TREATING INFERTILITY

Whatever may be the cause of infertility, it is now possible to have a baby of your own genes with the various methods of treatment available.

Male infertility is a problem that has been plaguing couples for a long time. Thanks to medical breakthroughs, today there are several methods to help couples conceive. According to consultant gynaecologist Dr Rishma Dhillon Pai, when a couple fails to conceive even a year after trying for a baby, it is labelled as infertility. “The man is responsible for infertility in 30 to 40 per cent of the cases. The semen analysis may show low sperm count or movement (normal is more than 20 million sperms/ ml and more than 50 per cent motility) or in some cases, no sperms in the semen sample,” she says.

Some of the common causes of male factor infertility are sexually transmitted diseases like gonorrhea or chlamydia, which may cause blockage of the tubes that carry the sperms. “Mumps in childhood can cause testicular damage and failure and absent sperms. A boy may be born with congenital absence of the vas or the testes may not come down into the scrotum at birth and this can cause damage to testes and failure of sperm production. Swelling of blood vessels around testes, surgery for hernia, hydrocoele can all lead to male infertility. There are many new treatments for male factor infertility whereby even men with no sperms or very few sperms can become fathers. When the count is at least 10 million, an intrauterine insemination (IUI) can be tried. Here the semen is washed by special methods in the laboratory and a small quantity of sperms are placed with a thin tube right inside the uterus (womb). This is a simple and inexpensive procedure,” says Dr Pai.

If the count is very low, then the procedure of choice is Intracytoplasmic Sperm Injection (ICSI), which is like a test tube baby procedure. “The woman’s eggs are removed with a needle under sonography control. The eggs are placed under a microscope and each sperm is picked up with a needle and injected directly into the egg with a micromanipulator. The eggs then fertilise and divide and after two to three days the embryo is put back into the womb of the wife. In cases where there are no sperms in the semen and if the man’s hormone test is normal, then the sperms can be removed directly from the testes with the help of a tiny needle. In some cases, there is complete testicular failure with abnormal hormones and no sperms are seen in the testes on biopsy. In these cases, the only treatment is to use donor sperms. These are taken from a semen bank where HIV, hepatitis B etc tested donor semen is banked. This is inseminated into the woman and one can obtain a high rate of pregnancy by this simple and inexpensive technique of donor insemination,” she says.

According to gynaecologist Dr Nandita Palshetkar, in our country, nearly 20 million couples suffer from infertility. “Those patients who don’t conceive even after three to four attempts of ICSI can opt for donor sperm. Today we can say that ‘no man is infertile.’ Whatever may be the cause of infertility, it is now possible to have a baby of your own genes with the help of Artificial Reproduction Techniques (ART). So consult your physician as soon as you feel there is some problem and do not waste time. Remember, it is very important not to attach blame to yourself or your partner, even if one of you is facing infertility. Scientific advancement in the infertility field is moving at a very fast pace and, hopefully soon there will be more answers to the problems faced by couples who desire to have their own children,” says Dr Palshetkar.