Infertility is defined as the inability to conceive after one year of unprotected sex. However, many couples can conceive within that time frame.
Are you struggling to conceive a child? You are not alone. Infertility is a common problem that affects millions of people each year. In this blog post, we will discuss everything you need to know about infertility. We will cover the causes, symptoms, and treatment options available. We hope this information will help you get the answers you need and start on the path to parenthood!
What is infertility?
Infertility is defined as the inability to conceive after one year of unprotected sex. However, many couples can conceive within that time frame.
Infertility may also refer to the biological inability of an individual to contribute to conception or to a female who is unable to carry a pregnancy to full term.
Types of infertility
There are two types of infertility: primary and secondary.
- Primary infertility denotes those couples who have never conceived.
- Secondary infertility is the inability to conceive after previously being able to. It indicates the previous pregnancy but failure to conceive afterward.
What causes infertility?
There are many possible causes of infertility, including:
Faults in male
Male infertility is usually caused by a problem with the production of sperm. It can also be due to ejaculation problems, blockages in the reproductive tract, or health conditions that affect the testicles.
1. Defective spermatogenesis: It can be due to
- Orchitis: An inflammation of one or both testicles
- Undescended testis
- Genetic or chromosomal disorders
- Endocrinal factors like thyroid dysfunction
- Primary testicular failure
2. Obstruction of the efferent duct system: It can be due to the congenital absence of vas deferens or certain infections.
3. Failure to deposit sperm high in the vagina:
- Impotency
- Ejaculatory failure
- Hypospadiasis
- Psychosexual
4. Errors in the seminal fluids:
- Immotile sperms
- Low sperm count
- Low fructose count
5. Varicocele: A varicocele is a swelling of the veins that drain the testicle. This can cause the testicles to become too warm, which can affect sperm production.
6. Klinefelter syndrome: This is a condition that affects males who are born with two X chromosomes and one Y chromosome. It can cause problems with the development of the testicles and reduce sperm production.
7. Testicular cancer: Cancerous and noncancerous tumors in the testicles can affect sperm production.
8. Injury: An injury to the testicles or scrotum can cause infertility.
9. Hormone imbalance: A hormone imbalance can affect sperm production and function.
10. Aging: Sperm production declines with age.
Faults in the female
Female infertility can be caused by:
- Anovulation: The ovaries do not produce or release eggs.
- Oligoovulation: The ovaries produce few eggs.
- Luteal phase defect: The uterine lining does not develop properly.
- Tubal factor infertility: The fallopian tubes are damaged or blocked, so the egg cannot travel to the uterus.
- Faults in the female reproductive system: These are the most common cause of infertility. These include problems with the ovaries, fallopian tubes, or uterus. blockages in the fallopian tubes prevent the egg from traveling to the uterus.
- Endometriosis: It is a condition in which tissue that normally lines the uterus grows outside of it and can cause infertility by interfering with the implantation of a fertilized egg.
- PCOS, or polycystic ovary syndrome: It is a hormone imbalance that can interfere with ovulation.
- Fibroid uterus: Non-cancerous tumors in the uterus can make it difficult for a fertilized egg to implant or can cause early miscarriage.
- Cervical factors: The cervix produces mucus that either prevents sperm from entering the uterus or makes it difficult for them to swim through.
Combined factors
Some couples may have a combination of male and female infertility factors. There are many different causes of infertility, but the most common cause is a problem with the reproductive system. If you have difficulty conceiving, it is important to see a fertility specialist to determine the cause.
Investigations
Once the couple has been thoroughly counseled, various investigations are done to find out the cause of infertility. These investigations help in planning the line of treatment.
Female investigations
The most important investigation in a woman is to find out whether she is ovulating or not.
1. History: The initial step is to take a detailed history of the couple. This includes
- Duration of infertility
- Age of the woman
- Menstrual history
- Medical history
- Family history
- Surgical history
- Drug history
- Previous pregnancies
2. Obstetric and gynecological examination: A detailed physical examination is done. Particular attention is paid to the pelvic organs.
3. Basal body temperature charting: The woman’s body temperature is measured every morning before she gets out of bed. This is done for at least three months to check for ovulation.
4. Ovulation predictor kits: These are urine tests that measure the level of luteinizing hormone (LH) in the body. A surge in LH indicates ovulation is about to occur.
