Keyhole surgery as an infertility treatment?
Are you struggling with infertility and confused about treatments that would work best for you? Look no further; our expert panel has all the answers for you
Doctors suggest of the total Indian population, approximately 20 percent are dealing with issue of infertility. Dr Duru Shah, owner and scientific director, Gynaecworld Fertility Center, Mumbai, agrees with this figure.
“In about one-third of the cases, there is a problem with the woman’s reproductive system and in another one third, the men are infertile. The rest are caused by a mixture of male and female problems,” says Dr Shah. While in women, changes in the menstrual cycle, ovulation and hormones could indicate infertility, for men, changes in hair growth, sexual desire, lump or swelling of the testicles, problems with ejaculations could be the causes.
Infertility in men is increasing at an alarming rate. “Presently more than 50 percent of infertile couples have male factor causes,” says Dr Mohan Keshavamurthy, director, urology, andrology and transplantation, Fortis Hospitals, Bengaluru.
He further adds that cases of infertility in southern states, particularly Tamil Nadu, are higher. “Measured by childbirth per women, it is 1-2 in Tamil Nadu and West Bengal and 3-4 in Uttar Pradesh and Bihar,” he says.
Infertility treatments in India
“Fertility treatments can be grouped under three categories for both men and women,” says Dr Shah. These treatments include the following processes:
- Medicines to improve fertility: These are sometimes used alone, but can also be used in addition to assisted conception.
- Surgical treatments: These may be used when a cause of the infertility is found and can be assisted by an operation.
- Assisted conception: This includes several techniques such as intrauterine insemination (IUI), gamete intrafallopian transfer (GIFT), and intracytoplasmic sperm injection (ICSI) egg or sperm donation and surrogacy.
According to Dr Manisha Singh, consultant gynaecologist and infertility specialist, Fortis Hospitals, Bengaluru, a surgery can be performed in two ways. “One is the conventional form and the other is keyhole surgery. Keyhole surgery is performed using an operative laparoscope (through the abdomen) or an operative hysteroscope (through the cervix and into the uterus),” she adds.
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The other two prominent methods employed as infertility treatments include:
- Ovulation induction: It can be induced with a range of medications in tablet or injectable forms. Oral medications such as clomiphene citrate (Clomid, Serophene) can dull the response of receptors in the brain to naturally occurring estrogens in the body. This leads to an increase in the release of hormones from the brain, which stimulates ovulation.
- In vitro fertilisation (IVF): It is the conception outside of the human body. The woman undergoes ovarian stimulation using a hormonal agent and at the right time, the eggs are collected. This is done through the vagina under light sedation and ultrasound control.
The treatment of infertility is mainly based on the causative factor. “They are usually in the form of medications to decrease the oxydative stress and improve nutrition to the sperms. Surgical corrections of any mechanical issues are also done to improve the testicular environment and functioning,” says Dr Mohan Keshavamurthy, director, urology, andrology and transplantation, Fortis Hospitals, Bengaluru.
He says that the best psychological counselling for the couple is to educate them. “They must be informed of the fact that out of the millions of sperms in the semen only one sperm is enough to fertilise the ovum and there are lot of techniques to make that happen,” he says.