Q.1	What is infertility ?
Q.2	My husband and I have an active sex life, we are both healthy, and my periods are regular. However, we have still not conceived ! Please help !
Q.3	How can I determine my "fertile" period ?
Q.4	My gynecologist has done an internal examination and said I am normal. Do I still need to get tests done to determine why I am not conceiving ?
Q.5	Do painful periods cause infertility ?
Q.6	My husband's blood group is A Negative and I am O positive. Could this blood group "incompatibility" be a reason for our infertility ?
Q.7	After having sex, most of the semen leaks out of my vagina. How can we prevent this ? Should we change our sexual technique ? Could this be a reason for our infertility ?
Q.8	My husband refuses to get his semen tested. He says the fact that it is thick and voluminous means it must be normal.
Q.9	Are infertility problems hereditary ?
Q.10	My sister in law is advising me to keep a pillow under my hips during and after intercourse . Will this increase my chances of conceiving ?
Q.11	My tubes are blocked. I've never had symptoms of a pelvic infection, so how could my tubes get blocked?
Q.12	My husband's sperm count varies every time we test it ! How do we determine what the "real" sperm count is ?
Q.13	All my tests are normal, and yet I can't get pregnant. My doctor says my infertility is "unexplained" ! What does this mean ? The very fact that I cannot conceive means there must be something wrong !
Q.14	My husband and I have an active sex life for 2 year, we are both healthy, and my periods are regular. However, we have still not conceived?
Q.15	What is timed sexual intercourse?
Q.16	What are the main causes of infertility?
Q.17	What are the main factors that hinder pregnancy?
Q.18	When and why was the Dr. Madhu Jindal Memorial Test Tube Baby Centre set up ?
Q.19	Why the female is blamed all the times for infertility?
Q.20	What is "fertile" period ?
Q.21	What treatment options do infertile couples have ?
Q.22	My periods are irregular & come once in 2 months. Could this be a reason for my infertility ?
Q.23	How successful is infertility treatment ?
Q.24	Can ovulation induction increase the risk of ovarian cancer ?
Q.25	What about the health risks for children born following infertility treatment ?
Q.26	My semen analysis report shows I have no sperm in the semen (azoospermia). Is this because I used to masturbate excessively as a boy ?
Q.27	What is endometriosis?

Response to Frequently Ask Questions

A.1
Infertility, whether male or female, can be defined as 'the inability of a couple to achieve conception a year or more of regular, unprotected coital Exposure.


A.2
You need to remember that it's not possible to determine the reason for your infertility until you undergo tests to find out if your husband's sperm count is normal; if your fallopian tubes and uterus are normal; and if you are producing eggs. Only after undergoing these tests will your doctor be able to tell you why you are not conceiving. While testing does cause considerable anxiety, it's far better to intelligently identify the problem so that we can look for the best solution.


A.3
Your fertile period is the time during which having sex could lead to a pregnancy. This is the 4-6 days prior to ovulation ( release of a mature egg from the ovary). Women normally ovulate 14 days prior to the date of the next menstrual period.


A.4
A routine gynecological examination does not provide information about possible problems which can cause infertility, such as blocked fallopian tubes or ovulatory disorders. You need a systematic infertility workup.


A.5
Painful periods do not affect fertility. In fact, for most patients, regular painful periods usually signal ovulatory cycles. However, progressively worsening pain during periods (especially when this is accompanied by pain during sex) may mean you have endometriosis.


A.6
There is no relation between blood groups and fertility.


A.7
Loss of seminal fluid after intercourse is perfectly normal, and most women notice some discharge immediately after sex. Many infertile couples imagine that this is the cause of their problem. If your husband ejaculates inside you, then you can be sure that no matter how much semen leaks out afterwards, enough sperm will reach the cervical mucus. This leakage of semen ( which is called effluvium seminis) is not a cause of infertility. In fact, this leakage is a good sign - it means your husband is depositing his semen normally in your vagina. Of course, you cannot see what goes in - you can only see what leaks out - but the fact that some is leaking out means enough is going in!


A.8
Semen consists mainly of seminal fluid, secreted by the seminal vesicles and the prostate. The volume and consistency of the semen is not related to its fertility potential, which depends upon the sperm count. This can only be assessed by microscopic examination.


