Infertility : Understanding & Finding Support for Your Healthy Journey

When a couple tries regular unprotected sex but is unable to conceive, it is said that they are infertile.

Every seventh couple may have trouble becoming pregnant.

If they engage in regular, unprotected intercourse, around 84% of couples will conceive spontaneously within a year (every 2 or 3 days). The probability of becoming pregnant naturally during the following year is 1 in 4, or fewer, for couples who have been trying to conceive for more than 3 years without success.

Most couples define infertility as the inability to become pregnant while engaging in regular, unprotected intercourse for at least a year.

There might be infertility from a problem with either you or your spouse, or from a number of variables that work together to hinder conception. Fortunately, there are several treatments that are risk-free and efficient and dramatically increase your chances of getting pregnant.

Causes

To become pregnant, every step during ovulation and fertilisation must take place as intended. The problems that prevent couples from becoming pregnant sometimes exist at birth and other times they arise later in life.

One spouse may be affected by infertility factors or both. Sometimes there is no apparent cause.

Male infertility causes

These may consist of:

• Abnormal sperm function or production brought on by undescended testicles, genetic flaws, medical conditions like diabetes, or infectious diseases like chlamydia, gonorrhoea, measles, or HIV. 
• Additionally, swollen veins in the testes, or varicocele, might reduce the quality of sperm.
• Sperm delivery issues are brought on by sexual issues, including early ejaculation; some hereditary illnesses, like cystic fibrosis; anatomical issues, like a blockage in the testis; as well as harm or damage to the reproductive organs.
• Excessive radiation exposure as well as exposure to other environmental contaminants like pesticides and other poisons
• Fertility can also be impacted by cigarette smoking, alcohol use, marijuana use, anabolic steroids, and prescription drugs for depression, high blood pressure, and bacterial infections.
• Regular heat exposure, like that seen in saunas or hot tubs, can increase body temperature and have an impact on sperm production.
• Cancer-related harm, including that caused by chemotherapy or radiation therapy. Cancer therapy can have a detrimental influence on sperm production, sometimes quite considerably.

Causes of infertility in women

Infertility in women may have several causes, such as:

• The release of eggs from the ovaries is hampered by ovarian diseases. Among these are endocrine conditions like polycystic ovary syndrome.
• Hyperprolactinemia is a condition when the hormone prolactin is present in excess. that increases the production of breast milk but may prevent ovulation. Both an overproduction of thyroid hormone (hyperthyroidism) and an underproduction of thyroid hormone (hypothyroidism) can cause irregular menstrual cycles or infertility.
• Other underlying causes include excessive exercise, eating disorders, or cancer.
• Uterine or cervicovaginal anomalies, such as polyps or changes in the uterus' shape. Uterine fibroids, which are benign (noncancerous) tumours of the uterine wall, can prevent a fertilised egg from implanting in the uterus or obstruct the fallopian tubes, both of which can result in infertility.
• Injury or blockage to the fallopian tube is commonly caused by inflammation of the tube (salpingitis). This may be the outcome of pelvic inflammatory disease, which is often brought on by endometriosis, adhesions, or a sexually transmitted infection.
• Endometrial tissue proliferates, resulting in endometriosis and develops outside of the uterus. It may interfere with the ovaries', uterus', and fallopian tubes' normal operation.
• When the ovaries cease generating menstrual blood before the age of 40, this condition is known as primary ovarian insufficiency or early menopause. Early menopause has several risk factors, including immune system disorders, genetic problems like Turner syndrome or carriers of Fragile X syndrome, radiation or chemotherapy treatment, and other ailments, even if the cause is frequently unclear.
• Pelvic adhesions are bands of scar tissue that bind organs and can develop as a result of abdominal or pelvic surgery, appendicitis, endometriosis, or pelvic infections.
• Therapy options for cancer. Some illnesses, most notably reproductive tumours, commonly impair female fertility. Radiation and chemotherapy both have the potential to affect fertility.

How to check if you have Infertility?

