Infertility Guide 2021: Causes, diagnosis, risks and treatments

infertility

It is the dreaded situation couples face, wanting to have a baby.

Infertility is when a couple is unable to conceive a baby, despite regular unprotected sex.

This may be due to reasons pertaining to the man or woman, or being subjected to other complications.

Factors can also include but isn’t limited to issues like egg or sperm production, having genetic concerns, age factors, irregular menstrual cycle and many more.

This blog post aims to focus on what makes a couple infertile and what are good fertility treatments.

We will dig into all the reasons and how you can diagnose them and work out a treatment plan that will benefit your case in accelerating things for the betterment and reduce the risk of infertility.

depression caused by infertility

Let’s begin:

What is Infertility?

In simple words- it’s the inability of a couple to conceive a child.

You are declared infertile when you can’t conceive despite having an active sexual life without using birth control.

In cases where women are over 35, there may be more complications pertaining to this. And doctors evaluate your case in six months instead of 12 months.

Having to face regular miscarriages also means you are infertile. Unexplained issues either due to the male or female are analyzed by your doctor when the desired results don’t show. We will also discuss the various assisted reproductive technologies.

Now we will look into when you should see a doctor:

 

Infertility Symptoms

The major symptom is that you don’t get pregnant despite having a healthy sex life. Men get tired often and sense a change in sexual function.

While many couples may eventually be able to conceive, for others, after regular efforts and no results, they should see their gynaecologist.

However even pre-conceiving days, women can opt to have a proper check-up with their doctor if they plan to have a baby if:

When to visit the doctor- for women

They are above the age of 35 years and have been trying to conceiver for more than six months

Women who wish to conceive over the age of 40 years

Having irregular and absent periods

Having painful periods isn’t a healthy sign

Previously diagnosed with infertility concerns

A diagnosis of endometriosis or pelvic inflammatory disease

Suffered multiple miscarriages in the past

Undergone cancer treatment

When to visit the doctor- for men

When it comes to men, they should get an appointment fixed with a specialist when:

Have a low sperm count

Known to have other issues with the sperm

Hold a history of testicular, prostate or sexual problems

Undergone cancer treatment

Have smaller than normal testicles

Face constant or regular swelling in the scrotum

Have a history of infertility in the family

 

Now before moving forward, we will first burst the bubble of a common myth:

 

Is infertility just a woman’s problem?

it is due to many issues and concerns due to women problems

In one word: No.

It isn’t indeed just pertaining to a woman’s capability to conceive. Her partner has equal chances of being a contributor to the infertility.

According to research in about 35% of couples with infertility, a male factor is identified along with a female factor. Whereas in about 8% of couples with infertility, a male factor is the only identifiable cause.

 

Let’s look into the causes of:

 

Male Infertility- the reasons and risk factors

It can be either to one or more of the following issues:

Ineffective production of sperm

Less sperm count, or the number of sperm

Shape of the sperm isn’t idol

Unhealthy movement of the sperm, which includes the wiggling motion and the transport of the sperm through the tubes of the male reproductive system

Risk factors can be:

Older age

Intensive smoking of cigarettes

Heavy use of alcohol

Overweight or obesity

Exposure to toxins

Having medical complications:

Male infertility can be hit upon due to having certain medical conditions like:

Retrograde ejaculation

Varicocele, which is the swelling of the veins around the testicles

Testicles not descended into the scrotum yet

Taking antibodies which affect your sperm count

A hormonal imbalance

Taking intensive medications and drugs, like:

Chemotherapy

Radiation therapy

sulfasalazine (Azulfidine, Azulfidine EN-Tabs)

Calcium channel blockers

Tricyclic antidepressants

Anabolic steroids

Recreational drugs such as marijuana

So now that you have had a good handle on looking at the causes of male infertility, let’s move onto the concerns with women:

 

Female Infertility- the reasons and risk factors

There can be a range of reasons like:

Age: once you cross the age of 32 years, you begin to fall into a lower probability of conceiving. According to statistics, infertility rates have increased by 4% since the 1980s, mostly from problems with fecundity due to an increase in age

Smoking: heavy smoking causes intense infertility. It has also been determined that many women who are heavy smokers have a higher chance of pregnancy loss.

Passive smoking also causes lower fertility.

Alcohol consumption causes lower infertility

Obesity or overweight is also a risk factor

Eating disorders plays a strong role

Having a lack of folic acid, iron, zinc, and vitamin B-12 affects fertility

A wholesome diet plays a key role in your fertility levels. Women, who follow a vegan diet, should ask the doctor about supplements.

Maintaining a good exercise regime is important

Sexually transmitted infections can damage the fallopian tubes and cause infertility

Chemical exposure like pesticides and toxins can be a contributing factor

Mental stress reduces sexual activity and increases

 

Contributing ovulation disorders:

Contributing medical conditions for women mainly circle around ovulation disorders. Ovulation is when a fertile egg is released. Complications that can arise in this process are:

Premature ovarian failure

Polycystic ovary syndrome (PCOS)- when ovaries are not functioning properly and ovulation doesn’t happen

Hyperprolactinemia- this is when prolactin levels are high and ovulation and fertility is affected

Poor egg quality- the eggs have developed genetic abnormalities

Thyroid problems- it is when an overactive or underactive thyroid gland causes hormonal imbalance

Chronic conditions can play a role

Complications in the uterus or fallopian tubes

Other Causes include:

Surgery- certain surgeries like pelvic surgery can cause scarring and damage to the fallopian tubes. Also cervical surgery can cause issues to the cervix which is a major part of the uterus.

