Infertility means not being able to get pregnant or conceiving even after a year of trying by having regular unprotected sexual intercourse. A woman that is able to get pregnant but not keep it can also be termed as infertile. In the United States infertility affects women aged 15 to 45 years which is around 10% of the women population.

Talking about worldwide figures, infertility affects about 8 to 12% of partners. However, infertility is not just limited to women alone, as it equally affects men as well. Approximately 50% of infertility cases worldwide are seen due to the factors affecting males. Some of the factors that increase the risk of infertility in men and women are:

In Men

  • Ineffective sperm production
  • Low sperm count
  • Older age (fertility is males tend to drop after 40)
  • Being overweight
  • Issues with the function of the reproductive organs
  • Chemotherapy

In Women

  • Absence of ovulation/irregular and painful periods
  • Older than 35 years (fertility in females tend to drop after 30)
  • Endometriosis/ Polycystic ovary syndrome
  • Sexually transmitted infections
  • Chemotherapy

Infertility Testing

If a couple has been trying to conceive for at least a year without any positive results, it is important to consult a doctor to rule out if they are having infertility related issues.

  • Men

If a man is having any of the following problems along with trying for pregnancy for a year should see a doctor:

  • Low libido or sex drive
  • Any pain or swelling in and around the genitals
  • Retrograde or delayed ejaculation
  • Erectile dysfunction
  • Any previous surgery is done in the genital area

Based on the above factors and after going through his medical history, a doctor then takes a physical examination of the reproductive organs to check for any kind of abnormalities. Then a semen count test is taken. Here a sample of semen is taken and sent to the laboratory to check for any sperm count and sperm shape abnormalities.

Based on the outcome of these results, the doctor then might run some further tests, which include:

  • Hormone test for hormonal imbalances
  • Ultrasound of the genitals
  • Genetic examination

  • Women

Just like in men, age is a factor that significantly contributes to infertility in women as well. For a woman that has been trying to conceive for a year and is under 35 years of age should see a doctor after that first year period. For a woman that is over 35 years of age should see a doctor after six months of trying to conceive. The doctor follows a certain number of steps to ascertain infertility. First, the doctor might ask for her medical history, past surgeries if any, sexual history, general health. Then comes a pelvic examination wherein the doctor checks for any kind of fibroids, pelvic inflammatory disease or endometriosis. 

After these tests follow the ovulation test, herein the doctor checks if the woman is regularly ovulating each month or not, this test can be done at home with a home ovulation test kit or via a blood test at the doctor’s office. An ultrasound of the uterus and the ovaries might also follow after this. 

Based on these tests, the doctor might ask for some more tests to be done like:

  • X-ray of the uterus and the fallopian tubes or hysterosalpingography
  • Laparoscopy test to check the internal organs
  • FSH or follicle-stimulating hormone test

Infertility Treatments

Infertility treatments for both men and women can be done with the help of certain medications and also through surgery. For men if they are facing issues related to blockages in the testicle tubes that carry sperm or if they are having erectile dysfunction issues, these can be cured with the help of medications or in some cases surgeries might have to opt for. 

Also for women, the help of medicines and surgery is taken when it comes to infertility treatments. For fallopian tube blockages, in cases of endometriosis, polyps and scarring surgery is done to remove these. 

Besides surgeries and medications Assisted Reproductive Technology (ART) is also an option. (ART) Assisted Reproductive Technology involves specific procedures that help in treating infertility in both men and women.

  • Assisted Reproductive Technology (ART)

ART involves certain procedures that help in achieving conception. This is done via a series of different procedures wherein a woman’s eggs and a man’s sperm are combined outside of the woman’s body and when the embryo is formed it is then put back in the uterus. Some Assisted Reproductive Technology choices are:

  • Intrauterine insemination (IUI)

Intrauterine insemination is a type of Assisted Reproductive Technology. In this process, a long narrow tube is used to place a healthy number of sperm in the woman’s uterus. This is done specifically at the time of her ovulation. 

  • In vitro fertilization (IVF)

This is a procedure wherein the woman’s ovaries are first stimulated to produce more eggs with the help of hormonal therapy. The egg is then removed and combined with sperm in a laboratory which is then incubated to form an embryo. The embryo is then placed inside the uterus wherein if it attaches itself to the uterine lining results in a successful pregnancy. In vitro fertilization is a more expensive procedure as compared to Intrauterine insemination.

  • Third party-assisted ART

When both IVF and IUI fail, couples may try for a Third party-assisted ART. In this, the couple takes the help of a third person to get pregnant. The third person helps the couple by donating eggs, donating sperm or embryos. Surrogates and gestational carriers also come under Third party-assisted ART.

  • Men 

For men treatment of infertility involves the prescription of medicines, surgeries as well as Assisted Reproductive Technology (ART). Medicines are prescribed to correct any hormonal imbalances in the body that might affect the sperm count and quality. These are also prescribed for treating conditions like erectile dysfunction or ED and certain infections. 

Surgeries have resorted to cases where there are blockages that prevent the sperm from coming out of the testicles when a man ejaculates. Surgery is also used to treat certain conditions like Varicocele. In Assisted Reproductive Technology procedures like In vitro fertilization, sperm is taken from the testes to be combined with an egg in a lab. It is either done via ejaculation, is directly taken from the testes or from a sperm donor.

  • Women

Just like in men, treatment of female infertility also involves the help of medications, surgeries and Assisted Reproductive Technology (ART). Medications that treat hormonal imbalances in the body are prescribed. These medications treat infertility by stimulating the ovulation process. 

Surgeries are opted for in cases like blockages of the fallopian tubes, scarring on the uterus, removal of polyps, fibroids, and endometriosis.  In vitro fertilization (IVF) type of Assisted Reproductive Technology eggs and sperm are combined in a laboratory to form an embryo which is then placed in the uterus via a long narrow tube when the woman is ovulating. In IUI or Intrauterine insemination, healthy sperms are inserted in the uterus around the time of ovulation.

Find more detailed information on your fertility and infertility with a professional consultation with Embry Women’s Health specialist. 

Outlook on infertility

Infertility is a worldwide problem that affects a lot of men and women. Being diagnosed with infertility, however, should not entail low self-esteem as it sadly the case. It should also not cause couples to lose hope of having a child and being parents. It might take longer for some couples to conceive than others, but that does not mean that they should stop trying. Some couples might be able to have a child without any treatment or assistance, while some might have to take medical help. 

Couples undergoing any sort of infertility treatment need to understand that its treatment and success is based on a lot of factors like age, medical history, etc. Also, the success rate of fertility treatments differs from case to case. In some instances, when a fertility issue cannot be treated, the doctor might recommend other options considering the difference in circumstances. These options might be opting for a sperm or egg donation, adoption, and surrogacy. 

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