Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse, as mentioned by WHO.

Infertility affects millions of people of reproductive age worldwide – and has an impact on their families and communities. Estimates suggest that between 48 million couples and 186 million individuals live with infertility globally.

What causes infertility among male and females?

In the male reproductive system, infertility is most commonly caused by problems in the ejection of semen, absence or low levels of sperm, or abnormal shape (morphology) and movement (motility) of the sperm.

In the female reproductive system, infertility may be caused by a range of abnormalities of the ovaries, uterus, fallopian tubes, and the endocrine system, among others.

What are types of infertility?

Infertility can be primary or secondary. Primary infertility is when a pregnancy has never been achieved by a person, and secondary infertility is when at least one prior pregnancy has been achieved.

Fertility care encompasses the prevention, diagnosis and treatment of infertility. Equal and equitable access to fertility care remains a challenge in most countries; particularly in low and middle-income countries. Fertility care is rarely prioritized in national universal health coverage benefit packages.

What causes infertility?

Infertility may be caused by a number of different factors, in either the male or female reproductive systems. However, it is sometimes not possible to explain the causes of infertility.

In the female reproductive system, infertility may be caused by:

1. Tubal disorders such as blocked fallopian tubes, which are in turn caused by untreated sexually transmitted infections (STIs) or complications of unsafe abortion, postpartum sepsis or abdominal/pelvic surgery;

2. Uterine disorders which could be inflammatory in nature (such as such endometriosis), congenital in nature (such as septate uterus), or benign in nature (such as fibroids); disorders of the ovaries, such as polycystic ovarian syndrome and other follicular disorders;

3. Disorders of the endocrine system causing imbalances of reproductive hormones. The endocrine system includes hypothalamus and the pituitary glands. Examples of common disorders affecting this system include pituitary cancers and hypopituitarism.

Photo-Bio modulation therapy in treating Infertility

Ovarian reserve (actively witnessed via, increased AMH and decreased FSH) are intimately tied to optimising fertility by increasing egg quality. There is preliminary evidence for the effectiveness of low level laser therapy in treating Infertility, a study that was performed in an IVF center in Japan used LLLT in women with low or undetectable AMH levels, out of 188 patients treated almost 56% reported pregnancy & 38% reported live births. This study was conducted from April 2010 to Nov. 2015 on patients with low or undetectable AMH level.

They were administered with LLLT for the neck and the abdominal lumbar regions. For better understanding out of 13 patients with an AMH level of 0.1, 6 patients were found to achieve a clinical pregnancy and 5 patients gave birth. An extension of this study showed 50% pregnancy rates.

A study in Denmark showed a 60% pregnancy rate in women who had struggled with infertility of 4 or more years with failure of ART procedures.   

Although there are only a few studies on the effectiveness of LLLT several case studies have been reported that LLLT is effective in ovarian age reversal and thus can be used effectively to treat infertility especially in the patients with low AMH levels. More clinical research is needed, although the preliminary studies show high potential for LLLT to be a valuable method in optimizing fertility in women undergoing natural or artificial conception.

Specific patients who would most benefit from photo bio modulation therapies, for natural conception or in combination with assisted reproductive technologies (IVF)

• Women with low ovarian reserves.
• Women of advanced maternal age.
• Men with low sperm count or quality.
• Women who have been through multiple cycles of IVF with high retrieval rates but low blastocyst rates.
• Women with PCOS ovarian cysts or fibroids.
• Women with endometriosis.
• Women with poor egg quality.
• Women with poor implantation rates repeat pregnancy loss or chemical pregnancies.

Scientific Back-Up

All our cells are powered by little structures called mitochondria. Ovum/ Eggs have about 200 times more mitochondria than any other Cell.

When eggs are developing they use a tremendous amount of energy and early embryo division and implantation requires lots of energy.

After 35yrs the mitochondria wear down, at age 40, 9 out of 10 eggs are normal.

LLLT to the acupressure points, activates ATP in cells, which in-turn increases the quality of cell and reduces oxidative damage. Thus researchers prove there is a significant role of laser therapy in enhancing the fertility of the individual and restoring fertility quality of life.

Dr.  Rekha Krishna Ayachit

Life positive Change Clinic

No 4013, KR road,  Banashankari 2nd stage

Bengaluru-560070

Mob:80881 32477 / 99456 38763

www.lifepositivechange.in 

The post Infertility : Why it is increasing among male and females? appeared first on Health Vision.

It has been 41 years since the birth of the world’s first IVF baby, Louise Brown. The day– July 24^th, has since been observed as World IVF Day, inspiring and giving hope to millions of infertile couples of completing their family. Today, with the advancement of medical science and technology, the IVF industry has grown leaps and bounds, providing couples battling infertility with advanced treatment options and solutions.

