Written by Dr.M.D.Mazumdar, MD
The aim of treatment of female infertility is to remove any of the factors identified during the tests for the diagnosis of the cause of infertility.
Thorough investigation to identify the causes in the male partner as well as the causes in the female partner should be done and a plan of treatment evolved accordingly.
Most couples appreciate a description of the process of fertilization and conception. A sympathetic hearing of their difficulties goes a long way in decreasing the stress involved in visiting a doctor for treatment of infertility.
An improvement in diet and general health can relieve stress to some degree. Obesity should be brought under control.
Both the male and the female partner is tested for all the causes of female infertility as well as male infertility . Since the main cause of female infertility is either a lack of ovulation or a block in the genital tracts, treatment is aimed at managing these two causes.
Failure of ovulation or anovulation is usually due to hormonal problems. A low thyroid hormone level, a high prolactin level, a high androgen (male hormone) level or a high insulin level will cause anovulation.
Polycystic Ovary Syndrome is a common cause of female infertility. It is a syndrome characterised by a high androgen and insulin level, anovulation, male pattern hair growth, obesity and irregular menstruation. Ultrasound will show a number of small cysts in the ovary.
The different types of hormonal imbalance can be managed by medicines - either by supplementing a deficiency or by normalizing high hormone levels.
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This method involves collecting the sperm by masturbation and injecting it gently into the uterus, thus bypassing the cervix. It is carried out in cases where it is suspected that the female cervical mucus may be hostile to the sperm or where the number of male sperm is believed to be inadequate for fertilization. The insemination should be done within 2 hours of collecting the semen. There are two types of IUI:
AIH is done in cases of impenetrable cervical mucous or when disease or deformity of the cervix makes it impossible for the sperm to enter the uterus. It is also carried out in cases of impotence, premature ejaculation or retrograde ejaculation.
This method is more commonly known as the test-tube baby method. Ovum is collected from the wife and sperm from the husband and fertilization is allowed to occur in the laboratory. In the early experiments, fertilization was allowed to occur in a test-tube, hence the name, 'test-tube baby'. The fertilized ovum is cultured up to a 16-celled stage and replaced in the wife's uterus. Success rate is about 25 - 30 %.
In this method, a single sperm is injected into a mature ovum. It is a part of the IVF procedure and the advantage lies in the fact that men with a very low sperm count can also utilize this method. It has also been successfully used in men suffering from azoospermia (complete absence of sperm). In these cases, sperm has been aspirated from the testes directly.
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