Subfertility (Both Male and Female )

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Subfertility (Both Male and Female)

MALE SUBFERTILITY
Causes of Male Subfertility
  • Pretesticular Causes
  • Testicular Causes
  • Post-testicular Causes
Pretesticular Causes
Include the causes like
  • Hypothalamic Diseases (like :- Kallman Syndrome)
  • Pituitary Diseases( like:- Intake of Steroid Injections , Thyroid Disorders etc )
Testicular Causes
Include the causes like
  • Congenital Conditions 
  • Aquired Conditions ( like :- Orchitis (Mumps) , Varicocele )
Postesticular Causes
Include the causes like
  • Congenital Absence of Vas Deferens
  • Errectile Dysfunction like in case of Diabetes Mellitus or neuropathy etc.

Investigations of Male Subfertility
Interpretation of Semen Analysis:-
(1)-FSH , LH decreased 
Testosterone =Normal 
Diagnosis:-
Anabolic steroids use
(2)-FSH , LH = Normal 
Testosterone =Normal
Diagnosis: -
Maturation Arrest
Best test for assessing tubal function :-
Best test for assessing tubal function is the spontaneous intrauterine pregnancy.
Management of each type of Subfertility Disorder
Maturation Arrest
Best treatment of maturation arrest is donnor insemination .
Oligoastheoteratozoospermia
Testicular Biospy then IVF with ICSI.
FEMALE SUBFERTILITY
Causes of Female Subfertility :-
How to detect Ovulation
A progesterone level of 30nmol/L or above on day 21 of cycle is indicative of ovulation.
Hysterosalpingography
It is done on day 8th
How common is Varicocele in Subfertile Couple
Varicocele is found in 11 % of men with normal semen and about 25 % men with abnormal semen.
Management of Female Subfertility
  • Appropriate Patient's Counselling.
  • Identification of Causeby history and Investigations.
  • Management of that specific condition.

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