What is infertility?
Infertility is defined as inability to conceive after 1 year of unprotected well- timed intercourse. This duration reduces to 6 months in case you are over 35 yrs of age .
How does pregnancy happens?
Pregnancy is result of complex chain of events which occurs in a month serially. These events are:
1. A woman grows and releases eggs from ovaries. This is called follicles growth and followed by ovulation. The egg if taken up by tubes it travels towards the uterus slowly. The motile sperms after travelling through cervix, uterus and tube pierce the egg which is called fertilization. The fertilized egg starts dividing into more and more cells and gets attached to the inner lining of uterus which is called implantation.
2. When the embryo implants it prevents shedding of lining of uterus and so missed period occur which leads to probability of diagnosing a pregnancy.
How many people are suffering from infertility?
Out of 100 couples around 10 – 14 of them are suffering from infertility. In about 1/3rd cases are due to female partners, 1/3rd cases are due to male partners and rest due to unexplained or combined factors.
Infertility in males is caused by factors that affect sperm production [Quantity, quality and motility] and how sperm travels,hormone production, anatomical problems. It can also be due to genetics or inborn illness, injury or infections.
What does semen analysis means?
This checks the number, shape and movement of sperms. A second sample should be rechecked after about 10 – 12 weeks and then inference should be drawn ideally.
What are the common causes of male infertility?
These are varicocoele, infections, genetic abnormality, hormonal disbalance, undescended testis, chemotherapy, retrograde ejaculation, absence of vas, obstruction of vas, radiotherapy and medications and some times idiopathic also.
Are there any tests that may be required apart from semen testing?
Yes, you may be asked to do some Hormonal Tests, Ultrasound, Karyotyping, Y Chromosome Microdeletion and may be Testicular Biopsy.
What is the treatment?
If it a treatable condition, it can be treated and couple then have a chance to become parents naturally, but in few cases iui or ivf may be required.
What can the male partners do to improve their chances?
1. Exercise to maintain ideal body weight.
2. Stay away from alcohol smoking and drug addiction.
3. Timely treatment for sexually transmitted disease.
4. Avoid excessive heat like sauna bath.
5. Semen freezing before chemotherapy and radiotherapy.
6. Avoid excessive cycling.
7. Stay away from stress and anxiety.
8. Balanced healthy diet rich in antioxidants.
What are the female factors which can lead to infertility?
These can be related to
1. OVARIAN factors like pcos, less ovarian reserve.
2. TUBAL factors like PID, Endometriosis, surgery for ectopic pregnancy, pelvic tuberculosis.
3. UTERINE factors like fibroids, adenomyosis.
There may be combination of one or more factors.
what importance does the age has over fertility?
As the age increases, the chances of having a baby decreases, especially after 35 yrs. This is due to decrease in number of eggs and quality of eggs released by ovary.
With increase in age there are more of health problems like high BP, diabetic and chances of miscarriage increase.
For any couple between 20 -30 yrs, the chances to get pregnant is about 25 – 30% in any menstrual cycle and it decreases with age.
When should the couple consult a infertility specialist?
Women under age of 30 yrs after trying for 1 year,
Women under age of 35 yrs after trying for 6 months,
Women with history of painful menses, irregularly delayed menses, h/o pelvis surgery, h/o miscarriage, h/o pelvis tuberculosis, etc.
What can doctor do to treat infertility?
Infertility can be treated by medicines, surgery, intrauterine insemination or in vitro fertilization.
The guiding principles behind the treatment planned includes ovarian reserve testing and semen analysis. The duration of infertility, the age of couple, tubal status, general health status and preference of the couple.
What other test doctor may require?
These may include serial ultrasound for egg growth and maturation, ovulation test kit, SSG / HSG to see the uterine cavity and passage of fluid through tubes, laparoscopy and hysteroscopy for pelvis assessment. Others include hormonal, eg. TSH, prolactin, AMH and genetic testing.
What can female partner do to improve fertility?
First of all don’t delay your pregnancy unnecessarily as age is important factor
1. Remove stress and anxiety.
2. Eat balanced diet rich in antioxidants.
3. Avoid vigorous athletic training.
4. Try to maintain proper body weight.
5. Avoid smoking and alcohol.
6. Get treated for sexually transmitted infections.
7. Stay positive.