It is characterized by inadequate stimulation of otherwise normal testicles and genital tract.
The basic and the most important test to evaluate Male Infertility is Semen Analysis. It may have to be repeated two or even 3 times to get an accurate reflection of the parameters. Semen parameters can vary widely over time, even among fertile men. Semen sample should be provided after 2-3 days of abstinence.
It is an effective treatment for male factor Infertility. Donor Semen Samples are taken from the semen banks where all donors are screened for infectious diseases. The Semen is frozen and kept for a period of 6 months, so that donor can be again tested for HIV. We don’t do Donor Inseminations with fresh semen samples as this can be hazardous to patient’s health. With the new options for treating male infertility like ICSI, the need for Donor Insemination has decreased. But still it is a viable option for couples who cannot afford ICSI.
It involves any anatomic abnormalities in the Tubes that prevent union of sperm and ovum. These include cases of completely blocked fallopian tubes, cases with either one blocked tube or tubal scarring or other damage. The Tubal and peritoneal pathology is among the most common causes of Infertility and is present in approximately 30-35% of Infertile Couples.
The major cause of Tubal factor infertility is PID (Pelvic Inflammatory disease) and the Pelvic Infections Tuberculosis is still an important cause of Tubal damage in India. Other causes are Inflammation due to endometriosis, inflammatory bowel disease or surgical Trauma.
Initial investigation to detect Tubal damage is HSG (hysterosalpingography). In this procedure contrast material (dye) is injected through the cervix to the uterine cavity and if the fallopian tubes are open the dye flows in the abdominal cavity through the tubes. This is documented with x-ray pictures during the procedure. Other method of detecting Tubal damage and peritoneal adhesions is Laparoscopy.
The treatment options for patient with Tubal factor Infertility is Tubal surgery or IVF. Tubal surgery is a good option for women seeking pregnancy after a previous tubal sterilization, for those with mild distal Tubal disease and women with apparent proximal tubal occlusion.
It is a disorder in which endometrial tissue or lining of the uterus grows outside the uterus such as the ovaries or elsewhere in the abdominal cavity.
Progressively increasing dyspareunia may be a symptom of endometriosis. Others are dyspareunia or pain during intercourse and pelvic congestio
In mild cases the relationship with Infertility is Controversial. It may lead to mild Inflammation within the pelvic. In severe cases, it affects conception in various ways. It causes adhesions & scarring. These adhesions may involve the ovaries, fallopian tubes and the Intestines & thus interfere with the release of eggs from the ovaries or the ability of the tubes to pick up the egg. Ovulation may also be affected by the presence of chocolate cysts.
Diagnosis can be made on the basis of symptoms. In a symptomatic patient it is often diagnosed on Ultrasound scanning which can pick up the chocolate cysts in ovaries. To confirm the diagnosis Laparoscopy is the gold standard.
Unexplained Infertility is labeled when all the standard Infertility evaluation yields normal results. The incidence of unexplained Infertility ranges from 10% to as high as 30% among infertile population.
The cessation of normal functioning of ovaries in a woman under age of 40 years. This is confirmed by high FSH levels and low estrogen hormone levels.
The most common first symptom of ovarian failure is Irregular period or Amenorrhea. Others are infertility, hot flushes and might sweats, irritability and dryness of vagina.
As the first symptom is irregular periods, menstrual history is important in diagnosis. Hormonal studies are done, High FSH levels above about 30-40 IU indicates ovarian insufficiency. In addition a serum AMH level (Anti Mullerian) and ovarian Antral follicle Count is also low.
