 Male and Female Infertility – The Causes
Treatment can start for the infertile couple once they have been trying to become pregnant for a year or more and in that time have not used any pregnancy preventing measures. The examination of both partners starts simultaneously. Supposedly, around one in six couples may have difficulty conceiving in the UK. This is approximately 3.5 million people.
Male Infertility
Male infertility accounts for around 30 per cent of all common causes of infertility, and is linked to sperm quality and quantity changes. In many cases it is possible to apply a treatment that can improve sperm quality.
Semen quality may be considered poor for fertilisation due to undescended testicles, non-production of sperm in the testicles, occurrence of certain infectious diseases and testicular cancer among other causes. Fertility is also affected by consistent emotional and psychological stress, work-related stress, poor nutrition, obesity, environmental pollution, smoking and alcohol consumption.
Depending on the quality of semen, various treatments are available. If sperm quality is considered ‘average’, the most commonly used fertility procedure is intrauterine insemination (IUI). If sperm quality is considered ‘poor’ then in vitro fertilization (IVF) is the most usual choice of procedure. If sperm quality is very poor, micro insemination or sperm injection into the ova cytoplasm (ICSI) can help couples get pregnant. In cases where sperm is not found in semen, sperm is extracted directly from the epididymis or testicle (TESA procedure).
Female infertility
Causes of female infertility are usually associated with ovulation problems and tubal pathology. The difficulty in getting pregnant rises with a woman’s age. It is believed that by the time they are 40 years old, just one third of healthy women are able to conceive.
Fertility is affected by consistent emotional and psychological stress, work-related stress, poor nutrition, obesity, environmental pollution, smoking and alcohol consumption.
Treatment of infertility in women begins with comprehensive medical history collection, physical examination and ultrasound examination. Then, according to the circumstances, a suitable infertility treatment is selected – pharmacological, surgical or assisted fertilisation procedures.
Hysteroscopy and laparoscopy – these are minimally invasive endoscopic-gynaecological surgical operations. They are performed for both diagnostic and therapeutic purposes.
There is also HyCoSy (Woman’s tubal Patency Test), of which more information can be found here.
Often, only a minimum surgical correction is needed before a couple successfully become pregnant. Nowadays, gynaecological endoscopic surgery is performed with particularly responsive methods and instruments. For example, hysteroscopy is performed with thin, precise instruments; laparoscopic surgery to treat endometriosis is performed in a way that helps maximise the retention of ovarian function. This means couples should not be afraid to seek medical attention as soon as possible, because infertility medication and surgical treatment can help infertile couples start their family.
In cases where these treatments are not effective assisted reproductive techniques are applied. Depending on where fertilisation occurs these methods are divided into two groups: intrauterine insemination (IUI) and in vitro fertilization, outside a woman’s body (IVF). Intrauterine insemination is carried out during ovulation under the natural cycle, or under stimulation of the cycle using fertility medication, when specially prepared sperm is placed into the uterus with the help of thin catheter. After the fertilisation procedure, roughly 10 to 15 per cent of women manage to fall pregnant. It is recommended to repeat the procedure 4-6 times. The method is appealing as there is no need for surgery or anaesthesia and the procedure is simple and painless. Fertilisation ‘in vitro’ (in an artificial environment outside the body) is the method under which the ovums, stimulated with the help of drugs, are collected from the female`s body, and combined with the specially prepared sperm in a laboratory. Thus the fertilisation of the egg happens in vitro.
Unexplained Infertility
It is possible that both partners can be infertile. Even after going through a full range of tests to try and discover the cause of the infertility, one in five couples will be told that their infertility is unexplainable. However this doesn’t mean that there isn’t a reason for their fertility problems.
Treatment for couples can still be effective in these cases as unexplained infertility is often down to relatively small changes in the reproductive system. In such cases, the first option recommended is usually intrauterine insemination (IUI). If this treatment is ineffective, then in vitro fertilization (IVF) can be performed.