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Infertility Therapy

Infertility Therapy What is Infertility Almost all of us want to conceive a child at some point of life. However, due to factors such as unhealthy lifestyle, stress and physical inability, some couples face a hard time to do so.  Most couples (approximately 85%) will achieve pregnancy within one y... Read more...
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<h2 dir="ltr" style="text-align: justify;"><strong><span id="xxx" style="color: #333333; font-family: arial, helvetica, sans-serif;">Infertility Therapy</span></strong></h2> <h3 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>What is Infertility</strong></span></h3> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Almost all of us want to conceive a child at some point of life. However, due to factors such as unhealthy lifestyle, stress and physical inability, some couples face a hard time to do so.  Most couples (approximately 85%) will achieve pregnancy within one year of trying, with the greatest likelihood of conception occurring during the earlier months. Only an additional 7% of couples will conceive in the second year. As a result, infertility has come to be defined as the inability to conceive within 12 months. This diagnosis is therefore shared by 15% of couples attempting to conceive. We generally recommend seeking the help of a reproductive endocrinologist if conception has not occurred within 12 months. </span></p> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <h3 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>Types of Infertility</strong></span></h3> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Primary infertility refers to couples who have not become pregnant after at least 1 year having sex without using birth control methods.</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Secondary infertility refers to couples who have been able to get pregnant at least once, but now are unable.</span></li> </ul> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <h3 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>Causes of Infertility</strong></span></h3> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Many physical and emotional factors can cause infertility. It may be due to problems in the woman, man, or both.</span></p> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <h3 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>Female Infertility</strong></span></h3> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Female infertility may occur when:</span></p> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">A fertilized egg or embryo does not survive once it attaches to the lining of the womb (uterus).</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">The fertilized egg does not attach to the lining of the uterus.</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">The eggs cannot move from the ovaries to the womb.</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">The ovaries have problems producing eggs.</span></li> </ul> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Female infertility may be caused by:</span></p> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Autoimmune disorders, such as antiphospholipid syndrome (APS)</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Birth defects that affect the reproductive tract</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Cancer or tumor</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Clotting disorders</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Diabetes</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Drinking too much alcohol</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Exercising too much</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Eating disorders or poor nutrition</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Growths (such as fibroids or polyps) in the uterus and cervix</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Medicines such as chemotherapy drugs</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Hormone imbalances</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Obesity</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Older age</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Ovarian cysts and polycystic ovary syndrome (PCOS)</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Pelvic infection or pelvic inflammatory disease (PID)</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Scarring from sexually transmitted infection, abdominal surgery or endometriosis</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Smoking</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Surgery to prevent pregnancy (tubal ligation) or failure of tubal ligation reversal</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Thyroid disease</span></li> </ul> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <h3 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>Male Infertility</strong></span></h3> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Male infertility may be due to:</span></p> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Decreased number of sperm</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Blockage that prevents the sperm from being released</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Defects in the sperm</span></li> </ul> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Male infertility can be caused by:</span></p> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Birth defects</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Cancer treatments, including chemotherapy and radiation</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Exposure to high heat for prolonged periods</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Heavy use of alcohol, marijuana, or cocaine</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Hormone imbalance</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Impotence</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Infection</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Medicines such as cimetidine, spironolactone, and nitrofurantoin</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Obesity</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Older age</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Retrograde ejaculation</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Scarring from sexually transmitted infections, injury, or surgery</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Smoking</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Toxins in the environment</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Vasectomy or failure of vasectomy reversal</span></li> </ul> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <h3 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>Diagnosis</strong></span></h3> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">History and physical examination – First and foremost, your fertility physician will take a very thorough medical and fertility history. Your doctor may ask you many of the following questions: </span></p> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">How long have you been trying to get pregnant?