Dr Ahmed Ismail

Consultant Gynaecologist & Fertility Expert

 

Fertility

Infertility is a serious and saddest story in women’s life. Infertility problem is basically a woman who has regular sexual relationship mainly heterosexual on average 3 times a week uninterrupted for a period of 6-12 months and can not get pregnant with proven that husband semen analysis is normal.
Infertility treatment requires a high expertise in our speciality to enable the gynaecologist to identify where is the problem to establish appropriate line of treatment.

Causes of infertility in female:

 

  1. Dividing by anatomy
  2. Dividing by aetiology
  3. Dividing by pathology
  4. Dividing by age
  5. Dividing by history
  6. Dividing by obstetric history

As we can see from above causes of infertility require a detailed history to involve all the above factors.
Let us talk about infertility as a primary problem i.e. a woman never been pregnant in the past that should be divided in the following:

  1. A woman has a period
    1. A woman who has a period regular further cause need to be addressed later in the article
    2. A woman has a period irregular one of the commons cause Polycystic Ovarian Syndrome and other causes will be discussed later in the article
  2. A woman who does not have a period
    1. Genital obstruction like imperforate hymen or cervical atresia
    2. Ovarian failure
      1. Congenital ovarian atresia such case of Turner’s Syndrome
      2. Woman who had a regular period fallowed by premature ovarian failure
      3. Woman in premature menopause
      4. Women who develops ashermans disease after curettage or deliveries
Infertility dividing by anatomy as you can see from the picture
  1. Vulva and Vagina
  2. Cervix
  3. Uterus
  4. Fallopian Tubes
  5. Ovaries
  6. Pelvic Factors

Each of the above must be checked and examined in details to identify any congenital or pathological problem of great significant to contribute to fertility such as

 Vulvo-Vaginitis as a result of infections which could be from a non sexual health diseases or from sexual health diseases examinations and investigations would be valuable.

 Cervical erosion, Cervisitis, Cervical Polyps, Cervical Cancer

Endometritis, Multiple Submucous Fibroids, Adenomyosis, Ashermans Syndrome, Endometrial Polyps, Endometrial Hyperplasia

Tubal obstruction, Peritubal adhesions, Tubal fimosis

Ovary: Atrophic Ovary, Ovary:Polycystic Ovary, Dermoid Cyst, Large follicular Cyst, Choclate Cyst secondary to endometriosis

Pelvic adhesions secondary to abdominal operation such as: Appendecectomy, Myomectomy, Caesarean section, ovarian cystectomy, ectopic pregnancy,and other pelvi-abdominal surgery. Post Inflammatory, Post Infectious Adhesions: Pelvic Inflammatory Disease (PID), pelvic infections such as Chlamydia, and many other factors could cause pelvic adhesions.

  1. Vulva and Vagina:
  2. Cervix:
  3. Uterus:
  4. Fallopian Tubes:
  5. Overies:
  6. Pelvic Factors:

Conclusion:

Careful medical history, examination for woman and man, investigations for both partners will enable us to identify where is the problem before embarking on any line of treatment until a diagnosis of infertility is made.
Unexplained infertility has been addressed in the literature but we at the Queensway Clinic we do not believe in the case of unexplained infertility but we can say the clinician failed to identify the cause of infertility, that is why there is one clinician better than the other and it is a fact of the profession....Queensway Clinic wisdom note.

IVF 'may be boosted by time-lapse embryo imaging'

Queensway Clinic Director, Gynaecologist and IVF Expert Dr Ahmed Ismail has indicated that taking thousand of pictures for growing embryo may help to select a better embryo to be selected for transfer or according to the findings may be Transfer will be abandoned if it was proven that embryo’s failed to progress satisfactory.

Embryo developed unsatisfactory would subject the patient to have miscarriages or embryo will fail to develop in utero.

Queens Clinic Fertility Photo Gallery 

Infertility Investigations...read more...

Infertility Treatments...read more...

 
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