Frequently Asked Questions
Most experts define infertility as not being able to get pregnant after at least one year of trying. Women who are able to get pregnant but then have repeat miscarriages are also considered infertile.
No, infertility is not always a female problem. In about one-third of cases, infertility is due to the female factor. In another third of cases, infertility is due to the male factor. The remaining cases are caused by either a mixture of male and female factors or by unknown factors.
Infertility in men is most often caused by a couple of reasons: problems making sperm - producing too few sperm or none at all, and problems in the sperm's ability to reach the egg and fertilize it - abnormal sperm shape or structure prevents it from moving correctly. Sometimes the man is born with the problems that affect his sperm. Other times problems just start later in life due to illness or injury. For example, cystic fibrosis can often cause infertility in men.
The number and quality of sperm can be affected by the overall health and lifestyle. Some things that may reduce sperm number and quality include:
- Environmental toxins;
- Tobacco consumption;
- Radiation treatment and chemotherapy;
- Old age.
Problems with ovulation account for most cases of infertility in women. Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods. Less common causes of female fertility problems include:
- Blocked fallopian tubes;
- Surgery for an ectopic pregnancy;
- Uterus problems, such as uterine fibroids.
Many things can affect the female ability to have a baby. These include:
- Poor diet;
- Overly-intense athletic training;
- Being overweight or underweight;
- Tobacco and alcohol consumption;
- Sexually transmitted diseases (STDs);
- Hormonal changes.
More and more women are delaying parenthood until their 30s and 40s. Because of that, age is an increasingly common cause of fertility problems. Aging decreases the chance of having a baby in the following ways:
- The ability of ovaries to release eggs ready for fertilization declines with age;
- The health of eggs declines with age;
- As the woman ages she is more likely to have health problems that can interfere with fertility,
- As the woman ages, her risk of having a miscarriage increases.
Most healthy women under the age of 30 shouldn't worry about infertility unless they've been trying to get pregnant for at least a year with no success. At this point, said women should talk to their doctors about a fertility evaluation. Men should also talk to their doctors if this much time has passed.
In some cases, women should talk to their doctors sooner. Women in their 30s who've been trying to get pregnant for six months should speak to their doctors as soon as possible. The chances of having a baby decrease rapidly every year past the age of 30. So getting a complete and timely fertility evaluation is especially important.
Some health issues also increase the risk of fertility problems. Because of that, women with the following issues should speak to their doctors as soon as possible:
- · Irregular or no menstrual periods;
- · Very painful periods;
- · Endometriosis;
- · Pelvic inflammatory disease;
- · More than one miscarriage.
No matter how old you are, it's always a good idea to talk to a doctor before you start trying to get pregnant. Doctors can help you prepare your body for a healthy baby. They can also answer questions on fertility and give tips on conceiving
Infertility can be treated with medicine, surgery, artificial insemination, or assisted reproductive technology. Many times these treatments are combined. About two-thirds of couples who are treated for infertility are able to have a baby. In most cases infertility is treated via drugs or surgery.
Doctors recommend specific treatments for infertility based on:
- Test results;
- How long the couple has been trying to get pregnant;
- The age of both partners;
- The overall health of both partners;
- Preference of the partners.
Doctors often treat infertility in men in the following ways:
- Sexual problems: If the male is impotent or has problems with premature ejaculation, doctors can help him address these issues. Behavioral therapy and/or medicines can be used in these cases.
- Not enough sperm: If the male produces too few sperm, sometimes surgery can correct this problem. In other cases, doctors can surgically remove sperm from the male reproductive tract. Antibiotics can also be used to clear up infections affecting sperm count.
Doctors also use surgery to treat some causes of infertility. Problems with ovaries, fallopian tubes, or uterus can sometimes be corrected with surgery. Intrauterine insemination (IUI), also known as artificial insemination, is another type of treatment for infertility. In this procedure, the female is injected with specially prepared sperm. Sometimes the patient is also treated with medicine that stimulates ovulation before IUI.
IUI is often used to treat:
- Mild male factor infertility;
- Female who have problems with their cervical mucus;
- Couples without an apparent cause of infertility.
Assisted reproductive technology (ART) is a term that describes several different methods used to help infertile couples. ART involves removing eggs from the female body, mixing them with sperm in the laboratory, and putting them back in.
Several treatments fall under assisted reproduction such as intra uterine insimination (IUI), in vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), intra-cytoplasmic sperm injection (ICSI) and testicular sperm aspiration (TESA).
- IUI – intra-uterine insemination
Intra-uterine insemination - also known as artificial insemination is a relatively straightforward technique involving the insemination of a prepared sperm sample directly into the uterus at the time of ovulation.
- IVF – in vitro fertilization
IVF is a technique involving the fertilization of eggs by sperm outside the body. The term literally means 'fertilization in glass' - hence the commonly used description 'test-tube baby' technique.
- GIFT- gamete intrafallopian transfer
GIFT is an assisted reproductive procedure which involves removing female eggs, mixing them with sperm and immediately placing them into a fallopian tube. One of the main differences between this procedure and the in vitro fertilization is that the fertilization process takes place inside the fallopian tube rather than in the laboratory. However, healthy tubes are necessary for GIFT to work.
- ICSI – intra-cytoplasmic sperm injection
ICSI – the microsurgical fertilization technique of ICSI is currently the most advanced technique available for the treatment of male infertility. It is used in conjunction with IVF and involves an extremely precise microscopic surgical procedure on an egg to assist fertilization. ICSI can be used in cases where the male produces a very small number of sperm which are incapable of penetrating the barriers surrounding the egg. This is usually because the sperm have extremely poor to no movement. ICSI is also mandatory when sperm is directly retrieved from the testes. The preparation to ICSI procedure is the same like for IVF procedure.
- TESA – testicular sperm aspiration
Total azoospermia (total absence of sperm in the ejaculate) can be due either to a blockage, absence of the vas deferens or a failure of the testes to produce spermatozoa. The degree of this failure can be variable. Testicular biopsy involves taking one or several small samples of the testes - either for analysis, or for the recovery of sperm. These operations are done as day-cases under general or local anaesthesia. However, the collected sperm is unable to fertilize the egg in the natural way and thus ICSI always is necessary.