Infertility is when a man or women cannot conceive due to some issues with the reproductive system of either partner.  It is defined as the inability to get pregnant after 12 months of trying. Infertility can be primary or secondary. Primary infertility is when someone is not able to conceive at all. Secondary infertility is when someone has previously conceived but is no longer able to .

CAUSES

The common causes of infertility in males are-

• Problems with sperm and semen- semen is a milky fluid that the penis releases during ejaculation which consists of fluid and sperm. The sperm is produced in testicles. When the ejaculate comes out of the penis, semen helps to transport the sperm toward the egg for fertilization. Certain issues with sperm to fertilize the egg include having a sperm count below 15 million, low sperm motility, or sperm that have an unusual shape and harder time fertilizing the egg.

The issues with sperm can result from-

• Overheated testicles- causes include an undescended testicle, a varicocele, use of saunas or hot tubs, wearing tight clothes, and working in hot environments.
• Ejaculatory disorders- if the ejaculatory ducts are blocked, semen may be ejaculated into the bladder.
• Medical condition- testicular infection, cancer, or surgery.
• Hormonal imbalance- hypogonadism , can lead to testosterone deficiency.
• Other causes may include-
• Genetic factors- if a person has 2 X chromosomes and 1 Y chromosome as in Klinefelter syndrome, the testicles develop abnormally, there will be low testosterone and a low /no sperm count.
• Mumps- this causes inflammation of the testicles that affects the sperm production.
• Hypospadias- this is a congenital anomaly, the urethral opening is under the penis instead of its tip, if correction not done, it may be harder for sperm to reach the female’s cervix.
• Other diseases- lower fertility in males are anemia, Cushing’s syndrome, diabetes, and thyroid disease.

The infertility causes in females are- ovulatory disorders make up 25% of infertility cases in females. The ovulatory disorders can occur due to

• Polycystic ovary syndrome (PCOS)- this hormonal condition can cause frequent or prolonged menstruation and can affect the ovulation
• Thyroid issues- an underactive or overactive thyroid gland can lead to hormonal imbalance affecting ovulation
• Problems with the fallopian tubes and uterus
• Other causes-
• Chronic conditions- like cancer or AIDS
• Primary ovarian insufficiency (POI)
• Poor egg quality- as the age of female advances the number and quality of eggs declines. The older a female is the higher is the risk.
• Surgery- pelvic surgery can at times lead to damage to the fallopian tubes. Cervical surgery can lead to scarring or shortening of cervix.
• Submucosal fibroids- benign tumors in the walls of uterus may prevent the sperm fertilizing the egg.
• Endometriosis
• Tubal ligation- the process can be reversed but the chances of becoming fertile again are not high.

DIAGNOSIS

Infertility tests for males include-

• Semen analysis
• Blood tests
• Ultrasound
• Chlamydia test

Infertility tests for females include-

• Blood tests
• Hysterosalpingography
• Laparoscopy
• Ovarian reserves testing
• Pelvic ultrasound
• Thyroid function test

INFERTILITY TREATMENT

• Frequency of intercourse- the first strategy is to have sexual intercourse more often for the couple trying to conceive
• Medications for erectile dysfunction as well as for ovulation
• Surgical procedures
• Intrauterine insemination (IUI)
• In vitro fertilization (IVF)
• Sperm or egg donation
• Surgical sperm aspiration
• Electric or vibratory stimulation to achieve ejaculation

WHEN TO SEE A DOCTOR

An infertility specialist can help determine whether there is an identifiable cause of infertility and provide appropriate treatment. Dr. Nikita Bharpoda is one of the best Obstetrician and Gynaecologist in Vadodara.