Most experts define infertility as not being able to get pregnant after at least one year of trying.
Women who are able to get pregnant but then have repeat miscarriages are also said to be infertile.
Pregnancy is the result of a complex chain of events. In order to get pregnant:
- A woman must release an egg from one of her ovaries (ovulation).
- The egg must go through a fallopian tube toward the uterus (womb).
- A man's sperm must join with (fertilize) the egg along the way.
- The fertilized egg must attach to the inside of the uterus (implantation).
Infertility can result from problems that interfere with any of these steps.
80% of couples achieve conception if they so desire, within 1 year of regular trying. Another 10% will achieve the objective by the end of 2nd year. As such, 10% remain infertile by the end of second year.
No, infertility is not always a woman's problem. In about one-third of cases, infertility is due to the woman (female factors). In another 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.
Infertility in men is most often caused by:
- Problems making sperm -- producing too few sperm or none at all
- Problems with the sperm's ability to reach the egg and fertilize it - abnormal sperm shape or structure prevent it from moving correctly
Sometimes a man is born with the problems that affect his sperm. Other times problems start later in life due to illness or injury.
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:
- Environmental toxins, including pesticides and lead
- Smoking cigarettes
- Health problems
- Radiation treatment and chemotherapy for cancer
Problems with ovulation account for most cases of infertility in women. Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.
Other causes of fertility problems in women include:
- Blocked fallopian tubes due to pelvic inflammatory disease, endometriosis, or surgery for an ectopic pregnancy
- Uterine anomalies
- Uterine fibroids
Many things can affect a woman's ability to have a baby. These include:
- Poor diet
- Being overweight or underweight
- Tobacco, smoking
- Sexually transmitted diseases (STDs)
- Health problems that cause hormonal changes
More and more women are waiting until their 30s and 40s to have children. Ageis an increasingly common cause of fertility problems. About one-third of couples in which the woman is over 35 have fertility problems.
Aging decreases a woman's chances of having a baby in the following ways:
- The ability of a woman's ovaries to release eggs ready for fertilization declines with age.
- The health of a woman's eggs declines with age.
- As a woman ages she is more likely to have health problems that can interfere with fertility.
- As a women ages, her risk of having a miscarriage increases.
Sometimes doctors can find the cause of a couple's infertility by doing a complete fertility evaluation. This process usually begins with physical exams and health and sexual histories. If there are no obvious problems, like poorly timed intercourse or absence of ovulation, tests will be needed.
Finding the cause of infertility is often a long, complex, and emotional process. It can take months for you and your doctor to complete all the needed exams and tests. So don't be alarmed if the problem is not found right away.
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.
For a woman, the first step in testing is to find out if she is ovulating each month. There are several ways to do this. A woman can track her ovulation at home by:
- Recording changes in her morning body temperature (basal body temperature) for several months/li>
- Recording the texture of her cervical mucus for several months/li>
- Using a home ovulation test kit (available at medical stores)
Doctors can also check if a woman is ovulating by doing blood tests and an ultrasound of the ovaries. If the woman is ovulating normally, more tests are needed to check for uterine, tubal and peritoneal factors.
Infertility can be treated with medicine, surgery, artificial insemination, or assisted reproductive technology. Many times these treatments are combined. About two-thirds of couples who are treated for infertility are able to have a baby. In most cases infertility is treated with drugs or surgery.
Doctors recommend specific treatments for infertility based on:
- Test results
- How long the couple has been trying to get pregnant
- The age of both the man and woman
- The overall health of the partners
- Preference of the partners
Success rates vary and depend on many factors. Some things that affect the success rate of ART include:
- Age of the partners
- Reason for infertility
- Fertility clinic
- Type of ART
- If the egg is fresh or frozen
- If the embryo is fresh or frozen
The CDC collects success rates on ART for some fertility clinics. According to the 2003 CDC report on ART, the average percentage of ART cycles that led to a healthy baby were as follows:
- 37.3% in women under the age of 35
- 30.2% in women aged 35-37
- 20.2% in women aged 37-40
- 11.0% in women aged 41-42
ART can be expensive and time-consuming. But it has allowed many couples to have children that otherwise would not have been conceived. The most common complication of ART is multiple fetuses. But this is a problem that can be prevented or minimized in several different ways.
Your treatment options will depend on the cause of your infertility. Lifestyle changes, medication, surgery, or other approaches may be recommended. Some treatments may be combined to improve results. Infertility often can be successfully treated even if no cause is found.
Staying at a healthy weight and eating a healthy diet can be helpful for both men and women with infertility. If you and your male partner smoke, use illegal drugs, or drink alcohol, you should stop.
In women, surgery may be able to repair blocked or damaged fallopian tubes. Surgery also may be used to treat endometriosis, which is commonly associated with infertility. Women with polyps or fibroids in the uterus also may have surgery
A common problem that leads to male infertility is the enlargement of a vein in the scrotum. It sometimes can be treated with surgery.
is the use of drugs to help your ovaries release an egg. This treatment is used when ovulation is irregular or does not occur at all and other causes have been ruled out. Ovulation induction may be used with other infertility treatments.
