How can ICSI help in infertility?

Intracytoplasmic sperm injection (ICSI) is an advanced in vitro fertilization (IVF) procedure in which a single sperm is injected directly into the cytoplasm of a human egg. This treatment assists couples who are struggling with severe male infertility or have had past fertilization failure with conventional insemination. ICSI is frequently done by some fertility clinics for every IVF cycle, while others typically save the procedure for couples who have severe infertility issues.

Why do we need ICSI?

ICSI is the best method for couples struggling with infertility to overcome these challenges if they are experiencing any of the issues listed below:

• Oligospermia or a very low sperm count
• Asthenozoospermia, commonly known as low sperm motility
• Teratozoospermia, the term for sperm that are improperly formed
• Sperm retrieved through TESE or testicular sperm extraction
• Retrograde ejaculation
• Sperm that has been frozen is being used, but it doesn’t appear to be active
• Preimplantation genetic diagnosis, or PGD, is being used
• Unexplained infertility
• Fertilization of cryopreserved oocytes
• Advanced age of female partner
• Low oocyte yield

Related: How can male infertility be treated?

What are the procedures for ICSI treatment for infertility?

• The transvaginal oocyte retrieval process is used to remove oocytes from female donors.
• On the same day that the eggs are taken, the partner’s sperm is also obtained.
• A holding pipette stabilizes the oocyte or egg by gently sucking through a microinjector.
• A single sperm is carefully picked up after being immobilized by the tail being cut off with a sharp, sensitive, and hollow needle.
• The needle is used to inject the sperm directly into the cytoplasm, and it is then carefully removed.
• To stabilize the oocyte, the polar body is placed at the 12 or 6 o’clock position.
• The egg is put into cell culture, the next day it is examined for evidence of fertilization and then in following days the embryo is observed for the growth.

After the embryo is grown for 3 to 5 days, it is inserted into the woman’s uterus. Following that, a blood test is done for the confirmation of pregnancy after 14 days.

What is the success rate of ICSI in infertility?

The fertilization rate attained in the UCSF IVF laboratory, which is currently 80 to 85 percent, provides insight into the ICSI success rate.

Through ICSI, male factor infertility couples have achieved fertilization rates of 70 to 80% for all injected eggs, which is similar to fertilization with regular sperm. In couples without a male factor infertility, the pregnancy rates obtained by ICSI are comparable to those obtained through IVF.

Related : The Ultimate IVF Guide

Takeaway

Despite the fact that some medical professionals think ICSI causes birth malformations, it’s also possible that it does so because parents who undergo the treatment run the risk of developing abnormalities. If a person wants to undergo ICSI treatment, they should speak with their doctor, who can inform them about the procedure’s dangers and side effects.

 

 

Things to Consider Before Freezing Your Eggs

Egg freezing is a technique used to preserve women’s future fertility. Unfertilized eggs taken from your ovaries are frozen and kept to be used later in the future. It is possible to thaw a frozen egg, combine it with sperm in a lab, and transfer the embryo in your uterus (in vitro fertilization). 

How does egg freezing work?

Egg freezing is the act of extracting your eggs and freezing them so you can attempt pregnancy in the future through in vitro fertilization (IVF). If you’ve decided on egg freezing, you go through some of the same preliminary stages as those who undergo an IVF treatment:

• Step one: To increase egg production, fertility medications will be given to you. Your ovaries produce multiple eggs at once rather than just one when the hormones are injected. It’s known as ovarian stimulation.
• Step two: Your eggs will be removed from the ovaries after they are sufficiently matured. The treatment is typically conducted painlessly while you are sedated. This is a day-care procedure and requires hospitalization for  a short time.
• Step three: When the eggs are retrieved, they are frozen until you are ready to try to conceive in the future.
• Step four: The eggs are thawed and combined with sperm when you’re ready to try for pregnancy. Any developing embryos are then transferred to the uterus for implantation.

Why is it done?

Egg freezing can be done if you’re not ready to get pregnant right now but want to make sure you can get pregnant in the future. You can consider freezing your eggs if:

• You have a disease or situation that can impair your fertility.
• You require medical attention for cancer or another condition that might impair your ability to conceive.
• You want to preserve your younger eggs now for future use.

How many eggs are frozen?

The total number of eggs that are frozen will vary depending on the individual and the quantity of viable eggs produced during ovarian stimulation.

What should you consider before egg freezing?

Here are a few key points to consider before freezing your eggs: 

• It’s better to freeze your eggs when you’re young: Your ovarian reserve of eggs will be higher and healthier when you are young. As a result, you’ll have a better probability of getting pregnant. You can learn about your ovarian reserve and whether or not you should choose egg freezing from your doctor by taking a fertility hormone test. It is advised against egg freezing for women over the age of 38.

• There may be some side effects: Although the surgical method for freezing eggs is generally painless, it could result in slight discomfort. Due to the ovaries growing to make room for numerous increasing follicles with a maturing egg in each, the hormone injections may result in bloating and moodiness. Occasionally, in very few cases the hormone levels may get too high and it can result in ovarian hyper-stimulation syndrome (OHSS). The signs and symptoms include vomiting, nausea, and weight gain.

• There’s no guarantee of successful pregnancy: According to some research, there is only a 2–12% probability that a single frozen egg would result in a live birth. There haven’t been many studies done on this, though. The quality of the male partner’s sperm, the thawing process, and the viability of the eggs all have a role in whether or not a pregnancy using frozen eggs will be successful.
• You may need more than one procedure: According to study, you need to freeze several eggs, say about 15, to have a decent chance of becoming pregnant in the future. But whether a woman produces enough eggs in a single cycle depends on her ovarian reserve, her age at the time, and how her body reacts to stimulation. 

Takeaway

Making decisions concerning your fertility can easily leave you feeling stressed. We can assist you in taking immediate action so that you can determine whether or not egg freezing is something you would want to think about. If you choose to store your eggs and use them later, for instance, knowing your current AMH levels, which represent your ovarian reserve, can help you predict the effectiveness of IVF as well as ovarian stimulation, the process by which you take hormone therapy to produce eggs.

 

What Are The Various Tests Performed Before Undergoing IVF?

