Infertility is an issue, which people of different parts of the world are continuously being made aware of; it is a global issue. Infertility has also been the reason for the extinction of many animal species in our world. The bad news is that it has started growing in humans too. Now, as we humans have the privilege of education, science, and technology with us, so medical science has come up with many techniques and treatments.
Infertility, first of all, is the inability of the couple to get pregnant even after trying for a year (if aged below 35) or six months (if aged above 35). Medical science has done a lot of research and understood the different causes, abnormalities, conditions, symptoms, and treatments for this.
In Vitro Fertilisation (IVF) is the most common and popular technique of conceiving if the couple is facing infertility. In this, the eggs and sperms of the couple or donor(s) are retrieved, tested, and then fertilized outside the body. Then, the fertilized egg is planted back into the woman’s uterus (coupled) or a surrogate mother (in the case of surrogacy). The IVF treatment is so popular that it’s a popular misconception that infertility has only one treatment, and that’s IVF. That’s not the case, and there are several treatments available for treating infertility, simple prescribed medicines and lifestyle changes still solve most of the cases.
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How Does a Person Get Infertile?
There are many causes behind infertility. Infertility is spread most equally among genders, so below, we have maintained four categories of infertility:
- Solely female infertility causes
- Solely male infertility causes
- Common causes
- Unexplained infertility
Solely Female Infertility Causes
These are the cause for infertility in women, problems, or issues in their reproductive tract or any deformity or disability. Infertility in women reasons are:
- Ovulation disorders – When a woman’s ovaries aren’t able to release eggs, it is called ovulation disorder. It mainly happens because of hormonal disorders such as polycystic ovary syndrome (PCOS/PCOD), hyperprolactinemia, hyperthyroidism, hypothyroidism, or any other such disease. There are some other non-hormonal causes like exercise, eating disorders, or tumors.
- Uterine or cervical abnormalities – These abnormalities can be in the cervix, polyps in the uterus, or the shape of the uterus. Noncancerous tumors in the uterine wall can also cause infertility, as they block fallopian tubes.
- Fallopian tube damage or blockage – The root cause of this inflammation in fallopian tubes. It can be caused by pelvic inflammatory disease, which is usually caused by a sexually transmitted infection, endometriosis, or adhesions.
- Endometriosis – It occurs when endometrial tissue grows outside of the uterus. It may affect the function of the ovaries, uterus, and fallopian tubes.
- Primary ovarian insufficiency (early menopause) – When the ovaries stop working, and menstruation ends before age 40, it is called premature menopause.
- Pelvic adhesions – These are the bands of scar tissue(s). They bind the organs. They can be formed after pelvic infection, appendicitis, endometriosis, or abdominal or pelvic surgery.
Solely Male Infertility Causes
Infertility in men is as common an issue as infertility in women. The below infertility causes can only be found in the male.
- Irregular sperm production or function – This is a common issue and happens due to genetic defects, health problems such as diabetes, undescended testicles, or infections such as chlamydia, gonorrhea, mumps, or HIV. The enlarged veins in the testes (varicocele) can also affect the quality of sperm.
- Problems in delivery of sperm – This is either premature ejaculation, certain genetic diseases (cystic fibrosis), structural issues (blockage in the testicle), or damage or injury to the reproductive organs.
- Overexposure to certain environmental factors – This includes pesticides and other chemicals, radiation, cigarette smoking, alcohol, marijuana, anabolic steroids. Other medications that are consumed to treat bacterial infections, high blood pressure, and depression can also affect fertility.
Issues that are common in both the genders
- Cancer treatment – Cancer treatment means exposure to heat and radiation. Strong medicines are also used, which might raise the temperature of the body. Both males and females can get infertile because of this.
- Obesity – It is caused by high body weight and laziness. High body weight also means the risen temperature in a body if an individual. Inactivity or sitting at one place might result in blood not reaching the necessary organs (rarely happens though).
- Lifestyles – High stress, less sleep, vigorous physical exercises, and a lot more. Modern lifestyle has affected fertility more than anything. In essence, there are a lot of dimensions to a lifestyle that only your fertility doctor can explain to you.
As the name suggests, this is the type of infertility that doctors yet don’t know about. In such cases, sometimes, they aren’t even sure whether who is infertile, male or female. All the tests show average results, or the identified problem is already cured. Still, the couple faces an issue in conceiving. This type of infertility is rare, and cases are getting reduced in this category, as science is always finding new causes of infertility.