</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">How often are you having intercourse?</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Do you have pain with menstrual periods or intercourse?</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Have you been pregnant before? What happened with your prior pregnancies?</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Have you had any sexually transmitted infections or abnormal pap smears? How often do you have menstrual cycles?</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Do you have any medical problems or prior surgeries? Do you have a family history of medical problems?</span></li> </ul> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">These and many other questions will help your physician design a specific evaluation and potential treatment for you. In addition to a careful history, a physical evaluation may also be performed.</span></p> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"><strong>Transvaginal ultrasound</strong><strong> –</strong> Ultrasound is an important tool in evaluating the structure of the uterus, tubes, and ovaries as it can detect uterine abnormalities such as fibroids and polyps, distal fallopian tube occlusion, and ovarian abnormalities including ovarian cysts. Additionally, transvaginal ultrasound affords the opportunity for your physician to assess the relative number of available eggs. This measurement is called the antral follicle count and may correlate with fertility potential.</span></p> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"><strong>Laboratory testing</strong><strong> –</strong> Depending on the results of the evaluation discussed above, your physician may request specific blood tests. The most common of these tests include measurements of blood levels of certain hormones such as estradiol and FSH, which are related to ovarian function and overall egg numbers; TSH, which assesses thyroid function; and prolactin, a hormone that can affect menstrual function if elevated.</span></p> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"><strong>Hysterosalpingogram (HSG)</strong><strong> –</strong> This test is essential for evaluating fallopian tubal patency, uterine filling defects such as fibroids and polyps, and scarring of the uterine cavity (Asherman syndrome). Many uterine and tubal abnormalities detected by the HSG can be surgically corrected.</span></p> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"><strong>Semen analysis </strong><strong>–</strong> The semen analysis is the main test to evaluate the male partner. There are four parameters analyzed:</span></p> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"><strong>semen volume</strong><strong> –</strong> should be at least 1.5 to 2 ml. A smaller amount may suggest a structural or hormonal problem leading to deficient semen production;</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"><strong>sperm concentration</strong><strong> –</strong> normal concentration should be at least 20 million sperm per 1 ml of semen. A lower concentration may lead to a lower chance for conception without treatment;</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"><strong>sperm motility or movement</strong><strong> –</strong> a normal motility should be at least 50%. Less than 50% motility may significantly affect the ability for sperm to fertilize the egg without therapy;</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"><strong>morphology, or shape </strong><strong>–</strong> there are three parts of the sperm that are analyzed for morphology: the head, midpiece, and tail. Abnormality in any of those regions may indicate abnormal sperm function and compromise the ability of sperm to fertilize the egg.</span></li> </ul> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <h3 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>How do Infertility Drugs Work</strong></span></h3> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <h4 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong> IN MEN-</strong></span></h4> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Stimulate hormone production</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Improve semen production</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Normalize blood sugar levels</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Stimulate blood flow</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Increase libido</span></li> </ul> <h4 style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>IN WOMEN-</strong></span></h4> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Stimulating ovaries to produce more eggs</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Control Ovarian hyperstimulation (superovulation)</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Preventing premature ovulation during assisted reproductive technology (ART) procedures</span></li> </ul> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <h3 style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>Common Medications</strong></span></h3> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Please note that these drugs are listed only for informational purpose.You should always check with your medical practitioner before using them. You are advised not to use them by yourself. However, if you use them on a regular basis, you can buy infertility drugs online from a reputed online pharmacy. </span></p> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <h4 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>FOR MEN</strong></span></h4> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Clomiphene</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Gonadotropins (hCG and hMG)</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Letrozole</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Synthetic testosterone pills, injections, or gels</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Bromocriptine</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Imipramine</span></li> </ul> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <h4 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>FOR WOMEN</strong></span></h4> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"></span></p> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Clomiphene citrate</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Letrozole</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Human menopausal gonadotropin (hMG)</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Follicle stimulating hormone (FSH)</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Human chorionic gonadotropin (hCG)</span></li> </ul> <ul style="text-align: justify;"> <li><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Gonadotropin-releasing hormone (GnRH) antagonists</span></li> </ul> <ul> <li style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Metformin hydrochloride</span></li> </ul>
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