Fertility & Reproductive Medicine

Infertility is generally defined as:

• Trying to conceive for 12 months or more without success (if under 35 years old)
• Trying for 6 months without success (if over 35 years old)

Infertility can affect:

• Ovulation; when the ovary releases an egg
• Fallopian tubes; where fertilisation normally occurs
• The uterus (womb); where pregnancy implants and grows
• Sperm factors
• Hormonal balance
• Or a combination of factors

Sometimes, no clear cause is identified; this is called unexplained infertility

The first consultation includes a detailed medical history for both partners, covering:

• Menstrual cycle patterns

• Previous pregnancies or miscarriages

• Medical conditions

• Previous pelvic infections

• Surgical history

• Lifestyle factors

A physical examination and targeted investigations are then arranged.

Fertility care is highly individualised. Testing may include:

Hormonal Blood Tests

These assess whether ovulation is occurring and evaluate hormone levels such as:

• Follicle-stimulating hormone (FSH)

• Luteinising hormone (LH)

• Progesterone

• Thyroid hormones

• Prolactin

Hormones regulate ovulation and menstrual cycles.

A pelvic ultrasound uses sound waves to examine:

• The uterus

• The lining of the womb (endometrium)

• The ovaries

• The presence of ovarian cysts

• Follicle development (egg growth)

This helps assess ovarian reserve, meaning the number of eggs remaining.

The fallopian tubes are essential for pregnancy because fertilisation – when sperm meets egg – usually occurs in the tubes.

Blocked tubes can prevent pregnancy.

 Assessment may include:

• Tubal patency testing: checking whether tubes are open

Laparoscopy: a minimally invasive surgical procedure using a small camera inserted through a small abdominal incision to directly visualise the tubes and pelvic organs.

A hysteroscopy is a procedure where a small camera is inserted through the cervix into the uterus to examine the uterine cavity.

This helps identify:

• Polyps: small growths inside the womb

• Fibroids: non-cancerous growths

• Scar tissue

• Structural abnormalities

If abnormalities are found, they can often be treated during the same procedure.

Dr. Dutywa diagnoses and manages conditions such as:

Polycystic Ovary Syndrome (PCOS)

A hormonal condition that can cause irregular ovulation and difficulty conceiving.

Endometriosis

A condition where tissue similar to the lining of the womb grows outside the uterus, potentially causing pain and infertility.

Ovarian Cysts

Fluid-filled sacs that may interfere with ovulation.

Tubal Blockage

Often related to previous infection or inflammation.

Uterine Abnormalities

Including fibroids, polyps, or structural differences.

Recurrent Pregnancy Loss

Defined as two or more consecutive miscarriages. Evaluation may include hormonal, anatomical, genetic, and clotting assessments.

For women who are not ovulating regularly, medication may be used to stimulate ovulation. This is called ovulation induction.

Treatment is monitored carefully with ultrasound and blood tests to ensure safety and effectiveness.

IUI is a fertility procedure where prepared sperm is placed directly into the uterus around the time of ovulation to increase the chance of fertilisation.

This may be recommended in selected cases.

In cases where advanced treatment is required, such as In Vitro Fertilisation (IVF), where fertilisation occurs outside the body in a laboratory, Dr Dutywa provides:

• Pre-IVF evaluation

• Cycle monitoring

• Ongoing reproductive care

• Referral to specialised fertility centres when appropriate

As a certified laparoscopic surgeon, Dr Dutywa offers minimally invasive procedures where indicated, including:

• Laparoscopy for infertility evaluation

• Treatment of endometriosis

• Removal of ovarian cysts

• Surgical management of ectopic pregnancy (in stable patients)

• Tubal assessment and selected tubal procedures

Minimally invasive surgery involves small incisions, reduced recovery time, and less postoperative discomfort.

For couples planning pregnancy, preconception care focuses on:

• Optimising chronic medical conditions

• Reviewing medications

• Nutritional supplementation, including folic acid

• Lifestyle guidance

• Weight management advice

Optimising health before pregnancy improves outcomes for both mother and baby.

Infertility affects not only the body, but emotional wellbeing. Many patients arrive feeling discouraged, anxious, or exhausted.

Dr Dutywa believes fertility treatment should include:

• Clear explanations

• Realistic expectations

• Honest discussion of options

• Emotional reassurance

Each treatment plan is tailored to the individual couple. There is no “one-size-fits-all” approach in reproductive medicine.