What is Infertility ?
Infertility is inability of a person to reproduce. It can be due to fertility problem in any/ both of the partner (male/ female). Doctors consider a couple as infertile, when they are unable to conceive even after one year of regular unprotected intercourse.
There are developed procedures for infertile couples to conceive. Infertility treatment depends on various factors like, age, cause of infertility and your personal preferences. If infertility problem is treatable by fertility drugs and surgeries, they are treated accordingly.
Infertility In Men
The most common symptom of infertility in males is inability to produce child. However, there can be many external signs of infertility but in some cases there could be no observable sign.
Signs and symptoms associated with male infertility include:
- Difficulty in ejaculation
- Little amount of semen ejaculation
- Decreased sexual desire
- Erectile Dysfunction
- Pain or Swelling in Testicles
- Abnormal breast growth (Gynecomastia)
- Decreased facial and body hairs
Male infertility problem can be caused by following reasons:
Absence of sperm in semen (Azoospermia):
It is the sperm cell only which fertilise the egg. Semen is only nourishing material which also act as fluid medium for sperm to swim. Semen without sperm cannot fertilise egg.
Low sperm count (Oligospermia):
Normal sperm count in adult male is minimum 15 million sperm cells per ml of semen. Decrease in this number reduce the chances that a sperm will penetrate the egg.
Genetic reasons like klinefelter’s syndrome:
Person with this syndrome have small testes (microorchidism). They cannot produce adequate level of testosterone hormone which leads to infertility.
Deficiency in semen:
Semen is the fluid medium in which sperm swim and move. Semen provide nourishment to the sperms so that they remain viable. Any deficiency in semen can cause early death of sperm.
Enlargement of the veins of scrotum (Varicocele):
In this condition veins of scrotum swell, making it difficult for sperm to move. Sperm quality is also reduced.
Some sort if infections cause scarring in the veins of the reproductive system and hence block them with the scar tissue.
Drug and Alcohol abuse:
Use of drugs like cocaine and marijuana can reduce number and quality of sperm.
Alcohol lowers the testosterone level, cause erectile dysfunction and decrease sperm production.
Male infertility treatments include, Surgeries, hormone treatment, treatment of infection, treatment for sexual intercourse problem. A brief detail of the treatments are as follow.
Surgeries for male infertility are vasectomy reversal, varicocele repair, repair of obstructed vas deferens and sperm retrieval technique is used for retrieval of sperm directly from testicles or epididymis.
2. Use of antibiotic:
Antibiotics can be used to treat infections of reproductive tract but not necessarily it will treat infertility problem.
3. Hormone treatment:
In case of infertility due to hormone imbalance, doctors recommend medications and hormone replacement.
Sexual intercourse problems like, premature ejaculation or erectile dysfunction can be treated by counseling and medication.
Infertility in women
The most common symptom of female infertility is inability to conceive. There are some symptoms through which you can determine if you have any infertility problem or not.
Signs and symptoms associated with female infertility include:
- Irregular menstrual period
- No menstrual period
- Facial hairs
- Reduced sexual desire
- Weight gain
- Painful intercourse
Female infertility problem can be caused by:
Problems like, polyps, fibroids, scar tissue, adhesions, previous ectopic pregnancy etc can interfere with the pregnancy. These problems make implantation difficult or increase the chance of miscarriage. In some cases cervix produce mucus which do not allow sperm to travel through the cervix into uterus.
Ovulation disorder can be caused by problem in ovaries or in production of reproductive hormone. Females have infrequent ovulation or no ovulation.
PCOS (Polycystic Ovarian Syndrome) is a condition in which ovaries produce many follicles each containing and immature egg. Eggs in this condition never mature enough for fertilisation.
STD ( sexually transmitted disease):
STD like gonorrhea cause inflammation and scar in fallopian tube. This scarring blocks the way of sperm to egg and hence egg cannot get fertilised.
Infections in reproductive system can block tubes by scar tissue and inflammation. This will prohibit the sperm and egg to meet.
Excess weight or very low weight can cause ovulation disorders.
Alcohol or Drug Abuse:
High alcohol and drug abuse can reduce fertility. It also affect the health of developing embryo.