IVF is one of the most popular infertility treatments used for helping couples who are trying to conceive. The decision to undergo in vitro fertilization procedure depends on a variety of factors. A woman’s suitability for IVF is determined by a series of tests that are done before the procedure. 

These IVF tests are done so as to find out the reason for infertility so that, proper course of treatment can be decided and any additional treatment if required planned. These tests also ensure that the couple do not have any type of disease or infection which may impair the result.  

Different tests performed before IVF are as follows:

Semen Analysis

A sample of sperm will be taken and submitted to a facility for testing in order to perform a semen analysis. The morphology, motility, count, and concentration of the sperm can all be determined with a semen test. If the semen parameters are altered like low count, motility and/or the normal morphology is poor then, ICSI may be recommended by the doctor. ICSI is a cutting-edge technique that includes injecting sperm into the egg.

Ovarian Reserve Testing

It is a blood hormone test that enables the IVF specialist to determine the total number of eggs in ovaries that is her ovarian reserve. The hormones which are mostly tested are  FSH, AMH, and estradiol. The doctor usually performs these tests on the day 2 or 3 of the menstrual cycle. Out of these blood tests AMH or Anti mullerian hormone is the most reliable test used for estimation of ovarian reserve.

Infectious Diseases Screening

An IVF specialist frequently requests that couples or donors undergo viral markers screening when getting ready for pregnancy through assisted conception treatment. The specialist will perform tests to check for infectious disorders like HIV, Hepatitis B, Hepatitis C, Chlamydia, Rubella, etc. before moving on with IVF. This is due to the fact that the disorders can impact the fetus’ growth and cause complications in the future.

Uterine Cavity Examination

Abnormalities of the uterine cavity could contribute to subfertility or continuing implantation failure, among other things. Your fertility specialist would advise the uterine cavity assessment before the IVF procedure. The endometrial lining, ovaries and uterine cavity  are scanned using transvaginal ultrasound. Hysteroscopy may be required in cases of recurrent implantation failure, recurrent miscarriages or in patients where abnormality is detected by ultrasound. 

Prolactin and Thyroid Hormones

The primary hormone for generating breast milk is prolactin, and high levels of this hormone can have an impact on pregnancy. Thyroid hormones are helpful for various metabolic activities. Pregnancy might also be impacted by thyroid hormone levels that are higher or lower. This test helps the IVF specialist in selecting the appropriate medications to balance hormone levels.

Mock Embryo Transfer

The procedure of embryo transfer has to be smooth with minimal handling of cervix, as manipulations may lead to uterine contractions which have adverse effect on outcome of the procedure. Mock embryo transfer is done with the embryo transfer cannula to determine the direction of cervical canal and uterus. As a result, the specialist will take the necessary precautions if required to customize the actual procedure.

The tests listed above are important tests carried out to determine whether IVF is the best course of treatment for you. All these tests help to make sure that there is a higher chance of conceiving with IVF treatment.

 

Blocked Fallopian Tubes Treatment

The fallopian tubes are two tubes, one on each side of the uterus, that picks up the released egg from ovaries, allows sperm to enter in the fallopian tube, fertilization and early development of embryo occurs here. The embryo then moves towards the uterus with the help of hair-like structure in the fallopian tubes. If fertilization doesn’t occur the egg gets degenerated. When a blockage, such as scarring, an adhesion, or an infection, prevents the movement of sperm/egg/embryo in the tube, it is said to have a blocked fallopian tube, which is also referred to as tubal factor infertility. A blocked fallopian tube may affect fertility.

What are the symptoms of blocked fallopian tubes?

People who have blocked fallopian tubes rarely show any symptoms. Many people with this issue believe their fertility is normal. It’s not always the case. The first “symptom” of blocked fallopian tubes is often infertility.

Blocked fallopian tubes can occasionally cause a mild, ongoing abdominal ache on one side. This may occur in a hydrosalpinx, a form of blockage. When a blockage causes the tube to expand or grow, and fill with fluid, the condition is known as hydrosalpinx. 

Blocked fallopian tubes can have a variety of causes, some of which may also have unique symptoms. For instance, painful menstruation and painful sexual activity may be brought on by endometriosis and pelvic inflammatory disease, both of these diseases may affect the tubes.

How does a blocked fallopian tube affect fertility?

One common reason for infertility is blocked fallopian tubes. In the fallopian tube, sperm and an egg come together to fertilize. And when there is a blockage in the fallopian, it prevents the sperm and egg from meeting.

You might be able to conceive with one or both partially blocked fallopian tubes. But the chance of an ectopic pregnancy rises. However, without medical help, pregnancy will not be possible if both tubes are completely blocked. 

What are the causes of blocked fallopian tubes?

Pelvic inflammatory disease is the most typical cause of blocked fallopian tubes. Although not all pelvic infections are connected to STDs, but sometimes pelvic inflammatory disease is the outcome of a sexually transmitted disease. Additionally, even in the absence of PID, a history of PID or pelvic infection raises the possibility of blocked tubes.

Blockage of the fallopian tubes can also result from:

• Chlamydia and gonorrhea can result in pelvic inflammatory disease and scarring.
• Pelvic inflammatory disease can cause scarring or hydrosalpinx.
• Endometrial tissue can accumulate and block the fallopian tubes.
• Past ectopic pregnancy can scar the fallopian tubes.
• Fibroids can grow and block the fallopian tube, particularly, when they grow near the opening of fallopian tubes into the uterus
• Past abdominal surgeries, especially on the fallopian tubes themselves, can lead to pelvic adhesions that block the tubes.

How to diagnose a blocked fallopian tube?

A hysterosalpingogram(HSG) or Sonosalpingography (SSG), is a test to check for the patency of fallopian tubes. 

One of the primary fertility tests that every couple having trouble getting pregnant gets is an HSG or SSG. A small tube is used to inject a dye or saline into the cervix during the test. The dye should pass through the uterus and fallopian tubes before spilling out around the ovaries and into the pelvic cavity if everything is normal. X-rays of the pelvic region are taken after the dye has been injected in HSG. Similarly, pelvic ultrasound is done to see if saline is present in the pelvic cavity. But if the dye doesn’t get past the tubes, then you may have a blocked fallopian tube.

