02/19/2024
Infertility is a condition in which you are unable to conceive after one year of trying. Infertility can be caused by ovulatory issues, endometriosis, a low sperm count, or low testosterone. As you become older, your chances of infertility increase. Infertility patients have various treatment options available to them.
Symptoms And Causes
What Are The Indicators Of Infertility?
The key indicator of infertility is the inability to conceive after six months or a year of regular, unprotected intercourse. You may not experience any additional symptoms. Some people may experience physical symptoms, such as
- Pelvic or abdominal pain.
- Irregular vaginal bleeding, irregular periods, or no menstruation.
- Penile disorders
What Causes Infertility?
There are many possible causes of infertility, and there is not always an easy explanation for why you are unable to conceive. Only a healthcare professional can identify the cause and provide the best treatment for you.Infertility can be caused by various factors, including age, eating disorders, excessive alcohol use, environmental toxins, radiation treatment, sexually transmitted infections, smoking, substance abuse, and being overweight or underweight. Female infertility can be caused by endometriosis, autoimmune disorders, kidney disease, and disorders of the hypothalamus and pituitary glands. Male infertility is most common due to issues with sperm shape, mobility, or quantity. Other causes include varicocele, cystic fibrosis, chromosomal diseases, heat exposure, scrotal injury, hypogonadism, misuse of anabolic steroids, sexual dysfunction, undescended testicles, previous chemotherapy or radiation treatment, and prior to surgical sterilization.
Diagnosis
If you have been unable to conceive within a reasonable period, consult your doctor for an evaluation and treatment of infertility. You and your partner should be evaluated. Your doctor will ask for a complete medical history and perform a physical check-up.Some fertility tests are discussed below:
Tests For Men
Male fertility depends on the testicles producing enough healthy sperm. The sperm must be released from the penis into the vagina and travel to the waiting egg. Male infertility tests aim to determine whether any of these processes have treatable issues.A physical exam may include an examination of your genitals. Specific infertility testing can include:
Semen Analysis
Your healthcare staff may request one or more samples of your sperm and a lab examines your sperm sample. In rare circumstances, urine may be examined to determine whether it contains sperm.
Hormonal Testing
You may be given a blood test to determine your testosterone and other male hormone levels.
Genetic testing. This can be done to determine whether a genetic abnormality is the cause of infertility.
A Testicular Biopsy
A biopsy is a procedure that involves removing a small sample of testicular tissue to examine under a microscope. It is rarely used in infertility testing but may be used to diagnose reproductive system blockages, infertility disorders, or for assisted reproductive techniques.
Healthcare providers may suggest tests like ultrasound or brain MRI to detect internal body issues, such as scrotum issues or benign pituitary gland cancers, which can affect sperm production.
Tests For Women
Fertility for women relies on the ovaries releasing healthy eggs. The reproductive tract must let an egg pass into the fallopian tubes and join with sperm. Then the fertilized egg must travel to the uterus and attach to the lining. Tests for female infertility try to find problems with any of those steps.
You may have a physical exam, including a regular pelvic exam. Infertility tests may include:
Ovulation Testing
A blood test measures hormone levels to find out whether you're ovulating.
Thyroid function test- If the gland makes too much or little thyroid hormone, that could play a role in fertility trouble.
Hysterosalpingography
It checks on the condition of the uterus and fallopian tubes. It also checks for blockages in the fallopian tubes or other problems. Special dye is injected into the uterus, and an X-ray is taken.
Ovarian Reserve Testing
This helps your care team find out how many eggs you have for ovulation. The method often begins with hormone testing early in the menstrual cycle.
Other Hormone Tests
These check the levels of hormones that control ovulation. They also check pituitary hormones that control processes involved in having a baby.
Imaging Tests
Pelvic ultrasound looks for diseases of the uterus or ovaries. Sometimes a test called a saline infusion sonogram is used to see details inside the uterus that can't be seen on a regular ultrasound. Another name for the saline infusion test is a sonohysterogram.
Rarely, testing may include:
Hysteroscopy
Depending on your symptoms, your health care team may use a hysteroscopy (his-ter-os-ko-pee) to look for a disease of the uterus. During the procedure, a thin, lighted device is placed through the cervix into the uterus to check for any irregular signs. It also can help guide minor surgery.
