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Indian Express
22 May 2010
By Anuradha Mascarenhas

SO far, donor insemination was the answer to male infertility but In Vitro Fertilisation (IVF) specialists in the city, who are seeing an increase in male infertility cases in the last couple of years, say newer techniques can now help in morphologically selecting sperms to ensure a healthy pregnancy.

Techniques like Intra Cytoplasmic Morphologically Selected Sperm Injection (IMSI) are showing good results, according to IVF specialists who attribute the decline in semen quality seen of late to lifestyle changes, stress and also pollution.

Dr Sunita Tandulwadkar, chief of the IVF and endoscopy centre at Ruby Hall Clinic, says, “Historically, infertility has been attributed to women. However, the incidence of male infertility is about 4045 per cent...We get patients from both urban and rural population but male infertility is being seen more among urban men because of lifestyle factors.“

Dr Bharati Dhorepatil, director at Pune Fertility Centre, says earlier, the focus was on women who could not conceive. Now, out of the 150 couples seeking treatment every month, 40 per cent identified with the infertility problems are male, says Dhorepatil.

Experts say diagnosis of more cases is also contributing to higher male infertility numbers. According to Dr Leena Patankar, director, Genesis Test Tube Baby Centre, the incidence of male infertility was 15–20 per cent earlier. Now it has increased to over 40 per cent and one of the reasons is diagnosis of more cases. Advanced techniques like blastocyst culture and embryo freezing provide higher pregnancy rates but if the sperm count is much too low, it may be possible to surgically extract enough sperm cells from the testes to be used for ICSI (Intra–cytoplasmic Sperm Injection).

Tandulwadkar says semen analysis is a must for treatment on a couple to begin.

“We do not start treatment before reports tell us the sperm count,” she says. A ‘normal’ count will have an overall volume of at least 2 ml, sperm density of more than 20 million sperm per ml, motility (the percentage of sperm cells present that are moving) of 50 per cent or better with the proportion of normal forms being 15% or greater.

Very severe male infertility can be overcome with techniques like ICSI and sperms can be selected by IMSI, which is at present available at Ruby Hall Clinic.

The technique has helped over 150 men in 2009–10, says Tandulwadkar. “Here, we study the morphology of the sperm and if it indicates it is genetically normal then we proceed with the ICSI technique,” says Tandulwadkar.

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