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What everyone should know about infertility

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ONE of the several goals couples have is to conceive a child at some point after marriage. As such, getting to know about infertility is crucial in helping the couple recognize when to seek help.

Infertility, while it sounds like a casual word meant for Hollywood entertainment shows only, it’s actually more serious than people take it to be. In Nigeria, the prevalence of infertility is about 100 thousand cases per year.

What makes matters worse is the fact that it lurks in the shadows, and mainly only gets noticed when the woman is unable to get pregnant.

What is Infertility?

Infertility has been considered as the inability to get pregnant despite having carefully timed, unprotected sex for one year. One year is considered the focal point because approximately 85% of couples achieve pregnancy within the first year of trying.

If conception does not take place within one year of trying, it is advised you visit a reproductive endocrinologist.

Know about infertility!

Can you suspect a case of infertility before attempting to get pregnant?

When should you visit a reproductive endocrinologist?

While 12 months is considered the benchmark for confirming a case of infertility and visiting a doctor, there are some cases which should warrant an earlier visit to the doctor. And yes, there are some certain things pre-attempt to get pregnant that should prompt you to visit a doctor.

These factors include:

A history of Infection or Sexually Transmitted Diseases (STDs) Inflammation and permanent scarring of the fallopian tubes are a few causes of infertility, and STDs can lead to them. Normally, for fertilization to take place, the fallopian tubes are meant to be open and free (so sperm cells can reach and fertilize the ready eggs. However,  if infections such as gonorrhea or Chlamydia has been suffered before, there’s a possibility that there might be an issue with the tubes. So, if an infection has been previously suffered, one should visit the doctor without necessarily trying to conceive a year. Upon visiting a doctor, as part of the fertility evaluation, he will perform an HSG.

HSG is a test carried out to evaluate if the fallopian tubes are open.

Infrequent Menstrual Periods

For a woman to be able to conceive with ease, ovulation must take place at the required time. This gives the couple looking to have a child an idea of the right time to copulate. Normally, woman’s menstrual period should occur within every 21 to 35 days, with Ovulation taking place approximately two (2) weeks before the start of a new period.

If a woman’s menstrual cycle is infrequent, I.e. if it occurs at intervals greater than 35 days, it is recommended that she goes for evaluation. This is because she might not be ovulating predictably or at all, and ovulation is necessary for pregnancy.

Semen abnormalities of the male partner

If a male partner has in the past, experienced a case of infertility with another partner perhaps due to semen abnormalities, it is advised that she gets evaluated within 3 – months of trying to achieve pregnancy

Female 35 years or older

Although the reason why is unknown, but as women age, a lot of things about her egg production change. These changes include a decrease in the number of eggs produced, the decline in the quality of eggs, and a lesser likelihood of the eggs being genetically normal. Therefore, in a case where the woman is 35 years or older, and pregnancy has been attempted for 6 months, she should get evaluated.

What are the causes of Infertility?

There are a good number of things that can lead to infertility. Although there are some cases where the cause is unknown, the cases are few (approximately 15%). Fortunately, even in cases like this, some fertility treatments are able to lead to a healthy delivery. To know about the causes of infertility, read on.

Some of the causing factors of infertility include:

Semen abnormalities of the male partner:

Research has shown that infertility in males -as a contributing factor- accounts * 40-50% of cases and 15-20% as its sole cause. Where this is the cause of infertility, hormonal treatments or surgical treatments may be carried out. The male will also be advised to make some lifestyle changes (e.g. quit smoking).

Blocked Fallopian tubes(Tubal occlusion):

A blocked Fallopian tube would not allow an ovulated egg to get to the uterus, and the sperm gets to the egg. This means that the chances of fertilization taking place are very slim. Depending, one or both fallopian tubes might be blocked or the both of them. In a case where a single tube is blocked, the affected tube is either removed or separated from the uterus prior to any other treatment that will follow. If both fallopian tubes are blocked, In Vitro Fertilization (IVF) can be applied.

Advanced maternal age:

Unlike in the past when women conceived in their teens, a majority now delay childbirth to their 30s and 40s. Childbirth within this age range is what is referred to as advanced maternal age. It has been discovered to have a negative effect on egg function, often leading to infertility. From the age of 45, a woman becomes hardly fertile, however, her age rarely apples to her ability to conceive with donor eggs.

Female infertility due to advanced maternal ages is the most common cause of infertility today.

Endometriosis:

Endometriosis is a disorder in which tissues which normally line the inner walls of the uterus grows outside the walls. It causes infertility by producing inflammation and scarring which has serious detrimental effects on the egg. The disorder often goes accompanied by excruciating pain. It is found in about 10-50% of women in the advanced maternal age category.

Can Infertility be treated?

Yes, depending on the situation at hand, infertility can be treated. The treatments are usually aimed at significantly raising the chances of getting pregnant. There are several available treatments for infertility, and what determines which specific treatment will be issued is the case at hand.

What everyone must know about infertility will discuss a few available treatments. Later on, other stories centered on the treatments of infertility will follow. Meanwhile, here are some of the available infertility treatments.

In Vitro Fertilization (IVF):

This is a kind of fertilization that takes place outside the body, instead of inside the fallopian tube. It is usually carried out in situations when both fallopian tubes are damaged. The process involves taking out eggs from the woman’s ovary, fertilizing it with sperm and then transferring the embryo into the uterus. IVF can also be used to treat some other situations such as  Endometriosis, advanced maternal cases, and some others.

Fertilization actually takes place in the fallopian tube, thereafter, the fertilized egg travels and implants in the uterus.

Insemination:

This is the artificial introduction of sperm into a female’s cervix or uterine cavity. The process is done to bring about a higher concentration of motile sperm closer to the tubes and ovulated eggs.

The procedure involves taking the mans’ sperm and washing it in a solution that is completely safe. Thereafter, the washed sperm is put in a centrifuge to separate the viable sperm from the non-viable sperm. The motile and viable sperm is then injected into the uterine cavity by means of a very long, thin and flexible catheter.

This treatment is often used when the male has a very low sperm count.  It is also used when the sperm isn’t strong enough to swim through the cervix and up into the fallopian tubes. For this treatment to be used at least one of the fallopian tubes must be in good condition.

Inducing ovulation and egg development via medications

This treatment comes in two forms: Injections and pills taken by mouth. The medication stimulates the ovary to develop mature eggs for ovulation. The pills (an anti-estrogen) work by binding in the hypothalamus – a part of the brain responsible for stimulating the ovary to grow and release an egg.

Surgery

Surgery is also one of several treatments that can be used to correct abnormalities leading to infertility. The doctor may decide to perform one based on the results gotten from physical examination and an ultrasound. The most common surgeries carried out when it comes to curbing infertility are abdominal myomectomy, laparoscopy, and hysteroscopy

Third party reproduction

This process involves another person providing sperm or eggs to another woman or couple to help them have a child. Third party reproduction comes in 4 types.

1.Sperm donation – Here, donated sperm is introduced into the recipient’s uterus, of for egg fertilization in IVF procedure.

2.Ovum or egg donation – Here, the eggs or ovum from a donor are harvested, fertilized and the embryos are then transferred to the recipient’s uterus.

3.Gestational surrogacy – In this type of reproduction, another woman carries and delivers a baby for another woman or couple. The woman who carries the baby is called the gestational surrogate. The embryo may be transferred to the gestational surrogate or carrier.

4.Embryo donation – This involves the transfer of a fully developed embryo from a couple who underwent IVF to the uterus of another woman. As stated earlier, there are still some infertility treatments not discussed in this post. The will come in our subsequent posts on infertility.

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