- Infertility means not being able to become pregnant after trying to get pregnant with unprotected intercourse for 1 year in a women under 35 years of age and for 6 months in a women than 35 years of age.
- Infertility is a common problem of about 25% of women aged 15 to 44.
- Infertility can be due to the woman (30%), the man (30%) and by both sexes or due to unknown problems (40%), approximately.
- Infertility in men can be due to varicocele, low or absent sperm count, sperm damage or certain diseases.
- Risk factors for men’s infertility include alcohol and drug use, toxins, smoking, age, health problems, medicines, radiation, and chemotherapy.
- Risk factors for women’s infertility include ovulation problems, blocked Fallopian tubes(especially dye to TB in our country), uterine problems, uterine fibroids, age, stress, poor diet, athletic training, and those risk factors listed for men.
- Aging decreases a woman’s fertility; after age 35 about 33% of couples have fertility problems; older women’s eggs are reduced in number, not as healthy and less likely to be released by the ovary – the woman is also more likely to have a miscarriage and other health problems.
- Women under 35 should try for a year or 6 months if 35 or older to become pregnant before contacting their doctor if they have no health problems.
- Doctors use the histories of both partners and may run tests such as sperm studies, ovulation tests,ultrasound, hysterosalpingography, or laparoscopy.
- Infertility may be treated with medicine, surgery, artificial insemination, or assisted reproductive technology, based on the couples test results and other factors.
- There are multiple medicines that may be used to treat infertility in women.
- Intrauterine insemination is artificial insemination where a woman is injected with sperm into the uterus.
- ART (assisted reproductive technology) is when a woman’s eggs are removed, mixed with sperm to make embryos that are placed back in the woman’s body; it’s successful about 11% to 39%, depending on the woman’s age.
- There are several types of ART; in vitro fertilization and intracytoplasmic sperm injection.
- Surrogacy (the woman’s male partner sperm is used to fertilize another woman egg and that other woman carries the fetus to term and the infant is then adopted ) is a way for some couples to obtain a baby.
- A gestational carrier is a woman who has an embryo placed in her uterus, carries the fetus to term and gives the baby to the couple (or responsible persons) that produced the embryo.
What is infertility?
Infertility means not being able to get pregnant after one year of trying. Or, six months, if a woman is 35 or older. Women who can get pregnant but are unable to stay pregnant may also be infertile.
Pregnancy is the result of a process that has many steps. To get pregnant:
- A woman must release an egg from one of her ovaries (ovulation).
- The egg must go through a Fallopian tube toward the uterus (womb).
- A man’s sperm must join with (fertilize) the egg along the way.
- The fertilized egg must attach to the inside of the uterus (implantation).
Infertility can happen if there are problems with any of these steps.
What causes infertility in men?
Infertility in men is most often caused by:
- A problem called varicocele. This happens when the veins on a man’s testicle(s) are too large. This heats the testicles. The heat can affect the number or shape of the sperm.
- Other factors that cause a man to make too few sperm or none at all.
- Movement of the sperm. This may be caused by the shape of the sperm. Sometimes injuries or other damage to the reproductive system block the sperm.
Sometimes a man is born with the problems that affect his sperm. Other times problems start later in life due to illness or injury. For example, cystic fibrosis often causes infertility in men.
What increases a man’s risk of infertility?
A man’s sperm can be changed by his overall health and lifestyle. Some things that may reduce the health or number of sperm include:
- Heavy alcohol use
- Environmental toxins, including pesticides and lead
- Smoking cigarettes
- Health problems such as mumps, serious conditions like kidney disease, or hormone problems
What causes infertility in women ?
Most cases of female infertility are caused by problems with ovulation (Egg release), . Without ovulation there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.
Ovulation problems are frequently caused by polycystic ovarian syndrome (PCOS). PCOS is a hormone imbalance problem which can interfere with normal ovulation. PCOS is the most common cause of female infertility. Primary ovarian insufficiency (POI) is another cause of ovulation problems. POI occurs when a woman’s ovaries stop functioning (working properly) before she is 40 years old.
Other causes of female infertility.
- Blocked Fallopian tubes due to pelvic inflammatory disease,endometriosis, or surgery for an ectopic pregnancy
- Physical problems with the uterus like fibroids, polyp, adenomyosis etc.
- Harmonal disturbance in the thyroid or adrenal gland, diabetes etc.
Laparoscopic treatment for infertility :
Today laparoscopy has come as a boon for Infertility patients as it requires only 1 day hospital stay, early resumption of day to day activities, minimal blood loss and minimal adhesions make this procedure highly beneficial for the patients and also lead to higher pregnancy rate.
During Laparoscopy for Infertility :
Procedures that are easily done are-
- Lap Myomectomy- Removal of fibroids.(for more detail on fibroid click here).
- Resection of Endometriosis.(for more details on Endometriosis click here.)
- Tubal Reconstruction is case of previous Laparoscopic Ligation also Known as Tubal Recanalisation.
- PCOD Drilling- for polycystic ovarian syndrome for patients who do not respond to medical management alone.
- Lap Adhesiolysis especially in cases of tuberculosis.
- Tubal Cannulation for Mucosal blocks in the tube.
Wherein the inner cavity of the uterus is examined by a per size scope and any abnormalities corrected.
- Hysteroscopic Myomectomy : Wherein fibroids present inside the cavity of the uterus are removed at the same setting with special instruments like Resectoscope or Hysteroscopic Morcellators.
- Hysteroscopic Polypectomy: Polyps are benign growths present in side the uterus which lead to infertility and irregular bleeding per vaginum. These growths are removed at the Hysteroscopy.
- Septal Resection: Uterine septum is the presence of an abnormal wall within the cavity of the uterus which is reserted(removed) at the time of Hysteroscopy so that infertility or miscarriage is prevented.
- Hysteroscopic Adhesiolysis is for ashermans syndrome: Sometimes small bands of tissue (Synechiae) present inside the cavity of the uterus are separated with special Hysteroscopic scissors.
- Hysteroscopic Tubal Cannulation.