Treatments

Most couples have the strong desire to conceive a baby (or more) at some point during their lifetime. But the reality is that many fail to do so due to a multitude of reasons. The inability to get pregnant despite having carefully timed, unprotected sex for one year, or miscarrying repeatedly is commonly referred to as infertility.

According to the World Health Organization (WHO), infertility is “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.”

Thus, couples are generally recommended to seek medical help if conception has not occurred within 12 months. Although, there are scenarios where one is advised to seek medical help earlier. These include:

• Irregular menstrual periods: When a woman has regular menstrual cycles occurring every 21 to 35 days, it generally indicates that she is ovulating regularly. Ovulation of the egg occurs about two weeks before the next period starts. If cycles occur at intervals of more than 35 days, it may indicate that she is not ovulating an egg normally. Ovulation of the egg is essential for pregnancy. Therefore, an evaluation should be scheduled if menstrual cycles are irregular.
• A history of sexually transmitted diseases (STDs) or pelvic infections: STDs like gonorrhea or chlamydia can cause inflammation and permanent scarring of fallopian tubes. Immediate evaluation is a must for a couple attempting pregnancy if a woman has a prior history of pelvic infection.
• Known uterine fibroids or endometrial polyps: Uterine abnormalities tend to indent the endometrial cavity. On the other hand, endometrial polyps can impair how the endometrium (the lining of the uterus) and embryo interact and lower pregnancy rates. These abnormalities result in abnormal bleeding between menstrual cycles. Evaluation should be pursued if the woman has a known history of such abnormalities or of bleeding between menstrual cycles.
• Known semen abnormalities: If a male partner has a history of infertility with a prior partner or if there are abnormalities with his semen, earlier fertility evaluation, ideally within six months of attempting pregnancy, is recommended.

What are the Common Causes of Infertility?

Quite naturally, the question that comes to mind now is what causes infertility. The common causes of both male and female infertility are as follows:

• Age: Egg numbers decrease rapidly as women keep aging. Moreover, as aging occurs, egg quality or the chances of an egg being genetically normal decreases. Therefore, fertility evaluation is imperative for a couple attempting pregnancy for six months or more when the woman is 35 years of age or older.
  Unlike women, some men may be fertile even in their 60s and 70s. But as they age, they start encountering problems related to the quality and quantity of their sperm. They are also prone to sperm gene defects.
• Health problems: Both men and women have diseases or conditions that affect their hormone levels, leading to infertility. The common conditions include polycystic ovary syndrome (PCOS) and primary ovarian insufficiency or POI.
  Women who have PCOS ovulate rarely or never. Failure to ovulate is the most common cause of infertility in women.
  With POI, a woman’s ovaries generally tend to stop working before she turns 40. It is not to be mistaken as early menopause. Some with POI may still get a period sometime. But pregnancy is unlikely to happen.
  In men, common health problems that affect their reproductive function include sexually transmitted infections (STIs), surgery on the prostate gland, diabetes, or a testicle injury or disorder.
• Lifestyle factors: Certain lifestyle choices leave a negative effect on both men. These include stress, eating disorders, smoking, alcohol consumption, obesity, and so on.

Infertility Treatment Options for Men and Women

Doctors recommend specific treatments for infertility based on:

• Test results
• How long the couple has been trying to get pregnant
• The age and overall health of both the partners
• Preference of the partners

Infertility can be best treated with assisted reproductive technology (ART). Medication, artificial insemination, and surgery are often combined for best results.

What is Assisted Reproductive Technology (ART)?

Assisted reproductive technology (ART) comprises a group of different methods used to treat infertile couples. ART works by removing eggs from a woman’s body. Then, these eggs are mixed with sperm to form embryos. The embryos are put back in the woman’s body.