Many individuals and couples are affected by infertility worldwide. Based on data from the WHO, about one in every six individuals of reproductive age around the world go through infertility at some point in their lives. Infertility can be defined as being unable to conceive even after a year of regular, unprotected sex (1). Struggling with infertility significantly impacts the couple’s relationships, emotional health, and overall quality of life. It is essential to seek medical advice to diagnose the root cause behind infertility and get the appropriate treatment options in order to manage this condition effectively.
Infertility is a complex problem that affects a person's ability to conceive. Infertility might happen due to issues with either the female or male reproductive systems or both. For successful conception, it is essential for the males to have healthy sperm and the woman to have viable eggs. It is also essential that the woman’s fallopian tubes are open and that the sperm is motile enough to fertilize the egg. The appropriate implantation of the fertilized egg in the uterus and the growth of a healthy embryo are two more aspects that affect fertility.
Certain lifestyle choices, including smoking, excessive alcohol consumption, and drug use, can have detrimental effects on fertility (2). Conditions like polycystic ovary syndrome can lead to hormonal imbalance, which may be responsible for irregular or absent ovulation, making conception even more challenging (3). Blocked or damaged fallopian tubes due to pelvic inflammatory disease or endometriosis can also hinder fertilization. Uterine abnormalities like fibroids may present obstacles to embryo implantation (4). Age is also a significant factor that can impact men's and women's fertility (2).
It's important to remember that infertility isn't exclusive to women; male infertility factors contribute in around half of the cases, often accompanied by a combination of factors for many couples. In some situations, the precise cause of infertility might remain unknown. Seeking advice from healthcare professionals is crucial if pregnancy is proving difficult. Infertility treatment approaches can vary, considering factors like the woman's age and how long the couple has been trying to conceive (2).
Diagnosis of the underlying signs of infertility is important for providing effective treatment. Examining your medical history and lifestyle forms the basis. Physical examinations assist in detecting any potential anatomical issues. A sperm analysis for men looks at sperm count, motility, and shape of the sperm. Hormone testing looks for hormonal imbalances that may influence sperm production (5). Scrotal ultrasonography provides images of the health of the testes (6). Women undergo similar tests. Hormone testing examines ovulation and hormone abnormalities. Ovulation kits and body temperature monitoring aid in determining when ovulation occurs. Ultrasound allows doctors to inspect the ovaries and uterus, detecting any problems and monitoring how eggs develop. Tests such as hysterosalpingogram help determine whether the tubes are open or not. Endometriosis can sometimes be diagnosed by minor surgery (2).
Some healthcare providers can perform initial infertility evaluations. However, for more intricate infertility causes, it's recommended to seek assistance from a certified reproductive endocrinologist who is an OB/GYN specialized in infertility and certified by the American Board of Obstetrics and Gynecology.
The treatment plan for infertility depends on the underlying causes and your objectives. Factors like age, duration of infertility, and personal preferences influence the chosen treatment. Sometimes, only one partner needs treatment; other times, both partners might require it. Numerous individuals and couples facing infertility have a decent likelihood of achieving pregnancy. Employing treatments such as assisted reproductive technology (ART), surgery, or medications can be advantageous. Adjusting your lifestyle or refining the timing of intercourse can enhance your chances of conception. Treatment plans may involve a combination of these approaches (7).
Healthcare providers might offer advice to enhance your chances of getting pregnant. These suggestions may involve monitoring ovulation by tracking basal body temperature, utilizing a fertility tracking app, observing cervical mucus consistency, or using a home ovulation kit. Treating infertility in men involves various options such as medications to raise hormone levels and there are also drugs to help maintain an erection during sex if needed. Surgery might sometimes be necessary to fix blockages in sperm tubes or correct structural problems. Varicocele surgery, for instance, can improve sperm health and the chances of getting pregnant.
Advancements in medical technology and assisted reproductive techniques bring hope to individuals facing fertility difficulties. However, it is also critical to address the emotional consequences of infertility. Individuals and couples can benefit from support networks, counseling, and therapy to help them negotiate the emotional issues they confront. In this resource, we offer comprehensive information guiding you toward a holistic approach. Reviewed by medical experts, the content covers medical, emotional, and psychological aspects that are essential for making informed decisions and finding effective solutions.
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The most common causes of infertility include poor-quality semen, irregular ovulation, damaged or blocked fallopian tubes, and endometriosis (8).
A woman's fertility typically starts to decline around age 30, which accelerates in the mid-30s. By age 45, fertility significantly decreases thereby lowering the possibility of a natural pregnancy (9).
Men and women are equally likely to have problems with infertility. About one-third of cases are due to issues with men's reproductive system, another third to problems with women's reproductive system, and the last third to a mix of problems from both or due to unexplained reasons (10).
Endometriosis is a common cause of infertility. It happens when endometrial tissue grows around the ovaries or fallopian tubes, leading to inflammation and scar tissue. Treatments include pain relief medications and hormonal therapies to suppress ovulation and periods. Laparoscopic surgery can remove or treat endometriosis and can help deal with infertility (11) (12).
STIs such as chlamydia and gonorrhea can lead to certain conditions such as pelvic inflammatory disease (PID) and resulting infertility. Silent infections in the upper genital tract can result in lasting damage to the fallopian tubes, uterus, and nearby tissues. Unfortunately, this damage raises the chance of infertility (13).
Polycystic ovarian syndrome can influence fertility by interfering with egg formation and ovulation. Eggs may not develop properly or be discharged as expected. Although PCOS has no treatment, its symptoms can be managed. Consulting a doctor and using medications are common approaches to managing symptoms (14).
According to the World Health Organization, around one in six people globally are affected by infertility (15).
You can preserve your fertility by maintaining a healthy body weight, refraining from smoking, practicing protected intercourse, and engaging in regular exercise (16).
Primary infertility refers to the situation where a person has never achieved a pregnancy, while secondary infertility occurs when they have previously achieved at least one pregnancy (1).