Infertility, by one current medical definition, is when a couple fails to conceive by natural means or carry a child to term after a year of unprotected sex.
Possible infertility causes are numerous with infertility occurring in men as well as in women, with sometimes different contributing factors. The following can play a part in decreasing a person’s fertility:
- Sexually transmitted infections
- Abnormalities, damage or diseases of the reproductive organs
- Hormonal imbalances
- Certain genetic disorders
- Age (in women particularly)
- Lifestyle factors like being overweight and smoking.
However, in roughly a third of cases, no obvious cause for infertility can be identified in either partner.
What are its symptoms?
The primary sign of infertility is not having fallen pregnant despite 12 months of regular, unprotected intercourse. Other infertility symptoms may not be as obvious or may not be present at all, but signs to look out for in women include:
- Irregular menstruation
- Ovulation issues, such as polycystic ovary syndrome (PCOS)
- Pre-existing pelvic inflammatory disease or endometriosis
- Previous miscarriage
- Age over 40
- Previous cancer treatment.
Signs to look out for in male partners include:
- Sexual dysfunction, which may be the result of hormonal imbalances
- Swelling in the scrotum
- Previous cancer treatment
- Previous vasectomy or scrotal surgery
- Diagnosed low sperm count or sperm production issues.
How is it diagnosed?
In cases where a couple has been trying to and has been unable to conceive for a year, a healthcare provider may advise additional tests to reach an infertility diagnosis.
For men, these tests may include semen analysis to evaluate the health of the sperm, hormonal tests or imaging tests of the reproductive system.
In women, ovarian reserve testing in which the quality and quantity of available eggs is measured is one possible test of fertility. Tests to examine the uterus (hysteroscopy), or uterus and fallopian tubes (hysterosalpingogram) may also be performed, along with hormone tests, genetic tests and other imaging tests.
What are your treatment options?
Infertility treatment methods ultimately depend on the cause of the problem. More moderate possible treatment options may include medication to correct hormonal imbalances, drugs to prompt ovulation or a procedure called intrauterine insemination (IUI), in which healthy sperm are placed directly in the uterus during ovulation.
Some structural abnormalities of the reproductive system can also be corrected with simple surgical procedures. When conservative medical interventions fail, a fertility specialist may suggest assisted reproductive technology (ART) and treatment types like in vitro fertilisation (IVF), in which both the egg and sperm are combined in a lab before being transplanted into the woman’s uterus.
Can it be prevented?
Infertility is a complex problem, meaning prevention is not always possible.
However, lifestyle factors can contribute towards infertility, so by keeping the following factors in check you are able to increase your chances of conception:
- Maintain a healthy weight: Being over- or underweight can interfere with hormone levels in both men and women, contributing to infertility.
- Stop smoking: Multiple studies have shown that tobacco use negatively affects fertility in both sexes,
- Practise safe sex until you are ready to fall pregnant: Many sexually transmitted infections, including chlamydia and gonorrhoea, can lead to infertility.
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