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  • What is considered infertile?

    Infertility refers to the inability to conceive after trying for a certain period, usually one year, despite regular unprotected sexual intercourse. Infertility can affect both men and women. The approximate causes are: male factor 20–30%, female factor 40–55%, both partners 10–40%, and unknown causes 10–20%.

    Indicators of infertility include:

    • Having regular sexual intercourse (2–3 times per week) without using any form of contraception for one year but still unable to conceive.

    • Couples who are older, especially women over 35 years of age, as age can reduce fertility. They may also have conditions that affect the reproductive system, such as endometriosis or polycystic ovary syndrome (PCOS).

    Causes of Infertility

    1. Causes from women

    Causes in women may include congenital abnormalities of the reproductive system, infections, or hormonal disorders that affect ovulation, abnormal growth of the uterine lining, fallopian tube blockages, adhesions, ovarian cysts, and endometriosis.

    1. Causes from men

    Common causes in men include low sperm count, poor sperm motility, abnormalities in sperm production or transport, sexual dysfunction, ejaculation problems, and reduced ability of sperm to fertilize eggs. Other contributing factors may include immune system disorders, retrograde ejaculation, blockages in the vas deferens, infections, congenital reproductive abnormalities, obesity, physical disabilities, stress, smoking, and alcohol consumption. These factors can directly affect sperm health.

     

    By Assoc.Prof. Matchuporn Sukprasert

  • How to Diagnose and Treat Infertility?

    There are various methods for the treatment of infertility. The choice of treatment depends on several factors, including the underlying cause of infertility, the age of the partners, the timing of conception attempts, and other environmental factors.

    The first step in managing infertility is to identify its underlying cause. A thorough evaluation should be performed for both partners, as infertility may originate from either. In some cases, no abnormalities are detected. Even then, treatments such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), which are assisted reproductive technologies (ART), can be offered to increase the chances of pregnancy.

    Infertility Evaluation in Married Couples

    Infertility evaluation should be conducted for both partners together. The evaluation usually begins with a detailed review of each partner’s medical history.

    Women: A detailed history should include gynecological history, past medical and surgical history, menstrual history (including cramps), history of pelvic infections, in utero exposure to diethylstilbestrol (DES), and any history of endocrine disorders.

    Men: The history should include any surgery or trauma involving the reproductive organs, past infections (such as mumps), other relevant medical conditions, and sexual history of both partners, including issues with ejaculation, pain, or other sexual abnormalities. Family history of genetic disorders in both partners should also be assessed.

    General Health Checkup

    A general health evaluation should include gynecological examination to assess the reproductive organs and development, Pap smear testing, physical examination of the testes, semen analysis, assessment of ovulation, and additional tests for fallopian tube patency. It is also important to assess any history of previous pelvic surgery or infections, as these may affect fertility.

    After identifying the underlying cause of infertility, appropriate treatment methods can be determined, including the use of advanced reproductive technologies to enhance fertility and assist conception.

     


    By Assoc.Prof. Matchuporn Sukprasert

  • Does “hip raises” and “leg raises” after sex increase your chances of getting pregnant?

    There is no scientific evidence to support this. Lying down, elevating your hips with pillows, or raising your legs after sex does not increase your chances of becoming pregnant. Normally, after ejaculation, sperm are capable of swimming through the cervix and uterus toward the fallopian tubes on their own, without the need for gravity.

     

    By Assoc.Prof. Matchuporn Sukprasert

  • In infertility treatment, is it necessary for everyone to do Hysterosalpingography (HSG) before starting treatment?

    There is no need for every patient to undergo hysterosalpingography before starting infertility treatment. This test is usually considered by the doctor based on specific risk factors, such as a history of pelvic surgery, endometriosis, uterine tumors, uterine fibroids, a congenitally abnormal uterus, or other related gynecological conditions.

  • What is Hysterosalpingography (HSG) ?

    Hysterosalpingography (HSG) is an internal procedure used to examine the uterine cavity and the patency of the fallopian tubes. A small catheter is inserted through the cervix, and radiopaque contrast material is injected into the uterine cavity while X-ray images are taken as the contrast flows through the fallopian tubes into the pelvic cavity.

    This test may cause lower abdominal discomfort during and after the procedure, which varies among individuals. Doctors usually prescribe oral pain relievers before the test. The procedure is typically performed without sedation. The ideal time for HSG is between 2–5 days after menstruation ends, and usually no later than day 10–12 of the menstrual cycle.

     

    By Assoc.Prof. Matchuporn Sukprasert

  • PCOS VS Chocolate Cyst

    PCOS (Polycystic Ovary Syndrome) and Chocolate cysts are different conditions.

    PCOS (Polycystic Ovary Syndrome)

    PCOS is an endocrine disorder that causes imbalances in estrogen, progesterone, androgen, and insulin levels. It is characterized by multiple small fluid-filled cysts in one or both ovaries, which may increase ovarian size. This condition may result in irregular menstrual periods, acne, hirsutism, or infertility. It is most commonly found in women of reproductive age.

    Chocolate Cyst (Ovarian Endometrioma)

    Chocolate cysts are believed to form when menstrual blood flows backward through the fallopian tubes into the abdominal cavity and becomes trapped in the ovaries, forming blood-filled cysts. They are more common in women of reproductive age. Symptoms and severity vary among individuals. Although not life-threatening, chocolate cysts can cause significant discomfort and complications, and the condition is relatively common.

     

    By Assoc.Prof. Matchuporn Sukprasert

  • What type of problem should ICSI be used?

    Indications for assisted reproductive techniques (ART) include:

    1. Women over 35 years of age.

    2. Women with blocked or damaged fallopian tubes.

    3. Women with a hard zona pellucida, preventing sperm from penetrating the egg.

    4. Women with a history of repeated unexplained miscarriages.

    5. Couples who have been trying to conceive for more than one year without success, despite using other methods such as timed intercourse based on ovulation monitoring or intrauterine insemination (IUI).

    6. Men with sperm abnormalities, such as low sperm count (oligospermia) or poor sperm motility.

    7. Men with azoospermia (absence of sperm in semen) or those who have had a vasectomy but still wish to have children. In such cases, sperm retrieval procedures such as PESA or TESE are performed to obtain sperm for intracytoplasmic sperm injection (ICSI).

    8. Couples with a family history of genetic disorders or previous children with genetic abnormalities.

     

    By Assoc.Prof. Matchuporn Sukprasert

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