Infertility can be a very difficult and confusing medical condition that can be a condition by itself or a symptom of another disease or problem.
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. The actual cause can be difficult to identify. Up to 25% of couples experience infertility at some point.
In those cases where an identifiable cause is noted – On average, men’s health can be the cause in 30-40% of the situations and women’s health in 60%.
A couple who believes they are having fertility difficulties needs to be interviewed by a medical provider and/or fertility specialist. Questions will be asked regarding the use of cigarettes, alcohol, other drugs.
Other questions will revolve around a possible 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.
– DNA Damage (Can affect female eggs or male sperm)
– Genetic changes
– Thyroid disorders
– Adrenal Disease
– External toxins (glues, solvents, chemicals, Tobacco, dusts, silicone, and many others)
– Tubal blockage
– Age-related problems
– Uterus problems
– Previous Tubal ligation
– Pelvic Inflammatory Disease
– Polycystic Ovarian Syndrome
– Sperm dysfunction (The main cause in Men)
– A physical exam should be performed for both partners
– Lab tests are often essential
– The women should chart basal body temperatures for several months â€“ Oral temperature taken daily
– The male partner will have their sperm analyzed
– An Ultrasound
– Exploratory Laparoscopy
– Biopsies may be performed/considered in some cases
*** This largely depends on the cause of infertility.
Induction of Ovulation
– Clomiphene citrate – causes elevation of LH, gonadotropin, and other hormones or enzymes
– Human menopausal gonadotropins (hMG)
– Gonadotropin-releasing hormone (GnRH)
Inadequate Transport of Sperm
– The implant of sperm into the uterus (insemination)
– Frozen sperm implanted into the uterus
– Typically seen in men who on analysis have no measurable sperm
Assisted Reproductive Technologies (ART)
Typically artificial means of overcoming infertility such as:
1.) In vitro fertilization (IVF)
2.) Gamete intrafallopian transfer (GIFT)
3.) Zygote intrafallopian transfer (ZIFT)
4.) Assisted Hatching
5.) Egg donation
7.) and others