TREATMENT OF INFERTILITY IN THE FEMALE.
The treatment of infertility should be tailored to the problems unique to each couple .treatment in all cases depend upon correction of the underlying disorder or disorders suspected of causing infertile and wishing children.
Nutritional :protein, energy, vitamin and mineral deficiencies must be corrected
Good nutrition for stability of body weight, requires that energy and protein intake, vitamins and minerals are balanced over time. The average energy intake is about 2800 kcal/ day for men and about 1800 kcal/ day for women, the protein need is about one gram/ kg body weight per day, though these estimates vary with age, body size and activity level.
Additional vitamins which support better fertility is better gives to the women as such as:
1.Vitamin A 20 000 IU per oral [PO] daily. Since the lack of vit A interferes with the process of ovulation, an adequate dietary supply of this vitamin necessary for normal fertility.
2.Vit E-alpha tocopherol 100 IU , per oral once daily. If vit E deficiency in female, ovarian function is normal but uterine physiology is disturbed. There is partial failure of implantation, and the fertilized ova implanted grow and develop only to a certain stage , at which time the embryo show generalized hemorrhage, die, and is aborted or resolved. Administration of vit E during the first half of gestation permits normal embryo development and parturition.
3.Vit C 500 mg , per oral once daily. Vit C is concerned fundamentally with the formation of intercellular substances, including the collagen of fibrous tissue structures, the matrices of bone, cartilage, and dentin, and all non epithelial cement substance, including of vascular endothelium. Administration of vit C, within a few hours rapid repair of tissues in wounds and bone fractures, and is an important factor in determining resistance to infection.
Source: Philip B. Hawk, Ph.D., Sc. D. [Hon].Practical Physiological Chemistry, McGraw-Hill, New York, 1954, p 1104-1296.
Treatment of endocrine disorders.
1. Estrogenic hormone: Estradiol 1 mg once daily for the 6th-11h day of the woman menses, this hormone will stimulate the ovulation on the 14th of menses, and hope the next menses on the 28th day of menses.
2. Clomiphene citrate is administered in dose of 100 mg/ day for 5 days. Clomiphene is used in the treatment of disorder of ovulation in patient who wish children. Usually, a single ovulation is induced by a single course of therapy, and the patient must be treated repeatedly until pregnancy is achieved. The compound is no of value in patients with pituitary failure.
3. The gonadotropins are produced by a single type of pituitary cell..These hormones serve complementary functions in the reproductive process. The follicle stimulating hormone [FSH] and luteinizing hormone [LH] from anterior pituitary gland control the function of ovary. The FSH is responsible for the early maturation of the ovarian follicles; that FSH and LH together are responsible for their final maturation. The doses begin with 75 IU FSH plus 75 IU LH [one ampule] intramuscular daily for 9-12 days. If pregnancy still does not result, increase the dose to 2 ampules daily for 9-12 days.
4. Human menopausal gonadotropins [hMG] is known as menotropins consist of FSH 75 IU and LH 75 IU for subcutaneous or intramuscular injection. Its mechanism of action is to induce maturation of follicles and expulsion of ova.
5. Treatment of hypothyroidism with combination of levothyroxin[TY] and liothyronine [T3].Levothyroxine 25 microgram per oral daily for 2 weeks, increasing the daily dose by 25 microgram for the next 2 weeks. Liothyronine 5 microgram daily for 2 weeks such as levothyroxine.
Surgical measures correction of congenital, tumors, for the lower genital tract. Surgical
excision of ovarian tumors restore fertility. Surgical relief of tuba uterine
obstruction due to salpingitis will reestablish fertility.
Sodium bicarbonate 500 mg two times one gram per oral daily will induce the secretion of cervix, uterus and tuba uterine become base or alkaline which are favorable media for sperma to “swim” which facilitate fertilization.
Base-forming foods.Diet with a large amount of vegetables and fruits on burning outside or inside the body leave an ash or residue in which the basic elements [sodium, potassium, calcium, and magnesium] predominate; where as cereals, meat, and fish foods leave an ash in which the acid forming elements [chlorine, phosphorus, and sulfur] predomite.Such foods are spoken of a base forming and acid forming foods, respectively, and will influence the acid-base balance of the body, particularly [the cervix, uterus, and tuba uterine] can produce the alkaline secretion , which favorable for sperms life and motility, and then facilitate fertilization.
Source: Pilip B.Hawk et al.Practical Physiological Chemistry, McGraw-Hill, NewYork, 1954, p1097 and Appendix IV, p 1357-1364.
9. TREATMENT OF INFERTILITY IN THE MALE