Sterility and its treatment

Done by: Mariam Droubi.

Submitted to:Dr. Mahmoud Halablab.

What is sterility test?

A

number of females and males are suffering from STERILITY .

STERILITY means difficult or no conception and in other word it is
inability on the part of the female or the male partner to produce any
offspring.
It should be noted that in man sterility and impotence are two different
terms. Impotence means inability to sexually gratify a woman and
sterility means inability to impregnate her. An impotent can be sterile.
For conception, only the discharge of semen with living sperms is
required. It does not matter whether the erection is strong or the
retentive power is long or the female is duly satisfied. The sterility on
the part of the male is the absence of living sperms in the semen.
Either they are not present at all or are dead.
Thus the first step to be taken is to get the semen tested before the
cause is assigned to the sterility of the wife. If the semen is found
lacking in sperms, a well qualified homeopathic practitioner can assist
in producing them in plenty. However, if the semen is found quite
normal then the cause should be treated out in the female.

Causes of sterility in males and

females:
Sometimes

the cause is the presence of acidic secretions

specially lactic acid in the vagina and soon as the semen
is discharged all the sperms are killed as they cannot live
in acid.
Diet which is sour or rich in acids should be given up.
Sometimes sterility is due to failure of the ovaries to
yield the ova. Conception is only possible when sperm
comes in contact with the ovum of the same side.
Hypertrophy of the cervix.
Sometimes sterility is due to the weakness of the uterus
which is incapable of holding the fetus.
Diabetes, ulceration of the uterus, fibroid tumors and
enlargement of the uterus.
Endocrinal deficiencies,obesity due to defective thyroid
secretion.

Malformation

or destruction of tubes
due to inflammatory condition like
appendicitis.
Atrophied testes.
Defective seminal discharges , no
sperms or undeveloped sperms or a
few sperm non-motile sperms, this
may be due to some previous or
present disease of the testes, like
mumps, tuberculosis, gonorrhea,
syphilis.

Techniques Used to treat

sterility:
Laparoscopy.
IUI:

Intrauterine insemination.
IVF/ICSI.

Artificial Insemination (also known as

Intrauterine insemination or IUI)
How

it works: Specially prepared ("washed")

sperm is inserted directly into the uterus through
a thin, flexible catheter during IUI, the most
commonly fertility method. If you choose this
method, your doctor might recommend that you
take fertility drugs as well, to increase the
chances of fertilization.
Best for: Cases in which men have slow-moving
or lower quality sperm or a low-sperm count. Also
for women who have produced antibodies to their
partners' sperm or whose cervical mucus is too
scant, acidic, or thick to transport the sperm to
the egg.

In Vitro Fertilization
(IVF):
How

it works: Multistep process

(called a cycle) in which eggs are
extracted and fertilized with sperm in a
lab. Once embryos develop, one or two
are implanted in your uterus and the
rest are stored.
Best for: Older women or women with
blocked or severely damaged fallopian
tubes or scarring from endometriosis;
men with very poor sperm quality;
couples with unexplained infertility.

Intracytoplasmic Sperm
Injection (ICSI):
How

it works: An embryologist
selects a healthy-looking, single
sperm from the male's semen and
injects it directly into the egg with a
microscopic needle. Once an
embryo develops it's transferred
into the uterus through IVF.
Best for: Couples in which the man
has a very low sperm count or poor
sperm quality.

Reproductive Surgery:
How

it works: Surgery--sometimes
requiring a hospital stay, sometimes
done on an outpatient basis--is used to
correct anatomical abnormalities,
remove scarring and clear blockages in
either the man or the woman.
Best for: Couples with diagnosed
diseases or abnormalities (such as
endometriosis, wherein uterine tissue
grows outside the uterus, causing
scarring and blockages).

Efficacy of every type of

treatment:
Laparoscopy

is cost effective in the initial management of

young women with infertility, particularly when infertility
treatment dropout rates exceed 9% per cycle.
The success of IUI depends on several factors. If a couple
has the IUI procedure performed each month, success rates
may reach as high as 20% per cycle depending on variables
such as female age, the reason for infertility, and whether
fertility drugs were used, among other variables. While IUI is
a less invasive and less expensive option, pregnancy rates
from IUI are lower than those from IVF. If you think you may
be interested in IUI, talk with your doctor to discuss your
options.
The use of IVF-ICSI to avoid disease transmission in HIV-1
serodiscordant couples desiring children yields high rates of
success and appears to be safe. Best candidates appear to
be women of younger age.

Conclusion:
A

thorough but time-efficient investigation of the infertile

couple is required prior to a diagnosis of unexplained
infertility. Couples should undergo a semen analysis,
ovulation testing, assessment of ovarian reserve, and
imaging to assess for tubal and uterine factors before a
diagnosis of unexplained infertility is made. This workup
can be completed within 1 menstrual cycle. In the
couples with unexplained infertility, various treatment
modalities are available, including expectant
management with lifestyle changes, operative
laparoscopy, COH (clomiphene citrate or gonadotropins)
with IUI, and IVF (with or without ICSI). The optimal
treatment strategy needs to be based on individual
patient characteristics such as age, treatment efficacy,
side-effect profile such as multiple pregnancy, and cost
considerations.