Infertility affects millions of people of reproductive age
worldwide — and has an impact on their families and communities.
Infertility is defined as not being able
to get pregnant (conceive) after one year (or longer) of unprotected sex.
Because fertility in women is known to decline steadily with age, some
providers evaluate and treat women aged 35 years or older after 6 months of
unprotected sex.
اضافة اعلان
Infertility can be primary or secondary
Primary
infertility refers to couples who have not become pregnant after at least one
year having sex without using birth control methods.
Secondary
infertility refers to couples who have been able to get pregnant at least once,
but now are unable.
Male or female infertility
Possible causes of female infertility
• Failure to ovulate
• Structural problems of the reproductive system
• Infections
• Failure of an egg to mature properly
• Implantation failure
• Endometriosis
• Polycystic ovary syndrome
Possible causes of male infertility
• Low
sperm count: The man ejaculates a low number of sperm.
• Low
sperm mobility (motility): The sperm cannot “swim” as well as they should
to reach the egg.
• Abnormal
sperm: The sperm may have an unusual shape, making it harder to move and
fertilize an egg.
This can result from:
• Infection
• Ejaculation issues
• Antibodies that attack sperm
• Tumors
• Undescended testicles
• Hormone imbalances
• Defects of tubules that transport sperm
If both
partners are young and healthy and have been trying to conceive for one year
without success, a visit to a doctor could help to highlight potential
medical problems earlier rather than later.
Women over
the age of 35 should see their physician or women’s health nurse practitioner
after six months as fertility tests can take some time to complete, and age may
affect the treatment options that are open in that case.
Infertility tests for
men
Collect your medical history, medications, and
sexual habits and have a physical examination conducted. The testicles will be
checked for lumps or deformities, and the shape and structure of the penis will
be examined for abnormalities.
Semen analysis: A sample may be taken to test
for sperm concentration, motility, color, quality, any infections, and whether
any blood is present. Sperm counts can fluctuate, so that several samples may
be necessary.
Blood test: The lab will test for levels of
testosterone and other hormones.
Ultrasound: This may reveal issues such as
ejaculatory duct obstruction or retrograde ejaculation.
Infertility tests for
women
A woman will undergo a general physical
examination, her medical history, medications, menstruation cycle, and sexual
habits.
Ovarian reserve testing, to find out how
effective the eggs are after ovulation.
Pelvic ultrasound, to produce an image of the
uterus, fallopian tubes, and ovaries.
Blood test: This can assess hormone levels and
whether a woman is ovulating.
Hysterosalpingography: Fluid is injected into
the woman’s uterus and X-rays are taken to determine whether the fluid travels
properly out of the uterus and into the fallopian tubes. If a blockage is
present, surgery may be necessary.
Treatment depends on the cause of infertility, but may include
counselling, fertility treatments.
Assisted conception
The following methods are currently available
for assisted conception.
Intrauterine insemination (IUI): At the time of ovulation, a fine catheter is
inserted through the cervix into the uterus to place a sperm sample directly
into the uterus. The sperm is washed in a fluid and the best specimens are
selected.
The woman may be given a low dose of ovary-stimulating
hormones.
IUI is more commonly done when the man has a
low sperm count, decreased sperm motility. It can also help if a man has severe
erectile dysfunction.
In vitro fertilization
(IVF)
IVF is the most commonly used assisted
reproductive technology. It has been proven useful in overcoming infertility
conditions, such as blocked or damaged tubes, endometriosis, repeated IUI
failure, unexplained infertility, poor ovarian reserve, and poor or even nil
sperm count.
Intracytoplasmic sperm injection is used in
case of poor semen quality, low sperm count or failed fertilization attempts
during prior IVF cycles. This technique involves an injection of a single
healthy sperm directly injected into mature egg. The fertilized embryo is then
transferred to womb.
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