Are both male and female responsible for infertility?
Contrary to the popular belief that female factors predominate in infertility, today if you take 100 cases of infertility, 40 cases are attributed to females, 40 to males and 20 to both. Hence both husband and wife should visit the doctor together.
Is it true that male infertility is on the rise?
Yes, In the last decade or so, male sperm counts are falling. The exact cause is not known. Apart from medical causes, tight underwear, working near high temperatures, increased consumption of tobacco, smoking and gutka, extensive use of 2 wheelers, unknown drug interactions, environmental pollution and stressful living have been identified as possible co-factors for male infertility.
What are the common causes in males?
Varicocele, Hydrocele, undescended testis, hernia, tobacco, nicotine smoking, alcohol & drug abuse give rise to oligospermia (less sperm count). Congenital abs Vas or infections giving block of vas can give rise to obstructive azospermias. Testicular developmental problems give rise to non-obstructive azospermias (azospermia means NIL sperms), typhoid or STDS and of course unexplained infertility.
Why do couples delay medical help? What is their worry?
Mounting social pressure forces an infertile couple to seek treatment. The couples usually are afraid to face the reality ( Who is responsible?) The worry about the expensive treatment modalities and the different tests they may be subjected to. Normally 95% of couples can be treated successfully with simple counseling and simple hormonal Rx, planned relations and IUI ( Intra uterine Insemination). Only 5% of couples resolve advanced & expensive procedures such as IVF or ICSI.
What is the relationship between HIV & Infertility?
We test all infertility patients for HIV to protect our lab/patients and ourselves as handling of blood/semen entails risks. We do detect HIV the cases unsuspecting couples who seek infertility treatment. They are given necessary counseling and advises against child bearing. All semen donors are screened for HIV (including widow period) HbsAg, VDRL and genetic abnormalities.
How Common is the problem of infertility?
Infertility affects 2-3% of entire population and 10-12% of married couples. India is estimated to have about 12 million infertile couples.
Does delayed marriage lead to infertility?
Fertility reduces with age. Women are most fertile between 16-23 years of age. The fertility in men also reduces after 40 years. Hence late marriages have more chances of infertility.
What is your advise to modern day couples?
Marry before 30 years of age. Do not postpone children for too long. “Prove your fertility & then use contraception.”
When should a couple seek doctor’s help for infertility?
When a couple staying together with normal sex life without contraception does not conceive for one year they should consult a doctor. The older they are (by age), the earlier they should seek assistance.
What are the common disorders in females that contribute or cause infertility?
Ovulation disorders, ovarian failure, hormones deficiency, PCOD (Polycystic Ovarian Disease), endometriosis, tubal factor ( blocked tubes) due to infection, tuberculosis, uterine fibroids, uterine malformations. In some cases no cause is identifiable (on explained infertility)
What is the normal cost of investigation and treatment for an infertile couple?
Initial work up and hormonal profile costs about Rs. 3500-10000 per cycle depending upon hormones used for the couple; rFsn (recombirent Fsn) is costlier. Diagnostic hysterolaproscopy costs around Rs. 7000. IUI costs including injections works out to Rs. 3500-10000 per cycle. IVF costs Rs. 25000 per cycle. ICSI costs Rs. 35000 per cycle. In IVF and ICSI ( Cost of injection is extra and may come to Rs. 30000-50000/- depending on no. of injections. Our effort is directed towards making IVF / ICSI / IUI safe, affordable and result oriented. Our goal is to help nature achieve a successful pregnancy and our mission is to see a child in every barren arm and a smile on every childless couple’s face. Overseas patients have to pay 25% extra for improved services.
Are there any complications of IVF and related procedures?
IVF-ICSI is extremely safe as of today. However some complications can occur such as OHSS (Ovarian Hyper Stimulation Syndrome). In this, the ovaries produce too many follicles which causes fluid collection in the abdomen and hemodynamic abnormalities which require intensive management. Good and prompt treatment usually sets it right. Hospitalization is necessary at times.
What are the results of different procedures?
We have excellent results with our super ovulation. IUI Program success rates are around 35%, sometimes more. In IVF and ICSI our success rates are around 35-40%. There is also some foetal wastage in form of abortions. We have had 230 live births from IVF/ICSI so far in our ICSI program. So have faith in God and trust us you will get a baby.
Is there any hope for patients who have failed ICSI cycles?
Several patients conceive after failed ICSI, sometimes naturally, sometimes by IUI. We also have cheaper alternatives such as embryo donation and ovum donation program. then there is always donor insemination and of course adoption. So there is always hope for an infertile couple.