Infertility

A couple is considered infertile if there is no pregnancy after one year of unprotected intercourse between them. Infertility is classified as primary or secondary, depending on various factors like – previous history of pregnancy, menstrual cycle history, hormonal profile etc. History of pregnancy includes all pregnancies, even those that resulted in miscarriage or ectopic pregnancy.

Primary infertility is a case where a couple can never conceive a baby naturally.

Secondary Infertility describes a couple who are having trouble conceiving again, even though they have previously achieved pregnancy.

COMBINED INFERTILITY

In some cases, both the man and woman maybe infertile or sub-fertile and the couple’s infertility may arise from the combination of conditions. In other cases, the cause is suspected to be immunological or genetic; it may be that each partner is independently fertile but the couple cannot conceive together without assistance.UNEXPLAINED INFERTILITY

Despite proper checkup there is no certain cause of infertility in 15 to 20% of the couples which is called unexplained infertility.

Based on WHO (World Health Organization) approximately 8 to 10% of couples are suffering from infertility across the world. About 40% of the issues are involved with infertility are due to the male partners, another 40% due to female partners, and 20% result from complications with both partners.

• Infertility in married women ages 16 – 20 = 4.5%
• Infertility in married women ages 35 – 40 = 31.8%
• Infertility in married women over the age of 40 = 70%

Causes Of Infertility

Factors that can cause male as well as female infertility are genetic factors.

A Robertsonian translocation in either partner may cause recurrent spontaneous abortions or complete infertility.

General factors causing infertility 

• Diabetes Mellitus
• Thyroid disorders
• Adrenal Disease
• Hypothalamic-pituitary factors
• Hyperprolactinemia

The presence of anti-thyroid antibodies is associated with an increased risk of unexplained subfertility.

ENVIRONMENTAL FACTORS

Toxins such as volatile organic solvents or silicones, physical agents, chemical dusts, and pesticides can have adverse effects on reproductive health and fertility of an individual. Tobacco smokers are 60% more likely to be infertile than non-smokers.

SPECIFIC FEMALE INFERTILITY

Ovulation problems:

• Failure of production of an egg
• Irregular Production of egg

Female Assessment for fertility

Health check up:

• Sonography-Trans vaginal Sonography(TVS). Transvaginal ultrasound is a test used to transvaginal ultrasound is a test used to look at the woman’s reproductive organs including the uterus, ovaries and cervix. Transvaginal means across or through the vagina. It is important and primary part of diagnosis and treatment of infertility.

• Blood Test– To check if there are any abnormalities in blood which may affect directly or indirectly the pregnancy.

• Check up of fallopian tube:- An HSG (Hysteronsalpengiography) is done in order to look inside the uterus and fallopian tube to find any blockage in fallopian tube.

During hesterosalpangio gram, a dye contrast material is put through a thin tube that is put through the vagina and into the uterus, because the uterus and fallopian tubes are hooked together, the dye will flow into the fallopian tubes, SSG (Sonosalpingography).Pictures are taken using a steady beam of X-ray (Fluoroscopy) as the dye passes through the uterus and fallopian tubes.

Before any treatment the tubes must be checked and it is beneficial.

These tests are more complicated in females, so the couple must be prepared circumstantially, mentally and financially. After proper diagnosis, the couple should understand and discuss the possibilities of pregnancy and should find the root cause of problem, like age of female, eagerness to get pregnant, past treatment mentally, physically, etc. All these aspects must be understood and appropriate advice should be sought before proceeding with the treatment.

For any couple despite spending money, 100% surety cannot be given that first try will give them the desired result, so couple and doctor should understand all aspects of the treatment, choice and if needed better treatment options at an appropriate time can be chosen.

Image Source : http://www.boldsky.com/pregnancy-parenting/basics/2012/women-infertility-causes-030928.html