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Male and Female Infertility: Causes, Symptoms, Diagnosis & Treatment


Male Infertility

Female Infertility

Infertility is increasing day by day.

Causes of Infertility (General)

Increasing age of partners

Smoking

Alcohol consumption

Multiple partners

Late marriages

Delay due to career settling

Along with traditional causes

Male Infertility

Causes

Inadequate semen volume

Low sperm count

Poor sperm motility

Other semen-related factors

Investigations

Basic semen analysis

Advanced semen test

Especially sperm DNA fragmentation

If fragmentation is more than 30%, infertility chances increase

Color Doppler study of both testes (if required)

Lower abdomen sonography

Important Clinical Point (Both Partners)

Doctors must delicately ask about proper physical relationship.

Many cases found where:

Husband and wife did not have proper contact

Doctors kept doing tests and treatments unnecessarily

Proper intercourse history and examination is very important

Female Infertility

Traditional Causes

Tubal blockage

Hormonal causes

Polycystic Ovarian Disease / Syndrome (PCOD/PCOS)

Endometriosis

Endometriosis

Description

Estrogen-dominant condition

Causes:

Painful periods

Painful intercourse

Fertility Aspect

Fallopian tubes may be open

Still pregnancy may not occur due to:

Pro-inflammatory pelvic condition

Treatment

Long-term and patient treatment

Treatment options:

Medicines

Laparoscopy

Procedures:

Removal of chocolate cyst

Adenomyoma tomy 

Polycystic Ovarian Disease (PCOD / PCOS)

Increasing Incidence

Increasing day by day

Types

Adolescent PCOS

Child-bearing age PCOS

Post-menopausal PCOS

Adolescent PCOS

Causes

Increased weight

Hormonal imbalance

Growth hormone issues

Lifestyle factors

Treatment

Diet control

Exercise

Lifestyle modification

Metformin

Oral contraceptive pills

PCOS in Child-Bearing Age

Investigations

Blood tests

Sonography

Hormonal tests:

FSH

LH

AMH

Thyroid

Prolactin

Treatment Based on Pregnancy Desire

If patient wants pregnancy:

Ovulation induction drugs

Tablets

Injections

If patient does not want pregnancy:

Oral contraceptive pills

Metformin

Insulin-sensitizing drugs

Vitamin D3

Approach to Infertility Treatment

Holistic and individualized approach

Identify whether:

Male factor

Female factor

If male factor excluded → focus on female

Possible causes to assess:

Tubal factor

Endocrine factor

Immunological factor

PCOS

Endometriosis

Treatment depends on:

Cause

Patient’s requirement (pregnancy or not)

Advanced Treatment Options

IVF

ICSI

IUI

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