Homoeopathic management of Infertility.

2. What is Infertility ?
Causes .
Priority special things.

3. Infertility is defined as a failure to conceive within one or more year of regular
unprotected coitus.
6 month for 35 years old or more.
The man is directly responsible in 30- 40% & female is 40- 55% and both is 10%
cases . The remaining 10% is unexplained.
Subfertility : Sub-fertility is relative state of lowered capacity to conceive.

4. Primary infertility: Denotes those patient who have never conceive.
Secondary infertility: Who have conceive at some time in the past.

13.  Ovulatory disorder-15%-25% may be more.
 Tubal factor-25%-35%.
 Endometriosis-25%-50%.
 Uterine and cervical factor---5%-10%.
 Primary ovarian insufficiently .
 Unexplained.

15.  General factors: Advanced of the wife beyond 35 years.
 Infrequent intercourse.
 Lack of knowledge of coital technique.
 Timing of coitus to utilize the fertile period.
 Apareunia & Dyspareunia .
 Anxiety & apprehension.
 Use of lubricants during intercourse – which may spermicidal.
 Immunological factor.

16. Age of the female partner.
Semen parameter of husband
Cause of infertility (PID, Endometriosis, Abnormal
semen, Reduced Ovarian Reserve)
Scope of living together
Cost involvement

17. Age of menarche.
Age of marriage.
Gynae/Obstetrics history.
Gravida / Para.
Family History.
Coital History frequency.
Both partner counselling.
Any PID , Mumps , STD.
Use OCP.
Others .

18. A 25 years woman attends to GOPD with her partner. They have been trying to
conceive for 15 month without success. She has regular menstrual cycles, with
bleeding every 28 days.
Q. What is your diagnosis ?
A 33 years old woman attends to GOPD having been trying to conceive for 12
month. She had 2 pregnancies , which resulted in the birth of her son 3 years
previously by emergency caesarean section for foetal distress & a miscarriage at
10 weeks gestation, following which she required uterine evacuation.
Q. What is your diagnosis ?

19. Infertility investigation &
Homoeopathic approach.

20. General examination: obesity , weight loss, acne, hirsutism & goiter should be noted.
Systemic examination: Hypertension , organic heart disease ,chronic renal failure .
Gynaecological examination : Cervical tear , infection, uterine size position ,presence
of nodules in the pouch of douglas.
Speculum/ PV examination:
Examination of cervix.
Uterus size.
Adnexal mass or tenderness.
Anteverted / fixed retroverted uterus.
Abnormal cervical discharge .The discharge is to be collected for gram stain &
culture.

21. Routine examination:
TC, DC, ESR , Hb % , X-Ray chest , Mantaoux test to exclude TB.
Blood sugar estimation to exclude examination.
Urine analysis.

22. Semen analysis.
Prostatic smear & culture to exclude gonorrhea.
Hormone analysis: Estimation of FSH , LH, testosterone , TSH, T3, T4
& prolactin.
Testicular biopsy will exclude spermatogenesis arrest from testicular
atrophy.
Immunological test: sperm agglutinating & sperm immobilizing
antibodies.

23. i. Ovulatory trouble.
ii. Tubal patency.
iii. Uterine cavity.
iv. Cervical.

24. Basal Body temperature: (0.4 degree F , Progesterone effect)
Cervical mucus change. (Oestrogen + Progesterone)
Vaginal cytology: Cell change (Eosinophilic & Karyopyknotic cell)
Endometrial sample: Proliferative & Secretory phase .
Simplest Day 21 serum progesterone.
Urinary LH.
Follicular monitoring.(USG)

26. Tubal patency test
Screening: Hysterosalpingography .
Time: Post menstruation ,i.e Follicular phase .
D 5 to D 11.

27. USG.
HSG.
Saline infusion sonography.
Hysteroscopy.

28.  Post coital test (Sims Huhner test)
 Cervical mucous characteristics.
 Shaky / circulatory motility sperm.

29. Treatment Plan for male
General care:
 Improvement of general health ,reduction of weight in obese , avoidance alcohol & Smoking.
 Use food supplement vitamin E,C,D,B12 & Folic acid.
 Medical treatment : See Repertory
 Surgical treatment:
 Obstruction of vas should be corrected by microsurgery: Vasoepididymostomy or vasovacectomy.
 Correction Varicocele.
 Impotence
 Assisted Reproductive Technology (ART)

30. Medical therapy:
Hormone therapy : The only clear indication for hormone therapy is a proven failure of ovulation .
Hormone gonadotrophin ot GnRH with clomiphene.
Bromocriptine. (See Repertory)
Operative treatment:
Dilatation of cervix.
Tubal insufflations.
Hysterosalpingography.
Laparoscopy.
Reconstriction operation on the tube (Salpingostomy ,Re-implantation of the tube)
Implantation of the ovary into the uterus or into a hydrosalphinx.
Correction of uterine position.

31. In vitro fertilization and Embryo transfer (IVF-ET)
Intra-Uterine insemination (IUI)
Tubal embryo transfer.
Zygote intra-fallopian transfer.

32. Repertory
Synthesis
MALE GENITALIA/SEX - STERILITY
GENERALS - LABORATORY findings - sperm count - low
FEMALE GENITALIA/SEX - STERILITY
Murphy
Female - INFERTILITY
Diseases - INFERTILITY