Infertiliy

Ashwini Hospital & Endoscopy Centre
What is infertility?

Infertility is the inability to conceive after a year of unprotected intercourse in women under 35 and after six months in women over 35. Couples who have known barriers to fertility, such as endometriosis, polycystic ovarian syndrome, male factor infertility, irregular cycles, etc., do not need to sit out the traditional waiting period to seek expert care for infertility.

How common is infertility?

One in every six couples of childbearing age have an infertility problem. There is a female problem in 35% of the cases, a male problem in 35% of the cases, and a combined problem of the couple in 20% of cases. Therefore, it is essential that both the man and the woman be evaluated during an infertility work-up. In 10% of cases, the problem is "unexplained", meaning that all testing yielded normal results.

When should I seek help for infertility?

Conventional medical advice is to seek treatment if you have been trying to conceive for at least one year. However, if the male partner has a known or suspected low sperm count or the female partner is over 30 years old, has a history of pelvic inflammatory disease, painful periods, recurrent miscarriage, or irregular periods, then we suggest you seek treatment sooner.

What are "primary" and "secondary infertility"?

Primary infertility is infertility without ever conceiving or successfully carrying a pregnancy to a live birth. Secondary infertility is the inability to conceive again after one or more successful pregnancies.

When is a woman's most fertile time?

A woman's most fertile time is during ovulation. Ovulation typically occurs within day 11 through day 21 of a woman's cycle.Counting from the first day of a woman's last period, day 1 is the first day a woman starts bleeding, the 11th day is most likely the earliest day a woman will ovulate. The 21st day is most likely the last. A woman's period comes between the 28th and 32nd day of the cycle. This pattern may differ slightly with each woman depending on a variety of factors.

Is infertility a medical problem related to the woman only

Infertility is a medical condition that is found in both men and women, and men and women are affected almost equally. With men, declining sperm counts, testicular abnormalities, and decreased reach of climax are common causes of infertility. Shop Products to Help Increase Sperm Count With women, the most common causes are tubal blockage, endometriosis, PCOS, and advanced maternal age which affects egg quality/quantity.

How common is infertility?

Infertility is a growing issue for many couples. Infertility affects 6.1 million American couples (approximately 10% of American couples of childbearing age). 25% of infertile couples have more than one cause of infertility. The current increase in infertility might be the result of more women choosing to delay starting a family until later in life, when their reproductive health can be affected. The increase of some STD's such as Chlamydia can result in conditions such as blocked tubes, preventing pregnancy from occurring.

How long should a couple try to conceive before going to the doctor?

The American Society of Reproductive Medicine recommends that a woman consult her health care provider if she is: 1) under 35 years old and has been trying to conceive for more than 12 months, or 2) over 35 years old and has been trying to conceive for over 6 months.

Can you find out earlier if you have fertility issues?

You always have the option of asking your health care provider to conduct a complete examination to determine if either partner has possible fertility issues. You can also choose to do at-home fertility testing, available for both men and women.

Does the position chosen for intercourse affect fertility?

After ejaculation, enough sperm will remain inside the woman to fertilize an egg. Therefore, there is no significant advantage of one intercourse position over another.

What about fertility treatments?
  • Fertility treatments can increase the likelihood of getting pregnant.
  • Treatments can include lifestyle changes, supplements, surgery, medication, or assisted reproduction. Shop Fertility Supplements Now
  • There are several treatments under assisted reproduction such as in vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), and zygote intrafallopian transfer (ZIFT). All these procedures involve harvesting a number of eggs in the hope of fertilizing at least one egg, and then insert the fertilized egg(s) into the uterus. infertility is a condition of the reproductive system that prevents the conception of children. It affects approximately 6.1 million individuals throughout the United States. The diagnosis of infertility is usually given to couples who have been attempting to conceive for at least 1 year without success. Conception and pregnancy are complicated processes that depend upon a number of factors, including: 1) the production of healthy sperm by the man, 2) healthy eggs produced by the woman; 3) unblocked fallopian tubes that allow the sperm to reach the egg; 4) the sperm's ability to fertilize the egg when they meet; 5) the ability of the fertilized egg (embryo) to become implanted in the woman's uterus; and, 6) sufficient embryo quality. Finally, for the pregnancy to progress to full term the embryo must be healthy and the woman's hormonal environment adequate for its development. If just one of these factors is impaired, infertility can be the result.
Is infertility primarily a woman’s problem?

It is a common assumption that infertility is primarily related to the woman. In reality, only one-third of infertility cases are related to the woman alone. Statistically, one-third of infertility problems are related to men and the remaining one-third is a combination of fertility factors involving both partners or unknown causes. Unknown causes account for approximately twenty percent of infertility cases.

What causes infertility in men?

