Infertility refers to an inability to conceive after having regular unprotected sex.Infertility is becoming a common problem in today’s society. With increasing age at marriage, delaying childbirth due to various reasons as well as change in lifestyle it is estimated that approximately 10-15% of couples will need help to conceive. The reasons could be abnormaility in either women or men. However unexplained infertility is also an important factor. It is estimated that about 20% of cases of infertility are due to a problem in the men, about 40% to 50% of cases of infertility are due to a problem in the women and about 30% to 40% are either unexplained or due to problems in both the partners.
Women could have problems with ovulation, tubal damage, cervical abnormalities, fibroids or endometriosis. Endometriosis is one of the major cause of infertility in women and often remains undiagnosed. Men with sperm abnormailities or ejaculation problems have infertility.
Some statitics from US & Europe show the chance of conception could be 20% within one month. 70% within 6 months, 85% within 12 months, 90% within 18 months and about 95% within 24 months.
When should onee start seeing a doctor?
A couple should start investigation for infertility when they have had unprotected sex for a year. However if the age of the parteners is more than 35 then the evaluation could be started sooner.
Risk factors for infertility
- Age- As women age their fertility starts to drop after 32 years, so the biological clock is important.
- Smoking - increases the risk of infertility in both men and women
- Obesity –along with a sedentary lifestyle
- Eating disorders –exteremly under weight as well as over weif=ght, both affect infertility adversely
- Sexually transmitted infections like chlamydia can damage the fallopian tubes
- Mental stress -ovulation and sperm production may be affected
- Polycystic Ovarian Syndrome (PCOS)
- Ovulatory Dysfunction
- Uterine Fibroids
- Ovarian cysts
- Uterine septum or intra uterine adhesions
- Damaged tubes
- Unexplained infertility which could be due to Undiagnosed endometriosis, pelvic infections or ovulatory dysfunction
- Uterine polyps
When to start?
Usually after one year on unprotected sex. But in the followin g groups one can start evaluation after 6 months-
- Women above 40 years
- Women with infrequent periods or No periods
- Stage 3 or 4 endometriosis
- Women with a history of chemotherapy and/or radiation
BLOOD TESTS & HORMONE ANALYSIS
Done in the beginning of the cycle
- Tests to find out the ovairan reserve that reflects the ability to produce eggs
- Hormones tests
- Diagnostic Hysteroscopy
- Diagnostic Laparoscopy
When is hysteroscopy indicated?
Can be used to diagnose abnormal uterine bleeding, recurrent miscarriages, uterine adhesions, fibroids, or polyps in women suffering from infertility. It is a day care procedure.
When is Laparoscopy indicated?
In cases of suspected endometriosis and unexplained infertility, laparoscopy can diagm=nose the condition accurately. It is a surgical procedure where a telescope is placed inside the abdomen and evaluate the entire abdomen and pelvis through a small incision. It is a day care procedure.
Procedures done for infertility treatment
- Ovulation induction
- Intra Uterine Insemination
- In Vitro Fertilisation
- Intra Cyoplasmic Sperm Innoculation
Was invited to operate at Raipur Medical College at the FOGSI North Zone Yuva Congress. Dr Rooma Sinha demonstrated urogynecological surgeries for the delegates and later also gave lecture on setting standards for caesarean Section.