Semen– Human semen is 3-5 ml white liquid containg 40-100 million sperms. When sperms count is good the semen has a good viscocity. If there no sperms the semen is thin and watery. Soon after ejaculation the semen is viscous and in 5-10 mins it liquifes. When there is infection it is yellow in colour. Some men have ejaculatory dysfunction where the help of a sexual medicine doctor is taken. Common problem in semen are
Astheno Spermia : Normally sperms are highly motile cells the move so rapidly that there tail cannot be visualised. Sometimes due to heat , toxins , genetic problems sperm motility is decreased. Such sperms cannot naturally fertilise an egg. ICSI is the treatement of choice.
Terato spermia : Sometimes sperms may have abnormal morphology like
1) tail defect.
2) middle piece defect.
3) neck defect.
4) head & achrosomic cap defect.
Many of these defects have minor significance and hence these sperms can be used for ICSI. Only when NECK DEFECT are seen donor sperms are advisable as the NECK has centrosomes which are required for cell division after fertilization.
MESA : MESO EPIDIDYMAL SPERM ASPIRATION.
TESA : when tha sperm are aspirated from the testis with a needle it is called TESTICULAR SPERM ASPIRATION ( TESA ).
PESA : when the sperm are removed from Epididymis it called PER CUTANEOUS EPIDIDYMAL SPERM ASPIRATION ( PESA ).
MICRO TESE : when testis are cut and seminiferous tubules are pulled out and cannulaed to aspirate the sperm with the help of operating microscope it is call MICRO TESE.
ICSI has revolutionized the treatement of male infertility even a few sperms are enough to produce embryos.
1) semen analysis – Husbund gives his semen after 2 days of abstinence by masturbation. If the semen sample is brought frmon home it should reach the lab within 1 hour. If sample collection is difficult by masturbation than semen sample can be collected by special condoms and natural intercourse.
2) Trans vaginal ultrasound. ( TVS ) – Ultrasound is a techonology by which sound waves by high frequency > 2megha hertz pass through the soft tissues and according to there consistencies sound wave are echoed back to the transducer and images are displed on the monitor. TVS probes are of 5-7.5-10 MHz and we can see uterus , endometrium ovaries , fluid filled cysts. This is the best non invasive investigation giving maximum information about the pelvis. It is very useful in IVF for follicular study and oocyte aspiration.
Follicular study : It is the study of monitoring ovarin follicles and the day of ovulation with the help TVS probe for planned intercourse and IUI. It is done when tablets and injection of FSH / HMG are used for ovulation induction.
Ovum pickup : with the help of TVS probe follicles can be aspirated under anesthesia with the help of a needle. This is called Ovun Pickup.
HSG ( HYSTERO SALPINGO GRAPHY ) : Is a test done to check the patency of fallopian tubes , shape of the uterine cavity with the help of the Radio Opaque dye pushed in the uterine cavity and x-ray film’s are taken. They show the inner lining of uterus, tube and spillage of the dye in the peritoneal cavity it is done without done anestheisa.
LAPROSCOPY : Always done under anesthesia is an Invasive procedure where a key hole is made at the umbilicus and a scope is passed to visualise the uters tubes ovaries. It can be extended to do any corrective surgery like removal of adhesions or ovarian cysts.
HYSTERO SCOPY : Here we visualise the uterine cavity the Ostia by passing a scope through the cervix.