Your doctor may use laparoscopy to perform additional testing if the tubal patency test  is unable to provide a conclusive diagnosis. 

How to treat blocked fallopian tubes?

Your doctor may perform laparoscopic surgery to remove any scar tissue or adhesions that are blocking your fallopian tubes and open them. However, it may not be able to treat the blockages in your fallopian tubes if there is a significant amount of scar tissue or adhesions present. 

Surgery may be an option to restore tubes that have been harmed by an infection or ectopic pregnancy. Here is what you need to know about surgery for blocked tubes:

• Laparoscopic Surgery: Laparoscopic surgery may often be able to clear scar tissue or unblock blocked tubes. Unfortunately, it isn’t always effective. The possibility of success is influenced by your age, the position and severity of the blockage, as well as its underlying cause. The likelihood of becoming pregnant following surgery is good if there are only a few adhesions between the tubes and ovaries.
• In Vitro Fertilization: Women with blocked tubes had no other alternatives for getting pregnant before the introduction of in vitro fertilization (IVF), especially if repair surgery didn’t work or wasn’t an option. IVF has made it possible for such women to get pregnant as the fertilization occurs in the lab so the work of fallopian tubes are bypassed.

Takeaway

When only one fallopian tube is blocked, it may still be possible to conceive naturally or with minimal medical assistance. Surgery or IVF treatment, however, can be required when both tubes are blocked.

Following treatment for blocked fallopian tubes, pregnancy is possible. However, the type of treatment you receive and how severe the block is will affect your chances of getting pregnant.  The likelihood of a successful pregnancy increases if the blockage is close to the uterus. If the blockage is at the fallopian tube’s end, close to the ovary, the success percentages are lower. 

 

Oligospermia: Symptoms, Causes & Treatment

When a person’s sperm count is below the standard set by the World Health Organization (WHO) for healthy sperm counts—15 million sperm per milliliter of semen—this condition is referred to as oligospermia or oligozoospermia. Oligospermia, which is characterised by a low sperm count, can affect your ability to conceive naturally.

What are the causes of Oligospermia?

It’s normal for your sperm count to change over the course of your life, especially as you become older. However, a person’s risk of oligospermia can also be increased by health issues and lifestyle choices.

• Varicocele: Varicocele, or enlarged veins in the scrotum, can reduce testosterone production, impair spermatogenesis that is sperm production, and cause oxidative stress, all of which can have a detrimental effect on sperm count. Nearly 15% of males have a varicocele, making it a rather prevalent condition. Since the symptoms of varicocele are normally modest, it often goes unrecognised during adolescence.
• Exposure to heat: Heat exposure has the potential to generate oxidative stress and impairment of sperm production, which has been demonstrated to have an adverse effect on semen parameters. A drop in sperm count, motility, and viability is linked to heat stress, which can be caused by sitting for lengthy amounts of time each day, using saunas or hot baths, positioning computers or other heat-producing gadgets close to your genitals, or dressing tightly.
• Exposure to toxins and radiation: The quantity of sperm can be significantly impacted by radiation exposure as well as by contact with chemicals, metals, pesticides, and petrochemicals. You may have a higher chance of acquiring low sperm count if you work in the military, agriculture, pesticides, plastic manufacturing, tobacco processing, or welding industries, among others.It has been established that individuals who work in these type of  high-risk workplaces not only have lower sperm counts but the quality of the and sperm is also affected.
• Hormone imbalance: Numerous hormones, including testosterone, follicle-stimulating hormone, and luteinizing hormone, are responsible for male fertility. These hormones, along with a few others, are crucial for the development of sperm. Your sperm count along with other sperm health parameters may alter if any of these hormones are out of balance.
• Smoking, Drugs and Alcohol use: It has been found in various studies that smoking not only reduces the number,motility and morphology of the sperm but also has adverse effects on DNA material of sperm. The use of various drugs, such as cocaine and marijuana, may lower sperm counts. Drinking too much also has the same effect.

What are the signs and symptoms of oligospermia?

The main sign or symptom of oligospermia is the inability to conceive a baby with a partner after one year of unprotected sexual intercourse.

How does oligospermia affect fertility?

Some oligospermic men can still conceive even though their sperm counts are low. However, fertilisation might be more challenging. It can take more tries than it would for couples without a  fertility issue.

Men are more likely to experience various fertility problems as a result of some of the most typical oligospermia causes. This involves issues with sperm motility. 

Sperm motility describes how active the sperms are. Active sperms can easily swim in the direction of an egg. However, sperms may not travel sufficiently to reach an egg if they have abnormal motility.

How is oligospermia diagnosed?

Analysing the semen is the main diagnostic procedure for oligospermia. A lab technician does a semen analysis by examining a sample of semen under a microscope to count and evaluate the sperm. A condition like oligospermia or azoospermia is normally diagnosed by two consecutive abnormal semen analyses.

Most of the time, a person with oligospermia won’t be aware of it until they start trying to conceive and have trouble.

How to treat oligospermia?

Depending on your situation, several oligospermia treatment options may be used:

• You may require surgery to close off enlarged veins in order to redirect blood flow to the testicles if a varicocele is the cause of your oligospermia.
• You could need correction of hormones if a hormone imbalance is the cause of your oligospermia in order to increase sperm production and restore a healthy balance.
• You might require a course of treatment if you have a virus or bacterial infection in order to get rid of the infection and inflammation. The treatment may not help the sperm count improve depending on how far advanced the infection is, but it can stop further declines in sperm count.
• Your sperm counts might increase with weight loss and appropriate weight maintenance. Additionally, it might lower your risk for a variety of other illnesses. Stop smoking, using tobacco, alcohol, and other substances to increase sperm production and to stop further damage to sperms.

How to conceive with oligospermia?

There are various treatment modalities available for conception. However, the final line of treatment is decided after evaluating the couple. 

