Infertility...waiting game

      
      

“ We got married since five years..No issues!"

" We are much worried . We can't answer to questions from everybody"
        Infertility affects every aspect of a couple’s life, their marriage, sex life, social relationships and finances. For many couples, infertility can become the central issue of their lives, both as individuals and as a couple. Infertility rate is high in our country, lots of women have been anxious to conceive and have a “lucky baby” Infertility is generally a complex problem, and may involve one or both partners.

   If a couple is infertile, this means that they have been unable to conceive a child after 12 months of regular sexual intercourse without birth control. The term “Primary infertility” is used medically to denote for whom they have never had a child and the term “Secondary infertility” means that the infertile person has had one or more children in the past, but a medical problem is impairing fertility.

Multiple body functions must be operating normally in order to conceive a baby and carry a pregnancy to term. The man must be producing healthy, motile, swimming sperm in enough quantities to fertilize an egg cell. The woman's cervical mucus must be at the right PH and in consistency to facilitate the sperm's journey to the reproductive tract; the ovaries must release healthy eggs; her fallopian tubes must be free of blockages; the uterine environment must be suitable for implantation of a fertilized egg; and all along the way, the endocrine system must be secreting various reproductive hormones in the right sequence and at proper levels for the pregnancy to occur.

Every one is curious to locate the problem and find remedy to it. Every one needs basic knowledge in male reproduction and female reproduction.

How to confirm infertility?

Medical History and Physical Examination

The first step in any infertility work up is a complete medical history and physical examination of both partners. Sexual technique and timing, menstrual history, lifestyle issues, such as smoking and drugs, alcohol and caffeine consumption and a profile of the patient's general medical and emotional health can help the physician decide on appropriate tests.


Laboratory Tests

Semen Analysis

The basic test to evaluate a man's fertility is a semen analysis. To perform this test, a man collects a sample of his semen in a collection jar during masturbation either at home or at the laboratory. A man should abstain from ejaculation for four days before the test, because each ejaculation can reduce the number of sperms. A semen analysis should be repeated at least three times over several months. The analysis reports on any abnormalities in sperm count, motility and morphology, as well as any problem in the semen.

Sperm Count

A low sperm count should not be viewed as a definitive diagnosis of infertility but rather as an indicator of a fertility problem. Counts of less than 20 million per milliliter are currently considered strong indicators of infertility, although pregnancy is sometimes possible even with such low counts.


Sperm Motility

Motility is the speed and quality of movement. It is graded on a 1 to 4 ranking system.

     Grade 1 sperm wriggles sluggishly and makes little forward progress.
     Grade 2 sperm moves forward, but is either very slow or does not move in a straight line.
     Grade 3 sperm moves in a straight line at a reasonable speed and can home on an egg accurately.
     Grade 4 sperm is as accurate as Grade 3 sperm, but moves at terrific speed. Sperms that clump together may indicate that antibodies to the sperm are present.


Sperm Morphology

Morphology is the structure of the sperm. About 60% of the sperm should be normal in size and shape for adequate fertility. Determining the morphology of the sperm is particularly important for the success of the fertility treatment.

Seminal Fluid

The semen itself is analyzed for abnormalities. Most men ejaculate 2.5 to 5 cc of semen. Amounts of 2.5 cc may indicate of prostate problems or frequent intercourse. Normal semen is liquefied within 20 minutes by certain enzymes. If it remains sticky, fertility may be impaired. An absence of fructose indicates that an obstruction has occurred either in the vas defererens or in the epididymis, since fructose is added to the semen in the epididymis. Conversely, if there is fructose in the semen but no sperm, then the channel from the epididymis is open but there is a defect in sperm production. Thus infections may be detected.

Blood Tests

Blood tests are taken to evaluate hormone levels. Blood studies include FSH, LH, testosterone, estrogen and progesterone as prescribed to the appropriate partners. Blood studies for thyroid function and prolactin levels are also measured.

Postcoital Test

The postcoital is designed to evaluate the effect of a woman's cervical mucus on a man's sperm. To perform this test, a woman is asked to come into the physician's Laboratory within two to 24 hours after intercourse at mid-cycle, when ovulation occurs. A small sample of cervical mucus is obtained and examined under a microscope. The problem is detected if the physician observes no surviving sperm or no sperm at all. Imaging studies.

Ultrasound


    Ultrasound is a noninvasive method for evaluating the uterus and ovaries by using sound waves rather than by x-rays and should be the first procedure. A series of ultrasounds may be an accurate and cost effective method for tracking ovulation. Fibroid tumors and ovarian cysts can be diagnosed as well. In males, ultrasonogram is helpful to detect the tumors varicocele

Hysterosalpingography

    Hysterosalpingography is performed for the female partner to discover possible blockage in the fallopian tubes and abnormalities in the uterus. To determine this, a tube is inserted into the cervix through which a dye is injected. The dye passes into the uterus and up through the fallopian tubes. If the dye is seen emerging from the end of the tube, it is proved of no blockage. The procedure may reveal other conditions, including endometrial polyps, fibroid tumors or structural abnormalities of the uterus and tubes. In some cases, it may restore fertility, probably by clearing away tiny tubal blockages.

Testicle Biopsy


    Occasionally, a testicle biopsy may be performed for male partner in which tissue samples are removed under anesthesia. A biopsy is most useful for detecting obstruction in the transport system, when sperm production looks normal, but the count is low.

Clinical evidence

 

Click on the following links

 

    Cases with PCOD conceived and delivered
     Cases with Thyroid disorders conceived
     A couple with multifactor complaints succeeded
     Habitual abortion…treated successfully with Homoeopathic treatment
     IVF failed couple conceived