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1.
Cureus ; 16(3): e55566, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38586799

ABSTRACT

Infertility is the failure to conceive after one or more years of regular, unprotected life for a fertile female. Around 45% of males are responsible for infertility worldwide. Research shows that nearly 50% of infertility in India is related to male reproductive factors or diseases. The male-carrying pathology in semen production includes low sperm count, volume, motility, abnormal forms, and sperm functional tests. This case presents a 31-year-old male with complaints of wanting issues after a complete year of regular, unprotected intercourse. He had undergone all the routine diagnostic investigations on his wife, which reported no issues and recorded regular ovulatory cycles with patent tubes. Then, progressing in the diagnosis, a semen analysis revealed a semen volume of 2 mL, a sperm concentration of 4 million/mL, progressive motility of 8%, non-progressive motility of 3%, and immotile sperm of 89%, with normal sperm morphology. Based on clinical examination, semen analysis, and investigation, the case was diagnosed as oligoasthenozoospermia. Oligozoospermia means low sperm count, and asthenozoospermia means low sperm motility. Oligoasthenozoospermia can be correlated to the Shukra Kshaya Lakshanas mentioned in Ashta Shukra Dushti. There is no satisfactory treatment in modern medicine for these conditions. Yoga and Ayurvedic intervention are the better options for these conditions. This case report focuses on the management of oligoasthenozoospermia through yoga and Ayurvedic medicines, Youvanamrit Vati and Shilajitrasayan Vati, given to the patient for four months.

2.
Cureus ; 16(3): e55523, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38576657

ABSTRACT

Infertility, a complicated reproductive health issue that affects both men and women, can have a variety of causes, from anatomical abnormalities to hormone imbalances. This research addresses a couple who have been struggling with infertility for the past four years: a 31-year-old woman with bilateral tubal blockage and her 34-year-old spouse who suffered from primary infertility due to retrograde ejaculation (RE) for the same period. Analyzing the male's semen sample, it was discovered that there were dead sperm and urine, indicating RE. A hysterosalpingography indicated bilateral tubal obstruction in the female partner. Pelvic factors were examined via laparoscopy, which played a crucial role in addressing further issues. The procedure of treatment included testicular sperm aspiration for sperm extraction and intracytoplasmic sperm injection. Hormonal support was involved in the follow-up, and on the 14th day, the ß-hCG test came back positive. The intricate procedures of RE and cornual block are discussed, with a focus on how they affect reproductive health.

3.
Cureus ; 16(2): e54071, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38481882

ABSTRACT

We presented a 30-year-old man suffering from severe oligozoospermia caused by substantial sperm maturation arrest around the spermatid stage. Additionally, he was suffering from a varicocele. For three years, the couple had been trying to conceive. The clinical and endocrinological evaluation of the woman revealed that she was medically fit to undergo pregnancy. We performed laparoscopic ligation of the spermatic vein to treat the varicocele. Semen analysis was conducted at the beginning of the clinical pregnancy journey and after three and six months of treatment, which included 80 mg/day of phytoestrogens for six months. Six months following the end of the therapy, a second semen analysis was carried out. The inherent characteristics of the semen substantially improved in the third month, facilitating the implementation of the reproductive method referred to as intrauterine insemination. Following this treatment, the patient delivered a healthy baby weighing 3300 g. Sperm parameters improved substantially after three months of therapy; however, they reverted to baseline values during the wash-out period. These promising findings strongly suggest that phytoestrogens could be utilized for therapeutic purposes in the management of oligozoospermia. To further demonstrate the potential impact of phytoestrogens on male infertility, it is imperative to conduct a validation phase and randomized controlled trials.

