What is Infertility?

Infertility is a condition when a person cannot conceive due to the inadequate levels of certain hormones. It refers to a situation when a woman cannot conceive even after having carefully timed and unprotected sex for over a year. A man suffers from infertility if the semen that he ejaculates contains less number of sperms or if the sperm is of low quality.

In such a scenario, a man will not be able to regenerate the required quantity. It is difficult to pinpoint the exact cause of infertility. However, this may occur due to inadequate levels of some hormones in both sexes.

What are the signs and symptoms of Infertility?

Infertility symptoms in males:

• Having problems in sexual function

• Pain and swelling in the testicle areas

• Abnormal breast growth (gynecomastia)

• Decreasing facial or body hair or abnormality in the hormones

• A sperm count lower than normal

Infertility symptoms in females 

• Pain during sex

• Long, painful and heavy periods

• The flow of dark and pale menstrual blood

• Chronic pelvic pain

• Bowel problems or pain in the movement of bowels

• Fatigue, back pain, nausea

What are the causes of Infertility?

Studies suggest that there are more than 15 percent of people who suffer from infertility. Infertility can affect both the partner individually which interferes with the factor of pregnancy. However, there are safe, effective therapies and treatments for infertility which are proven to be very helpful. It also improves the chance of getting pregnant. 

Causes of male infertility

• Abnormal production of sperm: Due to a genetic disorder, or health problems such as diabetes, HIV, mumps, chlamydia. It can also happen due to undescended testicles. The quality of sperm can also be affected by enlarged veins in testes. 

• Problem with sperm delivery: There is a problem in the delivery of sperm due to the following conditions like certain genetic disorder, structural problems, blockage in testicles, or if there is any damage in the reproductive organs.

• Overexpose to specific environmental conditions: Certain environmental conditions like pesticides or other chemical radiations affect infertility in males. Smoking cigarettes, alcohol, marijuana or certain medicines like anabolic steroids, antibiotics can also cause infertility in males. 

Causes of female infertility:

• Ovulation disorders: In this, there is an effect on the release of eggs from the ovaries. Polycystic ovary syndrome is also included in ovulation disorder. Thyroid glands such as hypothyroidism or hyperthyroidism can also affect the menstrual cycle which also causes infertility in females. Other causes include eating disorders, injury, tumor and excessive exercise. 

• Abnormal Uterine: Abnormalities related to the opening of the cervix, polyps in the uterus or shape of the uterus. Most of the times there is interference of the fibroid with the implantation of a fertilized egg which causes infertility in females. 

• Damage or blockage in the fallopian tube: Blockage or damage in the fallopian tube caused by the inflammation of fallopian tube can lead to pelvic inflammatory disease and endometriosis. 

• Primary ovarian insufficiency: This is also called early menopause. It happens when there is a stoppage of the menstruation cycle before the age of 40 and then ovaries stop functioning. Although the main reason for this is unknown, there are multiple factors like immune system disease, genetic disorder, radiation, chemotherapy treatments, and smoking responsible for it.

How to diagnose Infertility?

Some of the tests are done by the doctor to understand the sexual functions and then the recommendations are made after this. There are different fertility tests for males and females. 

Infertility tests for men

• Semen Analysis: In this, doctor diagnose the specimen of semen and in some of the cases, sperm is also tested. 

• Hormone testing: Blood test can be done to determine the level of male hormones and testosterone.

• Genetic testing: This test is done to check if there is any genetic effect or hereditary problem.

• Testicular biopsy: It is done to check the abnormalities which contribute to infertility.

• Another speciality testing: These speciality tests are done to evaluate sperm quality.

Infertility tests for women

• Ovulating testing: In this, blood test is done to determine if a person is ovulating or not.

• Ovarian reserve testing: This test is done to determine the quality and quantity of eggs which are left for ovulation.

• Hormone testing: In this, it checks ovulatory hormones or the pituitary hormone levels that control the reproductive process.

• Hysterosalpingography: This looks for blockage or other problems which evaluates the condition of your uterus and fallopian tube.

What is the best treatment for infertility?

Infertility can be due to a number of different reasons and their treatments differ too. 

Fertility treatments for male

Infertility treatment for male includes treatment for premature ejaculation, varicoceles, blockage of the ejaculation duct, retrograde ejaculation and also surgery for epididymal blockage. Medication and behavioural therapy can help a man to overcome general sexual problems like premature ejaculation and erectile dysfunction. A varicose vein in the scrotum, which can cause infertility, can be surgically removed. 

In case of blockage of the ejaculatory duct, sperm can be injected into an egg in the laboratory after it has been extracted directly from the testicles. Retrograde ejaculation is treated by taking sperm directly from the bladder and later injected into eggs. The epididymis is a coil-like structure in the testicles that help to store and transport sperm. Surgery can help to remove the blockage if it gets blocked. 

