Infertility Treatments

Couples that should seek help early are:

• Women who have irregular periods, which is a sign that ovulation may not be occurring
• Women who have had pelvic surgery (to ovaries, tubes or appendix) or pelvic infection which may have damaged fallopian tubes
• Women over 35 years of age
• Women with known reproductive pathology, e.g. endometriosis, fibroids, PCOS
• Men who have had genital surgery, infection or significant trauma

What is infertility?

Infertility means not being able to get pregnant after one year of trying (or six months if a woman is 35 or older). Women who can get pregnant but are unable to stay pregnant may also be infertile.To get pregnant:

• A woman’s body must release an egg from one of her ovaries (ovulation).
• The egg must go through afallopian tube towards 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 happen if there are problems with any of these steps.

Is infertility a common problem?

Yes. About 10 percent of women ages 15-44 have difficulty getting pregnant or stayingpregnant.

Is infertility just a woman’s problem?

No, infertility is not always a woman’s problem. Both women and men can have problems that cause infertility. About one-third of infertility cases are caused by women’s problems. Another one third of fertility problems are due to the man. The other cases are caused by a mixture of male and female problems or by unknown problems.

 

What causes infertility in men?

Infertility in men is most often caused by:

• A problem calledvaricocele,happens when the veins on a man’s testicle(s) are too large. This heats the testicles. The heat can affect the number or shape of the sperm.
• Other factors that cause a man to make too few sperm or none at all, movement of the sperm, shape of the sperm, Sometimes injuries or other damage to the reproductive system block the sperm.
• Sometimes a man isborn with the problemsthat affect his sperm. Other times problems start later in life due to illness or injury. For example, cystic fibrosis often causes infertility in men.

What increases a man’s risk of infertility?

Overall health and lifestyle may affect the health or number of sperms, include:

• Heavy alcohol use, drugs, smoking cigarettes, medicines
• Age
• Environmental toxins, including pesticides and lead
• Health problems such as mumps, serious conditions like kidney disease, or hormone problems, Radiation treatment and chemotherapy for cancer

What causes infertility in women?

• Blocked fallopian tubes (most common cause) If both tubes are blocked, then in vitro fertilization (IVF) is required.
• Another most cause is problems with ovulation. Without ovulation, there are no eggs to be fertilized. Ovulation problems are often caused by polycystic ovarian syndrome (PCOS, a hormone imbalance problem).

Less common causes of fertility problems in women include:

• Physical problems with the uterus
• Uterine fibroids, which are non-cancerous clumps of tissue and muscle on the walls of the uterus.
• Primary ovarian insufficiency

What things increase a woman’s risk of infertility?

Many things can change a woman’s ability to have a baby. These include:

• Age
• Smoking, Excess alcohol use, Stress, Poor diet
• Athletic training, Being overweight or underweight
• Sexually transmitted infections (STIs)
• Health issues causing hormonal changes, such as polycystic ovarian syndrome  and primary ovarian failure.

How does age affect a woman’s ability to have children?

age is a growing 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:

• Her ovaries become less able to release eggs
• She has a smaller number of eggs left
• Her eggs are not as healthy
• She is more likely to have health conditions that can cause fertility problems
• She is more likely to have a miscarriage

How long should women try to get pregnant before calling their doctors?

It should be at least one year. Women 35 or older should see their doctors after six months of trying. A woman’s chances of having a baby decrease rapidly every year after the age of 30.

It is a good idea for any woman to talk to a doctor before trying to get pregnant. Doctors can help you get your body ready for a healthy baby. They can also answer questions on fertility and give tips on conceiving. Some health problems also increase the risk of infertility. So, women should talk to their doctors early if they have:

• Irregular periods or no menstrual periods
• Very painful periods
• Endometriosis
• Pelvic inflammatory disease
• More than one miscarriage

How will doctors find out if a woman and her partner have fertility problems?

We do an infertility checkup, involves a physical exam, also both partners’ health and sexual histories. Sometimes this can find the problem. However, most of the time, you need to do more tests.

In men, evaluation begins withtesting the semen for the number, shape, and movement of the sperm. Sometimes they also need for testing the level of hormones.

In women, the first step is to find out if she is ovulating each month. There are a few ways to do this. A woman can track her ovulation at home by:

• Writing down changes in her morning body temperature for several months
• Writing down how her cervical mucus looks for several months
• An ultrasound of the ovaries.

If ovulation is normal, there are other fertility tests available.

Some common tests of fertility in women include:

• Hysterosalpingography (HSG): This is an x-ray of the uterus and fallopian tubes. This can help find physical blocks that may be causing infertility. Blocks in the system can keep the egg from moving from the fallopian tube to the uterus. A block could also keep the sperm from reaching the egg.
• Laparoscopy: A minor surgery under anaesthesia to see inside the abdomen,can check the ovaries, fallopian tubes, and uterus for disease and physical problems. We can also find scarring and endometriosis by laparoscopy.

Finding the cause of infertility can be a long and emotional process. It may take time to complete all the needed tests. So don’t worry if the problem is not found right away.

How do doctors treat infertility?

Infertility can be treated with medicine, surgery, artificial insemination, or assisted reproductive technology. Many times these treatments are combined. 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 and overall health of both partners
• Preference of the partners

We often treat infertility in men in the following ways:

• Sexual problems: Doctors can help men deal with impotence or premature ejaculation. Behavioral therapy and/or medicines can be used in these cases.
• Too few sperm: Sometimes surgery can correct the cause of the problem. In other cases, doctors surgically remove sperm directly from the male reproductive tract. Antibiotics can also be used to clear up infections affecting sperm count.
• Sperm movement: Sometimes semen has no sperm because of a block in the man’s system. In some cases, surgery can correct the problem.

In women, some physical problems can also be corrected with surgery.

What is intrauterine insemination (IUI)?

Often called artificial insemination, woman is injected with specially prepared sperm. Sometimes the woman is treated with medicines that stimulate ovulation before IUI.

IUI is often used to treat:

• Mild male factor infertility
• Women who have problems with their cervical mucus
• Couples with unexplained infertility

What is assisted reproductive technology (ART)?

ART is a group of different methods used to help infertile couples. ART works by removing eggs from a woman’s body. The eggs are then mixed with sperm to make embryos. The embryos are then put back in the woman’s body.

How often is assisted reproductive technology (ART) successful?

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
• Type of ART
• If the egg/embryo is fresh or frozen

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.

What are the different types of assisted reproductive technology (ART)?

Common methods of ART include:

• In vitro fertilization (IVF) means fertilization outside of the body. IVF is the most effective ART, often used when tubes are blocked or too few sperm.
• Zygote intrafallopian transfer (ZIFT) or Tubal Embryo Transfer is similar to IVF.
• Gamete intrafallopian transfer (GIFT)
• Intracytoplasmic sperm injection (ICSI) is often used when serious problems with the sperm, sometimes for older couples or for those with failed IVF attempts.

ART sometimes involve the use of donor eggs (eggs from another woman), donor sperm, or previously frozen embryos.

Surrogacy

Women with no eggs or unhealthy eggs might also want to consider surrogacy. A surrogate is a woman who agrees to become pregnant using the man’s sperm and her own egg. The child will be genetically related to the surrogate and the male partner. After birth, the surrogate will give up the baby for adoption by the parents.

Gestational carrier

Women with ovaries but no uterus may be able to use a gestational carrier. This may also be an option for women who shouldn’t become pregnant because of a serious health problem. In this case, a woman uses her own egg. It is fertilized by the man’s sperm and the embryo is placed inside the carrier’s uterus. The carrier will not be related to the baby and gives him or her to the parents at birth.