Infertility Problems

Infertility Problem:
Infertility is the inability to conceive a child. A couple may be considered infertile if, after two years of regular sexual intercourse, without contraception, the woman has not become pregnant.
Primary infertility is infertility in a couple who have never had a child.
Secondary infertility is failure to conceive following a previous pregnancy.
Infertility may be caused by infection in the man or woman, but often there is no obvious underlying cause.
The main cause of male infertility is low semen quality.
For women, problems with fertilisation arise mainly from either structural problems in the Fallopian tube or uterus or problems releasing eggs

About 40% involved with man, 40% due to the woman,10% result from complications with both partners and 10% remain unexplained.
Pregnancy is the result of a process that has many steps. To get pregnant:
A woman must release an egg from one of her ovaries (ovulation).
The egg must go through a Fallopian tube toward the uterus (womb).
A man’s sperm must join with (fertilize) the egg along the way.
The fertilized egg must attach to the inside of the uterus (implantation)
Q.When a couple is considered as infertile?
A couple is considered as infertile when the couple could not conceive after 12 months of unprotected sex.
Q.Who is responsible more regarding infertility – Male or female?
Men and women are equally likely to have a fertility problem

Q:What are the major factors for infertility in female?
Age, weight and anovulation. Rarely, in the uterus, fibroid growths, endometriosis, tumors, cervical problems, or irregular uterine shape can keep the egg from implanting in the uterus. In women, fertility declines with age, and even more so after the age of 35. Conception after age 45 is rare. Being overweight or underweight can also play a role in having trouble conceiving. Anovulation refers to a woman who is not ovulating and therefore cannot conceive.
Q. Is there any vitamines / minerals may play role for Women to become pregnant?
Women trying to conceive should add a supplement of at least 600 mcg folic acid, either alone or as part of their prenatal vitamins to decrease the risk of fetal malformations. Folic acid may also decrease the risk of a miscarriage. The folic acid supplement should be started at least one to two months prior to conception to maximize its efficacy. At the same time zinc supplementation will also need to be essential.
Q. Which time is considered for sexual intercourse for pregnancy?
If the menstruation cycle is regular the fertility period will be 11th to 18th day of menstruation.
Q. Does the fertile days of a woman’s cycle can vary from month to month?
A woman is most fertile around one to two days before ovulation (when the egg is released from the ovary). Ovulation occurs on different days for different women. It can vary month to month for many women, and some women can have longer or shorter cycles. Ovulation typically happens for most women 11 to 21 days into a menstrual cycle.

Q. Should a woman need to avoid pregnancy for three months after discontinuing birth control pills?
There’s no reason to wait to try to get pregnant after discontinuing birth control pills. Most women start ovulating again about two weeks after taking the last pill.

Q. What is the fertility status of male with the age?
Men who are 40 years of age or older often have decreased fertility. However, in men, the most common reasons for infertility are sperm disorders. These problems include: Low sperm count (too few or no sperm in the semen); Low sperm motility (sperm don’t move as well as they should); malformation of the sperm, and/or blocked sperm ducts .

