Monday, November 20, 2017

Role Homeopathic in Infertility

Inferlity ---
  “A woman of reproductive age who has not conceived after 1 year of unprotected vaginal sexual intercourse, in the absence of any known cause of infertility”
NICE guideline, CG156
  Primary infertility; couple have failed to conceive before.
Secondary infertility; woman has previously been pregnant regardless of the outcome of the pregnancy and now unable to conceive
Chances of conception
  over 80% of couples in the general population will conceive within 1 year if:
- the woman is aged under 40 years
- they do not use contraception and have regular sexual intercourse.
Half of those who do not conceive in the first year will do so in the second year
Factors affecting Fertility
Frequency/Timing of sexual intercourse:
- Every 2 to 3 days optimises the chance of pregnancy
  Frequency of intercourse
  1 time per week                ---Probability of conception       17 %
  3 times per week             Probability of conception (within 6 months)               50%
Obesity:
- Women who have BMI of over 30 should be informed that they are likely to take longer to conceive and will affect treatment success rates.
Low body weight
- Women with BMI less than 19 and irregular menstruation should be counselled to gain weight.
  Smoking
-
Strong association between smoking and fertility in both partners.
- Affects success rates of ARTs.
  Caffeinated beverages:
-
No evidence on effect of caffeine on fertility.
Alcohol
- Female patients should be informed that 1 or 2 units of alcohol once or twice per week reduces risk of harming a developing fetus.
- Intoxication may affect semen quality.
Tight underwear
- There is an association between elevated scrotal temperature and reduced semen quality
Causes
  In about 40% of cases disorders are found in both the man and the woman.
Male         25% 
Female ----55 %
  Ovul               25 %               
  Tubal            20%
  Uterine           10%
  Unexplained        20%

Basic Work-up for Infertility
  Detailed history and physical examination.
        Past history                      Treatment history
       Menstrual history              Obestric history
     Mental history                  Personal history
  Physical examination-
   Pelvic examination (internal and external)-- Inflammatory   -- Rule out PID ,,Cervical erosion ,, Screening for Chlamydia trachomatis Infections in Women. ... Modern diagnostic tests are highly sensitive for the detection of chlamydia; testing can be performed on vaginal swabs or urine  Culture
                The vast majority of chlamydial infections are asymptomatic. ... In addition, risk is markedly increased in men and women with Neisseria gonorrhoeae or C. trachomatis infection 
  Semen analysis. –  
  semen volume: 1.5ml or more
- pH: 7.2 or more
- sperm concentration: 15 million spermatozoa per ml or more
- total sperm number: 39 million spermatozoa per ejaculate or more
- total motility: 40% or more motile
or 32% or more with progressive motility
- vitality: 58% or more live spermatozoa
- sperm morphology (percentage of normal forms): 4% or more
  USG –Male testes –rule out varicose  ,,,other testes structure disease
  Evidence of ovulation.   (Day 2-3 gonadotrophins,FSH ,LH , Day 21 progesterone)
1.      Menstrual history of regular cycles.
2. Serum progesterone in the mid-luteal phase of their cycle (day 21 of a 28-day cycle) even if they have regular menstrual cycles.
3. Serum gonadotrophins (follicle-stimulating hormone and luteinising hormone) on Day2-3 especially in irregular periods
2.       Serum prolactin
3.       Thyroid function tests,,
  Susceptibility to rubella  
    A small number of women in their childbearing years, however, remain susceptible to rubella virus because of missed vaccinations (either intentional or unintentional) or vaccine failure. ... Young adults are now recognized as a population at risk for measles and mumps viral infections.
  testing for rubella antibodies (IgG). ..
                  Antibody levels <10iu are="" as="" b="" ml="" reported="">rubella susceptible
       Note -- Mostly in secondary infertility   or history of abortion
  Ovarian reserve
-More important in >35 years old, suspected ovarian failure and to detect response to ovulation induction.

1. T
otal antral follicle count.
2. Anti-Müllerian hormone of less than or equal to 5.4 pmol/l for a low response and greater than or equal to 25.0 pmol/l for a high response
3. Follicle-stimulating hormone greater than 8.9 IU/l for a low response and less than 4 IU/l for a high response.
  Investigation of suspected tubal and uterine abnormalities:
1. Hystersalpingography (HSG):
- usually after failed successive cycles of ovulation induction.
- good predictive but requires expertise.
  -Mostly in secondary infertility
Investigation of suspected tubal and uterine abnormalities:
2. Hysterosalpingo-contrast-ultrasonography
- TVS scan during which air and saline or a solution of D-galactose is infused into the uterine cavity and observed to flow along the fallopian tubes.
- Requires more expertise.
- Less invasive.
My Cured  cases  of  infertility  by Homeopathy


Summary
  Infertility is a significant medical and social problem affecting couple worldwide.
  It is a sensitive issue that should be handled with great care with continuous professional counseling.
  Most young couples will conceive naturally within 2 years.
  Evaluation of both partners for causes is essential.
Homoeopathic Aproach n
Treatment depends on the cause, and varies from medical treatment
Inflammatory disease ---------calendula ,, arnica ,Eupionum ,,, sil ,,  Bryonia  ,hydras,, Belladonna,  , Pulsatilla  ,,, guic ,,,thuja ,,
Hydrosalpix ---angelica ,,merc sulph ,,apis ,apocynum Sabina
Easy for conception --- borax,,,con ,,canth ,,nat carb
Tubercular tubal blockage ---ars iod ,,tuberculi ,,,bacillinum,,carcino
Hypothyroid --- constitutional  remedy ,,iod og any salt ,,spige ,,brom
Ovary function ---- plum iod ,,cimici ,,ovarin
I have cured many cases of infertility ,,,discuss all case in your next issue one by one
Dr Mrs Neeraj Gupta
B.H.M.S ,M.D (HOM)
Perusing PhD  From  Tantia university from Rajasthan
Associate professor at K.G.H.M.C Gwalior M.P





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