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No, infertility is not always a woman’s problem. Both men and women contribute to infertility.

Many couples struggle with infertility and seek help to become pregnant; however, it is often thought of as only a women’s condition.According to CDC study analyzed National Survey of Family Growth and found that 7.5% of all sexually experienced men younger than age 45 reported seeing a fertility doctor during their lifetime – this equals 3.3-4.7 million men. Of men who sought help, 18% were diagnosed with a male-related infertility problem, including sperm or semen problems (14%) and varicocele (6%).

Is infertility a common problem?

Yes. About 6% of married women 15-44 years of age in the world are unable to get pregnant after one year of unprotected sex (infertility).

Also, about 12% of women 15-44 years of age worldwide have difficulty getting pregnant or carrying a pregnancy to term, regardless of marital status (impaired fecundity).

What causes infertility in men?

Infertility in men can be caused by different factors and is typically evaluated by a semen analysis. A specialist will evaluate the number of sperm (concentration), motility (movement), and morphology (shape). A slightly abnormal semen analysis does not mean that a man is necessarily infertile. Instead, a semen analysis helps determine if and how male factors are contributing to infertility.

Conditions that can contribute to abnormal semen analyses include –

Varicoceles, a condition in which the veins on a man’s testicles are large and cause them to overheat. The heat may affect the number or shape of the sperm.

Medical conditions or exposures such as diabetes, cystic fibrosis, trauma, infection, testicular failure, or treatment with chemotherapy or radiation.

Unhealthy habits such as heavy alcohol use, testosterone supplementation, smoking, anabolic steroid use, and illicit drug use.

Environmental toxins including exposure to pesticides and lead. Continue Reading

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What causes infertility in women?

Women need functioning ovaries, fallopian tubes, and a uterus to get pregnant. Conditions affecting any one of these organs can contribute to female infertility. Some of these conditions are listed below and can be evaluated using a number of different tests.

Ovarian function (presence or absence of ovulation and effects of ovarian “age”)

Ovulation. Regular predictable periods that occur every 24–32 days likely reflect ovulation. Ovulation can be predicted by using an ovulation predictor kit and can be confirmed by a blood test to see the woman’s progesterone level. A woman’s menstrual cycle is, on average, 28 days long. Day 1 is defined as the first day of “full flow.”

A woman with irregular periods is likely not ovulating. This may be because of several conditions and warrants an evaluation by a doctor. Potential causes of anovulation include the following:

Polycystic ovary syndrome. PCOS is a hormone imbalance problem that can interfere with normal ovulation. PCOS is the most common cause of female infertility.

Functional hypothalamic amenorrhea. FHA relates to excessive physical or emotional stress that results in amenorrhea (absent periods).

Diminished ovarian reserve (DOR). This occurs when the ability of the ovary to produce eggs is reduced because of congenital, medical, surgical, or unexplained causes. Ovarian reserves naturally decline with age.

Premature ovarian insufficiency.POI occurs when a woman’s ovaries fail before she is 40 years of age. It is similar to premature (early) menopause.

Menopause. Menopause is an age-appropriate decline in ovarian function that usually occurs around age 50. It is often associated with hot-flashes and irregular periods.

Ovarian function. Several tests exist to evaluate a woman’s ovarian function.

No single test is a perfect predictor of fertility.

The most commonly used markers of ovarian function include follicle stimulating hormone value on day 3–5 of the menstrual cycle, anti-mullerian hormone value, and antral follicle count  using a transvaginal ultrasound.

General Infertility

“Infertility is a disease, defined by the failure to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse. Earlier evaluation and treatment may be justified based on medical history and physical findings and is warranted after 6 months for women over age 35 years.”

If you are trying to have a baby and it is not happening as quickly as you expected, you may wonder if you have an infertility issue. This section is designed to determine if you should see an infertility specialist.

Definition of infertility: 12 months or more of unprotected intercourse without pregnancy

Primary infertility: Infertility without any previous pregnancy.

Secondary infertility: Fertility problems occurring in a couple that has conceived on their own and had a child in the past.

Sterility: When there is no chance for a pregnancy. This is different from infertility which generally represents a reduced potential for pregnancy.

Most childless couples with a female age under about 43 that are having problems getting pregnant are considered to be infertile but not sterile.

When to see a fertility specialist?

In general, it is appropriate to see a doctor for medical assistance after 12 months of trying to get pregnant on your own.

Many couples will start the infertility workup process with their general gynecologist, while others prefer to go straight to a fertility specialist. Either option is appropriate.

It is advised to see a specialist sooner if the female partner is over 35 years old.

It is prudent to seek medical help for fertility issues without waiting for a year of trying on your own if you have a condition that is a known risk factor for fertility problems, such as irregular menstrual cycles, endometriosis, previous tubal pregnancy, PCOS – polycystic ovary syndrome, previous pelvic inflammatory disease, etc.

The appropriate amount of time to try on your own can be longer, or shorter than one year. For example, if you are only 25 years old and feel that you want to give it more time to occur naturally – you might try on your own for another 6 months before seeing a doctor for help.

For couples with a female partner age 40 or older, it is appropriate to see a fertility specialist if not pregnant by 3-4 months of trying to conceive. A high percentage of women over 40 will have age-related issues (egg quality) and will need medical help to get pregnant. If the female partner is 42 or older, it is recommended to see a specialist right away if wanting to have a baby.

Fertility advice

You do not need to have sex all the time in order to get pregnant. If you like it that way, then no problem – it doesn’t reduce a couple’s fertility potential either. The best fertility advice in terms of frequency of intercourse is – every day or every other day “around ovulation”.

Ovulation is usually on day 14 – if the menstrual cycle length (from day 1 to day 1) is 28 days, or on day 16 if periods are 30 days apart. In other words, ovulation usually occurs 14 days before the next period comes.

The egg only lives about 12-24 hours, while the sperm (if normal) will live in the female’s reproductive tract for up to 2-5 days – while maintaining the ability to fertilize an egg.

Therefore, the best fertility advice would be to have sex on the day of ovulation, or the day before ovulation (or both). Having sex more than about 24 hours after ovulation should be fun and all that, but it isn’t likely to increase the planetary population.

Fertility tourism is the practice of traveling to another country for fertility treatments.[61] It may be regarded as a form of medical tourism. The main reasons for fertility tourism are legal regulation of the sought procedure in the home country, or lower price. In-vitro fertilization and donor insemination are major procedures involved.

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