Infertility is basically defined as not being able to get pregnant even after one year of having unprotected intercourse. Or, for women of above 35 years, even after six months is considered as infertility. Women with more than one miscarriage or multiple miscarriages may be considered infertile as well.
What is the normal process of pregnancy ?
Pregnancy is the end result of many successive stages and infertility can come about if there are problems with any of these stages. The stages are ;
- Ovulation : This is the release of egg from ovaries to the uterus, where it will wait for fertilization by the male sperm or else be discarded from the uterus in the monthly period.
- Fertilization : This is the first step towards pregnancy, by fusion of the female egg & the male sperm.
- Implantation : The fertilized egg must attach itself to the inside of the uterus, and undergo development to form the fetus.
What are the causes of female Infertility ?
- Polycystic ovarian syndrome (PCOS) : These occur cyclically, as the eggs mature within the ovary in sacs or follicles but the follicles fail to release the eggs. What this means is that ovulation does not occur. This cycle repeats, follicles grow within the ovary and cysts keep forming and accumulating in the ovary.
- Primary ovarian insufficiency (POI) : Premature or early failure of ovarian function, before the age of 40 years.
- Blocked/ abnormal Fallopian Tubes due to endometriosis or surgery
- Anomalies of Uterus : Developmental abnormalities of uterus, occurring from birth itself.
- Uterine Fibroids : Benign or non-cancerous tumours of the muscle wall of the uterus that may cause unusual uterine bleeding or pelvic pain, and possibly interfere with normal conception & pregnancy.
What are the lifestyle factors causing Infertility in women ?
- Age of patient : As age increases, fertility also decreases, especially after the mid 30’s- 40’s for women.
- Cigarette Smoking, excess alcohol use & marijuana abuse.
- Stress
- Poor diet
- Environmental toxins, including pesticides and lead
- Health problems such as mumps, kidney dis¬ease, or hormone problems
- Medicines
How is Infertility diagnosed ?
An infertility evaluation has to be done for the patient. You can get checked by your regular gynaecologist or you can be evaluated by a specialist in infertility. There are general obstetricians/gynaecologists (ob/gyns) as well with special interest and training in the field of infertility.
Reproductive endocrinologists with special training in reproductive endocrinology and infertility also will have to be consulted.
The case history discussion to determine if you are infertile is the frequency or the regularity of your menstrual period, any pelvic pain or infection, unusual vaginal bleeding or discharge, and any systemic medical illnesses. You should expect questions concerning earlier pregnancies or miscarriages, previous operations and your usual contraceptive methods. Your partner will be questioned too regarding any genital injury, infections, surgeries, drugs and/or medication, any history of fathering children, and systemic medical illnesses. Your doctor will have to know the whole sexual and reproductive history of you and your partner. Since more than one factor causes infertility, it is extremely important to evaluate all factors that affect both you and your partner.
What is the treatment for Infertility ?
There are various tried and tested successful modalities.
- Drugs : Drugs that stimulate or regulate ovulation may have to be used. These include drugs that may work like natural hormones such as Gonadotrophin Releasing Hormone, Follicle Stimulating Hormone or Luteinizing Hormone. Certain medicines that are used in treatment of Polycystic ovarian syndrome (PCOS) also increase fertility.
- Surgery : These include either laparoscopic or hysteroscopic surgeries which correct uterine shape or any uterine abnormalities. Tubal surgeries work to correct tubal defects that cause infertility.
- Assisted reproductive technology (ART)
What is assisted reproductive technology (ART) ?
These include all treatments that comprise the laboratory handling techniques of the reproductive cells, the eggs or sperm, and/or embryos.
The most common examples of assisted reproductive technology (ART) are in vitro fertilization (IVF), intracytoplasmic sperm injection (sperm injection into the egg, then transfer to the uterus), donor egg or donor embryo transfer.
Explaining it further, the meth¬ods used to help infertile couples include ;
- Eggs from same woman + sperm from man= embryo, which is re-implanted into the uterus of woman.
- Donor eggs (eggs from another woman) or a donor sperm (sperm from another man) or a fertlilized donor embryo can be used.
Surrogacy
- For women with an egg problem, surrogacy can be a solution.
- A surrogate is a woman who agrees to become pregnant using the man’s sperm and her own egg.
- The child is then related genetically to the surrogate mother and the male partner.
- After the birth of child, the surrogate has to hand over the baby to the parents.
Gestational carrier
- Women with functioning ovaries but with no uterus can utilize a gestational carrier.
- This is also a good option for women who should avoid pregnancy because of some other grave health problem.
- So in these carriers, a woman will use her own egg. It is then fertilized by the man’s sperm and the fertilized embryo is positioned inside the carrier’s uterus.
- The carrier will not be genetically related to the baby and gives him or her to the parents at birth.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
