Sperm Development: Beginning in puberty a man’s body produces millions of sperms everyday of his life. Hormones secreted by the pituitary gland at the bade of his brain along with general health, local factors, environmental factors influence the development of mature sperm. An Egg develops in the woman: A woman has here entire life’s supply of eggs in here body when she is born. These immature eggs, which are stored in the ovary, develop one at a time very month through her reproductive life. These eggs decrease in quality as the woman ages.
	Fertilization and implantation: The sperm needs a clear passageway – an unobstructed fallopian tube to reach the egg. The process of fertilization occurs in the tube. The fertilized egg or embryo reaches the uterus in the next few days and embeds itself. This is called implantation. If implantation occurs in the tubes, tubal pregnancy results.

What is infertility?
Infertility is the inability to become pregnant after one year of trying to conceive.

How often does this happen?
Infertility is problem in one of six couple.

Where does the problem lie?
40% are related to the woman.
40% are related to the man.
10% are due to problems in both.
10% are unknown causes.

When does one seek help?
Investigations and Treatment are usually undertaken after one year of trying. However, exceptions to this may be made if the couple are older or if specific diseases are present.

What are the common reasons for infertility?
There may be may causes for infertility. Often more than reason is found in a couple. The following are the common ones.

	Female Infertility: • Failed ovulation – failure to develop or release an egg every month. This in turn may be due to hormonal imbalance, stress, obesity, ovarian disorders, medications etc., • Damaged or blocked fallopian tubes due to previous infection, surgery, tuberculosis, etc., • Disorders of the uterus • Problems around the uterus such as endometriosis • Age • Hormonal disorders
	Male infertility: • Low or abnormal sperm count • Stress, General ill health • Hormonal problems • Diabetes mellitus • Smoking, tobacco, alcohol consumption

Evaluation
In addition to a thorough interview, a complete physical examination will also be performed. A number of investigations and tests will need to be done to arrive at a definite diagnosis. Some of the following investigations will be done for most couple.

Female partner
• Blood test to check for infections.
• Hormone tests
• Ultrasound scan to check for ovulation
• Special x-rays and laprascopy to assess the tubes ant the uterus

Male partner
• Blood test to check for infections
• Semen analysis
• Hormone assay if necessary
• Urologist’s evaluation
• Doppler studies when indicated.

How is infertility treated?
Treatment will depend on the type of problems found after the tests. These may include one or more of the following:

Medications:
• To treat infection
• To make you produce an egg if this is the problem. This may need to be done for a few months..
• Correction of hormonal imbalances.

Surgical procedures:
• To clear blocks or obstructions.
• To remove growths such as fibroids..
• To correct uterine abnormalities
• To remove ovarian cysts, endometriosis, etc.,

Assisted Reproductive Technology Procedures:
• Various procedures tailored to the needs of the patients are currently available in the assisted reproductive technology laboratories.

	What is assisted reproduction? Intra Uterine Insemination (IUI) If you cannot become pregnant because your partner’s sperm motility / count is low, artificial insemination is an option. The sperm is collected, processed in the laboratory and then placed in the uterus using a thin catheter. If your partner’s sperm count is extremely low other procedures may become necessary. This procedure is also carried out for other indications.
	In-Vitro fertilization (IVF): In this procedure, the egg is fertilized with the sperm in the laboratory and implanted in to the woman’s uterus. This procedures is an option if your fallopian tubes are blocked or damaged and cannot be corrected with surgery.
	Intra Cytoplasmic Sperm Injection (ICSI): If the sperm count of your partner is extremely low this special procedure in which a single sperm is injected into an egg is offered.

Women’s Center
Sri Ramakrishma Hospital Campus, Coimbatore.
Phones : 0422 – 213411, 200033

Infertility is a challenge one probably never expects. Dealing with infertility and its treatment can be emotionally frustrating and exhausting. It can put a strain on even the best of relationships. Although it is natural to feel discouraged and confused there are good reasons to be optimistic. In most cases experts in this field can help you find the source of this problem and explore all possible solutions.

Women’s Center located at Sri Ramakrishna Hospital has been providing the most complete solution for women’s health care problems for the last twenty years. This unit and its back-up facilities represent one of the best set up centers in south India to deal with the entire spectrum of women’s health care needs.

The Assisted Reproductive Technology Center (ARTC) is the infertility wing of the women’s center and has one of the most extensive, dedicated infrastructures with current equipment and a totally committed staff. The Center has been successfully functioning since 1994 and has brought joy into the lives of numerous individuals

Adolscent care, pregnancy, new born care, state of the art facilities to deal with infertility related problems and preventive care such as cancer screening, menopause management are provided under one roof.

You can be sure that your problems will be dealt with, in an upto date diagnostic and treatment facility, by a dedicated team of professionals headed by Dr.Mirudhubashini Govindarajan FRCS (CANADA), Consultant in Obstetrics & Gynecology and Infertility management.