Infertility Scenario in India – What are the treatment options ?

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Infertility Scenario in India – What are the treatment options ?

infertility couples - Infertility , test tube baby

Infertility or childlessness is a sting to life which pricks till couple gets their own child. Childless couples are not only under mental and emotional stress, they even face social problems. 20% of couples have problems in conceiving a child. Incomplete information and misconceptions regarding fertility potential amongst couples leads to delays treatment for infertility. We will explain you about infertility, different causes of infertility and what the options available to deal with infertility are, and how to get a healthy child.

WHAT IS INFERTILITY?

In medical terminology, if a couple is not able to conceive even after 1 year of regular physical relationship without using any contraception, this condition called as infertility. According to report of 2015, 27.5 million Indian couples of fertile ages are suffered from infertility. Out of which 40%-50% infertility is due to female partner and 30-40 % because of male infertility. A rising trend of infertility is seen due to urbanization, environmental changes, and factors affecting lifestyle. Environmental causes include food adulteration, chemical, toxins entering the human body, air and water pollution. Factors affecting lifestyle includes mental stress, excess work malnutrition, obesity, alcohol consumption, smoking, late marriages and sexually transmitted diseases gonorrhea etc.

CAUSES OF MALE INFERTILITY

Dr. Swathi Mothe , who is IVF specialist at INDIRA IVF Hyderabad centre, says the reason of male infertility is decreases in sperm count, motility and absence of sperms in semen or production of sperms inside the testes but their absence in semen. A study done is AIIMS says three Decade back Adult males sperms count was 60 million/ml, has now reduce to 20 million/ml. According to world congress of reproductive of health, stress, Environmental and industrial pollution leads to decreased in sperms parameters and quality. Adverse effect of life style like more working hours, modern life style, working in factories, near furnaces, malnutrition, drug addiction, smoking etc are important causes for decreases in sperms count in males. Use of steroids for body building, sexually transmitted diseases leads to decrease in sperms count in very young age. Males working in corporate sector using laptop for long hours on their thighs can also suffer from decrease sperm count and infertility.

CAUSES OF FEMALE INFERTILITY

Dr. Nandini Devi is consultant gynecologist and IVF specialist at INDIRA IVF Chennai centre. According to her common cause of infertility in women are PCOS (polycystic ovarian syndrome), tubal block, endometriosis, adenomyosis , advanced maternal age, sub mucous fibroid , pelvic inflammatory disease, hormonal imbalance etc. Approximately 18 % of all infertile female have genital tuberculosis which results in damage to Fallopian tube and endomatrium. According to ESHRE (European Society of human reproduction and embryology) 33% of all females working in shifts, having hectic jobs or under stress suffers from menstrual irregularity. Excess stress causes hormonal imbalance. Out of these 33% females around 80% have difficulty in conception. Smoking and late marriages also increases risk of infertility. Common female infertility diagnostic test includes blood test to assess the hormone level, transvaginal ultrasound to assess uterus and ovaries and HSG to see the fallopian tube. Whereas to investigate male infertility semen analysis is done to assess count, motility, morphology and vitality of sperm.

SURGERY TO INCREASES FERTILITY

Dr. Vinod Kumar is Laproscopy & hysteroscopy surgeon and IVF specialist at INDIRA IVF Bangalore’s. He is of the opinion that amongst the various techniques to combat infertility, newer alternatives are available which provide the benefit of being minimally invasive. Amongst these techniques, laparoscopy and hysteroscopy are the two main procedures to diagnose and treat many of the causes of female infertility. These advanced technologies provide simultaneous diagnosis and surgery thus saving on time, cost and unnecessary procedures for the patient.

Laparoscopy

This technique includes using a laparoscope to which a camera and a light source is attached. It helps to visualize the abdominal and pelvic cavities and take a look at the outer structure of the reproductive system. This includes ovaries and fallopian tubes as well as the uterus. This method helps to detect various presentations and causes of infertility, rule out causes of pelvic or abdominal pain as well as a one sided or bilateral fallopian tube block. It can also be used to diagnose and treat conditions such as endometriosis, ovarian cysts, endometriomas and fibroids.

