Infertility

Introduction

Infertility is the state of failure of fertilization( read more about embryogenesis here) in the prospective couple. It is one of the growing concerns for 3 decades. It affects in both men and women. People from various countries visit  India because there are a lot of fertility clinics in our country. Infertility is the preventable condition hence awareness programs, and counselling services about reproductive health help in preventing the issue. Infertility is closely linked with lifestyle, general health and nutritional status of women. In some women prolonged mental stress, late marriage or conception after the age of 35 years can play a vital role in the occurrence of infertility. The condition is also seen in women with uterine defects and other reproductive tract infections. 

 

Table of Contents

1. Introduction

2. Risk factors of infertility 

3. Specific Causes of infertility

4. Strategies of Infertility management 

5. Types of ARTs

     5.1  In vitro fertilization

     5.2 Intrauterine insemination ( IUI)

     5.3 Intrafallopian transfer

     5.4 Gamete intra-fallopian transfer (GIT)

     5.5 Zygote intra-fallopian transfer (ZIT)

     5.6 Intracytoplasmic sperm injection

 

Risk factors of infertility 

Infertility is associated with poor physical health, congenital factors, systemic diseases, prolonged substance abuse, excessive drug intake, smoking, immunological issues and the recent major psychological stressors in the family such as the death of loved ones. 

 

Specific Causes of infertility

  1. Abnormal structure or function of sperm resulting in the poor quality of sperm with low motility and

  2. Low sperm or ovum count

  3. Genetic defects of reproductive organs

  4. General medical problems such as diabetes or infections such as chlamydia, gonorrhoea, mumps, and HIV.

  5. Low sperm and ovum count.

  6. Varicocele is the scrotum with enlarged veins can influence on the quality of sperm.

  7. Excessive heat and other environmental factors

  8. Occupational factors.

  9. Toxic effects related to tobacco, marijuana, or other drugs

  10. Inadequate diet intake associated with extreme weight loss or gain

  11. Age of men above 40 and for women above 30 at the time of conception.

  12. Diseases and defects of uterus, ovaries, and other sexual organs.

  13. Past history of abortion or medical termination of pregnancy.

  14. Exposure to certain harsh chemicals like Pesticides may increase the risk.

  15. Excess alcohol consumption in the case of males leads to infertility.

  16. Overweight or obesity may reduce the chance of conceiving.

 

Strategies of Infertility management through assisted reproduction techniques (ART)

ARTs are the artificial methods of fertilization in which the artificial insemination (introducing semen to the uterus) is being conducted with the help of assistive devices. This is a preferred method in those women with serious anatomical defects in the uterus and cervix.  In the case of men, it is associated with the low sperm count, sperms with low motility, and erection problems, and the men with age above 40 years. ARTs are a good choice in retrograde ejaculation -a condition in which sperms are deposited into the bladder instead of reaching ovaries. ARTs can also be used in case of uterine infections, injuries, any scars in the cervix.

 

Types of ARTs

A. In vitro fertilization: During an IVF cycle, a doctor collects a matured and healthy ova (egg) from the woman. Before fertilization, egg will be safely stored in an external environment similar to the mother’s uterus. The Fertilization is artificially supported at this stage and then the doctor implants the embryo back into the woman’s uterus.

B.Intrauterine insemination ( IUI): This is the more affordable option when compared to the IVF but its success rate is low. During an IUI the sperm is implanted into the woman’s uterus by using a probe.

C.Intrafallopian transfer: It is a method in which the doctor transfers fertilized egg into the uterus through fallopian tubes. The egg is fertilized in an external environment before placing them into the fallopian tube. Intrafallopian transfers are good options for couples with unexplained infertility, men with sperm mobility issues, or when the woman has an issue with her fallopian tube such as a blocked tube.

D.Gamete intra-fallopian transfer (GIT): In this case, the doctor transfers sperm and eggs into a woman’s fallopian tube in order to fertilize sperm with the target egg.

E. Zygote intra-fallopian transfer (ZIT): It is similar to IVF in which eggs are removed from the woman’s body and fertilized in an external lab setting, then transferred into the woman’s body when the embryo starts growing.  

F.Intracytoplasmic sperm injectionIn this case, a mature egg is injected with a single healthy sperm outside the uterus. When the eggs develop normally, they are transferred back to the woman’s body.





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