Authors
Dr. Anupama R, DGO, DNB, MNAMS, PG Diploma in USG, Chief Fertility Consultant, PRS Fertility Centre, PRS Hospital, Thiruvananthapuram.
Abstract
Background: Infertility, defined as a couple’s failure to conceive within 12 months of unprotected intercourse, affects a significant portion of the population. Its trends are complex, influenced by societal shifts like delayed childbearing, increased stress among working women, and declining male fertility, including sperm counts below 20 million/ml.
Current Scenario and Management: This article reviews the contemporary landscape of infertility, addressing major contributing factors such as endometriosis, which accounts for 20-40% of cases and is managed by endocrine therapy, laparoscopic microsurgery, and assisted reproductive technologies (ART). Polycystic Ovary Syndrome (PCOS), affecting 5-10% of women, requires lifestyle modifications, weight loss, medication like metformin, and ovulation induction. Male factor infertility, linked to genetic, infectious, and environmental causes, is also discussed.
Technological Advances: Modern science has revolutionized infertility treatment through various ARTs. These include in vitro fertilization (IVF), pre-implantation genetic diagnosis (PGD), assisted zona hatching (AZH), autologous endometrial coculture (AEC), and intracytoplasmic sperm injection (ICSI). ICSI is considered a safe and effective therapy for male factor infertility, though potential risks of genetic abnormality transmission are noted. Assisted hatching has demonstrated high success rates for specific patient profiles.
Conclusion: While infertility continues to be a growing challenge, continuous advancements in medical and assisted reproductive therapies provide increasingly effective solutions, making biological parenthood attainable for many. Further prospective randomized trials and innovations are necessary to address unresolved therapeutic problems, particularly in complex conditions like endometriosis.