Infertility is the inability to get pregnant (conceive) after one or more years of unprotected sex. For women above 35, infertility could mean not being able to conceive after six months of unprotected sex. Women generally face this issue due to problems with the ovaries, fallopian, or uterus.
Luckily, infertility is treatable in many cases. Modern studies of gynecology offer several infertility treatments to help couples conceive and enter the realm of parenthood.
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What Are The Causes Of Infertility?
Women can lack the ability to conceive due to many reasons, one of which is anovulation. Anovulation is when your ovaries do not release the egg during a menstrual cycle. While occasional anovulation is not a significant cause of concern, chronically having this problem generally leads to infertility.
Several reasons or issues can contribute to anovulation. Here is a brief overview of some of them.
- Polycystic ovary syndrome (PCOS): It is one of the most common reasons for infertility in women. This condition is characterized by the inability to ovulate or ovulate irregularly. This problem is also linked to heightened testosterone levels.
- Functional hypothalamic amenorrhea (FHA): This condition also causes a profound dysfunctionality of the female reproductive organs, leading to disrupted ovulation. This problem is generally caused by stress, excessive weight loss, or strenuous physical activity.
- Diminished ovarian reserve (DOR): Diminished Ovarian Reserve (DOR) refers to fewer eggs produced than expected at a particular time. This problem may be due to medical, surgical, congenital, or other reasons.
- Premature ovarian insufficiency (POI): This condition generally occurs when a woman’s ovaries fail before she turns 40. While certain medical conditions and treatments like chemotherapy and pelvic radiation therapy have been shown to cause POI, the exact reason for this issue remains unknown in most cases.
- Menopause: Menopause is when a woman’s menstrual cycle ends. This usually happens at the age of 50. A woman is generally said to be in menopause when she hasn’t had a period for around twelve months.
Problems with the Fallopian Tubes and Uterus
Infertility is also caused by issues other than the ones that lead to anovulation. For example:
- Structural problems in the reproductive system: Abnormal tissue growth in the uterus or fallopian tubes is one of the most common structural issues leading to infertility in women. These growths hamper the movement of eggs, preventing sperm from reaching those eggs for fertilization. And growths in the uterus affect implantation. These growths include endometriosis, polyps, uterine fibroids, and scarring in the uterus. An unusually shaped uterus can also cause infertility.
- Infections: Pelvic inflammatory disease in women can lead to blocked fallopian tubes, affecting fertility. Sexually transmitted infections can also affect a woman’s ability to conceive.
- Autoimmune disorders: Problems like Hashimoto’s, lupus, rheumatoid arthritis, or thyroiditis can cause infertility in women. According to medical specialists, these disorders may be associated with inflammation in the placenta and uterus.
Identifying the Cause of Infertility
Several tests may be performed to determine the cause of infertility. Factors that are generally analyzed in this regard include the following:
- Your doctor may ask you to check your basal body temperature for a few days to determine if you are ovulating. An increase in temperature is generally an indirect indication of ovulation. You may also use an ovulation predictor kit at home. Moreover, your doctor may check your hormonal levels during your menstrual cycle.
- Fallopian Tubes: The doctor may inject dye into your fallopian tubes and uterus and take an X-ray test to determine whether your fallopian tubes are open. Or, they may inject a salt-water solution and view your uterus and tubes through ultrasound.
- Cervix: The doctor may ask you to submit a sample of cervical fluid extracted after intercourse. They will examine this fluid to see whether your cervix allows easy passage of sperm.
- Uterus: Your doctor may examine the shape of your uterus through HSG or hysterosalpingogram. Alternatively, they may insert a device called a hysteroscope into your cervix through the vagina. And in some cases, they may take a biopsy sample of your uterine lining to check its readiness for embryo implantation.
Infertility in Men
Infertility is not just a female problem; some couples cannot conceive due to problems with their male partners. Men’s infertility typically stems from issues with sperm production, function, or delivery. These issues may include hormonal imbalance, dilated veins around the testicles, and congenital problems.
Problems that may contribute to male infertility include
- Chronic health conditions
- Several other factors
Infertility in men often goes asymptomatic. However, some signs may occur occasionally. For example:
- Reduced sexual function – such as difficulty ejaculating, erectile dysfunction, or reduced libido
- Swelling, pain, or growths in the testicular region
- Gynecomastia, or increased breast size
- Lower sperm count (generally diagnosed during a lab test)
Consult a physician if you notice any of these symptoms. You should see a doctor if you haven’t conceived after a year of unprotected sexual intercourse.
Infertility treatments are available in three types:
- Assisted conception, such as In Vitro Fertilization (IVF) and intrauterine insemination (IUI)
Your doctor may prescribe the following medicines to improve fertility:
- Clomifene – encourages ovulation in women with irregular ovulation or no ovulation at all
- Tamoxifen – promotes ovulation like clomifene
- Metformin – helps women with PCOS
Some medicines can cause hot flashes, headaches, nausea, or other side effects. Speak to your doctor to explore options to avoid these side effects.
Various surgical procedures are available to help couples conceive. Those procedures include the following:
- Fallopian tube surgery: This treatment is provided to women with blocked or scarred fallopian tubes. During surgery, the scar tissue is broken up to allow easy passage of the eggs.
- Laparoscopy: Laparoscopic surgical treatment is generally provided to women with endometriosis, fibroids, or PCOS. The surgeon uses heat or laser energy to destroy problematic tissue during this treatment.
- Surgery to correct epididymal blockage: This treatment is provided to men with blocked epididymis – the coil-like structure that stores and transports sperm. This blockage prevents the release of sperm, causing infertility.
The two most common assisted conception procedures are;
- In vitro fertilization (IVF): During this treatment, the egg is fertilized outside the body with sperm and is placed into the womb. The doctor may give you fertility medicine to encourage ovulation prior to extracting the eggs.
- Intrauterine insemination (IUI): This procedure is also called artificial insemination. It involves inserting a thin tube into the womb through the cervix to place sperm, inducing pregnancy.
Does IVF affect a baby’s gender?
IVF alone doesn’t help determine or select the baby’s gender. However, specific diagnostic measures, such as PGD/PGS/PGT-A, can be included in the IVF procedure to identify XX or XY chromosomes in an embryo. This allows the doctor to choose particular embryos, depending on the couple’s choice of the baby’s gender.
Schedule a Consultation
EuroMed Clinic is a state-of-the-art medical facility in Dubai offering treatments for several medical problems, including infertility. For more information, call us at +971 4 394 5422. You can also book a consultation online through the form below.