When you and your partner are unable to conceive even after 1 year of unprotected intercourse, then you may be having infertility and require infertility treatment. The incidence of infertility in India varies from 3.9% (for age 25-39 years) and 16.8% (in the age group 15-49 years), according to WHO.

Symptoms Of Infertility

The main symptom is the inability to become pregnant, without any obvious symptoms.

What Causes Infertility?

There are many causes of infertility. Male factor is the most common cause of infertility, such as low sperm count or movement abnormality of the sperm and function.

In women, infertility due to the abnormal uterus or fallopian tubes contributes to nearly 10 to 30 percent. Fibroids, polyps, and adenomyosis cause uterus abnormalities. These problems create obstruction and prevent conception ability. Septate uterus leads to a high rate of miscarriage. Due to endometriosis, the fallopian tubes do not function properly.

Causes of male infertility

These may include:

  • Abnormal formation or functioning of sperm due to undescended testicles, developmental disorders, diabetes, or diseases such as chlamydia, gonorrhea, mumps, or HIV. Swollen veins can also influence the consistency of sperm in the testicles (varicocele).
  • Genital illnesses, such as premature ejaculation, sperm delivery issues; some developmental disabilities, such as cystic fibrosis; medical problems, such as testicular blockage; or impairment or harm to the reproductive organ.
  • Overexposure and radiation of some environmental conditions, such as toxins and other chemicals. Cigarette smoking, alcohol, marijuana, anabolic steroids, or other drugs controlling infections; antihypertensive, or antidepressants can also impair fertility. Frequent sun exposure, such as in saunas or hot tubs, can increase body temperature and can affect the production of sperm.
  • Harm associated with and treatment of cancer, including radiation or chemotherapy. Cancer therapy can inhibit the development of sperm, often seriously.

Causes of female infertility

Causes of female infertility may include:

  • Ovulation disorders impair the ovaries’ production of eggs. That includes hormone abnormalities such as the disease of polycystic ovaries. Ovulation can also interfere with hyperprolactinemia, a disorder in which you have too much prolactin, the hormone that activates the development of breast milk. Abnormal thyroid levels affect menstruation and infertility. Other underlying causes may include too much exercise, eating disorders, or tumors.
  • Uterine or vaginal anomalies, including cervical abnormalities, uterine polyps, or the shape of the uterus. By blocking the fallopian tubes or preventing a fertilized egg from implanting in the uterus, noncancerous (benign) tumors in the uterine wall (uterine fibroids) may cause infertility.
  • Harm to or blockage of the fallopian tube, mostly due to inflammation of the fallopian tube (salpingitis). This may occur from inflammatory pelvic disease, commonly caused by sexually transmitted cancer, endometriosis, or attachment.
  • Endometriosis affects the functioning of the ovaries, uterus, and fallopian tubes.
  • Ovarian insufficiency (early menopause). When menstruation stops before 40 years. Though the reason for early menopause is not clear, some causes such as disorders of the immune system, genetic conditions (Turner syndrome or carriers of Fragile X syndrome), and treatment with radiation or chemotherapy. 
  • Pelvic adhesions, scar tissue bands that connect organs that may develop after pelvic infection, appendicitis, endometriosis, or pelvic or abdominal surgery.
  • Cancer and its therapy. Certain cancers also impair female fertility, particularly reproductive cancers. Chemotherapy and radiotherapy also affect fertility.

Investigations For Infertility

Semen diagnosis, along with total physical examination, entails infertility analysis for males. In females with no identifiable abnormality, the analysis is considered complete. A PAP smear test is done to rule out other causes of infertility such as cervical cancer, sexually transmitted disease or any other problem. 

The levels of hormones help in the determination of ovulation patterns. To search for the reproductive organs, an x-ray and ultrasound of the abdomen may be recommended. Ultrasound and blood investigations evaluate the ovarian reserve (number of eggs).

When To See A Doctor

If you fulfill any of the following conditions given below, then consultation with the doctor is very important:

  • If age more than 35 with the inability to conceive for more than six months
  • If age is more than 40 years
  • Problem with irregular or absent periods / painful periods
  • Diagnosed with fertility problems
  • Previous history of miscarriages

Men should talk to a doctor if they have:

  • Low sperm count 
  • History of sexual problems
  • Previous treatment for carcinoma
  • The size of testicles is small 
  • Swelling in the scrotum
  • Familial history of infertility

Infertility treatments

  • IUI (intrauterine insemination): During the time of ovulation, sperm from the partner is directly put inside the uterus of the woman.
  • IVF (in vitro fertilization): The sperm from the male and the egg from the female are collected and in a laboratory setting, together are grown for a period of 3-5 days. After this time duration, the embryo is implanted into the uterus.
  • GIFT (gamete intrafallopian transfer): The sperm and the egg are collected and directly put into the fallopian tube immediately.

ZIFT (zygote intrafallopian transfer): The fertilized egg (in a laboratory) is put into the fallopian tube at 24 hours.

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