If you are having trouble getting pregnant, here’s a guide to various symptoms, causes, diagnosis and treatments of infertility.
Infertility happens when a couple is trying to get pregnant with regular and unprotected intercourse for at least a year without success. A woman is considered as infertile if she is trying to conceive for one year and hasn’t used birth control. A man is considered infertile if his sperms to not healthy enough to meet woman’s egg or has too less sperms. Male infertility or female infertility, or a combination of few affects many lives in the US. About 10-18% couples have trouble getting pregnant or successfully deliver a baby.
Not getting pregnant is the main symptom of infertility. There are no other obvious symptoms. Sometimes, an infertile woman can experience irregular or missed mensural periods.
Among men, there are rare symptoms of infertility such as hormonal problems like sexual function or changes in growth of hair.
Causes of infertility in men
Below are some of the causes of infertility in men.
Sperm and Semen
- Low sperm count: If the sperm count is less than 15 million, it is considered as low. If a man ejaculates less sperms, it may not meet the woman’s eggs.
- Abnormal sperm: If the sperms have unusual shape, it becomes difficult to move and fertilise an egg.
- Sperm mobility: Mobility of a sperm can make it difficult for it to swim to the egg
Testicles are responsible for producing and storing sperm. If they are damaged, quality of semen can be seriously affected. Below are some of the main causes:
- Testicular surgery
- Testicular cancer
- Infection in testicles
- Injury to testicles
- Congenital defect (problem since birth)
Medicines and drugs
Some medicines listed below can cause infertility problems in men.
- Sulfasalazine: Medicine used to treat conditions like Crohn’s disease and rheumatoid arthritis. Effects from this medicine are temporary and sperm count should be normal once you stop consuming it
- Chemotherapy: Medicines used during chemotherapy can lead to reduced sperm count
- Anabolic steroids: It is used (mostly illegally) to build muscles and improve athletic performance
- Herbal remedies: There are few herbal remedies like root extracts of a Chinese herb
- Other drugs: Illegal drugs like marijuana and cocaine can also reduce sperm count
Some men prefer to have a vasectomy, when they don’t want kids or more kids. This process would cut and seal off the tubes which carry the sperm out of testicles. Thus, semen would no longer contain any sperm.
Some men may experience problems in ejaculating which can make it hard for them to release semen during sex.
Other causes may include:
- Mental stress: Stress can be a cause of infertility in men specially if it leads to reduced interest in sexual activity
- Obesity: Being overweight can also reduce the chances of conceiving
- Age: Fertility in men starts reducing after the age of 40
- Excess alcohol consumption: Excessive alcohol consumption can affect male fertility, especially, for those who already have low sperm count
Causes of infertility in women
Problem in uterus or Fallopian tubes
Such an issue can prevent an egg from travelling from ovary to the womb. It may cause due to following reasons:
- Endometriosis: Cells which usually grow in the lining of uterus start growing elsewhere in the body
- Surgery: Pelvic surgery may cause damage to fallopian tubes. Cervical surgery may cause shortening or scarring of the cervix
- Sterilization: If women have chosen to block their fallopian tubes for some reason, the chances to become fertile reduces even if the process is reversed
- Submucosal fibroids: Non-cancerous tumors appear in muscular walls of uterus, which can interfere with implantation. This prevents sperm from fertilizing an egg.
This is one of the most common causes of infertility in women This kind of disorder may be caused due to:
- Poor egg quality: Eggs which develop genetic abnormalities or are damaged cannot sustain pregnancy. The risk increases with the age
- Premature ovarian failure: Ovaries can stop working before the age of 40
- Thyroid problem: Under active or overactive thyroid gland can cause hormonal imbalance
- Chronic situations: It includes cancer or AIDS
- Hyperprolactinemia: In case prolactin levels are high and women is breastfeeding or isn’t pregnant, it may cause infertility
Medications and drugs
Some drugs can cause infertility in women.
