What is infertility?

  • Inability to become pregnant after one year of trying. In women above 35 year, a failure to conceive after 6 months of trying is also considered Infertility.
  • Repeated loss of pregnancy is also taken as Infertility.

Facts about Infertility

  • It is a common problem. About 10% of women between age group of 15-45 have difficulty in getting pregnant or staying pregnant.
  • It is not always due to female factors. Infertility can be due to a male factor also.
  • Approximately 1/3 of infertility cases are due to female factor, 1/3rd due to male factors and in about 1/3rd cases a combination of male and female factor is responsible.
  • Fertility of a woman decreases with age. Almost one third of women above 35 years of age have fertility issues.

DiagnosisM

  • A thorough history of couple is taken.
  • Semen examination of male is done to check the quality and quantity of sperms.
  • In case of any abnormality in semen a detailed examination of the male partner is done by a urologist or surgeon.
  • Women are evaluated for normal anatomy, regularity of periods and ovulation.
  • A detailed gynecology examination along with certain blood tests and ultrasound of abdomen is done to check for any structural abnormality, hormonal status and any pathological problem.
  • A hysterosalpingography( HSG) is done to check the normal anatomy of uterus and patency of tubes.
  • In some patients a diagnostic and corrective laparoscopy is done to evaluate the status of ovaries, tubes and surrounding tissues. In case of any abnormal adhesions or abnormalities, corrective steps are also done in the same sitting, in most of the cases.

Management

  • Treatment depends on the causative factors and age of the patient.
  • In most of the cases medical treatment and surgical correction is the treatment of choice.
  • If female is normal but male sperm count is low or quality of sperm is poor than artificial insemination techniques( IUI) are used after sperm concentration and washing.
  • If sperms are totally absent or very poor in quality than Artificial insemination with donor semen is one of the option.
  • In cases where sperms are poor in quality, modern technique of ICSI( Intra cytoplasmic Sperm Injection) is used.
  • Couples in whom IUI fails other artificial reproduction techniques are used.