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Problems of Infertility

Problems of Infertility

Infertility is defined as the inability to conceive after one year of unprotected intercourse. After one year, 80% of healthy couples of child bearing age are able to achieve pregnancy.

Experts recommend that couples, in which the female partner is under the age of 35, who have not conceived after one year of unprotected intercourse, seek the help of a physician that specializes in the treatment of infertility; couples, in which the female partner is over age 35, should seek help after six months of being unable to conceive. Couples who have known causes of infertility (such as endometriosis, fibroids, irregular periods, prior abortion, DES mothers, varicoceles, prior cancer treatment or about to receive chemotherapy, etc.) should seek help from a specialist sooner.

Infertility is a very common health problem in both men and women. According to the health statistics approximately 4.5 million couples experience infertility each year. This equates to approximately 1 in six couples in the United States. Less than 2 million of these couples actually seek help from the medical community.

Fortunately, 90% of all cases of infertility have a specific cause that can be uncovered with proper diagnosis by physicians who specialize in reproductive medicine.

It is important to remember that about 40% of infertility is due to the male, 40% of infertility is due to the female, 10% is a combination of both male and female factors, and 10% is unexplained.

The most common cause of female infertility is anovulation that is brought on by irregularities in the hormones needed to produce and release healthy eggs. Another common cause of female infertility is blocked fallopian tubes, which can result from Pelvic Inflammatory Disease or endometriosis. Male infertility may be caused by a number of factors, including problems with sperm production, blockage of the sperm delivery system, injury to the testicles, problems relating to hormone production, anatomical problems or the presence of varicose veins in the testicles (varicoceles). All of these problems may affect sperm quality and quantity.

About 44% of infertility cases are hard for doctors to explain why fertility is such a struggle. Below are some indicators of fertility problems:

COMMON INDICATORS OF FERTILITY PROBLEMS
For Women:	• Difficulty in ovulation or monthly production of an egg. • Fallopian tube disease accounts for 20% of fertility struggles. Adhesions, blockage or damage can occur in the fallopian tubes from an STD or surgery. Endometriosis, ectopic pregnancy and surgical abortion can also be contributors of fallopian tube damage. • Incompetent cervix, poor cervical mucus, or cervical damage. • The age in which a woman is trying to conceive a child also makes a difference. 4.0% of women 15 to 24 struggle with fertility. 13.2% of women 25 to 34 are also infertile. The rise continues, bringing infertility to 21.3% among 35 to 44 year-olds. The longer a woman waits to have children; the higher the risk of infertility. • Smoking decreases the chance of pregnancy. In one study, 38% of females who did not smoke conceived within their first cycle. However, only 28% of the women who do smoke conceived during their first cycle. Smokers were also 3 to 4 times more likely to have a wait longer than a year before conceiving. • High or very low amounts of body fat can affect a woman's ovulation cycle as well as the ability to get pregnant or carry a pregnancy to full term. • Hormonal imbalance also may cause struggle in conceiving, due to menstrual cycles being irregular.
For Men:	• Absence of sperm production. • Blockage along sperm tract. • Poor quality or lower number of sperm, whether it's the shape of the sperm or endurance. Some medications and drug use commonly cause this. • Hormonal abnormalities and other problems caused by infections, antibodies, and exposure to drugs, toxins, radiation, and stress. • Inability to reach climax (ejaculation). • Smoking lowers a man's sperm count by 13% to 17%.

If a problem exists, an orderly and timely fertility assessment will uncover the cause of a couples' problem most of the time. Rational treatment based on the cause of infertility provides the best hope of resolving the problem without wasting precious time. If you are under 35 and have not been able to get pregnant in the last year, or if are 36 and over and have been trying to conceive for over 6 months, it is time to consult a physician regarding an infertility work-up.

A compete medical history and physical examination is the first step undertaken to investigate the cause of infertility. Menstrual history, family history of infertility and sexual factors are examined. Blood and urine tests to determine hormonal levels, prolactin levels, hyperthyroidism and diabetes are taken to evaluate the possible causes of infertility. Hormonal imbalances are sometimes caused by pituitary gland tumors. Blocked fallopian tubes do not allow the egg to travel to the uterus and can be a cause for infertility. One of the primary tests for detecting infertility in women is to check whether she is ovulating correctly. This can be done by monitoring body temperature and checking the texture of the cervical mucus.

Hysterosalpingogram: In this test for checking the infertility of women, an x-ray of the fallopian tubes and uterus is taken after they are injected with dye. The x-ray displays the shape of the uterus and the state of the fallopian tubes. This diagnostic test is also useful in diagnosing conditions such as endometrial polyps, fibroid tumors and structural abnormalities of the uterus or fallopian tubes.

Laparoscopy: This is a test for checking the fallopian tubes and other female reproductive organs for disease. Chromosomal tests are conducted to detect sperm abnormalities and other abnormal patterns in the man and woman.

Choosing a Clinic

An infertility center conducts tests and diagnoses the problems of infertility and treatments to correct the obvious causes. You need to choose the right type of infertility clinic since you will be entrusting them with an important aspect of your health. You need to consider the monetary aspect too, since insurance plans do not generally cover a full course of infertility treatment procedures. Here are certain precautionary steps you must take before selecting an infertility center:

• What are the procedures used at the infertility clinic? The center for infertility treatment must be abreast with the latest technological progress and remedial treatments. Ensure that the endocrinologists are certified and qualified in premature ovarian failure, endometriosis, fibroids and other aspects of reproductive endocrinology.

• Are the ethical issues of infertility treatment taken into consideration? Are the patient's views and needs taken into consideration? Are the doctors sensitive to the emotions of the couple?

• How much does the treatment at the infertility clinic cost? Most medical insurance policies do not cover the course of infertility treatment.

Infertility clinics also provide support services such as genetic counseling and support groups. Infertility clinics offer Assisted reproductive technologies (ART) to retrieve eggs from the ovary and plant them later. A reputed infertility center would be able to provide pre-implantation genetic diagnosis, egg freezing, embryo freezing and blastocyst transfer. Artificial insemination involves placing the sperm inside a woman's vagina, uterus or cervix.

SOME INFERTILITY FACTS

Infertility affects 1 in six couples in American.

Infertility affects both men and women almost equally.

Advances in medication and medical treatments make conception possible for more than half of infertile couples pursuing treatments.

25% of infertile couples have more than one factor that contributes to their infertility.

In approximately 50% of infertile couples, the male partner is either the sole cause or a contributing cause of infertility.

Irregular or abnormal ovulation accounts for approximately 25% of all female infertility cases.

Endometriosis is found in about 35% of infertile women who have laparoscopy as part of their infertility work-up.

There are more than 70,000 babies born in the United States as a result of all assisted reproductive technologies.

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