• Intrauterine insemination (IUI): In this fertility procedure, sperm is washed (processed) and then put right into the patient’s uterus. IUI can increase the likelihood of pregnancy for people with mild to moderate oligospermia, according to studies. IUI is an excellent first-line treatment choice before attempting more invasive or expensive techniques like IVF and ICSI because it is one of the least invasive and least expensive assisted reproductive therapies.
• In vitro fertilization (IVF): For the purpose of encouraging fertilisation outside of the body, this process requires extracting oocytes from the ovary and combining them with sperm. The embryos are grown in the lab for three to five days.Then the embryo/ embryos are transferred into the uterine cavity. IVF success rates can vary based on the age of the female partner, quality of embryo etc.  
• Intracytoplasmic sperm injection (ICSI): In this form of treatment, single sperm is injected in an egg for fertilization and placed in an incubator. Then, like IVF the embryos are grown in the lab for three to five days and then transferred into the uterus . According to one study, the pregnancy rate for individuals with oligospermia is 36.4%. ICSI can be a promising assisted reproductive method for persons who have low sperm count as a result of an obstruction (such as those with obstructive azoospermia).

PCOS & Pregnancy Complications: What should be done?

Women with polycystic ovarian syndrome(PCOS) who are pregnant need to be more cautious about potential complications as compared to women without PCOS. It is widely known that women with PCOS are more likely to experience problems during pregnancy and delivery. An increased chance of early pregnancy loss and gestational diabetes are the two main side effects of PCOS in pregnancy.

However, maintaining a healthy weight and controlling weight gain before and throughout pregnancy can reduce the risk for several pregnancy problems.

What are the other pregnancy complications in women with PCOS?

Women with PCOS and their prenatal babies are more likely to face specific complications, such as:

• Miscarriage: Numerous studies indicate that women with PCOS have an increased risk of miscarriage, although some researchers link this risk to other elements such as obesity, advanced age, and the usage of fertility treatments. An increased risk of unexpected miscarriage may also occur in women taking ovulation-inducing medications as compared to those women who ovulate regularly. Some studies have shown that  intake of tablet metformin can lower the risk of miscarriage in pregnant women with PCOS.
• Gestational Diabetes: An increase in the mother’s blood sugar levels during pregnancy is known as gestational diabetes mellitus (GDM). This kind of diabetes typically develops in the second half of pregnancy and blood sugar levels return to normal after 12 weeks of pregnancy. However,if the blood sugar level remains high even after 12 weeks of delivery then the patient has Diabetes mellitus.These patients have increased chances of developing GDM in future pregnancies and also are at higher risk of suffering from diabetes in future. GDM-affected mothers frequently have larger-than-average babies and thus are at higher risk for cesarean delivery. Metformin usage before and during pregnancy lowers the rate of developing gestational diabetes in patients with PCOS.
• Preeclampsia: Pre-eclampsia is defined as a new onset of increase in blood pressure during pregnancy after 20 weeks of gestational age and proteinuria, that is protein in the urine, or a new onset of increase in blood pressure during pregnancy after 20 weeks of gestational age with end organ dysfunction with or without proteinuria. Patients may or may not have any symptoms  like swelling of legs and/or hands, excessive weight gain, headache etc. It is a serious disorder which can develop into eclampsia if untreated, which can lead to kidney and liver damage, seizures, and in rare instances, even death. The most crucial preventive step you can take is to keep your blood pressure within normal limits. Make sure to check in with your doctor if you experience any changes in your health while pregnant.
• Gestational Hypertension: Gestational Hypertension is a pregnancy-related high blood pressure after 20 weeks of gestational age. Unlike preeclampsia there are no proteins excreted in the urine. Twelve weeks following delivery, blood pressure frequently returns to normal. Your chance of developing gestational hypertension can be reduced by lowering your high blood pressure, losing at least 10% of your weight pre-conception  if you are overweight or obese, and engaging in regular exercise.
• Preterm Birth: Women with PCOS are more likely to deliver preterm babies, especially if their blood levels of androgen are high. This risk is increased in cases of multiple pregnancies. Multiple pregnancy, history of previous preterm delivery, incompetent cervix, and hypertensive disorders are a few of the factors that contribute to preterm birth.
• Cesarean Delivery: Women with PCOS have a higher risk of pregnancy and neonatal problems, which frequently requires cesarean or C-section delivery. 

What care do women with PCOS need during pregnancy?

• Regular Exercise: Walking for 10 to 20 minutes after eating can help manage postprandial hyperglycemia, which in turn helps manage blood pressure and insulin resistance. Additionally, yoga has been proven to be particularly useful in enhancing PCOS and fertility. It’s essential to remember that while yoga won’t treat PCOS, it will make you feel closer to your body, help you get your hormones back in check, and possibly even improve blood flow to your pelvis.
• Balanced diet : A nutritionist can be consulted for a balanced diet. This personalised healthy eating plan makes sure you obtain the nutrients you need, put on the proper amount of weight, and keep your blood sugar under control. The most crucial thing is to make sure your diet is full of foods rich in essential nutrients, and has balanced carbohydrates, fat and  protein. Your best bet is to stay away from processed and junk food.
• You may require frequent visits to the doctor during pregnancy so that if needed timely diagnosis and treatment of complications can be made.As discussed above, intake of tablet metformin plays an important role in preventing complications secondary to PCOS in pregnancy. Thus, it is important to take this medicine regularly along with other medication in the prescribed dose by your doctor.
• Blood sugar: Glucose tolerance test is recommended for all pregnant females who are at risk of developing diabetes in pregnancy for example patients with obesity, history of GDM in previous pregnancy or family history of diabetes. Even if the glucose tolerance test comes within normal limits, it is important to check blood sugar values regularly if you are at high risk for developing GDM. Ask your doctor what your blood glucose readings should be. 
• Blood Pressure: Your blood pressure is usually checked at every visit to the hospital. However, it is better if you can monitor your blood pressure if you are at high risk of developing hypertension in pregnancy or preeclampsia for early diagnosis and treatment. Consult your obstetrician if the readings at home are coming higher than normal range.

It’s crucial to prepare your body and maintain its health before getting pregnant. Although it may be challenging, making additional efforts to enhance your health will have a positive impact on both the result of your pregnancy and the wellbeing of your unborn child.

