Thursday, 6 October 2016

Infertility and its Treatment – Understand it better

Infertility is defined as a couple’s inability to conceive after one year of unprotected intercourse. Infertility is perceived as a social problem in our country. However, advances in medical science have made it possible for infertile couples to experience the joys of parenthood.

What are the main treatments used for infertility?

Fertility treatments can be grouped into three categories:

Medicines to improve fertility:  

  • Clomiphene is a medicine, which has been used to help with fertility for many years. It’s taken as a tablet. It releases more gonadotrophin hormones than normal. The extra amount of gonadotrophin hormones may stimulate the ovaries to ovulate.
  • Medicines that contain gonadotrophins are another type of treatment.  If this is injected, these medicines can also improve the fertility in men with certain types of hormonal problems that can affect the sperm count.
  • Metformin may also help to improve the fertility in some women with PCOS. It is commonly used to treat people suffering from diabetes.

What are the surgical treatments for fertility?

There are different types of surgical treatments for the fertility. Here are some of them:

Fallopian tube problems:  This surgery may help some women with infertility caused by fallopian tube problems.
Endometriosis:  This is a condition that occurs when cells from the lining of the womb (uterus) grow in other areas of the body. This surgery may help to improve fertility in women with endometriosis.
Polycystic ovary syndrome (PCOS):  An operation on the ovaries may be suitable for some women with PCOS.
Fibroids:  For women with fibroids, surgery (to remove the fibroid) may be considered if there are no other explanations for the infertility.

What is assisted conception? What are the processes associated with them?
Assisted reproductive technology (ART) is one technology, which is used to achieve pregnancy in various procedures such as fertility medication, artificial insemination, in vitro fertilization (IVF) and surrogacy. It is a reproductive technology used primarily for infertility treatments, and is also known as Fertility Treatment. Here are the various procedures associated with them: 
Intrauterine insemination (IUI)
This is the process by which sperm are placed into the woman's womb (uterus). It is done by using a fine plastic tube which is passed through the neck of the womb (the cervix) into the womb. Sperms are passed through the tube. It is relatively a straightforward procedure. It can be timed to coincide with ovulation (about halfway through a monthly cycle) in women who are still ovulating. Fertility medicines may also be given beforehand, to maximize the chance of ovulation occurring. Women, who have this procedure, need to have healthy fallopian tubes to allow the egg to travel from the ovary into the womb. If successful, fertilization takes place within the womb. Then the sperm can be used either from the male partner, or from a donor. If IUI does not work, couples tend to move on to try other methods described below.
In vitro fertilization (IVF)
IVF means In vitro fertilization outside the body. In vitro literally means in glass (either, in a laboratory dish or test tube). IVF is used in couples, whose infertility is caused by blocked fallopian tubes, or where their infertility is unexplained. It may also be used where there are certain problems with ovulation or a combination of factors causing infertility.
Gamete intra-fallopian transfer (GIFT)
A gamete is an egg or sperm. Eggs and sperm are collected in the same way as for IVF. The eggs are mixed with the sperm. The mixture of eggs and sperm is then placed into one of the woman's fallopian tubes. Therefore, unlike IVF, the sperm fertilises the egg naturally inside the woman's fallopian tube or womb, and not outside the body in a laboratory dish. GIFT is no longer a recommended process to be used.
Intracytoplasmic sperm injection (ICSI)
This technique involves an individual sperm being injected directly into an egg. Some cases of infertility are due to the sperm of a male partner, not being able to penetrate the outer part of the egg to fertilise the egg. ICSI can also be used when a male partner has a low sperm count, as only one sperm is needed.
Egg donation
This involves stimulating the ovaries of a female donor with fertility medicines, and collecting the eggs which form. The eggs are mixed with and fertilised by sperm of the recipient's partner (similar to IVF). After 2-3 days, embryos are placed in the womb of the recipient, via the cervix.
Embryo donation
Couples who have had successful IVF treatment may decide to donate any spare embryos to help other infertile couples.

What is surrogacy?

Surrogacy is a procedure in which a woman acts as a temporary mother by allowing her womb (uterus) to carry a pregnancy for another couple.

When is the help of surrogate mothers required?

  Absence of uterus from birth.

  • Uterus has been accidentally removed at a young age, either because of heavy bleeding or an accident during the first childbirth, or due to a tumor.
  • Repeated IVF failure. When failure is suspected to be due to a defective or diseased uterus, as in endometriosis or adhesion (gluing) between two inner walls of the uterus.
  • Sometimes, working women want surrogacy in order to avoid absence from work. Alternatively, some married women prefer surrogacy in order to not lose their abdominal shape or figure. However, these indications have not been accepted in the ‘guidelines’ being prepared for the ART clinics in India.
Guru Hospital Anish Fertility Centre offers Best Infertility Treatment in Madurai with the help of dedicated team of doctors and other staff. 

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