And If First Line Of Treatment Fails...

As practiced all across the globe IUI has been considered the first line of treatment and maxtmum of 06 cycles of IUI with or without controlled ovarian stimulatuon ls to be done an a complete reproductive life of a female It has been observed that the pregnancy rate with IUI lS not more than 12.15%, the best of the hands and environment provided to the patient.

Therefore the second line of treatment us to be brought into the practice and following should be the considerations.

1 - Immunological evaluation of both the partners
2 - Genetic testing of both the partners
3 - Diagnostic laparoscopy incase of PID. history of Endometriosis, tubal evaluation, tubo ovarian relationship, tuberculosis. uterine factors such as partial septum, polyp, cervical factors or any SOL to be ruled out.
4 - Antisperm antibodies

In case of any anomaly diagnosed treatment procedure is to be made understood to the couple and NF programming is to be made either by down regulation or by antagonist cycle to be initiated. We at Vardaan are practicing both the protocols and have not found any significant difference in results between the two protocols.

ICSI is a choice of technique where the sperm count is in 100‘s and the abnormal sperms are the primary factor and as everybody knows fertilization rate is better with this technique in case of.

- A low sperm count
- Poor sperm motility and morphology
- Sperms retrieved by surgical procedure (T ESA / MESA] PESA/TESE)
- An obstruction which prevents sperm release.

In Vltro Fertilization (NF-ET) now days is being practiced in a very systematic manner all across the globe and specially in india where the percentage of such couples have gone as high as 15% to 20%. We should understand why it is increasing day by day so that more awareness among the general masses should be made to know the reason behind this growing and challenging problem and let us all take initiative and rnalre the campaign of awareness more effective.

Our effective awareness campaign has given new vision to the infertile couples and as per our experience and observation following are the major causes of problems experienced by the suffering couples:

- Unawareness
- Social stigma
- Indecisiveness
- Home remedies
- Financial constraints
- Fear of side effects of treatment due to unawareness
- Hesitation to share the problem
- Improper earlier treatments taken
- Travelling hurdles