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- Health, Infertility
Understand common infertility myths and learn the medical facts about conception, age, lifestyle, male infertility and fertility treatment.
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- Health, Infertility
Infertility: Causes, Evaluation, and Treatment WHEN TO VISIT A FERTILITY SPECIALIST? If you are not able to get pregnant (conceive) after one year (or longer) of unprotected sex. Fertility in women is known to decline steadily with age. It is wise to see a fertility specialist if you are aged 35 years or older after 6 months of trying to conceive. Women over 40 years may consider seeking more immediate evaluation and treatment. FOR WOMEN Irregular periods or no menstruation Severe abdominal pain, dysmenorrhoea and ultrasound findings suggestive of endometriosis. Previous history of pelvic inflammatory disease Known or suspected uterine or tubal disease on ultrasound examination. A history of more than two miscarriages. Known genetic or acquired conditions that predispose to diminished ovarian reserve (e.g., chemotherapy, radiation). FOR MEN A history of testicular trauma Bilateral hernia surgery Prior use of chemotherapy A history of infertility with another partner Sexual dysfunction (Erectile or Ejaculation difficulties) HOW DOES A NATURAL PREGNANCY OCCUR? A woman’s body must release a healthy egg (oocyte) from one of her ovaries. The egg is then sucked into the fallopian tube through brush-like structures called fimbriae. During the ovulatory period, if intercourse occurs, semen is ejaculated into the female partner’s vagina. The fertilizable life span of an egg is 12–24 hours; sperm lives 48–72 hours. Only 10% of sperms cross the cervical barrier; about 300–500 reach the egg, and one fertilizes it. The fertilized egg (zygote) travels and implants in the uterus as a blastocyst. Infertility may result from a problem with any of these steps. DOES INFERTILITY OCCUR IN FEMALES ONLY? No, infertility is not always a woman’s problem. Both men and women can contribute to infertility, alone or in combination. 15% of infertility cases are unexplained (unknown cause). WHAT CAUSES INFERTILITY IN FEMALES? Women need functioning ovaries, patent fallopian tubes, a normal uterus, and favourable endometrium. Ovarian Factors: Polycystic ovarian disease Premature ovarian insufficiency Low or poor ovarian reserve Menopause Tubal Factors: Blocked/swollen fallopian tubes due to infections or surgeries (e.g., TB, gonorrhoea, appendicitis). Uterine Factors: Abnormalities like fibroids, adhesions, polyps, adenomyosis, congenital anomalies, or infections. Pelvic Factors: Pelvic adhesions or endometriosis affecting reproductive anatomy. WHAT CAUSES INFERTILITY IN MALES? Infertility in men is often evaluated via semen analysis (90% of diagnoses). Abnormal semen parameters (count, motility, morphology) indicate male factor infertility. Azoospermia may require hormonal or genetic tests. Advanced tests (DNA integrity) may be advised in recurrent pregnancy loss or IVF failures. COMMON FERTILITY DISRUPTORS (BOTH PARTNERS) Being overweight or obese Smoking Excessive alcohol or drug use High physical or emotional stress Radiation exposure HOW WILL THE DOCTOR ASSESS FERTILITY PROBLEMS? Detailed medical and sexual history of both partners. Initial evaluation includes: – Semen analysis (for males) – Tubal patency tests – Ovarian reserve tests HOW TO TREAT INFERTILITY? Treatment depends on the cause and may include: – Medications for ovulation induction – Fertility-enhancing surgery (for tubal/uterine abnormalities) – Intrauterine insemination (IUI) – Assisted reproductive techniques (IVF/ICSI/IMSI) HOW TO DECIDE THE BEST TREATMENT OPTION? Doctors base treatment decisions on: Factors contributing to infertility Duration of infertility Female partner’s age Couple’s preferences after counselling about success rates, risks, and costs