Laparoscopy
Laparoscopy is a surgical procedure that involves a small cut beneath the navel to check the fallopian tubes, ovaries, and uterus for issues like endometriosis, scarring, and blockages. It can also treat certain conditions like fibroid removal. Not every test is needed to be done, you and your healthcare professional will decide which tests are suitable for you.
Treatment
If pregnancy doesn't happen after a year of unprotected sex, couples often can still become pregnant through infertility treatments called assisted reproductive technology. But treatment can involve big financial, physical, emotional and time commitments.
Treatment For Men
Men's treatment for general sexual problems or a lack of healthy sperm may include:
Lifestyle Changes
Your healthcare provider may advise you to take the following steps. Have intercourse more frequently and closer to ovulation. Perform regular exercise. Reduce your alcohol consumption or quit smoking.
Medicines
Your team may prescribe medicines to improve sperm count and boost the chances of a successful pregnancy. These prescription drugs may help the testicles function better too.
Surgery
Surgery can potentially reverse sperm blockage and restore fertility, or repair a large varicocele, potentially improving pregnancy chances.
Sperm Retrieval Procedures
Sperm retrieval treatments are used when ejaculation is not possible or sperm is absent in semen, or when assisted reproductive approaches are being considered due to low or irregular sperm levels.
Treatment For Women
Fertility Medicines
IUI, an infertility treatment, aids ovaries to release egg release if irregular or stopped. IUI can be timed with your menstrual cycle or with the use of fertility medicines.
Surgery To Restore Fertility
Hysteroscopy can treat uterine conditions like polyps, scar tissue, and fibroids, while laparoscopic or traditional surgery may be needed for endometriosis, pelvic adhesions, and larger fibroids.
Assisted Reproductive Technology
Assisted reproductive technology (ART) is any fertility treatment in which the egg and sperm are handled.In vitro fertilization (IVF) is the most common ART technique. Some of the key steps in a cycle of IVF include:
- Fertility medicines are used to help the ovaries make eggs.
- Mature eggs are removed from the ovaries.
- The eggs are fertilized with sperm in a dish in a lab.
- The fertilized eggs, also called embryos, are placed in the uterus. Embryos also can be frozen for future use.
Sometimes, other techniques are used in an IVF cycle, such as:
Intracytoplasmic Sperm Injection (ICSI)
A single healthy sperm is injected directly into a mature egg. Often, ICSI is used when semen quality or quantity is poor. Or it might be used if fertilization attempts during prior IVF cycles didn't work.
Assisted Hatching
This technique helps an embryo attach to the lining of the uterus. It opens part of the outer covering of the embryo, which is why it's called hatching.
Donor Eggs Or Sperm
ART typically uses a couple's own eggs and sperm, but can also be sourced from a donor for medical reasons like age-related issues, sperm blockages, genetic diseases, or infertility treatment leftover embryos from frozen infertility treatment couples.
Gestational Carrier
Individuals without a functioning uterus or facing health risks may opt for IVF using a gestational carrier, where the embryo is placed in a willing uterus.
Genetic Testing
Embryos made with IVF can be tested for genetic problems. This is called preimplantation genetic testing. Embryos that don't seem to have a gene problem can be placed in the uterus. This lowers the risk of a parent passing on a genetic condition to a child.
Complications of treatment
Complications of infertility treatment may include:
Multiple Pregnancy
Multiple pregnancy is a common complication of infertility treatment, increasing the risk of premature labor, gestational diabetes, and health challenges. It's crucial to discuss these risks with healthcare professionals before starting treatment.
Ovarian Hyperstimulation Syndrome (OHSS)
OHSS, caused by fertility medicines and assisted reproductive technologies, causes swollen and painful ovaries. Symptoms include mild stomach pain, bloating, and upset stomach, with longer nausea in pregnant women.
Bleeding Or Infection
Assisted reproductive technology or reproductive surgery comes with a risk of bleeding or infection.
Conclusion
Infertility can be a difficult and emotionally draining experience for many couples and individuals. However, remember that you are not alone, and there are numerous resources and solutions (e.g. ART) available to assist you on your path to becoming a parent.