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Monday, July 28, 2014

Infertility cases rising

KATHMANDU, Feb 11: Life has never been so difficult for 32-year-old Meena Thapa (name changed) of Terathum. If she is not able to conceive some time soon, her married life might come to an end.

Married for seven years now, Thapa realized last year that she has an infertility problem, and she is receiving treatment at an infertility center at Bujulibazar, New Baneshwor. However, despite having to spend a hefty amount on the treatment, there is no guarantee she will be blessed with a baby.

“I am undergoing treatment and it´s so expensive. However, it is not certain I´ll eventually have a baby. I wish instead that I had never married,” said the visibly distressed woman. “I will let my husband marry another woman if the treatment fails,” she added.

The Thapa couple run a small grocery shop at Gairidhara. They planned their stay in Kathmandu in the hope that good mkedical treatment might solve their problem.

Mrs. Thapa´s case is definitely not exceptional. Sedentary lifestyle, unsafe sex, late marriage, overuse of drugs, alcohol and tobacco, water and environment pollution and improper food habits, among other things, are causing more and more couples to take recourse to infertility treatment centers, doctors state.

For instance, at least six new cases of infertility are registered per day at the renowned infertility center at Bijulibazar, as compared to just one case a day or less only five years ago. While infertility in men or women can literally devastate their personal and family life and their finances, doctors admit that treatment and cure cannot always be guaranteed.

According to Chariman of Om Hospital Dr Bhola Rijal, infertility is such a serious problem that married couples can go to any extreme to cope with it. He also says that a cure cannot always be guaranteed. According to him, infertility is not only physical, it is even more a psychological or social problem, and the factors that cause it need to be addressed.

“The misery of such couples is beyond measure, and sadly, the problem is just getting worse. This calls for serious intervention by the government; the entire health sector has to be revamped,” he remarks.

The assessment of Dr Uma Srivastav, founder of the infertility care center, is no different. “If you ask me whether infertility is on the rise, my answer is definitely yes, and it´s on the rise both in the cities and villages. The lack of proper health services in the villages has worsened the problem,” Srivastav said.

“People come here for treatment all the way from Dailekh, Jajarkot, Rukum and Rolpa. Many come when it is too late,” she adds. According to her also, there used to be one client per day or less until five years back. Now, at least six cases are registered in a day. “Awareness levels have increased, but not sufficiently.”

According to Dr Srivastav, late marriage, obesity, induced abortion in the first pregnancy and inactive lifestyle are the main reasons behind infertility among women in urban areas. “And the common causes like genital tuberculosis, infection in the related parts and poor egg quality apply to all.”

As far as males are concerned, abnormal sperm production, sub-fertility and blockage of sperm delivery are common reasons preventing them from fathering children, Srivastav said. “Excessive consumption of tobacco and alcohol, sexually transmitted diseases and abnormal hormones pose high risk of infertility for both males and females.”

Dr Rijal adds that infertility in Nepal is also rising because of the increasing number of males going abroad for employment. “In course of treatments I have found the problem of infection or tube blocks due to infection in a maximum number of women.

“Millions of Nepalis who work in India and other countries transmit sexual diseases to their wives, and in case of lack of timely treatment, the tubes are permanently blocked in some women. Men might also lose their fertility due to excessive manual work.”

Rijal says,“People are least aware about reproductive health, and they have no access to timely treatment when problems arise, which leads to them becoming totally infertile.”

Published on 2012-02-11 05:36:26

Saturday, June 14, 2014

Started ICSI

  • Started ICSI as part of infertility treatment at Grande City Clinic.

Thursday, February 27, 2014

Ovarian Hyperstimulation Syndrome

Ovarian Hyperstimulation Syndrome (OHSS), a serious complication of Polycystic ovarian syndrome (PCOS) can be prevented during Controlled Ovarian Hyperstimulation!

Infertility Centre has been well known in the successful treatment of infertility with PCOS.
As anovulation is the major problem with PCOS, different ovulation inducers (CC, Letrozole, Gonadoliberins, Gonadotropins) are used to recover ovulation. During the induction period scannig shows a variety of pictures of growing follicles. The sizes of follicles may vary from 10-100mm. Similarly number of follicles may also vary from 12-40 or above. When the size of the ovary increases more than 5cm, there may be a danger of OHSS.
A study was done to overcome this situation. Study duration: Jan 2011-Dec.2013
The ladies were advised to take egg white (albumin) twice or thrice daily (depending on their body weight) from the time they are induced. The number of eggs they took varied according to the number & size of the cysts during monitoring.
Serial scanning & serum estradiol monitored the follicle development. If there was >5cm of ovaries with >12 follicles with 15mm, no HCG! If there was pain in the pelvis, acetaminophene was prescribed.
There had been no cases of OHSS during these years.
The conception rate has also not been reduced.