Infertility is a common condition with important psychologic, economic, demographic, and medical implications. Demand for infertility services has grown substantially even though the prevalence of infertility has been stable. This phenomenon may be due to entry of the "baby boom" generation into the reproductive age group during a period of highly publicized technologic advances, and unparalleled publicity given to fertility issues in the lay press.

1. Dr. Laxmi Shrikhande MD; FICOG; FICMCH;FICMU
 Director-Shrikhande Fertility Clinic, Nagpur
 Senior Vice President FOGSI 2012
 Chairperson HIV Committee FOGSI 2009-12, Received best FOGSI
committee award
 Peer Reviewer-The Journal of OB / GY of India FOGSI
 Publications-Eleven National & seven International
 Editor-FOGSI Focus on HIV in women
 Editor-FOGSI Focus on SUI- Myths & Facts
 Presented Papers at FIGO, AICOG,
SAFOG, AOFOG conferences

2. Overview of Infertility

3. Infertility – A Global ProblemInfertility – A Global Problem

4. Approx 1
in 6
couple
are
affected
by
infertilit
y

5. Causes of Infertility-Couple

6. Causes of Infertility-Women

7. How to evaluate?

8. Overview of Evaluation
• Female
– Ovary
– Tube
– Corpus
– Cervix
– Peritoneum
• Male
– Sperm count and function
– Ejaculate characteristics, immunology
– Anatomic anomalies

9. Tubal Function
• Indications-
– PID
– Previous pelvic surgery
– Secondary infertility
– Fibroids / endometriosis / polyp
• Tests
– HSG
– Sonosalpingography
– Laparoscopy

10. Anovulation
• Clomiphene- total 6 cycles in her entire
lifetime
• Letrozole
• Gonadotrophins
Baseline scan

11. Male Factors

12. Male Factors-Semen Analysis
• Collected after 3 days of abstinence
• Evaluated within one hour of ejaculation
• If abnormal parameters, repeat twice, 2
weeks apart

13. Clinical semen collection
• MESA
• TESA
• PESA
• TESE
• Vas deferens aspiration
• Spermatocele aspiration

14. Unexplained Infertility
• 5-10% of couples
• treatment:
– Ovulation induction
– IUI
– IVF and its variants
• Adoption

15. Assisted Reproductive Techniques

16. Counseling
Fertile period
Ovulation study and timed intercourse
IUI
Hyst-laparoscopy
IVF
ICSI
Egg donation
Embryo donation
TESA/PESA
Surrogacy

17. Summary
• Infertility is a problem of couples
• Psychological support is important
• Evaluation must be thorough, but individualized
• Guide the couple Step by step from basic
evaluation to surrogacy
No need to loose hope

18. Take Home Message
We can help a couple to have
baby even if he doesn’t have
sperm & she doesn't have egg
and or uterus

19. Dr. Laxmi Shrikhande
Shrikhande Fertility Clinic
Ph-8805577600 / 8805677600
shrikhandedrlaxmi@gmail.com