Fertility Evaluation & Counselling

What is Infertility:

If a couple is infertile, this means that they have been unable to conceive a child after 12 months of regular sexual intercourse without birth control.

Five important hormones stimulate the reproductive system of a woman:

gonadotropin-releasing hormone

luteinizing hormone

follicle stimulating hormone

estrogens

progesterone

When you learn you are infertile, it may feel as though you have entered into a foreign territory. With medical jargon and recommendations for testing and treatments never before heard of, the unfamiliar world of infertility can be confusing. This section of our Web site provides resources and support that will help you learn more about infertility and the diagnosis and treatment process.

Infertility Facts and Statistics

Infertility, which affects as many as 1 in 6 couples, is defined as the inability of a couple to conceive a child after one year of unprotected sex and is usually diagnosed through medical interviews and physical examinations of both partners.

Infertility can be caused by a wide variety of factors. One-third of the time the problem lies with the male, one-third of the time it lies with the female, and one-third of the time infertility is caused by problems with both the male and the female. Sometimes either the sperm or the egg are unhealthy or there is some sort of mechanical obstruction keeping the sperm from fertilizing the egg. Once an egg is fertilized it must be able to become implanted in the uterus and then the embryo must be healthy and have the proper hormonal environment in which to develop properly. Metabolic imbalances, stress, increasing age, smoking, alcohol, exposure to toxic chemicals and drugs, and nutritional deficiencies or excesses can all negatively affect fertility.

Infertility Facts and Statistics

Male Infertility

About six percent of males between the ages of fifteen and fifty struggle with infertility. Male infertility can be caused by a variety of problems. Some of the more common disorders are listed below.

Deficient Sperm Production:Ninety percent of male infertility is caused by the failure to produce enough sperm. Azzospermia occurs when no sperm is produced while olibospermia is diagnosed when few sperm are produced. Since most sperm are destroyed before ever reaching the egg, the more sperm there are the better the chances that one will successfully fertilize the egg. However, a low sperm count, or a total sperm count of less than 5 million/ml, does not necessarily mean that a man is infertile if the sperm that he does have are healthy, properly formed, and mobile.

A low sperm count is determined by analyzing a semen sample. Over the last few decades, sperm count has been declining steadily. Many studies have linked this alarming trend to our modern high-fat, nutrient-deficient diet. Since sperm are highly vulnerable to free radical and oxidative damage, healthy sperm formation requires an adequate and ready supply of the proper nutrients and antioxidants. Other possible reasons for low sperm count include increased scrotal temperature (elevated temperatures hinder the maturation of sperm), varicoceles, environmental factors (pollution and exposure to heavy metals), and exposure to synthetic estrogens such as those found in birth control pills and in livestock.

Not only the sperm count but sperm morphology as well as motility n survival are very important deciding factors for fertility.In motility RLP is very important,morphologically normal spermatozoa are the one which will create a healthy embryo after fertilization,12 hour and 24 hourt survival is crucial for spermatozoa to reach the site of fertilization.

Varicocele: A varicose vein around one of the two spermatic cords can cause blood to pool in the testes; this, in turn, causes the temperature to increase in this area. Higher temperatures decrease sperm production and can lead to infertility. Fortunately, this problem can be fixed by surgery ,But the surgerycan cause increase in sperm count or decrease in sperm count, or Azoospermia in some casesa

Infections: Twenty-eight to seventy-one percent of infertile men show some signs of an infection of their reproductive organs. The presence of antisperm antibodies, which attack and destroy the sperm, are usually a good indicator that an infection is present. Of these infections, chlamydia trachomastis is the most common and the most serious. This disease is sexually transmitted and can damage the epididymis and the vas deferens in the male. Such infections are usually treated with an antibiotic.

Ductal Obstruction: Blockage or damage to the spermatic tubes which is usually caused by a sexually transmitted disease, infections, or a congenital abnormality.