How to Treat Infertility?
Infertility treatment depends on its causes, duration, age, and personal preferences. Some causes of infertility can’t be treated or corrected. In cases where spontaneous pregnancy can’t happen, couples achieve the same through the use of assisted reproductive technology. Also, consider that infertility treatment may involve significant financial, physical, psychological, and time commitments. At the same time, some couples show an absolute indication for IVF, many not. This is the reason often infertility treatment and IVF are considered to be the same, as many opt for IVF after getting termed infertile.
There are many other low cost and less complicated fertility treatment options for the couples. In many cases, a simple medical treatment of hormonal imbalance, or correction of a metabolic disturbance can result in improved reproductive function. To experience natural conception, surgical removal of fibroids and polyps from inside the uterine cavity can also increase the chance of pregnancy. Ovulation induction of superovulation treatments cost a fraction of IVF treatments. They can achieve pregnancy rates close to those of fertile couples.
Below there’s a detailed explanation of various types of treatments:
Infertility Treatment for men
Infertility treatment for male include:
- Changing lifestyle factors – Often, male partners worry that changing lifestyle means significant changes. In actuality, these are small improvised changes that make the lifestyle and certain behaviors more suitable for fertility. These changes can discontinuation of all or selected medications, reducing or eliminating harmful substances, improving frequency and timing of coitus, exercising regularly, and optimizing other factors that may otherwise impair fertility.
- Medications – Certain medications can improve sperm count, which eventually will increase the chances of a successful conception. The medicines may increase testicular function, including sperm production and quality.
- Surgery – In some cases, surgery may be able to reverse a sperm blockage and hence restore the fertility. In other instances, surgically operating a varicocele can improve overall chances for pregnancy.
- Sperm retrieval – Through these techniques, the sperm is obtained. It is done when sperm production is healthy, but there’s a blockage or an ejaculatory issue. This technique is also used in assisted reproductive techniques (ART).
Infertility Treatment for women
The case of treating infertility in women is bit different and complex from men. Some women might need one or two therapies to improve fertility, while some might need different types of treatment and surgeries to achieve pregnancy.
- Stimulating ovulation with fertility drugs – Fertility drugs are the primary treatment for a woman. They help her in ovulation disorder, egg retrieval, and also during assisted reproductive techniques (ART). These medications assists, induces, and paces the ovulation process.
- Intrauterine insemination (IUI) – In this, healthy sperm is artificially placed directly in the uterus. This is done prior to the time when the ovary is just about to release the eggs. As per the cause of infertility, the timing of IUI is coordinated with the release of the egg. Women might be releasing the egg under the normal cycle or with fertility medications.
- Surgery to restore fertility – Uterine problems such as endometrial polyps, a uterine septum, intrauterine scar tissue, and some fibroids are mostly treated through hysteroscopic surgery. Endometriosis, pelvic adhesions, and larger fibroids can be treated by laparoscopic surgery or an abdomen surgery with larger incisions.
Assisted reproductive technology (ART)
Assisted reproductive technology (ART) is a type of fertility treatment in which the egg and sperm are fertilized through artificial assistance. The following are the types of ART:
In Vitro Fertilization (IVF)
As discussed throughout this article, it is the most common assisted reproductive technique. IVF involves stimulating the ovaries for retrieving multiple mature eggs, then fertilizing them artificially with retrieved and tested sperm. Then the fertilized egg (the embryo) is implanted back in the uterus.
IVF is not simple as you read, there might be some sub-techniques in between. Depending upon the situation, either or many are used. The sub techniques are:
- Intracytoplasmic sperm injection (ICSI) – In this, the single healthy sperm is injected directly into the mature egg. This method is often used when there is poor semen quality or quantity, or if fertilization attempts in prior IVF cycles have failed.
- Assisted hatching – This is the technique where the implantation of the embryo is done by opening the outer cover of it. If the doctor feels that the woman’s uterus might have problems in implanting, then only this technique is used.
- Donor eggs or sperm – Most ART is done using a couple’s eggs and sperm, but in case of severe problems with either the eggs or the sperm, the doctor may consult the couple use eggs, sperm, or embryo of a known or an anonymous donor.
- Gestational carrier – This is also called surrogacy and is used when the females have a functional uterus issue, or the pregnancy poses serious health for her. In these cases, when the couple chooses IVF, with it, they also have a known or anonymous carrier for their embryo who will carry and give birth to their baby.
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