"We had tried everything we could and had almost given up all hope."
Infertility means not being able to get pregnant after one year of trying (or six months if a woman is 35 years or more). Infertility is a common problem and on a rise especially in today's world where couples plan babies later because of late marriages and also because career oriented women tend to delay child bearing. Despite the spread of progressive ideas in society, the 'barren status' is still a social stigma and even the 'developed' west is no exception to this. It affects about 10% of men and women of reproductive age. Most cases of infertility (85-90%) can be treated with medication or surgery. Improvements in fertility treatment with the advent of new and advanced technologies like IVF (In Vitro Fertilization), ICSI, along with the aid of fertility enhancing endoscopic surgery has made it possible for many women to conceive.
CAUSES IN WOMEN
Causes can be in the woman, in the man or both. Unknown factors cause infertility 10% of the time. Causes in women, to enumerate a few, are -
• Pelvic inflammatory disease (this can cause infertility by severe scarring and by blocking the fallopian
tubes)
• Endometriosis
• Ovarian cysts and polycystic ovaries
• Growths such as Fibroids and polyps in the uterus
• Lifestyle factors like smoking, alcohol, drug abuse, excessive exercise, obesity etc.
• Age of a woman. A woman's peak fertility is during her 20's and after 35 yrs the likelihood of becoming
pregnant is less than 10% per month.
• Auto immune diseases
• Endocrine diseases like thyroid problems/ hormonal imbalances
• Birth defects that affect the reproductive system
CAUSES IN MEN
Causes in men may be many and multifactorial. Some of them are-
• Hormonal problems
• Impotence
• Infections
• Birth defects
• Lifestyle factors like smoking, alcohol, drug abuse
• Other medications
• Working in high heat for long periods
• Retrograde ejaculation
DIAGNOSIS
Infertility testing involves complete medical history and physical examination of both partners. Blood and imaging tests will be done. In women this may include blood tests to check hormonal levels, pelvic ultrasound, HSG (Hystero Salpingography), diagnostic hysteroscopy and diagnostic laparoscopy.
Tests in men may include semen analysis, checking hormonal levels, Ultrasound of the scrotum, testicular biopsy (rarely).
TREATMENT
Treatment depends upon the cause of infertility. It may involve-
• Education and counseling
• Medicines that help a woman grow and release eggs from the ovaries
• Other medical management to treat infections and other diseases
• Fertility enhancing hysteroscopic or laparoscopic surgery.
• In conjunction with the above, fertility treatments like IUI and IVF may be needed
