I am 33 years old. For the past six months I am suffering from primary infertility, PCOS and diagnostic laparoscopy tubal block at right isthmus. Also, laboratory tests like Mantoux (positive), HBsAg (positive), ANA (positive) and LFT raised tests are done. The IUI done twice and my current medication is Metformin and Folic acid. Please suggest me.
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Tubal blockage or fallopian tube obstruction is a major cause of female infertility.
Blocked fallopian tubes will not let a sperm and ovum to unite thus interfering with fertilization.
The primary and the very first step for pregnancy is the formation of zygote followed by embryo and its implantation. This step is interrupted in tubal blockage.
I suggest you that if both the tubes are blocked, then there is no point in going for intrauterine insemination (IUI) and you need to go for IVF -in vitro fertilization.
Before that I suggest you that you need to go for hormonal profile, D2 or D3 luteinizing hormone (LH), follicle-stimulating hormone, estradiol, prolactin, AMH (anti-mullerian hormones) and thyroid profile.
After this IVF can be commenced like oocyte retrieval, spermicide collection, in vitro fertilization and embryo transfer are the steps.
You need not worry about being HBsAg positive as a transfer to the baby can be prevented by giving Hepatitis B immune globulin (HBIG) and Hepatitis B virus (HBV) vaccination as per recommendation soon after the delivery.
Your LFTs (liver function test) are raised and that is of concern as this may be a marker of acute viral hepatitis. I suggest you to go for HBeAg, HBV DNA and anti HBcAg-hepatitis B core antigen to know the viral replication.
Being ANA (antinuclear antibody test) positive may lead to pregnancy difficulties like miscarriages due to immune rejection. This may need immunosuppressive therapy with steroids and progesterone supposition.
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