Most of the people have a strong desire to conceive at some point during their lifetime. According to a study, most couples (approximately 85%) will conceive within one year of trying, with the greatest chances of conception occurring during the earlier months. Only an additional 7% of couples will achieve pregnancy in the second year. Infertility refers to an inability to conceive within 12 months. In such cases, it is advised to seek the help of a reproductive endocrinologist at the earliest.
Causes of Infertility-
There are several factors that cause infertility. This include:
- 1. Irregular menstrual period- When a woman has regular menstruation, it means that normal cycles are occurring every 21 to 35 days; this almost always signifies that she ovulates regularly. Ovulation of the egg occurs approximately 14 days before the start of the next menstrual cycle. If any woman has cycles at intervals of greater than 35 days, it indicates that she is not ovulating an egg in the normal process. Ovulation of the egg is essential for pregnancy. Therefore, it is important to seek medical advice if menstrual cycles are infrequent in a couple attempting pregnancy.
- 2. Female is 35 years or older in age - Because of unclear reasons, egg numbers decrease rapidly as women age. Moreover, as the age increases, the likelihood of an egg or egg quality being genetically normal, decreases. Therefore, a woman is recommended fertility evaluation if she is 35 years of age or older and has been attempting pregnancy for 6 months or more.
- 3. A history of sexually transmitted diseases or pelvic infections- Sexually transmitted infections such as gonorrhea or chlamydia can cause inflammation and permanent scarring of the fallopian tubes. The presence of open tubes is very essential for natural conception because the sperm must traverse the tubes in order to reach and fertilize the ovulated egg. It is best to schedule an evaluation at the earliest in such cases.
- 4. Semen abnormalities in male - If the male partner has a history of infertility with his prior partner, or if there are any abnormalities on his semen analysis, then it is best to go for fertility evaluation, ideally within six months of attempting pregnancy.
- 1. Education-Educating patients about the normal process of fertility, treatment options and problems that cause infertility empower them to make the best decisions. Understanding the normal reproductive system process is essential in knowing about the best time to seek help. Helping patients to develop a deep understanding of their fertility options will make this process smoother.
- 2. Medications to induce egg development and ovulation: The medications that stimulate the ovary to develop mature eggs for the ovulation come in two forms:
a) Infertility drugs
The most commonly prescribed drug or pill that helps in stimulating ovulation (generally of one mature egg) is clomiphene citrate. This clomiphene citrate pill is taken from menstrual cycle days 3 – 7. The other most commonly prescribed injections that stimulate the ovary is gonadotropins. This gonadotropin in these formulations are FSH, and in few cases, a combination of FSH and LH (luteinizing hormone). These injections are taken in the night, typically for 5 – 10 days and act directly on the cells to stimulate egg development. You can get these infertility drugs either from any pharmacy store or you can buy infertility drugs online after it is prescribed by your doctor.
Side-effects of infertility drugs- Fertility drug side effects and risks depend on upon the medication that you are taking. Oral fertility drugs have milder side effects in comparison to injectable fertility drugs. Some of the most common fertility drugs side effects are a headache, bloating, upset stomach, breast tenderness, and mood swings. The most common fertility drug risks are multiple pregnancies like twins or triplets or more and developing ovarian hyperstimulation syndrome (OHSS).
- 3. Insemination-Intrauterine insemination is also known as IUI is a process in which sperm is washed and prepared for placement into the uterine cavity, thereby bypassing the cervix and bringing a high concentration of motile sperm closer to the tubes and ovulated mature egg. Furthermore, the semen is washed with a solution that is safe for sperm and eggs and then centrifuged to a separate motile sperm from immotile sperm and other cells. After this process, those motile and viable sperms are placed in a very small amount of solution, and then very smoothly and painlessly injected into the uterine cavity through a very thin, flexible and soft catheter. A minimum one open tube is required for this IUI process.
- 4. In Vitro Fertilization (IVF): The word in vitro means “outside the body.” IVF is processed in an embryology laboratory where eggs are collected and then fertilized by the sperm outside the body. The first IVF baby was born in 1978 in England. IVF was a major breakthrough because it allowed for successful pregnancies in female that were previously deemed permanently infertile. IVF involves the process of removing eggs directly from the ovary by fertilizing with sperm in the laboratory, followed by transfer of the embryos directly into the uterus, thereby bypassing the tubes.
- 5. Third party reproduction: Third-party reproduction is a general reference to a normal process where another woman acts as a gestational surrogate or another person provides sperms or eggs with the purpose of helping another person or couple to have a healthy child.