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Overview

“Pregnancy is God’s gift to a woman as she has an absolute power to create life”. It’s a unique and wonderful experience for both the parents. Any problem in getting pregnant can really make the couple to face serious conditions like low self esteem, marital problems and depression. Infertility has serious implications on the mental and social health of a couple.Infertility is a condition in which a woman is unable to produce off spring. In this, a lady fails to conceive after trying for more than a year. For getting pregnant, a woman’s body must release an egg from the ovaries and it travels through fallopian tube towards the womb. Man’s sperm gets fused with the egg and fertilized egg must attach to the inside of the uterus. This is the whole process of conception. When a woman conceives, she carries the pregnancy to full term. Any obstruction in any of these steps can cause infertility. Infertility can’t be restricted to females only even men can be impotent or infertile.

What are the types of infertility?

Infertility can be of many types, some of them are:

• Primary infertility – It occurs when a woman fails to become pregnant after trying for more than 12 weeks
• Secondary infertility – It arises in the couple who encounters no problem in conceiving first child but fails to conceive for the second time
• Sub fertility- There are couples who are unable to conceive a child together, but can produce off spring with other people

What are the causes of infertility?

Infertility in men can occur due to genetic defects such as DNA damage and other infections like mumps and varicocele. Premature and retrograde ejaculation and some medications like steroids or narcotic analgesics can cause problem in release of sperm.

Infertility in women can occur due to hormonal disorders like polycystic ovary syndrome and other uterine or cervical disorders. Any blockage in fallopian tubes doesn’t allow the joining of sperm and ovum thus obstructs the fertilization process.

What are the risk factors for infertility?

There are certain risk factors that contribute to this condition are as follows:

• With increase in age, there is decrease in the women’s fertility. Women after the age of 35 and men after age of 50 are less fertile
• Smoking is one of the main reason that can lead to infertility
• Obesity or overweight are one of the main reasons that causes hormonal changes in the body that avoids pregnancy
• Consumption of alcohol can decrease the sperm count and can cause miscarriages
• Stress can really affect the ovulation and production of sperm. Increased levels of stress directly affects the reproductive state
• Disease conditions like hypothyroidism and polycystic ovary syndrome increases the chances of infertility
• Exposure to certain chemicals like pesticides, herbicides can cause infertility problems

When should a couple seek help?

After trying for more than one year, when a couple fails to achieve conception then there is a need to consult a gynecologist or fertility specialist. There are certain conditions in which there is need to seek help such as:

• Women encountering irregular or missed cycles
• Women who are above the age of 35 years
• Women who have tubal disorders or other pelvic infections
• Men who have abnormal semen analysis
• Men who have erectile or ejaculatory dysfunctions

What are the diagnostic measures?

Diagnosing the underlying problem is the most important factor in determining the root cause of infertility. Fertility of woman is tested by the gynecologist and various tests are done such as

• Test of ovulation – hormonal level of body are dually checked to evaluate that whether you are ovulating or not.
• Examination of fallopian tubes and uterus – X ray image of uterus and fallopian tube is taken in order to see any obstruction or other associated problem 
• Ovarian reserve test- in this, the capacity of fertilization is evaluated by observing the potency of eggs. 
• Other hormone levels- Thyroid and Pituitary hormone levels are analyzed as they have major role in regulating reproductive hormones

In case of Men, the following tests are done such as:

• Analysis of semen – in this semen sample is given in the lab and pathologist analyses the potency of semen fluid
• Hormonal test- Reproductive hormone levels are tested in order to assess the fertility
• Hypo-osmotic swelling test – It is done to see the outer layer of the sperm that whether it is broken or intact

What are the treatment options available?

Treatment of infertility is a complex blend of drugs and surgeries. There are various treatment options available like medication, reproductive therapy, artificial insemination or assisted reproductive technology.

Medication therapy is used to correct the irregular cycle of menstrual periods. The first line of treatment is an oral medication if the basic cause is not related to ovulation problems. These drugs produce regular menstrual cycle. Other medical remedy is Gonadotropin therapy that helps in inducing ovulation. This is injected every day for almost one week and along with this close monitoring is done by taking blood tests and ultrasounds

Some oral medications are as follows:

• Clomiphene citrate is an oral medicine used in ovulation problem associated with the pituitary gland i.e. a master gland of the body. It is given in the women who have polycystic ovary syndrome
• Follicle stimulating hormone analogs are injected in order to stimulate the process of ovulation
• Metformin is the anti diabetic drug that lowers the level of male hormones in the women’s body having polycystic syndrome. This drug helps in ovulation
• Bromocriptine is a drug given to treat ovulation problems related with high levels of prolactin in the body

If oral medications fail to cause conception, then couples have other techniques such as:

• Artificial insemination
• Reproductive surgeries
• Assisted reproductive technologies

For the treatment of male infertility, drugs are given in case of erectile dysfunction or retrograde ejaculation. Surgical procedures are also adopted such as:

• Microsurgical vasectomy reversal 
• Microsurgical correction of obstruction in the epididymis
• Microsurgical varicocele ligation

 Also read: HCG Vaccines: Best way to Deal with Infertility in Women