Submucosal fibroids: these are non-cancerous tumours in uterus wall.  Complications lead to the blockage of the fallopian tube. This restricts the sperm from fertilizing the egg.

Endometriosis- this is the growth of these cells not in the uterus lining but somewhere else in the body.

If a woman has had a sterilization treatment where their fallopian tubes were blocked, having the process reversed will still not lead to high fertility chances.

Medications and drugs

Consuming certain drugs and medications can also affect the fertility in women. These include:

Non-steroidal anti-inflammatory drugs (NSAIDs)

Chemotherapy: it can result in ovarian failure which in certain cases is permanent

Radiation therapy- this when done near the reproductive organs increases fertility problems

Illegal drugs cause infertility

Cholesterol-having high levels of cholesterol impacts fertility in women

 

Diagnosis of Infertility

learn ways in which infertility is diagnosed

Let’s now touch upon how the diagnosis will be done.

Pre-infertility testing, your specialist will first create a proper intel on your sexual activity and will recommend non-medical ways on how to try to once more before moving to medical evaluation.

Since this is an expensive procedure and consists of painful treatments, it is always the last resort by many couples, however many do get positive results.

Here are the set of tests you and your partner will get to:

Tests for men

For men, the main concern is that the testicles should be able to produce healthy sperm. And this should then move into the vagina swiftly and reach the egg effectively.

The tests are done to determine if any of these processes are working properly. It also includes a look into your genitals. Some of the common tests you will get done are:

Semen analysis- your semen is collected and a lab analysis is done on the specimen

Hormone testing- this is when a blood test is done to check on your testosterone and other male hormones.

Genetic testing- In order to check on a genetic defect, this test is usually run

Testicular biopsy-this test looks into abnormalities which contribute to infertility

Imaging- abrain MRI, transrectal or scrotal ultrasound which is time-consuming and expensive, is conducted

Tests for women

For women the major concern with not being able to conceive depends on your eggs.

The procedure needs to be highly effective where a fertile woman releases a perfectly healthy egg.

This egg should pass into the fallopian tube where it needs to merge with the sperm for a compatible fertilization.

The fertilized egg then should properly travel into the uterus where it implants effectively on the lining.

These tests aim to find if there are any problems any of these mentioned processes.

Your gynaecologist will do certain fertility tests to confirm all systems. These tests and which ones you need are determined by your doctor after an initial and physical examination.

You may have a general physical exam, including a regular gynaecological exam. Specific fertility tests may include:

Ovulation testing- this is measurement of your hormone levels to see if you’re ovulating

Hysterosalpingography- this looks into the condition of your uterus and fallopian tubes to determine if there are any blockages that need attending

X-ray contrast – it is an x-ray checks if your cavity is normal or no

Ovarian reserve testing– this determines the number of eggs available for ovulation

Imaging tests- this is when a pelvic ultrasound takes place to look for any ovarian disease.

Sonohysterogram- this is a saline infusion sonogram which provides details inside of the uterus

Hysteroscopy– this test tries to determine if you have any uterine disease. A thin, lighted device is inserted through your cervix into your uterus to check for any complications.

Laparoscopy– this is a popular method in which a small incision beneath your navel is made and a device is inserted to examine your fallopian tubes, ovaries and uterus.

 

So now, after the symptoms have been identified, a diagnosis is carried and tests have been recommended, which have determine your infertility.

 

What happens next?

 

If you are willing and committed to conceiving, you will now invest time and efforts into infertility treatments.  This treatment plan will be created by your doctor after a thorough study and complete check on your medical history as well as a few associating factors like:

How long has it been since you have been trying to get pregnant?

What are the ages of you and your partner?

The overall health of both you and your partner

What are your preferences?

 

Infertility Treatment for Men

From the diagnosis and test results, male infertility is looked into and there are a number of treatment options to consider:

Surgery

This is opted for circumstances where sperm isn’t available during ejaculation. It is conducted to solve a varicocele condition as well.

Medications

For most of the causes and reasons for infertility, which aren’t overly complicated like hormonal imbalances, your doctor may treat the condition with certain medications.

These medications are used to treat other conditions as well that affect male fertility, like ED or conditions which affect the sperm count and mobility.

ART

This is the treatment in which eggs and sperm are handled outside of the body. These are expensive treatments and consist of procedures like vitro fertilization (IVF) and intracytoplasmic sperm injection.

 

Infertility Treatment for Women

When it comes to dealing with female infertility, it also involves many different treatment plans including surgery, medication and other procedures. Medications in women aim to work on the hormones so to get them active and excited in the regulation of ovulation.

