A Study on Management of An ovulatory Infertility in Urban Nepalese Population
Keywords:Anovulation, Clomiphene citrate, Premenstrual Syndrome, Semen Analysis
The objective of this study is to investigate the causes of an ovulatory infertility, its management and outcome in an urban Nepalese population. An observational study conducted was among 58 couples visiting the department of Infertility Centre Pvt. Ltd. from November 2010 to May 2011. Infertile patients were mostly of middle reproductive stage ages from 24-39 years .The major contributing factors for female infertility were menstrual disorders due to hormonal disorders, premature ovarian failure and polycystic ovarian syndrome. The main menstrual disorders were amenorrhea (15.5%), oligomenorrhea (10.3%) and menorrhagia (3.4%). The various types of female infertility observed were PCOS (75.9%), premature ovarian failure (3.40%) and poor ovarian reserve (20.70%). Male causes of infertility were mainly oligospermia (10.7%), azoospermia (13.8%), asthenospermia (3.4%) and teratospermia (10.4%). The different types of infertility observed were primary infertility (48.3%) and secondary infertility (27.6%). For the management of anovulatory infertility, female patients with hormonal disorders were prescribed hormonal replacement therapy (48.3%) and those who failed to ovulate were prescribed Clomiphene Citrate (27.6%) for medical ovulation induction. Letrozole (17.2%) prescribed as an aromatase inhibitor used in whom ovulation induction with Clomiphene Citrate had failed. Hyponid, a herbal formulation was given as insulin sensitizing agents. M2 tone was given in managing functional menstrual disorders of adolescents. Vitamin B complex along with Clomiphene Citrate and folic acid prescribed for prevention of fetus neural tube defect. Calcium was prescribed for treating the disturbances with premenstrual symptoms. The majority of the patients who have undergone ovulation induction with Clomiphene Citrate were conceiving mainly by Intrauterine Insemination technique. Infertility is considered as a disgraceful condition, and something that is not discussed freely in developing countries like Nepal. With timely detection and proper therapeutic management an ovulatory infertility can be avoided.
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