WHAT IS INFERTILITY?

WHAT IS INFERTILITY?

  • Infertility means failure to conceive after one year of frequent unprotected intercourse during the fertile period.

FERTILE PERIOD:

  • Means Days of Menstrual Period During Which If You Have Sexual Relationship Chances of Conception Are High.
  • Usually If Female Has Regular Cycle 0f 28-30 Days then Fertile Period is Between 10th To 20th Day of The Menstrual Cycle.
  • One must remember that, majority of infertile couple can have a baby with the help of assisted reproductive technology.
  • So, positive attitude of patient gives better result.

  • OVER ALL 15 % COUPLE REQUIRE MEDICAL ATTENTION TO CONCEIVE.
  • FEMALE PARTNER IS RESPONSIBLE IN 30%
  • MALE PARTNER IS RESPONSIBLE IN 30%
  • BOTH ARE RESPONSIBLE IN 20%
  • IN REMAINING 20% WE DO NOT FIND ANY CAUSE.

TYPES OF INFERTILITY

PRIMARY INFERTILTIY: A COUPLE THAT HAS NEVER CONCEIVED

SECONDARY INFERTILTY: INFERTILITY THAT OCCURS AFTER PREVIOUS

PREGNANCY REGARDLESS OF OUTCOME.

CAUSES OF INFERTILITY

THE CAUSES OF INFERTILITY CAN BE GROUPED UNDER FOUR MAIN FACTORS:

  • FEMALE FACTORS: 30%
  • MALE FACTORS: 30%
  • BOTH MALE AND FEMALE FACTORS: 20%
  • UNEXPLAINED FACTORS; 20 %

ALL OVER THE WORLD, THERE IS INCREASING TREND FOR MALE AND FEMALE INFERTILTIY.

THE MOST COMMON LIFESTYLE FACTORS CAUSING INFERTILITY ARE AS FOLLOWS:-

  • STRESS
  • FOOD HABBITS LIKE CONSUMPTION OF JUNK FOODS, FROZEN FOOD,
  • LATE NIGHT SLEEP, POOR PHYSICAL ACTIVITIES.
  • LATE AGE MARRAIGES
  • PRESERVATIVES IN FOOD
  • POLLUTION
  • MOBILE PHONE RADIATION
  • HABBIT OF PUTTING LAPTOP ON LAP
  • INCREASE IN DAIBETIC AND OBESE POPULATION

FLORA FERTILITY CENTER IS ONE OF THE BEST INFERTILITY SPECIALISTS IN AHMEDABAD, HERE YOU ATTAIN THE COMPLETE INFERTILITY SOLUTION BY OUR SPECIALIST

MALE INFERTILITY

  • 50 % MALE HAVE INFERTILTIY PROBLEM.
  • OUT OF THAT 30% ARE SOLELY RESPONSIBLE FOR INFERTILTY
  • 20% BOTH PARTNERS HAVE PROBLEMS.

ANATOMY AND FUNCTIONS OF REPRODUCTIVEORGANS

  • TESTIES: SPERMS PRODUCTION
  • EPIDYDEMIS: STORAGE AND MATURATION OF SPERMS.
  • VAS DEFFERENCE: TRANSPORTATION OF SPERMS
  • SEMINAL VESICAL: SUPPLEMENTATION OF ENERGY FLUID
  • PENIS: EXPULSION OF SEMEN CONTAING SPERMS

CAUSES OF MALE INFERTILITY:

APART FROM LIFESTYLE FACTORS

MOST COMMON CAUSES FOR MALE IINFERTILTITY:

  • VARICOCELE: MEANS DILATED VEINS OF SCROTUM
  • MUMPS INFECTION IN CHILD HOOD
  • DIABETES AND OBESITY
  • H/O TRAUMA, INFECTION, TORSION AND TUMOURS OF TESTIES AND SURGERY OF SCROTAL AREA
  • CHRONIC MEDICAL ILLNESSES: DM, HYPERTENSIVE, HYPOTHYRODISM, PSYCHIATRIC DISORDERS,
  • ON MEDICATIONS: CIMETIDINE, SPIRENOLACTON, CHEMOTHERAY
  • SMOKING, ALCOHOL AND TOBACCO CONSUMPTION
  • DRUG ADDICTION
  • H/O RADIATIONS
  • OCCUPATIONAL: WORKING IN HOT CONDITION LIKE NEAR FURNACE

