Dr. Vishali Joshi

Female infertility is considered as the inability of conceiving. As per WHO it is described as the inability to be pregnant, maintain and carry forward a pregnancy to its full term. It is often of two types:

1. Primary Infertility: This is the inability to give birth to a baby either due to the inability to become pregnant or maintain a pregnancy, which includes stillborn and miscarriage.
2. Secondary Infertility: This refers to the inability to give birth when there is already a live birth or the woman was pregnant.

The causes of infertility can vary from being acquired or genetic. However, following factors are largely responsible for infertility:

1. Genetic: Some genes can lead to mutation leading to infertility like, in case of BMP15 gene there is a hypergonadotrophic ovarian failure which causes infertility.
2. Acquired: This is caused by factors like age, smoking, sexually transmitted diseases, obesity, body weight, eating disorders, diseases like diabetes, thrombophilia and also radiation and chemotherapy.

The treatment for infertility usually depends on the cause, age, duration of time for which a person has been infertile and preference of the patient. Infertility is believed to be a complex disorder and the treatment involves a huge amount of physical, financial and psychological commitments. All this also requires a lot of time. Some women might need just a minimum of two therapies to attain fertility while others might require different treatment before they can conceive.

Treatment is largely aimed to restore the fertility either by means of medication and surgery or help in reproduction with the help of some procedures.

Fertility Restoration through medication

This is the main treatment for women who are infertile because of ovulation disorders. These drugs include:

1. Gonadotropins: These are injected to stimulate the ovaries. Drugs like Menopur, Repronex, Follistim AQ, Gonal-F, Bravelle restore the production of eggs, while Ovidrel and Pregnyl are used for maturing the eggs and for their release.
2. Clomiphene citrate: This is taken orally and stimulates ovulation by releasing more Follicle Stimulating Hormone and Luteinizing Hormone from the pituitary gland.
3. Metformin: This is used in females who have PCOS and also when insulin resistance plays a major role in infertility.
4. Bromocriptine: Used when the infertility is caused due to excess prolactin production.
5. Letrozole: This also induces ovulation

Fertility Restoration through surgery

Surgical procedures can amend the problem of infertility. However, these treatments are very rare these days owing to the success of other fertility treatments. These include:

1. Tubal ligation reversal surgery: In case a tubal ligation has been performed it can be reversed by reconnecting the tubes again through surgery.
2. Hysteroscopic surgery: This corrects or removes the abnormalities that cause infertility. This surgery can correct the shape of the uterus, remove endometrial polyps and improve chance of getting pregnant.
3. Tubal surgeries: In case of blocked fallopian tubes laproscopic surgery can be performed to dilate the tubes, removed blockages or create a new opening.

Assistance in Reproduction through techniques

The most common used techniques for reproduction assistance are:

1. Intrauterine insemination or IUI: In this about million healthy sperms are put in the uterus at the time of ovulation.
2. Assisted reproductive technology: In this mature eggs are retrieved from a woman and this is then fertilized with sperms in a dish in the lab. Once the fertilization is done the embryo is placed in the uterus for further development. IVF is the most common and effective assisted reproductive technology. This procedure takes place over weeks with several blood tests and hormone injections.

Dealing with infertility is not easy and can be emotionally and physically draining. To cope with the various tests and treatments of infertility one should be fully prepared, eat a healthy diet, exercise reach out for help and support of family and friends and look for other options like a donor egg, adoption or no children.

Influenza or flu is a contagious respiratory infection that affects the lungs, throat, nose and occasionally, the ears. It usually does not require treatment but Paracetamol can provide relief from most of the symptoms. Rarely, influenza can lead to severe complications like pneumonia, sinus problems and asthma. Annual vaccinations can prevent these complications even if you do get a mild flu.
Causes
The influenza virus is air borne and can be spread through coughing, sneezing, skin to skin contact, or indirect contact like touching a contaminated object. Type A, Type B and Type C influenza viruses affect the respiratory organs.
People with weak immune systems are infected more easily than others- children under the age of 4, people above the age of 60 pregnant women, obese people and those who are suffering from kidney disorders and diabetes are at greater risk of infection. Air pollution also aggravates the problem.
There is also little chance that your body has the necessary antibodies to fight the virus if you have been infected before. This is because the influenza virus modifies constantly and new strains of the virus appear rapidly. So, the antibodies that work against one particular variant do not work effectively against the others. This is why vaccination is also not a foolproof preventive technique against this disease.
Symptoms
The symptoms of influenza begin to show within a few days after infection. In a few cases, the infection may be asymptomatic. When they do show, the symptoms are very common- high fever, shivering, a blocked and runny nose, frequent coughing and sneezing and chest congestion are the predominant signs. In the later stages, there are headaches, body aches, general fatigue, reddened and watering eyes, throat pains and difficulty in speaking.
In the cases where the patient is a child, there are a few other symptoms like digestive and gastrointestinal disorders such as nausea, vomiting, diarrhea and abdominal pain. The last two are especially common in children who have been infected by influenza virus Type B.
Aged people often have low resistance to the virus. This is why the flu quickly escalates and the complications like primary viral pneumonia or secondary bacterial pneumonia. In such cases, there are sever symptoms like breathing problems, the presence of blood in the sputum, red and itchy skin and petechial rashes (caused by minor punctures in the capillary blood vessels). If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.