A presentation on the basics of infertility diagnosis and management (assisted reproductive technologies)- aimed at educating public (non-clinicians).

2. INFERTILITY
The inability to conceive
within 1 year of
unprotected intercourse

3. CHANCES OF CONCEPTION
“Getting pregnancy is a game of
odds”
Only about 25% each month in a
normal couple
Over a period of 1 yr is 80 – 90%

4. CONDITIONS THAT WARRANT
EARLY TREATMENT
 Irregular Periods
 History of Pelvic Infection
 2 or more miscarriages
 Women over 35 yrs
 Men who had prostate
infection

5. INFERTILITY
DECLINING FERTILITY

6. INFERTILITY
AVERAGE BIOLOGICAL INFERTILITY COMMENCES
10YEARS BEFORE THE MENOPAUSE
• GRAPH

7. INFERTILITY
PREGNANCIES IN OLDER WOMEN
• GRAPH

8. IS INFERTILITY JUST A
WOMAN’S PROBLEM ?
ABSOLUTELY NOT !
 Problems are equally shared
between men and women
 35 % of problems lie with men,
35 % are women’s and
20 %combination of both
 10 % unexplained

9. INFERTILITY
CAUSES OF INFERTILITY: RELATIVE
INCIDENCE

10. CAUSES OF
I N F E R T I L I T Y

11. FEMALE

12. CAUSES OF FEMALE
INFERTILITY
 Problems in ovulation
 Age
 Obesity
 General medical illnesses
 Hormonal imbalance
 Thyroid & other hormones
 Pcos

13. CAUSES OF FEMALE INFERTILITY
(cont.)
 Tubal problems
 Tubal blocks
 Tubal disease

14. CAUSES OF FEMALE INFERTILITY
(cont.)

15. MALE
 Hormonal
imbalance
 Varicocele
 Abnormalities in
sperm
 Count
 Motility &
 abnormal
forms

16. TREATMENT
 Wait & Watch
 Medical treatment
 Surgical treatment
 Fibroids
 Endometriosis
 Ovarian cysts
 Varicocele repair for men
 Assisted Reproductive Techniques

17. ASSISTED REPRODUCTIVE
TECHNIQUES (ART)
 IUI
(Intra Uterine Insemination)
 GIFT
(Gamete Intra Fallopian Transfer)
 IVF
(In Vitro Fertilization)
 ICSI
(Intra Cytoplasmic Sperm Injection)

18. IUI
Placing competent sperm
into uterus
during ovulation days

20. IUI - SUCCESS RATES
Highly dependent on sperm
quality

21. IVF
Fertilizing eggs
with the sperms
in the Laboratory &
placing embryos
into uterus

23. IVF – INDICATIONS
 Tubal Infertility
 Male Infertility
 Advanced Endometriosis
 Ovulatory disorders
 Unexplained Infertility
 Immunological Infertility
 Failed IUI Treatments
 Donation of eggs and embryos
 Surrogacy

39. QUADRUPLETS

41. (Freezing)
• Eggs, Ovarian tissue
• Sperms
• Embryos

43. One live sperm
for one egg

50. PRE IMPLANTATION GENETIC
DIAGNOSIS ( PGD )
Testing 1 cell of the embryo
For a specific
Genetic disease

52. ART
Is it a sure shot ! No
 IUI – 10 – 15 % / cycle
- 40 % b7 5 – 6 cycles
 IVF – 30 % / cycle
 ICSI – 40 % / cycle

53.  10 – 15 % of couples
 1 in 8 may need help
How big is the problem !

55.  Falling sperm count
 Increasing incidence of infections
 Increasing age of woman at the
time of planning for pregnancy
Is the problem increasing ! Yes

56. Can it be avoided !

57.  Sexually Transmitted diseases
 Biggest preventable danger
 Using barrier methods
 Timely tests & treatment
Can this be avoided !

58. PREVENTIVE MEASURES
In Young Boys
 Early recognition of undescended
testis
 Surgery before 2 yrs of age
 Educating mothers
 Immunize against mumps

59. PREVENTION IN MEN
 Occupational hazards
 Radiation
 Industrial chemicals
 Anaesthetic gases
 Exposure to intense heat
 Long distance driving
 To avoid tight undergarments
 Review drugs
 BP, Ulcers
 Sperm freezing before cancer therapy

61. PREVENTIVE MEASURES –
IN WOMEN
 To approach physician early
 In case of severe cyclical pain
• To look for endometriosis
 Life-style measures - in polycystic ovarian disease
 Risk increase with obesity
 For proper contraception
 Avoid IUCD
 sterilization
 To avoid unnecessary surgeries
 like pregnancy termination
 removal of small cysts

62. GENERAL PREVENTIVE
MEASURES
 Stop smoking (even passive)
 Stop alcohol
 Stop drug abuse
 Limit caffeine intake
(Tea, coffee, soft drinks)

63. BODY WEIGHT - INFERTILITY
 Extreme weight levels
 High &
 Low contribute to infertility
 Fat cells secrete estrogen hormone
 High or low levels cause
hormonal imbalance

64. OBESITY
 Reduces sperm
count & also
 Affects egg
development
in women

65. TIPS FOR SELF HELP
 Diet control

66. Exercise

67. AGE OF WOMAN
 Fertility low from 30 & halved from
38 yrs. Of age
 Most fertile age is 24 – 28 yrs

69. BALANCING CAREER & FERTILITY
Plan at right time