WHAT IS INFERTILITY?
When a couple is living a Conjugal life without practicing any form of contraceptive for 1 year and still has not conceived, then the couple is clinically known as an Infertile couple.
IS INFERTILITY ONLY A FEMALE PROBLEM?
Infertility has both male and female factors, although male factor is 25%, whereas female factor is 75%, but still male factor if detected should be treated by Uro-andrologist. The female partner should be treated by Gynaecologist. Both man and woman should equally participate in the treatment
DOES INFERTILITY TREATMENT ONLY MEAN ASSISTED REPRODUCTIVE TECHNIQUE?
The assisted reproductive technique is the last resort. The couple should be thoroughly evaluated on the basis of history taking, clinical examination, and investigations. IVF i.e. in – vitro – fertilization signifies fertilization of egg and sperm outside the body. Not all couples with infertility need IVF, but some cannot get pregnant without it, like the men with low sperm count and women with blocked tubes. These procedures are expensive. Results are not absolute.
What is the role of Laparoscopy in Infertility?
Infertility has become a very common problem nowadays. It is again related to lifestyle and other factors. Laparoscopy is a procedure that involves insertion of a narrow telescope-like instrument through a small incision in the belly button. This allows visualization of the abdominal and pelvic organs including the area of the uterus, fallopian tubes, and ovaries. This procedure allows us to determine whether there are any defects such as scar tissue, endometriosis, fibroid tumours and other abnormalities of the uterus, fallopian tubes, and ovaries. If any defects are found then they can often be corrected with operative laparoscopy which involves placing instruments through ports in the scope and through additional, narrow (5 mm) ports which are usually inserted at the top of the pubic hairline in the lower abdomen.
Because of the cost and invasive nature of laparoscopy, it should not be the first procedure or diagnostic test performed as part of the couples’ infertility diagnostic evaluation. In general, semen analysis, hysterosalpingogram and documentation of ovulation should be assessed prior to consideration of laparoscopy. For example, if the woman has a clear ovulation problem or her male partner has a severe sperm defect then it is unlikely that laparoscopy will provide additional useful information that will help them to conceive. Laparoscopy traditionally used to be part of the female infertility work-up. However, this tradition has recently been challenged as potentially being a questionable procedure when assessed by its cost-effectiveness and invasiveness.
The procedure usually takes between 20 minutes to 2 hours depending upon how much operative corrective work is required. A complicated case could take up to 4 hours or more. The woman is generally discharged home from the hospital approximately two hours after completion of the surgery. The woman will usually need to take off an additional 1-2 days from work following the procedure. Mild to moderate pain should be expected to last for up to 7 days or so after the procedure.
What EXPERT SPEAK ON SIMPLE BUT SIGNIFICANT FACTS ON INFERTILITY?
Infertility should not be treated as a social stigma. It is no one’s fault. Society should be kind and supportive. Couples with known problems like low sperm count, polycystic ovaries, fibroid, and endometriosis should see a doctor as soon as possible.
ARE THERE SURGICAL WAYS OF TREATING INFERTILITY?
There are many pathological conditions which lead to female infertility like a uterine polyp, fallopian tube blockage, submucous fibroids, uterus having two cavities, uterine synechiae. These conditions have to be corrected surgically; otherwise even assisted reproductive technique will not yield any results.
DOES MALE INFERTILITY REQUIRE SURGICAL MANAGEMENT?
Common causes of male infertility are a varicocele, undescended testis, and testicular atrophy. These conditions have to be tackled surgically to improve the quality and quantity of sperms.
DOES LIFESTYLE OF MALE AFFECT FERTILITY?
Yes, definitely malefactors like obesity, tobacco use, smoking, alcohol use, heavy exercise, tight undergarments, exposure to hot environmental conditions, use of too many mobile phones can adversely affect fertility. Hence alleviation of these factors drastically improves fertility. Sometimes results are obtained with proper counseling and without further intervention.
DOES LIFESTYLE OF A FEMALE AFFECT FERTILITY?
Yes. Obesity, sedentary lifestyle, exposure to radiation leads to infertility. Corrections of these factors improve fertility significantly.