Infertility treatment in Chennai

Infertility means not conceiving after one year of regular intercourse without contraception, or after six months when the woman is 35 or older. It is not a verdict. It is the point at which testing is worth doing.

The cause lies with the woman in about a third of couples, with the man in a third, and with both or neither in the rest. In women the common causes are eggs not releasing each month (anovulation, usually from PCOD), blocked tubes, often after an infection, fibroids or polyps inside the uterus, endometriosis, thyroid or prolactin imbalance, and a falling egg reserve with age. In men it is a low sperm count, or poor movement or shape of the sperm. Smoking, alcohol, excess weight and severe stress lower the chances for both.

Secondary infertility, not conceiving again after a first child, is just as common and is worked up the same way. Repeated miscarriage, three or more losses, counts too.

The first visit is unhurried, and both of you are asked about periods, how long you have been trying, past pregnancies, health and habits.

For the woman. A transvaginal scan on day two or three of the period to count the small follicles in each ovary and look for PCOD, fibroids, polyps or cysts. Blood tests: AMH (egg reserve), thyroid (TSH), prolactin, and sugar and insulin if PCOD is suspected. Ovulation tracking (follicle study): scans every two to three days from about day nine to confirm the egg grows and releases. A tube test (HSG, an X-ray with dye) to check the tubes are open; Dr. Ragavi tells you where and on which day to have it.

For the husband. A semen analysis at a laboratory after two to five days of abstinence, reporting count, movement and shape. An abnormal result is repeated after a few weeks.

For repeated miscarriage. Antiphospholipid antibodies, thyroid, sugar, a scan of the uterus and, where needed, hysteroscopy or chromosome tests for both partners.

Treatment starts with the cause, not with injections.

Ovulation induction. If the egg is not releasing, tablets (letrozole or clomiphene) taken for five days early in the cycle make a follicle grow. Scans follow it, and when it is ready a trigger injection and timed intercourse give the egg its chance. If tablets do not work, injections (gonadotropins) are the next step. Most women with PCOD ovulate on tablets alone.

Treating the cause. Thyroid or prolactin imbalance is corrected with tablets. PCOD is treated with weight change, metformin and cycle regulation. Fibroids, polyps or a septum inside the uterus are removed by hysteroscopy; a blocked tube, endometriosis or an ovarian cyst by laparoscopy. Both are done by Dr. Ragavi at the affiliated hospital; see laparoscopic gynaecological surgery in Chennai.

What the clinic does not do. RV Clinic does not do IUI, IVF or ICSI. If both tubes are blocked, the sperm count is very low, the egg reserve is low, or three to six cycles of ovulation induction have not worked, Dr. Ragavi says so clearly and refers you to a fertility centre.

Once you conceive. The pregnancy is followed at the clinic under pregnancy care in Chennai, and as a high-risk pregnancy if you have had losses before.

Consultation, scans, follicle monitoring and blood test requests happen at RV Clinic Madipakkam or RV Clinic Thalambur, whichever is closer. A follicle study needs scans every two to three days for about a week, so choose the branch you can reach easily; Thalambur's evening hours suit couples working on OMR.

Hysteroscopy and laparoscopy are done by Dr. Ragavi herself at Unittas Multispeciality Hospital, 21 km from the Madipakkam clinic and 5 km from the Thalambur clinic, usually as day-care procedures. RV Clinic is an outpatient clinic. No operation is done at either clinic address.