Unless you have been routinely trying to conceive for at least a year, you generally do not need to see your doctor about infertility. However, women should speak with a care provider sooner if they:

• Are at least 40 years old and have been trying to conceive for at least six months 
• Are those who are 35 or older with irregular or nonexistent periods
•  Are having really painful periods
• Have knowledge of reproductive issues
• Have experienced several miscarriages and/or endometriosis or pelvic inflammatory disease
• Have received cancer treatment

If a man experiences any of the following:

• Low sperm count or other sperm-related issues
• Testicular, prostate, or sexual issues in the past
• Received cancer therapy
• Little testicles or an increase in the testicles
• Other infertility issues in your family

Risk Factors

There are many similar risk factors for male and female infertility. They consist of:

Age. Age-related losses in women's fertility are noticeable, especially in the mid-30s, and beyond age 37, it reduces quickly. Infertility in older women is most often brought on by the decreasing quantity and quality of eggs, however, it can also be brought on by fertility-related health issues. Guys over 40 may have lower fertility than men of earlier ages.

Using tobacco. Both partners using tobacco or marijuana may lessen the chance of getting pregnant. Smoking also reduces the potential effectiveness of reproductive therapy. Women who smoke are more likely to experience miscarriages. Erectile dysfunction and low sperm counts are more common among men who smoke.

Using alcohol. No safe place exists for women. Alcohol use may be a factor in infertility. Heavy drinking can reduce sperm count and motility in males.

weighing too much. 

Being too thin. Women who have eating disorders, such as bulimia or anorexia, or who adhere to an extremely low-calorie or restricted diet are at risk of having reproductive issues.

Concerns with exercise. Obesity raises the risk of infertility and is a result of inactivity. Less frequently, ovulation issues in women who are not overweight may be linked to frequent, intense, rigorous activity.

Symptoms

Not being able to get pregnant is a major sign of infertility. There might not be any other evident signs. Infertile women may have erratic or nonexistent menstrual periods. Hormone-related symptoms in infertile men might include altered sex habits or hair growth.

Without or with therapy, most couples will ultimately become pregnant.

Prevention

Some kinds of infertility cannot be avoided. However, a few tactics might raise your chances of getting pregnant.

Couples

For the highest pregnancy rate, engage in frequent sexual activity multiple times around the period of ovulation. Your chances of getting pregnant increase if you have sexual contact at least five days prior to ovulation and for one day following it. Ovulation normally occurs in the middle of the cycle, or halfway between periods, for the majority of women, whose menstrual cycles are typically about 28 days apart.

Men

Although the majority of male infertility issues cannot be avoided, the following techniques may be useful:

• Avoid engaging in activities that may impair a man's capacity to conceive, such as taking drugs, smoking, or consuming large amounts of alcohol.
• Avoid using hot tubs and hot baths as their high temperatures might momentarily impair sperm motility and production.
• Avoid being around Toxins from industry or the environment that may have an impact on sperm production.
• Limit prescription and over-the-counter medicines that might affect fertility. If you frequently use any prescriptions, discuss them with your doctor; nevertheless, never cease using prescription drugs without first consulting a doctor.
• Engage in light exercise. Regular exercise may improve sperm quality and increase the likelihood of becoming pregnant.

Women

Several strategies for women might increase their odds of conception:

• Give up smoking. In addition to harming your overall health and the health of the foetus, smoking has other detrimental impacts on fertility. Stop smoking right away if you are considering getting pregnant.
• Do not use alcohol or illegal substances. Your ability to conceive and have a healthy pregnancy might be affected by these medications. Avoid consuming alcohol and other illicit substances, similar to marijuana, if you are attempting to conceive.
• Limit your caffeine intake. For women who are trying to get pregnant, caffeine consumption may need to be controlled. For advice on how to take caffeine safely, consult your physician.
• Engage in light exercise. While it is crucial to exercise regularly, fertility may be impacted if you exercise so hard that your periods become irregular or nonexistent.
• Avoid extremes in weight. Your hormone production might be impacted by being overweight or underweight, which can lead to infertility.

Treatments

Treatment for infertility relies on:

• What is the root of infertility?
• Length of your infertility
• Ages of you and your companion
• Individual preferences
• Some infertility reasons are unfixable.

