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Will I be able to conceive, based on temperature charts?

Q: I am 34 years old, trying to conceive for the past 6 months. In between I also took clomiphene (clomid). I have been following temperature charts, as told by my doctor, she said I was ovulating. My doctor recently asked me to go for a HSG (Hysterosalpingography). It's very costly in the United States, around $450. She also asked my husband who is 41 years old to go for a semen analysis which he will go. I was thinking if I could get the test done in India as I will be visiting, could you tell me how much it will cost me there and if Calcuttas nursing homes or hospitals have the facility. Do I need a prescription for that? Or the test isn't necessary.

A:It is difficult to say conclusively that you are ovulating solely on basis of temperature charts. You should have follicular monitoring by ultrasound, and preferably a serum Progesterone done on day 21 of your cycle (if your cycle is of 28 days). It is also advisable to get an endometrial sampling/ biopsy done on day 24 of your cycle - this will give lot of information. However, you should abstain from your husband in the cycle you get the endometrial biopsy done as well as in the cycle you get the HSG done. Following the EB and USG and serum Progesterone measurement, you should go in for the HSG. Husbands semen analysis is a MUST - you should abstain for at least 5 days before the semen test. After these tests, you should have a post coital test. In this test (PCT), you are instructed to have intercourse between days 12 and 16 of your cycle - preferably also have ultrasound monitoring of follicle. Otherwise, these are the days when cervical fluid / secretions are in plenty and clear and you can see it / feel it at the vagina opening (introitus). About 2 to 4 hours after intercourse, you report to the gynaecologist (with prior appointment) and she takes a smear from your cervix and examines it under the microscope to see the no. of sperms and their motility. Clomid is usually given if you fail to ovulate on your own, or in cases of unexplained infertility. But it requires thorough monitoring. All the tests can be done in Kolkata - there are very good gynaecologists there - but please get a prior appointment - you can look up the yellow pages when you reach there. Price of HSG etc depends upon the place where tests are done. HSG cost can vary, approximately from Rs 900/ to Rs 1600/.

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