Overview of fertility problems
When you start trying to conceive, you should make yourself aware of things you could do to aid in conception. For instance, keep track of your basal body temperature to determine when you ovulate, and try in those windows.
No matter the case, it is a good idea to educate yourself on what are the possible problems you may encounter when you set your heart on having a baby.
When and Who to consult
If you have been trying to conceive for one year without success, it is probably a good idea to consult your OBGYN first, which may refer you to a reproductive endocrinologist after some preliminary tests. However, in some special cases it is recommended to consult a doctor much earlier.
Irregular menstrual cycle
A healthy regular menstrual cycle (21- 35 days) is an indication of regular ovulation, which is very important for conception. If the interval expands more than 35 days, it may point to a problem with ovulation of the egg.
Age more than 35
As the woman’s age increases, the quantity, and quality of egg goes down. So does the probability of the egg being genetically normal. A woman of age 35 or above should consult a doctor if unable to conceive within 6 months.
History of pelvic infections or STDs
Sexually transmitted diseases may cause inflammation and permanent scarring of the fallopian tubes in a woman. It is vital for conception that the fallopian tubes remain open. An HSG test can be conducted to check if the tubes are open.
Known uterine abnormalities
If any anatomical abnormalities like fibroids or cysts were present, it is a good idea to consult a doctor within 6 months. These types of problems may interfere with the endometrium (wall of the uterus) and the embryo interaction.
Known infertility problems with male partner
If the male partner has any known abnormalities or problems conceiving with a prior partner, a doctor should be consulted within 6 months. If after a preliminary semen test problems are found, a reproductive urologist must be consulted.
The cause of infertility may come from a number of places.
As mentioned earlier, the woman’s progressing age may hinder the conception. The eggs are reduced in number and quality as the woman gets older. And the probability of genetic abnormalities also increases. The cause for this is not known beyond an evolutionary hypothesis.
Most common ovulation disorder in this age is PCOS (PolyCystic Ovary Syndrome). Others include hypogonadotropichypogonadism. The problem may lie in the ovary itself or in pituitary gland and hypothalamus. The slightest of hormonal imbalance may disrupt the ovulation cycle. Problems that affect metabolism (like stress, over/underweight, over-exertion etc.) also affect ovulation.
Scarring of tubes due to a past STD or pelvic surgery may result in a blockage. Blockage in fallopian tube hinders the egg from reaching the endometrial cavity and consequently conception.
There are a number of uterine abnormalities which may eventually cause infertility. These abnormalities may have existed since birth or cause due to a previous trauma or surgery.
- Exposure to certain drugs before birth cause uterine deformities resulting in infertility.
- Abnormalities in cervical mucus may hinder movement of sperm through vagina and cervix. Antibodies in this mucus may even kill the sperm before reaching the egg.
- Uterine fibroids – a certain type of fibroids such as sub-mucosal fibroids are known to reduce the chance of conception by 50%. They also cause heavy bleeding or bleeding between periods.
- Endometrial polyps – they are fingerlike growths on the endometrium that have been related to infertility in many studies.
Is a case where cells similar to the lining of uterine cavity are found elsewhere. This is usually accompanied by pain during periods and/or intercourse. This is found in about 15% of women (of reproductive age).
Male’s reproductive system
Male factor infertility has been identified as a contributing factor in 40-50% of the cases and as the sole cause in 15-20% of the cases. The most common problem is low sperm count. Others include:
- Testicular injury or failure.
- Hormonal problems in testicles or pituitary gland.
- Antibodies that attack sperm may be present in semen. This happens when the sperm is exposed to the immune system. Could be caused by an injury, infection or vasectomy.
- Drug use and abuse.
- Genetic problems.
- Structural problems like blocked ejaculation, varicocele in testicles, the absence of vas deferens (a birth defect), retrograde ejaculation etc.
There are a number of tests/procedures that to evaluate fertility problems. Most doctors will start with a thorough history.
Physical examination and background
A thorough medical background of the couple and their families can go a long way in identifying fertility issues. The doctor may want to know details regarding the menstrual cycle of the woman, history of surgeries/trauma, stress levels etc.
Ultrasounds are usually conducted to investigate the structural condition of uterus, tubes, and ovaries. They can detect tube blockages, anatomical abnormalities such as polyps etc.
Based on tests/examinations done so far, further lab tests may be called for. These are usually to check hormone levels in the blood.
HysteroSalpingogram is a test conducted for evaluating fallopian tube patency, uterine defects such as fibroids or polyps. Many of these can be corrected by surgery.
This is the main test for male fertility analysis. It checks for sperm count(volume), concentration, motility, and morphology. Abnormality in any of these areas may compromise the ability to fertilize the egg.
There is no straightforward way to treat this. There are however, a lot of options available now that weren’t present earlier due to advance in medicine. Treatment may include medicine, lifestyle changes or surgery. It is important to consider all options and choose the one best suited to you. Most of these procedures are costly and it is important that you and your partner agree on every step of the way.
Most grueling force you have to fight throughout will be stress. Take the time to understand the financial and personal implications of your choice of treatment before committing to it.
There are medications for various ovulation related issues. You may take pills or injections to stimulate ovaries to produce mature eggs for ovulation.
Intra Uterine Insemination is a process where the sperm is washed and placed directly into the uterus. This compensates for low sperm count and some minor defects in mobility of sperm. However, they have to be mobile enough to fertilize the egg once placed in the uterus. And atleast open fallopian tube has to be open so the egg/embryo can reach the uterus.
In Vitro Fertilization is a process where the egg is taken directly from the ovary and fertilized outside the body in a lab. And the embryo is placed back in the uterus for development. This was first designed to overcome the fallopian tube blockages, but since then it has become a viable alternative for thousands of couples to overcome a number of fertility issues.
Is also a widely accepted option for couples these days. It involves a third party – generally a sperm donor or another woman who acts as a gestational surrogate.
There are certain procedures which may help in the process of conception. Most commonly used are laparoscopy, hysteroscopy, and abdominal myomectomy (removal of uterine fibroids).
The most important thing throughout the process is to not lose hope. There are a number of options available for you to choose from. It is extremely important that you keep your body and mind healthy and stress-free.
“Enjoy your Path to Mom. Relish every moment!”
Disclaimer: All content on this website, including medical opinion and other health-related information, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.