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Monday 12 October 2015

INFERTILITY


Causes of infertility
As per statistics, it is fount that, out of all infertile couple, 30 % will have female factors, 30% will have male factors and 40% will have both factors for infertility meaning to say that both partners have to be evaluated simultaneously. infertility

Female factors for infertility 
Common causes of female infertility are grouped into. 
Group I Hormonal Changes
FSH
LH
Prolactin
TSH
The hormones secreted by a gland in the brain & any alteration in their levels influences the ovulation, endometrial receptivity and embryo implantation.
Group II Ovarian factors
Infrequent ovulation as in polycystic ovaries, Premature ovarian failure where the egg count is depleted prematurely at an young age Endometriosis – where there is blood clots in the ovaries
Group III Tubal factors
By nature, the egg which is released from the ovary is fertilized by the sperm which took place in the fallopian tube which is present on both sides of uterus. This embryo then travels to the uterus to get embedded there in 4 – 5 days.So at least one tube should be patient for natural conception.
There fallopian tubes can be blocked as a result of infection (pelvic inflammation disease) or there can be adhesions around the tube as in endometriosis of pelvic tuberculosis which prevents the tube from moving freely and picking up the eggs from the ovary.fertility treatment process


Tubal Block

Group IV
The common uterine factors for infertility are
1. Fibroid uterus which prevents the embryo from implanting (or) it can cause abortion by increasing uterine contractions
2. Adenomyosis - A condition in which there are blood cystic in the muscle of the uterus.
3. Intrauterine adhesions
It occurs due to Tuberculous infection of the uterus or due to repeated trauma in the form of D&C.Where the inner layer of uterus (ie) the endometrium is thin and adherent to each other.
So there is no place in the uterine cavity for the embryo to implant,
4. Septate uterus - Uterus is usually formed by fusion of two mullerian ducts (genital precursors) from both sides and by resorption of the middle septum. If this resorption doesn't take place completely, it results in septate / sub septate uterus.
Septate uterus
Septate uterus
This septum prevents embryo implantation and also causeabortion

Causes of Male factor infertility 1. Hormonal Changes - FSH, LH, TSH, Prolactin, Testosterone are the hormones that control sperm production and also influence sexual function of male. Any alterations in it will affect the sperm count / motility / Sexual function.
2. Varicocele – It is a condition of dilated veins in the scrotum. As a result the basal temperature of scrotum is increased affecting the sperm production. Surgically treating the varicocele improves the semen parameters a lot.
3. Medical conditions like long standing Diabetics, decreased thyroid levels, increased prolaction levels.
4. H/o mumps / chicken pox / measles in childhood and H/o trauma to scrotum / Any Hernia or Hydrocele surgery etc.
5. H/o Smoking / alcohol consumption - It has been proved scientifically that having more than 2 cups of coffee a day can alter sperm functions. Then thick of smoking and alcohol!!
More over it takes 75 days for a sperm to mature completely. So anything dexterous in that 2 months can produce changein sperm parameters.
So stopping alcohol consumption (or) cessation of smoking for a week or so during treatment will not given much results;
6. Block in the passage between the testis and the external genitalia which can be differentiated by hormones and scan
7. Working on laptops by keeping them on our lap. It emits radiations as well as heat which is detrimented to the sperm.

8 comments:

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