Hysteroscopy

A hysteroscopy is an instrument to which a camera and light source is attached which is used to visualize the interior portion of the cervix and the uterus. Conditions like abnormal uterine bleeding and its many causes can be detected using hysteroscopy. It also helps to determine the condition of the endometrium and rule out infections like tuberculosis or conditions like endometriosis all of which contribute infertility. Structural causes like fibroids or polyps which may contribute to infertility can be treated.

Follicular monitoring

Follicular monitoring is a technique to detect the number, measure the size and monitor the growth of follicles in the ovary. It is the cornerstone of infertility treatment. Ovulation is the time when chances of pregnancy are high and thus detection of ovulation is very important. This transvaginal sonography helps to determine the conditions of the ovary, the uterus, the endometrium and formulate further course of treatment. On the second day of a patient’s menstrual cycle we perform a transvaginal ultrasound. This is repeated at regular intervals and around the tenth day, the growth of the follicle is assessed. Around day twelve of the cycle the diameter of the follicle is expected to reach around 18 mm, following which a trigger injection is given to rupture it. Usually 36 hours after the trigger injection the oocyte or egg is likely to fertilize. Thus follicular monitoring can be used to time ovulation in natural cycles, during IUI procedures and during IVF treatment. Thus transvaginal ultrasound helps to determine the conditions of the uterus and endometrium, both fallopian tubes, of both ovaries and the surrounding pelvic area or adenexae. Follicular monitoring helps to determine number, size and growth of the follicles and identify those likely to reach 18-24mm size and to estimate the time of their rupture. Thus follicular monitoring is the best predictor of ovulation and thus helps to time sexual intercourse so as to provide the best window for fertilization and increase chances of pregnancy.

Treatment options for infertility…..what are they??

Medical science have given many options in the field of infertility, those are very safe and effective for being a father which includes IUI (intrauterine insemination) IVF (in vitro fertilization) ICSI ( Intracytoplasmic sperm injection).
Which technique is safe, effective and feasible in which couple is depend on the condition of female partner and that is decided by the expert clinicians of this field.

IUI technique

Many a times it has been seen that in case of male infertility either sperms are low in number or theory are defective, due to which they are not capable of fertilization and couples are unable to achieve pregnancy. In IUI sperms are washed and processed in such a way that they become more concentrated and efficient, and after that sperms are directly placed in the uterine cavity at the time of ovulation, and chances to achieve pregnancy is increased if female partner is normal. If sperms are absent, or defective due to some genetic reasons then facilities of sperm banking can be taken.This procedure of IUI hardly takes 24 hours.

IVF Technique

It also known as “test tube baby technique”, when rest of the options were not helpful, then IVF becomes a good option to proceed ahead. In this technique egg and sperms are fertilized outside the body in a laboratory dish, to retrieve eggs hormonal injections are given to female partner to produce more eggs in both ovaries, after eggs retrieval from female, eggs and male sperms are fertilized in (embryology lab) laboratory dish then embryos are formed and then embryos are transferred to the uterine cavity around day 2 – 5.

ICSI technique

In this procedure single sperm is injected directly into the egg with the help of glass pipette in the laboratory dish, and then after fertilization is confirmed, embryos are formed and they are transfer to female uterine cavity on day 2 – 5. This technique is useful in cases of severe male factor infertility, in which male partner has very less number of sperms in semen or the sperms are taken directly from the testis (in case of TESE). If there are no sperms or sperms are defective due to some reason then donor sperm remains an option to precede.

Get Happiness of motherhood even after menopause

Sometimes pressures of the modern life style, stress or exercise or health issues like thyroid dysfunction or PCOS can lead to hormonal imbalances and result in an ovulation and amenorrhea (absence of menstrual bleed) in women. Normally women attain menopause around the age of 50 years but some women may become menopausal at the age of 40 years or less. Many such women do not realize that they can have a baby even after menopause with the help of IVF. These women are required to undergo a battery of tests to ensure that they are fit to carry a pregnancy and then their menstrual cycles are restarted with the help of Hormone Replacement Therapy. An egg donated by a healthy donor is then used for IVF to help such women have a baby.

 

 

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