While PCOS may affect your fertility and pregnancy, conception and a healthy pregnancy is still possible with the correct care and treatment!

How can male infertility be treated?

If a man and a woman have regular unprotected sex for over a year and the woman doesn’t get pregnant then either one, or both of them may have infertility issues. Male infertility is a common issue and the process of conception could be challenging. Fortunately, having infertility problems does not prevent you from having a child of your own. There are procedures and medications that can increase the likelihood of conception.

Must Read: 10 Ways to Support Baby’s Brain Development in the Womb

How common is male infertility?

One in eight couples experience difficulties conceiving or maintaining a pregnancy. One-third of infertility causes are generally attributed to the female partner, one-third to the male partner, and one-third to a combination of issues affecting both couples.

High amounts of environmental contamination, such as pesticides, herbicides, and water pollutants, are likely to cause male infertility. While infertility has not significantly increased recently, several studies claim that sperm levels have been dropping globally.

What causes male infertility?

• Genetic diseases: For example, Klinefelter’s syndrome, myotonic dystrophy, microdeletion etc.
• Drugs: Including a few prescription medications, anabolic steroids, alcohol, and marijuana, as well as certain antibiotics.
• Chronic Disease: Such as diabetes, cancer, some autoimmune disorders, cystic fibrosis, malnutrition, anemia or history of mumps in childhood.
• Varicocele: A condition where the veins in the scrotum enlarge which may affect the number and motility of sperm.
• Diseases of the male genital tract: Includes  cancer, infection, or injury.
• Surgery on the male genital tract: Inguinal hernia or a testicle-removal operation.
• Hormonal disorders: Male infertility may be impacted by conditions that affect your hypothalamus or pituitary gland.

What are the symptoms of male infertility?

Being unable to conceive is the only symptom of male infertility.

How is male infertility diagnosed?

Male infertility issues are typically diagnosed by:

• Medical history and examination: Your doctor will inquire about any hereditary disorders, ongoing health issues, illnesses, injuries, or surgeries that may have an impact on your fertility. Your doctor will examine your genital area to look for any undiagnosed problems. Additionally, your doctor might inquire about your sexual behaviours and how those changed as you approached puberty.
• Semen analysis: There are several techniques to collect samples of semen. You can submit a sample by masturbating and ejaculating into a special container provided at the clinic. In certain circumstances, semen can be obtained by using a unique condom during sexual activity.

After that, the semen sample is examined in a lab to see if their number, motility and morphology are normal. Your semen will also be examined in the laboratory for signs of issues including infections.

Which males are most likely to have infertility?

 A male may have a higher chance of being infertile if:

• He is obese or overweight.
• He has been exposed to radiation.
• He has been exposed to toxins found in the environment, such as lead, calcium, pesticides, or mercury. 
• He is currently using a number of drugs, such as cyproterone, flutamide, spironolactone, bicalutamide, cimetidine, or ketoconazole.
• He has a history of undescended testicles.
• He has a history of varicoceles, which are widened veins in your scrotum.
• He has been exposed to testosterone.
• He uses tobacco, marijuana or alcohol.
• He has a history of mumps

How is male infertility treated?

There are now more treatment options available for male infertility. Infertility treatments might vary depending on the underlying cause, such as:

Medications:

• Hormone therapy can help to boost sperm production.

Lifestyle changes:

• Keep your weight within a healthy range.
• Give up smoking.
• Give up drinking.
• Abandon marijuana use.
• Stop using drugs recreationally.

Surgeries:

• Sperm Retrieval: If the semen analysis shows no sperm in ejaculate, then sperm must be found through a testicular biopsy. There are various surgeries which can be performed like Percutaneous epididymal sperm aspiration (PESA), Testicular sperm aspiration (TESA), Testicular sperm extraction (TESE),  Testicular sperm aspiration (TESA ) and Microsurgical testicular sperm extraction (Microdissection TESE). The sperm found through these methods can be used with the spouse’s egg for fertilization through intracytoplasmic sperm injection (ICSI) or can be frozen for future if conception is not planned immediately. 
• Vasectomy reversal: This common surgery is used in patients with a history of vasectomy to undo the procedure. The vas deferens, the scrotal tube through which your sperm travels, is reconnected by the surgeon. The surgeon delicately stitches the ends of the vas deferens back together while using a high-powered surgical microscope to observe it so that the sperm may travel back into ejaculate.
• Vasoepididymostomy: A similar method is used to clear blockages in your epididymis. The blockage is surgically removed, the ends of the tube are rejoined.

Other methods:

• Intrauterine insemination: This method can be used in patients with erectile dysfunction or with below average sperm count or mild motility or morphology issues. In this method semen sample is collected in a sterile container, prepared in the iui lab and transferred into the  female partner’s uterus using IUI cannula after her follicle is ready egg is matured and released, which is monitored through ultrasound.
• In vitro fertilization: In vitro fertilisation (IVF) is the treatment of choice for some couples coping with male infertility. Injectable fertility drugs are used during IVF to stimulate the ovaries and enhance the maturation of eggs. When the eggs are ready, a day care oocyte retrieval  procedure is carried out to collect them.  The eggs are exposed to sperm in a culture plate. After that embryos are grown in the lab for three to five days, then a tiny catheter is inserted through the cervix to transfer the embryo/embryos into the uterus.
• Intracytoplasmic sperm injection: This treatment is known to have helped even the most severe cases of male factor infertility. Similar to IVF procedure the female is prepared  using injectable fertility drugs followed by oocyte retrieval.  One sperm is directly injected into each mature egg, through a procedure known as intracytoplasmic sperm injection. Then the embryos are grown in the lab for three or five days and transferred to the uterus. 

With advancement of medical science there are chances of conception even in patients with severe male factors to have an offspring of their own. If you are facing any difficulties in conception then it is better to approach fertility specialists and discuss your problems as early as possible.

Are you trying to Conceive? Here are the best tips to increase your chances 

A woman trying to conceive typically has a low probability of getting pregnant each month. However, the majority of women become pregnant within the first year of trying, and others may require medical assistance.

Mentioned below are some of the best tips, techniques and other factors that can help improve your chances of getting pregnant.

