Infertility

Infertility is inability to conceive after having regular unprotected sex.

Infertility is becoming a common problem in today’s society.

With increasing age at marriage, delaying childbirth as well as change in lifestyle it is estimated that approximately 10-15% of couples will need help to conceive. The reasons could be abnormality in either women or men. However unexplained infertility is also an important factor.

It is estimated that about 20% of cases of infertility are due to a problem in the men, about 40% to 50% are due to a problem in the women and about 30% to 40% are either unexplained or due to problems in both the partners.

Women could have problems with ovulation, tubal damage, cervical abnormalities, fibroids or endometriosis. Endometriosis is one of the major cause of infertility in women and often remains undiagnosed. Men with sperm abnormalities or ejaculation problems have infertility.

According to statistics, the chance of conception is about 20% within one month, 70% within 6 months, 85% within 12 months, 90% within 18 months and about 95% within 24 months of unprotected sex.

When should one start seeing a doctor?

A couple should start investigation for infertility when they have had unprotected sex for a year. However if the age of the partners is more than 35 then the evaluation could be started sooner.

Risk factors for infertility

Mental stress

Ovulation and sperm production can be affected

Smoking

Increases the risk of infertility in both men and women

Age

As women age their fertility starts to drop after 32 years, so the biological clock is important.

Eating disorders

Both extreme under weight and overweight can affect your fertility potential.

Sexually transmitted infections

Obesity

along with a sedentary lifestyle

COMMON Treatable CAUSES OF INFERTILITY

  • Polycystic Ovarian Syndrome (PCOS)
  • Ovulatory Dysfunction
  • Endometriosis
  • Uterine Fibroids
  • Ovarian cysts
  • Uterine septum or intra uterine adhesions
  • Damaged tubes
  • Unexplained infertility which could be due to Undiagnosed endometriosis, pelvic infections or ovulatory dysfunction
  • Uterine polyps

INITIAL EVALUATION

When to start?

Usually after one year of unprotected sex. But in the following groups one can start evaluation after 6 months-

  1. Women above 35 years
  2. Women with infrequent periods or No periods
  3. Endometriosis
  4. Women with a history of chemotherapy and/or radiation

BLOOD TESTS & HORMONE ANALYSIS

Done in the beginning of the cycle

  1. Tests to find out the ovairan reserve that reflects the ability to produce eggs
  2. Hormones tests
  3. HSG
  4. Diagnostic Hysteroscopy
  5. Diagnostic Laparoscopy

What can these tests tell us?

It can diagnose abnormal uterine bleeding, uterine adhesions, fibroids, or polyps in women suffering from infertility. It can also tell us about cause for recurrent miscarriages.

When is Laparoscopy or Hysteroscopy indicated?

Both Laparoscopy and Hysteroscopy can diagnose and treat the conditions causing infertility. Indicated when the first line of medical intervention does not help or causes like endometriosis, fibroids, endometrial polyps or septum are suspected. It is a surgical procedure where the concept is to SEE & TREAT. It is a day care procedure.

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