It vary according to the cause of infertility. Some cases can be treated by fertility drugs alone while some may require surgeries and other techniques.
These are helpful to females, infertile due to ovulation disorder. These drugs are used to regulate or stimulate ovulation. Some drugs are used for producing better egg or multiple egg.
Fertility drugs generally act like natural hormones FSH (follicle stimulating hormone) and LH (luteinizing hormone).
Fertility drugs also include some risks like, ovarian hyperstimulation syndrome, tumors etc.
Laparoscopic or hysteroscopic surgeries are used for removal of scar tissue, uterine fibroids, polyps, pelvic adhesion, endometriosis and correcting abnormal uterine shape.
Blocked fallopian tubes or hydrosalpinx (fallopian tubes filled with fluid) can also be treated by laparoscopic surgeries.
Advance Infertility treatment options for couples
For couples who are unable to conceive even after initial treatments, they can opt for ART (assisted reproductive technology).
Brief details of these procedures are as follows:
IUI (Intrauterine insemination):
In this technique, doctor places the sperm in the uterus, while the women is ovulating, so that the sperm immediately fertilizes egg.
When egg get fertilised as a result women conceive and the zygote gets implanted in uterus wall.
Most of the sperms die after 1-2 days in uterus and few can survive for a longer period but not more than 5 days.
Egg remains in uterus only for 24 hours i.e. 1 day after release.
Egg is released after two weeks of last menstrual period. If egg is not fertilised within 24 hours after release, it disintegrates. So, sperm is injected within this time period i.e. 24 hrs.
IVF (In vitro fertilisation):
First eggs are retrieved from female body and sperm is collected from her partner or donor.
Eggs are then fertilised with sperm outside of body, in a laboratory. These are allowed to grow for three to five days in an artificially made environment, suitable for growth of embryo.
This 3 or 5 days grown embryo is then transferred to the woman’s uterus for further development. If the embryo attaches well in uterus walls, in next ten to fifteen days, woman gets a positive pregnancy test.
Sometimes donor is required in cases of recurrent IVF failure and if any of the partner is unable to produce mature and good quality of egg or sperm.
ICSI (Intracytoplasmic sperm injection) is almost same as conventional IVF, except the process of fertilisation.
In IVF, sperm naturally penetrates egg and fertilises it while in ICSI, a single sperm is picked at a time and injected into the egg.
This technique is especially used in those cases where sperms are in less amount or sperm is unable to penetrate egg.
GIFT (Gamete intrafallopian transfer):
In this technique the eggs are retrieved from the women body and sperm is collected.
The eggs are mixed with sperm outside the body and immediately transferred to the fallopian tube using a laparoscope.
ZIFT (zygote intrafallopian transfer):
Unlike GIFT, in this technique fertilised eggs are transferred to the fallopian tube.
Eggs are fertilised outside the body and using a laparoscope inserted into the fallopian tube in 24 hours. This technique is closer to IVF.
This method is used when a female cannot conceive, uterus is not suitable for implantation or when patient have a history of recurrent ivf failure or miscarriage.
In surrogacy another female carries the embryo till birth. The surrogate mother conceives either by IUI or IVF.
Basically there are two types of surrogacy, traditional and gestational.
Surrogate mother conceive through ivf, in which the embryo is made outside the body with egg and sperm of intended parents / donor.
This 3 or 5 day old embryo is then transplanted to the uterus of surrogate mother. The developing embryo is not genetically linked to the surrogate mother.
Traditional surrogacy :
Surrogate mother conceive by artificial insemination. Egg of surrogate mother is fertilised by the sperm of intended father/ donor. The developing embryo is genetically linked to the surrogate mother.
As a third party is involved in surrogacy and sometimes come up with the issues of custody of child, it requires the fulfilment of some legal formalities. Some fertility centers provide assistance with the legal formalities.
For any of the infertility treatment you must choose the hospital or doctor very carefully. These techniques are complicated and only certified and experienced doctors must perform these. The success rate of these techniques also depend on the choice of hospital and doctors because it demands selection of suitable procedure and skilled hands as its a matter of experience. To find best hospitals for the infertility treatment, estimated cost, payment options and any other related information you can go through our website letsmd.
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