LESS COMMON CAUSES ARE

  • HYPOTHALEMIC PITUITORY DISORDERS LIKE:
    • PITUATORY FOSSA TUMOURS
    • KALLMAN SYNDROME
  • GENETIC DISORDERS LIKE:
    • KLINEFELTER SYNDROME
    • Y CHROMOSOME MICRO DELETION

HOW TO EVALUATE THE MALE INFERTILITY:

  • FIRST IMPORTANT PART IS THE PROPER HISTORY TAKING AND PHYSICAL EXAMINATION.
  • SEMEN ANALYSIS: SIMPLE, NONIVASIVE AND MOST IMPORTANT
    • SEMEN WILL BE COLLECTED BETWEEN 3-5 DAYS OF ABSTENENCE.
    • IF SEMEN IS NORMAL USUALLY THERE IS NO NEED FOR FURTHER INVESTIGATION OF MALE PARTNER.
    • TERMINOLOGY USED IN SEMEN ANALYSIS
AZOOSPERMIA ABSENCE OF SPERM IN SEMEN.
OLIGOZOOSPERMIA DECREASED COUNT OF SPERMS IN SEMEN
ASTHENOZOOSPERMIA DECREASED MOTILTY OF  SPERMS IN SEMEN.
TERATOZOOSPERMIA HIGH NUMBER OF MORPHOLOGICALLY ABNORMAL SPERMS.
ASPERMIA ABSENCE OF SEMEN.
  • USG & DOPPLER OF SCROTUM (MOST COMMON TEST) TO RULE OUT
    • VARICOCELE: GRADE III AND IV REQUIRES MINOR SURGERY
    • TESTICULAR DISORDER
  • HORMONAL ANALYSIS: IN SEVERE OLIGOASTHENOSPERMIA
  • TESTICULAR BIOPSY: IN AZOOSPERMIA
  • GENETIC TESTS (CHROMOSOMAL ANALYSIS)
  • Y CHROMOSOME DELETION
  NORMAL MILD / MODERATE
(OLIGOZOOSPERMIA
ATHENOZOOSPERMIA
TERATOZOOSPERMIA)
SEVERE OLIGOZOOSPERMIA
ASTHENOZOOSPERMIA
TERATOZOOSPERMIA
Azoospermia
COUNT >15 MILLION/ML 5-15MILLION/ML 1-5 MILLION/ML Absent
MOTILITY >50% RP:>30% <25% <15% Absent
MORPHOLOGY >4% NORMAL <4% < 2% Absent

FOLLOWING CATOGARIES OF SEMEN ANALYSIS.ALL OTHER TESTS HELP IN DECIDING THE MODE OF TREATMENT.

  • There are lots of variations in semen analysis between two sample taken few days apart.
  • So, if first sample is abnormal then semen analysis should be repeated after 15 days.

HOW TO TREAT MALE INFERTILITY?

  • Mode of infertility treatment is only decided after investigations of both male and female partners.
  • Most common treatments are as follows depending on cause and abnormality of semen analysis.
  • TREATMENT OF OBVIOUS CAUSE:
    • SURGICAL TREATMENT OF GRADE III AND IV VARICOCELE
    • CONTROL OF CHRONIC MEDICAL CONDITIONS
    • CONTROL OF CHRONIC MEDICAL CONDITIONS E.G. DM, HYPERTENSION
    • AVOIDING MEDICATIONS THAT AFFECT SPERMATOGENESIS
    • STOPPING DRUGS, TOBACCO, LIMITING ALCOHOL CONSUMPTION

