by: Dr. Pooja Mehta
When a couple gets married, the wife’s age plays a major role. If the age of the wife is less than 35 years of age, and if they’ve been married for one year and they don’t get pregnant, then investigations need to be done for both husband and wife, and this holds true, for a couple whose age of marriage is more than 35 years. They have been married for six months 20 years back when I started my practice, the incidence of infertility was 7 to 10% and now the incidence has risen to almost 17 to 20% Coming to the major reasons why the incidence of infertility has increased first is the age of marriage. It has increased significantly, previously girls used to get married at a very early age, and now the age has risen dramatically.
We cannot change the age of the marriage. I am not saying she should get married at a very early age. What I am saying is that if the lady if the girl has not been married for at least 30 years, then she should start investigating herself basic AMH and ultrasound needs to be done, along with baseline investigations to see if everything is ok. If the test results are not ok, she should go for EGG FREEZING or fertility preservation. In fact, if a married couple doesn’t want to have a baby for a few years after marriage, they should go for investigations, and they can go for EMBRYO FREEZING. I’ll be telling you about two cases, one patient X and another patient Y Both patients had poor ovarian reserve both patients’ ages were between 35 and 37. Patient X went for Different treatments, she kept changing doctors. She kept changing medications, thinking that her ovarian reserve would come back to normal, but there was no change. Her AMH test report went down, and then later on she had to go for 3rd Party option of egg donation!!
Patient Y straight away went for IVF and embryo freezing. ( Fertility preservation) She underwent three cycles of IVF in which Five embryos were frozen later on., She achieved pregnancy and delivered, A healthy child !! The biggest thing that we learned from these two patients is that timely treatment is very important. Pregnancy happens only if the couple meaning, both male and female are normal 50% of males and 50% of females are responsible for infertility
For a lady to get pregnant, the tubes should be open. A proper egg formation should be there. The uterus should be normal. Nowadays we get a lot of patients with PCOD endometriosis. Poor ovarian reserve, fibroid uterus Husband should go for semen testing there can be low count, low motility, abnormal sperms, or absence of sperms. If the males are responsible, they are easier to treat, Advances in ART technology like testing for DFI ( DNA fragmentation index) make it easier to identify the cause and treat the husband Males can be treated with simple medications, change in lifestyle, and advanced techniques like IVF, ICSI IMSI PICSI MICROFLUDDIC TESA PESA MICROTESA!
Now If the patient has undergone IVF and she fails, how to treat this ?? The biggest thing is that IVF is not a simple treatment, it is the PROCESS OF FORMATION OF NEW LIFE. That’s why the result is limited !!!. Majorly there are 4 reasons why IVF Fails First is the Embryonic reason, which means the problem is either in the egg or sperm or both egg and sperm, we need to identify that and treat it accordingly Second reason is the Uterus whether the lining is too thin or thick for which we might have to Hysteroscopy! The third reason is the body of the lady whether she has any medical conditions like thyroid, HT, DM, or some Autoimmune processes a detailed investigation is very important and treats the cause.
The fourth reason which is not given very much importance is the IVF LAB. Whether the lab conditions were good, whether the embryo quality was good, whether the lab had advanced technologies. So, in the end, I would like to say that the biggest thing to getting pregnant is that the couple should support each other, they should have a lot of patience, they should believe in Science and if the couple changes their lifestyle, follow healthy habits, eat home cooked food, exercise regularly, avoid Alcohol, Smoking and trust the doctors only 10% will require IVF 90% will be treated by simple treatments.
Author is MBBS, MD (Fertility Expert), Head of Department Fortis Bloom IVF Centre, Mohali
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