Q. Which sexually transmitted disease can result in infertility in women?

Pelvic inflammatory disease. Pelvic inflammatory disease or PID, is an infection of the female reproductive organs. PID is one of the most serious complications of certain sexually transmitted diseases in women. PID can cause irreversible damage to the uterus, ovaries, Fallopian tubes, or other parts of the female reproductive system, and is the primary preventable cause of infertility in women.
What are the causes infertility in men?
Infertility in men is most often caused by:
A problem called varicocele . This happens when the veins on a man’s testicle(s) are too large. This heats the testicles. The heat can affect the number or shape of the sperm.
Other factors that cause a man to make too few sperm or none at all.
Movement of the sperm. This may be caused by the shape of the sperm. Sometimes injuries or other damage to the reproductive system block the sperm.
Sometimes a man is born with the problems that affect his sperm. Other times problems start later in life due to illness or injury. For example, cystic fibrosis often causes infertility in men.
What are the factors may be responsible for decreasing the fertility in male partner?
A man’s sperm can be changed by his overall health and lifestyle. Some things that may reduce the health or number of sperm include:
Heavy alcohol use
Some Drugs
Environmental toxins, including pesticides and lead
Smoking cigarettes
Wearing tight undergarments
Bathing with hot water(contact with testis),
Using close contact with Laptop,
•Frequent radiation from mobile phone keeping close to testis
More Age
Health problems such as mumps, serious conditions like kidney disease, or hormone problems
Trauma to testis
Radiation treatment and chemotherapy for cancer
Q. What are the causes of female infertility ?
Most cases of female infertility are caused by problems with ovulation. Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.
Ovulation problems are often caused by polycystic ovarian syndrome (PCOS). PCOS is a hormone imbalance problem which can interfere with normal ovulation. PCOS is the most common cause of female infertility. Primary ovarian insufficiency (POI) is another cause of ovulation problems. POI occurs when a woman’s ovaries stop working normally before she is 40. POI is not the same as early menopause.
Less common causes of fertility problems in women include:
Blocked Fallopian tubes due to pelvic inflammatory disease, endometriosis, or surgery for an ectopic pregnancy
Physical problems with the uterus
Uterine fibroids, which are non-cancerous clumps of tissue and muscle on the walls of the uterus.
Q. What things increase a woman’s risk of infertility?
Many things can change a woman’s ability to have a baby. These include:
Poor diet
Athletic training
Being overweight or underweight
Excess alcohol use
Sexually transmitted infections (STIs)
Health problems that cause hormonal changes, such as polycystic ovarian syndrome and primary ovarian insufficiency
Q. How does age affect a woman’s ability to have children?
Aging decreases a woman’s chances of having a baby in the following ways:
Her ovaries become less able to release eggs.
She has a smaller number of eggs left.
Her eggs are not as healthy.
She is more likely to have health conditions that can cause fertility problems.
She is more likely to have a miscarriage.
Q. How will doctors find out if a woman and her partner have fertility problems?
Doctors will do an infertility checkup. This involves a physical exam. The doctor will also ask for both partners’ health and sexual histories. Sometimes this can find the problem. However, most of the time, the doctor will need to do more tests.
In men, doctors usually begin by testing the semen. They look at the number, shape, and movement of the sperm. Sometimes doctors also suggest testing the level of a man’s hormones.
In women, the first step is to find out if she is ovulating each month. There are a few ways to do this. A woman can track her ovulation at home by:
Writing down changes in her morning body temperature for several months
Writing down how her cervical mucus looks for several months
Using a home ovulation test kit (available at drug or grocery stores)
Doctors can also check ovulation with blood tests. Or they can do an ultrasound of the ovaries. If ovulation is normal, there are other fertility tests available.
Some common tests of fertility in women include:
Hysterosalpingography: This is an X-ray of the uterus and Fallopian tubes. Doctors inject a special dye into the uterus through the vagina. This dye shows up in the X-ray. Doctors can then watch to see if the dye moves freely through the uterus and Fallopian tubes. This can help them find physical blocks that may be causing infertility. Blocks in the system can keep the egg from moving from the Fallopian tube to the uterus. A block could also keep the sperm from reaching the egg.
Laparoscopy : A minor surgery to see inside the abdomen. The doctor does this with a small tool with a light called a laparoscope . She or he makes a small cut in the lower abdomen and inserts the laparoscope. With the laparoscope, the doctor can check the ovaries, Fallopian tubes, and uterus for disease and physical problems. Doctors can usually find scarring and endometriosis by laparoscopy. During this surgery doctors use a tool called a laparoscope to see inside the abdomen. The doctor makes a small cut in the lower abdomen and inserts the laparoscope. Using the laparoscope, doctors check the ovaries, Fallopian tubes, and uterus for disease and physical problems. Doctors can usually find scarring and endometriosis by laparoscopy.
Q. How do doctors treat infertility?
Infertility can be treated with medicine, surgery, artificial insemination, or assisted reproductive technology. Many times these treatments are combined. In most cases infertility is treated with drugs or surgery. Doctors recommend specific treatments for infertility based on:
Test results
How long the couple has been trying to get pregnant the
Age of both the man and woman
The overall health of the partners
Preference of the partners
Doctors often treat infertility in men in the following ways:
Sexual problems: Doctors can help men deal with impotence or premature ejaculation. Behavioral therapy and/or medicines can be used in these cases.
Too few sperm: Sometimes surgery can correct the cause of the problem. In other cases, doctors surgically remove sperm directly from the male reproductive tract. Antibiotics can also be used to clear up infections affecting sperm count.
Sperm movement: Sometimes semen has no sperm because of a block in the man’s system. In some cases, surgery can correct the problem.
In women, some physical problems can also be corrected with surgery.
A number of fertility medicines are used to treat women with ovulation problems. It is important to talk with your doctor about the pros and cons of these medicines. You should understand the possible dangers, benefits, and side effects.

