Aspect
Male Infertility Factor
Amongst primary infertile couple male factor appears to be responsible in 30 to 40 percent. One-half of these men experience irreversible infertility and cannot father children. Remaining One-half of these cases have a treatable medical condition. Infertility can result from a condition that is present at birth (congenital) or can develop later (acquired).
Sperm development (spermatogenesis) takes place in the ducts (seminiferous tubules) of the testes. Cell division produces mature sperm cells (spermatozoa) that contain one-half of a man's genetic code this genetic material are present in head of sperm. Each Sperm development cycle consists of six stages and each takes about 16 days to complete to produce one mature sperm. Each sperm’s tail has energy-generating mitochondria, present inside them which enable them to swim inside female reproductive canal.
In the middle of the menstrual cycle, the cervical mucus becomes watery.
xamination called: postcoital test(sperm-mucus interaction test) is important and can gives us idea that 1)whether enough semen was delivered to the cervix;2) the sperm are able to swim through the female reproductive tract and are energetic or not 3) sperm are healthy or not: do not show large numbers of motionless, or dead cells. Intercourse is recommended during this time to have conception.
Common causes for male infertility are: Disease Of Testes, Infection, Testicular Trauma, Defect Or Obstruction In Reproductive tract, Hormone Dysfunction, Previous Medications or infections, Metabolic Disorders, Systemic disease of body, Varicocele. These causes Produces 1) impaired sperm production, 2) impaired sperm delivery, and 3) testosterone deficiency.
Male examination and testing is easy. A thorough examination and a review of the man's medical and surgical history are necessary. Assessing reproductive-fertility history is important. Physical examination may detect testicular irregularities, evidence of hormonal disorders, or evidence of testosterone deficiency.
A semen analysis usually performed. The following parameters are assessed:
- Volume (total volume of ejaculate)
- Standard semen fluid test (thickness, color)
- Morphology (sperm shape; normal structure associated with sperm health)
- Motility (or mobility; % sperm movement)
- Concentration (sperm/milliliter; cc)
- Total motile count (total number of moving sperm)
Azoospermia is the absence of sperm in the semen. Men with normal reproductive tracts and hormone systems can have azoospermia due to a lack of sperm-producing tissue in the testes or an obstruction.
Drug therapy for male infertility can improve sperm production and make sperm qualitative and more mature so that conception takes place. Alternative medicine has got high role and there are good medicine available which can give satisfactory result.
Herbal Homeopathy treatment corrects Spermatogenesis by making harmony in hormone as well as other associate urological condition. In Oligospermia homeopathic treatment is ideal for patient with minimum 2 million sperm count with zero motility and more than 90 % abnormal sperm morphology. If sperm count is less than 1 million than treatment period is more.
Psycho Social Aspects of Infertility
Most couple simply take it for granted that they will be able to have children. They take conception for granted, and assume that pregnancy will happen when the time is right. Unfortunately, this is not always the case. In fact, one in six couples trying to have a baby will experience problems in doing so. People are often shocked when they discover that they are infertile and commonly at beginning go through a period of disbelief. Few others rush into treatment without proper diagnosis and planning. Infertility is often described as a life crisis. The overall impact of infertility on individuals differs greatly, and is influenced by many factors such as cultural background; individual life gets up… etc. Infertility is often associated with numerous tests, multiple fertility treatments, and increasing financial strain. For men facing infertility, the going can be especially difficult. Infertility is generally seen as a woman’s issue, and therefore many men may not be getting the emotional support they need when struggling with male infertility
Shock is often the first emotion that occurs after a diagnosis of infertility. Most of us grow up with the idea that if we work hard, we can achieve anything. Unfortunately, this is not always the case with infertility. Along with shock, feelings of denial may come. Denial can lead to ineffectual treatment or even prevent treatment from ever happening.
Secondly at some point during fertility treatments, couple experience anger. Anger is a normal and healthy response but few enter in to physical or emotional confrontation.
Guilt and blame are other common emotions. This can lead to severe depression, isolation, and self-esteem problems… couple may blame partner for being unable to have a child, or blame others around, including friends or family members. Unspoken guilt and blame can make life very difficult.
Couple feels utterly alone. For them it can be hard to talk to others about feelings. They might also find it increasingly difficult to go to work, socialize, or even get out of bed and meet family. Other feelings such as worthlessness, difficulty sleeping or sleeping too much, lack of interest in activities or relationships, change in appetite, weight loss or gain, alcohol or drug, thoughts of suicide may also be present.
It can be difficult to deal with the wide range of emotions that infertility can bring. Women undergoing fertility treatments are at a high risk for developing depression. Not only do they require time and money, but also intense emotional commitment. This depression can lead to numerous physical side effects and put a strain on relationships, work, and enjoyment of daily life. That is why it is very important to receive help for depression.
