Author: Dr. Shruti N Mane

Qualification – M.B.B.S, M.S (OBG), PG Diploma in ART AND Reproductive Medicine

When to visit a fertility specialist ?

  • If you are not able to get pregnant (conceive) after one year (or longer) of unprotected sex.
  • Fertility in women is known to decline steadily with age.
  • It is wise to see a fertility specialist if you are aged 35 years or older after 6 months of trying to conceive.
  • Women over 40 years may consider seeking more immediate evaluation and treatment.

For Women

  • Irregular periods or no menstruation.
  • Complaint of severe abdominal pain ,dysmenorrhoea and ultrasound findings suggestive of endometriosis.
  • Previous history of pelvic inflammatory disease.
  • Known or suspected uterine or tubal disease on ultrasound examination.
  • A history of more than two miscarriages.
  • Known Genetic or Acquired conditions that predispose to diminished ovarian reserve (chemotherapy, radiation).
Infertility treatment in Kharghar
For Men
  • A history of testicular trauma
  • Bilateral hernia surgery
  • Prior use of chemotherapy
  • A history of infertility with another partner
  • Sexual dysfunction (Erectile or Ejaculation difficulties)
How does a natural pregnancy occur?
Pregnancy is the result of a process that has many steps. To get pregnant:
  • A woman’s body must release an healthy egg(oocyte) from one of her ovaries
  • The egg is then sucked into the fallopian tube through brush-like structures  called fimbriae.
  • During the ovulatory period if coital act occurs the semen is ejaculated in the vagina of the female partner
  • The fertilizable life span of an egg (oocyte ) is 12-24 hours and that of the sperm is 48-72hours.
  • Only 10% of sperms out of the total ejaculate traverse into the uterine cavity crossing the cervical barrier in females.
  • Out of these 10% only 300-500 sperms reach the ovum (egg ) in the tube and only one healthy sperm penetrates into the egg  to fertilize it.
  • The fertilized egg is called a zygote which then divides eventually into a blastocyst stage embryo and simultaneously travels through the fallopian tube into the uterine cavity.
  • The healthy  embryo in its blastocyst stage attaches to the lining (endometrium) of the uterus (implantation).
  • Infertility may result from a problem with any or several of these steps.
Does infertility Occur in females only?  
  • No, infertility is not always a woman’s problem.
  • Both men and women can contribute to infertility singularly or in combination.
  • 15% of the cases of infertility are due to an unknown cause or where the cause cannot be defined termed as unexplained infertility.
 What causes infertility in females? 
  •  Women need functioning
  • Ovaries
  • Patent and healthy Fallopian tubes
  • Uterus without any anomalies or abnormalities
  • Favourable Endometrium for implantation to get pregnant
  • Ovarian Factors
  • Disruption of ovarian function (presence or absence of ovulation and effects of  “age” on oocyte (egg)
  • Polycystic ovarian disease
  • Premature ovarian insufficiency
  • Low or Poor ovarian reserve
  • Menopause
Uterine factors
Physical characteristics of the uterine cavity to be evaluated by a transvaginal ultrasonography / hysterosalpingography such as
  • Fibroids
  • Intrauterine adhesions
  • Endometrial polyps
  • Adenomyosis
  • Congenital anomalies of the uterus like septum, unicornuate, bicornuate uterus
  • Infections like chronic endometritis/Tuberculosis
Pelvic factors
Pelvic adhesions which can cause disruption of the normal female reproductive anatomy. Pelvic Endometriosis that can only be evaluated on invasive procedures.
What causes infertility in males? 
  • Infertility in men can be caused by different factors and is typically evaluated by a semen analysis.
  • Semen parameters like count ,motility and morphology are assessed , which help to determine if and how male partner contributes to infertility.
  • 90% of diagnosis of infertility can be achieved through semen analysis .
  • However, in certain cases like azoospermia(absence of sperm in the ejaculate) some specialized tests along with hormonal assay and genetic testing may be required.
  • In cases of recurrent abortions or repeated IVF failures some advanced tests for sperm function and DNA integrity may be advised
What are the most common factors responsible for Fertility disruption?Fertility disruptors (may increase the risk of infertility) in both partners
  • Being overweight or obese
  • Smoking
  • Excessive alcohol and drug use (opioids, marijuana)
  • Excessive physical or emotional stress
  • Exposure to radiation
How will the doctor assess if you have fertility problems?
Doctors will begin by collecting a detailed medical and sexual history from both partners.
The initial evaluation usually includes a 
  • Semen analysis for males .
  • Tubal patency tests  to check if the fallopian tubes are open or damaged
  • Tests for ovarian reserve.
How to treat infertility?Infertility can be treated with
  • Medicines for ( ovulation induction agents) and pairing with fertile window coitus or planned relations after follicular study for evidence of  ovulation .
  • Fertility enhancing surgery in cases where uterine/tubal abnormalities and pathologies are the cause of infertility
  • Intrauterine insemination (IUI)
  • Assisted reproductive techniques (IVF/ICSI/IMSI)
Above modalities of treating infertility can be used as a combination or alone after complete evaluation of the cause .
How to decide which is the best treatment option?
Doctors recommend specific treatments for infertility on the basis of:
  • The factors contributing to infertility.
  • The duration of infertility.
  • The age of the female.
  • The couple’s treatment preference after counselling about success rates, risks, and benefits of each treatment option.
In conclusion, the cause of infertility, although difficult to determine the above mentioned key indicators, significantly help couples know their chances of conception. To know more causes, evaluation and treatment of infertility consult with IVF Specialists at Motherhood Fertility & IVF Centre by calling 08067238900 or book an appointment with us.
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