Sterility and its treatment

Sterility and its treatment Done by: Mariam Droubi.Submitted to:Dr. Mahmoud Halablab.

What is sterility test?A number of females and males are suffering from STERILITY .STERILITY means difficult or no conception and in other word it is inability on the part of the female or the male partner to produce any offspring. It should be noted that in man sterility and impotence are two different terms. Impotence means inability to sexually gratify a woman and sterility means inability to impregnate her. An impotent can be sterile. For conception, only the discharge of semen with living sperms is required. It does not matter whether the erection is strong or the retentive power is long or the female is duly satisfied. The sterility on the part of the male is the absence of living sperms in the semen. Either they are not present at all or are dead.Thus the first step to be taken is to get the semen tested before the cause is assigned to the sterility of the wife. If the semen is found lacking in sperms, a well qualified homeopathic practitioner can assist in producing them in plenty. However, if the semen is found quite normal then the cause should be treated out in the female.

Causes of sterility in males and females:Sometimes the cause is the presence of acidic secretions specially lactic acid in the vagina and soon as the semen is discharged all the sperms are killed as they cannot live in acid.Diet which is sour or rich in acids should be given up.Sometimes sterility is due to failure of the ovaries to yield the ova. Conception is only possible when sperm comes in contact with the ovum of the same side.Hypertrophy of the cervix.Sometimes sterility is due to the weakness of the uterus which is incapable of holding the fetus.Diabetes, ulceration of the uterus, fibroid tumors and enlargement of the uterus.Endocrinal deficiencies,obesity due to defective thyroid secretion.Malformation or destruction of tubes due to inflammatory condition like appendicitis.Atrophied testes.Defective seminal discharges , no sperms or undeveloped sperms or a few sperm non-motile sperms, this may be due to some previous or present disease of the testes, like mumps, tuberculosis, gonorrhea, syphilis.

Techniques Used to treat sterility:Laparoscopy.IUI: Intrauterine insemination.IVF/ICSI.Artificial Insemination (also known as Intrauterine insemination or IUI)How it works: Specially prepared ("washed") sperm is inserted directly into the uterus through a thin, flexible catheter during IUI, the most commonly fertility method. If you choose this method, your doctor might recommend that you take fertility drugs as well, to increase the chances of fertilization.Best for: Cases in which men have slow-moving or lower quality sperm or a low-sperm count. Also for women who have produced antibodies to their partners' sperm or whose cervical mucus is too scant, acidic, or thick to transport the sperm to the egg.

In Vitro Fertilization (IVF):How it works: Multistep process (called a cycle) in which eggs are extracted and fertilized with sperm in a lab. Once embryos develop, one or two are implanted in your uterus and the rest are stored.Best for: Older women or women with blocked or severely damaged fallopian tubes or scarring from endometriosis; men with very poor sperm quality; couples with unexplained infertility.

Intracytoplasmic Sperm Injection (ICSI):How it works: An embryologist selects a healthy-looking, single sperm from the male's semen and injects it directly into the egg with a microscopic needle. Once an embryo develops it's transferred into the uterus through IVF.Best for: Couples in which the man has a very low sperm count or poor sperm quality.

Reproductive Surgery:How it works: Surgery--sometimes requiring a hospital stay, sometimes done on an outpatient basis--is used to correct anatomical abnormalities, remove scarring and clear blockages in either the man or the woman.Best for: Couples with diagnosed diseases or abnormalities (such as endometriosis, wherein uterine tissue grows outside the uterus, causing scarring and blockages).

Efficacy of every type of treatment:Laparoscopy is cost effective in the initial management of young women with infertility, particularly when infertility treatment dropout rates exceed 9% per cycle.The success of IUI depends on several factors. If a couple has the IUI procedure performed each month, success rates may reach as high as 20% per cycle depending on variables such as female age, the reason for infertility, and whether fertility drugs were used, among other variables. While IUI is a less invasive and less expensive option, pregnancy rates from IUI are lower than those from IVF. If you think you may be interested in IUI, talk with your doctor to discuss your options.The use of IVF-ICSI to avoid disease transmission in HIV-1 serodiscordant couples desiring children yields high rates of success and appears to be safe. Best candidates appear to be women of younger age.

Conclusion:A thorough but time-efficient investigation of the infertile couple is required prior to a diagnosis of unexplained infertility. Couples should undergo a semen analysis, ovulation testing, assessment of ovarian reserve, and imaging to assess for tubal and uterine factors before a diagnosis of unexplained infertility is made. This workup can be completed within 1 menstrual cycle. In the couples with unexplained infertility, various treatment modalities are available, including expectant management with lifestyle changes, operative laparoscopy, COH (clomiphene citrate or gonadotropins) with IUI, and IVF (with or without ICSI). The optimal treatment strategy needs to be based on individual patient characteristics such as age, treatment efficacy, side-effect profile such as multiple pregnancy, and cost considerations.