What is the incidence of infertility in India and world wide?
Approximately 20 to 25% of fertile age group couples suffer from Infertility. According to WHO approximately 8-10% of couples experience one or other form of infertility problem. Incidence of infertility may vary from region to region.
What are the causes of infertility?
The main causes of male and female infertilty are:
ETIOLOGIC CAUSES OF INFERTILITY
MALE FACTOR 35% - 40%
FEMALE FACTOR 40%
OVULATORY 20% - 40%
TUBAL 20% - 40%
ENDOMETRITIS 10%
ADVANCED AGE 18% - 50%
LUTEAL PHASE DEFECT < 10%
UTERINE FACTORS 10%
FIBROIDS 2% - 3%
UNEXPLAINED 10% - 15%
COMBINATION 10% - 20%
Causes of female infertility (Organ)
HYPOTHALMUS : Weight, Exercise, Poly Ovarian Syndrome(PCOS), Systemic Disease, LIVER, KIDNEY, Kallamann's Syndrome
PITUTARY GLAND : Hyperprolactinemia, Hypothyroidism, Sheehan's Syndrome
OVARY : Premature Ovarian Failure POF, Luteinized Unruptured Follicle LUF, Polycystic Ovarian Disease PCOD, Luteal Phase Defect LPD
CERVIX : STENOSIS, POOR CERVICAL MUCUS
FALLOPIAN TUBE : INFECTION
UTERUS : ASHERMAN'S SYNDROME, FIBROIDS/POLYPS, MULLERIAN ANOMOLIES
OTHERS : DOUCHING, SMOKING
UNEXPLAINED
CAUSES OF MALE INFERTILITY : Genetic Factors, Psychological Dysfunctions, Anatomic Factors, VARICOCOELE, CRYPTORCHIDISM, CONGENITAL ANOMOLIES, Hypospadias, Epispadias
Endocrine Factors : CUSHING'S SYNDROME, ACROMEGALY, PITUTARY TUMOUR
Infection : GONORRHEAL/CHLAMYDIA, PROSTATITIS, EPIDIDYMITIS
Idiopathic Factors
Immunologic Factors : SPERM ANTIBODIES, Prescribed Medications, Toxins and Environmental Substances
Mechanical Damage : TRAUMA/TORSION OF TESTES
Ejaculatory Dysfunction : RETROGRADE EJACULATION, EJACULATORY FAILURE, NEUROLOGIC IMPAIRMENT
What are the investigations of infertility?
HORMONAL PROFILE
sLH, sFSH, sTSH, sE2, sProlactin
sDHEAS, sTESTO,fasting insulin, AMH
HSG, DIAG LAP AND HYST
Detailed Husband semen analysis and culture sensitivity
Ovulation study
Other ROUTINE INVESTIGATIONS
TB PCR to rule out endometrial tuberculosis
What is the management for different causes of infertility?
Different form of management for infertility are VARIOUS METHODS OF ASSISTED REPRODUCTIVE TECHNIQUES
INTRAUTERINE INSEMINATION I.U.I WITH OR WITHOUT SUPEROVULATION
A.I.D
G.I.F.T
Z.I.F.T
I.V.F.E.T
I.C.S.I – M.E.S.A, T.E.S.A, P.E.S.A
EGG DONATION
LASER ASSISTED HATCHING
Both my husband and I have same blood group. Could this be the reason for infertility?
No,there is no relation between blood group and infertility.
What are the side effects of infertility management?
There are no such major side effects. Skin redness, swelling, brusing, pain are some time reported at the injection site. OHSS is reported if care is not taken on doses of injection.
Is there any risk of developing any ovarian cancer?
Various extensive studies have found no association between ovulation inducing drugs and ovarian cancer. Infertilty it self is a risk for ovarian cancer.