Sub: - Summary of the treatment

We are marred since last 3.3 years and trying to have a baby since last 2 years, there was no such serious daisy with both of us till date, my age is 31years and my wife’s age is 26 years her LMP was 28.07.2010. her period is normal in interval of 28 days. Her last three TVS result was as followed

1. Date: 03.07.2009
CYCLE     RT. OVARY     LT. OVARY     ENDOM     P.O.D.
13th Day     Follicle present Measure: 17.5mm     Follicle present Measure : 16.7mm     Central in position and triple line seen Measure : 7.5mm     No fluid seen
Date: 01.08.2009
CYCLE     RT. OVARY     LT. OVARY     ENDOM     P.O.D.
13th Day     Follicle present Measure: 19.9mm     No follicle Seen     Central in position and triple line seen Measure : 8.8mm     No fluid seen
Date: 01.011.2009
CYCLE     RT. OVARY     LT. OVARY     ENDOM     P.O.D.
13th Day     No follicle Seen     No follicle Seen     Central in position and triple line seen Measure : 9.4mm     No fluid seen

2. DETERMINATION OF INSULIN LEVELIN HUMAN SERUM

INVESTIGATION RESULT UNIT BIOLOGICAL REFERENCE INTERVAL

FREE INSULIN, serum by CLIA 7.98 plU/ml 1.1 – 14.3
3. DEPARTMENT OF HORMONE ASSAY

INVESTIGATION RESULT UNIT BIOLOGICAL REFERENCE INTERVAL
Testosterone, serum by CLIA 0.53 ng/ml Male : 1.66 – 8.11
Female : 0.13 – 1.08

4. BIOCHEMISTRY THYROID FUNCTION TESTS REPORT BY ELISA

TEST DESCRIPTION     RESULT     UNIT     NORMAL VALUE
T 3     1.21     ng/ml     0.52 – 1.85
T 4     6.28     pg/dl     4.4 – 11.6
TSH     2.26     pIU/ml     0.39 – 6.6

5. GONADOTROPIC HORMONE TEST REPORT

TEST VALUE UNIT
1. LUTEINIZING HORMONE (L.H) 2.64 pIU/ml

2. FOLLICLE STIMULATING HOROMNE (FSH) 8.55 pIU/ml

TYPICAL VALUES

HORMONE SEX CATEGORY RANGE
LH Normal male 0.7 – 7.4
Normal Female follicular Phase 0.5 – 10.5
Midcycle 18.4 – 61.2
Luteal phase 0.5 – 10.5
Postmenopaosal 8.2 – 40.8

FSH Normal Male 1.0 – 14.0
Normal Female follicular Phase 3.0 – 12.0
Midcycle 8.0 – 22.0
Luteal phase 2.0 – 12.0
Postmenopaosal 35.0 – 151.0

6. Report (Hysterosalpingogram)
Uterus normal with normal uterine cavity
Fallopian tubes are well visualized.
Bilateral spillage noted

7. Report on the examination of seminal fluid

Date: June 12, 2009
General Examination
Quantity 2ml
Viscosity low
Colour whitish
Reaction 8.0
Liquefaction time 40 minutes

Microscopical Examination
Actively motile 50%
Sluggishly motile 10%
Non Motile 40%
Total Sperm Count 42.0 million / cc
Epithelial cell Nil
Leucocyte 2 – 4 / h.p.f
R.B.C Nil
Crystal Nil
Normal Spermatozoa 45 %
Abnormal Spermatozoa 55 %

8. U.S.G. OF WHOLE ABDOMEN
Liver: Liver is normal in size, having a smooth outline and of homogeneous echopattern no focal parenchyma lesion is seen intra hepatic biliary channels are not dilated Rt. Lobe of liver measures: 127.8mm

Porta: Portal vein at porta hepatic measures: 7.6mm in diameter, the appearance of porta is normal

Gall- Bladder Gall Bladder is optimally distended with normal contour and wall thickness no calculus of any intraluminal mass is seen.

C.B.Duct. Common bile duct is not dilated. No calcular opacity not any intraluminal echogenecity could be detected at the visualized portion of common bile duct. Common bile duct measure: 3.0mm in diameter

Pancreas: Pancreas is normal in size and of normal echopattern. Pancreatic duct is not dilated no calcification nor any pancreatic collection of fluid could be detected

Spleen: Spleen is normal in size and of homogeneous echopattern. Splenic vein at hilum is normal. Spleen measure 113.8mm

Kidneys: Both kidneys are normal in size shape margin and axis
Cortico-medullary differentiation is normal
No calcular opacity nor any hydronephrotic change noted
Rt. Kidney measure : 95.3 mm in L.A.
Lt.Kidney measures : 100.2 mm in L.A

Ureters : Both ureters are not visualized. Hense it is not dilated

U. Bladder: IBladder is normal in size having a normal wall thickness. Neither intraluminal lesion nor any calcular opacity could be demonstrated

Uterus: Uterus is normal in size, shape and anteverted in position. Endometrial echo is central in position no space occupying lesion, Uterus measures: 86.5 mm x 40.8mm x 34.0mm

Ovaries: Left ovary is slightly enlarged in size & appearance, Lt. Ovary measure: 42.8 mm x 12.9 mm, Right ovary polycystic appearing, Rt. Ovary measure: 39.7 mm x 15.1 mm

P.O.D: No Fluid is seen in pouch of douglus

IMPRESSION left ovary slightly enlarged, right ovary polycystic appearing

Suggested: Clinical correlation

9. USG OF PELEVIS
KIDNES:

Both kidneys are normal in size shape and position. Cortico medullary demarcation appears normal. No evidence of calculus or hydronephrosis seen.
Right kidney measure 103.6 mm in length. Left kidney measures 109.5 mm in length
URINARY BLADDER:

Well distended. Bladder wall appears normal. No lesion noted inside

UTERUS:

Anteverted with normal size and shape. Myometrial texture is normal. Endometrial echo is in midline and normal in thickness (9.4 mm). Uterus measure 83.3 mm x 37.0 mm x 36.0 mm

OVARIES:

Both ovaries are normal in size. Shape maturing follicles (11 mm x 12 mm) are noted in both side. Right ovary measure 33.0 mm x 23.4 mm. Left ovary measure 29.3 mm x 22.2 mm

IMPRESSION: features suggest Study within normal limit

Now My Doctor Shankar Sarbagna (M.D. DNB. FICOG. DIP. ENDO. SURGERY (FRANCE) suggesting for Laparoscopy. Kindly suggest and help what should I do now because my wife gating mentally very upset and her dream of become a mother is seriously hart

Please help up and get us out of this misery

Please reply me in bellow mention Mail Id

Wating for your early reply

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