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Infertility: Who Needs Treatment and Who Does Not!
The diagnosis of infertility is often not absolute, but it is important from the outset to identify the cause of the infertility problem to determine for whom IVF treatment is imperative, for whom it is advisable and for whom it is probably a matter of preference or convenience.
Infertility is defined as a failure to conceive even after a full year of regular intercourse. Fertile women under 36 years of age, who have fertile partners and have regular intercourse, will experience about a 16-18% pregnancy rate per month and approximately a 10-12% chance of having a baby from such a pregnancy. According to recent stats, in one year, approximately 70% women will conceive, shared Dr. Mini Kumari (Centre Head- Indira IVF centre in Begusarai)
What is important to bear in mind is that this still leaves about 30% of cases where, in spite of no obvious barrier to fertility, the woman still fails to conceive within a year. Why is this so?
The timing of intercourse is critical. It must occur immediately prior to ovulation, not after ovulation. The reason for this is that the detection of the ovulation hormone LH, in the urine (upon which this test is based) does not reliably pinpoint the exact time of ovulation. Indeed, ovulation begins within 38-42 hours of the spontaneous LH surge, but the LH only reaches the urine several hours later, and very often by the time the urine is tested, it might already have been in the bladder for several hours. This is especially common when testing for the LH surge is done upon awakening in the morning or late in the day. In such cases, the urine will have been pooled for some time before being tested and the women might in fact have ovulated many hours prior, thereby missing the fertility window. To know more precisely about infertility problems and need of IVF treatment, visit Indira IVF and consult our best IVF specialist in Begusarai.
The diagnosis of male infertility is often made on the basis of a single semen analysis and the parameters tested are based on sperm count, motility and morphology which are often “in the eye of the beholder”. Since at least 50% of infertility is reportedly due to “sperm dysfunction” and this diagnosis (especially in mild to moderate cases) is often inaccurate, it is easy to see how male infertility is often misdiagnosed, stated Dr. Mini Kumari (Centre Head- Indira IVF clinic in Begusarai)
Endometriosis, regardless of its severity, is invariably associated with a “toxic factor” present in the pelvic secretions. This toxin interferes with fertilization, thereby reducing the likelihood of pregnancy per month of trying by a factor of about 4–6. Such women have reduced fertility potential. They are not totally incapable of conceiving (sterile). In such cases the chance of pregnancy might be reduced from 16-18% per month (the normal) to 3-4%, and the chance of having a baby could be reduced from 70% in one year to about 40% within 3 to 4 years. This helps explain why many women with even mild endometriosis, where the doctor often states that the cause of infertility is “unexplained” often take longer than one year to conceive, and thus end up being labeled with the diagnosis of infertility, whereas in reality they have “reduced fertility”, confirmed - Indira fertility clinic in Begusarai
In case of absent or dysfunctional ovulation, women may, in spite of their condition, still experience intermittent functional ovulation, at which time they could still conceive on their own. It might take them longer to conceive but that does not mean that they are totally incapable of doing so.
There are women who have damaged, yet patent, fallopian tubes where the journey of the sperm, egg and embryo to reach their destinations is rendered much more difficult and hazardous. Since the intra-tubal environment is much less hospitable to the embryo than the uterus, embryos rarely will attach and grow inside the fallopian tubes (when they do, it results in an ectopic pregnancy, and can be very dangerous). As such, these women might take longer to achieve a pregnancy, but again this certainly does not mean that they are totally incapable of doing so on their own, stated Dr. Mini Kumari (Centre Head- Indira IVF, best IVF centre in Begusarai
So when should “infertility” be treated and when should we delay or avoid treatment? In answering this question, it is important to consider that waiting indefinitely might put some women completely out of the running. This is because the biological clock is relentless and cannot be “reset”. So it is that older women (with ever declining egg quality) and those who regardless of their age, have diminishing ovarian reserve (high FSH, low AMH and inhibin B, low antral follicle counts, etc.) do not have the luxury of waiting to see whether pregnancy will indeed occur on its own. They need to “make hay while the sun shines” lest by waiting, the opportunity should slip away. Also, since most couples are desirous of having more than one child, by waiting to have the first one, the rapidly ticking biological clock could make it far less likely that they will be able to have a second one. Thus, the sooner they get treated the better.
The same applies in case of existence of endometriosis, moderately severe male infertility or non-occlusive tubal disease which reduces the ability to conceive. Here again, time becomes important and even if such women might well have conceived on their own, they simply cannot take the chance of waiting and then running out of time, said Dr. Mini Kumari (Centre Head- Indira IVF, best IVF clinic in Begusarai)
There are however certain situations where the infertile couple is faced with the dire requirement of undergoing definitive Assisted Reproductive treatment (IVF-related). These include:
Totally blocked fallopian tubes
Inability of the male partner to produce any viable sperm
Failure to ovulate, due to hormonal imbalance or absolute ovarian failure (menopause).
The presence of high blood levels of antisperm antibodies (either the male or female)
Absence of, or severe disease of the uterus (here IVF is done using a gestational surrogate).
Intractable immunologic implantation dysfunction.
A case involved a young couple who had been trying to conceive for 4 long years. The male partner had a very low sperm count and poor motility. While awaiting IVF with intracytoplasmic sperm injection (ICSI), conception occurred. Unfortunately, she miscarried early in the first trimester and afterward, believing that she would again conceive on her own, tried for another 5 years to achieve pregnancy through natural conception. When this failed, she came for IVF with ICSI and soon conceived and subsequently gave birth to twins, shared Dr. Mini Kumari (Centre Head- Indira IVF hospital in Begusarai)
In summary, it is indeed an undeniable fact that infertility is often not synonymous with sterility. However, for reasons cited above, this does not mean that treatment should be withheld. It is also important to recognize the time and need of the treatment. Finally, it is well to emphasize that infertility treatment is thus often as important for the couple with reduced fertility as it is for the women with absolute sterility. For an affordable IVF cost in Begusarai district, talk to Indira IVF’s best IVF doctor in Begusarai and start your parenthood journey without a further ado.
Gynaecologist & IVF Specialist
Sometimes people are misled and misguided with superstitious and hence, we should attempt to debunk myths related to infertility. Also, proper counsel...