Family Matter’s Dr Q. Diale is a gynaecologist and obstetrician specialising in fertility care. With compassion and empathy, Dr Diale strives to assist those struggling to conceive, those with fertility deterring conditions and those keen to preserve their fertility
When is it necessary to see a fertility specialist?
If you and your partner have been struggling to fall pregnant for over a year or have had two or more miscarriages, it may be time to see a fertility specialist to investigate.
A fertility specialist may also assist in fertility therapy through intrauterine insemination, IVF, fertility preservation through egg freezing, embryo (egg) freezing; egg and sperm donation and the process of surrogacy.
Who is regarded as infertile?
Infertility affects 15% to 20% of the South African population. Infertility is the difficulty of falling pregnant. It is generally diagnosed if a couple has been actively trying and engaging in frequent, unprotected sex to conceive for a year, with no success.
What can be expected during my visit?
In order to treat infertility and help you conceive, Dr Diale needs to investigate the cause for your fertility problems. For women, it may be a combination of factors such as a problem with the womb, the fallopian tubes, the female hormones or the presence of a gynaecological disorder such as fibroids , endometriosis or uterine septum that hinders pregnancy or that make a woman unable to carry a pregnancy to full term. With that said, a range of factors can affect a man’s fertility too – hence the need for infertility investigations such as a semen analysis.
During your consultation with Dr Diale, she will discuss your concerns, study your gynaecological history and perform a routine gynaecological check-up and pap smear. With a clear picture of your health, she may suggest infertility investigations such as blood tests for hormone levels and ovarian reserve, ultrasound and semen analysis. In some cases, she may suggest a hysteroscopy or laparoscopy to identify and treat any diseases of the reproductive system that may lead to infertility or failure of treatment.
What is the plan going forward?
Once we know what is causing your fertility problems, treatment is tailored to you personally. This may involve stimulating ovulation with fertility drugs or restoring fertility by correcting abnormalities or removing endometriosis, fibroids, ovarian cysts and other adhesions with hysteroscopic or laparoscopic surgery.
What about artificial insemination and in vitro fertilisation (IVF)?
In other cases, reproductive assistance may be needed and can be done in the form of intrauterine insemination (IUI) in which the sperm is placed inside the uterus during ovulation.
Assisted reproductive technology such as in vitro fertilisation (IVF) or intracytoplasmic fertilisation (ICSI) may be done. This involves retrieving mature eggs from the woman and fertilising them with the man's sperm in a dish in a lab before transferring the embryos into the uterus after fertilisation. This may be transferred into your own uterus or the uterus of a surrogate.
What about genetic testing?
Preimplantation genetic testing, also known as PGT can also be done during IVF treatment for the assessment of any chromosomal disorders. Since IVF involves multiple eggs being retrieved from the woman before being fertilised in the IVF lab, cell samples can be taken from each embryo to check the chromosomal make-up of the embryo and the X and Y chromosome, which will also enable you to tell between male or female embryos.
With the advancement of technology and the success rates of fertility treatments these days, there are many safe and effective treatments for infertility that significantly improve your chances of getting pregnant with a healthy baby. It's just a matter of seeking assistance from a fertility specialist!