It is important to consider natural outcomes in pregnancy. Within a year of marriage if the couple are having regular intercourse, 90% of the women should become pregnant. This figure rises to 95% after a 2 year period. No fertility treatment should be started during this period, as the delay in pregnancy is by chance, since these couples have low normal fertility than infertility. Thus 5-10% of couples will seek medical advice for delay in achieving pregnancy.

These couples, without further delay, should be investigated and referred to a specialist early. It is vital that investigations are planned bearing in mind that 15% of couples have multiple causes of infertility. It is wiser to do complete investigation in the beginning than to start treatment on the first abnormal result.

If a woman is over 35 years, there is a substantial fall in the chance of success with fertility treatment. A woman of 35 years with an older partner would have a 20% chance of conceiving in any month. Compare this to a woman in 19-26 years of age who has a 50% chance of conceiving
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Indications For An Early Referral To A Specialist Infertility Clinic:
1.Duration of infertility more than 3 years.
2. Woman's age more than 38 years.
3. FSH (follicle stimulating hormone) more than 10 IU/I in early menstrual phase.
4. Low and abnormal sperm count according to World Health Organisation (WHO) guidelines for sperm examination.
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Some Solutions:
A. Intra-uterine Insemination:
Intra-uterine Insemination(IUI) may be used to overcome potential problems like thickening of female cervical mucus, premature ejaculation, impotence or anatomical abnormalities. This enables the sperm to be inserted directly into the cervix via the vagina. IUI is only suitable for women with healthy Fallopian Tubes. It involves placing a specially prepared sample of sperm into the uterus at the optimum time in the cycle. To increase the chances of pregnancy, the female partner is given fertility drugs. The treatment is monitored by regular Ultrasound scan's to prevent multiple pregnancies.

B. In Vitro Fertilisation:
There are times when it is difficult for the sperm and egg to meet in the fallopian tube and the normal processes of fertilisation cannot take place in the body. In vitro fertilization (IVF)offers an opportunity to avoid such problems by allowing fertilisation to occur outside the body in a glass dish(culture dish).Up to 3 of any resultant embryos can be replaced in the womb. Appropriate IVF can be done with donated eggs, sperm or embryos.

C. Intracytoplasmic Sperm Injection:
Patients who are unlikely to achieve fertilisation with conventional IVF can be treated with micro-manipulation of the egg and sperm. The technique used is called intracytoplasmic sperm injection(ICSI).ICSI involves injecting a single sperm into the egg, using a very fine needle ICSI may be appropriate where the male partner has very few sperm or where the sperm have poor or no motility.
With the progress in medical science, a wide number of treatment options are available, with huge success rates. Thus it is advisable that couples visit specialist infertility clinics at the earliest.

Healthy Tips

KEEPING SKIN HEALTHY DURING WINTER 
Ivy Katema

Cold winter winds take a toll on our skin, hair, and even health but there are ways to beat the drying weather and the flaky, itchy skin it may cause. We need to be aware of what causes winter skin problems so that we can avoid them.

Change in temperatures and humidity, indoor heating, hot showers and bath remove important oils and moisture from the skin causing dryness, flakiness and cracking of the skin. If you think winter equals to dry cracked skin with no or very less preventative measures, think again.