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What is infertility?


Infertility is the inability of a couple to achieve pregnancy even after having unprotected sex for one year. Consultation and investigation are advised after one year of attempts. To conceive, a woman needs a healthy egg which should be impregnated by a healthy sperm. If a male is capable of producing a semen sample on demand and that sample contains prescribed number of sperms, motility and morphology are normal, then the male is considered normal.

A woman ovulates 14 days prior to her period. If she has regular interval between periods whether it is 28 days, 30 days, 35 days, one can almost tell the time of ovulation. A ovum remains alive for about 24 hrs in female genitalia and sperm lives for more time.

pageBasic investigation includes

  • Counseling about proper contact
  • Ovulation confirmation
  • Semen analysis
  • Post coital test
  • Patency of tube

Commonly seen in this part of Kerala is thyroid disorder, mostly hypothyroidism. This definitely affects both men and women. Treating it after blood test with the proper dose of medicines, will help the couple to achieve pregnancy.

Hormonal disorders

  • High Prolactin level
    • In woman results in irregular periods & anovulation.
    • In men results in decreased libido.
    • This is treated with medicines.
  • Insulin
    When high causes changes in the hormones related to ovulation. Sometimes it causes irregular period, anovulation, hair growth etc.
  • Thyroid Leads to
    • Gaining weight
    •  Irregular periods
    • Increased bleeding during periods
    • Anovulation and
    • Abortion.
  • Adrenal hyperplasia can also cause changes.
  • Pituitary hormones
    • Hypogonadotropism
    • Hypergonadotropism - which is seen in Premature Ovarian Failure (POF)

Diseases

  • Polycystic ovaries
  • Endometriosis
  • Pelvic inflammatory disease following a D&C for abortion can result in tubal blocking. This will result in tubal infertility. Women can have fibroids in the uterus, causing distortion of endometrial cavity, which may result in implantation problems for the embryo. The mouth of the uterus called cervix can have antibodies resulting in cervical hostility. In this condition, no live sperm reach the egg which is in the Fallopian tube.
  • Ovum pickup by the tube becomes difficult due to peritubal adhesion.

Authored By Dr. N.P. Vijayalakshmy MBBS, M.D., D.G.O

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