Couples can frequently still conceive even when a natural pregnancy does not occur by using assisted reproductive technologies. There may be significant time, effort, and financial commitments associated with infertility treatment.

Therapy for Men

The following therapies for general sexual problems or a lack of quality sperm are available for men:

• Adapting lifestyle elements. Changing one's lifestyle and engaging in certain behaviours, such as quitting some medications, abstaining from harmful substances, increasing the frequency and timing of sexual activity, engaging in regular exercise, and optimising other elements that might otherwise reduce fertility, can increase the likelihood of getting pregnant.
• Medications. Certain drugs may increase sperm counts and success rates.
• A productive pregnancy. These drugs may improve sperm quality and production as well as testicular function.
• Surgery. In some circumstances, surgery may be able to remove a sperm barrier and restore fertility. In some situations, surgically treating a varicocele could increase a woman's overall probability of getting pregnant.
• Sperm extraction. When ejaculation is difficult or there is no sperm in the ejaculate, these methods can help. In situations when assisted reproductive procedures are intended but sperm counts are low or otherwise aberrant, they may also be employed.

Women's Treatment

Some women can increase their fertility with just one or two treatments. Other women may need to undergo a range of procedures in order to conceive.

• Using fertility medications to promote ovulation. Women's primary form of therapy is fertility medication. who suffer from ovulation issues and are infertile. These drugs control or trigger ovulation. The benefits and drawbacks of each type of fertility medicine should be discussed with your doctor.
• Implantation intrauterine (IUI). IUI involves the direct implantation of healthy sperm into the uterus at the precise moment when the ovary releases one or more eggs for fertilisation. The time of IUI can be synchronised with your regular cycle or with fertility drugs, depending on the causes of infertility.
• An operation to regain fertility. Hysteroscopic surgery can be used to address uterine issues such as endometrial polyps, a uterine septum, intrauterine scar tissue, and certain fibroids. Bigger endometriomas, pelvic adhesions, and wider fibroids may require laparoscopic surgery or surgery requiring a larger abdominal incision.

 Use of assisted reproduction techniques

The term "assisted reproductive technology" (ART) refers to any fertility procedure that manipulates the sperm and egg. ART comes in a variety of forms.

In vitro fertilisation is the most widely used ART technique (IVF). The process of in vitro fertilisation (IVF) entails activating and removing several mature eggs, fertilising them with sperm in a dish in a lab, and implanting the embryos in the uterus a few days later.

IVF cycles occasionally include other techniques, like:

• Injection of intracytoplasmic sperm (ICSI). A developed egg is given a direct injection of one healthy sperm. When there is little or low-quality semen, or if fertilisation attempts during previous IVF cycles were unsuccessful, ICSI is frequently performed.
• Aided egg hatching. This approach helps open the embryo's outer shell to allow implantation of the embryo into the uterine lining (hatching).
• Donor sperm or eggs. The majority of ART uses the eggs and sperm from the couple. However, if the sperm or eggs have serious flaws, you may opt to employ the eggs, sperm, or embryos from a known or unidentified donor.
• Pregnancy carrier. IVF utilising a gestational carrier may be an option for women who lack a functioning uterus or for whom pregnancy offers a major health risk. In this instance, the carrier's uterus is used to carry the couple's embryo.

Treatment complications

Treatment for infertility may include the following side effects:

• Twin, triplet, or more pregnancies. Generally speaking, the likelihood of early labour and delivery as well as pregnancy complications such as gestational diabetes increases with the number of foetuses. Premature babies are more likely to experience health and developmental issues. Before beginning treatment, discuss any worries you may have regarding multiple pregnancies with your doctor.
• Syndrome of ovarian hyperstimulation (OHSS). In particular with ART, fertility drugs to stimulate ovulation might result in OHSS, when the ovaries swell and hurt. Mild nausea, bloating, and stomach pain that lasts for about a week—or longer if you get pregnant—may also be symptoms. Rarely, a more severe variant that requires immediate medical attention causes rapid weight gain and shortness of breath.

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