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.
- 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 dysfunctionÂ (Main cause in Men)
- A physical exam should be preformed 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
- Biopsies may be preformed 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
- Implant of sperm into uterus (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
- and others