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Infertility

Written and reviewed by
MBBS, MD - Obstetrics & Gynaecology, FICS, FICOG
Gynaecologist, Mumbai  •  42 years experience
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Hi,

I am Dr. Shubhada Khadeparkar here. Today I am going to discuss about infertility. Infertility means a couple who is unable to conceive and after trying for at least one year of uninhabited intercourse now infertility today in India is a major problem. There are about 27.6 million couples who are infertile and if you ask me the incidence it is about 10% on an average. Certain states like Uttar Pradesh has less infertile couples like 3.6% and states like Kashmir is about 15% infertile couples. Now infertility can again be divided into 2 types primary and secondary. Now primary infertility is when the couple just does not conceive at all and secondary infertility is when they have one baby and they do not conceive after again for the 2nd child may be one year after trying for that. Now the infertility couple as we say are male and female partners. So infertility can again further be divided into a female factor a male factor and there is a third factor which is unknown infertility.

The female factor contributes to about 40 to 50%. The male factor in total infertile couples the male factor contributes to about 30 to 40% and the unknown factor which we call idiopathic infertility is about 10 to 20%. What is the causes of female infertile couple? Now when the ovaries are damaged or not healthy as we see in polycystic ovaries when there are multiple small eggs getting formed or when the ovary is infected inflamed or when the ovary again is because of age is not producing adequate oocytes in all these cases we see that the patient can become infertile. In polycystic ovaries commonly we see cycles become very irregular patients become obese gets acne on the face and hormonal imbalance is seen. Certain other causes for ovarian infertility are thyroid hormone insufficiency deficiency prolactin hormone etc. The other second common cause in female infertility is tubal factors.

Now if the tubes are blocked then the female cannot conceive. Which are the common causes of tubal infertility? Again infection which is a pelvic inflammation we see also tuberculosis. In our country tuberculosis is endemic it's all around the year and this is one of the very common causes again. The third common cause for infertility is the uterine factors. Now in the lining of the uterus which we call the endometrium is not healthy. We again see that the baby cannot implant or the embryo cannot implant in the uterine cavity and again the patient becomes infertile. Commonest causes again for uterine factor are infection any procedure done in the uterine cavity in the past specially when adequate antibiotic coverage is not given and that is again pelvic infection and also ageing. Ageing uterus does not have good lining of the endometrium and the patient can become infertile. So today I have discussed basically the main factors in the female the next session I want to discuss the male factors and then of course I will go to the management of the infertile couple.

Thank you!

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