Overview of Infertility
Infertility is usually defined as the inability of a couple
to achieve a pregnancy after repeated intercourse without contraception for 1
year.
Frequent intercourse without birth control usually results
in pregnancy:
For 50% of couples within 3 months
For 75% within 6 months
For 90% within 1 year
To maximize the chance of pregnancy, couples should have
frequent intercourse in the 6 days—and particularly the 3 days—before the
ovaries release an egg (ovulation). Ovulation usually occurs in the middle of
the menstrual cycle, which is about 14 days before the first day of a women's
next period.
Two of the more common methods women can use to estimate
when ovulation occurs are
Measurement of body temperature at rest (basal body
temperature)
Home ovulation predictor kits (probably the best way)
If women have regular periods, they can estimate when
ovulation occurs by measuring their temperature each day before they get out of
bed. A decrease suggests that ovulation is about to occur. An increase of 0.9°
F (0.5° C) or more suggests ovulation has just occurred. However, this method
is inconvenient for many women and is not reliable or precise. At best, it
predicts ovulation only within 2 days.
Basal Body Temperature
basal_body_temperature_high_blausen
Home ovulation prediction kits are more accurate. These kits
are used to detect an increase in luteinizing hormone in the urine.
(Luteinizing hormone stimulates the ovaries to stimulate ovulation.) Usually,
this increase occurs 24 to 36 hours before ovulation. Women usually need to
repeat the test for several consecutive days, so kits typically include five to
seven sticks. The sticks can be held under a stream of urine or dipped into
urine that is collected in a sterile container.
Whether estimating when ovulation will occur increases the
chance of pregnancy for couple who have intercourse regularly is unknown.
However, estimating when ovulation will occur is likely to help couples who do
not have intercourse regularly estimate when the best time for intercourse is.
Up to one in five couples in the United States do not conceive for at least a year and are thus considered infertile. However, of the couples who have not conceived after a year of trying, more than 60% conceive eventually, with or without treatment.
Causes of Infertility
The cause of infertility may be due to problems in the man,
the woman, or both:
Problems with sperm (in 35% or more of couples)
Problems with the fallopian tubes and abnormalities in the
pelvis (in about 30%)
Problems with ovulation (in about 20%)
Problems with cervical mucus (in 5% or fewer)
Unidentified factors (in about 10%)
Consuming a lot of caffeine (for example, more than 5 to 6
cups of coffee per day), using excess tobacco, and/or drinking excess alcohol
can impair fertility in women and should be avoided.
Diagnosis of Infertility
A doctor's evaluation
Various tests depending on the suspected cause
The diagnosis of infertility problems requires a thorough
assessment of both partners. Usually, the assessment is done after at least 1
year of trying to achieve a pregnancy. However, it is done sooner if
The woman is over 35 (usually after 6 months of trying to
become pregnant).
The woman's menstrual periods occur infrequently (fewer than
nine times a year).
The woman has a previously identified abnormality of the
uterus, fallopian tubes, or ovaries.
Doctors have identified or suspect problems with sperm in
the man.
Age is a factor, especially for women. As women age,
becoming pregnant becomes more difficult, and the risk of complications during
pregnancy increases. Also, women, particularly after age 35, have a limited
time to resolve infertility problems before menopause.
Tests are done depending on the suspected cause. They may
include
For problems with eggs: Blood tests to measure the hormones
involved in the release of eggs (ovulation) by the ovaries, such as
follicle-stimulating hormone
For problems with ovulation: Ultrasonography to determine
whether and when ovulation occurs
For sperm disorders: Semen analysis
Treatment of Infertility
Treatment of the cause
Sometimes drugs
Sometimes assisted reproductive techniques
Measures to lessen stress, including counseling and support
The goals of treatment are
To treat the cause of infertility if possible
To make conception more likely
To reduce the time needed to conceive
Even when no cause of infertility can be identified, the
couple may still be treated. In such cases, the woman may be given drugs that
stimulate several eggs to mature and be released—so-called fertility drugs.
Examples are clomiphene, letrozole, and human gonadotropins. These drugs are
most helpful for women who have problems with ovulation. However, fertility
drugs increase the chances of having more than one fetus.
Alternatively, doctors may use assisted reproductive
techniques, such as
An intrauterine insemination technique that selects only the
most active sperm, which are then placed directly in the uterus
In vitro fertilization (IVF), which involves stimulating the
ovaries, retrieving the mature eggs, fertilizing them with sperm in culture
dishes (in vitro), growing the embryos in the culture, and implanting one or
more embryos in the woman's uterus
Assisted reproductive techniques may result in more than one
fetus.
While a couple is being treated for infertility, one or both
partners may experience frustration, emotional stress, feelings of inadequacy,
and guilt. They may alternate between hope and despair. Feeling isolated and
unable to communicate, they may become angry at or resentful toward each other,
family members, friends, or the doctor. The emotional stress can lead to
fatigue, anxiety, sleep or eating disturbances, and an inability to concentrate.
In addition, the financial burden and time commitment involved in diagnosis and
treatment can cause marital strife.
These problems can be lessened if both partners are involved
in and are given information about the treatment process (including how long it
takes), regardless of which one has the diagnosed problem. Knowing what the
chances of success are, as well as realizing that treatment may not be
successful and cannot continue indefinitely, can help a couple cope with the
stress.
Information about the following is also helpful:
When to end treatment
When to seek a second opinion
When to consider adoption
For example, if pregnancy has not occurred after 3 years of
attempting it or after 2 years of being treated for infertility, the chance of
pregnancy is low and adoption can be considered. Ideally, couples should ask
for this information before treatment is begun.
Counseling and psychologic support, including support groups
such as RESOLVE and Path2Parenthood, can help.
- CORONA VIRUS
- MONKEY POX
- VAGINAL DRYNESS
- FIBROID
- INFERTILITY
- OVULATION CYCLE
- OVARIAN CANCER
- VAGINAL BACTERIA
- MALE INFERTILITY
- BEST DAYS OF CONCIEVING
- MUCUS AFTER OVULATION
- FOODS FOR ERECTILE FUNCTIONS
- PREGNANCY ANEMIA
- DO AND DONT DURING PREGNANCY
- ERECTILE DYSFUNCTION
- U.T.I IN PREGNANCY
- STROKE RISK
- EAT THIS NOT THAT
- HOOKWORMS INFECTION
- OMEGA 3 BENEFITS
- FASTING
- WEIGHT LOSS TIPS
- vitiligo
- ABORTION
- DENGUE VIRUS
- EBORA VIRUS
- FEVER
- URINARY TRACT INFECTION
- HOSPITAL INFECTIONS
- WEST NILE VIRUS
- YELLOW FEVER
- EYE DISEASE
- ZIKA VIRUS
- STRESS
- IRON DEFFICIENCE
- INSOMNIA (SLEEPING PROBLEMS)
- HEART PROBLEMS
- COMPONENTS OF BLOOD
- BLOOD DISORDER
- LABORATORY TEST OF BLOOD DISORDER
- BONE MARROW EXAMINATION
- BLOOD ANEMIA
- ANIMAL BITES
- EYE BURN
- CHOCKING
- HEAT STROKE
- SMOKE EFFECTS
- SNAKE BITE
- MALARIA VACCINE
- BEST WAY TO SLEEP A CHILD
- CHILD FEVER REDUCING
- ELEPHANTIASIS
- WOMEN BEARDS
- DATES
- PAPAYA FRUITS