4.
Cureus ; 16(2): e54095, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38487118

ABSTRACT

This research presents a case study involving a 39-year-old male and his 34-year-old female partner seeking fertility consultation in Maharashtra, India, after struggling to conceive for over three years. Despite the male participant's lack of discernible medical conditions and typical lifestyle, semen analysis revealed severe oligozoospermia attributed to elevated stress levels from his physically demanding occupation and infertility-related emotional strain. The female partner exhibited normal blood parameters, including anti-Müllerian hormone (AMH). Embracing holistic approaches, the couple integrated yoga and Yoga Nidra into their daily routine to address stress-induced hormonal imbalances. The customized yoga regimen is aimed at stress reduction and overall well-being, incorporating physical postures, breathing exercises, and meditation. Yoga Nidra, a guided relaxation technique, was employed to induce profound rest and alleviate stress. Over a 12-week period, the male participant diligently adhered to the regimen, reporting heightened relaxation, improved sleep quality, and reduced stress levels. Semen analysis before and after intervention showed significant improvements in sperm count and motility alongside diminished morphological abnormalities. In parallel, the female partner underwent intrauterine insemination (IUI), resulting in a positive beta-human chorionic gonadotropin (ß-hCG) analysis. Weekly follow-ups monitored progress, with supplementation administered as needed. While promising, further research with larger sample sizes and controlled trials is warranted to establish definitive efficacy. Overall, yoga and Yoga Nidra offer noninvasive adjuncts to conventional therapies for male infertility, underscoring the importance of integrating holistic practices into comprehensive fertility management strategies.

5.
Cureus ; 16(1): e53268, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38435865

ABSTRACT

Infertility, defined as the inability to conceive after 12 months of unprotected sexual activity, affects millions globally. Approximately 80% of cases have identifiable causes, including endometriosis, tubal obstruction, ovulatory dysfunction, and male sperm abnormalities. Lifestyle factors, such as smoking and obesity, also impact fertility. Sperm morphology, a key factor in male infertility, often presents as teratozoospermia, with defects in the head, midpiece, or tail. Poor ovarian reserve, indicated by low anti-mullerine hormone (AMH) and antra-follicular count (AFC) values, contributes to female infertility, often exacerbated by age-related factors. Elevated follicle-stimulating hormone (FSH) levels further diminish oocyte quantity and quality. Intracytoplasmic Sperm Injection (ICSI), a micromanipulation technique aiding infertile couples, may face challenges in detecting subtle sperm morphology defects. Advanced methods like Motile Sperm Organelle Morphological Examination (MSOME) and Intracytoplasmic Morphologically Selected Sperm Injection (IMSI) under high magnification enhance sperm selection accuracy. We present the case of a 36-year-old woman and her 42-year-old husband who sought assistance after seven years of infertility. Previous Intrauterine injection (IUI) and ICSI attempts failed due to the wife's low ovarian reserve and elevated FSH, compounded by the husband's teratozoospermia. Their earlier In-Vitro Fertilization (IVF) experience yielded a single poor-quality oocyte, hindering blastocyst formation. Investigations revealed the wife's poor AFC, AMH of 0.033ng/ml, and FSH at 24IU/L. Her medical history included hypertension and gallbladder removal. The husband exhibited 98% defective sperm, devoid of a substance abuse history. The wife's family had a polycystic ovarian syndrome (PCOS) history, and her low AMH and AFC yielded only three poor-quality oocytes during the current assessment. Oocytes were retrieved, and sperm were selected with the help of IMSI. After ICSI, the patient successfully conceived.