In certain cases, you will be needed to have a mix of various treatments to get accurate results.

Surgery

This is one of the leading treatments as it improves fertility by providing the following benefits and improving fertility by:

Figuring out the issues with an abnormal shaped uterus

It successfully unblocks fallopian tubes

Removes fibroids

ART

This is considered as reproductive assistance as it consists of methods like intrauterine insemination (IUI). The IUI focuses on injecting more than a million sperms into a women’s uterus when she is ovulating.

Another popular treatment is IVF and this consists of the removal of eggs. These are then separately fertilized with sperm. After which a successful fertilized embryo is put back into the uterus.

 

Natural Remedies for Infertility

adapting healthy eating habits is a good boost

Aside from seeking medical guidance and help, there are certain natural remedies you can opt for as well. In 2018, it was reported that almost 29 per cent of the couples facing infertility issues will try to adapt natural treatment.

Let’s look into some of the most common ones:

Acupuncture– this is one of the oldest ways of treatment. The specialist inserts small needles into various points of the body to stimulate healing. While doctors haven’t confirmed that this treatment works, it has been considered as benefitting by many.

Yoga– this is the practice of beneficial postures and adapting special breathing techniques which help the body to gain positive energy flow and make the organs stimulated to perform better. While there is limited evidence of its effectiveness on treating infertility, it is highly practiced.

Vitamins– there are a range of vitamins and minerals you should take in on a regular basis which promote conception. Proper doses of folate, zinc, vitamin C, vitamin E, and iron will be helpful in keeping your system hormonally balanced.

Tea and Oil- Did you know that there is a range of fertility teas extremely benefitting? Again, while this hasn’t been proved as yet, the antioxidant compounds of this tea help sperm count and women’s sexual activity.

There are also various kinds of oil which promote relaxation and reduce stress levels. However there hasn’t been a lot of research done on knowing the actual effects of this oil on infertility.

Fertility diet

Consume more food items which are fertility boosters. A woman should indulge in food items which help in their ovulation.  These recommendations also help with the improvement of men’s sperm.

Dietary recommendations by leading gynaecologists and nutritionists are:

Fiber-rich foods like vegetables

Avoid trans fats which are in processed foods

Indulge more in vegetarian diet than animal protein

High-fat dairy is better than low-fat products

 

Fertility cycle and Ovulation Dates

Ovulation is just one day of the whole month- that is how crucial it is. It is that day when your ovaries release a mature egg, which travels through the fallopian tubes.

If it encounters sperm during this time, fertilization happens. If the egg doesn’t fertilize, it will die within a day of the ovulation.

Having a one on one consultation with your doctor will also provide you with an exact timeframe on your ovulation cycle. It helps for you to track your sexual activity, which increases your chances to conceive.

Because ovulation doesn’t happen at the same time every month, your doctor will guide you in determining when it happens.

 

Prevention Techniques

We will now look into certain techniques that can increase the chances for you to get pregnant. While infertility is unavoidable in particular situations, in others you can adapt tactics that will help you to remain fertile:

Some types of infertility aren’t preventable. But several strategies may increase your chances of pregnancy. Let’s look into what these are:

Health Tips for Men

Male infertility increases with high usage of drug and tobacco; avoid them as much as possible.

High temperatures affect sperm motility negatively, avoid taking hot baths

Exposure to toxins is harmful; avoid such places as it affects sperm production

Discuss with doctor to reduce medications which affect sperm count; this includes prescription and non-prescription drugs

You should also indulge in more physical activities like jogging, cycling etc.

Health Tips for Women

Tobacco is extremely harmful. It also causes complications to the fetus and pregnancy. Women should quit smoking altogether.

Alcohol causes issues which affect your ability to conceive. Alcohol drinks and drugs of any kind should not be used.

Caffeine also affects your chances of getting pregnant and should only be consumed if the doctor gives their consent

Again exercise is the key. It affects your fertility in a positive way when done moderately.

Also having extreme weight fluctuations affects hormonal production. This causes infertility.

 

Strive for Your Happy Family

Infertility causes depression, extreme sadness and even conflicts between couples. But it is something you can fight against.

The world has advanced in various ways including its techniques and tools on how to combat infertility.

This guide aimed to give you the latest updates on symptoms, causes and diagnosis of infertility.

It is also a comprehensive look into the tests that determine the cause.

As well as what treatments can give you a good success rate.

We also looked into various home remedies that are known to have helped in various cases, as well as prevention techniques you can adapt if you plan to get pregnant.

A child is the most amazing gift you can get. If it isn’t happening, strive to know the reason. Even if you had a rainbow baby, you can continue to strive for your ultimate happy goal.

There might be a way for you to get past the complications and over onto success.

 

The Dr.Amal Promise…

One of the most highly qualified and professional medical services is at your disposal.

Having an accomplished and competent team of medical professionals including that of our gynaecology department, Dr. Amal Al Qedrah is available to answer any queries and questions you may have regarding infertility providing consultation and guidance on how you too can fulfil your wish to have a family.

It is within the reach, you just need to make the first step. Call today and our assistant will set you an appointment to know more.

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