Infertility

Hello!

I am Dr. Yukti Wadhawan. I am an IVF specialist. I am the founder of Origin IVF. Aaj hum infertility ke baare mein baat karenge. Infertility means the inability to conceive after 12 months of unprotected intercourse. Infertility ka ye matlab nahi hai ki aap kabhi conceive hi nahi kar sakte. You might need some help, kuch assistance jiske baad aap pregnant ho sakte hain. Infertility 2 tarah ki hoti hai: primary and secondary. Primary infertility means jab kabhi bhi conceive na kiya ho, first baby na ho. Secondary infertility means yadi aap ke paas ek bachcha hai aur doosre bache ke waqt aap ko pareshani aa rahi ho. Aaj kal statistics ke hisab se infertility is equally prevalent in males and in females. So, 50% is the male factor and 50% is due to the female factors. So common causes females mein kya hote hain? Increasing age at marriage aaj kal shadi ki umar he ladkiyon ki badh gayi hai, ambitious hai, work stress included hai, bad lifestyle hai, junk food hai, alcohol, smoking hai, hormonal disturbances hai, PCOD, endometriosis yeh sab bohot hi common causes hai jo females mein paye jate Hain.

Whereas agar hum males mein dekhe the biggest cause is work stress, increased use of mobile phones, laptops, bad food habits, bad lifestyle in fact jo log extra exercise karte hai ya bohot zada cycling karte hain un males mein bhi infertility ke chances zada hote hain. Lifestyle, bad lifestyle changes kya hote hai? Increased weight aaj kal aap dekhe bohot hi prevalent hai, bohot sare log obese hai, increased weight hai because khane ka proper waqt nahi hai, junk foods pe zada hai, increased caffeine intake hai, less of salad, less of healthy food hai, less of exercise hai. So ye sab causes hai jo male and females mein paye jate hai. So, what are the basic problems that we see which causes the infertility? Specially females mein the most common aaj kal every two patients out of five patients are PCOD, polycystic ovarian disease. Second is endometriosis which is very common.

Menstrual irregularities, blocked tubes, hormonal disturbances ye sab causes hai jo ki females mein paye jate hai. Now what are the treatments? What are the investigations which are required? Jo basic investigations hai vo sab blood investigations hai. Females mein hysterosalpingography hoti hai jisko hum tube test commonly kehte hain, then ultrasound. So ye sab test karne mein takreeban 2-3 visit aap ko apne IVF specialist ke paas lag jati hai, 6 months lag jate hai jisme ek proper diagnosis ban jaye taki aap ka treatment shuru ho paye. And surprisingly 85 to 90% cases if properly diagnosed, properly investigated with a conventional treatment jo ki medical, surgical treatment hai unhi se pregnant ho jate hai. Jo nahi ho pate hai vo cases ko ART that is artificial reproductive technology ki jarurat padti hai. So, the line of treatment is first is hormones, second is surgery and third is ART. Hormonal treatment means contraceptive pills pe daalte hain, ovulation induction karte hain, aap ko thode injections se boost up karte hain taki aap ki egg quality improve ho jaye. Second is surgery which will include hysteroscopy, laparoscopy kayi bar diagnostic laparoscopy, hysteroscopy se hi kafi zada farak padta hai. Jin cases ko in dono se aram nahi milta, vo cases are the potential cases for ART.

ART means artificial reproductive technology which will include IUI and IVF. IUI ka success rate we all know is about 15 to 20% and IVF success rate is about 37%. IUI means intrauterine insemination is mein hum husband ka semen lete hain, lady ka scanning karte hain, follicular monitoring se unke eggs dekhte hai ki kaise grow ho rahe hai. In case unko requirement ho to kuch tablet ya injections de dete hai. Jab hame lagta hai ki jo egg ka size hai vo optimum ho gaya hai for conception to happen, so us din hum husband ka semen leke us OT mein leja ke patient ko, tube se insert kar dete hai uterus ke andar. This is just an assistive process than a normal pregnancy. In IVF it is a little different. Hum lady ke again follicular monitoring karte hai but we stimulate her with injections only. Unko alternate day ya daily injections dete hai jisse unke eggs achi quality ke and ache size ke ban jaye.

When they reach the optimum size hum unhe OT mein under anaesthesia eggs ko remove kar dete hain. Simultaneously usi din husband ka semen sample lete hai. Usme se achi quality ke, ache ek dum correct vale jo sperms hote hai vo leke unhe artificially bahar slides mein fertilize karte hain. Jab vo ache embryos ban jate hai so third day or fifth day depending on the case, hum unn embryos ko wapas se uterus mein transfer kar dete hai. This is IVF. There are also cases jinme ya to eggs ache nahi hai ya sperm ache nahi hai, inhi cases mein hame donor ki zarurt padti hai; ya donor eggs ki ya donor semen ki. So those cases are either IUI donor cases or IVF donor cases.

Thank you.