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Infertility

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Introduction

Infertility is a common problem with several underlying causes. About 85% of the couples achieve pregnancy within one year of attempting to conceive. Infertility constitutes the rest 15%. They should consult with reproductive endocrinologists and infertility specialists if they do not conceive after trying for one year.

Infertility is the failure to achieve pregnancy after attempting to conceive for one year. There are various steps for achieving pregnancy. A problem in one or more steps may result in infertility. A situation in which a woman can conceive but is unable to complete full-term or carry a pregnancy is also considered infertility.

Male and female equally contribute to infertility. Approximately one-third of the infertility cases are solely due to males, while another one-third constitutes female problems. In the remaining one-third, the reason is unknown or contributed by both genders.

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What are the Causes of Male Infertility?

  • ● The problem in sperm production due to underlying conditions such as genetic disease, diabetes, and undescended testes.
  • ● Reduced quality of sperms due to conditions such as varicocele.
  • ● Inferior sperm characteristics such as sperm count, motility, and shape.
  • ● Altered sperm delivery due to obstruction in the testicle, cystic fibrosis, erectile dysfunction, and reproductive organ injuries.
  • ● Factors such as stress, overexposure to toxic substances, excessive smoking, and certain medications.
  • ● Damage to the testis due to chemotherapy or radiation therapy.

What are the Causes of Female Infertility?

  • ● Advanced maternal age.
  • ● Medical conditions such as endometriosis and uterine fibroids.
  • ● Blockage or damage of the fallopian tubes.
  • ● Early menopause due to various reasons such as genetic diseases, autoimmune diseases, and chemotherapy or radiation therapy.
  • ● Surgery-related complications such as pelvic adhesions.
  • ● Ovulation disorders due to hormonal alterations, eating disorders, or excessive exercise.

What are the Symptoms of Infertility?

  • The main symptom of infertility is the inability to get pregnant. The other symptoms are associated with the underlying cause. For instance, males with erectile dysfunction have stress and performance anxiety. Similarly, infertility caused due to hormonal problems may result in menstrual disorders.

How is Infertility in Male Diagnosed?

  • Hormonal analysis: The doctor may determine the level of male hormones such as testosterone. Deficiency of testosterone may result in infertility.
  • Semen analysis: The doctor may advise undergoing comprehensive semen analysis. The tests provide the sperm count, motility, and morphology.
  • Imaging: Imaging techniques are also useful in determining the cause of infertility. The doctor may advise scrotal or transrectal ultrasound or vasography, a test for vas deferens.
  • Biopsy: The testicular biopsy serves two purposes. First, it helps in determining the cause of infertility. Second, the doctors use this technique to retrieve the sperms for in-vitro fertilization techniques.There are various methods to diagnose male infertility.

How is Infertility in Female Diagnosed?

  • Hormonal testing: Various female hormones affect fertility. The hormonal tests help in evaluating the level of these hormones.
  • Ovarian testing: Various tests help in determining the health of ovaries. These tests are ovarian reserve tests and ovulation tests.
  • Hysterosalpingography: This technique provides images of the uterus and fallopian tubes. The doctor injects the contrast agent into the uterus and takes X-rays to evaluate the uterus and fallopian tubes.
  • Imaging tests: Other imaging testing includes pelvic ultrasound and sonohysterogram. The doctor recommends a sonohysterogram when the image is not clear with ultrasound.

How is Infertility Treated?

  • Infertility treatment in men: Improving lifestyle helps in managing male infertility. The patient should avoid smoking and perform regular exercise. The doctor may also prescribe certain medications to manage erectile dysfunction or to improve sperm quality and count. The doctor may also recommend surgery in case of obstruction. When the above methods fail to deliver, the doctor may opt for assisted reproductive techniques.
  • Infertility treatment in women: The doctor may prescribe various fertility drugs to manage ovulation disorders. Hormonal replacement therapy improves the chances of getting pregnant. The patient may also undergo intrauterine insemination. It is a procedure in which the infertility specialist places healthy sperms directly into the uterus. The patients may undergo surgery to remove the obstruction or to treat other diseases.

What is the Results of Infertility Treatment?

With technological and therapeutic advancement, most females undergoing infertility treatment succeed in achieving pregnancy. The doctor generally starts the treatment with medications. If the medicines do not help in conception, the doctor resorts to other advanced procedures. The success of treatment depends on various factors such as maternal age and underlying medical conditions.

What are the Risks Associated with Infertility treatments?

  • There are certain risks associated with infertility treatment, especially with surgical interventions. The women may have multiple pregnancies with increased evidence of gestational complications such as preterm labor and gestational diabetes. In Assisted Reproductive Techniques, the women may have ovarian hyperstimulation. The other risks include bleeding and infection.

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FAQ's

What are the Risk Factors for Male Infertility?

Certain factors increase the risk of Male Infertility. These are excessive smoking, drinking alcohol, obesity, age above 40, and exposure to harmful chemicals.

What are the Risk Factors for Female Infertility?

Several factors increase the risk of female infertility. These are age above 35, excessive weight loss or weight gain, smoking, alcohol use, and amenorrhea due to physical and mental stress.

If I am a Male, How should I Prevent Infertility?

The person should lead an active life to avoid Infertility. Limit the consumption of alcohol and quit smoking. Avoid taking medications that affect the reproductive system. Avoid hot baths as they may alter the quality of sperms.

If I am a Female, How should I Prevent Infertility?

As a female, you should plan your pregnancy before 35 years of age. Avoid smoking and cut down the consumption of alcohol. Maintain your weight in a normal range. Limit the amount of caffeine and perform routine exercise.

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