While it is a blessing to be a mother do not fret if you are not able to get pregnant. These days a myriad of technologies are available which can help you full fill your desire

Infertility is defined as the inability to get pregnant after having regular unprotected contact. Almost 15 % of the couples have fertility issues. Either or both partners may have fertility issues.

The common causes of infertility are

FEMALE CAUSES

  • PCOD – a condition in which there is a hormonal imbalance resulting in anovulation, that is the egg is not released resulting in infertility. There may be other symptoms of PCOS as well and this may require proper treatment in terms of diet, regular exercise, ovulation inducing agents.
  • GENITAL TUBERCULOSIS – genital tuberculosis results in blocked fallopian tubes and poor growth of the endometrium. Often, it is first diagnosed when the patient comes with the inability to conceive.
  • ENDOMETRIOSIS – endometriosis is a condition where the endometrial tissue is found outside the endometrium. It often causes intense pain in the periods, pain during intercourse, altered menstrual cycle etc.
  • HYPERPROLACTINEMIA – increased prolactin levels don’t allow pregnancy
  • THYROID PROBLEMS – hypothyroid or hyperthyroid can cause fertility issues and require proper treatment
  • POOR OVARIAN RESERVE – age more than 35 causes a decline in the quality of eggs reducing the chances of pregnancy. Sometimes premature ovarian failure, a condition in which the ovaries stop functioning before the age of 40 can also be responsible for infertility.
  • PREVIOUS PELVIC SURGERY – this may result in intense adhesions, scarring etc which can cause blocked tubes, decreased ovarian reserve etc.
  • FIBROIDS AND POLYPS – can cause infertility and may require surgery
  • BLOCKED TUBES DUE TO PID – sometimes a chronic pelvis infection can result in blocked tubes and this may require surgery or other fertility treatment.

MALE CAUSES

  • Low sperm count due to undescended testes, genetic defects, childhood mumps, gonorrhea or medical conditions like diabetes can cause low sperm count
  • Problems with delivery of sperm due to premature ejaculation, infrequent sexual contact genetic diseases like cystic fibrosis etc can cause blockage of the male reproductive organs
  • Environmental toxins like cigarette smoking, hot saunas, alcohol, certain medications etc can cause an issue with fertility

WHAT CAN YOU DO TO IMPROVE FERTILITY

  1. Diet – give up junk food! Have a diet rich in vitamins and antioxidants.
  2. Exercise – regular moderate exercise helps !
  3. Maintain optimum weight – both underweight and excess weight can cause problems!
  4. Reduce stress – stop thinking about infertility constantly. While you should try for a baby do not make it the sole reason of your life. Stress infertility is a known cause for fertility issues.
  5. Stop smoking
  6. Stop alcohol
  7. Fertility window – you can track your ovulation. Make sure to have intercourse around your ovulation

WHEN TO CONTACT A DOCTOR

  • If you have been unable to get pregnant after 1 year of unprotected intercourse
  • If you are over 35 and have been unable to conceive after 6 months of trying
  • If you are a known case of endometriosis, genital tuberculosis it is better to seek help early
  • If you have any problem with your menstrual cycle etc

WHAT TO EXPECT

The doctor will take a detailed history, do a comprehensive physical examination and order investigations based on this assessment.

Some of the specific tests include

  1. Hormonal tests like FSH, LH, Serum TSH, Serum Prolactin, Serum AMH, serum testosterone, serum insulin etc.
  2. Ultrasound pelvis
  3. HSG
  4. Endometrial biopsy
  5. Laparoscopy
  6. Hysteroscopy

Specific investigations for the male partner

  1. Semen analysis
  2. ultrasound scrotum
  3. Hormonal tests like serum FSH, LH, Testosterone, TSH, Prolactin etc
  4. Sperm DFI

TREATMENT MODALITIES AVAILABLE

  1. COUNSELLING – sometimes counseling is all that is required. An explanation of a fertile period, small tips like weight control can make a vast difference
  2. OVULATION INDUCTION – sometimes you may require simple drugs like letrozole or clomiphene etc to help you a bit
  3.  IUI – in some selected cases IUI is done. In this you are given injections for ovulation, the semen is properly washed, prepared and inserted inside the uterus
  4. IVF / ICSI – this is a process in which multiple injections are given, eggs are collected from the woman and impregnated with the sperms. The embryos are then transferred to the uterus.
  5. DONOR GAMETES – in some cases donor egg or donor sperms may be required.

Where there is a will, there is a way

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