Track your menstrual cycle

A woman who wants to become pregnant should keep track of the time between her cycles to see if it is regular—that is, if the first day of her period usually occurs the same number of days apart each month. 

If your periods are regular, you will ovulate about two weeks before your next period. This indicates that you will have a fertile window of seven days prior to your anticipated ovulation. If your periods are irregular, it could be a little trickier to anticipate when you’ll ovulate and what your fertile window will be.

However, you can try a variety of methods to determine your ovulation and fertile window like:

• Ovulation predictor kit: Ovulation predictor kit can be easily used at home. However, it may have some false negative results.
• Follicular monitoring: Follicular monitoring documents follicle but you have to go to the clinic for this.

Take a Preconception Checkup

Get a checkup before you start trying to conceive. Being in good general health is important for both partners before trying for pregnancy. Visit your primary care physician for a checkup to make sure you don’t have any hidden health problems that might cause problems in your pregnancy. Females over the age of 35 years should get themselves checked as the chances of getting pregnant decreases with age.

Take a prenatal vitamin

One of the simplest ways to help in conception is by taking a prenatal vitamin every day. It can also be a standard multivitamin as long as it contains essential components like folic acid. Prenatal vitamins with a high folic acid content can aid in embryo development and lowers the risk of neurological birth abnormalities. Your partner can either consume a male fertility supplement free of additions to testosterone or daily multivitamin and a supplement containing Coenzyme Q-10.

Maintain a healthy body weight

Being overweight or underweight may lower a woman’s chances of getting pregnant. Body Mass Index (BMI) is a useful measure that can help you determine what weight is healthy for your height, but it’s not perfect because it loses accuracy when it accounts for factors like muscle mass or those who are very tall or short. When you begin attempting to conceive, try to be within 15% of your ideal body weight.

Have sex at the right time

Make sure you have intercourse during the fertile window, which is five days prior to ovulation, on the day of ovulation and a day after ovulation when you are most likely to become pregnant. By having intercourse during these days, you increase the likelihood that sperm will be present in your body when your egg is released, giving you the highest chance of becoming pregnant. 

Quit your smoking habits

Both men and women who smoke can experience issues with conception. Nicotine and carbon monoxide, two substances present in cigarette smoke, have effects on both eggs and sperm. However, exposure to passive smoke has also been related to an increase in pregnancy problems. Similarly, research suggests that marijuana use may have a deleterious effect on female fertility.

Quit alcohol consumption

When a woman is trying to get pregnant, it is best for her to completely avoid alcohol. If a woman decides to stop using birth control because she wants to get pregnant, she should also give up drinking. According to some research, having just two drinks per day can cause a 60% reduction in fertility. Alcohol is also associated  with birth defects of the baby. 

Limit your caffeine intake

According to some research, drinking more than 500 mg of caffeine per day, or roughly five cups of coffee, has a bad impact on fertility. Limit your daily caffeine intake to 200 milligrammes or roughly two cups of coffee. Also keep in mind that foods like soda, tea, energy drinks, chocolate, and supplements may also contain caffeine which is why you should carefully read your labels.

Eat healthy food

There isn’t one special food that will help you get pregnant. You should prioritize consuming a range of fruits, vegetables, complex carbs, and lean proteins. There are also certain foods that you must avoid while trying to get pregnant like refined carbs, processed meats like hot dogs, too many carbohydrates, and fish that are high in mercury including canned tuna, frozen swordfish, tilefish, and shark.

Exercise 

Exercise or yoga can lift your mood, tone your muscles and skin, support heart health, and also raise your chances of getting pregnant. Even making the effort to walk rather than drive or use public transportation, taking stairs instead of using the lift will help if you don’t have time for the gym. While exercising is said to be good for a woman trying to conceive, however, excessive exercise can also harm fertility.

Takeaway

The most important factors while trying to conceive are knowing your cycle, having a healthy lifestyle and observing your most fertile days. When you don’t get pregnant right away, it can be difficult, but try not to be stressed and follow the tips mentioned above. 

However, if you don’t get pregnant after 1 year of trying, you should consult a fertility specialist to identify the cause and for treatment of individualized guidance to increase your chances of getting pregnant.

PCOS & Endometriosis: What is the difference?

Both PCOS and endometriosis are common disorders in females. Endometriosis and polycystic ovary syndrome (PCOS) are mainly conditions that affect the female reproductive organs. Endometriosis can affect the ovaries, the uterus, and other organs, such as the bladder and intestines, whereas PCOS only affects the ovaries.

According to a 2018 study, Endometriosis affects between 70 percent of women who experience persistent pelvic discomfort. It is estimated that 10 to 15% of women have it. According to a 2017 study, 5 to 20 percent of women of reproductive age have PCOS.

Endometriosis Vs. PCOS

Even though endometriosis and PCOS have similar symptoms, they are two distinct diseases. While PCOS is a metabolic condition, endometriosis causes persistent pelvic pain. 

 

What is Endometriosis?

The condition known as Endometriosis results in the endometrium, the tissues that line a woman’s uterus, starting to grow outside of the uterus. The lining of a woman’s pelvic cavity, fallopian tubes, and ovaries can all be impacted by this endometrial tissue. For some women, this illness can be crippling and causes severe pain.

What is PCOS?

Women who have excessive androgen, or male sex hormone, production in their ovaries are said to have polycystic ovarian syndrome. These women also start to form tiny, fluid-filled follicles around the eggs in their ovaries. Women of all ages can develop PCOS, although those between the ages of 15 and 45 are most likely to have it.

What are the symptoms of Endometriosis & PCOS?

 

PCOS and Endometriosis both have some similar symptoms, such as excessive bleeding and trouble becoming pregnant. However, the majority of the symptoms vary.

Endometriosis:

• Heavy bleeding
• Bleeding between periods
• Difficulty getting pregnant
• Painful periods
• Pelvic pain before periods
• Pain during or after sex
• Painful urination or bowel movements
• Digestive issues
• Fatigue
• Low energy

PCOS:

• Heavy bleeding
• Irregular periods
• Missed periods
• Pelvic pain
• Excess body hair
• Hair loss on head
• Difficulty getting pregnant
• Acne
• Oily skin
• Dark, thickened skin
• Weight gain
• Bleeding without ovulation

Sometimes, these disorders might also exist without any symptoms. The symptoms can occasionally be vague or misdiagnosed.

