Infertility is the inability of a couple to obtain a clinically recognizable pregnancy after one year of unprotected intercourse. Single most important factor in determining the fertility is the age of the female partner. If the women age is above 35 or above fertility is helved. So it is essential to start the investigations – 6 months after unprotected intercourse. Counseling is an essential part before starting the treatment.
Advices that are given:
In nearly 10% of cases no fault is found. The only treatment they require is reassurance and advice to wait. They should be advised regarding the timing of coitus. Their general health is improved by advising the type of diet. If woman is obese, weight reduction is advised. If there is infection then antibiotics should be given accordingly.
Advices that may cure Male Infertility:
While considering treatment of male infertility, if husband is oligospermic then he is advised not to wear tight pants. Cold bath for scrotal area is advised. Correction of hydrocele or vasicoule is done. Improvement of general health, antioxidants therapy, use of antibiotics in the presence of infection. If no conception then IUI can be done.
If husband is azospermic the sperm aspiration and ICSI can be offered. If still not conceived the IUI via donor sperm can be offered with the consent of husband. But is has social and legal complications.
Advices that may cure Female Infertility:
On the woman side, treatment dependon the cause of infertility i.e. hypothalamic anovulation: in this case FSH & LH is <5u/e. MRI scan of pituitaryis done to rule out. Pitutary tumors GuRh is given
If hyperprolactnemia leads to anovations, dopamine against is given to restore the mensuturation. The following issues can also lead to female infertility:
Thyroid and Adrenal Systems: These disorders can be lead to menstrual disorders and ovulatory dysfunction. Abnormality in the sex chromosome also lead to infertility. When all these causes are ruled out and when both tubes and the uterus are normal, the couple is counseled. The induction of ovulation is done with increasing 3 doses of clomiphene citrate for 3-4 cycles. If no results occurs, then IOD is done with gonadotrophines for 3 cycles. If then also the couple doesn’t conceive then IUI can be done. If both tubes are blocked thenit must be ensured that there is no causative factor. If the husband is healthy and his semen analysis is normal and woman ovulate normally then reconstruction of the fallopian tubes are done. If the tubes are blocked due to tuberculosis then results are poor. IVF should be offered.
The most important aspect for the couple is to be persistent and not demoralized. Sometimes it takes time, however due to the recent advances in medical sciences a lot can be worked out to achieve the dream of having their own bundle of joy.