Infertility

In up to one third of infertility cases no cause can be identified.

The average couple takes around six months to start a pregnancy. Even two young, healthy and fertile people stand only once chance in four of starting a pregnancy in any cycle. For women over 35, the chances are lower -- Female fertility starts to decline after the age of 35. Most doctors would not consider initiating sub-fertility investigations for a year unless there is already evidence of impaired fertility. However, if you have not conceived after two years of trying, your chances of doing so (without assistance) are substantially reduced. For the average couple, studies show that 8.5 percent fail to conceive after one year of unprotected intercourse. Of these, 3-5% will conceive, some with and some without medical help; and 3-5% will fail to have children even after treatment.


Factors Affecting Fertility
Female factors affecting infertile couples:
1. Age
After the age of 35, female fertility starts to decline.

2. Blocked tubes
Past pelvic infection that was not promptly treated, endometrosis or previous surgery may have blocked or damaged the delicate fallopian tubes.

3. Hormonal problems
An imbalance may prevent ovulation.

Male factors affecting infertile couples:
1. Sperm damage
Sperm can be affected by environmental factors, such as heavy smoking or workplace chemicals.

2. Blockage
Damaged tubes can stop sperm being released when a man ejaculates.

3. Hormonal Problems
These may affect sperm productions.

Joint Factors Affecting Infertile Couples:
1. Infection
Couples re-infecting each other may damage sperm and fallopian tubes.

2. Antibodies
Men and women can create antibodies to sperm.

3. Physical Problems
Sexual difficulties or ignorance of the menstrual cycle may mean that sperm and ovum never meet.


Understanding Conception: When a mature egg is released from the ovaries it is carried along the fallopian tube towards the uterus. Fertilization usually occurs in the fallopian tube, with one of many competing sperm penetrating the egg. At this pint, the nucleus of the sperm fuses with the egg's nucleus. The fertilized egg divides first to become two cells, then four, eight and so on. The fertilized egg embeds in the uterus 5-7 days after fertilization.

Treatments of Infertility
No treatment should be started without proper investigation. Invasive treatments and investigations are very stressful and a self-help group may provide useful support. Remedies might include:

• The treatment of joint infections in both partners with appropriate antibiotics. Steroid treatment may be successful when either partner is producing antibodies to sperm, but it must be used only for short periods and be carefully monitored.
• In the man, improved diet, general health and a reduction in stress may improve sperm count; blockages can sometimes be surgically repaired; artificial insemination of sperm can ensure that a higher concentration gets to the right place at the right time; artificial insemination by an anonymous donor may also be considered. Drug treatments are only rarely appropriate.
• In the woman, improved diet and stress reduction may trigger ovulation without further intervention. Failing that, drugs to induce ovulation may be prescribed. These should not be used without correct diagnosis and careful monitoring because they are associated with a high level of multiple births and there has been no long-term follow-up of their effects on women's health. Surgery may clear blockages. In-vitro fertilization, where an egg is removed from the ovary, mixed with sperm until the egg is fertilized and then replaced in the womb, may achieve pregnancy. So too might gamete intra-fallopian transfer (GIFT), where the egg and sperm are mixed together and placed in the fallopian tube, but this route is stressful, usually expensive and may take many cycles if it is successful at all. Egg donation may be appropriate if the woman fails to produce them herself.