I've been treating instances of infertility for 23 years, and I've discovered several illnesses that go untreated rather regularly.
These diseases are what I refer to as "hidden" diseases since they frequently go undetected.
Talk to your reproductive endocrinologist about these potential reasons of infertility and/or chronic, recurrent miscarriage.
1. Urealplasmaurealyticum
The quantity and mobility of sperm may be impacted by these microorganisms.
It may result in an infection in women that makes getting pregnant more challenging.
According to a recent study, women who have unexplained infertility are more likely to have urealplasma urealyticum, a specific kind of ureaplasma.
Sexual contact can transfer these bacteria. Additionally, HIV can spread through non-sexual interactions including sharing needles, receiving blood transfusions, and, in rare instances, coughing, kissing (saliva), and exchanging secretions from the nose or eyes. The illness can spread to an unborn child in pregnant women.
It's possible that these germs have been there for a long time without creating any symptoms.
Testing for sperm DNA fragmentation (SDF) gauges sperm quality from a DNA perspective.
The presence of mycoplasma and ureaplasma on cervical cultures in no way suggests adultery or other sexual wrongdoing.
These extremely preterm infants with ureaplasma in their windpipe at delivery had a lower survival rate (71% compared to those without the illness or those with the germs only found in their nose).
90% and 100%), as well as having a higher risk of bronchopulmonary dysplasia and other respiratory conditions.
Women's cervixes (40%–80%) or vaginas (21%–53%) may include Mycoplasma hominid (another microbe) and Ureaplasma urealyticum.
Antibiotics have an 80% likelihood of successfully curing the illness when used as a therapy.
Urine sample and vaginal swab are the testing methods. It is not necessary to test the guy. He has it if his female partner tests positive.
Treatment
usually entails taking an antibiotic treatment. Azithromycin or doxycycline are the recommended medications for Ureaplasma infection.
Does the use of acupuncture and herbal therapy in the treatment of ureaplasma have any advantages?
No. Antibiotic therapy should be used only to treat this.
2. Fragmentation of SpermDNA
as a result, it is more important than the specifications as a package carrier. analyzed in earlier semen examinations. Damage to the DNA, like as fragmentation, can negatively impact fertilization and may hinder embryo development and result in infertility. Men who struggle to conceive had worse sperm DNA quality and more extensive sperm DNA damage. integrity compared to fertile males, and sperm with DNA damage can result in the likelihood that the progeny may develop hereditary disorders. Even in guys with normal semen analysis findings, SDF can be seen. The worth should guide the use of SDF as a separate indicator for assessing semen quality. but regrettably, it is not included in semen analysis processes. When utilizing ART, the selection of sperm with defective DNA might lead to unfavorable outcomes, including higher risks of miscarriage and birth malformations, chromosomal abnormalities, and miscarriages are all examples of offspring. Therefore, in the era of ART, it is crucial to fully comprehend help maintain the DNA integrity of sperm. This is really simple to test.
organic conception
Numerous studies have shown that sperm DNA damage has an impact on natural conception. According to an investigation, Zini stated that excessive SDF made natural conception challenging.
Natural conception was nearly impossible, according to Evenson et al. and Spano et al., if SCSA discovered SDF of greater than 30%.
Additionally, it has been shown that couples trying to conceive naturally who are at a higher risk of sperm DNA damage may experience a longer gestation period and a lower chance of a healthy pregnancy.
SDF testing is therefore important for male fertility in both IUI and IVF settings as well as for individuals who choose spontaneous conception. This is especially true for people whose infertility has an unidentified reason.
implantation intrauterine
According to Bungum et al., when the DNA fragmentation index was greater than 30%, the likelihood of becoming pregnant using intrauterine insemination (IUI) was almost nonexistent. Reduced pregnancy and delivery rates following IUI were predicted by DFI levels (>30%).
Recent research has shown that early pregnancy and embryo development are influenced by paternal variables and sperm DNA damage.
In a meta-analysis of 11 research, Zini discovered a link between low conception rates and aberrant sperm DNA damage test findings.
injection of intracytoplasmic sperm
The length of time it took for the embryo to develop into a blastocyst decreased the likelihood of becoming pregnant with ICSI and increased the level of sperm DNA damage.
lost pregnancy
There is currently no information on how SDF affects miscarriage following ART; however, a recent meta-analysis looked at the relationship between high DNA damage levels and a higher risk of miscarriage. Regardless of the ART method (IVF or ICSI), Zini et al. observed that sperm DNA damage was a prognostic factor for pregnancy loss following ART
According to Robinson et al., utilizing sperm with significant levels of DNA damage during IVF or ICSI increased the probability of miscarriage by 2.16 times. According to Carrell et al., male partners of couples who have repeatedly miscarried had greater rates of sperm DNA damage (35%) than the general population (22%) or fertile males (12%).
A DFI of 30% or greater was linked to high miscarriage rates and low continued pregnancy rates, according to Check et alstudy .'s of 106 males in couples with reproductive problems who had previously experienced losses.
Recurrent miscarriages and significant sperm DNA damage were shown to be positively correlated, according to Khadem et al. SDF measures can be viewed as a helpful technique in predicting miscarriages linked to paternal variables, in conclusion.
