Infertility

Infertility affects millions of people of reproductive age worldwide — and has an impact on their families and communities.

Infertility is defined as not being able to get pregnant (conceive) after one year (or longer) of unprotected sex. Because fertility in women is known to decline steadily with age, some providers evaluate and treat women aged 35 years or older after 6 months of unprotected sex.اضافة اعلان

Infertility can be primary or secondary

Primary infertility refers to couples who have not become pregnant after at least one year having sex without using birth control methods.

Secondary infertility refers to couples who have been able to get pregnant at least once, but now are unable.

Male or female infertility

Possible causes of female infertility

• Failure to ovulate
• Structural problems of the reproductive system
• Infections
• Failure of an egg to mature properly
• Implantation failure
• Endometriosis
• Polycystic ovary syndrome

Possible causes of male infertility

• Low sperm count: The man ejaculates a low number of sperm.
• Low sperm mobility (motility): The sperm cannot “swim” as well as they should to reach the egg.
• Abnormal sperm: The sperm may have an unusual shape, making it harder to move and fertilize an egg.

This can result from:

• Infection
• Ejaculation issues
• Antibodies that attack sperm
• Tumors
• Undescended testicles
• Hormone imbalances
• Defects of tubules that transport sperm

If both partners are young and healthy and have been trying to conceive for one year without success, a visit to a doctor could help to highlight potential medical problems earlier rather than later.

Women over the age of 35 should see their physician or women’s health nurse practitioner after six months as fertility tests can take some time to complete, and age may affect the treatment options that are open in that case.

Infertility tests for men

Collect your medical history, medications, and sexual habits and have a physical examination conducted. The testicles will be checked for lumps or deformities, and the shape and structure of the penis will be examined for abnormalities.

Semen analysis: A sample may be taken to test for sperm concentration, motility, color, quality, any infections, and whether any blood is present. Sperm counts can fluctuate, so that several samples may be necessary.

Blood test: The lab will test for levels of testosterone and other hormones.

Ultrasound: This may reveal issues such as ejaculatory duct obstruction or retrograde ejaculation.

Infertility tests for women

A woman will undergo a general physical examination, her medical history, medications, menstruation cycle, and sexual habits.

Ovarian reserve testing, to find out how effective the eggs are after ovulation.

Pelvic ultrasound, to produce an image of the uterus, fallopian tubes, and ovaries.

Blood test: This can assess hormone levels and whether a woman is ovulating.

Hysterosalpingography: Fluid is injected into the woman’s uterus and X-rays are taken to determine whether the fluid travels properly out of the uterus and into the fallopian tubes. If a blockage is present, surgery may be necessary.

Treatment depends on the cause of infertility, but may include counselling, fertility treatments.

Assisted conception

The following methods are currently available for assisted conception.

Intrauterine insemination (IUI): At the time of ovulation, a fine catheter is inserted through the cervix into the uterus to place a sperm sample directly into the uterus. The sperm is washed in a fluid and the best specimens are selected.

The woman may be given a low dose of ovary-stimulating hormones.

IUI is more commonly done when the man has a low sperm count, decreased sperm motility. It can also help if a man has severe erectile dysfunction.

In vitro fertilization (IVF)

IVF is the most commonly used assisted reproductive technology. It has been proven useful in overcoming infertility conditions, such as blocked or damaged tubes, endometriosis, repeated IUI failure, unexplained infertility, poor ovarian reserve, and poor or even nil sperm count.

Intracytoplasmic sperm injection is used in case of poor semen quality, low sperm count or failed fertilization attempts during prior IVF cycles. This technique involves an injection of a single healthy sperm directly injected into mature egg. The fertilized embryo is then transferred to womb.

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