Oral drugs used to induce ovulation include clomiphene citrate, aromatase inhibitors, and insulin-lowering drugs. While taking these drugs, you will be monitored to see if and when ovulation occurs. This can be done by tracking your menstrual cycle or with an ovulation-predictor kit (an at-home urine test). You may be asked to visit your doctor for a blood test or ultrasound exam.
If clomiphene citrate or other drugs are not successful, drugs called gonadotropins may be tried to induce ovulation. Gonadotropins also are used when many eggs are needed for infertility treatments.
Gonadotropins are given in a series of shots early in the menstrual cycle. Blood tests and ultrasound exams are used to track the development of the follicles. When test results show that the follicles have reached a certain size, another drug may be given to signal a follicle to release its matured egg.
In general, if you are less than 35 years old and have been trying for more than one year you should schedule an appointment with a fertility specialist. If you are greater than 35 years old we would like to see you after at least six months of properly timed, sexual intercourse. However, if you have a reason to suspect you may have a problem getting pregnant such as a history of pelvic inflammatory disease, painful periods, miscarriage, irregular menstrual cycles, or if your partner has a low sperm count, you should seek help sooner.
Many couples have a hard time admitting that there may be an infertility problem, but be reassured there are many things we can do to help you build your family.
No matter how old you are, it's always a good idea to talk to a doctor before you start trying to get pregnant. Doctors can help you prepare your body for a healthy baby. They can also answer questions on fertility and give tips on conceiving.
The most fertile time of a woman’s cycle is just before or on the day of ovulation. Ovulation usually occurs two weeks before a period starts, so it is necessary to count backwards from the anticipated start of the next period in order to find the most fertile time. Take the number of days in the usual cycle (from the beginning of one period to the beginning of the next) and subtract 14. For example, a woman with a 32-day cycle would likely ovulate around day 18 (32-14=18), while a woman with a 28-day cycle would ovulate around day 14 (28-14=14). We recommend every other day intercourse around the day of ovulation. That would mean days 12, 14 and 16 for women with 28 days cycles.
Yes. Your doctor will recommend that you adhere to the basic guidelines below during the IVF process and into your pregnancy.
- Smoking: It’s recommended that both partners stop smoking at least three months before beginning an IVF cycle, and before ovulation induction begins. The effects of tobacco have been shown to be toxic and harmful to a woman’s eggs.
- Drinking: Alcohol should be avoided at the outset of IVF treatment, until one’s pregnancy test, and if pregnant, until the birth of the child.
- Medications: It’s important to inform your doctor if you’re taking any prescription or over-the-counter medications. Some medicines can interfere with the prescribed fertility medication, or embryo transfer, and others may not be safe to take before surgery.
- Vigorous exercise: Intense physical activities like aerobics, weightlifting and running are prohibited during ovarian stimulation and until the results of one’s pregnancy are known.
IVF process can be understood with the help of certain steps which are explained below.
- Ovarian stimulation: The fertility specialist monitors the timing of egg release. Doctorwill make sure the hormonal level and other conditions for IVF are normal or not. The doctor watch over the produced eggs is appropriate or not.
- Egg retrieval: In this step, the eggs are taken out from female’s ovary by using needleunder light sedation. Further, the eggs are placed in a dish containing nutrient media andfurther it is shifted to the incubator.
- Fertilization: This is the next step of called fertilization where male sperms are taken andmixed with the most active sperm in a special chamber. Then, the egg and sperm are placedin incubator and the process is monitored so that healthy embryo can develop.
- Embryo transfer: It is the last step in which the healthiest embryo is transferred. Initially,the doctor examines so that healthy embryo can be selected. With the help of small plastictubes the embryo is transferred.
How much time IVF takes?
IVF involves two visits:(1) One day for checkup / pre-IVF preparation
(2) 15 days for IVF procedure
As compare to international IVF hospitals the cost of IVF is lower in India. The treatment cost ranges between INR 1,25,000 to 1,50,000. It is purely depends on patient’s medical condition which may vary the cost.
IUI stands for intrauterine insemination, is one of the common techniques of ART (Assisted Reproductive Technology). It allows putting sperm directly to the female’s uterus. In this process, the processed (washed) sperm is used. However, usage of this technique will resulting escalating the possibilities of conception.
No, IVF is not at all painful because the injections used for IVF are purified and injected in subcutaneous form. The egg collection process is done under light sedation which is totally painless. At the time of embryo transfer, anesthesia is not given but it is a 2 to 5 minutes of process which hardly cause any pain.
Low sperm count can also be known as oligospermia. One may undergo to ICSI (Intracytoplasmic sperm injection) where a single sperm is injected to mature egg. Adoptingthis treatment will leads to elevate the chances of conceiving. Besides this, the treatment is useful especially in case of male infertility, low sperm motility and poor sperm morphology.