Infertility

 

...is a term often defined as the inability to achieve a pregnancy after one year of unprotected intercourse. Approximately 90% of couples of reproductive age will achieve a pregnancy within 12 months of regular intercourse.

 

Whilst it is usual to start preliminary investigations after one year of trying it is important that couples with a shorter period should not be dismissed, as either partner may have a problem that needs sorting out sooner. For example if a woman has an irregular cycle or problems with her periods, or if the partner is known to have a fertility problem, then an early evaluation would be sensible.

 

Many couples who are unable to conceive when they want to can experience feelings of inadequacy, frustration, anger and blame. This can prove an extremely stressful period in a couple's relationship. It should be appreciated that couples with a fertility problem are not on their own. Tremendous progress has been achieved in the field of fertility and many treatment options can be explored offering more hope than ever before.

 

Many gynaecologists have a special interest in the treatment of infertility. Some gynaecologists undergo a further period of training to gain the necessary qualifications and are called reproductive endocrinologists. By the same token some urologists (water work specialists) specialise in the area of male infertility.

 

It is 'an old wives tale' that infertility is always a 'woman's problem'. About one third of infertility problems are due to male factors and one third are due to female factors. Other cases are due to a combination of male and female factors. When no factors have been found to explain the infertility problem the infertility is often referred to as 'unexplained' or 'idiopathic'.

 

Many couples defer having a baby until they have fulfilled their career ambitions and/or gained financial security. However it should be appreciated that the ability of the woman's ovaries to produce eggs declines with age, especially after the age of 35. For that reason the success rate of procedures such as in-vitro fertilization (IVF) are low after the age of 35. When the woman reaches the menopause the ovaries are no longer capable of producing eggs.

 

Infertility in women can be caused by problems with ovulation (egg production), blocked tubes which may result from pelvic inflammatory disease, endometriosis or surgery for an ectopic pregnancy.

 

In men the problem may be due to problems with making sperm or getting the sperm to reach an egg. Some men have the problem from birth or the result of an illness. Excessive smoking, alcohol and drugs can temporarily reduce sperm quality.

 

The basic infertility assessments include a semen analysis, blood test to check on ovulation and an ultrasound scan to check the uterus, tubes and ovaries. Other tests include hysteroscopy (examination of the cavity of the uterus with a telescope), laparoscopy (examination of the abdominal and pelvic organs with a telescope passed through a small incision just below the umbilicus 'belly button') and hysterosalpingogram (an x-ray procedure to check the tubes are open and to see if the shape of the cavity of the uterus is normal).

 

There are different approaches to the treatment of infertility depending on the cause. About 85 percent of infertility cases are treated with drugs or surgery. Surgery may need to be considered to repair damage to the ovaries, fallopian tubes or uterus. Also some men's problems can be helped with surgery.

 

Assisted reproductive technology has helped many couples to have children.

 

Please do not despair if you have a fertility problem as help can be just round the corner.

 

If you have a concern or question about Infertility our consultants are ready to help.

 

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Last page update : 00.00 - 17th Oct 05