IX.INFERTLITY

IX.INFERTLITY

What is infertility?

Infertility as not being able to get pregnant after at least one year of trying.

Is infertility just a woman's problem?

No, infertility is not always a woman's problem. In only about one-third of cases is infertility due to the woman (female factors). In another one third of cases, infertility is due to the man (male factors). The remaining cases are caused by a mixture of male and female factors or by unknown factors.

What causes infertility in men?

Infertility in men is most often caused by: (i) problems making sperm -- producing too few sperm or none at all (ii) problems with the sperm's ability to reach the egg and fertilize it -- abnormal sperm shape or structure prevent it from moving correctly (iii) Sometimes a man is born with the problems that affect his sperm. (iv) Other times problems start later in life due to illness or injury

What increases a man's risk of infertility?

The number and quality of a man's sperm can be affected by his overall health and lifestyle. Some things that may reduce sperm number and/or quality include: (i) alcohol/drugs (ii) environmental toxins such as pesticide (iii) smoking cigarettes (iv) a history of mumps (v) certain medications (vi) radiation treatment due to cancer.

What causes infertility in women?

Infertility in women may occur due to (i)Problems in ovulation (ii) blocked fallopian tubes (iii) physical problems with the uterus (iv) lumps in the uterus referred to as uterine fibroids.

What things increase a woman's risk of infertility?

Many things can affect a woman's ability to have a baby. These include: (i) Increasing age (ii) Stress (iii) Poor diet (iv) Being overweight or underweight (v)smoking (vi) Alcohol (vii) sexually transmitted diseases (viii)Health problems that cause hormonal changes.

How does a sexually transmitted disease cause infertility ?

The bacteria responsible for causing a sexually transmitted infection may gain access above the cervix to the uterus and tubes, the inside surfaces of the fallopian tubes are denuded of their skin. An abscess may be formed inside. Even when it gets resolved by treatments with antibiotics, the denuded inside of the tube may cause sticking together of the walls of the tube so that there is a blockage of the tube(s) later to sperm and eggs. For normal pregnancy, the sperm and the egg meet in the tube where fertilization takes place.

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: (i) The ability of a woman's ovaries to release eggs ready for fertilization declines with age. (ii) As a woman ages she is more likely to have health problems that can interfere with fertility. (iii) her risk of having a miscarriage increases.

How long should women try to get pregnant before calling their doctors?

(i) Most healthy women under the age of 30 shouldn't worry about infertility unless they've been trying to get pregnant for at least a year. (ii) Women in their 30s who've been trying to get pregnant for six months should speak to their doctors as soon as possible. A woman's chances of having a baby decrease rapidly every year after the age of 30. So getting a complete and timely fertility evaluation is especially important.

How is a man tested for an infertility problem?

For a man, doctors usually begin by testing his semen. They look at the number, shape, and movement of the sperm. Sometimes doctors also suggest testing the level of a man's hormones.

How is a woman tested for an infertility problem?

As a part of evaluating infertility in a woman, doctors may perform the following tests: (i) Check for ovulation by means of blood tests and ultrasound of the ovaries. (ii) Hysterosalpingography: This is an X –ray technique to check for functioning of the fallopian tubes (iii) Laparoscopy: This is a surgical technique by means of which doctors use a tool known as laparoscope to see inside the abdomen. Using the laparoscope, doctors check the ovaries, fallopian tubes, and uterus for disease and physical problems.

How do doctors treat infertility?

Infertility can be treated with medicine, surgery, artificial insemination or assisted reproductive technology. Many times these treatments are combined. Doctors recommend specific treatments for infertility based on: (i) test results (ii) how long the couple has been trying to get pregnant (iii) age of both the man and woman (iv) the overall health of the partners (v) preference of the partners.

How successful are these infertility treatment modalities?

About two-thirds of couples who are treated for infertility are able to have a baby.

How do doctors often treat infertility in men?

Doctors often treat infertility in men in the following ways: (i) Sexual problems: If the man is impotent or has problems with premature ejaculation, doctors can help him address these issues. Behavioral therapy and/or medicines can be used in these cases. (ii) Too few sperm: If the man produces too few sperm, sometimes surgery can correct this problem. Antibiotics can also be used to clear up infections affecting sperm count.

How do doctors often treat infertility in women?

Doctors often treat infertility in women in the following ways: (i) Various fertility medicines are often used to treat women with ovulation problems (ii) Doctors also use surgery to treat some causes of infertility. Problems with a woman's ovaries, fallopian tubes, or uterus can sometimes be corrected with surgery.

What is Artificial Insemination?

In this procedure, the woman is injected with specially prepared sperm. Artificial insemination is often used to treat (i) in case the male partner is infertile.(ii) women who have problems with their cervical mucus (iii) couples with unexplained infertility

What is assisted reproductive technology (ART)?

Assisted reproductive technology (ART) is a term that describes several different methods used to help infertile couples. ART involves removing eggs from a woman's body, mixing them with sperm in the laboratory and putting the embryos back into a woman's body. 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.

How often is assisted reproductive technology (ART) successful?

The average success rate has been seen to be 37 % for women less than 35 years of age. With rising age, the success rate tends to decline. Apart from age, success rates vary and depend on many factors. Some things that affect the success rate of ART include: (i) reason for infertility (ii) type of ART (iii) if the egg is fresh or frozen (iv) if the embryo is fresh or frozen

What are the different types of assisted reproductive technology (ART)?

Common methods of ART include: (i) In vitro fertilization (IVF) (ii) Zygote intrafallopian transfer (ZIFT) (iii) Gamete intrafallopian transfer (GIFT) (iv) Intracytoplasmic sperm injection (ICSI)

What is In vitro fertilization (IVF)?

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.

What is Zygote intrafallopian transfer (ZIFT) ?

ZIFT is similar to IVF. Fertilization occurs in the laboratory. Then the very young embryo is transferred to the fallopian tube instead of the uterus.

What is Gamete intrafallopian transfer (GIFT)?

Gamete intrafallopian transfer (GIFT) involves transferring eggs and sperm into the woman's fallopian tube. So fertilization occurs in the woman's body.

What is Intracytoplasmic sperm injection (ICSI)?

In ICSI, a single sperm is injected into a mature egg. Then the embryo is transferred to the uterus or fallopian tube. 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.