Approach for infertility,what you should know

    Infertility is a common problem now a days with huge psychosocial impact in a couple’s life.In majority of cases the lack of awareness regarding normal physiology of reproductive organs, is the cause of infertility.This post is dedicated for the desirous couple who need some insights.There are few noteworthy points which they should understand to solve their problems..

    1.Three basic requisites for conception are A.adequate healthy sperm count in semen(semen is a fluid comes out from male Sex organ at the time of orgasm.The process of release of semen is called ejaculation.Semen contains millions of sperms per millilitre of semen.Sperm fuses with egg in females’ fallopian tube to form embryo which develops into baby in womb in approximately nine months.)

    B.Ovulation(release of egg from women’s ovary)

    C.opportunity of the sperm to meet with ovum in the fallopian tube.(after sexual intercourse the sperm from the semen released from male into female’s vagina goes into her uterus which has two tubes attached on each side.Both the tubes have finger like projections which are close to the respective side of the ovary.One egg comes per month from any one side of the ovary.That egg via finger like projection of fallopian tube are taken up, as soon as released from ovary and if sperms reaches that tube at that time,the egg gets fertilized.)

    2.To know the sperm count,you can simply go to your local clinical lab and ask for seminal analysis.You can see your sperm count against the normal range of the same in your seminal analysis report obtained from the lab.

    If this is normal,your second issue is ovulation in your female partners ovary.For this you should know that on the day of ovulation her temperature rises.If you do daily check the temperature of your wife just before getting up from the bed early morning and make a record of it from the day one of the menstrual cycle,you can find her body temperature increased on fourteenth day if she has 28day menstrual cycle.If her menstrual cycle is of more than 28 days,you simply subtract 14from that figure.For example,suppose her period comes every 35days.You subtract 14 from 35..It comes 21.So she would ovulate on 21st day(assuming first day of bleeding is day one of the menstrual cycle.So in such case woman is likely to conceive on 21st day.So desirous couple should make effort on 21st day in above example.Here one important thing to note is,sperm can survive for1-2days after ejaculation and egg upto 3-4days of ovulation So two days before to four days after ovulation a woman has better chance to conceive.So in above example the couple can make effort from 19th day to 25th day. One important tip is that,the male should keep abstinence during other period for better results.Further the female should take folic acid tablets from two to three weeks prior to their efforts and should continue it.Apart from this both partners should take vitamin E supplements 400mg  every alternate day or 15days every month.Apart from this,they should get treatment of any Sexually transmitted disease they have.

    If you have taken care of above things and still your wife did not become pregnant.There may be technical problem in intercourse.No chemical,lubricants or oil should be used.After intercourse and ejaculation the female should remain in lying position for at least three hours Preferably the foot side of bed should be raised.

    Best approach to summarize, Male should abstain from Sex from the first day of his wife’s menstrual cycle.(even he should not masturbate).He should know the duration of her menstrual cycle by reviewing her last three period onset dates.Whatever the average duration of menstrual cycle comes  by assesing last three period onset dates,just take a note of that.Subtract furteen from average duration.The number which comes after subtraction is the day on which her egg will come or ovulation date.On that very day have Sex with her if possible twice or thrice and keep her in lying position on the bed whose foot end is raised for three hours.

    Once more I need to elaborate the calculation of ovulation date(date on which a female’s egg released from ovary and taken up in the fallopian tube of her uterus.)Take following steps:

    Step-1.Mark in your calendar when your bleeding starts in a new cycle.The marked day is day1. Similarly in the next two cycles mark the bleeding start day in your calendar. Suppose in march month your bleeding had started on 25 March 2015.So day1 of the new cycle which had started in march was 25 March 2015.That bleeding persisted for 5 to 7 days and finished.Again in April,your bleeding had started on 27th,then the day1 of this second cycle would be marked in calendar on 27th April 2015.Again in May the bleeding started on 21 so it day1 of third cycle would be marked as 21st May.Again in June. Suppose it came on 20th June,so the day1 of the fourth cycle should be marked on 20th June.

    Now you have got day1 of the four consecutive cycles:

    1.        25 March 2015

    2.         27 April 2015

    3.          21 May 2015

    4.           20 June 2015

    Step-2.    You can count the days between day1 of the first and the day1 of the  second cycle, between 25 March and 27 April. ……….. 33 days(first menstrual cycle duration)

    Similarly between day1 of second and day1 of third cycle,

    between 27 April and 21 May………………..24 days(second menstrual cycle duration)

    Similarly,between 21 May and 20 June…………29 days(third menstrual cycle duration)

    Step 3-Add all the three consecutive cycle duration and divide the resulting number with three.

    In above case 33+24+29=86

    86/3=27 approx.

    So this is the average of your three consecutive cycle duration.

    Step-4. Date of ovulation=Average menstrual cycle duration Minus 14

    So in above case it is 27-14=13

    So in this case ovulation day is 13 th day.

    So this female would be most likely to be pregnant,if sexual inter course would be done on 13th day from 20th June.

    If the dates are regular in a female then you are not required to do such calculation.Ask what is her expected date of coming period and do Sex 14 days before that expected date.

    If you have addressed the above points and still not being pregnant,then go for ultrasonography for pelvic organs and tubal patency test.If they are also normal.Get Yourself tested for VDRL, HIV,TORCH TEST,MICROFILARIA TEST,HORMONAL ASSESSMENT.

    But that part would better in consultation with your gynaecologist.