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Infertility and Treatment Options


Infertility affects approximately 10-20 % of couples in reproductive age group that is one out of six married couples experience difficulties in having children. Nearly 3-5% of the couple rarely achieve pregnancy unless some form of medical help is provided. Therefore, the management of infertility makes an important component of gynecological problems. Newer techniques of investigation have brought revolutions in this field and better pregnancy rates are achieved. Several million babies are already born the world over by Assisted Reproductive Techniques. Radical changes in understanding the causes of infertility, progress in the field of reproductive medicine, new diagnostic tools, miraculous new ART procedures have kindled new hopes for these unfortunate would be parents.

Infertility is a disease or condition of the reproductive system often diagnosed after a couple has had one year of unprotected, well-timed intercourse, or if the woman has been unable to carry a pregnancy that results in a live birth.


Causes

1. Due to Female Factor 35-40%
2. Due to Male Factor 35-40%
3. Combined Factor 10-15%
4. Unexplained Infertility 10-15%

Treatment of Male Infertility Factors



Diagnostic procedures for male infertility are:

  • Endocrine assay.
  • Semen Analysis
  • Kryotyping.
  • Assessment of seminal plasma for viscosity, thinness, blood contamination and biochemical constituents.
  • The basic infertility screening for male is the semen analysis and the treatment depends upon semen parameters.

The treatment is decided as under:

Count Therapy
Less than 20 million/mL but greater than 10 million /mL Intrauterine Insemination
Less than 10 million/mL but greater than 5 million /mL IUI with frozen sample
Count less than 5 million/mL Invitrofertilisation and embryo transfer.
Very low count or complete absence of sperm in the semen ICSI \ ICSI combined with MESA PESA or TESA/ donor insemination.

Treatment of Female Infertility Factors

Diagnostic procedures for female infertility:

  • Endocrine assays.
  • Kryotyping.
  • Transvaginal sonography
  • Hysterosalpingogram
  • Hysteroscopy
  • Laparoscopy

The treatment due to female causes is decided as under:

Cause Therapy
Menstural disorder Generally medicinal
Adhesions, Pelvic TB, Endometrosis Laparoscopy
Polyp, Intrauterine adhesions, Septum, Fibroids, Endometrosis Hysteroscopy
Tubes blocked or absent , Endometriosis, Unexplained Infertility, Repeated IUI failure IVF-ET
Unexplained Infertility , Oocyte abnormality ICSI