Infertility Treatment
A. INTRA UTERINE INSEMINATION (IUI)
Management and treatment of Infertility involves the following procedures:
1) Medical 2) Surgical 3) Assisted Conception {ART, IUI & IVF- ICSI}
- Medical correction of the hormonal imbalances like hypothyroidism, endocrinological disorders of the polycystic ovaries, hyperprolactinemia etc.
- Surgical intervention involves operative procedures like laparoscopy, hysteroscopy to detect and correct problems like removal of peritubal adhesions, fibroids, cysts in the ovaries, uterine septum & polyps & tubal dysfunction etc.
- Assisted Conception : Intra-uterine insemination (IUI) : The objective of IUI is to introduce a concentrate of semen into the female uterus thereby increasing the chances of fertilization. Couples seeking IUI treatment are properly counseled.
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INDICATIONS OF IUI “MALE PARTNER”
- Mild to moderate deficiency in semen parameters such as count, motility & morphology of sperms
- Ejaculatory dysfunction - semen is collected using electro-ejaculator
- Impotency
- Anatomical defects like hypospadias
- High seminal viscosity
- Elevated antisperm antibodies and sperm agglutination
- Retrograde ejaculation
- INDICATIONS OF IUI “FEMALE PARTNER”
- Unexplained Infertility
- Sub clinical tubal dysfunction
- Cervical mucus incompatibility
- Minimal to moderate endometriosis
- Antisperm antibodies in the cervix
- Psychological and psychogenic sexual dysfunction like vaginismus
| STEPS OF IUI TECHNIQUE
Empty the bladder
Patients are made to lie in dorsal lithotomy position
The semen sample is concentrated and cultured with nutrient culture media under all aseptic precautions in the lab
Semen is loaded in IUI catheter and 0.4 ml of the volume is inseminated into the uterus
It is injected slowly over 1-3 minutes to avoid back flow
Patient is asked to lie for only 2 minutes which is sufficient time for the sperms to disperse
Post IUI, support with progesterone is given for 2 weeks and continued if female gets pregnant
Urine Pregnancy Test (UPT ) is done 14 days after IUI
Patient is advised to report to the doctor if severe cramps or fever develops
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B. IN VITRO FERTILIZATION (IVF)
This is the most widely practiced assisted conception procedure in the world and in simple terms means fertilizing the eggs outside the body and transferring the resulting embryos in the uterus for implantation.
INDICATION OF IVF-ET
Female factors
A) Self Ooctyes
Bilateral tubal obstruction
Severe Endometriosis
Unexplained long term infertility
B) Donor Ooctyes
POF (Premature Ovarian Failure)
Poor Response to ovulation
Male Factors (ICSI + IVF)
Severe Oligozoospermia
Severe Asthenozoospermia
Azoospermia- where testicular or epidydmal sperm are retrieved
STEPS OF IVF-ET
- Ovulation induction
- Egg retrieval
- Sperm preparation and fertilization
- Fertilization
- Embryo transfer
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