Dr. Singh Test Tube Baby Centre

Infertility

Infertility means inability to bear their own child. Its incidence is 10-15% and cause may be in male or female or in both if husband and wife have normal sexual life for one year and wife is not able to conceive than this couple come under definition of infertile couple. Infertility is 40% due to problem in Female and 40% due to Male and 20% due to problem in both.

Infertility (cka>iu) dk vFkZ gS% vxj dksbZ diy xHkZfujks/kd vkSj daMkse ds bLrseky ds fcuk de ls de ,d lky ;k blls Hkh vf/kd le; rd lkekU; ;kSu thou esa gks vkSj mlds ckn Hkh larku lq[k ls oafpr jg jgs gks rks mu efgyk ;k iq#"k nksuksa esa ls fdlh ,d ds lkFk Infertility ¼ck¡>iu½ dh leL;k gks ldrh gSA
L=h esa leL;k ds dkj.k cka>iu 40%] iq#"k dh otg ls 40% vkSj nksuksa esa leL;k ds dkj.k 20% gks ldrk gSA
cka>iu ,d chekjh gS] dksbZ vfHk'kki ugha A bldk bykt vU; fcekfj;ksa dh rjg laHko gksrk gS A

Main Cause of Infertility In Female

> No ova formation in female
> Defective or damaged fallopian tubes (both)
> Abnormality in uterus eg. Fibroid, angenital defects
> Problems in hormone productiveness
> No definite cause
fL=;ksa esa ck¡>iu ds dkj.k
fL=;ksa esa Infertility ds dbZ dkj.k gks ldrs gSa tks dh dbZ LokLF; leL;k;ksa ls çHkkfor gks ldrh gS] tSls fd %& i‚yhflfLVd vksojh flaMªkse ¼ihlhvks½] ,saMksesVfjvksflt] Jksf.k lwtu dh chekjh] xHkkZ'k; Qkbcz‚,M] ,uhfe;k] Fkk;jkbM dh leL;k,a] vo#) QSyksfi;u Vîwct] dSafMMk vkSj ;kSu lapkfjr jksx ¼,lVhMh½] vf/kd efnjk&lsou] /kqeziku] vf/kd vk;q] eksVkik] vR;f/kd&ruko] vfu;fer ,oa nnZiw.kZ ekgokjh dh leL;k] iks"k.k&jfgr Hkkstu ;k fQj vR;f/kd 'kkjhfjd&çf'k{k.k Hkh L=h dh xHkZ&/kkj.k {kerk dks çHkkfor djus ds vge dkj.k gSaI
Cause of infertility Due To male Factor:

> Problem in sperm low count, defective formation, absence of sperm.
> Problem in external genital organs
> Abnormal hormone cause

iq#"kksa esa ck¡>iu ds dkj.k
iq#"kksa esa Infertility dh leL;k dbZ dkj.kksa ls gks ldrk gSa tSls dh oSjhdkslsy ¼vaMdks"kksa ls jD‍r ys tkus okyh jD‍rokfguh esa lwtu vk tkrh gS] rc oSjhdkslsy gksrk gSA blls vaMdks"kksa esa i;kZI‍r ek=k esa jD‍rçokg ugha gks ikrk½] çtuu {kerk esa deh] 'kqØk.kq dk de ;k ugha gksuk gS] dHkh&dHkh 'kqØk.kq dk detksj gksuk ;k vaMksa rd igqapus ls igys gh fuf"Ø; gks tkuk]vaMdks"kksa ij xaHkhj pksV Hkh 'kqØk.kqvksa ds L‍rj dks uqdlku igqapkrh gS] 'kqØk.kqvksa ds mR‍iknu ij xehZ dk cqjk vlj iM+rk gS] blfy, vf/kd nsj rd xeZ rkieku esa u jgs] cgqr vf/kd ruko] Fkdku vkSj vY‍dksgy dk lsou Hkh dkesP‍Nk ij udkjkR‍ed vlj Mkyrs gSaA

Investigations :-

Female -

> Blood Hormone level (D2-like FSH, LH, TSH, Prolactine, E2 Etc.)
> Ultra sound of female organs (Including colour Doppler)
> Laproscopy & Hysteroscopy (Only if needed )
> Hysterosalpingography etc. (If Require)

Male -

Semen examination -It is single most important examination done in male.
Other investigation are blood test, hormone levels, testicular biopsy where sperm totally absent.