What are the causes of Endometriosis & PCOS?

The exact causes of endometriosis and PCOS are not entirely understood by medical professionals. However, researchers have discovered a few potential causes.

Endometriosis:

• Retrograde menstruation: In retrograde menstruation, shed tissue reaches the pelvic cavity through the fallopian tubes, clings to tissue there, and forms ectopic endometriosis lesions.

• Weak immune system: Endometriosis might manifest in people with immune system issues or people having weak immune systems.

• Lymphatic or vascular system spread: Endometrial transit via the lymphatic system may be possible if shed endometrium is implanted in ectopic areas.

• Coelomic metaplasia: The mesothelial lining of the visceral and abdominal peritoneum contains specialized cells that undergo metaplasia and give rise to endometriosis.
• Surgery: Endometrial tissue may inadvertently move during some surgical procedures, such as a cesarean (C-section) or hysterectomy.

PCOS:

• Insulin resistance: Both obese and lean PCOS share the common trait of insulin resistance. It happens in 70-95% of obese PCOS patients and 30-75% of lean PCOS patients.
• Hormonal imbalance: PCOS may be exacerbated by high amounts of several hormones, including testosterone.

What are the risk factors for Endometriosis & PCOS?

 

Endometriosis:

• History of endometriosis in the family
• Starting menstruation before age 11
• Infertility
• Menstrual cycles lasting less than 27 days
• Severe menstrual bleeding that lasts longer than 7 days

PCOS:

• History of PCOS in the family
• Diabetes
• Sudden weight gain
• Being obese or overweight

How to diagnose Endometriosis & PCOS?

A number of tests are necessary to confirm the diagnosis of PCOS and endometriosis.

Endometriosis:

• Pelvic exam: Using this exam, a doctor can check for cysts or scarring behind the uterus.

• Imaging test: As MRI can help detect tiny locations of endometriosis, particularly around the intestine and pelvic ligaments, it is frequently used in combination with pelvic ultrasound.

• Blood test: A blood test known as the CA125 test measures the blood’s levels of the CA125 blood protein, which is also used to identify a specific protein present in the blood of endometriosis-affected women.

• Laparoscopy: A surgical technique known as laparoscopy enables a physician to access the belly and pelvis from the inside without having to make significant skin incisions.
• Medical history: If you have any family members who have endometriosis, your doctor will inquire about those issues as well.

PCOS:

• Pelvic exam: Using this exam, a doctor can check for cysts or scarring behind the uterus.

• Medical history: If you have any family members who have PCOS, your doctor will inquire about those issues as well.

• Ultrasound: Your uterus and ovaries can be visualized with ultrasound technology to check cysts.
• Blood test: Blood tests that show inflammatory marker readings that are abnormally high could be a sign of PCOS.

Can you have PCOS & Endometriosis at the same time?

 

Yes, it is possible to have both PCOS and endometriosis simultaneously. According to a 2015 study, endometriosis diagnoses are more common in women with PCOS.

Doctors think that the extra androgens and insulin, which result in excess estradiol, are to blame when a woman has endometriosis and PCOS at the same time. When levels of the hormone estradiol rise, women are more likely to develop endometriosis.

How to treat Endometriosis & PCOS?

For those who have endometriosis or PCOS, medications, surgery, and lifestyle modifications can reduce their symptoms and enhance their quality of life.

Endometriosis:

• Hormonal birth control
• Medication for pain
• Surgical removal of tissue
• Lifestyle changes

PCOS:

• Medication
• Lifestyle changes
• Hormonal birth control
• Weight management

Takeaway

Despite being distinct gynecologic disorders, endometriosis and PCOS are both chronic, challenging to treat conditions. 

When endometrial tissue leaves the uterus and harms other organs, endometriosis develops. However, PCOS manifests as numerous ovarian cysts and unusually increased androgen levels.

Infertility and masculine characteristics are side effects of PCOS. PCOS and endometriosis are treated with drugs, surgery, and lifestyle modifications. Both conditions are curable, but only through treatment.

 

यौन संचारित संक्रमणों का प्रजनन क्षमता पर गंभीर प्रभाव पड़ सकता है। यह एक पुरानी स्थिति है, जब अनुपचारित छोड़ दिया जाता है, तो यह कई प्रकार की समस्याएं पैदा कर सकता है। एसटीआई से संबंधित संक्रमण पुरुषों और महिलाओं की प्रजनन क्षमता पर नकारात्मक प्रभाव डाल सकते हैं।

महिलाओं की तुलना में पुरुषों में एसटीआई से संबंधित बांझपन कम आम है क्योंकि पूर्व में लक्षणों की संभावना अधिक होती है।

STI (एसटीआई) से संबंधित बांझपन

पुरुषों और महिलाओं में एसटीआई से संबंधित बांझपन या यौन संचारित संक्रमण बांझपन पाया जा सकता है। महिलाओं के लिए, यदि एसटीआई का इलाज नहीं किया जाता है, तो यह फैलोपियन ट्यूब में निशान और सूजन का कारण बन सकता है।

इसके अलावा, महिला शरीर के विभिन्न प्रजनन अंगों पर भी इसका नकारात्मक प्रभाव पड़ेगा। नतीजतन, शुक्राणु के लिए अंडे की यात्रा करना कठिन हो जाता है।

फैलोपियन ट्यूब स्कारिंग एक्टोपिक गर्भावस्था के जोखिम को और बढ़ा सकता है। एक्टोपिक गर्भावस्था एक प्रकार की अनिर्धारित गर्भावस्था है। यह एक ऐसी स्थिति है जहां अंडा निषेचित हो जाता है और गर्भाशय के बाहर प्रत्यारोपित हो जाएगा।

चूंकि गंभीर लक्षणों की उपस्थिति तक एक्टोपिक गर्भावस्था का पता नहीं लगाया जाता है, इससे घातक स्थितियों का खतरा हो सकता है।

पुरुषों में यौन संचारित संक्रमण भी देखे जा सकते हैं। जब स्थिति का इलाज नहीं किया जाता है, तो यह मूत्रमार्ग और एपिडीडिमिस को नुकसान पहुंचाएगा। इन अंगों को नुकसान होने से बांझपन का खतरा बढ़ सकता है।

कौन से एसटीआई प्रजनन क्षमता को प्रभावित कर सकते हैं?