6.
Cureus ; 16(2): e54342, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38500914

ABSTRACT

Polycystic ovary syndrome (PCOS) presents complex challenges in diagnosis and treatment due to its multifactorial nature. This case study focuses on a 31-year-old woman exhibiting symptoms of weight gain, irregular menstruation cycles, and hirsutism, leading to a diagnosis of PCOS. Conventional diagnostic criteria and ultrasound confirmation of multiple ovarian cysts supported the diagnosis. By integrating Ayurvedic principles alongside Western medical techniques, this study sought to address imbalances in the Kapha and Pitta doshas, fundamental energies according to Ayurveda, believed to contribute to PCOS symptoms. Clinical findings emphasized the role of Pitta dosha imbalance in inflammation, hormonal irregularities, and excessive body heat, while Kapha dosha imbalance manifested in fluid retention, weight gain, and increased mucus production. A holistic treatment approach was devised, aiming to restore doshic balance while addressing hormonal and metabolic dysregulation. The treatment protocol comprised lifestyle modifications, advocating for a regular exercise regimen focusing on activities enhancing insulin sensitivity and promoting weight loss. Swimming, yoga, and brisk walking were recommended to achieve these goals. Dietary interventions tailored to balance Kapha and Pitta doshas were prescribed, emphasizing nourishing, warming foods low in carbohydrates to prevent weight gain and boost metabolism. Anti-inflammatory foods, such as turmeric and ginger, were incorporated to mitigate inflammation. The integration of Ayurvedic principles alongside Western medicine offered a comprehensive approach to PCOS management, addressing both the root causes and symptoms of the condition. This personalized treatment strategy aimed not only to alleviate immediate symptoms but also to promote long-term health and well-being by restoring doshic equilibrium and optimizing hormonal and metabolic functions. In conclusion, this case study highlights the potential efficacy of combining Ayurvedic and Western medical approaches in the management of PCOS, offering a tailored and holistic treatment paradigm for patients seeking comprehensive care.

7.
Cureus ; 16(2): e54529, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38516424

ABSTRACT

This article evaluated the effect of the Shanghai protocol on a hypergonadotropic hypogonadism patient undergoing in vitro fertilization (IVF) treatment. Hypergonadotropic hypogonadism was characterized by low sex hormone levels and elevated gonadotropins, leading to infertility. Poor ovarian response and failed pregnancy outcomes were the results of previous IVF treatments using conventional stimulation methods. The 37-year-old female patient was advised to follow the Shanghai protocol, which involved gonadotropin stimulation following pituitary suppression with a long-acting gonadotropin-releasing hormone agonist (GnRH-a). The Shanghai protocol significantly improved the ovarian response. Two oocytes were retrieved, and one 4AA grade (number 4 represents an expanded blastocyst, the embryo is large, and the zona is thin; first A represents the inner cell mass of numerous and tightly packed cells; second A represents trophectoderm, with many cells organized in epithelium) embryo was formed. According to her previous result, the patient with hypergonadotropic hypogonadism who had one unsuccessful IVF cycle after visiting our infertility center was advised of the Shanghai protocol. Establishing these results and enhancing the Shanghai protocol's implementation to this specific patient treatment, clinical pregnancy was achieved.

8.
Cureus ; 16(1): e53018, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38410342

ABSTRACT

This case report revolves around a 35-year-old woman and her 39-year-old husband, who have been married for 10 years and were seeking treatment for their secondary infertility. The husband had been diagnosed with diabetes mellitus (DM) for the past seven years and had been on continued medication. Both partners underwent medical evaluations, and the husband was found to have normozoospermia. The wife had a normal ovarian reserve but was still facing difficulties in conception. Previous medical history showed that the husband's DM had been treated with metformin, and the woman had a history of unsuccessful in vitro fertilization (IVF) cycles and one miscarriage upon investigation. Our initial treatment attempt had failed, and upon assessment of the semen, it revealed a significantly increased sperm DNA fragmentation index, leading us to consider physiological intracytoplasmic sperm injection (PICSI). The couple then opted for a rescheduled ovum pick-up with PICSI over traditional ICS. PICSI involves selecting mature sperm with hyaluronic acid affinity, aiming to avoid immature, morphologically defective spermatozoa during microinjection. The couple then followed up for treatments; the husband continued with diabetes treatment, and the woman was advised to take progesterone supplements to ensure optimum uterine thickness. The PICSI procedure was followed by a successful embryo transfer, which subsequently led to a positive clinical pregnancy. This report highlights the importance of utilizing advanced technologies like PICSI in infertility cases after considering factors such as sperm quality to enhance the chances of a successful clinical pregnancy.

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