Infertility means not getting pregnant after unprotected sex for one year if the female is less than 35 years and 6 months if the female is more than 35 years of age.
About 15 to 20% of couples worldwide face the problem of infertility. For infertility, in 40% of cases, the female partner is responsible; in 40% of cases, the male partner is responsible; in 10-20% of cases, both partners are responsible. Sometimes a pinpoint cause cannot be found, which is called unexplained infertility.
Infertility can be primary where the woman has never been pregnant or secondary when there is difficulty conceiving after childbirth or miscarriage.
For pregnancy to occur, several things have to happen:
The mature egg must be released from the ovary (ovulation). The egg must then be picked up by one of the fallopian tubes.
A man’s sperm must travel through the uterus to the fallopian tube to meet and fertilize the egg.
There are several reasons why you might have trouble getting pregnant. It’s important to note that your fertility declines over the years, which could play a role.
The most common reasons for infertility in women are:
Problem with egg formation and ovulation
It is one of the most common reasons for infertility in women.
Women experience irregular periods, very early periods or no periods at all. Ovulation can be disrupted by disturbances of hormones that signal an egg to develop and be released from the ovary.
Problems that interfere with ovulation include:
Polycystic ovary syndrome
It is a condition where there may be a combination of symptoms, irregular ovulation, increase in body hair(hirsutism) due to an increase in male pattern hormones, weight gain and metabolic disturbances. The basic problem is there are many follicles in the ovary, but they do not grow in size, become mature and ovulate. Instead, these follicles are arrested in early development, causing multiple small cysts to appear in sonography, hence the name Polycystic ovary syndrome.read more
Low egg count or Diminished- poor ovarian reserve
If you have less number of eggs in the ovary, this can lead to difficulty in conceiving. There may not be any sign so that you can know but maybe early periods. read more
Disorders that can affect the thyroid, adrenal or pituitary glands can cause problems with ovulation
Poor or non-functioning of the fallopian tubes
Fallopian tubes are the passage where egg and sperm meet, fertilize and develop as an embryo. Tube transports embryos to the uterus for implantation. Tubal damage can be due to infections, previous surgery on a tube or nearby organ such as the appendix, history of ectopic pregnancy, endometriosis etc.
Problems with the uterus
The uterus can have developmental defects since birth like shape defects, size defects or even completely absent uterus. The uterus can have tumours like fibroids which can affect size, number and location. The uterus also might have scars of previous operations, external adhesions, adenomyosis which can hamper the normal function of the uterus.
Problems with endometrium
Endometrium grows and regresses with hormonal changes in a menstrual cycle. A damaged endometrium can’t develop well to receive embryos and successful implantation. Endometrial damage may be due to scarring from a previous infection, surgical trauma, miscarriage etc. There can be a polyp, foreign body, fibroids etc., in the endometrial cavity hampering pregnancy.
Infections in the reproductive tract
Infections can affect the whole reproductive tract and damage functioning. Common infections are Tuberculosis, chlamydia. Etc.
In endometriosis, a tissue similar to the lining of the uterus develops at abnormal locations, such as the pelvis, outer wall of the uterus, fallopian tubes or ovaries. It can also develop in the ovaries as a cyst called a chocolate cyst.
Obesity, caffeine intake, smoking, recreational drugs, alcohol, pollution, stress, irregular life, lack of sex etc., lead to reduced fertility.
Certain medications like antidepressants, tranquillizers, calcium channel blockers, narcotics, and anti-cancer drugs can alter hormones and fertility.
Chronic medical conditions
Poor general health like kidney disease, liver disease, sickle cell disease, HIV/AIDS, and hepatitis B or C can have a direct or indirect impact on fertility, pregnancy and childbearing.
Diagnosis of infertility in women
We at Bavishi fertility institute follow one cycle approach for diagnosis. In one menstrual cycle, step by necessary step test are done to arrive at a primary diagnosis. This test includes male partner semen examination, ovarian reserve evaluation, ultrasound & ovulation tracking, basic hormone and other blood tests. Read More
Female infertility treatment
We first focus on diagnosis and then make a highly individualized and personalized treatment plan with precisely customized treatment protocols.
Some of the treatment options are:
In females with disturbed ovulation due to PCOS or other factors, medications are given to produce good quality eggs. Fortunately, many oral and injectable drugs are available which can achieve desired ovulation almost 100%.
Laparoscopy – Hysteroscopy
This is a surgical procedure in which a lighted telescope-like instrument (laparoscope) is inserted through the wall of the abdomen into the pelvic cavity. For any structural problem like damaged tubes, fibroids etc. Surgical correction by minimally invasive laparoscopy – hysteroscopy can be done. Read more
Intra uterine Insemination – IUI
IUI is a simple outpatient procedure where at the time of ovulation washed and prepared semen sample is put in the uterus. It can give more than double the chance of conceiving compared to natural intercourse. Read more
In Vitro Fertilization – IVF is a treatment where eggs are taken out from the body, fertilized and grown in an IVF lab. Best embryos are selected and put back in the mother’s uterus.“ EASY IVF “ at BFI is Simple, Safe, Smart and Successful. 98% of our IVF patients who have put faith in us and done enough treatment have live-born child/children in their hands. Read more
PRP – Platelet Rich Plasma therapy in infertility
Platelets are blood cells that have a unique ability to divide rapidly. They are very rich in cytokines and many other growth-promoting factors. Activation and enrichment of platelets make them even more capable functionally. PRP is used as a rejuvenation tool in many areas of medicine. PRP helps in the growth of the tissues.
Injection of concentrated, activated, enriched PRP can enhance the egg-producing capacity of the ovaries. BFI has achieved many natural pregnancies also in these very poor pregnancy chance couples. Read more
Infections, surgeries or miscarriages can scar and cause severe damage to the endometrium – the functional layer of the uterus. This causes the walls of the uterus to stick together, forming adhesions.
Surgical correction by cutting the adhesions is possible with hysteroscopy. However new functioning endometrial layer should grow and cover the cut areas for good function.
PRP injection can help and promote normal endometrial growth and help achieve pregnancy.
PROCEDURE OF PRP PREPARATION
The procedure is very simple and safe.
The blood is collected from the patient.
It is processed in our own laboratory to separate platelets.
Special treatment is done to enrich the preparation and make it more effective.
The prepared PRP is injected in both ovaries or the uterus.
ADVANTAGES OF PRP
It is prepared from the patients to own blood, so no outside drug or material is injected into the body. It is a very simple & relatively inexpensive process. The effect can last for a long time, not only for one treatment cycle.
DISADVANTAGES AND LIMITATIONS OF PRP
PRP is still a new procedure. Even after PRP treatment, no improvement may occur.
Preservation of fertility – Prevention measures
There are some guidelines to reduce the risk of female infertility:
have a regular sex life
Avoid abortion – while not planning for pregnancy – use contraceptive methods
adhere to the rules of personal hygiene
Normal Body Mass Index – BMI
undergo a preventive examination by a gynaecologist
Freeze your eggs, If you are not planning for pregnancy in the near future
If you have irregular cycles, early periods, difficulty in intercourse, history of abdominal or pelvic surgery, late marriage, the urgency to conceive, miscarriages, hormone issues, history of tuberculosis, seek help early.