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The Common Causes of Female Infertility

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Trying For a Baby?

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What happens when you see your doctor?

See your GP in the first instance, if you have any reason for concern.

Your doctor will want to know about your development as a teenager and your periods. You’ll be asked when they started, how regular they are, whether you’ve ever been pregnant before or whether you’ve ever had a pelvic infection or sexually transmitted infection.

You can use our ovulation calendar to help identify when your most fertile days are.

It’s also important to mention any other illnesses you’ve had and any medication you may be taking.

Your doctor will examine you, including an internal examination, and send you for blood tests to check your blood count and hormone levels.

Your doctor may ask your partner about his development too, check his medical history for problems such as mumps, examine him and give him instructions to collect a semen sample for testing.

You may then be referred to a specialist clinic to a specialist clinic for further tests and advice. This is usually done once you’ve been trying to get pregnant for at least 18 months, but may be sooner if you’re in your mid-30s or older.

What can specialists do?
Once referred to a fertility specialist (a reproductive medicine specialist), the cause of your infertility will be investigated.

The treatment will depend on the cause. It can range from hormone treatments and the use of donor sperm, to assisted conception techniques such as in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI).

IVF and ICSI
IVF involves removing eggs from the woman’s ovaries and mixing them with either her partner’s or a donor’s sperm in a laboratory. If the eggs are fertilised successfully, they may then be placed back in the womb……….CLICK & SEE

This is a demanding treatment for the couple and only about one in three women will become pregnant after a single IVF/ICSI cycle. Some of these pregnancies will be lost in the early stages. Many cycles may be required before achieving successful pregnancy, and these treatments are not successful for everyone, no matter how many times they’re attempted.

ICSI is sometimes recommended to couples who’ve had no success with IVF. It involves injecting a single sperm into the egg. If a healthy embryo develops, it’s then placed back in the womb as in IVF………..CLICK & SEE

Access to IVF is limited on the NHS. Guidelines from the National Institute for Health & Clinical Excellence (NICE) say women aged 23 to 39 who have an identified cause of infertility or have had unexplained infertility for at least three years should be entitled to three cycles of IVF.

The Government has suggested that each primary care trust starts by offering couples one cycle, working up to three when possible. Access to NHS treatment varies, however, and it can depend on where you live, and what other local conditions are placed on you, such as your age.

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Source
: BBC Health.22nd. July.2010

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No Baby Blues

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It’s difficult to believe but true that despite our 1.2 billion  population in India, many of our young adults have difficulty in producing children. They may be called “sterile, infertile or sub fertile”. But before a couple is labelled “infertile”, they should have had at least 12 months of regular contraception-free intercourse.

Worldwide, infertility affects 7-10 per cent of the population. Although women actually produce the babies, if the reasons for the infertility are investigated the woman is at fault in a third of the cases; in a third it is the man and in the remainder either both are responsible or no real cause can be found.

Before embarking on a planned pregnancy, the woman should have had immunisations for measles, mumps rubella (MMR) and hepatitis B (3 doses). She should also start folic acid supplements (5mg/day). Children born with physical or mental defects because these basic facts were forgotten are a human tragedy. Both partners need to keep their body mass index (BMI, or weight in kilograms divided by height in metre squared) at around 23 and be physically active for around 40 minutes a day. They also need to treat any existing underlying disease like diabetes, high blood pressure or thyroid problems.

Studies show that caffeine (found in tea, coffee and cola drinks) affects fertility. Women who drink alcohol can produce babies with “foetal alcohol syndrome”. It also reduces the sperm count in men. Smoking affects the quality of the sperms and inhaled passive smoke is bad for the growing baby. Sperm counts may be reduced by inhaling hazardous chemicals in the work place or by working in high temperatures.

Women ovulate cyclically and the egg is released 14 days before the next period. For a woman to conceive, intercourse must take place around this time and the sperm count must be optimal. Initially, if a menstrual calendar is maintained, the fertile days can be calculated. A semen analysis for sperm count is a non-invasive simple test. Also, after intercourse lie down, don’t douche, and avoid lubricants and cleansing agents.

