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 |
