Infertility

EXHIBITION “UNDERSTANDING INFERTILITY”

What is infertility?

Infertility is failure to conceive within one or more years of regular unprotected coitus

TYPES OF INFERTILITY

Primary Infertility  Secondary Infertility 

INCIDENCE OF INFERTILITY 

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Worldwide 8-15% of couples suffer some form of infertility problems Male factor(30%) Female factor(30%) Both factors (30%) Unexplained factors(10%)

PRIMARY INFERTILITY It denotes those patients who have never conceived.

SECONDARY INFERTILITY 

It indicates previous pregnancy ,but failure to conceive subsequently.

CAUSES OF INFERTILITY

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CAUSES IN MALES 

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Defective spermatogenesis Obstruction of the efferent duct system Failure to deposit sperms high in the vagina Errors in the seminal fluid

DEFECTIVE SPERMATOGENESIS It is caused due to  Congenital causes ,namely,  Undescended testes  Hypospadias  Thermal factors  Infection  Genetic factors  Endocrine factors  Iatrogenic  Immunological factors

CAUSES IN FEMALES 

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OVARIAN FACTORS:Anovulation or oligo – ovulation Luteal phase defect Lutetinised unruptured follicle TUBAL FACTORS PERITONEAL FACTORS UTERINE FACTORS CERVICAL FACTORS VAGINAL FACTORS COMBINED FACTORS

STRESS

COITAL PROBLEMS

INVESTIGATIONS OF INFERTILITY

WHEN TO INVESTIGATE ? Infertile couple should be investigated after 1 year of regular unprotected exposure with adequate frequency. 

After the age of 35 years in women & 40 years in man ,interval is shortened to 6 months.

INVESTIGATIONS IN MALES          

History Examination Routine investigation Semen analysis Hormonal assay Testicular biopsy Transrectal USG Karyotype analysis Immunological tests Diagnostic laparoscopy

FEMALE INVESTIGATIONS         

History Examinations Hysterosalpingography Laparoscopy USG Hormonal assay Endometrial biopsy Vaginal cytology BBT CHART

COUPLE INSTRUCTIONS

1. ASSURANCE

2. MAINTENANCE OF NORMAL BODY WEIGHT

BALANCED DIET

3.AVOID SMOKING

4.AVOID ALCOHOL CONSUMPTION

6.REGULAR EXERCISE

7.COLD SCROTAL BATH

8. AVOID TIGHT & WARM UNDERGARMENTS

TREATMENT

MEDICAL TREATMENT       

Clomiphene citrate Testosterone GnRH therapy Antibiotics Dexamethasone hCG Ovulation induction

SURGICAL TREATMENT    

Vasoepididymostomy Vasovasostomy Orchidopexy High ligation of spermatic vein

ASSISTED REPRODUCTIVE TECHNOLOGY

SURGICAL INTERVENTIONS IN FEMALES 

Tuboplasty

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Myomectomy

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Metroplasty

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Tubal recanulization

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Operative laparoscopy

ASSISTED REPRODUCTIVE TECHNOLOGY( females) Intra uterine insemination (IUI)  In vitro fertilization & embryo transfer (IVF-ET)  Gamete intra fallopian transfer (GIFT) 

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Zygote intrafallopian transfer (ZIFT) Intracytoplasmic sperm injection

OVUM RETRIEVAL

OVUM & SPERM FERTILIZATION

CELL DIVISION AFTER FERTILIZATION