If these simple methods fail in a couple where the woman menstruates regularly and the man has a normal sperm count, a visit to a reproductive medical unit is warranted. Further investigations to establish the patency of the tubes and quality of the sperm may be needed. Depending on the problem, medication or surgical correction of a specific defect may be needed.

Conservative medical treatments are usually tried for periods varying from 6 months to a year. If they fail, assisted reproductive technology (ART) techniques are started.

In IUI (intrauterine insemination) the woman is scanned during her most fertile period to determine ovulation. Healthy treated sperms from her partner are then inserted into the uterus. The technique is used when the sperm count is low, the motility unsatisfactory or if donor sperm is being used.

In GIFT (gamete intra-fallopian transfer), eggs and sperms are collected, mixed and then placed in the woman’s fallopian tube. Fertilisation takes place naturally in the body.

In IVF (in vitro fertilisation) the eggs are harvested and fertilised with sperm in the laboratory. The resulting embryos are then placed in the uterus. This is used in cases where the fallopian tubes are blocked, the fertility unexplained or when several attempts with the other forms of ART have failed. It can result in multiple pregnancies. Some clinics offer “natural cycle IVF”. This involves collecting and fertilising the one egg released during the normal monthly cycle. It avoids the side effects of fertility drugs and multiple pregnancies are less likely.

In ICSI (intracytoplasmic sperm injection) a single sperm is injected into the centre of an egg. This is used when the male partner has a very low sperm count or if other problems with the sperm have been identified.

Donor eggs from other women can be used if the woman has no eggs of her own, or if she is over 40 and the eggs are of poor quality. Sperm from donors can be used if the husband has a low count (oligospermia) or no sperms (azoospermia). Surrogate mothers can be hired to carry the baby to term.

There is no right time to seek medical help, but if sexual intercourse at least three times a week without contraception for a year has been unsuccessful, it is probably time for proactive action. If, however, the woman has periods at intervals less than 21 days or more than 90 days, the flow is unpredictable (if it starts it does not stop and if it stops it does not start) or if there has been pelvic infection in the past, an evaluation should be done at the earliest. In men, if the testes are not felt in the scrotum, or there is a hydrocoele (swelling) or a past prostate infection, investigation and treatment should be started sooner.

Sources:The Telegraph (Kolkata,India)

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‘High temp leads to infertility’

NEW DELHI: Researchers recorded the temperature changes to the scrotum caused by laptop use among 29 healthy male volunteers aged between 21 and 35 and found that just sitting with thighs pressed together, caused scrotal temperatures to rise by 2.1 degrees C.

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The AIIMS study also found that majority of men who were exposed to high temperature at their work places welders, dyers, blast furnace workers, cement and steel factories are also more prone to infertility. All this happens because even small changes in temperature have a negative effect on sperm production.

Testes are located outside of the body, suspended by the spermatic cord within the scrotum. This allows for more efficient and fertile sperm production.

The temperature of the testes is usually three degrees lower than the core body temperature (37 degrees C or 98.6 degrees Fahrenheit). Even one degree elevation in testicular temperature leads to 14% depression of spermatogenesis.

“Not only has quantity of sperm production declined in males across the world, there has been a decrease in mortility (sperm movement) and morphology (shape and structure) of the sperms.

“There has been a 2% decrease in quality of male sperm annually. Also, 40% men in the reproductive age group are at present recording a quantitative and qualitative decline in sperm quality,” Dr Dada said. The study also found that nearly 20% of infertile men with low sperm count, or oligospermia, harboured genetic abnormalities.

The abnormality either involved sex chromosomes or autosomes or micro deletions in the ‘Y’ chromosome, said Dada. The ‘Y’ chromosome harbours the gene critical for germ cell development and differentiation, without which a person will have no sperms or will have very low sperm count.

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Source:The times of India