Dr Komalas Women Clinic - PESA

Infertility - PESA

Many individuals dream of starting their own families. Nevertheless, many couples suffer from emotional and physical disturbances in their lives due to infertility or the inability to conceive a baby. About 80% of the women get pregnant without any medical help, 10% of them achieve fertility by the end of the second year, and 10% remain infertile. 

To treat infertility, many advanced technologies have been used in medical science such as artificial insemination, intrauterine insemination, in-vitro fertilization, and many more. 

What is infertility?

The word “stress” in stress incontinence only refers to physical pressure and has nothing to do with mental stress. The main sy

Infertility is the failure to conceive within a year or more with regular unprotected coitus. A healthy pregnancy requires both the man and the woman to be healthy.

The male is directly responsible for conception in nearly 30-40 % of cases and females in about 40-55 % of cases. 

The following are important for a healthy conception:

  • Healthy sperm 
  • A healthy female genital organ (the fallopian tubes, uterus, ovaries should be devoid of any pathological or anatomical disorders) 
  • A motile sperm that ascends through the uterine cavity without any problem
  • A healthy ovum (female egg)
  • A potent sperm to fertilise the ovum (female egg cell)

ptom is urine leakage during forceful physical activities, which can be just a few drops or enough to soak your clothes. If you suspect you have any symptoms related to stress incontinence, you should immediately talk with your doctor. These symptoms may include involuntary leakage of urine due to:

  • Coughing
  • Sneezing
  • Laughing
  • Bending down
  • Exercising
  • Lifting something heavy
  • Sexual intercourse
  • jumping

Your doctor will discuss your symptoms and try to solve your problem using non-invasive treatment methods. If your condition does not get better even after such treatment, your doctor may recommend surgery.

Causes of infertility in males

Some of the common infertility causes in men are:

  • Defective sperm, i.e. either the number of sperm is low, motility (movement) of sperm is low, or a deformed shape of sperm. 
  • Obstruction in the ejaculation of sperm because of anatomical deformity, infection, or trauma 
  • Hormonal disorders 
  • Endocrinal disorders such as obesity, thyroid dysfunction 
  • Congenital defects such as undescended testes
  • Infectious conditions such as Varicocele and Mumps orchitis
  • Cancerous tumours and their treatment such as radiotherapy and chemotherapy 
  • Genetic defects in chromosomes 
  • Other factors such as chronic disease, excessive smoking, and excessive alcohol consumption

Causes of infertility in females-

Various causative factors lead to infertility in females. Some of them are-  

  • Ovulatory dysfunction like no formation of egg cells, or irregular formation of egg cells. 
  • Premature ovarian failure 
  • The tubal blockage is like a blockage in the fallopian tube. 
  • Pelvic infections like endometriosis or adhesions
  • Some uterine factors like an anatomical defect in the uterus, uterine fibroid, or tuberculosis of the uterus. 
  • Cervical infections also contribute to infertility in females. 
  • Vaginal infections
  • Untreated sexually transmitted diseases
  • Hormonal imbalance delays ovulation which hampers the formation of an ovum (female egg cells) that causes infertility. 
  • Genetic defects in chromosomes can also cause infertility. 
  • Some other diseases like obesity, thyroid dysfunction, PCOD, and diabetes mellitus are also responsible for infertility in females.

A few common reasons behind infertility

Both men and women face a common set of issues that could lead to infertility. These include:

  • Reduction in the testosterone, the male sex hormone, which leads to premature ejaculation, erectile dysfunction, and loss of libido 
  • Reduction in fertile periods among women who are in their mid-30s
  • Obesity 
  • Smoking 
  • Alcohol consumption 
  • Stress
  • Exposure to radiation (through radiotherapy or chemotherapy)
  • Consumption of illegal drugs


Investigations required before treating infertility

A physician needs to look at the couple’s medical history and conduct detailed examinations to confirm the causative factors of infertility and to form a protocol for its treatment. 

Here are some of the major investigations that are conducted in this regard: 

  • Routine investigations such as blood tests and urine tests
  • Semen analysis to rule out the problem with sperm in males 
  • Transrectal ultrasound in males
  • Hysterosalpingography (Tubal factor) in females to rule out tubal blockage
  • Serum progesterone (evidence of ovulation) to find out the dysfunction in ovulation. 
  • Basal body temperature charting in females
  • Transvaginal ultrasound in females
  • Laparoscopy in females

Treatment of infertility

As the process of treating infertility is a long and exhausting treatment, it is important to stay positive and work under the guidance of a physician. 

Here are some tips to follow: 

  • Improve your general health by following a healthy diet, exercising regularly and adopting a healthy lifestyle 
  • Reduce your weight 
  • Avoid smoking and consuming alcohol

Fertility treatment for men

Before beginning the infertility treatment, the serum has to be analysed in detail. Infertility caused by an infectious disease or obstruction in the reproductive system is treated accordingly. 

The treatment of male infertility has improved significantly with the advent of various advanced technologies like ART (assisted reproductive technology). 

Intrauterine insemination, in-vitro fertilization, PESA, MESA, and intracytoplasmic sperm injection (ICSI) are some of the treatment options available for infertile males. 

  • PESA

This extraction technology is used to extract the sperm from the epididymis suffering from a low number of sperm (Azoospermia). It is a simple surgical procedure done under local anaesthesia to extract the sperm from the fine needle. This procedure doesn’t require one to incise the skin. The fluid is gently extracted from the fine needle out of the body, which is sent to the laboratory afterwards for processing. 

Fertility treatment for females

To treat ovulatory dysfunction in females, specific medications are used to induce ovulation.  

If the infertility is caused due to some infection such as chronic cervicitis or a vaginal infection, it is treated according to it. Tumours and other abnormal growths are treated surgically. 

Assisted treatment technology is also used in treating infertility. It involves the manipulation of fertilisation of sperm and ovum outside the body for treating infertility.

Bottom Line

Infertility is a stressed disease and involves many investigations. The treatment is exhausting too.

Infertile couples, particularly women, experience a lot of stress in terms of their relationships and their status in society. But, today, technology has given a ray of hope to many couples.

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