Dealing with infertility

Infertility is a problem that affects both husband and wife. It is a problem that reaches deep into emotional life and invades intimate relationship. The desire of the children by women is stronger than self interest in beauty, stronger than the claims of career. Childlessness is generally a tragedy of married women. Children bridge a marital bondage.

Childlessness may result from recurrent abortion and stillbirth but the commonest cause is a failure to conceive. Sterility (infertility) is an absolute state of inability to conceive, sub-fertility is a relative state of lowered capacity to conceive. Secondary sterility and sub-fertility are the same states of developing after an initial phase of infertility. All these conditions can affect people.

Nearly 15% of marriages of reasonable age and desirous of having children prove sterile. The incidence of infertility is increasing in Bangladesh. It is because of late marriage, general hygienic condition, improper medication, random use of oral contraceptives for long time.

Fertility is a relative rather than an absolute state. Comparatively few individuals are sterile or fully fertile. The majority fall somewhere in between these two extremis.

The fertility of a marriage is sum of the fertilities of the two partners. This explains why some couples fail to reproduce, when they separate. Fertility also sometimes varies in the same individual and there are periods of physiological sterility.

The impediments of early diagnosis and treatment of patients are still many including poor socioeconomic status, lack of health awareness, social taboos and restoring to treatment by unqualified village health workers.

Unhealthy magazine, spurious advertisements and publications also cause a great loss to the couples. Sadly enough, the qualified physicians also sometimes fails to refer the unfortunate childless couples to specialist care where appropriate treatment is available.

Advance diagnostic tools like hormone analysis, Hystero-salpingogram, Laparoscopy, Cervical Scoring, Antiserum, Antibodies detection, Swim up method of sperm separation, BBT  and their judicial interpretation can ensure proper diagnostic and adequate treatment within a reasonable time and expenditure.

Considering the cost, time consumption IUI (intra uterine insemination) has a definite place in practice of assisted reproduction to bring an invaluable smile in shattered mother.

The writers is an embryologist at Bangladesh Institute of Medical Science (BIMS).

E-mail: drmabashed@yahoo.com