5. Blood tests: Blood tests are done to measure hormone levels. These include follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, thyroid stimulating hormone (TSH), and testosterone.
6. Ultrasound: An ultrasound is a painless test that uses sound waves to create an image of the inside of the body. An ultrasound can be used to check for the presence of ovarian cysts, measure the thickness of the uterine lining, and to check for fibroids or other abnormalities in the uterus. Ovulation can also be monitored by ultrasound.
7. Hysterosalpingography (HSG): HSG is an x-ray of the uterus and fallopian tubes. A contrast dye is injected into the uterus through the vagina and cervix. The dye fills the uterus and fallopian tubes, and an x-ray is taken. This test can show if the fallopian tubes are blocked.
8. Laparoscopy: Laparoscopy is a surgical procedure in which a small incision is made in the navel, and a thin, lighted tube called a laparoscope is inserted into the abdomen. This allows the doctor to see the inside of the abdomen and pelvis and look for conditions such as endometriosis, fibroids, or blockages in the fallopian tubes.
Male investigations
The initial investigation of a man is a semen analysis. This test measures the number of sperm, their motility (ability to move), and their morphology (shape). A semen analysis is usually done at a fertility clinic or lab. The results of the semen analysis are reported as follows:
- Concentration: This is the number of sperm in a given volume of semen. A low concentration may indicate a problem with sperm production.
- Motility: This is the percentage of sperm that are moving. Motile sperm are more likely to reach and fertilize an egg.
- Morphology: This is the percentage of sperm that have a normal shape. Sperm with a normal shape are more likely to fertilize an egg.
A semen analysis is often done along with other tests, such as a hormone profile, to help determine the cause of infertility. If a sperm analysis is abnormal, your doctor may recommend additional tests to find out the cause.
The other tests may include:
- Hormone profile: This measures the levels of hormones that are important for sperm production, such as testosterone.
- Post-ejaculatory urinalysis: This test is done to rule out a condition called retrograde ejaculation, in which sperm enter the bladder during ejaculation.
- Genetic test: This test is done to check for genetic conditions that may cause infertility, such as cystic fibrosis.
- Imaging tests: These tests may be done to check for blockages in the reproductive tract that could cause infertility. Imaging tests may include a transrectal ultrasound, testicular biopsy, or MRI.
Treatment of infertility
The treatment of infertility depends on the cause of the problem. If the cause is a treatable condition, such as endometriosis or a blocked fallopian tube, surgery may be recommended. If the cause is unknown, or if the problem cannot be corrected, fertility treatments like assisted reproductive technology may be recommended.
Fertility treatments include:
Ovulation induction:
This treatment is used to stimulate ovulation in women who are not ovulating regularly. Medications, such as clomiphene citrate or gonadotropins, are used to stimulate ovulation.
Intrauterine insemination (IUI):
This is a procedure in which sperms are inserted into the uterus through a small catheter. IUI is often done in conjunction with ovulation induction.
In vitro fertilization (IVF):
IVF is a procedure in which eggs are removed from the ovaries and fertilized with sperm in a lab. The fertilized eggs are then implanted in the uterus.
Intracytoplasmic sperm injection (ICSI):
This is a procedure used in IVF in which a single sperm is injected into an egg. ICSI is often used when there are male infertility problems.
Testicular sperm extraction (TESE):
This is a procedure in which sperm are removed from the testicles. TESE is often used when there are problems with sperm production.
Assisted hatching:
This is a laboratory procedure in which a hole is made in the outer covering of an embryo to help it hatch and implant in the uterus. Assisted hatching is often used in IVF.
Surrogacy:
This is an arrangement in which a woman carries and delivers a baby for another couple or person. Surrogacy may be an option for couples who cannot carry a pregnancy.
These are just some of the fertility treatments that may be recommended. Your doctor will work with you to create a treatment plan that is best for you.
Infertility can be a difficult and frustrating problem, but there are many treatment options available. With the help of a fertility specialist, you can find the cause of your infertility and get started on the road to treatment.
Conclusion
Infertility is a medical condition that affects both men and women. It can be caused by a variety of factors, including age, lifestyle, and health conditions. There are many treatment options available, depending on the cause of the problem. With the help of a fertility specialist, you can find the best treatment for you.
