Women's Health
Infertility

​​​Overview:

  • Infertility refers to the inability to become pregnant after a year of trying.
  • Older age reduces a woman's chances of conceiving a baby due to the decrease in the number of eggs and their reduced efficiency for fertilization.
  • Infertility in men is caused by various factors. It is usually evaluated with a semen sample test.
  • Certain health problems increase the risk of infertility. Therefore, couples should visit their doctor early on when they are trying to conceive. 
  • Infertility treatment is based on its cause. Treatment usually involves medication, surgery, intrauterine insemination, or assisted reproductive technology (ART).
What is infertility? 
It is the inability to conceive after a year or more of trying. Because fertility in women decreases with age, doctors examine and treat women who are 35 or older, 6 months after marriage.
Low fertility:
It is a woman's inability to become pregnant or have miscarriages that prevent delivering a baby.
Pregnancy is the result of many steps, as follows:
  • In a woman's body, one of the ovaries must release one egg, ready for fertilization.
  • The man's sperm must fuse with the egg for fertilization to occur. 
  • The fertilized egg then passes through the fallopian tube to reach the uterus.
  • After it is in the uterus, a fertilized egg usually attaches to (implants in) the lining of the uterus (endometrium). 
  • Infertility is caused by a disruption in or a problem with one of these steps.
Causes of infertility in women:
  • Ovulation disorders: A woman's menstrual flow occurs every 28 days on average. A cycle can still be considered regular if menstrual flow happens every 24-32 days. If a period is irregular, ovulation may not happen. To see if you are ovulating, a blood test can be done. This test measures the level of progesterone on day 21 of the menstrual cycle. The level of the hormone that stimulates ovulation can also be measured on day 3 to 5 of the menstrual cycle. Moreover, a transvaginal ultrasound machine can be used to confirm ovulation.
  • Polycystic ovary syndrome: it is a condition that causes ovulation to occur irregularly or not occur at all. Some women with ovarian cysts have high levels of testosterone which causes acne and excessive hair growth.
  • Amenorrhea: it is caused by vigorous sports, excessive stress, and extreme physical exhaustion. It is sometimes associated with eating disorders (e.g. anorexia).
  • Dysfunctional pituitary gland: the pituitary gland produces hormones to maintain regular ovulation. When an imbalance occurs, ovulation stops (e.g. increased prolactin hormone secretion). 
  • Fallopian tube blockage: it is often caused by inflammation of the fallopian tube (salpingitis). This can result from pelvic inflammatory disease, previous infection with gonorrhea and chlamydia, or any abdominal surgery.
  • Uterine abnormalities: a transvaginal sonar is used to see if there are noncancerous (benign) tumors in the uterine wall (uterine fibroids) or any uterine abnormality. 
Female infertility risk factors:
  • Older age reduces a woman's chances of conception because of the decrease in the number of eggs and their reduced efficiency for fertilization. Furthermore, with age, women are more likely to have problems with fertility and miscarriages. 
  • Excessive weight gain or extreme weight loss.
  • Smoking and drinking alcohol. 
  • Physical and mental stress that causes amenorrhea.
Causes of infertility in men:
  • Male infertility can be caused by various factors. It is usually evaluated with a semen test where the count, motility, and form of sperms are evaluated by a doctor.
  • Varicocele: It is an enlargement of the veins on the testicles, which causes them to get hot. The high temperature might affect the form and count of sperm. 
  • Unhealthy habits: like heavy drinking, smoking, anabolic steroid use, and drug use. 
  • Cancer treatment: This includes certain types of chemotherapy, radiation therapy, or surgery to remove one or both testicles.
  • Medical conditions: e.g. diabetes, cystic fibrosis, certain types of autoimmune disorders, and some types of infections can cause testicular failure.
  • Hormone imbalance: A malfunction of the pituitary gland, which produces hormones that maintain the normal function of the testicle, can contribute to infertility.
  • Genetic disorders: Klinefelter syndrome and other genetic disorders may result in no or too few sperms to be produced.
Male infertility risk factors:
  • Older age: Although older age plays a major role in the occurrence of infertility in women, men are likely to have problems with fertility after the age of 40.
  • Overweight and obesity
  • Smoking and drinking alcohol
  • Marijuana use
  • Exposure to testosterone: This may happen when a doctor prescribes a male patient a testosterone injection or a low testosterone topical gel. It also happens when a man takes testosterone or similar medications to increase muscle mass.
  • Exposure to radiation 
  • Repeated exposure of the testicles to high temperatures (e.g. use of a wheelchair or frequent use of saunas and hot tubs).
  • Exposure to environmental toxins, including pesticides, lead, cadmium and mercury.
How long should couples try to conceive before they see a doctor about infertility?
At least one year for women under the age of 35.  As for women who are 35 or older, they should see a doctor about infertility after 6 months of trying. A woman's chances of conceiving a child decrease significantly every year after the age of 30.
Some health problems also increase the risk of infertility. Therefore, couples who experience the following symptoms should see the doctor early on if they are trying to conceive: 
  • Irregular or non-existent periods;
  • Severe menstrual pain;
  • Endometriosis;
  • Previous pelvic inflammation;
  • Miscarriages;
  • Suspecting that the husband is infertile for certain reasons like a previous trauma to the testicles or a hernia surgery.
Diagnosis: 
The doctor will ask for the medical and sexual history of both spouses. His evaluation will begin with a semen test, ovulation tests, and an evaluation of the fallopian tubes.

Treatment: 
Infertility is treated based on its cause. Treatment could include medication, surgery, intrauterine insemination, or assisted reproductive technology, and is done by the doctor.

For inquiries, contact us by email​.


Last Update : 23 November 2020 01:01 PM
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