The inability of a woman to conceive or get pregnant and the inability to procreate in the case of a man is known as infertility. When a couple cannot get pregnant after one year of regular unprotected sexual intercourse, they are termed infertile. It can either be due to female factors or male factors. Many new advances have been made in this realm to enable a couple to conceive.
Male infertility: When infertility is due to male factors, it is called male infertility.
Female infertility: When infertility is due to female factors, it is called female infertility.
Infertility affects about 10-15% of couples. According to CDC, In the United States, infertility affects about 6% of married women aged 15 to 44 years. This percentage increases to about 12% in women aged 15 to 44 years.
Following are the risk factors for infertility;
There may be multiple causes of infertility, although 40 % of cases may be idiopathic.
1. Male causes of Infertility
2. Causes of infertility in females
3. Uterine tubal factors (30%)
4. Peritoneal Factors 40%
5. Unexplained (5-10%)
When a woman in a heterosexual relationship with regular sexual intercourse and menstrual cycles cannot become pregnant after 12 months of trying to conceive without using birth control, she and her partner should consult their health care physician.
It is vital to obtain a detailed history of the married couple. All the questions regarding the trials, previous losses, previous attempts on treatments, miscarriages, drugs history, medical and surgical history. A thorough physical examination is needed to be performed on both partners, especially to check for any abnormality in the reproductive organs.
Males' infertility is diagnosed by a semen analysis, ultrasounds, and blood tests. According to World Health Organisation (WHO), following is normal semen analysis result:
It may take up to 2 menstrual cycles to determine etiology in females. Investigations may include;
Many disorders are related to infertility which should be ruled out to make efficient progress towards the treatment.
In up to 25% of cases, the fault lies with the male partner, and in another 25 % of cases, it lies with the female partner; however, no fault is found in 10% of cases. This is known as unexplained fertility. Such couples need reassurance and guidance about their diet, obesity, anxiety due to overwork or other stressors, and options such as IVF technology.
Treatment should be directed towards treating the root cause of infertility in either of the partners. Treat for general health, anemia, infections, blocked tubes, or other reasons such as fibroids or endometriosis.
A fertility challenge can be given to women by prescribing Clomiphene Citrate tab 50 mg once /day for three months to induce ovulation. Other medicines used are gonadotropin-releasing hormone (GnRH) analogues, follicle-stimulating hormone (FSH), human chorionic gonadotropin (hCG), and metformin.
Assisted reproductive technology(ART): When the sperm and egg are handled in the laboratory to help the couple get pregnant, it is called ART. The most famous and successful technique is IVF In-vitro fertilization, in which eggs are retrieved from a female and fertilized with sperms in a dish, and then an embryo is transferred in the female’s uterus. Another procedure called Intracytoplasmic sperm injection (ICSI) is also used sometimes, which involves direct injection of healthy sperm into a mature egg.
Infertility can be very stressful. Couples should seek emotional support to combat anxiety and depression as it worsens the situation. Following lifestyle changes should be made to increase the chances of conception;
Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 22, 2023.
Infertility | CDC