NO OVULATION !! NO PREGNANCY !!! 
She has been married for over 10 years without having any child nor pregnancy.
She was such a pretty lady, with such great figure, and really deserves a baby of her own.
She visited our clinic for some tests . She had been attending some other clinics for years , and had undergone many tests , but nothing wrong was found with her .
When she came to our clinic, we decided to start with a simple TRANSVAGINAL ULTRASOUND SCAN, where we discovered that her ovaries were not functioning properly, and that was her main reason for her infertility in this instance. Further laboratory tests were done to confirm the diagnosis. She was treated by her doctor as per the diagnosis. After some few months she became pregnant.
Ovulation disorders are a common cause of infertility and are present in up to 30% of cases. Every month a normally ovulating female recruits eggs that develop to maturity and are released according to precise timing governed by hormone relationships in the menstrual cycle. Lack of ovulation is termed “anovulation” and irregular ovulation is termed “oligoovulation”.
CAUSES OF OLIGOOVULATION [IRREGULAR OVULATION] AND ANOVULATION [NO OVULATION:
[1] OVARIAN FAILURE AS A CAUSE OF OVULATION FAILURE — Women are born with all the eggs they will have for a lifetime and one is usually ovulated during each monthly menstrual cycle. As women age, infertility increases as ovarian function begins to decline until the menopause, where no more eggs are released and FSH levels are very high. Ovarian failure means that the ovaries cannot produce eggs that will normally fertilize and develop.
[2] POLYCYSTIC OVARIAN SYNDROME [PCOS] — a common condition characterized by elevated androgens (male hormone), reduced insulin sensitivity, and numerous cysts on the ovary. Elevated androgens can lead to oligoovulation.
[3] THYROID DYSFUNCTION— Abnormally high (hyperthyroidism) or low (hypothyroidism) levels of thyroid hormone can cause irregular ovulation thought to be due to the high levels of estrogen associated with these conditions.
[4] HYPERPROLACTINEMIA— Prolactin is responsible for breast milk production in pregnant women. Elevated levels of the hormone, prolactin, can lead to ovulatory disorders and infertility. Elevated levels in the absence of pregnancy cause irregular ovulation by reducing the levels of FSH and LH.
[5] EXCESSIVE EXERCISE, STRESS, AND ANOREXIA can lead to irregular ovulation.
[6] ADRENAL DYSFUNCTION— Androgens are produced by the adrenal glands and abnormally elevated levels lead to oligoovulation. Increased androgens are associated with elevated levels of prolactin, and/or tumors on the ovary, pituitary, or adrenal gland.
[7] UNEXPLAINED— Sometimes eggs will not fertilize and develop into health embryos for unexplained reasons. In many cases, these couples achieve pregnancy with donor egg IVF .
INFERTILITY DIAGNOSTIC TESTS
The Female Work-up (Diagnostic Tests)
[1] ULTRASOUND : The ultrasound is the only definitive way to tell you have ovulated.
Especially TRANSVAGINAL ULTRASOUND SCAN.
This can tell if you have LUFS (Lutenized Unruptured Follicle Syndrome), which looks exactly like you are ovulating
in every way except the egg is not released.
[2] HORMONAL BLOOD TESTS: perform some basic hormone blood tests. Here is a list of the common blood tests performed.
FSH (Follicle Stimulating Hormone)
LH (Lutenizing Hormone)
Estrogen
Progesterone
including estradiol, inhibin B, Pooled progesterone, prolactin,
thyroid stimulating hormone, testosterone.
[3] POSTCOITAL TEST: This test will tell if you and your partner’s cervical mucus and sperm are compatible.
During the fertile time of your cycle, the doctor will take a sample of the female’s cervical fluid within
two hours of intercourse. If the sperm survive and move forward in the cervical fluid, you will know the sperm and
cervical mucus are compatible.
[4] HSG (Hysterosalpingogram) : This will tell if your fallopian tubes are open by injecting dye
through the cervix. Blocked tubes and lesions or polyps on the uterine cavity can be found
with this method.