The most common causes of male infertility are azoospermia (no sperm cells are produced) and oligospermia (few sperm cells are produced). Sometimes, sperm cells are malformed or they die before they can reach the egg. In rare cases, infertility in men is caused by a genetic disease such as cystic fibrosis or a chromosomal abnormality. For men with low sperm count or motility issues, clinically proven supplements are available that can improve sperm parameters. Shop Male Supplements

What causes infertility in women?

The most common cause of female infertility is ovulation disorders. Problems with ovulation affect about 25% of all infertility situations. Other causes of female infertility include blocked fallopian tubes, which can happen when a woman has had pelvic inflammatory disease or endometriosis; Congenital anomalies (birth defects) involving the structure of the uterus, and uterine fibroids which are associated with repeated miscarriages; and aging, since the ability for ovaries to produce eggs tends to decline with age, especially after the age of 35.

When should someone get tested for infertility?

The American Society of Reproductive Medicine recommends that women under 35 begin testing after trying to conceive unsuccessfully for 12 months. The recommendation for women over 35 is to begin testing after trying to conceive unsuccessfully for 6 months. Some couples or individuals find that they are more relaxed when trying to conceive if they believe that everything is normal.

How early can you get tested?

Couples may request that their health care provider conduct an exam to determine if everything is healthy and working correctly. It is also possible to use over-the-counter screening tests using testing kits like Fertell to evaluate key aspects of fertility for both men and women.

How is infertility diagnosed?

As already noted, couples are generally advised to seek medical help if they are unable to achieve pregnancy after a year of unprotected intercourse. The doctor will conduct a physical examination of both partners to determine their general state of health and to search for physical disorders that may be contributing to infertility. The doctor will usually interview both partners about their sexual habits in order to determine whether intercourse is taking place properly for conception. If no cause can be determined at this point, more specific tests may be recommended. For women, these include an analysis of body temperature and ovulation, x-ray of the fallopian tubes and uterus, and laparoscopy. For men, initial tests focus on semen analysis.

How is infertility treated?

Approximately 85 to 90 percent of infertility cases are treated with conventional therapies such as drug treatment or surgical repair of reproductive organs. Assisted reproductive technologies such as in vitro fertilization account for the remaining infertility treatment options. Some people find it helpful to hear about the experiences of other infertile couples and to communicate with them. The pregnancy forums of APA or Shared Journey are sites where you can read and share stories.

What is in vitro fertilization (IVF)?

In cases of blocked or absent fallopian tubes or low sperm count, in vitro fertilization (IVF) offers couples the opportunity of biological parenthood. During IVF, eggs are surgically removed from the ovary and mixed with sperm outside the body in a Petri dish ("in vitro" is Latin for "in glass"). After about 40 hours, the eggs are examined to see if they have become fertilized by the sperm and are dividing into cells. These fertilized eggs (embryos) are then placed in the women's uterus, by-passing the fallopian tubes. IVF has received a great deal of media attention since it was first introduced in 1978 and currently accounts for less than five percent of all infertility treatments in the United States.

Is in vitro fertilization expensive ?

The average cost of an IVF cycle in the United States is $12,400. Like other extremely delicate medical procedures, IVF involves highly trained professionals with sophisticated laboratories and equipment, and the cycle might need to be repeated in order to be successful. While IVF and other assisted reproductive technologies are can be costly, they account for only three hundredths of one percent (0.03%) of U.S. health care costs.

Does in vitro fertilization work?

IVF was introduced in the United States in 1981. According to Society of Assisted Reproductive Technology (SART), who tracks ART success rates in the U.S., IVF currently accounts for more than 99% of ART procedures, with GIFT, ZIFT and combination procedures making up the remainder. The average live birth rate for IVF in 2008 was 34% of all cycles. The results are slightly better than the 20% chance that a reproductively healthy couple has of achieving a pregnancy in a given month and carrying it to term.

Do insurance plans cover infertility treatment?

The services covered by insurance will depend on where you live and the type of insurance plan. Fifteen states currently have laws that require insurers to cover or offer to cover at least a portion of infertility diagnosis and treatment. Those states are Arkansas, California, Connecticut, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas and West Virginia. HOWEVER, the existing laws vary greatly in their scope of what might be covered. For more information about specific laws in each of those states, you may contact your state's Insurance Commissioner's office. To learn about pending insurance legislation in your state, you may contact your State Representative. Whether or not you live in a state with an infertility insurance law, you can choose to consult with your employer's Human Resources Department to determine the exact coverage your plan provides. Another resource for determining coverage is, "Infertility Insurance Advisor: An Insurance Counseling Program for Infertile Couples." This booklet is available for a small fee from resolve, an infertility patient advocacy and information organization. Because the desire to have children and be a parent is fundamental to being human, people should not be denied insurance coverage for medically appropriate treatment for problems of infertility.