Fertility treatments for female

A woman is prescribed medications if she is suffering from ovulation disorders like clomifene, metformin, human menopausal gonadotropin, human chorionic gonadotrophin, bromocriptine and follicle-stimulating hormone. 

In addition, there are some surgical procedures available for women. Fallopian tube surgery helps to repair damaged or scarred fallopian tubes and makes it easier for eggs to pass through them. Laparoscopic surgery also helps to increase fertility. 

There are some methods which help in assisted conception like intrauterine insemination, In vitro fertilisation, intracytoplasmic sperm injection, donating sperm or egg, assisted hatching and surgical sperm aspiration. 

Who needs to consult a sexologist for infertility treatment?

There are no apparent signs or symptoms of infertility in men. The quantity and quality of the semen also appear normal to the naked eye. Therefore, the tests that can identify infertility in men are semen analysis, hormone testing, genetic testing, testicular biopsy, imaging and another specialty testing.

In the case of women, symptoms of infertility are irregular or no menstrual periods, endometriosis, pelvic inflammatory disease, very painful periods or multiple miscarriages. Some of the specific fertility tests that help to understand whether a woman is infertile are ovulation testing, hysterosalpingography, ovarian reserve testing, hormone testing and imaging tests.

Who is not eligible for the treatment?

A person is known to be infertile if he/she has not been able to conceive baby even after having frequent and unprotected sex over a year. A man or woman is not eligible for treatment if she has been able to conceive after having unprotected sex. A person is also not eligible if none of the fertility tests has been able to diagnose him/her as suffering from the condition.

What are the side effects of Infertility treatment?

Oral fertility drugs produce milder effects than injectable fertility drugs. The most common side-effects of fertility drugs are bloating, breast tenderness, upset stomach, hot flashes, mood swings and headache. The side effects of gonadotropins are headache, upset stomach, mood swings, acne, weight gain, abnormal menstrual bleeding, dizziness and even upper respiratory tract infection. Some of the serious side effects of fertility drugs are changes in vision, ectopic pregnancy, ovarian torsion, ovarian hyperstimulation syndrome and allergic reactions. However, the most common side-effect of infertility treatment is multiple pregnancies.

What are the post-treatment guidelines?

A person should adopt a healthy lifestyle to make sure that he/she does not get affected by this condition. Smoking and consumption of alcohol increases the risks of infertility and should be avoided. It is of utmost importance for an overweight man to lose some weight. Both men and women should exercise as a sedentary lifestyle increases the risks of infertility. Furthermore, a healthy diet containing adequate quantities of folic acid, iron, zinc and vitamin B-12 should be adopted. A person should also reduce stress as it reduces the chances of conception.

How long does it take to recover?

A woman who has undergone surgery can probably go home on the day of the surgery itself. However, a woman will take about 2-3 weeks to recover from the surgery. Research has shown a person can again reproduce within a time span of 2 months- 2 years after successful treatment. A lot of factors determine how soon a person will recover after taking infertility drugs. Some of the factors are the person’s age, health, medical issues, etc. A person taking clomiphene will normally see positive results after 5-12 days of taking the last clomiphene pill.

Can infertility be cured?

A person who has undergone successful treatment for infertility is generally able to reproduce within 2 years. However, this is not a permanent result. A person may again have infertility problems due to leading an unhealthy lifestyle like smoking, drinking or by not being active. Some health issues also may have an effect on the fertility of men and women.

What is the best diet for infertility?

Good diet plan always results in a better outcomes.

• Eating food rich in antioxidants

• Eating healthy breakfast

• Avoiding trans fats

• Cutting down on carbohydrates

• Eating less refined carbohydrates

• Including more fibre in the diet

• Swapping protein sources

• Choosing high-fat dairy products

• Increase in the iron intake

• Avoid intake of excessive alcohol

What are the natural treatments for infertility?

• Acupuncture: It is a kind of Chinese therapy in which a small needle is inserted in the specific spot to check the blood flow. Acupuncture helps in many ways like relieving the stress level, hormone balancing, making blood flow in the reproductive organs, etc. 

• Yoga: It helps to treat infertility in females as it relieves the stress level of the body and helps in getting pregnant. If there is low sperm count in males, the main cause can be depression and anxiety. Yoga helps in combating mental health which helps to cure infertility.

• Ayurveda: Infertility can also be cured with the help of Ayurveda as it helps the body to strengthen and balance mechanism and does not rely on the external substances or agents.

• Homoeopathy: A couple facing problems in conceiving, for them homoeopathy is a great help. Homoeopathy infertility works as a safe, effective and painless method. It leads towards a healthy way of natural pregnancy.

What are the alternatives to the treatment?

When infertility issues come up due to hormonal problems, using a natural progesterone cream can help a person to address it. Consumption of herbs like red raspberry leaf, nettle leaf, dandelion, alfalfa, red clover, maca and chaste tree berry also helps to cure infertility. Getting enough sleep has also proved to play an important part in treating infertility problems.