Q. What medicines are used to treat infertility in women?
Some common medicines used to treat infertility in women include:
Clomiphene citrate (Clomid): This medicine causes ovulation by acting on the pituitary gland. It is often used in women who have polycystic ovarian syndrome (PCOS) or other problems with ovulation. This medicine is taken by mouth.
Human menopausal gonadotropin or hMG (Repronex, Pergonal): This medicine is often used for women who don’t ovulate due to problems with their pituitary gland. hMG acts directly on the ovaries to stimulate ovulation. It is an injected medicine.
Follicle-stimulating hormone or FSH (Gonal-F, Follistim): FSH works much like hMG. It causes the ovaries to begin the process of ovulation. These medicines are usually injected.
Gonadotropin-releasing hormone (Gn-RH) analog: These medicines are often used for women who don’t ovulate regularly each month. Women who ovulate before the egg is ready can also use these medicines. Gn-RH analogs act on the pituitary gland to change when the body ovulates. These medicines are usually injected or given with a nasal spray.
Metformin (Glucophage): Doctors use this medicine for women who have insulin resistance and/or PCOS. This drug helps lower the high levels of male hormones in women with these conditions. This helps the body to ovulate. Sometimes clomiphene citrate or FSH is combined with metformin. This medicine is usually taken by mouth.
Bromocriptine (Parlodel): This medicine is used for women with ovulation problems due to high levels of prolactin. Prolactin is a hormone that causes milk production.
Many fertility drugs increase a woman’s chance of having twins, triplets, or other multiples. Women who are pregnant with multiple fetuses have more problems during pregnancy. Multiple fetuses have a high risk of being born too early (prematurely). Premature babies are at a higher risk of health and developmental problems.

Q. What is intrauterine insemination (IUI)?
Intrauterine insemination (IUI) is an infertility treatment that is often called artificial insemination. In this procedure, the woman is injected with specially prepared sperm. Sometimes the woman is also treated with medicines that stimulate ovulation before IUI.
IUI is often used to treat:
Mild male factor infertility
Women who have problems with their cervical mucus
Couples with unexplained infertility
Q.What is assisted reproductive technology (ART)?
Assisted reproductive technology (ART) is a group of different methods used to help infertile couples. ART works by removing eggs from a woman’s body. The eggs are then mixed with sperm to make embryos. The embryos are then put back in the woman’s body.
Q. What are the different types of assisted reproductive technology (ART)?
Common methods of ART include:
In vitro fertilization (IVF) means fertilization outside of the body. IVF is the most effective ART. It is often used when a woman’s Fallopian tubes are blocked or when a man produces too few sperm. Doctors treat the woman with a drug that causes the ovaries to produce multiple eggs. Once mature, the eggs are removed from the woman. They are put in a dish in the lab along with the man’s sperm for fertilization. After 3 to 5 days, healthy embryos are implanted in the woman’s uterus.
Zygote intrafallopian transfer (ZIFT) or Tubal Embryo Transfer is similar to IVF. Fertilization occurs in the laboratory. Then the very young embryo is transferred to the Fallopian tube instead of the uterus.
Gamete intrafallopian transfer (GIFT) involves transferring eggs and sperm into the woman’s Fallopian tube. So fertilization occurs in the woman’s body. Few practices offer GIFT as an option.
Intracytoplasmic sperm injection (ICSI) is often used for couples in which there are serious problems with the sperm. Sometimes it is also used for older couples or for those with failed IVF attempts. In ICSI, a single sperm is injected into a mature egg. Then the embryo is transferred to the uterus or Fallopian tube.
ART procedures sometimes involve the use of donor eggs (eggs from another woman), donor sperm, or previously frozen embryos. Donor eggs are sometimes used for women who can not produce eggs. Also, donor eggs or donor sperm is sometimes used when the woman or man has a genetic disease that can be passed on to the baby. An infertile woman or couple may also use donor embryos. These are embryos that were either created by couples in infertility treatment or were created from donor sperm and donor eggs. The donated embryo is transferred to the uterus. The child will not be genetically related to either parent.
Q. Do you think that In vitro fertilization (IVF) is suitable for all infertile couple?
No. IVF involves combining eggs and sperm outside the body in a laboratory. Once an embryo or embryos form, they are then placed in the uterus. IVF is a complex and expensive procedure; only about 5% of couples with infertility seek this treatment.