subject: Infertility and IVF treatments [print this page] What is Infertility? What is Infertility?
Infertility is a disease of the reproductive system that impairs one of the body's most basic functions: the conception of children. Conception is a complicated process that depends upon many factors: on the production of healthy sperm by the man and healthy eggs by the woman; unblocked fallopian tubes that allow the sperm to reach the egg; the sperm's ability to fertilize the egg when they meet; the ability of the fertilized egg (embryo) to become implanted in the woman's uterus; and sufficient embryo quality. Finally, for the pregnancy to continue to full term, the embryo must be healthy and the woman's hormonal environment adequate for its development. When just one of these factors is impaired, infertility can result.
What Causes Infertility?
No one can be blamed for infertility any more than anyone is to blame for diabetes or leukemia. In rough terms, about one-third of infertility cases can be attributed to male factors, and about one-third to factors that affect women. For the remaining one-third of infertile couples, infertility is caused by a combination of problems in both partners or, in about 20 percent of cases, is unexplained.
The most common male infertility factors include azoospermia (no sperm cells are produced) and oligospermia (few sperm cells are produced). Sometimes, sperm cells are malformed or they die before they can reach the egg. In rare cases, infertility in men is caused by a genetic disease such as cystic fibrosis or a chromosomal abnormality. The problems of present day life styles like smoking, use of tight undergarments, the job atmospheres like high temperature etc.can aggravate male infertility. Another cause for abnormal semen parameters is varicose veins affecting the testes.
The most common female infertility factor is an ovulation disorder. Other causes of female infertility include blocked fallopian tubes, which can occur when a woman has had pelvic inflammatory disease or endometriosis (a sometimes painful condition causing adhesions and cysts). Endometriosis is very common in Kerala.It may present as severe pain during menstruation or ovarian cysts or may be an incidental diagnosis in infertile woman. Congenital anomalies (birth defects) involving the structure of the uterus and uterine fibroids are associated with repeated miscarriages.
How is Infertility Diagnosed?
Couples are generally advised to seek medical help if they are unable to achieve pregnancy after a year of unprotected intercourse. The doctor will conduct a physical examination of both partners to determine their general state of health and to evaluate physical disorders that may be causing infertility. Usually both partners are interviewed about their sexual habits in order to determine whether intercourse is taking place properly for conception.
If no cause can be determined at this point, more specific tests may be recommended. For women, these include an analysis of body temperature and ovulation, x-ray of the fallopian tubes and uterus, and laparoscopy.
With the advent of Ultrasonography and colour Doppler the female infertility evaluation is simplified and less time consuming. It helps to evaluate the ovulatory status as well as some space occupying masses in Uterus or ovaries and a therapeutic strategy can be planned accordingly. The X-ray of Fallopian tube is known as hysterosalpingography. Other miscellaneous tests like estimation of various hormones in blood and significant presence of antisperm antibodies can be helpful to arrive at a diagnosis.
For men, initial tests focus on semen analysis. Semen analysis is the easiest test for male infertility. According to WHO recommendations there should be at least 20 millions of sperms per ML and of these at least 50% of them should be motile.
Infertility and IVF treatments
By: Dr.K.U.Kunjimoideen
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