The main aim of infertile couples is to conceive and have a healthy child. Infertility could be due to problems in men, women, or both in 20% of infertile couples all investigations may be normal and they may yet be infertile which is called unexplained infertility. One common treatment option for infertility is intrauterine insemination (IUI Pregnancy), which involves directly inserting sperm into a woman’s uterus to increase the chances of fertilization.
Abnormalities in women are not the only cause of infertility. The important causes of infertility are:
Evaluation of physical factors in a couple
FEMALE ORIENTED:
1) Problem in the development of eggs in the ovary.
2) Obstruction in the fallopian tubes prevents egg and sperm from meeting.
3) Anomalies in the uterus
MALE ORIENTED PROBLEMS:
1) Problem in the production of sperms.
2) Mental stress or anxiety and other reasons
FOLLICULAR STUDY:
Follicular study is a vital component of egg assessment and timing of release of the egg. It basically employs a simple technique for assessing ovarian follicles at regular intervals (from the 12th day of period 18th to the 20th day) and documenting the pathway to ovulation (mature egg is released from the ovary).
HORMONE ANALYSIS:
The level of hormones in the blood plays an important role in conception. T4, TSH (Thyroid stimulating hormone), and prolactin levels are tested routinely. FH and LH levels are also.
LAPAROSCOPY:
Laparoscopic surgery, also called minimally invasive surgery (MIS), or keyhole surgery, is a modern surgical technique. It is used to visualize ovaries, uterus, and fallopian tubes. Endometriosis can also be diagnosed. PCOD can be diagnosed. It is both diagnostic and therapeutic.
DIAGNOSTIC:
By directly visualizing the uterus, Ovaries, and tubes, and checking tubal potency, couples can be reassured.
THERAPEUTIC:
Therapeutic procedures like ovarian drilling, ovarian cyst removal, adhesion, and myomectomy can be done through laparoscopy. Hysteroscopy will enable to visualization inner side of the uterus and tubal opening.
TEST RELATED TO MEN
Semen analysis and hormone analysis are performed. In some cases, a urologist’s opinion is also taken. Treatment would be easier after the preliminary tests are done in the male along with his spouse Hormone tests like T4, TSH, Prolactin, FSH, LH, and testosterone are done.
INFERTILITY PROCESS:
In this modern era conceiving a child naturally seems difficult, due to the changes in the social structure and function, where the priority of the woman has shifted from marriage to education and career, squeezing pregnancy between career ladder and homemaking, reducing treatment of infertility a rate race. As the age of marriage is raised conception window is narrowed, and anxiety is built on attempts for early pregnancy.
Though reproductive medicine has stretched its wings far and wide and procreating children to many infertility couples, there are grey areas that don’t come under its preview. We are analyzing the other side of the coin – the functional aspect. The problem of infertility is like an iceberg – the visible part is the physical aspect. The tip of the iceberg – It is amenable to tests and treatment. The submerged invisible part is the functional aspects comprising of immune and hormone function not available for the scrutiny of the medical fraternity.
Intrauterine insemination (IUI) pregnancy is one of the advancements in reproductive medicine, where sperm is directly inserted into a woman’s uterus to increase the chances of fertilization. This procedure helps many couples achieve pregnancy despite the challenges posed by modern lifestyles.
The success of intrauterine insemination (IUI) depends on several factors.
IN FEMALE:
Age plays a major role in the IUI success. There is a gradual decrease in getting pregnant after 30 years and the worst decrease after 35 years of female age. After 35 years of female age, the incident of infertility increased to 50% and the quality of the ova also deteriorated and the incidence of aneuploidies in the fetuses increased. Actually in human being natural fertility ends at the age of 41 years for females.
The recommendations are that in a couple with unexplained infertility, IUI should be limited to couples with females aged under 40 years. No routine ovarian reserve screening prior to starting IUI treatment is required. IUI may be advised with donor sperm for up to 42 years. Ovarian reserve testing is required only to exclude older women and for them, effective treatment is only ovum donation. So, ovarian reserve tests are not required in IUI practice. In women aged <=38 years, IUI should be considered as an option particularly in cases of female factor infertility due to ovulatory disorder, in cases of normal ovarian reserve, in cases of secondary infertility, or when postwash semen count in a male is >=1 million with progressive motility >90%. In all these cases, follicular development with ovulation induction improves the chance of pregnancy.
Female obesity is associated with lower oocyte yield with gonadotropin stimulation, lower pregnancy rate, and increased pregnancy loss in IUI. But, fecundity rates are higher in obese patients, particularly in polycystic ovary syndrome (PCOS). Weight loss improves obstetric outcomes and not fecundity. The optimal body mass index (BMI) for natural conception is between 20 and 24.
IN MALE:
As the male age increases there will be a decrease in the quality of sperm (Count, Motility, and morphology). These parameters start declining after 35 years of age also DNA damage at an older age may cause multiple genetic and chromosomal defects. The miscarriage rate is increased if the paternal age is more because of oxidative stress-induced mtDNA damage and nuclear DNA damage. This damage may put them at a higher risk of transmitting multiple genetic and chromosomal defects. After 40 years, it has a negative effect on IUI success rate. But, there is no absolute cut-off for the age as far as male infertility is concerned.
For more details you can go through our book “TALKING TO THE BABY IN THE WOMB – GARBHA VIDYA”. Which is available in different languages on Amazon Website.
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