Infertility is the inability to get pregnant after a year of unprotected intercourse. About 10% of couples are affected by infertility. Both men and women can be infertile. According to research, 1/3 of the time the diagnosis is due to female infertility, 1/3 of the time it is linked to male infertility and the remaining cases of infertility are due to a combination of factors from both partners. However, for approximately 20% of couples, the cause cannot be determined.
Factors Affecting Female Fertility.
1. Age: Women are born with a finite number of eggs. Thus, as the reproductive years progress, the number and quality of the eggs diminish. The chances of having a baby decrease by 3% to 5% per year after the age of 30. This reduction in fertility is noted to a much greater extent after age 40.
2. Damage to fallopian tubes: Damage to the fallopian tubes (which carry the eggs from the ovaries to the uterus) can prevent contact between the egg and sperm. Pelvic infections, endometriosis, and pelvic surgeries may lead to scar formation and fallopian tube damage.
3. Hormonal causes: Some women have problems with ovulation. In these women, synchronized hormonal changes leading to the release of an egg from the ovary (ovulation) and the thickening of the endometrium (lining of the uterus) prior to menstruation in preparation for the fertilized egg, do not occur. These problems may be detected using basal body temperature charts, ovulation predictor kits, and blood tests to detect hormone levels.
4. Cervical causes: The Cervix is the neck/opening of the womb. A small group of women may have a cervical condition in which the sperm cannot pass through the cervical canal. This could be due to abnormal mucus production or a prior cervical surgical procedure; this problem may be treated with intrauterine inseminations (placing sperm directly into the uterus in order to reduce the distance to swim to the egg).
5. Uterine causes: Abnormal anatomy of the uterus (womb); the presence of polyps and fibroids which affect implantation of fertilized eggs and even reduce the chances o successful fertilization.
6. Unexplained infertility. The cause of infertility in approximately 20% of couples cannot be determined using currently available methods of investigation.
Fertility Testing: This is also referred to as a fertility evaluation. A standard fertility evaluation includes physical exams and medical and sexual histories of both partners. For women, doctors first check to see whether ovulation is occurring. Ovulation is a key step in fertility. In its absence, the woman’s egg is unavailable for fertilization by viable sperm. Ovulation can be determined and monitored through blood tests that detect hormones, ultrasound examinations of the ovaries, or an ovulation home test kit. An irregular menstrual pattern might indicate an ovulation problem, but it’s also possible for a woman with regular periods to have an ovulation disorder.
How To Determine The Cause Of Infertility: If male infertility is suspected, a semen analysis is performed. This test will evaluate the number and health of his sperm. A blood test can also be performed to check his level of testosterone and other male hormones. If female infertility is suspected, your doctor may order several tests, including:
1. A blood test to check hormone levels.
2. An endometrial biopsy (removal of cells from lining of the uterus for examination) to check the health of the lining of the uterus.
3. Two other diagnostic tests that may be helpful in detecting scar tissue and fallopian tube obstruction are Hysterosalpingography (HSG) and Laparoscopy.
Whatever the case, always remember that a diagnosis of infertility does not immediately mean you can never get pregnant. Some cases of infertility are in fact treatable and at least half of couples who seek treatment for infertility will get pregnant.
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