Have you been struggling with infertility issues? Here’s a quick guide to help you understand the basics of the causes, risk factors and treatment options of infertility.
What is infertility?
Infertility is a condition of the reproductive system that is characterised by a failure to conceive after 12 months or more of regular unprotected sexual intercourse. Fertility issues can occur in both males and females and can be caused by a variety of reasons.
What are the causes of infertility?
In some cases, infertility occurs due to unknown reasons. The identified causes of infertility include :
Female infertility:
- Issues in ovulation (conditions affecting the release of eggs from the ovaries like PCOS)
- Hormonal imbalances (increased prolactin, imbalances in thyroid hormones)
- Blocked fallopian tubes restricts sperm entry.
- Poor egg quality
- Endometriosis : The term “endometrium” refers to the uterus’ inner lining. Endometriosis is the growth of endometrium-like tissue outside the uterus. It is a painful condition
- Fibroids in the uterus
- Early menopause
- Untreated infections like gonorrhoea or chlamydia
- Chemotherapy or radiation therapy for cancer
- Genetic factors
Male infertility:
- Low sperm count
- Poor sperm motility
- Absence of sperm in semen
- Abnormality in sperm size or shape
- Issues in ejaculation (premature ejaculation)
- Problems in the structure (blockage in testicles, damage or injury to organs)
- Substance abuse of alcohol, tobacco, and certain medicines
- Exposure to certain chemicals, pesticides, and radiation
- Frequent exposure to heat (use of saunas, hot tubs, or occupational exposure in factories and mines)
- Untreated gonorrhoea or chlamydia
- Genetic factors
What are the risk factors for infertility?
- Age : With an increase in age, there is a decline in fertility. This occurs around the mid-thirties for women and after the age of 40 for men
- Use of alcohol and smoking tobacco
- Being overweight or underweight
- Lack of exercise
- Stress
What are the symptoms of infertility in women?
Signs or symptoms include :
- Abnormal, irregular, or painful periods
- Dark or pale menstrual blood
- Severe acne
- Facial hair
- Unexplained weight gain
- Discharge from the nipple
- Pain during sex
- Nipple discharge
- Long-term pelvic pain
What are the symptoms of infertility in men?
Signs and symptoms include :
- Problems with erections and ejaculation
- Changes in hair growth
- Changes in sexual drive
- Redness, lumps, swelling, and pain in the testicles
What should be done to prevent infertility?
Take the following preventive measures :
- Limit medications that can affect infertility
- Avoid alcohol consumption, drug use and tobacco use
- Maintain a healthy body weight through regular exercise. However, women should avoid strenuous exercise
- Bring your stress levels under control
What tests are done to diagnose infertility in women?
The following tests are performed on women :
- Ovulation test : this test measures hormone levels to check if a woman is ovulating
- Ovarian reserve testing : this is done to determine the quality and quantity of eggs
- Hysterosalpingography : this test evaluates the condition and checks for blockages in the uterus and fallopian tubes
- Imaging tests
- Other hormone tests : to check the level of ovulatory hormones and pituitary hormones, which control the process of reproduction
Depending on the condition, you may also be advised to undergo certain additional tests like laparoscopy, hysteroscopy, and genetic testing.
What tests are done to diagnose infertility in men?
The following tests are performed on men :
- Semen analysis : to detect the sperm count and the quality of the sperm
- Genetic testing : to detect if there are any genetic defects that are causing the infertility
Imaging tests - Hormone testing : to evaluate the levels of testosterone and other male hormones
- Testicular biopsy : A small portion of the testicles is removed and taken for examination in order to detect any abnormalities that are causing infertility
When should one consult a doctor for infertility?
Visit your doctor if :
- You are unable to get pregnant even after 12 months or more of, regular unprotected sexual intercourse
- There is a history of ectopic pregnancy (embryo attaches outside the uterus), repeated miscarriages, injury or trauma to the testes and scrotum, cystic fibrosis, and thyroid problems in your family
What are the treatment options for infertility in both males and females?
In males:
- Lifestyle modifications
- Medicines to improve the sperm count and increase the chances of a successful pregnancy
- Sperm examination and analysis in patients with a low sperm count or absence of sperm
- Surgery to reverse sperm blockage
In females:
- Regulate ovulation with fertility drugs
- Surgery to restore your fertility
- Intrauterine insemination: healthy sperm are placed directly into the uterus
- Assisted reproductive technologies : in vitro fertilisation (IVF), assisted hatching, donor eggs or sperm, intracytoplasmic sperm injection (ICSI), and gestational carriers
What are the complications of infertility treatment?
Complications of treatment include :
- Infection or bleeding
- Ovarian hyperstimulation syndrome (OHSS): causing swollen and painful ovaries
- Multiple pregnancies (twins, triplets, or more)
How do I cope with the issue of infertility?
Dealing with infertility is not easy, but remember that you are not alone. There is always hope for treatment, and most couples conceive eventually, with or without treatment. Here are some tips to help you cope with infertility and its treatment :
- Be prepared : There could be uncertainties in the treatment, and sometimes you may have to try multiple times and wait longer before you get a positive result
- Seek support from your friends and family
- Consider the available alternative treatment options
- Manage your emotional stress, both during treatment and also after knowing the effects of the outcome
- Exercise and have a healthy diet
