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MALE INFERTILITY |
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Male Infertility Causes |
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Fertility in men requires normal functioning of the hypothalamus and pituitary gland (hormone-producing glands in the brain), and the testes Therefore, a variety of conditions can lead to infertility. |
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30 to 40 percent of cases are due to problems in the testes |
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10 to 20 percent are due to a blockage in the pathway that sperm use to exit the testes during ejaculation. This can be caused by prior infection |
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1 to 2 percent of cases are due to conditions of the pituitary gland or hypothalamus |
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40 to 50 percent of cases have no identifiable cause, even after an evaluation |
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DIAGNOSIS |
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| In any fertility work-up, both male and female partners are tested if pregnancy fails to occur after a year of regular unprotected sexual intercourse. |
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Physical Exam |
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| A fertility specialist will perform a physical examination. A physical examination of the scrotum, including the testes, is essential for any male fertility work-up. It is useful for detecting large |
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Varicocele — A varicocele is a dilation of a vein (like a varicose vein) in the scrotum. |
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undescended testes, |
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absence of vas deferens, cysts, or other physical abnormalities |
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INVESTIGATION |
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Post-Ejaculatory Urine Sample |
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| A urine sample to detect sperm after ejaculation may rule out or indicate retrograde ejaculation. It also may be used to test for infections. |
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Semen Analysis |
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| The basic test to evaluate a man's fertility is a semen analysis. |
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Ultrasound |
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| Ultrasound imaging may be used to accurately determine the size of the testes or to detect cysts, tumors, abnormal blood flow, or varicoceles that are too small for physical detection (although such small veins may have little or no effect on fertility). It can also help detect testicular cancer |
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Genetic Testing |
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| Genetic testing may be warranted in men who are severely deficient in sperm and who show no evidence of obstruction, particularly in men undergoing the intracytoplasmic sperm injection (ICSI) procedure. Genetic testing can help identify DNA fragmentation, chromosomal defects, or the possibility of genetic diseases that can be passed on to children. If genetic abnormalities are suspected in either partner, counseling is recommended |
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TREATMENT |
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The treatment of male infertility depends upon the underlying cause. Several months to years of treatment are usually necessary to achieve fertility. The treatment often involves both male and female partners. |
| Treatment of Blockage of the reproductive tract — Men who have a blockage in the ducts conveying the sperm from the testis until ejaculation (so that sperm cannot get out) can undergo surgery to correct the blockage. If it is not successful, another option is assisted reproductive technologies using sperm retrieved from the testes. |
| Treatment of hypothalamic or pituitary deficiency — In a small percentage of cases (1 to 2 percent), male infertility is due to problems in the hypothalamus and pituitary gland (parts of the brain that regulate hormone production). In this case, treatment with human chorionic gonadotropin (hCG), recombinant human follicle stimulating hormone (rhFSH) (also called gonadotropin treatment) is often given. |
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Gonadotropin treatment — Gonadotropin treatment is started with injections of hCG three times per week (or sometimes every other day) for up to six months. |
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Varicocele can be treated surgically |
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An alternative to varicocele repair is assisted reproductive techniques (ART), such as intracytoplasmic sperm injection (ICSI). With ICSI, only a small number of sperm are needed |
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TREATMENT BY AYURVEDIC METHODS |
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| Treatment for infertility is our research medication having excellent result. |
| Some Ayurvedic drugs having good role on hormonal changes of body along with no side effect like allopathic drugs. |
| Some Ayurvedic procedure like basti is used for cystic obstruction in vas difference and rejuvenation of testies to produce sperms. |
| Ayurvedic drugs are having good role on sperm production and sperm motility without any side effect. |
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FEMALE INFERTILITY |
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Infertility is defined as a couple's inability to become pregnant after one year of unprotected intercourse. In any given year, about 15 percent of couples in North America and Europe who are trying to conceive are infertile. |
The fertility of a couple depends upon several factors in both the male and female partner. Among all cases of infertility in developed countries, about 8 percent can be traced to male factors, 37 percent can be traced to female factors, 35 percent can be traced to factors in both the male and female partners, and 5 percent cannot be traced to obvious factors in either partner |
