Category : Gynecology
Infertility is defined as inability to conceive within 1 year of unprotected intercourse, i.e., intercourse without the use of any contraceptive methods.
When should a couple consult a doctor for fertility treatment?
- When by definition, the couple has infertility.
- If the woman’s age is more than 35 years and the couple is not able to conceive within 6 months of marriage.
- If there is some problem in either of the couple known to cause infertility.
Whom to consult?
A gynaecologist or a fertility specialist
What are the common causes of infertility?
The cause of infertility could be in either of the partner or both of them. On an average, in 20% of infertile couples, the cause will be in the male partner, in 40% of them the cause is in the female partner and in others the cause will be in both. At times, any cause may not be found in both the partners. This is called “unexplained infertility”. Couples with unexplained infertility may have some subtle problem which may not be detected by routine tests.
Common causes of infertility in the female partner:
- Absence of ovulation or infrequent ovulation
- Block in the fallopian tubes
- Problems in the uterus (inherited or acquired, eg., fibroid uterus)
Problems with ovulation may be due to multiple causes:
- Unhealthy lifestyle
- Eating disorders
- Stress
Previous infection in the pelvis may lead to block in the fallopian tubes and many a time the woman may not have any symptoms and the tubal block will only be detected by tests.
A common problem which is on the rise now- a-days is advanced age of the female partner as women are attempting conception late due to various reasons. In women with advanced age there will be a decline in the number as well as quality of oocytes (eggs). Moreover, at advanced age, even if they become pregnant, they carry risk of developing various complications during pregnancy.
Common causes of infertility in the male partner:
Abnormalities in the number or quality of sperms which may be due to various causes:
- Inherited: Eg., Chromosomal aberrations/ block in the outflow track
- Infections
- Surgery in the genital region
- Medical disorders like diabetes mellitus
- Smoking, alcohol, recreational drugs
Common tests done in the male and female for evaluation of infertility:
- Semen Analysis
- Ovulation test
- HSG
- Ultrasound
If any abnormality is found advanced evaluation methods like hormonal assays and hystero-laparoscopy will be offered.
Treatment:
- Counseling plays a major role while dealing with infertile couples as quite a few issues can be dealt with by educating them regarding the fertile window.
- In couples where a cause is found, specific treatment is offered. Various treatment modalities include
- Ovulation induction with timed intercourse
- Intrauterine insemination (IUI)
- Assisted reproduction techniques like IVF and ICSI
Factors on which treatment is offered depend on:
- Age of the female partner
- Duration of infertility
- Investigation reports
- Previous treatment records
Delay in treatment may cause worsening of the cause of infertility in some couples, for example those with decreased ovarian reserve, in whom higher and more expensive treatment may have to be resorted to in case of delay. At times they may lose the opportunity to have their own biological progeny. Hence it is very important for the infertile couple to seek consultation with a gynecologist/ fertility specialist without any delay and adhere to the advice given.
Prevention:
Prevention is always better than cure. All women have to be aware that “you may delay, but time will not” as there is a decrease in the number of eggs after 35 years which will make conception difficult/ impossible. Hence the best time for the couple to conceive is when the woman is in her twenties.
Also, the couple should incorporate the following preventive measures:
This will go a long way in not only preventing infertility but also ensuring that the woman remains healthy during pregnancy and delivers a healthy baby.