INFERTILITY CAUSES AND TREATMENT
INFERTILITY CAUSES AND TREATMENT
What is Infertility ?
If a couple below age 35 cannot conceive within one year of regular intercourse or 6 months in case of above 35 years is called infertility
When to approach ?
There will not be physical disability like other disease, couple will complain only that since so and so time they are trying and could not conceive. On physical examination or by listening complaints doctors cannot diagnose. So by conducting certain tests on both partners, doctors can come to a final diagnosis.
What are the reasons for low fertility?
There could be a problem in either female or male or sometimes both Female sub fertility reasons
- ovulation failure
- pco ( altered FSH: LH Ratio ) pheripheral insulin resistance
- Hypo or Hyper Thyrodism
- Pituitary failure
- Low or high FSH / LH levels
- Ovarian Failure
- Primary or Secondary
- Uterine Problems
- Congenital ( comes by birth )
- Congenital absence of uterus
- Unicornuate bi-cornuate
- Septate uturus ( by birth ) i.e defects in size of shape
- Acquaired uterine problems
- Adenomysosis ( menstrual blood collection inside uterine muscular wall )
- Polyps ( growth )in endo metrium ( inner wall of uterine)
- Infections in the endometrium
- Thinning or thickinning of endometrium
- fellopian tubal problem
- Infections and adhessions of uterine tubes and alteration in tube ovarian relationship. Egg cannot enter uterine tube due to thin
- vaginal problems
- Any infection in the vagina, changes vaginal PH, where sperm cannot survive, so sometimes there may be anti bodies to sperm. By antisperm antibodies are there sperm cannot move.
- It is one of the important reason for most of the disease including infertility.
- Nutritional deficiency
- Protiens, vitamins and minerals are necessary for successful pregnancy.
MALE INFERTILITY REASONS
- Low sperm parameters ( count, motility, size and shape defects )
- Life style problems
- Stress, travelling, lack of times by food, exposure to chemicals or temperature
- Orchitis ( mumps, tubucurlosis, gonorrhea, etc) infection in testis
- Infection to appidydimis ( collection tubules )
- infection in seminal vessicle ( sucrose energy source to sperm )
- prostate ( supply alkaline PH medicine to sperm )
Excessive veins surroundings testis is called varicocele. It increase the testicular temperature so that sperm production or usually gets effected.
Collection of fluid around testis due to infections
4. General health problems
- Diabetes, Hypertesions / Hypo thyroidisim
- Use of Medicines for other health issues
- Chromosomal abnormalities ex: xxy y chromosome micro deletions
- Azoo spermia
- Primary testicular failure ( very small testis or testis in the groin)
- Pituitary failure – low FSH, LH levels.
- Obstruction for transport of sperms due to infections
- Congenital absence of vos difference
- Vasectomy ( family planning operations )
- General Blood Profile
- HSG ( X- ray of uterus and tubes )
- PCT – post coital tube and antisperm antibody test
- Hormones – FSH, LH AMH, Insulin FT3, FT4,TSH prolactin
- Laparoscopy and Hysteroscopy
- In case of repeated abortion – TORCH thrombo philia panel NK cells, phospolipid profile
- Chromosomal analysis ANA, ATA, TPO
- General blood profile Hormone profile
- FSH, LH, TSH, FT3, FT4 prolactin, testosterom ( free and total )
- Scrotal scanning for varicocele
- Rectal scanning for seminal vescicle syst and prostate
- Chromosomal analysis for azoo spermina
- Testicular biopsy
- Epidydimal sperm aspiration
Stage 1: History – physical examination – investigation – diagnosis
Treatments: Only medicine – to produce eggs – oral medicines or injections are added