Causative and risk factors
To get pregnant, ovulation and fertilization process should work right. Infertility may sometimes be due to a congenital cause and sometimes due to an acquired cause.
The male, female or both may be infertile.
In males, a reduced sperm count is the biggest cause of infertility. Sometimes the number of sperms is normal, but they are qualitatively poor. Addictions to alcohol, drugs, smoking etc, can damage the sperms thus making a man infertile. In addition, exposure to high temperatures for long periods can also destroy sperms.
Some men may be born with defects involving the testes or penis.
Advancing age, obesity exposure to chemotherapy or radiotherapy can also have a detrimental effect on sperm production.
In females, infertility can be caused by conditions affecting the uterus, fallopian tubes, ovaries or cervix. Birth defects or tumors involving any of these structures can lead to infertility. Pelvic inflammatory disease, ovarian cysts, uterine fibroids or cervical polyps can cause a female to become infertile. Lifestyle disorders such as diabetes, poor nutrition, excessive alcohol intake or indulging in regular vigorous exercise can also lead to infertility. As age of the female increases, the fertility goes on decreasing.
Clinical presentation
Failure to get pregnant even after 1 year of regular unprotected sex is a signal to investigate the couple for infertility. Other symptoms may be present depending upon the cause of infertility.
Diagnosis & Investigations
A woman suspected with infertility will need to undergo several tests to measure the hormone levels in the body including FSH, TSH, and luteinizing hormone. She is also required to undergo imaging studies such as ultrasound or endoscopic examination of the reproductive organs. Sometimes, a laparoscopy of the pelvis may be necessary to find and treat the cause of infertility.
A man suspected with infertility is first and foremost required to undergo a sperm examination test. An ultrasound of the testes is recommended. Very rarely, he may need to undergo a biopsy of the testes.
Treatment
The cause of infertility must be corrected first. Any underlying defects or conditions must be corrected via medications or surgery.
The couple is advised to have unprotected sex at least 3 times a week to increase the chances of pregnancy. Lifestyle corrections are advocated such as losing excess weight, curtailing smoking and drinking and avoiding exposure to high temperatures.
If the couple still fails to achieve pregnancy, assistive reproductive techniques such as Intra-uterine insemination (IUI) and In vitro fertilization (IVF) are recommended to the couple. More than 50% of couples with infertility problem become pregnant after treatment.
