Mala and Female Infertility

Infertility is defined as the inability of a person to reproduce by natural means. According to WHO infertility is a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular contraceptive-free sexual activity.

Primary infertility:
infertility in a couple who have never had a child

Secondary infertility:
failure to conceive following a previous pregnancy (either aborted or carried up to full term)

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Major causes of infertility:
Male infertility – 20 to 30%
Female infertility – 20 to 35%
Male & Female infertility – 25 to 40%
Unexplained infertility – 10 to 20%
The consequences of infertility are manifold and can include societal repercussions and personal sufferings and may have psychological effects. Marital discord often develops, especially when they are under pressure to make medical decisions. In many cultures inability to conceive bears a stigma.

Causes from male partner:
Low semen quality –
Oligozoospermia
Asthenozoospermia
Teratozoospermia
Necrozoospermia
Aspermia
Orchitis
Varicocele
Hydrocele
Cryptorchidism
Trauma

Causes from female partner:
Ovulation problems – PCOD, PCOS, Menstrual irregularities, anovulatory cycles Pelvic inflammatory disease caused by infections like tuberculosis Tubal blockage Uterine problems – fibroids, bicornuate uterus, infantile uterus etc. Endometriosis –
Age – related factors

Other causes:
Sexually transmitted infections: TORCH, HIV, Herpes Antisperm antibodies in male and/or female
Diabetes mellitus
Thyroid disorder
Overweight or underweight
Tobacco smoking

Diagnosis: Primary investigations in male are testosterone and FSH levels, semen analysis, ultrasonography and testicular biopsy
Primary investigations in female are hormonal assay and ultrasonography to evaluate uterus, ovaries and fallopian tubes, follicular study, hysteroscopy and hysterosalpingogram and TORCH screen etc.