Wednesday 10 July 2013

Infertility -3 , Male factor




Because of changes in life styles, stressful occupations male infertility is growing nowadays
The usual causes for male infertility are:
-Gross anomalies of external genitalia making performance of sexual intercourse difficult.
-Abnormal seminal parameters.
  These can be seen due to many causes like:
Ø      Structural abnormalities like varicocele

Ø      Maldevelpoment of testes or accessory organs
Ø      Obstruction in the structures of passage of semen
Ø      Infection
Ø      Hormonal abnormalities
Ø      General conditions like diabetes etc.
Ø      Alcohol, tobacco, some medicines can affect the seminal parameters
Ø      Psychological conditions like stress etc. are also can influence.
 
Semen analysis:
Normal seminal parameters are:
  • Volume : > 2ml
  • Concentration: >20 million/ml
  • Motility: > 50%, actively motile around 30%. If the count is high little bit of low motility can be taken as normal.
  • Morphology: >30% with normal morphology
  • pH: 7.2 to 7.8
  • WBC: >1 million/ml
  • Liquefaction time: < 60 minutes.
  • Fructose levels: >/ 3mg/ml or 13micromol/sample
  • Vitality: >75% sperms should be alive

Any deviation form normal levels can affect the fertility. And it has to be treated accordingly.


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Tuesday 9 July 2013

Infertility -2, Female factor



In causes of infertility usually female will contribute to 33%, male to 33% and both for remaining 34%.
The usual female factors contributing to infertility are:
  • Structural abnormalities: like uterine agenesis, mullarian abnormalities etc.
Some of the structural problems like agenesis of vagina etc. can be corrected.
But in many cases of structural problems depending on severity either artificial reproductive methods or adaptation of children etc. are needed.
  • Irregular cycles: Menstrual cycles can get affected due to many causes. Like,
Ø      Hypothalamic causes: hormones at the level of hypothalamus can get affected due to different causes like stress and strain, dietary changes or change in exercise schedule leading to weight changes etc.

Ø      Ovarian causes: poly cystic ovary disease, atrophic ovaries etc.
Ø      Thyroid hormonal abnormalities.
Ø      Elevated prolactin levels
Ø      Generalized causes like anemia, diabetes etc.
  • Secondary causes:
Ø      Tubal block due to previous infections etc.
Ø      Cervical fibroids obstructing the cervical os, submucosal or intramural fibroids obstructing the fallopian tubal openings etc.

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Monday 8 July 2013

Infertility -1



Nowadays incidence of infertility is increasing.
Both female and male factors, life style changes are contributing to this.

Basic things to be known related to infertility:
-If a couple not able to conceive even after one year of living together without usage of contraceptive methods, the only it can be called as infertility.
-Planning intercourse during the time of ovulation is important to get pregnancy.
-Ovulation can be tracked by following methods:
·         Cervical mucus method: usually during the period of ovulation, cervical mucus discharge will increase, becomes clear and more stretchable.
·         Basal body temperature method: during ovulation body temperature will increase around ½ degree.
·         Calendar method: in-case of regular periods the ovulation will usually occur in the middle of the month. In-case of 28 days cycle, the ovulation can occur on around 14th day and in-case of 30 days cycle, the ovulation can occur on around 16th day.
·         Ovulation kits can help in tracking the ovulation.

·         Follicular studies by ultrasound.


-Sexual intercourse should be planned around the period of ovulation, means if ovulation is expected on 14th day, intercourse should be planned on 12th to 16th days, at least on alternative days.
-After intercourse the woman should not getup and should lye down for around 15 to 20 minutes.
She should not clean her genitals with any antiseptic soup etc.
-If she crosses her expected date of periods, better to wait for 4 to 5 days and can go for urine pregnancy test kit for accurate result or she can choose blood test on around the day of expected periods.
Refer: http://srsree.blogspot.in/2012/05/pregnancy-tests.html
-The female expecting pregnancy should start taking folic acid prophylaxis 2 to 3 months before planning for pregnancy.



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