जैसा कि ऊपर बताया गया है, यौन संचारित संक्रमण प्रजनन क्षमता को महत्वपूर्ण रूप से प्रभावित कर सकते हैं, पुरुषों और महिलाओं दोनों के लिए। नीचे कुछ सामान्य यौन संचारित संक्रमण दिए गए हैं जो प्रजनन क्षमता को प्रभावित करेंगे:

1. क्लैमाइडिया

क्लैमाइडिया पैल्विक सूजन की बीमारी के प्रमुख कारणों में से एक है। इससे आपकी प्रजनन क्षमता पर सीधा असर पड़ सकता है जिससे बांझपन की संभावना दोगुनी हो जाती है। यह उन मूक संक्रमणों में से एक है जिसका ऊपरी जननांग पथ पर प्रभाव पड़ेगा।

यह फैलोपियन ट्यूब, गर्भाशय और अन्य अंगों को स्थायी रूप से नुकसान पहुंचाएगा। यह उन सभी अंगों को प्रभावित करेगा जो बच्चे को पैदा करने के लिए जिम्मेदार हैं। क्लैमाइडिया के प्रमुख जोखिमों में से एक यह है कि यह कोई लक्षण नहीं दिखाता है।

संक्रमण की अनुपस्थिति से इसका पता लगाना मुश्किल हो जाता है। हालांकि, क्लैमाइडिया के कुछ सबसे सामान्य लक्षणों में श्रोणि में असामान्य स्पॉटिंग और दर्द शामिल हैं।

महिलाओं को भी असामान्य निर्वहन का अनुभव होने की संभावना है। पुरुषों के लिए, क्लैमाइडिया निविदा या सूजे हुए अंडकोष की ओर ले जाएगा। क्लैमाइडिया होने पर पुरुषों और महिलाओं दोनों को दर्दनाक सेक्स का अनुभव होने की संभावना है।

2. हरपीज

हरपीज दुनिया भर में सबसे आम वायरस में से एक है। जननांग दाद न केवल बांझपन का कारण है, बल्कि गर्भपात भी है। यदि आपके पास जननांग दाद है, तो आप इसे अपने बच्चे को भी पारित कर सकते हैं। हालांकि इससे जीवन-धमकी की स्थिति होने का खतरा बढ़ सकता है।

अधिकांश यौन संचारित संक्रमणों की तरह, जननांग दाद कोई लक्षण नहीं दिखाता है।

हालांकि, जो लक्षण दिखाते हैं, उनमें दर्दनाक छाले और घाव शामिल हैं। जननांग दाद का कोई उचित इलाज नहीं है। आप अपने लक्षणों को प्रबंधित करने और जननांग दाद को नियंत्रण में रखने के लिए डॉक्टर से परामर्श कर सकते हैं।

3. एचआईवी (HIV)

एचआईवी, या मानव इम्युनोडेफिशिएंसी वायरस, प्रतिरक्षा प्रणाली को कमजोर करने के लिए जिम्मेदार है। इसलिए, यह प्रतिरक्षा प्रणाली को कमजोर और किसी भी बीमारी से लड़ने में असमर्थ बनाता है। एचआईवी एड्स का कारण बनता है, जो प्रतिरक्षा प्रणाली को पूरी तरह से नुकसान पहुंचाता है।

इसलिए, शरीर किसी अन्य संक्रमण से लड़ने में सक्षम नहीं होगा। यदि आपको एड्स है, तो आपके बहुत बीमार होने की संभावना है।

कुछ सामान्य लक्षण जो आपको यह समझने में मदद करेंगे कि आप एचआईवी से संक्रमित हैं या नहीं, उनमें सूजन लिम्फ नोड्स, रात को पसीना, बुखार, अचानक वजन कम होना, मांसपेशियों में दर्द और त्वचा पर बैंगनी रंग के धब्बे दिखाई देना शामिल हैं।

4. माइकोप्लाज्मा

यह यौन संचारित संक्रमणों के सबसे आम रूपों में से एक है। माइकोप्लाज्मा संक्रमण से महिलाओं में बांझपन होता है और पीआईडी भी। यह गोनोरिया या क्लैमाइडिया जितना सामान्य नहीं हो सकता है, लेकिन यह बेहद हानिकारक हो सकता है। इसके अलावा, माइकोप्लाज्मा पुरुषों में प्रजनन क्षमता को भी कम करता है।

5. उपदंश (Syphilis)

सिफलिस सबसे आम यौन संचारित संक्रमणों में से एक है। हालांकि एंटीबायोटिक दवाओं की खोज के बाद यह स्थिति पहले नहीं रही, लेकिन यह काफी आम हो गई है। पिछले कुछ वर्षों में, सिफिलिस के मामलों की संख्या में उल्लेखनीय वृद्धि हुई है।

सिफलिस एक संक्रामक स्थिति है जिसमें लंबी अवधि के लिए कई तरह की जटिलताएं हो सकती हैं। इसलिए, उपदंश भी संभावित रूप से बांझपन होने के जोखिम को बढ़ा सकता है। उपदंश के लक्षणों में नाक से पानी का स्राव, बढ़े हुए जिगर, दर्दनाक सूजन, बढ़े हुए प्लीहा और लिम्फ नोड सूजन शामिल हैं। यह जननांग घावों के जोखिम को भी बढ़ाएगा।

यदि आप भारत में आईवीएफ उपचार कराना चाहते है तोह बेस्ट इनफर्टिलिटी क्लिनिक को चुने, फर्टीसिटी फर्टिलिटी क्लीनिक, साउथ दिल्ली। हजारों रोगियों को सर्वोत्तम परिणाम देने के अनुभव के साथ, हम भारत में सबसे नैतिक आईवीएफ केंद्र के रूप में पहचाने जाते हैं।