NUTRIONAL SUPPLEMENTS WITH LIFE STYLE CHANGES

  • VITAMIN SUPLEMENTATION
  • ANTIOXYDANTS: COQ/ LYCOPIN/ARGININE
  • AYURVEDIC MEDICATIONS CAN BE TRIED

MEDICATIONS

    • CLOMIPHEN CITRATE / LETROZOLE:FOR OLIGOSPERMIA
    • PENTOXYPHYLINE:FOR ASTHENOSPERMIA
    • INJECTABLE HORMONS:FOR SEVERE OLIGOASTHENOSPERMIA AND TRAILS IN NON-OBSTRUCTIVE AZOOSPERMIA

ART (ASSISTED REPRODUCTIVE TECHNOLOGY)

    • SIMPLE PROCEDURES
      • OVULATION INDUCTION WITH INTERCOURSE AROUND

OVULATION

  • OVULATION INDUCTION WITH IUI
  • IVF:
    • CONVENTIONAL IVF
    • ICSI
    • TESA / PESA
    • IMSI
  • SPERM DONATION
  • RESEARCH LEVEL TREATMENT:
    • PRP: PLASMA RICH PLATLETS INJECTION
    • STEM CELL THERAPY

FEMALE INFERTILITY

PICTURE OF FEMALE REPRODUCTIVE ORGANS

FUNCTIONS OF FEMALE ORGANS

  • OVARY: PRODUCTION OF OVUM
  • FALLOPIAN TUBES:
    • PICK UP OF OVUM
    • TRANSPORT OF OVUM AND FERTILE EGG
    • PROVIDING PROPER ENVIRONMENT FOR FERTILISATION
  • UTERUS:
    • IMPLANTATION
    • SUPPORT EMBRYO GROWTH.

FEMALE FACTORS CHART

EVALUATION OF FEMALE FACTORS

  • PROPER HISTORY AND EXAMINATION
  • GENERAL BLOOD INVESTIGATIONS TO RULE OUT MEDICAL DISEASES
  • BASELINE SONOGRAPHY TO RULE OUT
    • UTERINE FACTORS
    • OVARIAN RESERVE
    • ENDOMETRIAL PROBLEM
  • HORMONAL TESTS IF NECESSARY
    • TSH
    • PROLACTIN
    • AMH
    • FSH
    • LH
    • TESTOSTERON
    • DHEAS
  • TUBAL PATENCY TEST
    • HYSTEROSALPINGOGRAPHY
    • LAPAROHYSTEROSCOPY: DIAGNOSTIC AND THERAPEUTIC
  • GENETIC TEST: IF NECESSARY
    • KARYOTYPE
    • EXON SEQUENCING

TREATMENT:

  • CONTROL OF MEDICAL DISORDERS
  • NUTRITIONAL SUPPLEMENTS
  • CORRECTION OF FEMALE FACTORS RESPONSIBLE FOR INFERTILTIY LIKE:
  • MYOMECTOMY: REQUIRED BIG OR DISTORTING ENDOMETRIUM.
  • METROPLASTY
  • ADHESOLYSIS
  • OVARIAN TUMOUR REMOVAL
  • SUGERY FOR ENDOMETRIOSIS: IN GRADE III AND IV
  • SEPTUM RESECTION:
  • TUBAL CANNULATION
  • POLYPECTOMY

MOST OF ABOVE TREATMENTS ARE DONE BY THERAPEUTIC LAPAROHYSTEROSCOPY

  • ET DEVELOPMENT TREATMENT
  • TREATMENT OF PROLACTINEMIA, GENITAL TB
  • ART (ASSISTED REPRODUCTIVE TECHNOLOGY)
    • SIMPLE PROCEDURES
      • OVULATION INDUCTION WITH INTERCOURSE AROUND OVULATION
      • OVULATION INDUCTION WITH IUI
      • PRP INJECTION
    • IVF:
      • CONVENTIONAL IVF
      • ICSI
    • OVUM DONATION
    • EMBRO DONATION
    • STEM CELL THERAPY
    • SUROGACY

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