- Chemotherapy: Some medicines used in chemotherapy can cause infertility in women and can be permanent in few cases
- Illegal drugs: Use of illegal drugs like cocaine or marijuana can cause fertility problems
- Non-steroidal anti-inflammatory drugs (NSAIDs): Usage of drugs like ibuprofen or aspirin for long-term can also cause infertility in women
How it is diagnosed
As opposed to apparent diseases, infertility is an inability to conceive and there is no way to certain way to diagnose infertility without multiple failed attempts. Nevertheless, there are few methods and tools which can be useful in diagnosing infertility.
- Blood test: A blood test can be used to identify whether you’re ovulating properly by checking hormone levels
- Hysteroscopy: With inpatient test, a thin device is inserted through vagina to examine inner uterus, cervix and fallopian tubes. Casual diseases of infertility like adenomyosis and endometriosis can be determined with this test
- Hormone tests: There are number of hormone tests available which can be done to access the chances of a patient’s fertility such as examining the levels of ovulatory hormones, early levels of mensural hormones to check ovarian reserve and pituitary hormones which control the reproductive system
- Laparoscopy: It is a slightly invasive surgical technique which involves making several incisions into abdomen, followed by inserting a small camera used to visualize the ovaries, uterus, fallopian tubes and surrounding organs
- Sonohysterography: This is an imaging method which uses an intravaginal ultrasound to show images which examine the fallopian tubes and the uterus. This technique is useful to find abnormal uterine bleeding, blockages or other symptomatic reasons of infertility
Can infertility be prevented or avoided?
Women who want to get pregnant in near future can improve their chance to conceive if they follow these practices:
- Quit smoking: Tobacco can have negative affect on fertility. If you want to get pregnant, quick smoking now
- Maintain a normal weight: Being underweight or overweight increases the risk of ovulation disorders in women. If you want to exercise, do it in moderation. Intense exercise if done for more than five hours in a week may result in decreased ovulation
- Avoid alcohol: High consumption of alcohol can lead to reduced fertility. Avoid alcohol if you want to get pregnant faster.
- Limit caffeine: According to a research, limiting limit your caffeine intake to less than 200 milligrams a day, which is about 6-8 ounces of coffee wouldn’t affect your chances of getting pregnant.
- Reduce stress: Many studies have proved that couples having psychological stress have lesser chances of getting pregnant.
Treatment of infertility
While not everyone with infertility can be treated, it’s always worth an effort to try and find a option to treat infertility. Below are some of the methods used to treat infertility.
Non-surgical methods to treat infertility
Medication: Women suffering from ovulation disorders are treated through fertility medication. It is done by stimulating ovulation through main hormones. This method increases the probability of producing good quality and quantity of eggs. However, make sure that you discuss the risks and benefits of the medication before using it.
Surgical methods to treat infertility
Laparoscopic surgery: In this surgical procedure, surgeon may remove all endometriosis tissue and adhesions to reduce inflammation and distortion. This may help to conceive as inflammation is highly reduced, which is one of the main causes of infertility.
Assisted reproductive technology (ART)
- In Virto Fertilization (IVF): This is one of the most common method for infertility treatment. With this method, mature eggs are stimulated and retrieved from uterus and fertilized in dish with sperm. Several days later, embryo is implanted back in uterus.
- Intrauterine insemination: During this method, a healthy sperm is put directly in uterus to ensure the right rime of release of egg and fertilization. Whether the method is normal or done by medication, it is properly timed with menstrual cycle.
- Third-party assisted ART: There are many third-party ARTs used to treat infertility either by themselves or in correspondence with above methods. It may include egg donation, sperm donation, gestational carrier or surrogacy.
When to do to doctor
Consult a doctor only if you have been trying to get pregnant for at least a year. However, consult your doctor If you’re a woman and:
- You’re aged above 40
- You’re aged between 35 to 40 and trying to conceive for more than six months
- Your periods are very painful
- Your menstrual cycle in not regular and not getting at all
- You had multiple miscarriages
- You have undergone cancer treatment
- You’ve ever been diagnosed with pelvic inflammatory disease
Consult a doctor, of you are a man and:
- You have a history of sexual problems, prostate or testicles
- Other people in your family had infertility problem
- Your sperm count is low
- You have undergone cancer treatment
- Your testicles are too small in size