Treatment Modalities For Infertile Couples

When all medical treatments fails, following treatment done for infertile couples:

A. IUI (Intra uterine insemination of sperm)
B. ART (Assisted reproductive techniques)

ART-

This includes (also called test tube baby)

1. IVF (In Vitro Fertilization)
2. ICSI (Intracytoplasmic Sperm Injection)

IUI (Intra Uterine Insemination of sperm):-

This is simplest technique by which sperm of husband prepared by sperm preparing media and highly motile sperms are injected in wife uterus at the time of ovulation.

So good sperm and ova meets naturally and pregnancy occurs. IUI is done only when female have cervical mucus in compatibility or sperm are low in count. Success rate of IUI is about 10-15%if done 6times(maximum)

ART (Assisted Reproduction Technology):-

This is most important and advance technique and is available only at infertility centre which are doing exclusive work in the field of infertility. ART also called test tube baby techniques because here 4-6 embryo is first made outside body means in test tube or four well dish and then transferred to female uterus.

IVF (In Vitro Fertilization):-

In this technique female is given hormone injections to stimulate her ovary and several ova are formed than those ova are taken out under anesthesia and combined with husband sperm in a carbon dioxide incubator. After fertilization when embryo attains 6-8 cells stage (after 2 days of ovum pick up) , then embryo transferred to wife uterus and thus pregnancy occurs. This method is used when female both tubes are damaged or she is not able to conceive by 0.6 time of IUI. Success rate of this procedure is near about 30% in whole world.

ICSI:-
vkbZlh,lvkbZ dk ç;ksx ml fLFkfr esa fd;k tkrk gS tc vaMksa dh la[;k de gksrh gS ;k iq#"k 'kqØk.kq dh ek=k 10 fefy;u ls de de gks tkrh gSA ftl dkj.k 'kqØk.kq] vaMk.kq ls fØ;k djus yk;d csgrj voLFkk esa ugha gksrsA blesa ekbØksesuhiqys'ku rduhd }kjk 'kqØk.kqvksa dks lh/ks vaMk.kqvksa esa batsDV djk;k tkrk gS rkfd fu"kspu gks ldsa] lQyrk nj ;gka Hkh 30% cuh gqbZ gSA
This method is applied when male sperm count is less than 10 million or ova not fertilized due to defect in sperm head during IVF. Hence under microscope sperm is injected in ova directly so that fertilization can occur success rate remains same 30% here also. Few other method like laser hatching etc. also done in indicated cases but these methods only used when their is any indication. These method not improve the success rate & pregnancy.

Sarrogate Mothers:-

It is a way to have your own genetical baby when female loss her uterus due to congenital cause or have anatomicaly distorted uterus. Here husband sperm & wife ova are taken out their embryo formed and transferred to a lady who wish to have child in her womb for 9 months and after the birth baby is given to genetically mother & father. It is legal procedure and law allow this only in those females who doesn't have their own uterus.

Few Important Things To Remember :-

1. IVF (TEST TUBE BABY) - Is a technique which help infertile couples to have there child but it do not assure them100%The success rate is whole about 30%.

2. It is a expensive procedure because hormones used to stimulate the ovary are expensive and are imported.

3. It is expensive because of high cost of instruments & high maintenance costs.

The basic investigations needed for an infertile couple are:

Semen Analysis with Sperm Function Tests Hormone Assay’s.

Wife (Day 2 FSH,LH, Prolactin, TSH, E2, ASA) (Day 21 Progestrone) Husband FSH, ASA (on any day) Antisperm Antibodies.

Presence of antisperm antibodies in the seminal plasma and/or in cervical fluid prevents motility of sperms. Levels of ASA in female and male partners determine the procedure in the treatment of infertility.

If ASA is high in the wife, then the treatment is IVF or condom’s/oral steroids.

If ASA is high in the husband then the treatment is IVF-ICSI with oral steroids.

Screening for HIV, Hepatitis B, STD’s (husband and wife) Torch (past history of spontaneous abortion).

Mucus Hostility Test- To check the receptivity of the cervical mucus to sperm at the time of ovulation.

Post Coital Test-After 6 hours of intercourse, samples of cervical mucus are examined to look for alive/ dead sperms.

Tubal Potency Test- To check the potency of the tubes. Hysterosalpingography (H.S.G.) Sonosalpingogaphy.

Testicular Biopsy - In case of Azoospermia.