A.9
If your mother, grandmother or sister has had difficulty becoming pregnant, this does not necessarily mean you will have the same problem! Most infertility problems are not hereditary.


A.10
Sperm are already swimming in cervical mucus as sexual intercourse is completed and will continue to travel up the cervix to the fallopian tube for the next 48 to 72 hours. The position of the hips really doesn't matter.


A.11
Many pelvic infections have no symptoms at all, but can cause damage, sometimes irreversibly, to the tubes.


A.12
Even a normal ( fertile ) man's sperm count can vary considerably from week to week. Sperm count and motility can be affected by many factors, including time between ejaculations, illness, and medications. There are other factors which affect the sperm count as well, all of which we do not understand.


A.13
Yes, you are right. Unexplained infertility is simply a confession of our ignorance, and means that our technology is not good enough to be able to identify the problem. For example, a semen analysis can show that your sperm count is normal. However, it tells us nothing about the functional competence of the sperm - whether they are able to fertilize the egg or not ! In any case, I feel the question should NOT be "Why am I not getting pregnant ? " Rather, it should be - What can I do in order to get pregnant ?" After all, no one cares about problems - we only care about results - about having a baby ! Fortunately, our technology for solving problems ( by bypassing them in the IVF lab !) is much better than our technology for identifying them - and perhaps this is just as well !T his means that rather than waste time trying to pinpoint the problem, we can just bypass it altogether !


A.14
t's not possible to determine the reason for your infertility until you undergo tests to find out. the reasons. You can do following. A) You can try timed intercourse for few months b) After no results you need to go for tests to determine the underlying couse of your problem which will include:

1. Detailed Seamen analysis
2. Ovulation Study
3. A HSG to find the status of your tubes.
   

A.15
To increase the chance of getting pregnant spontaneously, timed sexual intercourse is recommended. This means that sexual intercourse, or coitus, has to be taken place around the time of ovulation, which is the most fertile period of a woman. This is mostly about 14 days after the first day of the period. Therefore it is best to have intercourse 3-4 days before the expected ovulation and every other day until 2-3 days after the expected ovulation with no necessity for higher frequency.


A.16
The main causes:

• Due to Female factors 40%
• Due to Male Factors 40%
• Due to combined factors 10%
• No cause found 10%

In females, the causes could be:

• Irregular ovulation or egg production, hormonal imbalance 30%
• Tubal block 30%
• Problems in uterus like fibroids, adhesions, synechae congenital anomalies, chocolate cyst of ovaries 30%
• Unexplained 10%

Male contribute almost 40% to infertility. The common reasons are:

• Low motility of sperms with normal or low count
• Varicococele, congenital absence of Vas deferens, Testicular dysfunction and hormonal imbalance
• Azoospermia
  Top

A.17
The main factors are :

• Hormonal imbalance
• Intercourse during infertile phase of cycle
• Insufficient number of rapid, liner, progressive, motile sperms
• Mucous in the cervix is unfavorable and/or hostile to sperms
• Mechanical barriers preventing fertilization like blocked fallopian tubes, adhesions around the ovaries, disturbed tubo-ovarian relationship (preventing the age from gaining access into the tube.)
• Mental stress

A.18
Dr. Madhu Jindal Memorial Test Tube Baby Centre, a super specially center, was set up in December 2004 with the sole objective of addressing all issues related to infertility and childlessness, and for fulfilling the need for specialized treatment in India. We employ state-of-the-art techniques, a team of highly experienced specialists and equipment comparable to the best in the world, all under one roof.


A.19
Not at all. The incidence of infertility in men and women is almost identical. Infertility is exclusively a female problem in 30-40% of the cases and exclusively a male problem in 10-30% of the cases. Problems common to both partners are diagnosed in 15-30% of infertile couples. After thorough medical investigations, the causes of the fertility problem remain unexplained in only a minority of infertile couples (5-10%).


A.20
Your fertile period is the time during which having unprotected sex could make you pregnant. This is the period when ovulation take place. Usually it is the middle of normally menstrual cycle + 2 days before after (If you have 28 days cycle then D12 to D16 will be your fertile period.)


