not uncommon,
is an overstated diagnosis. Fertility treatment options
are limited so it is important that patients understand
the rationale behind their treatment. In this case, for
a young patient with normal pelvis and normal tubes, superovulation
was a better choice of treatment than IVF. Normal tubes
work far better than any embryology laboratory. The problem
was ovulation dysfunction, as reflected by tonically elevated
LH. Once the problem was corrected, the patient conceived
without assisted insemination.
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Case
#3 A 40-year-old
female patient with 18 years history of primary infertility.
The patient was diagnosed with
proximal bilateral tubal blockage. She failed one IVF
cycle after only two eggs were retrieved. She was also
a low responder to fertility drugs.
She went for a donor egg cycle
in another fertility centre which failed after rescue
ICSI!
We did hysteroscopic tubal cannulation
to overcome proximal obstruction of her tubes as the last
resort, since she could no longer afford fertility treatments.
She conceived on the following month with superovulation
/ insemination. She delivered a healthy male baby at 34
weeks gestation.
Comment: Tubal
surgery can be very rewarding if the patient is properly
selected and the procedure is done by a well-trained physician.
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