Infertility

Infertility is the inability of a couple to become pregnant (regardless of cause) after 1 year of unprotected sexual intercourse (using no birth control methods).

Infertility affects men and women equally.

Causes

The normal reproduction process requires interaction between the female and male reproductive tracts. The woman ovulates and releases an egg from her ovaries to travel through the fallopian tube to her uterus (womb).The male produces sperm. Both egg and sperm normally meet in the woman's fallopian tube, where fertilization occurs. The embryo then implants in the uterus for further development.

Pelvic inflammatory disease (PID)

Sexually transmitted diseases, namely, gonorrhea and chlamydia, may be associated with pelvic inflammatory disease (PID) and damage a woman's fallopian tubes

Endometriosis

Endometriosis affects women during their reproductive years. It can cause pelvic pain and infertility.

Environmental and occupational factors

Certain environmental factors may cause men to produce a less concentrated sperm. Exposure to lead, other heavy metals and pesticides has also been associated with male infertility. Many other factors, such as excessive heat exposure, microwave radiation, ultrasound, and other health hazards, are more controversial as to whether they induce infertility.
 
Toxic effects related to tobacco, marijuana, and other drugs

Smoking may cause infertility in both men and women. Nicotine has been shown to block the production of sperm and decrease the size of a man's testicles. In women, tobacco changes the cervical mucus, thus affecting the way sperm reach the egg.

In women, the effects of alcohol are related more too severe consequences for the fetus. Nevertheless, chronic alcoholism is related to disorders in ovulation and, therefore, interferes with fertility. Alcohol use by men interferes with the synthesis of testosterone and has an impact on sperm concentration. Alcoholism may delay a man's sexual response and may cause impotence.

Exercise
Over exercise may result in disruption of the ovulation cycle, cause no menstrual periods, or result in miscarriages (loss of pregnancy).In men, over exercise may cause a low sperm count.
Obesity has an impact on infertility only when a woman's weight reaches extremes.

Weight loss with anorexia or bulimia can create problems with menstrual periods (no periods) and thyroid levels, thus disrupting normal ovulation.

Infertility in men is most often caused by:

A problem called varicocele

Movements of the sperm

A man's sperm can be changed by his overall health and lifestyle. Some things that may reduce the health or number of sperm

 Heavy alcohol use

Drugs

Environmental toxins, including pesticides and lead

Smoking cigarettes

Health problems such as mumps, serious conditions like kidney disease, or hormone problems

Medicines

Radiation treatment and chemotherapy for cancer

Age

Most cases of female infertility are caused by

Problems with ovulation

Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.

Ovulation problems are often caused by polycystic ovarian syndrome (PCOS).

Less common causes of fertility problems in women

Blocked Fallopian tubes due to pelvic inflammatory disease, endometriosis, or surgery for an ectopic pregnancy

Physical problems with the uterus

Uterine fibroids which are non-cancerous clumps of tissue and muscle on the walls of the uterus

Diagnosis

Medical history

Physical examination

Further testing for men

The male partner will be asked to submit a semen sample for a complete semen analysis.

Further testing for women

Several conditions may affect a woman's ability to get pregnant.

The cervix 

Cervical mucus production, amount, and characteristics change according to the estrogen concentration depending on the menstrual cycle.

The uterus  

 Problems affect the development and function of the uterus (specifically the endometrium or inner layer of the uterus).

Ovaries may not release eggs. Fallopian tubes may be blocked.

Hysterosalpingogram

Ultrasound: Pelvic ultrasound has become an important tool in the evaluation and monitoring of infertile women. It is a way to detect uterine fibroids, endometrial polyps, ovarian cysts, and other abnormalities in the pelvis from the outside with sound waves.

Magnetic resonance imaging (MRI):

Hysteroscopy: This is a method of directly seeing the uterus with an instrument.

Case

This is the case of a woman [Mrs. R. Devi] aged 35 years. She came to see me for INFERTILITY. Her complaint was leucorrhea which thick and profuse since last 15 years. She also had itching and burning in vagina. Her menstrual cycle was irregular. She had no thirst. She was highly emotional and weeps easily. USG report was pelvic inflammatory disease. Semen analysis was normal.

On 22/08/10 she was prescribed KREOSOTOM, PYROGENUM, BOREX, OVA TOSTA, R-1 for fifteen days. She came on 09/09/10 with improvement in itching and burning vagina. She was repeated same medicines for fifteen days.

On 01/10/10 she reported with no leucorrhea, no itching, and no burning. She was prescribed PULSATILLA , NATRUM MUR, AGNUS CAST along with above medicines for fifteen days.

She came after four months on 6/2/2011 with amenorrhea last three months and she was advised for pregnancy test and USG for BWF

Pregnancy test was positive.USG report was 3 months pregnancy.   

Dr. G. S. Bhatnagar
D.H.M.S.  B.H.M.S.
Research officer
Sewa Mandir
Mobile 9829978284
E-Mail: sewamandir@usa.net, drgsbhatnagar@gmail.com