A.21
The main treatment options:

1. I.U.I (With husband Sperms)
2. I.U.I (With Doners Sperms)
3. IVF
4. ICSI
5. Egg Donation
6. Surrogacy
7. Surgery
8. Hormonal Treatment
Top

A.22
As long as the periods are regular, this means ovulation is occurring. Some normal women have menstrual cycle lengths of as long as 40 days. Of course, since they have fewer cycles every year, the number of times they are "fertile" in a year is decreased. Also, they need to monitor their fertile period more closely, since this is delayed (as compared to women with a 30 day cycle).


A.23
When talking of success rates for any type of infertility treatment, one should bear in mind that the average chance to conceive for a normally fertile couple having regular unprotected intercourse is around 25% during each menstrual cycle. It is estimated that 10% of normally fertile couples fail to conceive within their first year of attempt and 5% after two years. Comparable to normal fertility rates, effective treatments can be expected to have, on average, up to a 25% success rate per cycle of treatment, and may therefore need to be repeated several times before a pregnancy is achieved. Simple ovulation induction to compensate for hormonal imbalances has a very high success rate; more than 80% of women suffering from such disorders are likely to conceive after several cycles of treatment with drugs such as clomiphene citrate or gonadotrophins.


A.24
Ovarian cancer is a rare disease; the chance of a young woman developing an ovarian malignancy during her lifetime is lower than 1.5%. A number of factors have been found to increase the risk of ovarian cancer, including genetic predisposition and dietary habits. Scientific studies carried out in the last few decades have demonstrated that infertility itself is a risk factor for ovarian cancer. There is evidence that each pregnancy reduces the risk of a woman contracting ovarian cancer (this risk could be reduced by more than 25% by a first pregnancy). No epidemiological study has ever established a causal link between ovulation promoting drugs and ovarian cancer. An extensive study on this issue, reporting on more than 2,600 women treated between 1964 and 1974 and followed for an average of twelve years, found no association between ovulation inducing drugs and ovarian cancer.


A.25
Regarding children born following treatment with ovulation promoting drugs, the incidence of birth defects has never been found to be higher than that in the normal population.


A.26
Masturbation is a normal activity which most boys and men indulge in. It does not affect the sperm count. You cannot "run" out of sperms, because these are constantly being produced in the testes. There may be the obstetric azoospermia for that you need the testicular biopsy.


A.27
Endometriosis is a condition where tissue similar to the lining of the uterus (the endometrial stroma and glands, which should only be located inside the uterus) is found elsewhere in the body.

Endometriosis lesions can be found anywhere in the pelvic cavity: on the ovaries, the fallopian tubes, and on the pelvic sidewall. Other common sites include the uterosacral ligaments, the cul-de-sac, the Pouch of Douglas, and in the rectal-vaginal septum.

In addition, it can be found in caecarian-section scars, laparoscopy or laparotomy scars, and on the bladder, bowel, intestines, colon, appendix, and rectum. But these locations are not so common.
In even more rare cases, endometriosis has been found inside the vagina, inside the bladder, on the skin, even in the lung, spine, and brain.

The most common symptom of endometriosis is pelvic pain. The pain often correlates to the menstrual cycle, but a woman with endometriosis may also experience pain that doesn’t correlate to her cycle. For many women, the pain of endometriosis is so severe and debilitating that it impacts their lives in significant ways.
Endometriosis can also cause scar tissue and adhesions to develop that can distort a woman’s internal anatomy. In advanced stages, internal organs may fuse together, causing a condition known as a "frozen pelvis."
Overall, women with endometriosis find it harder to become pregnant than women in general. However, little research has been carried out into this topic, so it is not possible to give you an accurate indication of how much endometriosis will affect your fertility.

Nevertheless, studies indicate that women with minimal–mild endometriosis take longer to conceive (become pregnant) and are less likely to conceive than women in general.

It also appears that the more severe the woman’s endometriosis, the more likely it is that she will have difficulty becoming pregnant. Thus, women with moderate–severe endometriosis tend to have more difficulty conceiving than women with minimal–mild endometriosis.

However, it is important to remember that having endometriosis does not automatically mean that you will never have children. Rather, it means that you may have more problems.

Many women with endometriosis have children without difficulty, and many others become pregnant eventually  though it may take time, and may require the help of surgery or assisted reproductive technologies or both.