All for Life

infertility-treatment

Infertility treatments at Wellkin Hospital

Infertility is a growing problem in Mauritius due to multiple factors, just as it is the trend around the world. However, says Dr Shilpa Sinha, Consultant Gynaecology and Obstetrics, “couples should never lose hope and should seek medical treatment. Wellkin Hospital offers different types of infertility treatments at affordable prices”.

Infertility is the inability to conceive through unprotected intercourse. It generally advised for couples to seek medical advice if they are not able to conceive after one year of unprotected sex and for those above 30 years, after six months of unprotected intercourse.

There are multiple factors which contribute to the inability of couples to conceive. “About 20 – 30% cases are due to male infertility, compared to 20 – 30% of female infertility. 25 – 40% is due to combined problems in both and 10 – 20% are due to unexplained causes”, explains Dr Shilpa Sinha.

At Wellkin Hospital, both couples are examined and go through a variety of tests in order to determine the root causes of their difficulties to conceive. Semen analysis is done for the husband. There could be different problems : low sperm count, premature ejaculation, obstruction of the passage through which sperm comes, abuse of alcohol/smoking which affect sperm production, lack of hygiene or genetic factors which could lead to forming of abnormal sperms. For such male infertility complications, patients are referred to the Urology unit of Wellkin Hospital.

As far as female infertility is concerned, many times the patient will complain of irregular menses. “In such kind of patients, it could be that they are not ovulating. Some patients have poly-cystic ovaries due to hormonal imbalance. We also examine the Fallopian tubes. If the tubes are blocked, even if the eggs are released, it is not going to work. We also have to look for uterine causes. Some patients have fibroid in the uterus, in which case, implantation may not take place. In some cases, there could be miscarriages. Then we have also to examine the cervix”, says Dr Sinha. She adds that women who are older, over 37, their ovarian reserve usually goes down and therefore they become less fertile. Another cause of infertility in women is endometriosis, characterized by the lining of the uterus getting deposited outside the uterus.

The importance of conceiving before 30

In females, the ideal age to have babies is 24 to 30 since they are very fertile, and they have good quality of eggs. Over 30 years, the fertility goes down, especially after the age of 37. For men, after the age of 40, the sperm count may go down too. Statistics shows that infertility rate could vary between 12 to 28% worldwide. Social trends have changed around the world and girls are getting married late and are conceiving late. But we get young patients who are married since four or five years and who are still unable to conceive”, observes the consultant.

Follow-up of couples at Wellkin Hospital How are couples with infertility problems taken care of at Wellkin Hospital?

“I first make it a point to explain to the couple that the problem is not always with the female. It is also a fact that males do not accept their infertility problems easily whereas females accept things more easily. “That’s why we need to evaluate both partners”, says Dr Sinha. She adds that sometimes some couples need psychological therapy because financially and emotionally, they are much stressed. Also, physically they have to be ready, strong and positive enough to bear the treatments, which could be sometimes tiring.

Infertility Treatments available at Wellkin Hospital

     •   Ovulation Induction Treatment: Medications and injections are prescribed to induce ovulation.

  • Intra-uterine Insemination (IUI):The couple is recommended to have natural intercourse and they also undergo artificial insemination. This increases the chances of the couple to conceive since the success rate of artificial insemination itself is only 20 – 25 %. Insemination consists of depositing a small quantity of semen directly into the uterus of the female partner.
  • In-Vitro Fertilisation:It is the last step of six-week treatment for infertility. The female patient is prepared for the follicles to grow through injections. When the follicles are mature, the eggs are removed under anaesthesia (known as egg collection).  The male partner then gives his sperm. And the fertilisation process is carried out artificially in the laboratory. Two to five days later, the fertilised egg or the embryo is transferred into the uterine cavity where it is implanted.
  • Intracytoplasmic Sperm Injection (ICSI):Patients who have very low sperm count undergo this procedure which requires very few sperms. The sperm is inserted in one egg for fertilisation process to take place and the fertilised embryo is transferred into the uterine cavity.

IVF is the last resort…
Dr Sinha points out that In-Vitro Fertilisation (IVF) is not the first option for couples having difficulties to conceive. In fact, it is the last resort, that is, when all the other options have failed. “If everything is alright with both partners as per results of tests carried out, we try to do ovulation induction. It consists of giving medicines and injections to the female patient to make her ovulate. We also need to follow these patients closely. Some may respond to only tablets and others may require injections.

Lifestyle

“Couples should review their lifestyle if they want to conceive”. Such is the strong advice of Dr Sinha. “They need to eat healthy food because many couples who have infertility problems may be obese. Women who are overweight or obese have difficulties to ovulate. Women and men should also quit smoking. They should also limit their alcohol consumption”.

What about the costs?

• Baseline tests : around Rs 10 000

• Ovulation induction. The medications are not expensive however, each injection costs between Rs 700 and Rs 800

• IUI : Rs 14 100 (day care treatment, no hospitalisation needed)

• Ovulation induction injections and artificial insemination combined : Rs 22 000 to Rs 25 000

• IVF : Rs 180 000 to Rs 200 000

Success rate

• Ovulation induction : 15 to 20%

• IUI : 20 to 25 %

• IVF : 30 to 35

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