Leading Womens Superspeciality Hospital in Nanded

Infertility is a disease of the reproductive system that impairs one of the body's most basic functions: the conception of children. Conception is a complicated process that depends upon many factors: on the production of healthy sperm by the man and healthy eggs by the woman; unblocked fallopian tubes that allow the sperm to reach the egg; the sperm's ability to fertilize the egg when they meet; the ability of the fertilized egg (embryo) to become implanted in the woman's uterus; and sufficient embryo quality. Finally, for the pregnancy to continue to full term, the embryo must be healthy and the woman's hormonal environment adequate for its development. When just one of these factors is impaired, infertility can result.

No one can be blamed for infertility any more than anyone is to blame for diabetes or leukemia. In rough terms, about one-third of infertility cases can be attributed to male factors, and about one-third to factors that affect women. For the remaining one-third of infertile couples, infertility is caused by a combination of problems in both partners or, in about 20 percent of cases, is unexplained. The most common male infertility factors include azoospermia (no sperm cells are produced) and oligospermia (few sperm cells are produced). Sometimes, sperm cells are malformed or they die before they can reach the egg. In rare cases, infertility in men is caused by a genetic disease such as cystic fibrosis or a chromosomal abnormality. The most common female infertility factor is an ovulation disorder. Other causes of female infertility include blocked fallopian tubes, which can occur when a woman has had pelvic inflammatory disease or endometriosis (a sometimes painful condition causing adhesions and cysts). Congenital anomalies (birth defects) involving the structure of the uterus and uterine fibroids are associated with repeated miscarriages.

Couples are generally advised to seek medical help if they are unable to achieve pregnancy after a year of unprotected intercourse. The doctor will conduct a physical examination of both partners to determine their general state of health and to evaluate physical disorders that may be causing infertility. Usually both partners are interviewed about their sexual habits in order to determine whether intercourse is taking place properly for conception. If no cause can be determined at this point, more specific tests may be recommended. For women, these include an analysis of body temperature and ovulation, x-ray of the fallopian tubes and uterus, and laparoscopy. For men, initial tests focus on semen analysis.

In infertile couples where women have blocked or absent fallopian tubes, or where men have low sperm counts, in vitro fertilization (IVF) offers a chance at parenthood to couples who until recently would have had no hope of having a "biologically related" child. In IVF, eggs are surgically removed from the ovary and mixed with sperm outside the body in a Petri dish ("in vitro" is Latin for "in glass"). After about 40 hours, the eggs are examined to see if they have become fertilized by the sperm and are dividing into cells. These fertilized eggs (embryos) are then placed in the women's uterus, thus bypassing the fallopian tubes. If no cause can be determined at this point, more specific tests may be recommended. For women, these include an analysis of body temperature and ovulation, x-ray of the fallopian tubes and uterus, and laparoscopy. For men, initial tests focus on semen analysis.

Most eggs will fertilize when they are placed in a culture dish with several thousand normal sperm. This process is called “in vitro fertilization” or “IVF.” When there are not enough normal functioning sperm for IVF, fertilization will usually occur after a single live sperm is injected into each egg, termed “intracytoplasmic sperm injection” or “ICSI.” On rare occasions, fertilization does not occur even with ICSI, presumably because of a problem inherent to either eggs or sperm. In these cases, the use of donor sperm or donor eggs will usually result in fertilization. Your fertility specialist and IVF laboratory personnel will help you determine which approach is most likely to result in egg fertilization.

If you have stored embryos that you have decided not to transfer into your uterus to attempt pregnancy, you have four options for their final disposition. First, you can donate your embryos to another woman with fertility problems that you don’t know so that she can attempt pregnancy through a process called “anonymous embryo donation.” Second, you can donate your embryos to another woman that you do know so that she can attempt pregnancy though a process called “directed embryo donation.” Third, you can donate your embryos for laboratory research to help improve pregnancy rates for infertile couples in the future. Finally, you can ask that your embryos be thawed and discarded. In both of these last two situations, your embryos will not be transferred into another person and no child will be born as a result.

A response to ovarian stimulation depends on a number of different factors, the most important include available eggs, appropriate hormone levels, proper administration of any medications and lifestyle/environmental factors. In order to respond to ovarian stimulation, a woman must have eggs available to respond; this is sometimes referred to as ovarian reserve. If a woman has diminished ovarian reserve (identified by a high blood levels of follicle stimulation hormone (FSH), low blood levels of anti Müllerian hormone (AMH) or a low antral follicle count on ultrasound), she may not have as robust (or any) response to stimulation. For these patients, an alternate stimulation protocol may be tried or donated eggs may be used (from a woman known or unknown to the patient). It is possible that a woman does have the necessary eggs but lacks the appropriate pituitary hormones to respond. In this case, using a different medication- one which may contain both FSH and luteinizing hormone (LH) may allow for an optimal response. Lifestyle factors can also affect a woman’s response to stimulation. Optimizing weight, diet and stress and cessation of use of tobacco, alcohol and recreational substances can also improve a response to ovarian stimulation. Speak to your physician regarding improving your particular response to ovarian stimulation.

There are many options for treating infertility, however deciding on which one is best for you and your partner can feel a bit overwhelming at first. Start with learning about all of the options that are available to you. With advancing medical technology there are more choices for both men and women trying to conceive. It can be a broad spectrum of hormonal treatments, ovulation induction and Intrauterine insemination to more advanced technologies like in vitro fertilization, ICSI to surrogacy, egg/sperm donation and even embryo donation. If you are craving more information about your options check out family building options here.

Artificial insemination is more commonly referred to as an IUI (intrauterine insemination). Typically, this procedure is recommended for couples with unexplained infertility, minimal male factor infertility, and women with cervical mucus problems. The process uses the male partner or donor’s sperm, washing and treating the sperm, and then injecting it into the woman during the time of ovulation. Think of as putting the sperm in a taxi cab and delivering it right to the door of where it needs to be! Read more about IUI.

No, infertility is not always a woman's problem. In about one-third of cases, infertility is due to the woman (female factors). In another third of cases, infertility is due to the man (male factors). The remaining cases are caused by a mixture of male and female factors or by unknown factors.

Infertility in men is most often caused by: Problems making sperm -- producing too few sperm or none at all Problems with the sperm's ability to reach the egg and fertilize it -- abnormal sperm shape or structure prevent it from moving correctly Sometimes a man is born with the problems that affect his sperm. Other times problems start later in life due to illness or injury. For example, cystic fibrosis often causes infertility in men.