What is Infertility
If you are struggling to have a baby, you are not alone. Nearly 10-15% of the couples in India and across the world battle against infertility. Infertility is defined as inability to conceive despite regular unprotected intercourse for atleast a year. Age of the woman is of prime importance as far as infertility is concerned. Women whose age is between 35-38 years can try for 6m before they can consult the doctor. Women whose age is more than 38 years should consult a fertility specialist once they start planning for pregnancy. Nearly 95% of the couples conceive within 2 yrs of trying. With each passing year the ability to conceive decreases substantially
When to approach an infertility specialist
Couples who are unable to conceive after an year of unprotected and regular intercourse should consult a doctor. Women whose age is 35-38 years its better to approach an infertility specialist after trying naturally for 6 months. And in women more than 38 years should consult an infertility specialist once they start planning for pregnancy. For women with irregular cycles, tubal or peritoneal disease or advanced endometriosis and in men with suspected subfertility its better to get evaluated earlier.
Causes of infertility
Both the partners contribute to the problem of infertility equally. Women contribute in 30% of the cases, men contribute in 30% and in 30% of the cases both contribute. So its always better for both the partners to get evaluated simultaneously. In women the cause can be tubal, ovarian, uterine, hormonal disorders like hypothyroidism and other unexplained causes. In men it could be due to abnormal semen parameters like low or absent count, low motility, abnormal forms, hormonal discorders like diabetes, hypothyroidism. Obesity, smoking, alcoholism are also contributing factors to infertility in both the partners
Male factor infertility
This accounts for infertility in 25-40 % of couples. Problems with sperm include the abnormal shape of the sperm, the decreased number of sperm, or their inability to move effectively or the abnormal shape of the sperm. Obesity, smoking, alcoholism are also contributing factors to male infertility
Ovulation
Problems related to ovulation or release of womans egg accounts for 25-30 % of infertility cases in couples. This could be due to hormonal causes or abnormalities in the ovaries such as polycystic ovary syndrome. These defects can be overcome using medications that stimulate ovulation.
Tubal defect
Abnormality of the Fallopian tubes accounts for 20-30 % infertility cases among couples. Fallopian tubes connect the ovaries to the uterus. Functional tubal defects can be caused by infection like tuberculosisand pelvic inflammatory disese which cause damage to ciliary structures in the tube which might hamoer with the transportation of embryo. Tubal block can be caused by infections like tuberculosis, scarring from earlier surgery or a previous tubal ligation (tying of the tubes).
Endometriosis
Endometriosis refers to the attachment of the uterine lining to various pelvic organs such as the ovaries, Fallopian tubes and sometimes even the intestines. This can cause scarring, pain, and affects the ability of the eggs to fertilize and create a pregnancy. Endometriotic cysts in the ovaries often called chocolate cysts not only decrease the quantity of eggs but also afect the egg quality as well. This accounts for 5-10 % infertility in couples.
Unexplained infertility
In about 10-20% couples there is no obvious cause of infertility but are still unable to conceive. However, fertility treatments also are successful in these cases.