infertility-6Infertility is a medical condition that can be a condition itself and a symptom of another diseases.

Infertility is defined as an inability to become pregnant when a couple is sexually active for at least 1 year without contraceptives.

The definition in the United Kingdom is slightly different – the NICE guidelines define infertility as “the failure to conceive after regular unprotected sexual intercourse for 2 years in the absence of known reproductive pathology.”

This condition is more common than perceived.

Up to 25% of couples experience infertility at some point.

On average Men are at cause in 30-40% and women in 60%.

A couple which believes they are having fertility difficulties need to be interviewed by a medical provider.

Questions will be asked regarding use of cigarettes, alcohol, other drugs.

Other questions will revolve around history of sexually transmitted diseases, psycho-sexual concerns, menstruation patterns, Intrauterine Device History, libido, family history and more are required.

More than 20% of cases of Infertility will be unexplained.

Causes

  • DNA Damage  (Can affect female eggs or male sperm)
  • Genetic changes
  • Diabetes
  • Thyroid disorders
  • Adrenal Disease
  • Hyperprolactinemia
  • Hypopituitarism
  • External toxins (glues, solvents, chemicals, Tobacco, dusts, silicone, and many others)
  • Tubal blockage
  • Age related problems
  • Endometriosis
  • Uterus problems
  • Previous Tubal ligation
  • Pelvic Inflammatory Disease
  • Polycystic Ovarian Syndrome
  • Sperm dysfunction  (Main cause in Men)
  • Other

infertility1jpgDiagnosis

  • A physical exam should be preformed for both partners
  • Lab tests are often essential
  • The women should chart basal body temperatures for several months – Oral temperature taken daily
  • The male partner will have their sperm analyzed
  • Ultrasound,
  • X-ray
  • Laparoscopy
  • Biopsies may be preformed in some cases

 

Treatment

*** This largely depends on the cause of infertility.

Weight gain may be necessary as would be treatment of underlying conditions such as a Thyroid, Diabetes, mental conditions, Endometriosis and others

Induction of Ovulation

  • Bromocriptine
  • Clomiphene citrate – causes elevation of LH, gonadotropin, and other hormones or enzymes
  • Human menopausal gonadotropins (hMG)
  • Gonadotropin-releasing hormone (GnRH)

Inadequate Transport of Sperm

  • Implant of sperm into uterus (insemination)

Artificial insemination

  • Frozen sperm implanted into uterus
  • Typically seen in men who on analysis have no measurable sperm

Assisted Reproductive Technologies (ART)

Typically artificial means of overcoming infertility such as:

  • In vitro fertilization (IVF)
  • Gamete intrafallopian transfer (GIFT)
  • Zygote intrafallopian transfer (ZIFT)
  • Assisted Hatching
  • Egg donation
  • Tuboplasty
  • and others
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