Infertility

Infertility means the inability to conceive. It is different from sterility (absolute inability to conceive).

If a couple fails to achieve pregnancy after at least one year of “unprotected” and “regular intercourse”, it is an indication to investigate the couple.

• Unprotected—–i.e. without using any means that prevents conception.
• Regular Intercourse—i.e. timing should be such so that the ovulation period is not missed every month.

Types

• Primary infertility-Where conception has never occurred.

• Secondary infertility-When conception does not occur in spite of having produced a child or having an undoubted abortion.

Causes of infertility

In Males—

Semen Analysis

Normal Values–

• Total Volume = 3-5 ml
• Sperm Count = 60-120 million per ml
• Motility = 80-90%
• Morphology = 80% or more normal
• Liquification = 30 minutes
• pH = 7.2-7.8
• Fructose = 200-300 mg%
• Pus Cells = absent

Any deviation from the above parameters is considered abnormal.

Pituitary failure

• Frohlich’s syndrome
• Kleinfelter syndrome with 47 XXY chromosomes

Raised scrotal temperature

• Working in blast furnaces
• Wearing tight scrotal support
• Varicocele (confirmed by Doppler study)
• Ectopic testes(testes fail to descend to the scrotum, they are exposed to high temperature of abdominal cavity leading to less/no sperm genesis)

Testicular damage

• Accidental trauma(blow on testicles)resulting in haematoma formation
• Operative trauma(hernia, hydrocele, varicocele)
• Mumps, venereal diseases, tuberculosis
• Prolonged exposure to irradiation
• Neoplasm

5. Excessive smoking, alcohol consumption

6. Presence of antibodies causes agglutination of spermatozoa

Obstruction in the passage

This means bilateral obstruction causes azoospermia.

• Congenital lesions of the penile urethra(hypospadias)
• Absence or deformed vas deferens
• Damaged epididymis due to trauma, inflammatory diseases(gonorrhoea or tuberculosis)
• Occlusion of vas deferens due to surgery as in herniorrhaphy and bilateral vasectomy.

8. Chronic inflammatory disease of prostate and seminal vesicle.

In Females

Congenital defects

• maldeveloped vagina( non- canalization or occlusion by a septum
• non-developed vagina
• fetal type vagina
• congenital defects in fallopian tubes and stenosis
• rigid hymen
• elongated conical cervix with a pinhole
• acute anteflexion & retroflexion of uterus

Salpingitis

• Gonorrhoea
• Chlamydia
• Trachomatis
• Puerperal Infections
• Following Septic Abortions
• Tuberculosis Of Tubes

Dyspareunia

• Myoma
• Retroversion with prolapsed ovaries
• Inflamed appendages
• Pelvic endometriosis
• Urethral caruncle
• Vulvitis

1. Antispermal antibodies in cervical mucous
2. Genital tract infection
3. Pathological amenorrhea (ovarian deficiency)
4. Endocrine disorders
5. Pelvic inflammatory disease
6. Pelvic endometriosis
7. Chronic diseases
8. Hyperprolactinaemia
9. Hypothalamic and pituitary dysfunction
10. Chronic inflammations of the cervix
11. Asherman’s syndrome
12. Tuberculosis of the uterus
13. Corpus luteal defect
14. Fibroid

Treatment

Ayurvedic medicines cure infertility both in males and females. Treatment is cause based. As the cause so the treatment.

Male

• Surgical correction of varicocele and undescended testes improves semen quality. vaso-vasal anastomosis for obstructed vas.
• Medicines
• Artificial insemination

(IUI, IUTPI ,ICI, ITI, IVI)

Female

• Medicines
• Tubal microsurgery in case of tubal blockage
• IVF, ET in case of irreparably damaged tubes.