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CAUSES OF FEMALE INFERTILITY |
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| Age |
| Women become less fertile as they get older. A woman's fertility peaks between the ages of 22 to 26, after which it starts to decline, with this decline being accelerated after age 35 |
| Tobacco smoking |
| Tobacco smoking is harmful to the ovaries,. |
| Sexually transmitted disease |
| Sexually transmitted diseases are a leading cause of infertility.. |
| Body weight and eating disorders |
| Twelve percent of all infertility cases are a result of a woman either being underweight or overweight. Fat cells produce estrogen, in addition to the primary sex organs. Too much body fat causes production of too much estrogen and the body begins to react as if it is on birth control |
| Chemotherapy |
| Chemotherapy poses a high risk of infertility |
| Other general factors |
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Significant liver or kidney disease |
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Thrombophilia |
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| Hypothalamic - pituitary factors |
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Pituitary Tumors |
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| Pituitary tumors, although usually benign, can lead to destruction of some of the hormone-secreting cells in the pituitary gland, causing cessation of menstrual periods in women and reduced sperm production in men. Because of their location, these tumors also can cause visual field defects. |
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Hyperprolactinemia |
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| Ovarian factors – |
| 1. Polycystic Ovarian Syndrome |
| In polycystic ovarian syndrome (PCOS), there is a long-term inability to release eggs to the uterus, where they can be fertilized — a process called ovulation. Elevated insulin levels stimulate excess production of the hormone androgen, which cause some of the unfertilized eggs to disintegrate, leading to inconsistent or no ovulation. Most women with PCOS have multiple benign cysts in their ovaries. |
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Anovulation. Female infertility caused by anovulation is called "anovulatory infertility", as opposed to "ovulatory infertility" in which ovulation is present. |
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Diminished ovarian reserve |
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Premature menopause and Menopause |
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Luteal dysfunction |
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Gonadal dysgenesis (Turner syndrome) |
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Ovarian cancer |
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| Tubal (ectopic) / peritoneal factor |
| 1. Endometriosis |
Endometriosis occurs when tissue from the membrane lining the uterus, called the endometrium, grows outside the uterus. Between 25 and 50 percent of infertile women are estimated to have this condition. |
| 2. Pelvic adhesions |
| 3. Pelvic Inflammatory Disease |
Pelvic inflammatory disease (PID) in the female reproductive organs often occurs after a sexually transmitted disease such as gonorrhea or a chlamydia infection, or after miscarriage, abortion or childbirth. Symptoms include abdominal pain and tenderness, fever and an unpleasant-smelling vaginal discharge. Repeated attacks may occur with or without reinfection. About 20 percent of infertility is attributed to scarring from PID. |
| 4. Tubal occlusion |
| 5. Tubal dysfunction |
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| Uterine factors |
1) Uterine malformations
2) Uterine fibroids (leiomyoma)
3) Asherman's Syndrome |
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| Genetic factors |
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Various intersexed conditions, such as androgen insensitivity syndrome MRKH, or Mayer-Rokitansky-Küster-Hauser Syndrome, is a condition involving primary amenorrhea and an underdeveloped uterus. Women with MRKH are biologically female and is believed to occur in 1 in every 5,000 females. |
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Turner's Syndrome |
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DIAGNOSIS |
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| Diagnosis of infertility begins with a medical history and physical exam. Specialist may order tests, including the following: |
| Lab tests |
| Hormone testing, to measure levels of female hormones at certain times during a menstrual cycle |
| Day 2 or 3 measure of FSH and estrogen, to assess ovarian reserve |
| Measurements of thyroid function[51] (a thyroid stimulating hormone (TSH) level of between 1 and 2 is considered optimal for conception) |
| Measurement of progesterone in the second half of the cycle to help confirm ovulation |
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| Examination and imaging |
| An endometrial biopsy, to verify ovulation and inspect the lining of the uterus |
| laparoscopy, which allows the provider to inspect the pelvic organs |
| Fertiloscopy, a relatively new surgical technique used for early diagnosis (and immediate treatment) |
| Pap smear, to check for signs of infection |
| Pelvic exam, to look for abnormalities or infection |
| A postcoital test, which is done soon after intercourse to check for problems with sperm surviving in cervical mucous (not commonly used now because of test unreliability) |
| Special X-ray tests |
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AYURVEDIC TREATMENT |
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| Ayurvedic treatment for infertility is our research medication having excellent result. |
| Some Ayurvedic drugs having good role on hormonal changes of body along with no side effect like allopathic drugs. |
| Some Ayurvedic procedure like basti is used for obstruction of ovary and fallopian tube. |
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