TRANSVAGINAL ULTRASOUND SCAN
Definition
Transvaginal ultrasound is a imaging technique used to create a picture of the genital tract in women. The hand-held device that produces the ultrasound waves is inserted directly into the vagina, close to the pelvic structures, thus often producing a clearer and less distorted image than obtained through transabdominal ultrasound technology, where the probe is located externally on the skin of the abdomen.
Purpose
Transvaginal ultrasound can used to evaluate problems or abnormalities of the female genital tract. It may provide more accurate information than transabdominal ultrasound for women who are obese, for women who are being evaluated or treated for infertility , or for women who have difficulty keeping a full bladder. However, it does provide a view of a smaller area than the transabdominal ultrasound. Types of conditions or abnormalities that can be examined include:
· the endometrium of women with infertility problems or who are experiencing abnormal bleeding
· sources of unexplained pain
· congenital malformations of the ovaries and uterus
· ovarian cysts and tumors
· pelvic infections, such as pelvic inflammatory disease
· bladder abnormalities
· a misplaced IUCD (intrauterine contraceptive device)
· other causes of infertility
Transvaginal ultrasound can also be used during pregnancy. Its capability of producing more complete images means that it is especially useful for identifying ectopic pregnancy, fetal heartbeat, and abnormalities of the uterus, placenta, and associated pelvic structures.
FOLLICULOMETRY [ULTRASOUND]
Ultrasound Folliculometry is a serial Transvaginal ultrasound scan test carried out to monitor follicular growth .Ovulation/Follicular growth can be best monitored by ultrasound folliculometry, providing 0–60% effectiveness.
Folliculometry is one of the most accurate method for determining ovulation.
Ovulation scans allow the doctor to determine accurately when the egg matures; and when you ovulate. This is often the basic procedure for most infertility treatment since the treatment revolves around the wife’s ovulation. Daily scans are done to visualize the growing follicle, which looks like a black bubble on the screen. Most women can see the follicle clearly for themselves – and know by the scans when the egg has ruptured. Other useful information which can be determined by these scans is the thickness of the uterine lining – the endometrium. The ripening follicle produces increasing quantities of estrogen, which cause the endometrium to thicken. The doctor can get a good idea of how much estrogen you are producing (and thus the quality of the egg) based on the thickness and brightness of the endometrium on the ultrasound scan.
Ultrasound folliculometry is started from day 6 – 8 counting from the first day of menstruation. Folliculometry is performed every 2 or 3 days in the initial stages and can be done daily from the day 12, till after the follicle ruptures [post ovulation]. So in a routine ultrasound folliculometry the lady could be scanned transvaginally for between 3 to 6 sessions.
JOAS MEDICAL DIAGNOSTIX, Ikotun Lagos Nigeria, offer comprehensive infertility screening tests for both couples like Transvaginal Scan for uterine and ovarian functions,Ovulation/follicular tracking, HSG to evaluate the fallopian tubes, blood tests for hormone check, semen analysis etc. We also offer a simple assisted reproductive procedure like INTRAUTERINE INSEMINATION [IUI].
For accurate assessment of your fertility situation, contact us at JOAS MEDICAL DIAGNOSTIX, Ikotun Lagos Nigeria.
For FREE Consultation and FREE Counseling. Also for Quality and Accurate Medical Diagnostic Tests Contact
JOAS MEDICAL DIAGNOSTIX
JOAS MEDICAL DIAGNOSTIX——-WE ARE AN ULTRAMODERN MEDICAL IMAGING CENTER. WE ARE EXPERTS IN ULTRASOUND SCAN SERVICES, 3D/4D COLOUR DOPPLER SCAN SERVICES, X-RAY/RADIOLOGY SERVICES, ECG SERVICES, INFERTILITY SERVICES, HSG SERVICES, LABORATORY SERVICES,BLOOD BANKING SERVICES , DNA SERVICES, AND HEALTH CONSULTANCY/COUNSELLING SERVICES.
We are located at
JOAS HOUSE, 2, Okesuna Street,
Opposite The Synagogue Church Busstop,
Bolorunpelu, Ikotun, Lagos
Postcode: 100265
Nigeria.
TEL:
08032509975,
08184590752,
08058166504,
08064981455
EMAIL:
joasmedicaldiagnostix@yahoo.com
joasmedicaldiagnostix@gmail.com
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