First suggestion is cope with the emotion and talk with an infertility specialist who has the expertise to help emotional problem. An infertility specialist is trained to manage a number of different problems related to the infertility. Counseling sessions can often help bring these emotions to light in a supportive environment. An infertility specialist may be able to open the honest conversation between couple. One-on-one therapy may also be beneficial in helping to eliminate negative thought patterns and behaviors. Different strategies can work for different people and be appropriate for those particular stages of the infertility.
Talking with partner is one of the best ways to address depression. Support groups designed for infertility can often be very helpful. These support groups can provide the opportunity to speak with other infertile couple.
Try to view the treatment as a process journey. Remain positive but don't expect to see results right away. Undoubtedly family and friends want to be there to support through this challenging time. Get Involved in Life. It is important not to lose sight of your everyday activities or pursuing an activity that interests you.
There are a number of different treatments available to help manage depression. They are often used in combination with one another to provide the best results. Complimentary alternative therapies including prescription medications, homeopathy and herbal supplements, are available and can help couple leave the fog of depression behind.
When a couple receives treatment for infertility, whether it be medical or alternative therapy, they must decide at what point to discontinue treatment if a pregnancy is not achieved. While some couples may not consider treatment and simply accept their situation - infertility, other couples may spend years trying every possible technique available to realise their dream of having a child and that can add more and more stress. Deciding when to stop treatment can allow people to learn to accept their infertility and pursue other options such as adoption or living a child-free life and find the sources to live enjoyable life.
Cervical Factor Infertility
The tip of the uterus that extends into the vagina is called the cervix. As a part of natural defense mechanism, during most of the month, thick mucus plugs is there in cervix which does not allow out side foreign matters to enter uterus. Around time of ovulation, because of a rising estrogen levels, the cervical mucus become thinner and thus makes it easier for sperm can enter and swim up into the uterus. After the coitus external os bathe in the seminal pool.
Once sperm are ejaculated into the vagina they must swim through the cervical mucus, pass the cervix, and enter the uterus. Their final destination is the end of the fallopian tube, where fertilization occurs. Abnormalities in the cervical mucus can slow, damage, or destroy sperm.
Some women also have an abnormal narrowing of the cervical opening called cervical stenosis or the cervical canal may be obstructed by a polyp this can also interfere with both infertility testing and procedures.
Anatomic defects like congenital elongation of the cervix, second degree uterine prolapse and acute retroverted uterus prevents the sperm to enter. These conditions prevent the external os to bathe in the seminal pool.
Few women may have abnormally thick cervical mucus which can make it harder for conception. A test known as a post-coital test (PCT) can be performed within 6 hours of intercourse, just prior to ovulation timings, to see if the mucus is thin and stretchy, and to see if motile sperm are present within the mucus. The presence of motile sperm and normalcy of cervical mucus are the parameters for a normal post-coital test (PCT).
The post coital test has been the traditional method for identifying cervical factor infertility. It involves collection of a specimen of cervical mucus (by aspiration with a syringe) shortly before the expected time of ovulation and 2 - 4 hours after intercourse. The PCT includes both a gross and microscopic examination to grade mucus characteristics and to assess the number and motility of surviving sperm.
Normal Cervical Mucus:-
- Ferning - When the cervical mucus dries on a microscope slide, it should take on the appearance of ferns. This assures that the mucus has been exposed to adequate levels of estrogen without any exposure to progesterone.
- Amount - Cervical mucus production normally increases dramatically just prior to ovulation.
- Clarity - It should be very clear, almost watery.
- Cellularity - There should be relatively few cells present, other than sperm.
- Spinnbarkeit - This is the stretchiness of the cervical mucus. It should be almost elastic and may stretch 10 cms or more.
There is a direct relation between the plasma oestradiol concentration and the individual cervical score
The most common explanation for poor results or a "negative" PCT is improper timing, cervicitis (inflammation of the cervix), previous injury to the endocervical, and treatment with antiestrogens (clomiphene citrate).
Possible explanations for the absence of motile sperm in good quality mucus include ineffective coital technique, failed ejaculation, poor semen quality, and use of coital lubricants that may be toxic to sperm.
It is possible that the female produces antibodies to the sperm. The body "mistakes" the sperm for invading pathogens and the immune system produces antibodies to destroy them. This is essentially the same reaction seen when the body’s natural defense mechanism identifies a foreign bacteria or virus.
Results of the post-coital test- PCT can be correlated for successful treatment of infertility. PCT can also be judge as parameter for success in treatment of infertility. In women having an abnormal PCT, the sperm are then unable to penetrate the mucus and can have failure of treatment of infertility. An abnormal PCT with proper timing should be repeated to be corrected and have a normal one for successful outcome. |
