Mother & Child Clinic

Hello!

I am Dr. Laxmi Goel, infertility and IVF specialist, and consultant gynaecologist at Fortis Bloom Fertility Centre. Today I am going to speak about infertility, its causes, and treatment. Infertility is a very common problem in today's world. When do we say that the couple is infertile when they are having unprotective intercourse for 1 year and they are not able to conceive. It is called infertility. But if the female's age is more than 30 years then we wait for 6 months i.e. if they had in protective intercourse for 6 months and they are not able to conceive then it is termed as infertility. Then they should seek a doctor and start the treatment. Now we come to the causes of infertility.

Overall the causes of infertility, the female accounts for 30-40% and male accounts for the 30% of the cases of infertility. So, we should not only treat the females, males also should be treated. And malefactors should also be assessed. Now we come to the female factors. Among the females, the common causes of infertility include the ovulatory dysfunction. That means the female is not able to produce the eggs or if she is producing the eggs, the ovulation is not happening. The 2nd cause is the tubal factor that means the fallopian tubes are blocked. The 3rd cause is the uterine factor. There can be some infection in the uterus, tuberculosis which is very common in India. It can also hamper the uterine cavity which can lead to infertility and there can be cervical factors. So, whenever the couple is coming, we should always assess these factors and we always treat according to the cause.

Among the malefactors, the oligospermia that means the sperm count is low and when the sperm motility is very low. Now when we come to the treatment part. Sometimes there is no cause that is called unexplained infertility. It means we have evaluated everything. We have done follicle monitoring that means the patient is producing the egg, she is ovulating but her tubal factor, we have done HSG for that. Whenever we are going with treatment, first of all, we go with the simple treatment. In which we give 2-3 cycle. Follicular monitoring is done on the 2nd day then on 9th days, 11th days and 13th days till the mature follicle is 18-20 mm and then we give the trigger shot and when the follicle rupture, we tell the couple to have the natural intercourse and try these steps for 2-3 cycles. If the pregnancy does not happen in 2-3 months then we go for the next step that is IUI. In this process, when the female has produced the eggs i.e. of 18-20 mm, we give the trigger shot and we take the semen sample to process it and wash it and then transfer the semen sample inside the uterine cavity of the female.

It increases the chances of pregnancy by 5-10%. We go for IUI for 2-3 cycles. If the pregnancy is not happening then we go for laparohysteroscopy. With the help of laparoscope and hysteroscope we assess the uterus from inside, outside and we assess the tubes and the ovaries. After that, if everything is normal that we go for 2-3 cycles of IUI. But if we see anything abnormal like if we have locked tubes or we have endometriosis or we have decreased ovarian reserves we counsel the couple for IVF. We give 10 days of injections to the female and have her follicles are mature enough that means 18-20mm than we take the eggs out and we also take the sperm of the male to form the embryo outside with the help of IVF or ICSI.

And when the embryo is formed, on day 3 or day 5, we transfer back to the uterine cavity. So, this is the procedure of IVF. We have multiple advances in this field. So, a couple should not hesitate to go to the doctor because so many new things are coming up. You should always consult a doctor. Should always consult an infertility specialist if you are not able to conceive.

Thank You!