Treatment options for people with elevated SDF levels
1. Changes in lifestyle
Environmental and lifestyle factors that are known to affect sperm DNA integrity include physical elements like radiation and heat, tobacco smoke, airborne pollutants, chemical elements like anticancer medications, sexually transmitted infections, and biological elements like advancing male age, increased body mass index, and diabetes. The most fundamental, significant, straightforward, and simple strategy to enhance sperm quality is through lifestyle adjustment. Men with poor sperm quality should give up smoking and alcohol use, do regular exercise, control their weight, wear loose-fitting underwear, and stay away from hot situations like saunas, lower-body baths, and hot workplaces.
2. preventing infection
Inflammation and infection of the male genital tract have been linked to 8%–35% of instances of male infertility, and infections of the male reproductive system have been linked to sperm DNA damage. Reactive oxygen species, which are known to damage DNA, are produced by inflammatory cells. White blood cells seen in semen come from the male genital tract and epididymis, and antioxidants in the seminal plasma remove the reactive oxygen species that white blood cells make. However, when a significant amount of reactive oxygen species is created, oxidative stress results in DNA damage to sperm. Antioxidants, acupuncture, and herbal therapy can all be used to treat these individuals in an effort to reduce the quantity of reactive oxygen species that the white blood cells create, so enhancing sperm fertility.
3. Using antioxidants orally
15% of couples who are of reproductive age have problems becoming pregnant, and in 50% of those situations, the male spouse is to blame. But a lot of male patients are unaware of the reasons of sperm issues. By harming sperm DNA, oxidative stress is recognized to be a significant component in male infertility.
Greco et al. discovered that although the fertility rate, cleavage rate, or embryo shape were not different in individuals who took antioxidants prior to ICSI, they did have greater clinical pregnancy and implantation rates.
In a meta-analysis of 32 research on male infertility and antioxidants published between 2000 and 2013, Imamovic Kumalic and Pinter discovered that vitamin E, vitamin C, selenium, coenzyme Q10, N-acetylcysteine, zinc, and L-carnitine were all beneficial. Zinc and selenium also produced effects that were comparable to those of vitamin C and vitamin E in decreasing DNA fragmentation.
The use of acupuncture and herbal remedies has been shown to significantly reduce sperm DNA fragmentation, and this finding suggests that these treatments may help couples who are experiencing infertility due to sperm DNA fragmentation.
3. Polyps
Subfertile women commonly have endometrial polyps; how polyps develop pregnancy loss may occur and is unknown to be a factor in subfertility. Mechanisms are not well known. Possible connection to mechanical interference implantation of an embryo, sperm travel, or intrauterine Endometrial receptivity factors may be produced in an inflammatory or abnormal manner. Different diagnostic tools like transvaginal ultrasound in two or three dimensions, Hysteroscopy or saline infusion sonography are frequently used to assess endometrial polyps with high rates of detection. Yanaihara et al. found that the position of the endometrial mass affected the outcome of 230 subfertile women who had hysteroscopy and polypectomy in a retrospective research. Polyp may have an impact on fertility and chances of spontaneous pregnancy. The For polyps found at the uterus, the pregnancy rate within 6 months following surgery was 57.4%. 28.5% of posterior wall polyps and 40.3% of numerous polyps at the uterotubal junction. 14.8% for anterior uterine wall polyps and 18.8% for lateral wall polyps. These findings imply that the bulk of polyps may cause interference with activities of reproduction include sperm transportation, embryo implantation, or early gestational development In contrast, in a different retrospective analysis, 83 hysteroscopic subfertile women with a history of menstrual disorders Regardless of age, polypectomy appears to increase pregnancy and fertility rates. the polyps' size or quantity.
Diagnosis
A two- or three-dimensional transvaginal ultrasound, which is ideally conducted in the early proliferative phase of the menstrual cycle, saline infusion sonography, and hysteroscopy are the diagnostic techniques that are frequently used to assess endometrial polyps.
A comprehensive investigation and meta-analysis concluded that saline infusion
Sonography is highly accurate in diagnosing various forms of diseases.
various anomalies within the womb.
Outcome
Numerous studies show that removing endometrial polyps is advantageous for IUI, assisted reproductive technologies, and naturally occurring pregnancies (ART).
Biological Conception
An link between polypectomy and increased rates of spontaneous conception was discovered in three nonrandomized trials. Infertile women with and without endometrial polyps were evaluated by Varasteh et al. They discovered that the pregnancy rate following polypectomy was 78.3% as opposed to 42.1% in those with a normal uterine cavity. Shokeir et al. reported a 50% pregnancy rate following polypectomy in such individuals, however Spiewankiewicz as al. reported a 76% pregnancy rate when 19 out of 25 infertile women conceived within 12 months after polypectomy. According to these research, polypectomy may be beneficial for women whose infertility is otherwise unexplained.
implantation intrauterine
In another research, hysteroscopic polypectomy or no treatment was randomly assigned to 120 infertile individuals who were planning to undergo IUI and had been diagnosed with endometrial polyps. Four rounds of IUI were planned for each patient. Hysteroscopic polypectomy prior to IUI is a successful strategy that raises pregnancy rates, as evidenced by the considerably higher cumulative pregnancy rates in the study group (38.3 vs 18.3%; p = 0.015).
Does the use of acupuncture and herbal therapy in the treatment of polyps have any advantages?
No. The only treatment for this is surgery.
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