Primus Super Specialty Hospital, New Delhi, India
TURNING HOPES INTO HAPPINESS
Treatment for male and female infertility
Infertility is defined as inability of a couple to conceive naturally after one year of regular unprotected sexual intercourse. It remains a major clinical and social problem, affecting perhaps one couple in six. The most common causes of infertility are: male factor (33%) such as sperm abnormalities, female factor(33%) such as ovulation dysfunction and tubal pathology, combined male and female factors(33%) and unexplained infertility
Female factors that affect fertility include the following categories:
- Cervical: Stenosis or abnormalities of the mucus-sperm interaction
- Uterine: Congenital or acquired defects; may affect cavity, endometrium or myometrium (Septum, polyp fibroids Synechae ( Asher man syndrome) ; may be associated with primary infertility or with pregnancy wastage and premature delivery
- Ovarian: Alteration in the frequency and duration of the menstrual cycle—Failure to ovulate is the most common infertility problem. PCOD , Endometrioma, Poor Ovarian Reserve; Premature ovarian failure, Hypo / Hyperthyroidism; Hyperprolectinemia are other factors.
- Tubal: Abnormalities or damage to the fallopian tube; may be congenital or acquired due to infections(chlamydial,tubercular),Endometriosis, pelvic surgeries eg appendesectomy, cystectomy, salpingectomy.
- Peritoneal: Anatomic defects or physiologic dysfunctions (eg, adhesions due to infections, endometriosis)
- Vaginisum, vaginal septum .
Male factors that affect fertility include the following categories:
- Infections of genital tract & glands leading to obstructions,
- Smoking Tobacco leads to direct damage of head (nucleus) DNA.
- Medication; cemitidine.phenytoin etc
- Chromosomal defects like Robertsonian Translocations, Klineflter syndrome,
- Genetic Y Deletion syndrome,
- Hydrocele ,Hernia,
- Mumps ;direct damage to sperm producing cells,
- Acrosomal (sperm cap) defects affecting egg penetration.
- Congenital vas absence /obstruction.
- Retrograde ejaculation,
Factors that affect the fertility of both sexes include the following:
- Environmental/occupational factors
- Toxic effects related to tobacco, marijuana, or other drugs
- Excessive exercise
- Inadequate diet associated with extreme weight loss or gain
- Advanced age
Workup and Evaluation of the Infertile Couple
Workup for infertility should be started after 1 year of regular sexual intercourse in couples in whom the age of the female partner is less than 35 years and after 6 months when the age of the female partner is more than 35 years. In couples with a known risk for infertility like endometriosis, previous amenorrhea or irregular menstrual periods or a history of a sexually transmitted disease, especially Chlamydial ,TB, the workup can be started earlier. Infertility workup consists of a thorough history taking and a basic physical checkup and blood tests.
Infertility Testing in Women
Tests for clinical evaluation in the female partner may be both invasive and non-invasive. Blood tests for hormonal levels, especially of thyroid hormone & prolectin, the follicular stimulating hormone (FSH) and Luteinizing Hormone (LH) as well as an ultrasound of the pelvic organs are non-invasive tests. Invasive tests are the hysterosalpingography (HSG), laparoscopy, hysteroscopy, endometrial biopsy etc.
Tests for Male Infertility
Testing for male infertility is based mainly on the semen analysis. The sperm count, the sperm motility, as well as the presence or absence of other cells in the semen are important parts of the semen analysis. Other important tests are hormonal tests, especially the thyroid hormone levels and LH FSH levels. In some tests for antisperm antibody may also be required.
INSTITUTE OF REPRODUCTIVE MEDICINE AND IVF CENTER
PRIMUS SUPER SPECIALITY HOSPITAL CHANAKYAPURI, NEW DELHI 110021, INDIA
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Primus Hospital Super Speciality Hospital
Chandragupta Marg Chanakyapuri, New Delhi- 110021For appointments : +91 9999920206, 6620 6630, 6620 6640
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