Both the terms infertility and sterility mean inability to conceive after one year of sexual life without contraception when the couple worried for a baby some distinguish the terms as sterility being the absolute state of inability to conceive while infertility the relative state of failure to conceive.
Testis must produce healthy motile sperm.
Sperm transport . sperm has to be deposited at the external os through satisfactory coitus. This has to be transported through cervical mucus, uterine cavity and tubal lumen.
The ovary must produce healthy ovum by ovulation and ovum is picked up by the fallopian tube.
PATHOLOGICAL: Faculty male factors are responsible in about one quarter cases.
Systemic factors – Age above 45 years, obesity fatique, heavy smoking, alcoholism work through impotency.
Endocrinopathy – Hypothalamic pituitary dysfunctions, hypothyroidism
Diabetes- Defective spermatogensis
Psychological – Nervous tension about sex, psychiatric illness causes impotency.
Immunologic – Sperm auto agglutinating and automobilising antibodies develop against its sperm in 3-5% in vas obstruction, orchitis, or testicular biopsy.
Coital difficulty – Ignorance about sex-no consummation of marriage 5% , coital frequency-too few or too many.
(a) Defective spermatogensis – Undescended testis, hypopadias, klinefelter syndrome (small firm testis), testicular damage following small pox, mumps,varcocele, huge hyrocele, furnaceman (raising scrotal temperature).
(b) Genital duct obstruction and inflammation in herniorrhapy, hyrocele repair, vas ligation urethritis-gonococcal, rarely tubercular, Chlamydia and mycoplasma infection interfere normal sperm function.
Systematic factors – Age over 35 years, obesity.
Psychological – Fear of, doing sex, martial disharmony work through tubal spasm and infrequent coitus.
Endocrinopathy – Thyroid disorders, hypogonadotropic amenorrhea, metropathic bleeding, PCOD cause infertility through anovulation.
(a) Vaginal factors
(b) Cervical factors
Uterine factors (10%) – uterine fibromyoma, adenomyosis uterine hypopalsia, infantile uterus, tubercular endometritis-is an important cause in tropic (6.19%) in primary infertility, malkani, 5% in west (schaefer1953).
Tubal factors (10-40%) - due to tubal occlusions or peritubal adhesions caused by gonococcal, pyogenic, TB, chalamdial, appendicitis.
NRI patients can visit our clinic to get there treatment done at a low cost compared to the treatment aboard.