Infertility

INFERTILITY

Infertility: A couple is classified as infertile if they have not used contraception and not become pregnant for 12 months or more. Impaired Fecundity…

Dr. Shweta Bairagi · 28 May 2011

Infertility: A couple is classified as infertile if they have not used contraception and not become pregnant for 12 months or more.Impaired Fecundity: Women are stated to have impaired fecundity when they have difficulty becoming pregnant, are unable to become pregnant or cannot carry a baby to term..Infertility Services: Includes medical tests to diagnose infertility, medical advice and treatments to help a woman become pregnant, and services other than routine prenatal care to prevent miscarriage.xxiiiI nfertilityInfertility means not being able to get pregnant after one year of trying. Or, six months, if a woman is 35 or older. Women who can get pregnant but are unable to stay pregnant may also be infertile.Pregnancy is the result of a process that has many steps.To get pregnant:A woman’s body must release an egg from one of her ovaries (ovulation).The egg must go through a fallopian tube toward the uterus (womb).A man's sperm must join with (fertilize) the egg along the way.The fertilized egg must attach to the inside of the uterus (implantation).Infertility can happen if there are problems with any of these steps.infertility is not always a woman's problem . Both women and men can have problems that cause infertility. About one-third of infertility cases are caused by women's problems. Another one third of fertility problems are due to the man. The other cases are caused by a mixture of male and female problems or by unknown problems.Primary infertility describes couples who have never been able to become pregnant after at least 1 year of unprotected sex (intercourse).Secondary infertility describes couples who have been pregnant at least once, but have not been able to become pregnant again.FEMALE INFERTILITY:Most cases of female infertility are caused by problems with ovulation. Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.Ovulation problems are often caused by polycystic ovarian syndrome (PCOS). PCOS is a hormone imbalance problem which can interfere with normal ovulation. PCOS is the most common cause of female infertility. Primary ovarian insufficiency (POI) is another cause of ovulation problems. POI occurs when a woman’s ovaries stop working normally before she is 40. POI is not the same as early menopause.Female infertility may be due to:Problems with a fertilized egg or embryo being able to survive once it is attached to the lining of the uterusProblems with the fertilized egg being able to attach to the lining of the uterusProblems with the eggs being able to move from the ovary to the uterusProblems with the ovaries producing eggsFemale infertility may be caused by:Autoimmune disorders, such as antiphospholipid syndrome (APS)Clotting disordersDefects of the uterus and cervix (myomas or fibroids, polyps, birth defects)Excessive exercising, eating disorders, or poor nutritionExposure to certain medications or toxinsHeavy use of alcoholHormone imbalance or deficienciesLong-term (chronic) disease, such as diabetesObesityOvarian cysts and polycystic ovary syndrome (PCOS)Pelvic infection or pelvic inflammatory disease (PID)Scarring from sexually transmitted infection or endometriosisTumorMALE INFERTILITY : Male factor infertility may result from low sperm count or low sperm motility, or decreased ability of the sperm to fertilize the egg or abnormal shape of sperms or lack of semen or inability of man to deposit the sperm into vagina due to erectile dysfunction or hypospadios. The leading cause of male infertility is low sperm count. Others may be low sperm motility, bad quality sperms, lack of semen, presence of pus cells in semen & inability to deposit semen into vagina either due to absent ejaculation or due to any sexual dysfunctions as erectile dysfunctions. In general, most cases of male infertility are due to low sperm count. There are many biologic and environmental factors that can lead to low sperm count. Here is a list of conditions that may cause low sperm count in men. Please click the links for detail information about causes, investigations & treatment options.Oligospermia | Low Sperm CountAzospermia | Nil Sperms | Low Sperm MotilityPus in SemenAnti-Sperm AntibodyLess Semen FormationAbsent EjaculationDead SpermsAbnormal SpermsImmotile SpermsMale infertility may be due to:A decrease in the number of spermSperm being blocked from being releasedSperm that do not work properlyEnvironmental pollutantsExposure to high heat for prolonged periodsGenetic abnormalitiesHeavy use of alcohol, marijuana, or cocaineHormone deficiency or taking too much of a hormoneImpotenceInfections of the testes or epididymisOlder agePrevious chemotherapyPrevious scarring due to infection (including sexually transmitted diseases), trauma, or surgeryRadiation exposureRetrograde ejaculationSmokingSurgery or traumaWhat increases a man's risk of infertility?A man's sperm can be changed by his overall health and lifestyle. Some things that may reduce the health or number of sperm include:• Heavy alcohol use• Drugs• Smoking cigarettes• Age• Environmental toxins, including pesticides and lead• Health problems such as mumps, serious conditions like kidney disease, or hormone problems• Medicines• Radiation treatment and chemotherapy for cancerWhat things increase a woman's risk of infertility?Many things can change a woman's ability to have a baby. These include:• Age• Smoking• Excess alcohol use• Stress• Poor diet• Athletic trainingThe first diagnostic step is the evaluation of the infertile couple and to determine which partner is infertile.Normally the steps of a basic infertility evaluation would include:History: Taking a thorough medical history including any other medical conditions you might be having, any history of drug intake, and any other obstetric or gynaecological problems that you may have.Physical examination A thorough physical examination.Blood tests Depending on the individual couple’s situation, various blood tests on either the female or the male may be needed. They can include testing for the levels of various sex hormones.Taking a sample of semen and doing a semen analysisFinding out if the woman is ovulating or not (i.e. producing egg in every menstrual cycle)Hysterosalpingogram This test is done in order to assess the anatomy of the cavity of the uterus and the fallopian tubes.Laparoscopy May be required after basic tests have been done. The surgeon looks inside the abdomen through an endoscope to look for any deformities of the tubes or for endometriosis.