Ejaculatory  Dysfunction: These disorders are characterized by the failure to deliver sperm to the vagina. Impotence, or the inability to maintain an erection for intercourse, can be caused by a high fat diet (fatty deposits clog the arteries in the penis), by drugs used to treat high blood pressure, and by the nerve damage caused by diabetes,antipsychotic drugs.

Previous male reproductive tract surgeries:surgeries like hydrocele ,hernia,viricocele,vasectomy

Hot environment: men working near hot furnace,mines ,goldsmiths,chemical factories,software people working with laptops.

Medical conditions: like diabetis TB epididymis,mumps orchitis,

Anti sperm antibodies: Semen can cause an immune system response in either the man's or woman's body. The antibodies can damage or kill sperm. If a high number of sperm antibodies come into contact with a man's sperm, it may be hard for the sperm to fertilize an egg. The couple has a hard time becoming pregnant. This is called immunologic infertility.

Other Disorders: Other disorders that can cause male infertility include abnormal development or damage of the testes (caused by endocrine disorders or inflammation), disorders of accessory glands, coital disorders, exposure to diethylstilbestrol (DES) a synthetic estrogen used in the 1950's and 1960's that caused cysts in the male reproductive tract, unnotised undescended testicles, and in rare cases genetic disorders such as a chromosomal abnormality,loss of libido

Female Infertility

Polycystic Ovarian Disease: This disease is the most common cause of ovulation disorders in women and is characterized by the presence of many minute cysts in the ovaries, by excess production of androgens, and by infrequent periods (obliomenorrhoea) or absent periods (amenorrhoea). The failure to ovulate is the most common cause of female infertility and can occur for no apparent reason or as the result of stress, hormonal imbalances, and various diseases and disorders of the reproductive system (some of which will be described below).

Age: After the age of 30 the quality of your eggs begins to diminish, and it becomes harder to become pregnant and carry a fetus to term. The older a woman is the more likely it is that her eggs will have chromosomal abnormalities.

Pelvic Inflammatory Disease:This infection of the reproductive tract can lead to blocked or damaged fallopian tubes and is usually caused by sexually transmitted disease, miscarriages, abortions, childbirth, or an intrauterine device.

Ovulatory Dysfunction: This disorder occurs when a woman's ovaries are not producing eggs or are producing fewer eggs than usual because of age, hormonal imbalances, or other problems.

Uterine Fibroids: These benign uterine tumors occur in 40% of women and can interfere with embryo implantation or fetal growth.

Endometriosis : This disorder occurs when the tissue which lines the uterus (the endometrium) grows into growths or lesions outside of the uterus (usually on the ovaries, fallopian tubes, and ligaments that support the uterus; the area between the vagina and the rectum; the outer surface of the uterus; the lining of the pelvic cavity; the bladder, bowel, vagina, cervix, vulva, and in abdominal surgical scars). In sync with the menstrual cycle, this tissue builds up, breaks down, and sheds each month; but unfortunately, it has no way of leaving the body. As a result it causes internal bleeding, breakdown of blood and tissue from the lesions, and most often inflammation which can cause pain, infertility, scar tissue formation, adhesions, and bowel problems. The cause of this disorder is unknown although there are many theories.

Prenatal Exposure to Diethylstilbestrol (DES) : DES is a synthetic estrogen given to some women who were deemed at risk for miscarriage during the 1950's and 1960's. Women whose mothers took DES while pregnant with them are at high risk for certain reproductive tract cancers and menstrual irregularities, as well as abnormally shaped uteruses that can lead to repeated miscarriages.

Pelvic Adhesions : These are usually caused by surgery or infection, and occur when scar tissue forms between two or more internal organs. When this tissue affects the ovaries or fallopian tubes, infertility can result because of altered tuboovarian relastion and anatomical problems in catching egg

Immunological Infertility : This disorder occurs when the woman's system produces antisperm antibodies which destroy her partner's sperm

What is Egg Donation?In egg donation, eggs are borrowed from a young woman called the donor, with her consent. These eggs are then fertilized with the sperms of the husband of the recipient woman and the resultant embryo, is inserted into the womb of the recipient.