India has nearly 10-15 per cent of married couples who suffer from the inability to conceive naturally. IVF has been the solution for several such couples, helping them achieve their dream of parenthood. IVF is a complex modern medical procedure and one of the most well known fertility treatments in practice today. The IVF process includes the artificial stimulation of the ovaries to produce multiple eggs, removal of the eggs from the ovary (egg retrieval), selection of healthy sperms, fertilization of the eggs in the laboratory, and subsequent placement of the resulting embryos into the uterus (embryo transfer). The evolution of Assisted Reproductive Technology has helped provide more safer and effective treatment options for couples who have been unable to conceive for different reasons.

 “IVF has transformed the field of infertility since its inception in 1978. Major milestones in perfecting IVF were developed quickly since then, including the use of controlled ovarian hyperstimulation, luteal phase support, and improved culture media. Other significant advances soon followed with the development of intracytoplasmic sperm injection (ICSI), assisted hatching, and description of optimized ET techniques. These advancements improved the success rates associated with ART and the number of couples opting for IVF treatment.”

Improvements in culture medium, equipment’s, laboratory controls and cryopreservation techniques have increased the success rates in assisted reproduction. Following are some of the global best practices in the IVF industry that have helped ensure better success rate:

Intracytoplasmic Sperm Injection (ICSI)

ICSI is a technique sometimes used with in vitro fertilisation (IVF) in which one sperm is injected directly into one egg in order to fertilise it. This is especially useful for men with very low sperm counts since ICSI ensures that the sperm reaches the egg directly rather than waiting for the sperm to naturally fertilise the egg. ICSI is currently the most successful treatment for male infertility, with fertilisation rates of 60%-70% depending on quality of the sperm used. In some cases, assisted hatching may be used to increase the chances of implantation.

Pre-implantation Genetic Testing – Aneuploidy and Monogenic Disorder

Genetic testing is divided into separate categories: Preimplantation Genetic Testing – Aneuploidy (PGT-A) and Preimplantation Genetic Diagnosis – Monogenic Disorder (PGT-M). All couples are at risk of having abnormal embryos. The risk increases significantly as a woman gets older. An abnormal embryo almost always fails to implant, or even if it does, the pregnancy ends in a biochemical pregnancy, miscarriage, foetal death later in pregnancy, stillbirth or a baby with abnormalities.

PGT-A is observed to improve the success rate of IVF by 15-20%. The test is used to determine the number of chromosomes in an embryo. The normal number of chromosomes in an embryo is 46 and any missing number is characterised as a defect. Once the embryo grows in the lab, it is usually biopsied on day 5, which is called the blastocyst stage. Then the number of chromosomes within each cell is counted in these embryos.

PGT-M helps fertile couples who have a history of genetic condition in their families or any condition for which the couple’s offspring are at risk. The technology helps in screening the embryos for specific genetic diseases and chromosomal disorders, for example, single gene disorders including cystic fibrosis and sickle cell Anemia. PGD can be used to identify approximately 2,000 inherited single gene disorders and is 98 percent accurate in identifying affected and unaffected embryos.

In a recent case, a 43 year old woman, also a corporate professional, approached for treatment. “When the patient visited,  she reported suffering a miscarriage a year ago, post which she was unable to conceive. As part of her IVF procedure, we also recommended that she undergoes a Preimplantation Genetic Test – Aneuploidy. Through the test we found that only one out of the four embryos fertilized for the IVF cycle was normal. This embryo was used for implantation and resulted in a successful pregnancy and the birth of a healthy child. Advanced Assisted Reproductive techniques like this, gives hope to couples who have experienced repeated IVF failures, women who have late pregnancies, and couples who are carriers of genetic diseases.”

Other important ART techniques that help optimise clinical outcomes are:

Cryopreservation: Embryo cryopreservation is the process of freezing and storing embryos and is a part of most in vitro fertilization programs. The process is chosen for reasons as varied as providing an additional chance for pregnancy, or saving embryos in the face of certain medical treatments. There has been tremendous improvement in cryopreservation protocols, that has helped women undergoing cancer treatment or who wants to postpone having a baby.

Embryo or Blastocyst Culture: Blastocyst Culture is a technique in which an embryo is developed in the laboratory for 4-6 days after fertilization before being placed in womb. The embryo gains many cells as a result of being developed for so many days. The embryos developed for 4-6 days are much more advanced than the ones developed for just three days. This enables embryologists to select from the more advanced embryos with better potential for implantation. The biggest advantage of Blastocyst Culture method is that it significantly reduces the risk of multiple pregnancies.

Reproductive medicine has come a long way since the birth of the first IVF baby and the future looks bright. The research advances in this field will help in treating male and female infertility and fulfil the dreams of parenthood for many couples. The global best practices in IVF are being implemented in the Country and the   Assisted Reproductive Techniques (ART)   is bringing joy to thousands of childless couples and making India a preferred destination for fertility treatments.

Dr Saroja Koppala
Fertility Consultant
Nova IVI Fertility
Beside GVK One
Road No.1, Banjara Hills
Hyderabad – 500 082

The post How IVF  is bringing joy to thousands of childless couples? appeared first on Health Vision.